bluuebunny/crossref_metadata_2025 huggingface dataset:
The influence of age, gender, refractive error, and optic disc size on the optic disc configuration in Japanese normal eyes
Authors: Kashiwagi Kenji , Tamura Masahiro , Abe Keitetsu , Kogure Satoshi , Tsukahara Shigeo
Published: March 2003

Purpose: To investigate the influence of age, gender, refractive error, and optic disc size on optic disc configuration in Japanese normal eyes.

Methods: Ninety‐two eyes from 92 visually normal Japanese subjects (mean refractive error±SD: −1.26±2.25 D, range −8 D to +3 D) were examined using a confocal scanning laser tomograph, TopSS®. The following disc parameters were investigated: disc size, total or quadrant C/D area ratio and neuroretinal rim area, half‐depth area, volume below, and average cup depth.

Results: The disc diameter ( mean±SD: 1.84±0.16 mm) and disc size showed highly significant correlations with the C/D ratio (p<0.001) and the neuroretinal rim area (p<0.001). No other correlation was observed.

Conclusion: These results indicate that the optic disc diameter and disc size have higher correlations with the optic disc configuration than age, gender, and refractive error in Japanese. These results are similar to those data reported for eyes of Caucasians or Afro Americans, and should be considered when optic discs are evaluated.
Can vitreous fluorophotometry predict the necessity for photocoagulation? A 5‐year follow‐up study
Authors: Knudsen L. L. , Nielsen‐Kudsk F.
Published: March 2003

Purpose: To examine the long‐term outcome of vitreous fluorophotometry including the predictability of retinopathic proliferative development in diabetic subjects.

Methods: 21 diabetic subjects were examined by long‐term kinetic vitreous fluorophotometry and their barrier properties, as revealed by a permeability‐index, were compared to a group of normal subjects. 13 diabetics were classified as having a high permeability‐index, while 8 diabetics were classified as having a low permeability‐index. The two groups were followed for 5 years with regard to development of proliferative retinopathy.

Results: 6 of 13 diabetics with a high permeability‐index developed proliferative retinopathy within the 5‐year follow‐up period. This was in contrast to the low permeability‐index group where none of 8 diabetics developed proliferative retinopathy.

Conclusion: An increased permeability‐index points towards an increased risk of development of proliferative retinopathy.
The effect of phenylephrine on pain and flare intensity in eyes with uveitis
Authors: Zaczek Anna , Zetterström Charlotta
Published: March 2003

Purpose: To investigate the influence of protein concentration in the anterior chamber, measured by laser flare meter, on pain sensation after phenylephrine instillation in patients with iridocyclitis.

Methods: Twenty‐five consecutive patients with iridocyclitis were included. Patients with cataract, exfoliation syndrome, diabetes mellitus, glaucoma or any other previous ocular diseases or ocular surgery were excluded. Patients were divided into two groups: Group 1; without fibrinoid reaction (FR) in the anterior chamber (18 patients), and Group 2; with FR (7 patients). Protein concentration in the anterior chamber was measured with laser flare meter (FC 500, Kowa Co., Japan). Pupil size was measured by Alcon Tilo Scale, and pain sensation was estimated by Visual Analogue Scale (VAS, Kabi Pharmacia). All measurements were done before and 1 hour after topical instillation of 10% phenylephrine hydrochloride into the subconjunctival sac of the inflammed eyes.

Results: Eyes with iridocyclitis and fibrinoid reaction (FR) have a higher flare intensity compared to those without FR (p<0.05). Pupil size was significantly increased after phenylephrine instillation in both study groups (Wilcoxon test, p<0.05). The VAS pain and flare intensity were significantly decreased in group without FR after phenylephrine instillation (Group 1) compared to values before treatment (Wilcoxon test, p<0.05). In eyes with FR (Group 2), no significant influence of phenylephrine instillation was found on VAS pain and flare intensity.

Conclusions: After phenylephrine instillation, flare intensity and pain were significantly decreased only in eyes with iridocyclitis and without FR. The decreasing level of flare intensity, and paralysis of the pupil after phenylephrine instillation seem to alleviate pain in those eyes.
Anterior uveitis following combined vaccination for measles, mumps and rubella (MMR): A report of two cases
Authors: Islam S. M. Monowarul , El‐Sheikh Hisham F. , Tabbara Khalid F.
Published: March 2003

Purpose: To describe two children who developed anterior uveitis after vaccination for common childhood diseases.

Methods: A retrospective study of two Saudi patients who were seen at The Eye Center, Riyadh, Saudi Arabia.

Results: Aged 12 and 14 , respectively, the two patients developed anterior non‐granulomatous uveitis 6 and 4 weeks after having the combined vaccination for measles, mumps and rubella (MMR). No other definite cause of uveitis was detected from history or from laboratory work up. Both patients responded to traditional regimens of uveitis therapy. However, they required a treatment period of several months.

Conclusion: Anterior uveitis may occur following MMR vaccination. Cases of vaccination thus require ophthalmic awareness if visual symptoms or a painful red eye develop.
Intraocular pressure and progression in exfoliative eyes with ocular hypertension or glaucoma
Authors: Harju Mika
Published: March 2003

Purpose: This retrospective study was conducted in exfoliative eyes in order to study the influence of IOP and other possible factors on the conversion from ocular hypertension (OHT) to glaucoma and progression of glaucoma.

Methods: 139 patients with exfoliation OHT or glaucoma with exfoliation syndrome were included (mean follow‐up 5.2±3.6 years). The effects of age, gender, weighted mean IOP, maximum IOP, stage of glaucoma at the first visit, refraction, glaucoma medication, and interventions on the hazard of progression were studied by multivariate survival analysis.

Results: Conversion from OHT to glaucoma or progression of glaucoma was detected in 63 eyes (45.3%). A significant association with progression was found for age (relative risk 1.042; p‐value 0.043), weighted mean IOP (1.076; <0.001), and stage of glaucoma (1.436; <0.001). History of trabeculectomy (0.360; 0.002) related to a decreased risk.

Conclusion: The risk of conversion from OHT to glaucoma and progression of glaucoma increased in exfoliative eyes with severity of stage of glaucoma, weighted mean IOP, and the age of the patient. A history of trabeculectomy was related to decreased risk of progression.
The acute effects of stellate ganglion block on circulation in human ocular fundus
Authors: Nagahara Miyuki , Tamaki Yasuhiro , Araie Makoto , Umeyama Takae
Published: March 2003

ABSTRACT. Purpose: To study the acute effects of local‐anesthetic stellate ganglion block (SGB) on tissue circulation in the human fundus.

Methods: Eleven patients with Bell’s palsy (age 56±6 y, mean±SD) who underwent SGB for its treatment participated in the study. Using the laser speckle method, normalized blur (NB) value, a quantitative index of tissue blood velocity, was measured every 0.125 s over an area located halfway between the macula and the optic nerve head (ONH) with no discrete visible vessels and averaged over 3 pulses when fixation was satisfactory (NBch‐ret). NBch‐ret and intraocular pressure (IOP) in both eyes, blood pressure (BP), and pulse rate (PR) were measured before, and 10, 20, 30, and 60 min after SGB. SGB was induced by injecting 1% mepivacaine hydrochloride (5 ml) into the vicinity of the seventh cervical vertebra on the paralyzed side.

Results: The IOP in the blocked side significantly decreased between 20 and 60 min following SGB, compared to the baseline, while IOP in the unblocked side remained unchanged. The NBch‐ret was significantly increased after 10 min by about 8% in the blocked side, but its effect almost disappeared at 60 min. There was no significant change in NBch‐ret in the unblocked side, BP or PR throughout the experimental period.

Conclusion: SGB increased tissue circulation in the fundus in the blocked side, but its effect was thought to be small and transient.
N‐acetyl‐serotonin reduces copper (I) ion‐induced lipid peroxidation in bovine retinal homogenates
Authors: Siu Andrew W. , Cheung Josephine P. , To Chi H. , Chan Eric K. , Chan Joe K. , Cheung Jesse C.
Published: March 2003

ABSTRACT. Purpose: Chalcosis is an ocular condition caused by penetration injury of copper or its alloy, which leads to extensive ocular inflammation. N‐acetyl‐serotonin has recently been identified as a potent antioxidant against free radical stress. In this study, we determined the efficacy of N‐acetyl‐serotonin against the copper (I)‐induced retinal lipid peroxidation.

Methods: Copper (I)‐treated (100 μM) bovine retinal homogenates were incubated with 6 different concentrations (i.e. 0.00, 0.25, 0.50, 1.00, 2.00 and 4.00 mM) of N‐acetyl‐serotonin or vitamin E. The malondialdehyde level was measured as an index of lipid peroxidation.

Results: Copper (I) ions induced a significant dose‐dependent increase in malondialdehyde (p=0.007). Co‐incubation with N‐acetyl‐serotonin or vitamin E significantly suppressed the copper (I)‐induced malondialdehyde production (p<0.0001). The concentration to inhibit 50% of damage for N‐acetyl‐serotonin and vitamin E were found to be 1.54 mM and 0.45 mM, respectively.

Conclusion: Although N‐acetyl‐serotonin is only 29% as effective as vitamin E in suppressing the copper (I)‐induced lipid peroxidation, the present study supports a pharmacological potential of N‐acetyl‐serotonin combating free radical oxidative damages in the ocular tissues.
The impact of glaucoma on the quality of life of patients in Norway
Authors: Odberg Tor , Jakobsen Jan Erik , Hultgren Staale J. , Halseide Reidar
Published: March 2003

ABSTRACT. Purpose: To evaluate the feelings and experiences of patients living with glaucoma.

Methods: A questionnaire was delivered to patients willing to take part, at a regular visit to their ophthalmologist, for filling in anonymously at home. A total of 589 questionnaires were returned.

Results: More than 80% reported negative emotions on learning that they had glaucoma, one‐third were afraid of going blind. Half the patients had no visual problem at all, 14% complained of poor or very poor vision. This proportion increased with age.

One‐fourth of the patients on topical medication experienced adverse effects of moderate or high degree. About half the patients being treated with laser or surgery felt their situation had improved afterwards. Nine‐tenths of the individuals were satisfied with the information and care given, although their knowledge about glaucoma was rather incomplete. One‐fifth missed information, mainly on causes, treatment and prognosis of the disease. The younger patients were more anxious and inquiring, reported more side effects and were less satisfied than the older patients. The women were in general more dissatisfied than the men.

Conclusion: Giving a patient a diagnosis of glaucoma influences his quality of life negatively. Only half of our patients experienced any visual difficulties, whereas one‐fourth reported adverse reactions due to the therapy. Most of the patients were very satisfied with the information and care given. Ophthalmologists in private practice are quite central in the management and care of the glaucoma patients in a medical setting like ours.
External beam irradiation therapy for choroidal haemangiomas. Visual and anatomical results after a dose of 20 to 25 Gy
Authors: Ritland J. S. , Eide N. , Tausjø J.
Published: March 2003

ABSTRACT. Purpose: To evaluate the visual and anatomic results of radiation therapy in ten patients with choroidal haemangiomas.

Methods: Nine patients with circumscribed choroidal haemangiomas and one with diffuse choroidal haemangioma have been reviewed retrospectively. They were treated by lens‐sparing external beam radiation therapy (20–24 Gy) (9 eyes) and plaque brachytherapy (25 Gy) (1 eye), respectively.

Results: The visual acuity improved by two lines or more in 8 of 10 eyes. No eyes showed deterioration of visual acuity. In all cases the retinal detachment showed complete resolution. A regression in tumour thickness was observed in all cases, and a reduction of anisometropia in cases with submacular infiltration by the tumour. During follow‐up (0.4–8.8 years) there were no signs of radiation cataract, retinopathy or optic neuropathy.

Conclusions: External beam radiation (20–25 Gy) is a reasonable alternative for treatment of symptomatic choroidal haemangiomas.
A Horner‐like syndrome and cluster headache. What comes first?
Authors: Havelius Ulf
Published: March 2003

ABSTRACT. Purpose: To evaluate if an ocular sympathetic lesion may be a prerequisite for cluster headache to occur.

Methods: Patients with a permanent Horner‐like syndrome at the debut of cluster headache were identified from history and photographs.

Results: Among 57 patients with cluster headache, seven patients (5 males and 2 females) exhibited a permanent Horner‐like syndrome on the painful side when first seen at the outpatient department. During this study it was possible to get information from six of these patients and five of them had side constant cluster headache. In retrospect, these five patients had had a Horner‐like syndrome for years prior to the onset of ipsilateral cluster headache.

Conclusion: The findings indicate that a sympathetic lesion or dysfunction may be a prerequisite for the subsequent development of cluster headache.
Increased permeability of the blood‐aqueous barrier after panretinal photocoagulation for proliferative diabetic retinopathy
Authors: Larsson Lill‐Inger , Nuija Eva
Published: March 2003

ABSTRACT. Purpose: To measure the permeability of the blood‐aqueous barrier before and after panretinal photocoagulation (PRP) in patients with proliferative diabetic retinopathy.

Methods: Twenty patients with diabetic proliferative retinopathy in one eye and background retinopathy in the other eye were included. PRP was performed in the proliferative eye, while the other eye served as control. Aqueous flare intensity was measured with a laser flare cell meter before, 10 and 90 days after treatment.

Results: The flare was stable in the control eye with a flare of 4.5±2.3, 4.4±2.4, and 4.5±1.7 photon counts/ms (mean±standard deviation) on Day 0, 10 and 90. In the laser treated eye corresponding figures were 5.2±2.4, 9.6±3.3, and 7.1±2.8 photon counts/ms, with a significant increase in aqueous flare at 10 days (p<0.001) and 90 days (p=0.002).

Conclusion: A significant increase in aqueous flare was found 10 days after PRP, indicating a breakdown of the blood‐aqueous barrier after retinal laser treatment. The breakdown was still present, however, less pronounced, after 3 months.
The influence of level and polarity of figure‐ground contrast on vision
Authors: Pointer Jonathan S.
Published: March 2003

ABSTRACT. Purpose: To document the effect upon human foveal vision of changes in the level and polarity of figure‐ground contrast under photopic controlled test conditions, with particular emphasis on performance at low contrast levels.

Methods: Using a forced‐choice psychophysical paradigm, threshold acuity estimates were derived at 9 discrete levels over a near‐3 octave contrast range for Landolt ring‐type stimuli of either positive or negative polarity. Data were obtained under binocular conditions from 10 young adults, each wearing their optimum low myopic spectacle correction.

Results: Visual acuity declined linearly with reducing stimulus contrast, the deterioration increasing substantially at <10% figure‐ground contrast regardless of stimulus polarity. Performance was slightly (but not statistically significantly) better for positive contrast stimuli.

Conclusion: Irrespective of contrast polarity, a reduction in stimulus figure‐ground contrast <10% produces an accelerated decrement in photopic foveal vision compared to the performance at levels >10%. Some clinical and practical implications of this outcome are considered with regard to the examination of patients with normal and compromised visual function.
An intervention trial on efficacy of atropine and multi‐focal glasses in controlling myopic progression
Authors: Shih Yung‐Feng , Hsiao C. Kate , Chen Chien‐Jen , Chang Ching‐Wei , Hung Por T. , Lin Luke L.‐K.
Published: March 2003

ABSTRACT. Purpose: This randomized clinical trial assessed the treatment effects of atropine and/or multi‐focal lenses in decreasing the progression rate of myopia in children.

Methods: Two hundred and twenty‐seven schoolchildren with myopia, aged from 6 to 13 years, who were stratified based on gender, age and the initial amount of myopia were randomly assigned to three treatment groups: 0.5% atropine with multi‐focal glasses, multi‐focal glasses, and single vision spectacles. Each subject was followed for at least eighteen months. These results report on the 188 patients available for the follow‐up.

Results: The mean progression of myopia in atropine with multi‐focal glasses group (0.41 D) was significantly less than the multi‐focal (1.19 D) and single vision group (1.40 D) (p<0.0001). But no significant difference was noted between the last two groups (p=0.44). The progression of myopia was significantly correlated with the increases of axial length (r=0.65, p=0.0001), but not with the changes of corneal power (r=−0.09), anterior chamber depth (r=−0.023), lens thickness (r=−0.08), or intra‐ocular pressure (r=−0.008).

Conclusion: The 0.5% atropine with multi‐focal lenses can slow down the progression rate of myopia. However, multi‐focal lenses alone showed no difference in effect compared to control.
Timolol increased retrobulbar flow velocities in untreated glaucoma eyes but not in ocular hypertension
Authors: Bergstrand Ingar C. , Heijl Anders , Wollmer Per , Hansen Flemming , Harris Alon
Published: March 2003

Purpose: To investigate retrobulbar blood flow velocities and the effects of topical timolol treatment in eyes with newly detected, previously untreated open angle glaucoma or ocular hypertension.

Methods: Fifteen eyes with open angle glaucoma (OAG) and 12 eyes with ocular hypertension (OH), in the same number of patients, all untreated and newly detected, were examined with colour Doppler imaging of retrobulbar vessels before and after 1 month of topical timolol treatment (0.5% Timoptic® BID).

Results: Baseline central retinal artery end diastolic velocity was lower (48%, p=0.0002) and resistive index higher (7.6%, p=0.018) in the OAG group than in the OH group. In the glaucoma group mean end diastolic velocity increased by 41%, (p=0.006) while resistive index decreased by 5.8%, (p=0.02) on treatment, while no significant changes were seen in the OH group. Blood flow velocities in the ophthalmic artery did not change with treatment. Baseline IOP and IOP reduction did not differ between OAG and OH group.

Conclusion: Peripheral resistance to blood flow was found to be increased in untreated glaucoma eyes as compared to a similar group of eyes with ocular hypertension. Timolol treatment diminished resistance significantly in the glaucoma group, but not in the ocular hypertension group. Thus the two groups responded differently to timolol treatment. The reaction to IOP lowering treatment could indicate defective autoregulation in the glaucoma group.
Glaucoma in East Greenlandic Inuit
Authors: Bourne Rupert R. A. , Sørensen Knud Erik , Klauber Anne , Foster Paul J. , Johnson Gordon J. , Alsbirk Poul Helge
Published: March 2003

Purpose: To determine the prevalence of primary angle‐closure glaucoma (PACG) in an isolated Greenlandic Inuit community and to examine the anatomical risk factors for this disease.

Methods: All individuals aged ≥40 years were examined. Visual acuity, refractive error, anterior chamber depth (ACD), intraocular pressure (IOP), gonioscopy, and optic disc characteristics were recorded.

Results: Seventy‐nine individuals (65% response rate) were examined. Mean IOP was 12.0 mmHg. ACD was shallow and decreased with age and hypermetropia. ACD was deeper than observed in the same community in 1981 and another East Greenland population in 1970. Two subjects had definite PACG (2.5 %).

Conclusion: This is the first study to use applanation tonometry in a Greenland population and confirms a low IOP as found in other populations of Inuit and Mongolians. ACD measured in 1998 was deeper than in 1981 in the same community which may represent a cohort effect indicating a secular change.
Iris transluminance in type 2 diabetes
Authors: Voutilainen‐Kaunisto Raija , Niskanen Leo , Uusitupa Matti , Teräsvirta Markku
Published: March 2003

Purpose:  Cross‐sectional analysis of iris transluminance in type 2 diabetic patients compared with control subjects, all followed in a cohort study.

Methods:  A cohort consisting of a well‐characterized group of 82 type 2 diabetic patients were followed for 10 years after diagnosis, as were 125 control subjects. The prevalence of iris transluminance was determined by transscleral transillumination and by grading of black‐and‐white positive prints at the 10‐year examination. The frequency of diabetic retinopathy was prospectively determined by grading of fundus photographs at baseline and after five and 10 years.

Results:  Iris transluminance was found in 27% of diabetic patients and 8.0% of control subjects (P = 0.001). The diabetic patients with more severe and short‐term retinopathy more commonly had abnormal iris transluminance than those with no or only mild retinopathy (P < 0.05). Iris transluminance was not associated with intraocular pressure or glycemic control.

Conclusions:  In type 2 diabetic patients, abnormal iris transluminance tended to associate with more severe and short‐term retinopathy. Therefore we assume that hypoxia is responsible for the defects in the pigment layer of the iris. Thus, abnormal iris transluminance may serve as a marker for rapidly progressive retinopathy.
Use of latanoprost to reduce acute intraocular pressure rise following neodymium: Yag laser iridotomy
Authors: Liu Catherine J. , Cheng Ching‐Yu , Chiang Shu‐Chiung , Chiu Allen W. , Chou Joe C. K. , Hsu Wen‐Ming , Liu Jorn‐Hon
Published: March 2003

Purpose: To evaluate the efficacy of latanoprost in reducing acute intraocular pressure (IOP) elevation after neodymium:Yag laser iridotomy (LI).

Methods: Primary angle‐closure glaucoma (PACG) eyes were randomized to receive premedication with latanoprost and pilocarpine or with pilocarpine only before LI. Postoperative IOP changes were compared with Wilcoxon signed‐ranks test using the fellow eyes of 47 patients who had one eye in each group.

Results: Postoperative pressure spikes were significantly lower (p = 0.010) in the latanoprost group (4.1 ± 5.0 mmHg) than in the control group (6.7 ± 7.0 mmHg). Mean elevation of IOP was less in the latanoprost group than in the control group at 1 hour (2.5 ± 4.8 versus 4.1 ± 4.7 mmHg, p = 0.013) and 2 hours (0.8 ± 5.6 versus 4.4 ± 8.1 mmHg, p = 0.003) postoperatively. Eleven eyes in the latanoprost group (23.4%) and 20 eyes in the control group (42.6%) developed a rise in IOP ≥ 6 mmHg (p = 0.048).

Conclusion: Latanoprost may reduce the pressure rise following LI in PACG eyes, but its application is limited by a late onset of effect.
Characterization of melanoma associated spongiform scleropathy
Authors: Alyahya Ghassan Ayish , Heegaard Steffen , Prause Jan Ulrik
Published: March 2003

Purpose: Melanoma associated spongiform scleropathy (MASS) describes areas within the sclera where collagen bundles appear to have disintegrated into loose fibres. It is found adjacent to choroidal and ciliary body melanoma. This study aimed to characterize these changes histopathologically.

Methods: Sections of 218 eyes that had been enucleated for malignant melanoma between January 1994 and June 2000 were examined for MASS, using data collected from the files of the Eye Pathology Institute, University of Copenhagen. Findings were correlated to patient characteristics (age, gender and pre‐enucleation radiation) and tumour characteristics (location, morphology and invasion). Staining was applied using haematoxylin‐eosin (HE), periodic acid‐Schiff (PAS), haematoxylin‐phloxine‐saffron (HPS), alcian blue, colloidal iron and Masson's trichrome. Sixteen normal eyes and 29 eyes with diseases other than choroidal and ciliary body melanoma served as controls.

Results: Melanoma associated spongiform scleropathy was observed in 73 of the 218 eyes (33%) with melanoma. No changes were found in normal eyes or in eyes with other intraocular diseases. A significantly higher incidence of MASS was found in older age groups. Thirty‐six (49%) of the 73 cases of MASS were observed within a patient age range of 71–90 years, whereas only 14 cases (19%) were observed within an age range of 41–60 years. Pre‐enucleation radiation significantly reduced the incidence of MASS. Twenty‐two (10%) of the total 218 eyes had received pre‐enucleation radiation and in only two (1%) of these was MASS observed. Melanoma associated spongiform scleropathy was found only in areas of contact between the tumour and the sclera, and the degree of MASS correlated directly with the extent of this contact. No significant correlation with tumour cell type was found.

Conclusions: In eyes with MASS, the severity of the changes correlated to the extent of direct contact between the tumour and sclera. Melanoma associated spongiform scleropathy showed a significant predilection towards older age groups. Pre‐enucleation radiation significantly reduced the incidence of MASS. Melanoma associated spongiform scleropathy is probably caused by a deposition of amorphous material splitting the scleral collagen fibrils. This material may be secreted either directly from the adjacent tumour or from scleral fibroblasts stimulated by the tumour cells.
Neovascular age‐related macular degeneration and its relationship to antioxidant intake
Authors: Snellen E.L.M. , Verbeek A.L.M. , Van Den Hoogen G.W.P. , Cruysberg J.R.M. , Hoyng C.B.
Published: March 2003

Purpose:  Experimental and epidemiological studies suggest that low antioxidant intake may be associated with the occurrence of neovascular age‐related macular degeneration (AMD).

Methods: We investigated this hypothesis further with a case‐control study involving 72 case and 66 control patients attending the Ophthalmology Department of the University Hospital in Nijmegen. Data were collected by interview on antioxidant intake (i.e. in fruit and vegetables), cigarette smoking, sunlight exposure and familial predisposition. Antioxidant intake was calculated according to the method described in the Framingham Eye Study. Logistic regression analysis was used to estimate odds ratios (OR) and 95% confidence intervals (CI).

Results:  The prevalence rate of AMD in patients with low antioxidant intake and low lutein intake (dichotomized at the median value) was about twice as high as that in patients with high intake: OR = 1.7, 95% CI (0.8–3.7), and OR = 2.4, 95% CI (1.1–5.1). Further specification of intake data into quartiles of antioxidant intake and lutein/zeaxanthine intake showed a clear dose–response relationship.

Conclusion:  The effect of dietary antioxidants upon macular health warrants preventive studies.
The relationship between age and colour content in fundus images
Authors: Ege Bernhard M. , Hejlesen Ole K. , Larsen Ole V. , Bek Toke
Published: March 2003

Introduction:  The morphological appearance of the ocular fundus is one of the key parameters used in the diagnosis and management of retinal disease. However, optical imperfections in the refractive media result in blurring, low luminance and contrast, and changes in the colour composition of the image which can be seen as an increasing yellowish appearance with age. The introduction of a method for quantifying this age‐related change in colour content may help in diagnosing and grading pathological changes in the eye lens which are secondary to ocular and systemic diseases.

Methods: A total of 102 digitized fundus images from 102 healthy subjects (mean age = 50.4 years, range 7.0–94.3 years) were used to build a model for estimating the age of the subject from the colour content of the images.

Results: Estimation of age from the fundus images could be done within approximately 16 years. This variation could be reduced considerably by analysis of repeated photographs from the same examination.

Conclusion : The colour content of fundus images can be used to estimate the ages of healthy subjects. Furthermore, when the colour content of fundus images deviates from that expected according to subject age, this may indicate causes other than age of increased light absorption in the lens, such as cumulative exposure to hyperglycaemia in diabetic patients. This could potentially be used to identify patients with undiagnosed type 2 diabetes in the general population and help to establish their risk of developing late diabetic complications as the cumulative exposure to hyperglycaemia is unknown at the time of diagnosis of the disease.
Monitoring and analysis of bovine spongiform encephalopathy (BSE) testing in Denmark using statistical models
Authors: Paisley Larry G.
Published: March 2003

The evolution of monitoring and surveillance for bovine spongiform encephalopathy (BSE) from the phase of passive surveillance that began in the United Kingdom in 1988 until the present is described. Currently, surveillance for BSE in Europe consists of mass testing of cattle slaughtered for human consumption and cattle from certain groups considered to be at higher risk of having clinical or detectable BSE. The results of the ongoing BSE testing in Denmark have been analyzed using two statistical approaches: the ``classical'' frequentist and the Bayesian that is widely used in quantitative risk analysis. The analyses were intended to provide information for decision‐makers, the media and the public as well as to provide inputs for future BSE surveillance models. The results to date suggest that the total number of BSE cases that will be found in Denmark in 2001 will not exceed 16.
Effects of different embedding gels on periostealchondrogenesis in vitro
Authors: Nishikori Tetsuya , Ochi Mitsuo , Uchio Yuji , Kataoka Hiroko , Maniwa Sokichi
Published: March 2003

To develop a more useful organ culture model for periosteal chondrogenesis in vitro, we compared the effects of the embedding of explants in agarose versus collagen gels. Chondrogenic differentiation was examined by means of histological observation and in terms of the expression of mRNA encoding two cartilage markers,Type II collagenandAggrecan. Periosteal explants were derived from the tibiae of rabbits. These explants were embedded in either agarose gel or collagen gel and cultured for 6 weeks. Histological examinations revealed that in the agarose gel, cells were neither present in the explants nor in the gel. In the collagen gel, cells migrated from the explanted tissues into the gel, and some cells were round. However, no explants showed safranin‐O staining. Only 10% of 10 surviving explants in the agarose gel expressed theType II collagengene and theAggrecangene. On the other hand, of 25 surviving explants in the collagen gel, the expression of theType II collagengene was detected in 18 explants (72%) and that of theAggrecangene was detected in 21 explants (84%). In conclusion, we demonstrated that the periosteum exerts chondrogenesis in certain circumstances and its chondrogenesis is closely related to the culture material.
Intestinal spirochetosis in eight pediatric patients from Southern Sweden
Authors: Marthinsen LARS , WillÉN ROGER , CarlÉN BIRGITTA , Lindberg EVA , VÄRendh GUNILLA
Published: March 2003

Intestinal spirochetes in humans have been recognized for more than a century, but it is still a matter of debate whether they are just commensal organisms or whether they cause colorectal disease. Most descriptions to date are of adult patients, while reports in the pediatric literature have been scarce. In a retrospective study we found eight children with intestinal spirochetosis. The findings, clinical as well as pathological, with light‐ and electron microscopy, are presented. In all patients, a 3 μm‐thick layer of spirochetes was visualised on the luminal aspect of the epithelial cells covering the enterocytes and part of the gland openings. In five of the eight cases an inflammatory cell reaction was seen by light microscopy and in one patient a picture suggesting intracytoplasmatically located spirochetes was seen by electron microscopy. Despite partial or complete destruction of microvilli, spirochetes were still able to adhere to the enterocyte membranes. In three children there was a clear correlation between treatment and relief of symptoms. In four there was partial improvement and in one child no change in bowel‐related symptoms. We believe that intestinal spirochetes may cause colorectal disease in children. Possible pathogenic mechanisms are discussed.
Serum tetranectin is an independent prognostic marker in colorectal cancer and weakly correlated with plasma suPAR, plasma PAI‐1 and serum CEA
Authors: Høgdall Claus K. , Christensen Ib J. , Stephens Ross W. , Sørensen Steen , NØRgaard‐Pedersen Bent , Nielsen Hans J.
Published: March 2003

Soluble tetranectin (TN) was measured preoperatively in serum from 567 patients with primary colorectal cancer and levels were tested for association with prognosis. The prognostic significance of TN was also compared to that of plasminogen‐activator inhibitor‐1 (PAI‐1), urokinase plasminogen activator (uPAR) and carcinoembryonic antigen (CEA). Significantly shorter survival was found for patients with TN levels below a cut‐off point of 7.5 mg/l compared to patients with levels above, as illustrated by Kaplan‐Meier curves. By Cox analyses, log TN, log soluble uPAR as well as log CEA were found to have an independent prognostic value for survival (log TN: HR=0.47, 95% CI: 0.29–0.76); log soluble uPAR: HR=1.65, 95% CI: 1.18–2.31; log CEA: HR=1.11, 95% CI: 1.03–1.20). Based on the multivariate model, a patient with a combination of low levels of TN and PAI‐1 and elevated levels of soluble uPAR and CEA had a 2.43 increased risk as compared to a patient with median levels of these biochemical markers. Significant correlations were found with Dukes' stages for all the biochemical markers and between the respective biochemical markers. The findings confirm that TN is a strong prognostic factor in patients with colorectal cancer. TN may be valuable as a prognostic variable in future studies evaluating new treatment strategies for colorectal cancer.
The distribution of bacterial morphotypes around natural teeth and titanium implants ad modum Brånemark
Authors: Quiryen M. , Listgarten M. A.
Published: March 2003

The subgingival plaque around both teeth and implants was analysed by means of differential phase‐contrast microscopy. It was noted that, in comparison to natural teeth, the subgingival samples from implants were more frequently too small to provide adequate bacterial counts. In 24 partially edentulous patients (with implants and teeth in the same jaw), no significant differences in the distribution of bacterial morphotypes could be found between implants and natural teeth. The %s of coccoid cells, motile rods, spirochetes and other bacteria were 65.8, 2.3, 2.1, and 29.8 for implants and 55.6, 4.9, 3.6, and 34.9 for teeth, respectively. However, when the plaque composition on the implants of fully edentulous patients was compared with those of teeth or implants of partially edentulous patients (with teeth and implants in the same and/or opposite jaw), significant differences appeared. In fully edentulous patients, more coccoid cells (71.3%) and significant fewer motile rods (0.4%) and spirochetes (0.0) were found around the implants. The results suggest that teeth may serve as a reservoir for the bacterial colonisation of titanium implants in the same mouth.
Osseointegration of titanium fixtures in onlay grafting procedures with autogenous bone and hydroxylapatite. An experimental histometric study.
Authors: Schliephake H. , Van Den Berghe P. , Neukam F. W.
Published: March 2003

The aim of the present study was to determine the degree of osseointegration of fixtures in different onlay grafting materials. Hydroxylapatite blocks of 2 different pore sizes and free monocortical bone grafts from the iliac crest were inserted in Gijttingen minipigs and fixed with 2 titanium fixtures. The extent of the bone/implant interface area on the fixture surface was determined from histological specimens by morphometric measurements and related to the total thread surface of the fixtures. Fixtures inserted into bone grafts showed the most complete degree of osseointegration, whereas the smallest bone/implant interface area was found with fixtures inserted into those HA blocks with the smaller pore size. There was a significant decrease in the degree of osseointegration between the host bone site and the augmentation material only with the fixtures inserted into the HA blocks of smaller pore size.
Effects of chlorhexidine gel on periodontal health of abutment teeth in patients with overdentures
Authors: Keltjens H. M. A. M. , Schaeken M. J. M. , Van Der Hoeven J. S. , Hendriks J. C. M.
Published: March 2003

The aim of this study was to test the effect of chlorhexidine gel application on periodontal health of abutment teeth in patients with overdentures. 19 patients with immediate overdentures were distributed ar random among 2 experimental groups. In these groups, a placebo and chiohexidine gel were daily applied. Patients were recalled at 6‐month intervals over a period of 2 years. In both groups, pocket depth, tooth mobility and bleeding index were initially found to decrease after insertion of the overdenture. In the chlorhexidine group. the bleeding index remained very low over the 2‐year period. whereas in the placebo group. the bleeding index gradually returned to the baseline values. The pocket depth in the chlorhexidine group remained below the baseline value. in contrast to values in the control group. The width of the attached gingiva decreased in both the groups. but less in the chlorhexidine group.
A comparative study of the clinical efficacy of Screw Vent irnnlants versus Brånemark fixtures, installed in a periodontal clinic
Authors: De Bruyn H. , Collaert B. , Lindh U. , Flygare L.
Published: March 2003

The clinical success of 85 Screw Vent® and 107 Bråemark® implants, consecutively installed in a private periodontal clinic under the same conditions and by the same operator, is compared. Mobile implants were removed and considered as failures. Intraoral radiographs were assessed for the presence of peri‐implant radiolucencies and for analysis of bone loss after functional loading. 85 Screw Vent implants were installed in 31 patients. Of 23 implants installed in 9 mandibles, none failed after 16.8 (range 12–25) months of function. Of 62 Screw Vent implants installed in 23 maxillae, 6 failed at abutment connection, 1 failed after 2 months and 2 after 13 months of function. The absolute failure rate after 13.2 (range 6–24) months was 9162. Mean loss of bone was 1.47 mm (‐l.O–+4) after 12 months of functional loading. 107 Brånemark fixtures were installed in 25 patients. Of 51 fixtures inserted in 12 mandibles, none failed; of 56 fixtures installed in 13 maxillae 1 failed before and 2 failed during abutment connection. The absolute failure is 3156. All remaining fixtures were immobile after loading. 13 fixtures were more than 6 months in function. Only short‐term comparison between both systems is possible because the observation time is longer for the Screw Vent implants. In the 1st year, only 1 implant system was available to the periodontist. Short‐term comparison reveals 11.3% versus 5.3% of cumulative failure after 6 months for the Screw Vent and Brånemark implants, respectively. The results indicate that clinical efficacy is as effectively obtained with Screw Vent as with Brånemark implants in the mandible. The outcome of treatment with Screw Vent implants in the maxilla seems less predictable.
Visualisation of the mandibular canal by different radiographic techniques
Authors: Lindh Christina , Petersson Arne , Klinge Björn
Published: March 2003

6 mandibles were radiographically examined bilaterally to visualise the mandibular canal. 5 imaging techniques were used: periapical radiography, panoramic radiography, hypocycloidal tomography, spiral tomography and computed tomography (CT). Panoramic radiographs were obtained with 2 different X‐ray machines. The CT‐examinations comprised direct images and standard reconstructions based on axial slices. The specimens were subsequently sectioned for contact radiography. The visibility of the mandibular canal was estimated by 3 observers at special reference points on all radiographs and classified as clearly visible, questionable visibility or not visible. The contact radiographs served as the “gold standard”. The inter‐observer and the intra‐observer agreement were assessed by calculating the overall agreement and the x. value. Direct coronal computed tomography, as well as spiral and hypocycloidal tomography, gave better visualisation of the mandibular canal than periapical and panoramic radiography.
Ligature‐induced peri‐implant infection in cynomolgus monkeys.Clinical and radiographic findings.
Authors: Lang N. P. , Brägger U. , Walther D. , Bearner B. , Kornman K. S.
Published: March 2003

The purpose of this study was to compare the effect of plaque accumulation in conjunction with or without placement of plaque‐retaining ligatures on peri‐implant and periodontal tissues. Four cynomolgus monkeys received 2 ITI (Type F) dental implants in edentulous areas of each side of the mandible. Following a healing period of 2 months with regular prophylaxis procedures twice per week, plaque was allowed to accumulate. After 1 month (day 0), silk ligatures were placed around 1 of the 2 implants. The third molars served as controls and were ligated as well. Clinical examinations comprising Plaque Index (PlI), Gingival Index (GI), probing depth (PD) and loss of attachment (LA) were performed at the test and control sites before and 1, 2, 3, 4, 5, 6, 7 and 8 months after ligature placement. Sixty and 30 days prior to ligation and at 2, 5, 6 and 8 months following ligation, standardized radiographs were obtained and subtracted from a baseline radiograph obtained at the time of ligation. PI1 and GI scores increased significantly following the elimination of prophylaxis procedures. After ligation, these indices continued to increase and reached values significantly higher in ligated implant (LI) and ligated teeth (LT) sites than in non‐ligated teeth (NLI) sites. PD also increased after plaque accumulation and ligature placement. Significantly greater PD values were noted in LI and LT sites than in NLI sites. Also, loss of attachment was observed already after 1 month following ligation in LI and LT sites and reached a value of 3.8 mm after 8 months, whereas only 1.0 mm of attachment was lost after 7 months of plaque accumulation in NLI. Similar results were noted in the analysis of the subtraction images. LI and LT sites lost significantly more bone density and more alveolar bone height, but the NLI sites yielded relatively stable conditions throughout the study. It is concluded that the development of a peri‐implant infection progressed at a similar rate as the development of a periodontitis lesion and that ligature placement significantly promoted the development of these lesions when compared with the development of an inflammatory response in the peri‐implant tissues as a result of bacterial plaque accumulation.
Ligature‐induced marginal inflammation around osseointegrated implants and ankylosed teeth. Clinical and radiographic observations in cynomolgus monkeys (Macaca fascicularis).
Authors: Schou S. , Holmstrup P. , Stoltze K. , Hjørting‐hansen E. , Kornman K. S.
Published: March 2003

The purpose of the investigation was to gain more understanding of marginal inflammatory reactions around osseointegrated implants. The significance of the lacking periodontal ligament of implants was examined in the initial breakdown phase of supporting tissues by comparing clinical and radiographic manifestations of ligature‐induced marginal inflammation related to osseointegrated implants with those around ankylosed and normal control teeth in 8 cynomolgus monkeys (Macaca fascicularis). Bilateral extraction of the first and second mandibular molars was carried out initially, and 12 weeks later 2 implants were placed in each side. Ankylosis of the second maxillary molars was established by extracting and replanting the teeth after a drying period. When ankylosis and osseointegration were established, ligature‐induced marginal inflammation was induced in the right or left side at random around implants, ankylosed teeth and normal control teeth (second maxillary premolar) for 7 weeks. Although the clinical manifestations as expressed by plaque score, gingival score, probing depth and attachment loss were quite similar, the radiographic features differed. Significant loss of bone height was limited to implants and ankylosed teeth and did not occur in relation to normal control teeth. Furthermore, the bone loss around implants was significantly greater than the loss around ankylosed teeth. Bone loss was limited to implants and ankylosed teeth; the study therefore suggests that the presence of marginal inflammation around implants and ankylosed teeth may have more serious implications than does marginal inflammation around teeth with a periodontal ligament. However, variations in microbiota and susceptibility of different jaw positions to periodontal breakdown may influence the results of this study.
Tissue reactions towards titanium implants inserted in growing jaws. A histological study in the pig.
Authors: Sennerby L. , Ödman J. , Lekholm U. , Thilander B.
Published: March 2003

In this investigation, the tissue reactions towards titanium implants inserted in growing jaws of pigs were studied by means of histology. At the age of 12 weeks, 5 test pigs each received 4 Brånemark System* titanium implants (fixtures). The fixtures were inserted immediately after extraction of the mesial root of the second deciduous premolar (P2) and the deciduous canine (C) on one side of the mandible and the mesial root of the first deciduous premolar (PI) on the other side. The fourth implant was placed after extraction of the deciduous lateral incisor (L) on one side in the upper jaw. Furthermore, 1 pig in which no extractions or fixture installations were performed served as a control. All pigs were followed for 165 days with clinical, radiographic and biometric examinations, the results of which have been previously presented. In this study, 10‐μm‐thick ground sections were produced for histology after the jaws had been fixed by immersion in formalin and further processed and embedded in plastic resin. Six of the fixtures originally inserted were lost during the experimental period, and the remaining implants were found to be involved with mineralized bone to varying degrees. Regarding the fixture‐to‐teeth relationship, it was found that, in the premolar region of the lower jaw, the teeth were positioned superior to and buccally angulated in relation to the fixtures. In the upper jaw, the implants were positioned below the adjacent teeth but centrally in the alveolar process. Tooth germs adjacent to the fixture had a displaced eruption path, buccally or lingually to the fixture. If the bud developed in close contact with the fixture, a changed morphology of the germ could be observed.