Sample records for directional ocular blood

  1. Ocular Blood Flow Autoregulation Mechanisms and Methods

    Xue Luo


    Full Text Available The main function of ocular blood flow is to supply sufficient oxygen and nutrients to the eye. Local blood vessels resistance regulates overall blood distribution to the eye and can vary rapidly over time depending on ocular need. Under normal conditions, the relation between blood flow and perfusion pressure in the eye is autoregulated. Basically, autoregulation is a capacity to maintain a relatively constant level of blood flow in the presence of changes in ocular perfusion pressure and varied metabolic demand. In addition, ocular blood flow dysregulation has been demonstrated as an independent risk factor to many ocular diseases. For instance, ocular perfusion pressure plays key role in the progression of retinopathy such as glaucoma and diabetic retinopathy. In this review, different direct and indirect techniques to measure ocular blood flow and the effect of myogenic and neurogenic mechanisms on ocular blood flow are discussed. Moreover, ocular blood flow regulation in ocular disease will be described.

  2. Relationship between the Direction of Ophthalmic Artery Blood Flow and Ocular Microcirculation before and after Carotid Artery Stenting

    Masashi Ishii


    Full Text Available When internal carotid artery stenosis is accompanied by ocular ischemic syndrome, intervention is recommended to prevent irreversible visual loss. In this study, we used laser speckle flowgraphy to measure the ocular microcirculation in the optic nerve head before and after carotid artery stenting (CAS of 40 advanced internal carotid stenosis lesions from 37 patients. The aim was to investigate the relationship between ocular microcirculation and the direction of ophthalmic artery blood flow obtained by angiography. We found that there was a significant increase in blood flow after CAS (P=0.003. Peak systolic velocity as an indicator of the rate of stenosis was also significantly higher in the group with retrograde/undetected flow of the ophthalmic artery than in the group with antegrade flow (P=0.002. In all cases where retrograde flow of the ophthalmic artery was observed before stenting, the flow changed to antegrade after stenting. Through the use of laser speckle flowgraphy, this study found that CAS can improve ocular microcirculation. Furthermore, while patients displaying retrograde flow of the ophthalmic artery before stenting have a poor prognosis, CAS corrected the flow to antegrade, suggesting that visual loss can be prevented by improving the ocular microcirculation.

  3. Current Imaging Modalities for assessing Ocular Blood Flow in Glaucoma

    Mohindroo, Chirayu; Ichhpujani, Parul; Kumar, Suresh


    Glaucoma may be caused by an interplay of elevated intraocular pressure (IOP), vascular, genetic, anatomical, brain, and immune factors. The direct assessment of ocular hemodynam-ics offers promise for glaucoma detection, differentiation, and possibly new treatment modalities. All the methods currently in use to measure ocular blood flow have inherent limitations and measure different aspects of ocular blood flow. This review article attempts to provide detailed information on ocular perfu-si...

  4. Ocular Blood Flow Autoregulation Mechanisms and Methods

    Xue Luo; Yu-meng Shen; Meng-nan Jiang; Xiang-feng Lou; Yin Shen


    The main function of ocular blood flow is to supply sufficient oxygen and nutrients to the eye. Local blood vessels resistance regulates overall blood distribution to the eye and can vary rapidly over time depending on ocular need. Under normal conditions, the relation between blood flow and perfusion pressure in the eye is autoregulated. Basically, autoregulation is a capacity to maintain a relatively constant level of blood flow in the presence of changes in ocular perfusion pressure and va...

  5. Ocular Blood Flow and Normal Tension Glaucoma

    Ning Fan


    Full Text Available Normal tension glaucoma (NTG is known as a multifactorial optic neuropathy characterized by progressive retinal ganglion cell death and glaucomatous visual field loss, even though the intraocular pressure (IOP does not exceed the normal range. The pathophysiology of NTG remains largely undetermined. It is hypothesized that the abnormal ocular blood flow is involved in the pathogenesis of this disease. A number of evidences suggested that the vascular factors played a significant role in the development of NTG. In recent years, the new imaging techniques, fluorescein angiography, color Doppler imaging (CDI, magnetic resonance imaging (MRI, and laser speckle flowgraphy (LSFG, have been used to evaluate the ocular blood flow and blood vessels, and the impaired vascular autoregulation was found in patients with NTG. Previous studies showed that NTG was associated with a variety of systemic diseases, including migraine, Alzheimer’s disease, primary vascular dysregulation, and Flammer syndrome. The vascular factors were involved in these diseases. The mechanisms underlying the abnormal ocular blood flow in NTG are still not clear, but the risk factors for glaucomatous optic neuropathy likely included oxidative stress, vasospasm, and endothelial dysfunction.

  6. Ocular rigidity, ocular pulse amplitude, and pulsatile ocular blood flow: the effect of axial length.

    Dastiridou, Anna I; Ginis, Harilaos; Tsilimbaris, Miltiadis; Karyotakis, Nikos; Detorakis, Efstathios; Siganos, Charalambos; Cholevas, Pierros; Tsironi, Evangelia E; Pallikaris, Ioannis G


    Previous studies have shown a negative correlation between axial length (AL) and pulsatile ocular blood flow (POBF). This relation has been questioned because of the possible confounding effect of ocular volume on ocular rigidity (OR). The purpose of this study was to investigate the relation between AL, as a surrogate parameter for ocular volume, and OR, ocular pulse amplitude (OPA), and POBF. Eighty-eight cataract patients were enrolled in this study. A computer-controlled device comprising a microdosimetric pump and a pressure sensor was used intraoperatively. The system was connected to the anterior chamber and used to raise the intraocular pressure (IOP) from 15 to 40 mm Hg, by infusing the eye with a saline solution. After each infusion step, the IOP was continuously recorded for 2 seconds. Blood pressure and pulse rate were measured during the procedure. The OR coefficient was calculated from the pressure volume data. OPA and POBF were measured from pressure recordings. Median AL was 23.69 (interquartile range 3.53) mm. OR coefficient was 0.0218 (0.0053) μL(-1). A negative correlation between the OR coefficient and AL (ρ = -0.641, P < 0.001) was documented. Increasing AL was associated with decreased OPA (ρ = -0.637, P < 0.001 and ρ = -0.690, P < 0.001) and POBF (ρ = -0.207, P = 0.053 and ρ = -0.238, P = 0.028) at baseline and elevated IOP, respectively. Based on manometric data, increasing AL is associated with decreased OR, OPA, and POBF. These results suggest decreased pulsatility in high myopia and may have implications on ocular pulse studies and the pathophysiology of myopia.

  7. Ocular rigidity, ocular pulse amplitude, and pulsatile ocular blood flow: the effect of intraocular pressure.

    Dastiridou, Anna I; Ginis, Harilaos S; De Brouwere, Dirk; Tsilimbaris, Miltiadis K; Pallikaris, Ioannis G


    The purpose of this study was to characterize the pressure-volume relation in the living human eye, measure the ocular pulse amplitude (OPA), and calculate the corresponding pulsatile ocular blood flow (POBF) in a range of clinically relevant IOP levels. Fifty patients with cataract (50 eyes) were enrolled in the study. After cannulation of the anterior chamber, a computer-controlled device for the intraoperative measurement and control of IOP was used to artificially increase the IOP in a stepping procedure from 15 to 40 mm Hg. The IOP was continuously recorded for 2 seconds after each infusion step. The pressure-volume relation was approximated with an exponential fit, and the ocular rigidity coefficient was computed. OPA, pulse volume (PV), and POBF were measured from the continuous IOP recordings. The average rigidity coefficient was 0.0224 microL(-1) (SD 0.0049). OPA increased by 91% and PV and POBF decreased by 29% and 30%, respectively, when increasing the IOP from 15 to 40 mm Hg. The OPA is positively correlated with the coefficient of ocular rigidity (r = 0.65, P < 0.01). The present results suggest a nonlinear pressure-volume relation in the living human eye characterized by an increase in rigidity at higher IOP levels. The increased OPA and decreased pulse volume relate to the decreased POBF and the increased mechanical resistance of the ocular wall at high IOP levels.

  8. Contrast sensitivity, ocular blood flow and their potential role in assessing ischaemic retinal disease.

    Shoshani, Yochai Z; Harris, Alon; Rusia, Deepam; Spaeth, George L; Siesky, Brent; Pollack, Ayala; Wirostko, Barbara


    To examine the definition, evaluation methodology, association to ocular blood flow and potential clinical value of contrast sensitivity (CS) testing in clinical and research settings, focusing in patients with ischemic retinal disease. A review of the medical literature focusing on CS and ocular blood flow in ischemic retinal disease. CS may be more sensitive than other methods at detecting subtle defects or improvements in primarily central retinal ganglion cell function early on in a disease process. CS testing attempts to provide spatial detection differences which are not directly assessed with standard visual acuity chart testing. Analyzing all studies that have assessed both CS change and ocular blood flow, it is apparent that both choroidal circulation and retinal circulation may have an important role in influencing CS. The concept that CS is directly influenced by ocular blood flow is supported by reviewing the studies involving both. Although the studies in the literature have not established a direct cause and effect relationship per se, the literature review makes it logical to assume that changes in retinal and choroidal blood flow influence CS. This raises the possibility that a subjective visual characteristic, specifically CS, may be able to be evaluated more objectively by studying blood flow. It appears appropriate to study the relationship between blood flow and CS more extensively to develop improved ways of measuring various aspects of blood flow to the eye and to best quantify early changes in visual function. © 2011 The Authors. Acta Ophthalmologica © 2011 Acta Ophthalmologica Scandinavica Foundation.

  9. Estimation of ocular rigidity in glaucoma using ocular pulse amplitude and pulsatile choroidal blood flow.

    Wang, Jing; Freeman, Ellen E; Descovich, Denise; Harasymowycz, Paul J; Kamdeu Fansi, Alvine; Li, Gisele; Lesk, Mark R


    Theoretical models and animal studies have suggested that scleral rigidity plays an important role in the pathogenesis of glaucoma. The aim of this study was to present a noninvasive technique for estimating ocular rigidity (E) in vivo, and to compare the estimated rigidity between patients with open-angle glaucoma (OAG); ocular hypertension (OHT); suspect glaucomatous disc (GS); and normal subjects (N). We hypothesized that OHT patients would have higher rigidity. All patients underwent measurements of ocular pulse amplitude (OPA) using dynamic contour tonometry, pulsatile choroidal blood flow (ChBFP) using laser Doppler flowmetry; axial length (AL); and assessment of automated visual field mean deviation (MD). The ratio between OPA and ChBFP was calculated according to the Friedenwald's equation of ocular rigidity. The calculated ratio is denoted as (ER). The average ER values of the four diagnostic groups were compared using nonparametric tests. The relationship between ER and other ocular and systemic factors was examined using correlation and regression analysis. A total of 257 subjects were included in the study (56 N, 108 OAG, 48 GS, and 45 OHT). ER correlated negatively with AL and positively with MD, signifying that a lower rigidity was associated with a longer eye and a worse (more negative) MD. ER was also found to be highest in OHT (0.235 ± 0.16) and lowest in OAG (0.188 ± 0.14; P = 0.01). Estimated coefficient of ocular rigidity by OPA and ChBFP suggested that glaucoma patients had the lowest rigidity and OHT the highest. It supports the idea that a more compliant ocular shell may predispose the optic nerve head to intraocular pressure (IOP)-related damage.

  10. Ocular rigidity, outflow facility, ocular pulse amplitude, and pulsatile ocular blood flow in open-angle glaucoma: a manometric study.

    Dastiridou, Anna I; Tsironi, Evangelia E; Tsilimbaris, Miltiadis K; Ginis, Harilaos; Karyotakis, Nikos; Cholevas, Pierros; Androudi, Sofia; Pallikaris, Ioannis G


    To compare ocular rigidity (OR) and outflow facility (C) coefficients in medically treated open-angle glaucoma (OAG) patients and controls, and to investigate differences in ocular pulse amplitude (OPA) and pulsatile ocular blood flow (POBF) between the two groups. Twenty-one OAG patients and 21 controls undergoing cataract surgery were enrolled. Patients with early or moderate primary or pseudoexfoliative OAG participated in the glaucoma group. A computer-controlled system, consisting of a pressure transducer and a microstepping device was employed intraoperatively. After cannulation of the anterior chamber, IOP was increased by infusing the eye with microvolumes of saline solution. IOP was recorded after each infusion step. At an IOP of 40 mm Hg, an IOP decay curve was recorded for 4 minutes. OR coefficients, C, OPA, and POBF were estimated from IOP and volume recordings. There were no differences in age or axial length in the two groups. The OR coefficient was 0.0220 ± 0.0053 μl(-1) in the OAG and 0.0222 ± 0.0039 μl(-1) in the control group (P = 0.868). C was 0.092 ± 0.082 μL/min/mm Hg in the glaucoma group compared with 0.149 ± 0.085 μL/min/mm Hg in the control group at an IOP of 35 mm Hg (P 0.05). Manometric data reveal lower C in OAG patients and increased C with increasing IOP. There were no differences in the OR coefficient, OPA, and POBF between medically treated OAG patients and controls, failing to provide evidence of altered scleral distensibility and choroidal blood flow in OAG.

  11. Ultrafast Ultrasound Imaging of Ocular Anatomy and Blood Flow

    Urs, Raksha; Ketterling, Jeffrey A.; Silverman, Ronald H.


    Purpose Ophthalmic ultrasound imaging is currently performed with mechanically scanned single-element probes. These probes have limited capabilities overall and lack the ability to image blood flow. Linear-array systems are able to detect blood flow, but these systems exceed ophthalmic acoustic intensity safety guidelines. Our aim was to implement and evaluate a new linear-array–based technology, compound coherent plane-wave ultrasound, which offers ultrafast imaging and depiction of blood flow at safe acoustic intensity levels. Methods We compared acoustic intensity generated by a 128-element, 18-MHz linear array operated in conventionally focused and plane-wave modes and characterized signal-to-noise ratio (SNR) and lateral resolution. We developed plane-wave B-mode, real-time color-flow, and high-resolution depiction of slow flow in postprocessed data collected continuously at a rate of 20,000 frames/s. We acquired in vivo images of the posterior pole of the eye by compounding plane-wave images acquired over ±10° and produced images depicting orbital and choroidal blood flow. Results With the array operated conventionally, Doppler modes exceeded Food and Drug Administration safety guidelines, but plane-wave modalities were well within guidelines. Plane-wave data allowed generation of high-quality compound B-mode images, with SNR increasing with the number of compounded frames. Real-time color-flow Doppler readily visualized orbital blood flow. Postprocessing of continuously acquired data blocks of 1.6-second duration allowed high-resolution depiction of orbital and choroidal flow over the cardiac cycle. Conclusions Newly developed high-frequency linear arrays in combination with plane-wave techniques present opportunities for the evaluation of ocular anatomy and blood flow, as well as visualization and analysis of other transient phenomena such as vessel wall motion over the cardiac cycle and saccade-induced vitreous motion. PMID:27428169

  12. [Peculiarities of ocular blood flow in ischemic optic neuropathy and normal tension glaucoma].

    Mamikonian, V R; Galoian, N S; Sheremet, N L; Kazarian, E E; Kharlap, S I; Shmeleva-Demir, O A; Andzhelova, D V; Tatevosian, A A


    Characteristics of ocular hemodynamics in ischemic optic neuropathy (ION) outcome and normal tension glaucoma (NTG), the conditions that are difficult to be differentially diagnosed, have been investigated. The study enrolled 32 patients (40 eyes) with ION outcome, 26 patients (46 eyes) with NTG, and 20 patients (32 eyes) with no ocular pathology. Besides the standard ophthalmological examination, color Doppler imaging of ocular vessels, evaluation of ocular blood flow volume and individual normal range of intraocular pressure (flowmetry) were performed in all cases. The results showed that an excess of the actual intraocular pressure (IOP) over the individual normal range was much higher in patients with NTG than in patients with ION (39% and 14.5% correspondingly). It was also found that NTG is associated with a more significant decrease of ocular blood flow volume (30.1% in average) in comparison to ION outcome (11%). In both conditions a decrease in velocity parameters of the blood flow in main ocular vessels was registered, however, ocular hemodynamics changes appeared to be more severe in patients with glaucomatous optic neuropathy. A statistically reliable correlation between volumetric and velocity parameters of ocular blood flow has been discovered.

  13. Effect of 2-(6-cyano-1-hexyn-1-yl)adenosine on ocular blood flow in rabbits.

    Konno, Takashi; Uchibori, Takehiro; Nagai, Akihiko; Kogi, Kentaro; Nakahata, Norimichi


    Previously, we reported that a relatively selective adenosine A(2A) receptor agonist 2-(6-cyano-1-hexyn-1-yl)adenosine (2-CN-Ado) elicited ocular hypotension in rabbits (Journal of Pharmacological Sciences 2005;97:501-509). In the present study, we investigated the effect of 2-CN-Ado on ocular blood flow in rabbit eyes. An intravitreal injection of 2-CN-Ado increased ocular blood flow, measured by a non-contact laser flowmeter. 2-CN-Ado-induced increase in ocular blood flow was accompanied with the retinal vasodilation. The increase in ocular blood flow was inhibited by an adenosine A(2A) receptor antagonist 1,3,7-trimethyl-8-(3-chlorostyryl)xanthine, but not by an adenosine A(2B) receptor antagonist alloxazine or an adenosine A(1) receptor antagonist 8-cyclopentyl-1,3-dipropylxanthine. The repetitive applications of topical 2-CN-Ado twice a day for 7 days produced a persistent increase in ocular blood flow with ocular hypotension. These results suggest that 2-CN-Ado increases the ocular blood flow mainly via adenosine A(2A) receptor, and that the topical application of 2-CN-Ado for several days not only increases the ocular blood flow but also prolong ocular hypotension, indicating that 2-CN-Ado may be a useful lead compound for the treatment of ischemic retinal diseases such as glaucoma.

  14. Differences in ocular blood flow in glaucoma between patients of African and European descent.

    Siesky, Brent; Harris, Alon; Racette, Lyne; Abassi, Rania; Chandrasekhar, Kaarthik; Tobe, Leslie A; Behzadi, Jennifer; Eckert, George; Amireskandari, Annahita; Muchnik, Michael


    To investigate differences in ocular blood flow in individuals of African descent (AD) and European descent (ED) with open angle glaucoma (OAG). A retrospective data analysis was performed on OAG patients of AD and ED who were previously examined for ocular blood flow within the Department of Ophthalmology at Indiana University School of Medicine. Data analysis included blood pressure, heart rate, visual fields, intraocular pressure, ocular perfusion pressure, and color Doppler imaging of retrobulbar vessels. Color Doppler imaging measurements were performed on ophthalmic, central retinal, and nasal and temporal short posterior ciliary arteries, with peak systolic (PSV) and end diastolic velocities (EDV) as well as the Pourcelot vascular resistive index calculated for each vessel. Two-sample t tests of unequal variance were performed with P values <0.05 considered statistically significant. OAG patients of AD had statistically significant lower retrobulbar blood flow values than patients of ED including lower ophthalmic artery PSV (P=0.0001), ophthalmic artery EDV (P=0.0008), central retinal artery PSV (P=0.01), temporal short posterior ciliary artery PSV (P=0.0037), and nasal short posterior ciliary artery PSV (P<0.0001). No significant differences were found in terms of intraocular pressure or visual field parameters. Significantly lower blood flow values were identified in all retrobulbar blood vessels in AD compared with ED OAG patients. These findings suggest that the contribution of ocular blood flow to the disease process may be different in AD compared with ED OAG patients.

  15. Non-Viral Ocular Gene Therapy: Assessment and Future Directions


    The purpose of this review is to give the general reader a brief overview of the current state of the field of non-viral ocular gene therapy. For multiple reasons the eye is an excellent organ for gene therapy application and while non-viral gene therapy modalities have been around for quite some time; they have only been applied to the eye in the last few years. This review will cover the exciting current trends in non-viral gene therapy and their application to the eye in addition to a brie...

  16. Ocular Blood Flow Measured Noninvasively in Zero Gravity

    Ansari, Rafat R.; Manuel, Francis K.; Geiser, Martial; Moret, Fabrice; Messer, Russell K.; King, James F.; Suh, Kwang I.


    In spaceflight or a reduced-gravity environment, bodily fluids shift to the upper extremities of the body. The pressure inside the eye, or intraocular pressure, changes significantly. A significant number of astronauts report changes in visual acuity during orbital flight. To date this remains of unknown etiology. Could choroidal engorgement be the primary mechanism and a change in the curvature or shape of the cornea or lens be the secondary mechanism for this change in visual acuity? Perfused blood flow in the dense meshwork of capillaries of the choroidal tissue (see the preceding illustration) provides necessary nutrients to the outer layers of the retina (photoreceptors) to keep it healthy and maintain good vision. Unlike the vascular system, the choroid has no baroreceptors to autoregulate fluid shifts, so it can remain engorged, pushing the macula forward and causing a hyperopic (farsighted) shift of the eye. Experiments by researchers at the NASA Glenn Research Center could help answer this question and facilitate planning for long-duration missions. We are investigating the effects of zero gravity on the choroidal blood flow of volunteer subjects. This pilot project plans to determine if choroidal blood flow is autoregulated in a reduced-gravity environment.

  17. Directional sensitivity of anterior, posterior, and horizontal canal vestibulo-ocular neurons in the cat.

    Brettler, S C; Baker, J F


    Neurons subserving the vestibulo-ocular reflex transform the directionality and timing of input from semicircular canals into commands that are appropriate to rotate the eyes in a compensatory fashion. In order to assess the degree to which this transformation is evident in vestibular nucleus neurons of alert cats, we recorded the extracellular discharge properties of 138 second-order vestibular neurons in the superior and medial vestibular nucleus, including 64 neurons identified as second-order vestibulo-ocular neurons by antidromic responses to oculomotor nucleus stimulation and short-latency orthodromic responses to labyrinth stimulation (1.3 ms or less). Neuronal response gains and phases were recorded during 0.5-Hz sinusoidal oscillations about many different horizontal axes and during vertical axis rotations to define neuronal response directionality more precisely than in past studies. Neurons with spatial responses similar to anterior semicircular canal afferents were found to have more diverse maximal activation direction vectors than neurons with responses resembling those of posterior or horizontal canal afferents. The mean angle from neuron response vector to the axis of the nearest canal or canal pair was 19 degrees for anterior canal second-order neurons (n=28) and 20 degrees for anterior canal second-order vestibulo-ocular neurons (n=18), compared with 11 degrees for posterior canal second-order neurons (n=43) and 11 degrees for posterior canal second-order vestibulo-ocular neurons (n=25). Only two second-order vestibulo-ocular neurons (3%) showed a marked dependence of response phase on rotation direction, which is indicative of convergent inputs that differ in both dynamics and directionality. This suggests that spatiotemporal convergence is uncommon in the three-neuron vestibulo-ocular reflex arc of the cat. Neuron vectors included many that were closely aligned with canal axes and several that were better aligned with oblique or superior rectus

  18. Effects of Heat Stress on Ocular Blood Flow During Exhaustive Exercise

    Tsukasa Ikemura


    Full Text Available The hypothesis that heat stress reduces the ocular blood flow response to exhaustive exercise was tested by measuring ocular blood flow, blood pressure, and end- tidal carbon dioxide partial pressure (PETCO2 in 12 healthy males while they performed cycle ergometer exercise at 75% of the maximal heart rate at ambient temperatures of 20°C (control condition and 35°C (heat condition, until exhaustion. The blood flows in the retinal and choroidal vasculature (RCV, the superior temporal retinal arteriole (STRA and the superior nasal retinal arteriole (SNRA were recorded at rest and at 6 and 16 min after the start of exercise period and at exhaustion [after 16 ± 2 min (mean ± SE and 24 ± 3 min of exercise in the heat and control condition, respectively]. The mean arterial pressure at exhaustion was significantly lower in the heat condition than in the control condition at both 16 min and exhaustion. The degree of PETCO2 reduction did not differ significantly between the two thermal conditions at either 16 min or exhaustion. The blood flow velocity in the RCV significantly increased from the resting baseline value at 6 min in both thermal conditions (32 ± 6% and 25 ± 5% at 20°C and 35°C, respectively. However, at 16 min the increase in RCV blood flow velocity had returned to the resting baseline level only in the heat condition. At exhaustion, the blood flows in the STRA and SNRA had decreased significantly from the resting baseline value in the heat condition (STRA: -19 ± 5% and SNRA: -30 ± 6%, and SNRA blood flow was lower than that in the control condition (-14 ± 6% vs -30 ± 6% at 20°C and 35°C, respectively, despite the finding that both thermal conditions induced the same reductions in PETCO2 and vascular conductance. These findings suggested that the heat condition decreases or suppresses ocular blood flow via attenuation of pressor response during exhaustive exercise.

  19. Progress in measurement of ocular blood flow and relevance to our understanding of glaucoma and age-related macular degeneration.

    Harris, A; Chung, H S; Ciulla, T A; Kagemann, L


    New technologies have facilitated the study of the ocular circulation. These modalities and analysis techniques facilitate very precise and comprehensive study of retinal, choroidal, and retrobulbar circulations. These techniques include: 1. Vessel caliber assessment; 2. Scanning laser ophthalmoscopic fluorescein angiography and indocyanine green angiography to image and evaluate the retinal circulation and choroidal circulation respectively; 3. Laser Doppler flowmetry and confocal scanning laser Doppler flowmetry to measure blood flow in the optic nerve head and retinal capillary beds; 4. Ocular pulse measurement; and 5. color Doppler imaging to measure blood flow velocities in the central retinal artery, the ciliary arteries and the ophthalmic artery. These technique have greatly enhanced the ability to quantify ocular perfusion defects in many disorders, including glaucoma and age-related macular degeneration, two of the most prevalent causes of blindness in the industrialized world. Recently it has become clear, in animal models of glaucoma, that retinal ganglion cells die via apoptosis. The factors that initiate apoptosis in these cells remain obscure, but ischemia may play a central role. Patients with either primary open-angle glaucoma or normal-tension glaucoma experience various ocular blood flow deficits. With regard to age-related macular degeneration, the etiology remains unknown although some theories include primary retinal pigment epithelial senescence, genetic defects such as those found in the ABCR gene which is also defective in Stargardt's disease and ocular perfusion abnormalities. As the choriocapillaris supplies the metabolic needs of the retinal pigment epithelium and the outer retina, perfusion defect in the choriocapillaris could account for some of the physiologic and pathologic changes in AMD. Vascular defects have been identified in both nonexudative and exudative AMD patients using new technologies. This paper is a comprehensive update

  20. Changes in central retinal artery blood flow after ocular warming and cooling in healthy subjects

    Shamshad M


    Full Text Available Context: Retinal perfusion variability impacts ocular disease and physiology. Aim: To evaluate the response of central retinal artery (CRA blood flow to temperature alterations in 20 healthy volunteers. Setting and Design: Non-interventional experimental human study. Materials and Methods: Baseline data recorded: Ocular surface temperature (OST in °C (thermo-anemometer, CRA peak systolic velocity (PSV and end diastolic velocity (EDV in cm/s using Color Doppler. Ocular laterality and temperature alteration (warming by electric lamp/cooling by ice-gel pack were randomly assigned. Primary outcomes recorded were: OST and intraocular pressure (IOP immediately after warming or cooling and ten minutes later; CRA-PSV and EDV at three, six and nine minutes warming or cooling. Statistical Analysis: Repeated measures ANOVA. Results: (n = 20; μ±SD: Pre-warming values were; OST: 34.5±1.02°C, CRA-PSV: 9.3±2.33cm/s, CRA-EDV: 4.6±1.27cm/s. OST significantly increased by 1.96°C (95% CI: 1.54 to 2.37 after warming, but returned to baseline ten minutes later. Only at three minutes, the PSV significantly rose by 1.21cm/s (95% CI: 0.51to1.91. Pre-cooling values were: OST: 34.5±0.96°C, CRA-PSV: 9.7±2.45 cm/s, CRA-EDV: 4.7±1.12cm/s. OST significantly decreased by 2.81°C (95% CI: -2.30 to -3.37 after cooling, and returned to baseline at ten minutes. There was a significant drop in CRA-PSV by 1.10cm/s (95% CI: -2.05 to -0.15 and CRA-EDV by 0.81 (95% CI: -1.47 to -0.14 at three minutes. At six minutes both PSV (95% CI: -1.38 to -0.03 and EDV (95% CI: -1.26 to -0.02 were significantly lower. All values at ten minutes were comparable to baseline. The IOP showed insignificant alteration on warming (95% CI of difference: -0.17 to 1.57mmHg, but was significantly lower after cooling (95% CI: -2.95 to -4.30mmHg. After ten minutes, IOP had returned to baseline. Conclusion : This study confirms that CRA flow significantly increases on warming and decreases on cooling

  1. Family-directed umbilical cord blood banking

    Gluckman, Eliane; Ruggeri, Annalisa; Rocha, Vanderson; Baudoux, Etienne; Boo, Michael; Kurtzberg, Joanne; Welte, Kathy; Navarrete, Cristina; van Walraven, Suzanna M.


    Umbilical cord blood transplantation from HLA-identical siblings provides good results in children. These results support targeted efforts to bank family cord blood units that can be used for a sibling diagnosed with a disease which can be cured by allogeneic hematopoietic stem cell transplantation or for research that investigates the use of allogeneic or autologous cord blood cells. Over 500 patients transplanted with related cord blood units have been reported to the Eurocord registry with a 4-year overall survival of 91% for patients with non-malignant diseases and 56% for patients with malignant diseases. Main hematologic indications in children are leukemia, hemoglobinopathies or inherited hematologic, immunological or metabolic disorders. However, family-directed cord blood banking is not widely promoted; many cord blood units used in sibling transplantation have been obtained from private banks that do not meet the necessary criteria required to store these units. Marketing by private banks who predominantly store autologous cord blood units has created public confusion. There are very few current validated indications for autologous storage but some new indications might appear in the future. Little effort is devoted to provide unbiased information and to educate the public as to the distinction between the different types of banking, economic models and standards involved in such programs. In order to provide a better service for families in need, directed-family cord blood banking activities should be encouraged and closely monitored with common standards, and better information on current and future indications should be made available. PMID:21750089

  2. Retinal angiographic blood flowmetry is reduced in the ocular ischaemic syndrome

    Hansen, Grith Lssrkholm; Kofoed, Peter Kristian; Munch, Inger Christine;


    with ocular ischaemic syndrome (OIS) and 20 control eyes from subjects with carotid artery stenosis but without signs of ocular ischaemia. Analyses of video fluorescein angiograms extracting time intervals for the time delay between specific phases of the angiogram were performed. Time delay was compared...... and a correlation between flow and ocular perfusion pressure. While angiographic flowmetry proved effective in discriminating between groups of individuals, it can only be used to support the diagnosis of the ocular ischaemic syndrome in patients with extreme flow reduction....

  3. Peripheral blood metabolic and inflammatory factors as biomarkers to ocular findings in diabetic macular edema.

    Figueras-Roca, Marc; Molins, Blanca; Sala-Puigdollers, Anna; Matas, Jessica; Vinagre, Irene; Ríos, José; Adán, Alfredo


    To study the association between peripheral blood metabolic and inflammatory factors and presence of diabetic macular edema (DME) and its related anatomic features in type 2 diabetic mellitus (T2DM) patients. Observational cross-sectional study on a proof of concept basis. Seventy-six T2DM included patients were divided based on the presence (n = 58) or absence of DME (n = 18) according to optical coherence tomography (OCT). Ultra-widefield fluorescein angiography (UWFA) was performed in DME patients. Fasting peripheral blood sample testing included glycemia, glycated hemoglobin, creatinin and lipid levels among others. Serum levels of a broad panel of cytokines and inflammatory mediators were also analysed. OCT findings included central subfoveal thickness, diffuse retinal thickness (DRT), cystoid macular edema (CME), serous retinal detachment and epirretinal membrane. UWFA items included pattern of DME, presence of peripheral retinal ischemia and enlarged foveal avascular zone (FAZ). Metabolic and inflammatory factors did not statistically differ between groups. However, several inflammatory mediators did associate to certain ocular items of DME cases: IL-6 was significantly higher in patients with DRT (p = 0.044), IL-10 was decreased in patients with CME (p = 0.012), and higher IL-8 (p = 0.031) and VEGF levels (p = 0.031) were observed in patients with enlarged FAZ. Inflammatory and metabolic peripheral blood factors in T2DM may not be differentially associated to DME when compared to non-DME cases. However, some OCT and UWFA features of DME such as DRT, CME and enlarged FAZ may be associated to certain systemic inflammatory mediators.

  4. Ocular Hypertension

    ... Español Eye Health / Eye Health A-Z Ocular Hypertension Sections What Is Ocular Hypertension? Ocular Hypertension Causes ... Hypertension Diagnosis Ocular Hypertension Treatment What Is Ocular Hypertension? Written By: Kierstan Boyd Reviewed By: J Kevin ...

  5. Blood flow velocity and thickness of the choroid in a patient with chorioretinopathy associated with ocular blunt trauma.

    Ishikawa, Yuri; Hashimoto, Yuki; Saito, Wataru; Ando, Ryo; Ishida, Susumu


    Choroidal circulation hemodynamics in eyes with ocular blunt trauma has not been quantitatively examined yet. We quantitatively examined changes in choroidal blood flow velocity and thickness at the lesion site using laser speckle flowgraphy (LSFG) and enhanced depth imaging optical coherence tomography (EDI-OCT) in a patient with chorioretinopathy associated with ocular blunt trauma. A 13-year-old boy developed a chorioretinal lesion with pigmentation extending from the optic disc to the superotemporal side in the right eye after ocular blunt trauma. The patient's best-corrected visual acuity (BCVA) was 0.2 in the right eye. Indocyanine green angiography showed hypofluorescence from the initial phase, with a decrease of mean blur rate (MBR) on LSFG color map, which corresponded to the chorioretinal lesion. The BCVA and foveal outer retinal morphologic abnormality spontaneously improved during follow-up. MBR and choroidal thickness increased by 23-31% and 13-17 μm at the lesion site and by 11-22% and 33-42 μm at the fovea, respectively, during the 6-month follow-up period after baseline measurements in the affected eye. In contrast, these parameters showed little or no changes at the normal retinal site in the affected eye and the fovea in the fellow eye. Current data revealed that both blood flow velocity and thickness in the choroid at the lesion site decreased in the acute stage and subsequently increased together with improvements in visual function and outer retinal morphology. These results suggest that LSFG and EDI-OCT may be useful indices that can noninvasively evaluate activity of choroidal involvement in ocular blunt trauma-associated chorioretinopathy.

  6. Short-term effects of intravitreal triamcinolone acetonide injection on ocular blood flow evaluated with color Doppler ultrasonography

    Mustafa; Alpaslan; Anayol; Yasin; Toklu; Elif; Asik; Kamberoglu; Sabri; Raza; Hasan; Basri; Arifoglu; Huseyin; Simavli; Ayse; Gul; Kocak; Altintas; Saban; Simsek


    AIM:To evaluate the changes in ocular blood flow with color Doppler ultrasonography(CDU) after intravitreal triamcinolone acetonide(IVTA) injection.METHODS:A total of 46 patients who underwent IVTA(4 mg/0.1 mL) injection for diabetic macular edema(DME)(n =22), central retinal vein occlusion(CRVO)(n =12) and choroidal neovascular membrane(CNVM)(n =12) were included in the study. Peak systolic velocity(PSV), end diastolic velocity(EDV) and resistivity index(RI) were measured from the ophthalmic artery(OA), the central retinal artery(CRA) and the posterior ciliary artery(PCA)of each patient with CDU before, at the end of the first week and at the end of the first month following IVTA injection.RESULTS:In the DME group, PSV of OA at the first of the first month(mean ±SD)(37.48 ±10.87 cm/s) increased compared to pre-injection value(31.39 ±10.84 cm/s)(P =0.048). There was a statistically significant decrease(P =0.049) in PSV of CRA at the end of the first month(7.97±2.67 cm/s) compared to the pre-injection(9.47±3.37 cm/s).There was not any statistically significant difference onthe other parameters in the DME group. Also, there was not any statistically significant difference on the ocular blood flow values in the CRVO and CNVM groups.CONCLUSION:We observed that 4 mg/0.1 mL IVTA increased PSV of OA and decreased PSV of CRA in DME patients and did not have any effect on ocular blood flow values of CRVO and CNVM patients.

  7. Short-term effects of intravitreal triamcinolone acetonide injection on ocular blood flow evaluated with color Doppler ultrasonography

    Mustafa Alpaslan Anayol


    Full Text Available AIM:To evaluate the changes in ocular blood flow with color Doppler ultrasonography (CDU after intravitreal triamcinolone acetonide (IVTA injection.METHODS: A total of 46 patients who underwent IVTA (4 mg/0.1 mL injection for diabetic macular edema (DME (n=22, central retinal vein occlusion (CRVO (n=12 and choroidal neovascular membrane (CNVM (n=12 were included in the study. Peak systolic velocity (PSV, end diastolic velocity (EDV and resistivity index (RI were measured from the ophthalmic artery (OA, the central retinal artery (CRA and the posterior ciliary artery (PCA of each patient with CDU before, at the end of the first week and at the end of the first month following IVTA injection.RESULTS:In the DME group, PSV of OA at the first of the first month (mean±SD (37.48±10.87 cm/s increased compared to pre-injection value (31.39±10.84 cm/s (P=0.048. There was a statistically significant decrease (P=0.049 in PSV of CRA at the end of the first month (7.97±2.67 cm/s compared to the pre-injection (9.47±3.37 cm/s. There was not any statistically significant difference on the other parameters in the DME group. Also, there was not any statistically significant difference on the ocular blood flow values in the CRVO and CNVM groups.CONCLUSION: We observed that 4 mg/0.1 mL IVTA increased PSV of OA and decreased PSV of CRA in DME patients and did not have any effect on ocular blood flow values of CRVO and CNVM patients.

  8. Update and critical appraisal of combined timolol and carbonic anhydrase inhibitors and the effect on ocular blood flow in glaucoma patients

    Adam M Moss


    Full Text Available Adam M Moss, Alon Harris, Brent Siesky, Deepam Rusia, Kathleen M Williamson, Yochai ShoshaniDepartment of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, USAAbstract: Topical hypotensive therapy with both timolol and carbonic anhydrase inhibitors has been shown to be efficacious at reducing intraocular pressure. Many prospective studies have also suggested that carbonic anhydrase inhibitors augment ocular blood flow and vascular regulation independent of their hypotensive effects. Although consistent in their findings, these studies must be cautiously interpreted due to the limitations of study design and specific blood flow imaging modalities. The purpose of this review is to appraise and critically evaluate the current body of literature investigating the effects of combined treatment with topical carbonic anhydrase inhibitors and timolol in patients with glaucoma with respect to ocular blood flow, visual function, and optic nerve head structure.Keywords: ocular blood flow, carbonic anhydrase inhibitor, timolol, glaucoma, visual function, optic nerve head

  9. Update and critical appraisal of combined timolol and carbonic anhydrase inhibitors and the effect on ocular blood flow in glaucoma patients.

    Moss, Adam M; Harris, Alon; Siesky, Brent; Rusia, Deepam; Williamson, Kathleen M; Shoshani, Yochai


    Topical hypotensive therapy with both timolol and carbonic anhydrase inhibitors has been shown to be efficacious at reducing intraocular pressure. Many prospective studies have also suggested that carbonic anhydrase inhibitors augment ocular blood flow and vascular regulation independent of their hypotensive effects. Although consistent in their findings, these studies must be cautiously interpreted due to the limitations of study design and specific blood flow imaging modalities. The purpose of this review is to appraise and critically evaluate the current body of literature investigating the effects of combined treatment with topical carbonic anhydrase inhibitors and timolol in patients with glaucoma with respect to ocular blood flow, visual function, and optic nerve head structure.

  10. A prospective study of ocular toxicity in patients receiving ethambutol as a part of directly observed treatment strategy therapy

    Pragati Garg


    Full Text Available Background and Objectives: India is among the largest countries to implement the revised National Tuberculosis Control Program (RNTCP. This program provides intermittent regimens to the patients, where the doses of isoniazid and ethambutol are more as compared to the daily regimen, which is a cause of concern, particularly with regard to the ocular toxicity of ethambutol. The present study was undertaken to explore the ocular toxicity in the patients registered under the program. Materials and Methods: This was a prospective single center cohort study of 64 patients of categories I and II, coming to the RNTCP-Directly Observed Treatment Strategy (DOTS center at a tertiary care referral hospital. The detailed history, best corrected visual acuity, fundus examination, and color vision test were carried out in all patients at the start of treatment and then at the first and second month of treatment. Results: Loss in visual acuity from the baseline was noted at the second month follow up in 12 (9.4% eyes (P = 0.001, visual field defects were seen in eight (6.3% eyes (P = 0.0412, and optic disc abnormalities were observed in six (4.7% (P = 0.013 eyes. Color vision abnormalities were noted in 16 (12.6% eyes (P = 0.003, four eyes showed impairment in red-green color perception, and the others showed impairment in blue-yellow color perception as well. Patients with ocular symptoms were advised to stop ethambutol and they showed improvement in visual acuity after follow up of one to two months. The overall outcome of treatment was not affected by discontinuation of ethambutol in these patients. Conclusion: Ethambutol when taken according to program could cause ocular toxicity. The early recognition of ocular symptoms is important to prevent unnecessary delay in diagnosis and probable irreversible visual loss.

  11. Ocular toxocariasis.

    Arevalo, J Fernando; Espinoza, Juan V; Arevalo, Fernando A


    Ocular toxocariasis is an uncommon worldwide parasitic infection that affects mostly children and is found in both rural and metropolitan areas. In many parts of the world, parasitic infections of the eye are a major cause of blindness. The diagnosis of toxocariasis is essentially clinical, based on the lesion morphology and supportive laboratory data such as serum enzyme-linked immunosorbent assay (ELISA) titers and ELISA Toxocara titers on aqueous humor; other diagnostic methods are imaging studies including optical coherence tomography, fluorescein angiography, computed tomography, and ocular ultrasound. Treatment is directed at complications arising from intraocular inflammation and vitreous membrane traction. Early vitrectomy may be of value both diagnostically and therapeutically.

  12. Ocular Melanoma

    ... Español Eye Health / Eye Health A-Z Ocular Melanoma Sections What is Ocular Melanoma? Ocular Melanoma Causes ... Melanoma Diagnosis Ocular Melanoma Treatment What is Ocular Melanoma? Leer en Español: ¿Qué Es el Melanoma Ocular? ...

  13. Mapping blood flow directionality in the human brain.

    Park, Sung-Hong; Do, Won-Joon; Choi, Seung Hong; Zhao, Tiejun; Bae, Kyongtae Ty


    Diffusion properties of tissue are often expressed on the basis of directional variance, i.e., diffusion tensor imaging. In comparison, common perfusion-weighted imaging such as arterial spin labeling yields perfusion in a scalar quantity. The purpose of this study was to test the feasibility of mapping cerebral blood flow directionality using alternate ascending/descending directional navigation (ALADDIN), a recently-developed arterial spin labeling technique with sensitivity to blood flow directions. ALADDIN was applied along 3 orthogonal directions to assess directional blood flow in a vector form and also along 6 equally-spaced directions to extract blood flow tensor matrix (P) based on a blood flow ellipsoid model. Tensor elements (eigenvalues, eigenvectors, etc) were calculated to investigate characteristics of the blood flow tensor, in comparison with time-of-flight MR angiogram. While the directions of the main eigenvectors were heterogeneous throughout the brain, regional clusters of blood flow directionality were reproducible across subjects. The technique could show heterogeneous blood flow directionality within and around brain tumor, which was different from that of the contralateral normal side. The proposed method is deemed to provide information of blood flow directionality, which has not been demonstrated before. The results warrant further studies to assess changes in the directionality map as a function of scan parameters, to understand the signal sources, to investigate the possibility of mapping local blood perfusion directionality, and to evaluate its usefulness for clinical diagnosis.

  14. Non-viral therapeutic approaches to ocular diseases: An overview and future directions.

    Zulliger, Rahel; Conley, Shannon M; Naash, Muna I


    Currently there are no viable treatment options for patients with debilitating inherited retinal degeneration. The vast variability in disease-inducing mutations and resulting phenotypes has hampered the development of therapeutic interventions. Gene therapy is a logical approach, and recent work has focused on ways to optimize vector design and packaging to promote optimized expression and phenotypic rescue after intraocular delivery. In this review, we discuss ongoing ocular clinical trials, which currently use viral gene delivery, but focus primarily on new advancements in optimizing the efficacy of non-viral gene delivery for ocular diseases. Non-viral delivery systems are highly customizable, allowing functionalization to improve cellular and nuclear uptake, bypassing cellular degradative machinery, and improving gene expression in the nucleus. Non-viral vectors often yield transgene expression levels lower than viral counterparts, however their favorable safety/immune profiles and large DNA capacity (critical for the delivery of large ocular disease genes) make their further development a research priority. Recent work on particle coating and vector engineering presents exciting ways to overcome limitations of transient/low gene expression levels, but also highlights the fact that further refinements are needed before use in the clinic.

  15. The effect of ageing on ocular blood flow, oxygen tension and retinal function during and after intraocular pressure elevation.

    Jeremiah K H Lim

    Full Text Available PURPOSE: To investigate the effect of ageing on the recovery of ocular blood flow, intravitreal oxygen tension and retinal function during and after intraocular pressure (IOP elevation. METHODS: Long Evans rats (3- and 14-month-old underwent acute stepwise IOP elevation from 10 to 120 mmHg (5 mmHg steps each 3 minutes. IOP was then returned to baseline and recovery was monitored for 2 hours. Photopic electroretinograms (ERG were recorded at each IOP step during stress and at each minute during recovery. Ocular blood flow and vitreal oxygen tension (pO2 were assayed continuously and simultaneously using a combined laser Doppler flow meter (LDF and an oxygen sensitive fibre-optic probe, respectively. The combined sensor was placed in the vitreous chamber, proximal to the retina. Data were binned into 3 minute intervals during stress and 1 min intervals during recovery. Recovery data was described using a bi-logistic function. RESULTS: Rats of both ages showed similar susceptibility to IOP elevation, with pO2 showing a closer relationship to ERG than LDF. During recovery, both ages showed a distinctive two-phased recovery for all three measures with the exception of the LDF in 3-month-old rats, which showed only 1 phase. In all animals, LDF recovered fastest (1 hour. 14-month-old rats showed surprisingly faster and greater LDF recovery compared to the younger group, with similar levels of pO2 recovery. However, the ERG in these middle-aged animals did not fully recover after two hours, despite showing no difference in susceptibility to IOP during stress compared to the young group. CONCLUSIONS: Young and middle-aged eyes showed similar susceptibility to IOP elevation in terms of pO2, LDF and ERG. Despite this lack of difference during stress, older eyes did not completely recover function, suggesting a more subtle age-related susceptibility to IOP.

  16. In vitro biocompatibility of degradable biopolymers in cell line cultures from various ocular tissues: direct contact studies.

    Huhtala, A; Pohjonen, T; Salminen, L; Salminen, A; Kaarniranta, K; Uusitalo, H


    Synthetic biodegradable polymers have many potential therapeutic applications. In ophthalmology, biodegradable polymers have been used as viscoelastic agents and surgical implants. Other potential applications include controlled release of drugs and growth factors, gene therapy, and tissue engineering. In the present study, in vitro biocompatibility of three biodegradable polymers, 50:50 PDLGA, 85:15 PDLGA, and Inion GTR membrane was evaluated in comparison to tissue culture polystyrene by investigating cell proliferation and potential acute toxicity by the WST-1 cytotoxicity/cell proliferation test, the ATP test, and the lactate dehydrogenase (LDH) test. Evaluations were conducted with cell line cultures from various ocular tissues, human corneal epithelial cells (HCE), rabbit stromal fibroblasts (SIRC), bovine corneal endothelial cells (BCE), human conjunctival epithelial cells (IOBA-NHC), and human retinal pigment epithelial cells (ARPE-19) by direct contact studies by plating the cells on the polymer film specimens in 96-wells. The proliferation results show that cell lines from various ocular tissues attached and grew on PDLGA 50:50, PDLGA 85:15, and Inion GTR membrane. Cytotoxicity experiments with the LDH and ATP tests showed no or extremely slight toxic adverse effects. These polymers have potential to be used as scaffolds in cell transplantation devices or as surgical implants. Copyright (c) 2007 Wiley Periodicals, Inc.

  17. Mirtogenol® potentiates latanoprost in lowering intraocular pressure and improves ocular blood flow in asymptomatic subjects

    Robert D Steigerwalt Jr


    Full Text Available Robert D Steigerwalt Jr1, Gianni Belcaro1, Paolo Morazzoni2, Ezio Bombardelli2, Carolina Burki3, Frank Schönlau4 1Department of Biomedical Sciences, University of Chieti-Pescara, San Valentino, Italy; 2Indena S.p.A. Scientific Department, Milan, Italy; 3Horphag Research (UK Ltd., Geneva, Switzerland; 4Horphag Research (UK Ltd. South Kensington, London UKPurpose: The dietary supplement Mirtogenol® was previously shown to lower elevated intraocular pressure (IOP. We here present the effects of this supplement on IOP in comparison as well as in combination with latanoprost eye drops. Methods: Seventy-nine patients with asymptomatic ocular hypertension were randomly assigned to three groups receiving either the supplement, or latanoprost eye drops, or both in combination. Intraocular pressure and retinal blood flow were investigated in monthly intervals over 24 weeks.Results: Mirtogenol alone lowered IOP from baseline 38.1 to 29.0 mmHg after 16 weeks, with little further improvement during the following eight weeks. Latanoprost rapidly lowered IOP from baseline 37.7 to 27.2 mmHg within four weeks, without further effects thereafter. The combination of the supplement and latanoprost lowered IOP from 38.0 to 27.3 mmHg after four weeks, and further decreased IOP to 24.2 mmHg after six weeks. After 24 weeks IOP with the combination treatment (23.0 mmHg was significantly lower than with latanoprost alone (27.2 mmHg. Mirtogenol and latanoprost individually showed comparable effects for gradually increasing central artery blood flow with treatment duration. Combination treatment showed higher systolic blood flow velocity throughout the trial period. The diastolic blood flow velocity gradually increased with treatment duration in all three groups. From twelve weeks onwards, the diastolic component with combination treatment was higher than with individual treatments.Conclusions: Mirtogenol lowered elevated IOP in patients almost as effectively as

  18. Direct determination of internal radiation dose in human blood

    Tanır, Ayse Güneş; Güleç, Özge


    The purpose of this study is to measure the internal radiation dose using a human blood sample. In the literature, there is no process that allows the direct measurement of the internal radiation dose received by a person. The luminescence counts from a blood sample having a laboratory-injected radiation dose and the waste blood of the patient injected with a radiopharmaceutical for diagnostic purposes were both measured. The decay and dose-response curves were plotted for the different doses...

  19. Direct determination of internal radiation dose in human blood

    Tanır, Ayse Güneş


    The purpose of this study is to measure the internal radiation dose using a human blood sample. In the literature, there is no process that allows the direct measurement of the internal radiation dose received by a person. The luminescence counts from a blood sample having a laboratory-injected radiation dose and the waste blood of the patient injected with a radiopharmaceutical for diagnostic purposes were both measured. The decay and dose-response curves were plotted for the different doses. The doses received by the different blood aliquots can be determined by interpolating the luminescence counts to the dose-response curve. This study shows that the dose received by a person can be measured directly, simply and retrospectively by using only a very small amount of blood sample. The results will have important ramifications for the medicine and healthcare fields in particular. This will also be very important in cases of suspicion of radiation poisoning, malpractice and so on.

  20. Presence or absence of ocular surface inflammation directs clinical and therapeutic management of dry eye

    Sambursky R


    Full Text Available Robert Sambursky Coastal Eye Institute, Cornea and Comprehensive Ophthalmology, Bradenton, FL, USA Background: The presence of clinically significant inflammation has been confirmed in the tears of 40%–65% of patients with symptoms of dry eye. Ocular surface inflammation may lead to tear film instability, epithelial cell irregularities, and permeability, resulting in chronic symptomatic pain and fluctuating vision as well as negative surgical outcomes.Patients and methods: A retrospective single center medical chart review of 100 patients was conducted. All patients were tested with the InflammaDry test to determine if patients exhibited elevated levels of matrix metalloproteinase 9 (MMP-9. InflammaDry-positive patients were started on a combination of cyclosporine 0.05% twice daily, 2,000–4,000 mg oral omega-3 fatty acids, and frequent artificial tear replacement. InflammaDry-negative patients were started on 2,000–4,000 mg of oral omega-3 fatty acids and frequent artificial tear replacement. Each patient was retested at ~90 days. A symptom questionnaire was performed at the initial visit and at 90 days.Results: 60% of the patients with dry eye symptoms tested positive for elevated MMP-9 at the initial visit. 78% of all patients returned for follow-up at ~90 days including 80% (48/60 of the previously InflammaDry-positive patients and 75% (30/40 of the previously InflammaDry-negative patients. A follow-up symptom questionnaire reported at least 75% symptomatic improvement in 65% (31/48 of the originally InflammaDry-positive patients and in 70% (21/30 of the initially InflammaDry-negative patients. Symptomatic improvement of at least 50% was reported in 85% (41/48 of previously InflammaDry-positive patients and 86% (26/30 of previously InflammaDry-negative patients. Following treatment, 54% (26/48 of previously InflammaDry-positive patients converted to a negative InflammaDry result.Conclusion: Identifying which symptomatic dry eye

  1. Short-term effects of brimonidine/timolol and dorzolamide/timolol on ocular perfusion pressure and blood flow in glaucoma.

    Siesky, Brent; Harris, Alon; Ehrlich, Rita; Cantor, Louis; Shoja, Mohammadali M; Rusia, Deepam; Hollander, David A; Abrams, Leslie; Williams, Julia M; Shoshani, Yochai


    To examine the comparative short-term effects of brimonidine/timolol and dorzolamide/timolol on ocular perfusion pressure and retrobulbar blood flow in patients with primary open angle glaucoma (OAG). In a prospective, randomized, double-blind, crossover study, intraocular pressure (IOP), blood pressure (BP), ocular perfusion pressure (OPP), and retrobulbar hemodynamics were assessed in 15 patients with OAG (mean age 68.1 years, eight women) with well controlled IOP. IOP was measured by Goldman applanation tonometery and color Doppler imaging was utilized to assess the retrobulbar blood vessels before and 1 month after treatment with topical brimonidine/timolol and dorzolamide/timolol. Statistical analysis was performed by Friedman two-way analysis of variance by ranks and post-hoc Wilcoxon signed rank test for multiple comparisons with Holm's sequential Bonferroni procedure. P values <0.05 were considered statistically significant. The Friedman test and subsequent post-hoc analysis indicated that IOP, BP, OPP, and retrobulbar blood flow velocities did not significantly differ between brimonidine/timolol and dorzolamide/timolol after 1-month treatment administration in patients with OAG and well controlled IOP. In this cohort of patients with OAG, short-term treatment with brimonidine/timolol and dorzolamide/timolol results in similar effects on OPP and retrobulbar blood flow velocities.

  2. Direct determination of radiation dose in human blood

    Tanir, Ayse Gunes; Sahiner, Eren; Bolukdemir, Mustafa Hicabi; Koc, Kemal; Meric, Niyazi; Kelec, Sule Kaya


    Our purpose is to measure the internal radiation dose (ID) using human blood sample. In the literature, there is no process that allows the direct measurement of ID received by a person. This study has shown that it is possible to determine ID in human blood exposed to internal or external ionizing radiation treatment both directly and retrospectively. OSL technique was used to measure the total dose from the blood sample. OSL counts from the waste blood of the patient injected with a radiopharmaceutical for diagnostic or treatment purposes and from a blood sample having a laboratory-injected radiation dose were both used for measurements. The decay and dose-response curves (DRC) were plotted for different doses. The doses received by different blood aliquots have been determined by interpolating the natural luminescence counts to DRC. In addition, OSL counts from a healthy blood sample exposed to an external radiation source were measured. The blood aliquots were given different 0-200Gy beta doses and their ...

  3. Direct determination of external radiation dose in human blood

    Tanir, AG; Sahiner, E; Bolukdemir, MH; Koc, K; Meric, N; Keles, SK; Kucuk, O


    In this study it was shown that it is possible to determine radiation doses from external beam therapy both directly and retrospectively from a human blood sample. To the best of our knowledge no other studies exist on the direct measurement of doses received by a person from external beam therapy. Optically stimulated luminescence counts from a healthy blood sample exposed to an external radiation source were measured. Blood aliquots were given 0, 1, 2, 3, 4, 5, 10, 15, 20, 25, 50, 100 and 200Gy beta doses and their decay and dose-response curves were plotted. While the luminescence intensities were found to be relatively low for the doses smaller than 10Gy, they were measured considerably higher for doses greater than 10Gy. The dose received by the blood aliquots was determined by interpolating the luminescence counts of 10Gy to the dose-response curve. This study has important ramifications for healthcare, medicine and radiation protection

  4. Estimating the cost of blood: past, present, and future directions.

    Shander, Aryeh; Hofmann, Axel; Gombotz, Hans; Theusinger, Oliver M; Spahn, Donat R


    Understanding the costs associated with blood products requires sophisticated knowledge about transfusion medicine and is attracting the attention of clinical and administrative healthcare sectors worldwide. To improve outcomes, blood usage must be optimized and expenditures controlled so that resources may be channeled toward other diagnostic, therapeutic, and technological initiatives. Estimating blood costs, however, is a complex undertaking, surpassing simple supply versus demand economics. Shrinking donor availability and application of a precautionary principle to minimize transfusion risks are factors that continue to drive the cost of blood products upward. Recognizing that historical accounting attempts to determine blood costs have varied in scope, perspective, and methodology, new approaches have been initiated to identify all potential cost elements related to blood and blood product administration. Activities are also under way to tie these elements together in a comprehensive and practical model that will be applicable to all single-donor blood products without regard to practice type (e.g., academic, private, multi- or single-center clinic). These initiatives, their rationale, importance, and future directions are described.

  5. Highly sensitive detection of Staphylococcus aureus directly from patient blood.

    Padmapriya P Banada

    Full Text Available BACKGROUND: Rapid detection of bloodstream infections (BSIs can be lifesaving. We investigated the sample processing and assay parameters necessary for highly-sensitive detection of bloodstream bacteria, using Staphylococcus aureus as a model pathogen and an automated fluidic sample processing-polymerase chain reaction (PCR platform as a model diagnostic system. METHODOLOGY/PRINCIPAL FINDINGS: We compared a short 128 bp amplicon hemi-nested PCR and a relatively shorter 79 bp amplicon nested PCR targeting the S. aureus nuc and sodA genes, respectively. The sodA nested assay showed an enhanced limit of detection (LOD of 5 genomic copies per reaction or 10 colony forming units (CFU per ml blood over 50 copies per reaction or 50 CFU/ml for the nuc assay. To establish optimal extraction protocols, we investigated the relative abundance of the bacteria in different components of the blood (white blood cells (WBCs, plasma or whole blood, using the above assays. The blood samples were obtained from the patients who were culture positive for S. aureus. Whole blood resulted in maximum PCR positives with sodA assay (90% positive as opposed to cell-associated bacteria (in WBCs (71% samples positive or free bacterial DNA in plasma (62.5% samples positive. Both the assays were further tested for direct detection of S. aureus in patient whole blood samples that were contemporaneous culture positive. S. aureus was detected in 40/45 of culture-positive patients (sensitivity 89%, 95% CI 0.75-0.96 and 0/59 negative controls with the sodA assay (specificity 100%, 95% CI 0.92-1. CONCLUSIONS: We have demonstrated a highly sensitive two-hour assay for detection of sepsis causing bacteria like S. aureus directly in 1 ml of whole blood, without the need for blood culture.

  6. Assessment of effect of intravitreal ranibizumab injection on the ocular blood flow in patients with neovascular age-related macular degeneration

    V. V. Neroev


    Full Text Available Purpose: To evaluate the effect of intravitreal ranibizumab injection on the ocular blood flow in patients with neovascular agerelatedmacular degeneration (AMD.Methods: 35 patients with wet AMD undergone intravitreal 0.5 mg ranibizumab injection. Color Doppler Imaging (CDI and dopplerographywere used to measure hemodynamic parameters including the peak systolic velocity (Vsyst, cm / s, end-diastolic velocity (V diast, cm / s, and resistance index (RI of blood flow in the central retinal artery (CRA, the short posterior ciliary arteries (PCA, and the ophthalmic artery (OA. All patients were examined before and after injection on day 1‑7 and 30 day during the 3‑month follow up period.Results: Before intravitreal injection Vsyst was decreased in short PCA (p<0.05, RI in CRA and in short PCA significantly increased in comparison with normal index in same vessels. The peak systolic velocity in OA, in CRA and in short PCA was not significantly changed. After second injection resistance index in CRA and in short PCA was normalized.Conclusion: There was not impairment of ocular blood flow in retinal and choroidal after monthly intravitreal injection of ranibizumab during the 3‑month follow up period.

  7. Assessment of effect of intravitreal ranibizumab injection on the ocular blood flow in patients with neovascular age-related macular degeneration

    V. V. Neroev


    Full Text Available Purpose: To evaluate the effect of intravitreal ranibizumab injection on the ocular blood flow in patients with neovascular agerelatedmacular degeneration (AMD.Methods: 35 patients with wet AMD undergone intravitreal 0.5 mg ranibizumab injection. Color Doppler Imaging (CDI and dopplerographywere used to measure hemodynamic parameters including the peak systolic velocity (Vsyst, cm / s, end-diastolic velocity (V diast, cm / s, and resistance index (RI of blood flow in the central retinal artery (CRA, the short posterior ciliary arteries (PCA, and the ophthalmic artery (OA. All patients were examined before and after injection on day 1‑7 and 30 day during the 3‑month follow up period.Results: Before intravitreal injection Vsyst was decreased in short PCA (p<0.05, RI in CRA and in short PCA significantly increased in comparison with normal index in same vessels. The peak systolic velocity in OA, in CRA and in short PCA was not significantly changed. After second injection resistance index in CRA and in short PCA was normalized.Conclusion: There was not impairment of ocular blood flow in retinal and choroidal after monthly intravitreal injection of ranibizumab during the 3‑month follow up period.

  8. A microfluidic chip for direct and rapid trapping of white blood cells from whole blood.

    Chen, Jingdong; Chen, Di; Yuan, Tao; Xie, Yao; Chen, Xiang


    Blood analysis plays a major role in medical and science applications and white blood cells (WBCs) are an important target of analysis. We proposed an integrated microfluidic chip for direct and rapid trapping WBCs from whole blood. The microfluidic chip consists of two basic functional units: a winding channel to mix and arrays of two-layer trapping structures to trap WBCs. Red blood cells (RBCs) were eliminated through moving the winding channel and then WBCs were trapped by the arrays of trapping structures. We fabricated the PDMS (polydimethylsiloxane) chip using soft lithography and determined the critical flow velocities of tartrazine and brilliant blue water mixing and whole blood and red blood cell lysis buffer mixing in the winding channel. They are 0.25 μl/min and 0.05 μl/min, respectively. The critical flow velocity of the whole blood and red blood cell lysis buffer is lower due to larger volume of the RBCs and higher kinematic viscosity of the whole blood. The time taken for complete lysis of whole blood was about 85 s under the flow velocity 0.05 μl/min. The RBCs were lysed completely by mixing and the WBCs were trapped by the trapping structures. The chip trapped about 2.0 × 10(3) from 3.3 × 10(3) WBCs.

  9. Comparison of Intraocular Pressure, Blood Pressure, Ocular Perfusion Pressure and Blood Flow Fluctuations During Dorzolamide Versus Timolol Add-On Therapy in Prostaglandin Analogue Treated Glaucoma Subjects

    Ruta Barsauskaite


    Full Text Available Objective: To compare the effects of dorzolamide and timolol add-on therapy in open-angle glaucoma (OAG patients previously treated with prostaglandin analogue (Pg, by evaluating fluctuations in the intraocular (IOP, blood (BP, ocular perfusion pressures (OPP and retrobulbar blood flow (RBF parameters. Methods: 35 OAG patients (35 eyes, 31 women (88.6% age 63.3 (8.9 years were evaluated in a 3 month randomized, cross-over, single-masked study. During the experiments BP, heart rate, IOP and OPP were assessed 4 times per day (8–12–16–20 h. RBF was measured twice per day (8–20 h using Color Doppler imaging in the ophthalmic (OA, central retinal (CRA, nasal (nSPCA and temporal (tSPCA posterior ciliary arteries. In each vessel, peak systolic velocity (PSV and end-diastolic velocity (EDV were assessed and vascular resistance (RI calculated. Results: Both add-on therapies lowered IOP in a statistically significant manner from 15.7 ± 2.4 mmHg at latanoprost baseline to 14.9 ± 2.2 mmHg using dorzolamide (p < 0.001 and 14.2 ± 1.9 mmHg using timolol (p < 0.001. The IOP lowering effect was statistically significant at 20 h, favoring timolol as compared to dorzolamide (1.4 ± 2.4 vs. 0.2 ± 2.1 mmHg, (p < 0.05. Dorzolamide add-on therapy showed smaller IOP (2.0 ± 1.4, SPP (13.3 ± 7.9, systolic BP (13.5 ± 8.7 and diastolic BP (8.4 ± 5.4 fluctuations as compared to both latanoprost baseline or timolol add-on therapies. Higher difference between morning and evening BP was correlated to decreased evening CRA EDV in the timolol group (c = −0.41; p = 0.01. With increased MAP in the morning or evening hours, we found increased evening OA RI in timolol add-on group (c = 0.400, p = 0.02; c = 0.513, p = 0.002 accordingly. Higher MAP fluctuations were related to impaired RBF parameters during evening hours-decreased CRA EDV (c = −0.408; p = 0.01, increased CRA RI (c = 0.576; p < 0.001 and tSPCA RI (c = 0.356; p = 0.04 in the dorzolamide group and

  10. Directional plasticity rapidly improves 3D vestibulo-ocular reflex alignment in monkeys using a multichannel vestibular prosthesis.

    Dai, Chenkai; Fridman, Gene Y; Chiang, Bryce; Rahman, Mehdi A; Ahn, Joong Ho; Davidovics, Natan S; Della Santina, Charles C


    Bilateral loss of vestibular sensation can be disabling. We have shown that a multichannel vestibular prosthesis (MVP) can partly restore vestibular sensation as evidenced by improvements in the 3-dimensional angular vestibulo-ocular reflex (3D VOR). However, a key challenge is to minimize misalignment between the axes of eye and head rotation, which is apparently caused by current spread beyond each electrode's targeted nerve branch. We recently reported that rodents wearing a MVP markedly improve 3D VOR alignment during the first week after MVP activation, probably through the same central nervous system adaptive mechanisms that mediate cross-axis adaptation over time in normal individuals wearing prisms that cause visual scene movement about an axis different than the axis of head rotation. We hypothesized that rhesus monkeys would exhibit similar improvements with continuous prosthetic stimulation over time. We created bilateral vestibular deficiency in four rhesus monkeys via intratympanic injection of gentamicin. A MVP was mounted to the cranium, and eye movements in response to whole-body passive rotation in darkness were measured repeatedly over 1 week of continuous head motion-modulated prosthetic electrical stimulation. 3D VOR responses to whole-body rotations about each semicircular canal axis were measured on days 1, 3, and 7 of chronic stimulation. Horizontal VOR gain during 1 Hz, 50 °/s peak whole-body rotations before the prosthesis was turned on was <0.1, which is profoundly below normal (0.94 ± 0.12). On stimulation day 1, VOR gain was 0.4-0.8, but the axis of observed eye movements aligned poorly with head rotation (misalignment range ∼30-40 °). Substantial improvement of axis misalignment was observed after 7 days of continuous motion-modulated prosthetic stimulation under normal diurnal lighting. Similar improvements were noted for all animals, all three axes of rotation tested, for all sinusoidal frequencies tested (0.05-5 Hz), and for

  11. Ocular Sarcoidosis

    Pasadhika, Sirichai; Rosenbaum, James T


    Sarcoidosis is one of the leading causes of inflammatory eye disease. Ocular sarcoidosis can involve any part of the eye and its adnexal tissues, and may cause uveitis, episcleritis/scleritis, eyelid abnormalities, conjunctival granuloma, optic neuropathy, lacrimal gland enlargement and orbital inflammation. Glaucoma and cataract can be complications from inflammation itself or adverse effects from therapy. Ophthalmic manifestations can be isolated, or associated with other organ involvement. Patients with ocular sarcoidosis can present with a wide range of clinical presentations and severity. Multi-disciplinary approaches are required to achieve the best treatment outcomes for both ocular and systemic manifestations. PMID:26593141

  12. Traumatismos oculares Ocular traumas

    Gelen Welch Ruiz


    Full Text Available Se realizó un estudio descriptivo de tipo retrospectivo longitudinal cuyo universo estuvo constituido por 72 ojos de 72 pacientes con traumatismos oculares mecánicos que fueron hospitalizados en el Hospital Militar Central “Dr. Carlos J. Finlay” desde enero de 1999 hasta enero de 2005. Para el análisis estadístico de la información se utilizó el programa automatizado SPSS versión 11.5 en el cual también se conformó la base de datos y se realizaron los cálculos de acuerdo con el tipo de variable analizada. Se utilizaron medidas de resumen, tendencia central y asociación estadística con un nivel de significación de p A retrospective longitudinal and descriptive study was carried out in 72 eyes from 72 patients with mechanical occular traumas, who had been hospitalized in “Dr. Carlos J. Finlay” Military Hospital from December 1999 to January 2005. For the statistical data analysis, an automated program (SPSS 11.5 version was used to create the database and estimations were made according to the variable types. Summary measures, central tendency measures and statistical association with significance level equal to p < 0.05 were employed. Males prevailed (95.8%, the average age was 30.26 years with a minimum rate of 17 years and maximum rate of 82 years. The most frequent mechanisms of trauma were aggressions (23. 6% and injures from secondary projectiles (13.9%. The anterior segment traumas were more frequent (61, 1% than posterior segment traumas (6.94%. Both segments of the eyeball were affected in 39, 1% of eyes which evinced the worst visual acuity. The most common associated injures were hyphema (54, 2% and vitreous hemorrhage (16.6%. Closed trauma (contusions were more common and most of the eyes had better final visual acuity (45, 2% with vision range of 0.6-1.0 and 26.2% with vision range of 0.59-0.1. On the other hand, eyes affected by open trauma (simple wound, contusion-wound, wound with intraocular foreign body and

  13. Ocular rosacea

    Đaković Zorana


    Full Text Available Five cases of ocular rosacea (one male and four females are reported in this paper. Two of the patients were with keratoconjunctivitis sicca, one with conjunctivitis chronica and blepharitis, one with conjunctivitis chronica and meibomitis, and one with reccurent corneal erosions with meibomitis and chordeloum. In four patients ocular symptoms preceded the occurence of skin lesions. The treatment with oral tetracyclines significantly improved the state of ocular rosacea in four patients, while in one case the changes of the anterior eye segment progressed in more severe state of ulcerative keratitis. It is considered that in almost 20% of the patients with rosacea ocular lesions may precede the skin changes, representing a diagnostic problem. Thus, in those cases multidisciplinary approach is suggested. Such approach is particularly important because of the decrease of morbidity and the prevention of the onset of the eye complications such as drastic worsening of visual acuity, i.e., the blindness.

  14. Hyperemic responses of the optic nerve head blood flow to chromatic equiluminant flicker are reduced by ocular hypertension and early glaucoma

    Falsini, Benedetto; Riva, Charles E.; Salgarello, Tommaso; Logean, Eric; Colotto, Alberto; Giudiceandrea, Andrea


    We evaluated in ocular hypertension (OHT) and early glaucoma (EOAG) patients the optic nerve head (ONH) blood flow response (RF) to chromatic equiluminant flicker. This stimulus generates neural activity dominated by the parvo-cellular system. Eleven EOAG, 20 OHT patients, and 8 age-matched control subjects were examined. The blood flow (F) at the neuroretinal rim was continuously monitored by laser Doppler flowmetry before, during, and after a 60-s exposure to a 4 Hz, red-green equiluminant flicker stimulus (30 deg field). RF was expressed as percentage F-change during the last 20 s of flicker relative to baseline F. Responses were collected at a number of temporal sites. The highest RF value was used for subsequent analysis. As compared to controls, both OHT and EOAG patients showed a decrease (pRF. We conclude that RF elicited by chromatic equiluminant flicker is abnormally reduced in OHT and EOAG patients indicating an impairment of the parvo-cellular-mediated vasoactivity. This decrease of vascular response may occur independently of neural activity loss early in the disease process.

  15. Application of semi-nested polymerase chain reaction targeting internal transcribed spacer region for rapid detection of panfungal genome directly from ocular specimens

    Bagyalakshmi R


    Full Text Available Background: The incidence of fungal endophthalmitis has dramatically increased in recent years and rapid detection of fungi using nucleic acid-based amplification techniques is helpful in management. Aim: To evaluate semi-nested polymerase chain reaction (PCR targeting internal transcribed spacer (ITS region for detection of panfungal genome in ocular specimens. Statistical analysis used: Z test for two proportion. Materials and Methods: Standardization of PCR targeting ITS primers was carried out by determining analytical sensitivity and specificity. The sensitivity and specificity of PCR was determined by serial tenfold dilutions of C. albicans (ATCC 24433 DNA and DNA extracts of laboratory isolates of Aspergillus fumigatus , Fusarium lichenicola (4, other fungal and closely related bacterial strains and also human DNA. Semi-nested PCR was applied onto a total of 168 ocular specimens with clinically suspected fungal etiology during 2003-2005. Results and Conclusions: PCR was specific and sensitive to detect 1fg of fungal DNA with ITS primers. PCR detected fungal genome in 90 (53.57% in comparison with the conventional technique, positive in 34 (20.23% by smear examination and in 42 (25% by culture. The increase in clinical sensitivity by 28.57% using PCR was found to be statistically significant { P < 0.001 using Z test for two proportion}. The accuracy of the test was found to be 70.85%. PCR proved to be a rapid diagnostic technique for detection of panfungal genome directly from clinical specimens

  16. The Steroid Effect on the Blood-Ocular Barrier Change Induced by Triolein Emulsion as seen on Contrast-Enhanced MR Images

    Lee, Jong Yuk; Eun, Choong Ki [Graduate School of Inje University, College of Medicine, Busan (Korea, Republic of); Kim, Yong Woo [Cincinnati Children' s Hospital Medical Center, Cincinnati (United States); Kim, Hak Jin; Jung, Yeon Joo [Medical Research Center for Ischemic Tissue Regeneration, Busan (Korea, Republic of); Jae, Seung Youn; Cho, Byung Mann; Choi, Seon Hee [College of Medicine, Pusan National University, Busan (Korea, Republic of)


    The purpose of this study is to evaluate the effect of dexamethasone on the damaged blood-ocular barrier caused by triolein emulsion, using contrast-enhanced MR imaging. An emulsion of 0.1-mL triolein in 20 mL of saline was infused into the carotid arteries of 32 cats, 12 cats were placed in the treatment group and 18 cats were placed in the Control group. Thirty minutes after the infusion of triolein emulsion, a set of orbital pre- and post-contrast T1-weighted MR images (T1WIs) were obtained. Infusion of 10 mg/kg dexamethasone into the ipsilateral carotid artery of each of the cats in the treatment group cats and 20 mL saline in each of the cats in the control group was given. A second set of pre- and post-contrast orbital T1WIs were obtained three hours following triolein emulsion infusion. Qualitative analysis was performed for the the anterior chamber (AC), the posterior chamber (PC), and in the vitreous humor of the ipsilateral and contralateral eyes. The signal intensity ratios of the ipsilateral eye over the contralateral eye were quantitatively evaluated in the three ocular chambers on the first and second set of T1WIs, and were then statistically compared. Qualitatively, the AC, the PC or the vitreous did not show immediate contrast enhancement on the first and the second set of post-contrast T1WIs. However, the AC and the PC showed delayed contrast enhancement for both groups of cats on the second pre-contrast T1WIs. No enhancement or minimally delayed enhancement was seen for the vitreous humor. Quantitatively, the signal intensity ratios in the PC of the treatment group of cats were statistically lower than the ratios of the control group of cats for the second set of T1WIs (p = 0.037). The AC and vitreous showed no statistically significant difference between the feline treatment group and control group (p > 0.05). Contrast-enhanced MR images revealed increased vascular permeability in the PC of the eye after infusion of triolein emulsion

  17. Ocular perfusion pressure in glaucoma.

    Costa, Vital P; Harris, Alon; Anderson, Douglas; Stodtmeister, Richard; Cremasco, Fernanda; Kergoat, Helene; Lovasik, John; Stalmans, Ingborg; Zeitz, Oliver; Lanzl, Ines; Gugleta, Konstantin; Schmetterer, Leopold


    This review article discusses the relationship between ocular perfusion pressure and glaucoma, including its definition, factors that influence its calculation and epidemiological studies investigating the influence of ocular perfusion pressure on the prevalence, incidence and progression of glaucoma. We also list the possible mechanisms behind this association, and discuss whether it is secondary to changes in intraocular pressure, blood pressure or both. Finally, we describe the circadian variation of ocular perfusion pressure and the effects of systemic and topical medications on it. We believe that the balance between IOP and BP, influenced by the autoregulatory capacity of the eye, is part of what determines whether an individual will develop optic nerve damage. However, prospective, longitudinal studies are needed to better define the role of ocular perfusion pressure in the development and progression of glaucoma.

  18. Efficacy of 2-Month Treatment With Cord Blood Serum Eye Drops in Ocular Surface Disease: An In Vivo Confocal Microscopy Study.

    Giannaccare, Giuseppe; Buzzi, Marina; Fresina, Michela; Velati, Claudio; Versura, Piera


    To investigate the morphological changes of corneal epithelium and subbasal nerves by in vivo confocal microscopy in patients with ocular surface disease (OSD) treated with cord blood serum (CBS) eye drops. Twenty patients with OSD (mean age 61.1 ± 12.6 years) were included in this prospective 1-arm study and treated with CBS eye drops for 2 months. Corneal sensitivity, Schirmer test score, breakup time, subjective symptoms [Ocular Surface Disease Index (OSDI) and Visual Analogue Scale (VAS)], and corneal staining were evaluated before (T0) and after (T1) treatment. In vivo confocal microscopy analyzed giant epithelial cells, subbasal nerve number and tortuosity, neuromas, beading, and dendritic cells (DCs) in the central cornea. OSDI, Visual Analogue Scale, and Oxford grading values significantly decreased at T1 versus T0 (respectively, 44.1 ± 18.9 vs. 74.2 ± 13.9; 3.7 ± 1.5 vs. 8.9 ± 0.9; and 2.4 ± 1.1 vs. 3.3 ± 1.3; P < 0.0001), whereas corneal sensitivity, Schirmer test score, and breakup time significantly increased (respectively, 49.5 ± 2.6 vs. 47.9 ± 2.9; 3.2 ± 2.0 vs. 2.4 ± 2.2; 4.6 ± 3.1 vs. 3.8 ± 2.1; P < 0.0001). Corneal nerve morphology improved at T1 versus T0 with a higher total nerve number (3.4 ± 1.6 vs. 2.5 ± 1.6 per frame) and lower tortuosity (3.0 ± 0.7 vs. 3.5 ± 0.6) (P < 0.01). The number of patients presenting with giant epithelial cells, beading, and neuromas decreased at T1. DC density did not change after treatment. The detection of neuromas and higher DC density at T0 were associated with greater OSDI reduction at T1 (P < 0.001). CBS eye drops significantly improved corneal nerve morphology and subjective symptoms in patients with severe OSD. The presence of neuromas and higher dendritic cell density at baseline were associated with greater reduction of discomfort symptoms after treatment.

  19. Ocular dirofilariasis

    Nath Reema


    Full Text Available Dirofilaria is a parasite of domestic and wild animals that can infect humans accidentally. It is being reported in increasing numbers from Mediterranean countries like Italy. In India this infection is occasionally being reported. We report three cases of ocular dirofilariasis from the state of Assam presenting as periorbital and subconjunctival cysts. The parasites were identified as Dirofilaria repens. The purpose of this article is to take note of this emerging zoonosis in Assam; also to review literature in the cases reported.

  20. Injeção subconjuntival de soro autógeno no tratamento de queimadura ocular por álcali em coelhos Subconjunctival injection of autogenous blood in the treatment of ocular alcali burn in rabbits

    Marcela Colussi Cypel


    Full Text Available OBJETIVO: Estudar a ação da injeção subconjuntival de soro autógeno na evolução das complicações, após queimadura ocular grave por álcali induzida experimentalmente em coelhos. MÉTODOS: Foram utilizados trinta olhos de coelhos da raça Nova Zelândia, divididos em dois grupos, de 15 coelhos cada, ambos submetidos à queimadura grave por álcali. Em 15 olhos (grupo tratado, efetuamos, imediatamente após a queimadura, injeção de soro autógeno subconjuntival. Os resultados foram avaliados e comparados logo após a queimadura e nos dias 1, 3, 7, 15 e 30 por meio de ectoscopia biomicroscopia ocular. RESULTADOS: O grupo tratado apresentou melhor resposta de reepitelização da córnea, na fase inicial do processo do que o grupo controle (grupo sem soro autógeno, diferença esta estaticamente significante, assim como resultado final com um menor número de complicações. CONCLUSÃO: Os resultados obtidos neste estudo experimental sugerem que soro autógeno pode ter efeito no processo de cicatrização dos olhos após queimadura alcalina, diminuindo complicações tardias e melhorando o prognóstico quanto à estabilidade do processo inflamatório cicatricial.PURPOSE: To determine the activity of subconjunctival injection of autogenous serum in the treatment of ocular alkali burn induced experimentally in rabbits. METHODS: Thirty eyes of 30 New Zeland albino rabbits were divided into two groups of 15 and submitted to ocular alkali burn. One group (treated group received immediately after the alkali burn a subconjunctival injection of autogenous serum. The results were compared and recorded immediately after the alkali burn and on days 1, 3, 7, 15, and 30 by external ocular examination and manual portable slit lamp. RESULTS: The treated group presented a better reepithelialization of the cornea than the control group, in the beginning of the process, with a statistically significant difference; and a final result with less complications


    Mulla Summaiya A; Khokhar Neeta D; Revdiwala Sangita B


    Background: Isolation of common pathogens involved in ocular infection and their in-vitro susceptibility to commonly used ocular antibiotics, as well as the trends in antibiotic resistance developed by these pathogens were investigated. Material/Methods: All patients with suspected bacterial ocular infections presenting between march 2010 and feb 2011 were examined under slit lamp microscope and samples were collected by using aseptic techniques. All samples were processed for direct microsco...

  2. Cisticercosis ocular

    Danaides Arencibia González

    Full Text Available La cisticercosis establece un grupo de enfermedades zoonóticas parasitarias; cuando se aloja en el ojo y sus anexos producen una cisticercosis ocular y periocular. Constituye una de las causas de uveítis ocular y pérdida importante de la visión. El diagnóstico clínico se realiza mediante la observación directa del parásito, cuando existen opacidades de los medios, el ultrasonido se emplea como medio diagnóstico útil. Los anti helmintos asociados a esteroides forman parte de su terapéutica, sumado al tratamiento definitivo de la extracción del parásito, en este tipo de afección mediante vitrectomía vía pars plana. Se presenta un caso portador de esta condición, se describen las características más importantes del cuadro clínico, diagnóstico, manejo y curso evolutivo-terapéutico.

  3. Complete Blood Count and Retinal Vessel Calibers

    Gerald Liew; Jie Jin Wang; Elena Rochtchina; Tien Yin Wong; Paul Mitchell


    OBJECTIVE: The influence of hematological indices such as complete blood count on microcirculation is poorly understood. Retinal microvasculature can be directly visualized and vessel calibers are associated with a range of ocular and systemic diseases. We examined the association of complete blood count with retinal vessel calibers. METHODS: Cross-sectional population-based Blue Mountains Eye Study, n = 3009, aged 49+ years. Complete blood count was measured from fasting blood samples taken ...

  4. Prevalence of bacterial pathogens causing ocular infections in South India

    Ramesh S


    Full Text Available Background / Aims: The eye may be infected from external sources or through intra-ocular invasion of micro-organisms carried by the blood stream. This study was undertaken to isolate and identify the specific bacterial pathogens causing ocular infections and to determine their in-vitro antibacterial susceptibilities to commonly used antibacterial agents. Materials and Methods: A retrospective analysis of all patients with clinically diagnosed bacterial ocular infections such as blepharitis, conjunctivitis, internal and external hordeolum, suppurative scleritis, canaliculitis, keratitis, dacryocystitis, preseptal cellulitis, endophthalmitis and panophthalmitis presenting between January 2005 and December 2005 was performed. Extra-ocular and intra-ocular specimens were collected and were subjected to direct microscopy and culture. Results: A total of 756 patients with bacterial ocular infections were analyzed, of which 462(61% eyes had adnexal bacterial infection, 217(28.7% had corneal infection, 6 (0.8% had scleral involvement and the remaining 71(9.39% eyes had infection of the intra-ocular tissues. The predominant bacterial species isolated was S. aureus (195 of 776; 25% followed by S. pneumoniae (169 of 776; 21.78% and coagulase negative staphylococci (142 of 776; 18.3%. The largest number of gram-positive isolates were susceptible to cefazolin (545 of 624; 87.34%, chloramphenicol (522 of 624; 83.65% and gatifloxacin (511 of 624; 81.89% and gram-negative isolates were to amikacin (127 of 136; 93.38%, gatifloxacin (125 of 136; 91.91% and ofloxacin (119 of 136; 87.5%, while aerobic actinomycetes were to amikacin (100%, gatifloxacin (14 of 16; 87.5%, chloramphenicol (14 of 16; 87.5% and ofloxacin (13 of 16; 81.25%. Conclusions: S. aureus frequently causes infections of eyelids and conjunctiva, S. pneumoniae of lacrimal apparatus and cornea and coagulase negative staphylococci causes intra-ocular infections. Of all routinely used antibacterials

  5. Real-time PCR detection of Plasmodium directly from whole blood and filter paper samples

    Taylor, Brian. J.; Martin, Kimberly A; Arango, Eliana; Agudelo, Olga M; Maestre, Amanda; Yanow, Stephanie K.


    Background Real-time PCR is a sensitive and specific method for the analysis of Plasmodium DNA. However, prior purification of genomic DNA from blood is necessary since PCR inhibitors and quenching of fluorophores from blood prevent efficient amplification and detection of PCR products. Methods Reagents designed to specifically overcome PCR inhibition and quenching of fluorescence were evaluated for real-time PCR amplification of Plasmodium DNA directly from blood. Whole blood from clinical s...

  6. Skin and muscle components of forearm blood flow in directly heated resting man.

    Detry, J.-M. R.; Brengelmann, G. L.; Rowell, L. B.; Wyss, C.


    Changes in forearm muscle blood flow (FMBF) during direct whole-body heating were measured in 17 normal subjects using three different methods. We conclude that FMBF is not increased by direct whole-body heating. Since renal and splanchnic blood flow fall 30% under these conditions, maximal total skin blood flow in 12 previously studied subjects can be estimated from the rise in cardiac output to be 7.6 L/min (3.0-11.1 L/min).

  7. Vasoinhibins: novel inhibitors of ocular angiogenesis.

    Clapp, Carmen; Thebault, Stéphanie; Arnold, Edith; García, Celina; Rivera, José Carlos; de la Escalera, Gonzalo Martínez


    Disruption of the quiescent state of blood vessels in the retina leads to aberrant vasopermeability and angiogenesis, the major causes of vision loss in diabetic retinopathy. Prolactin is expressed throughout the retina, where it is proteolytically cleaved to vasoinhibins, a family of peptides (including the 16-kDa fragment of prolactin) with potent antiangiogenic, vasoconstrictive, and antivasopermeability actions. Ocular vasoinhibins act directly on endothelial cells to block blood vessel growth and dilation and to promote apoptosis-mediated vascular regression. Also, vasoinhibins prevent retinal angiogenesis and vasopermeability associated with diabetic retinopathy, and inactivation of endothelial nitric oxide synthase via protein phosphatase 2A is among the various mechanisms mediating their actions. Here, we discuss the potential role of vasoinhibins both in the maintenance of normal retinal vasculature and in the cause and prevention of diabetic retinopathy and other vasoproliferative retinopathies.

  8. Toxoplasmosis and its Ocular Manifestations

    Koev Kr.


    Full Text Available The present review provides general information about the parasitic infection of toxoplasmosis and describes the ways of its transmission. It outlines the importance of the consequences of toxoplasmosis infection and the methods of its prevention. The review traces the harmful effects of the disease on human and animal organisms, the causes and stages of development of the disease. The review specifically focuses on the ocular manifestations of toxoplasmosis which can cause ocular lesions, inflammation and scarring. Herein are described the ways toxoplasmosis can damage the eyes causing chorioretinitis, nystagmus, microphthalmia, etc. Furthermore, the review addresses the problem of how congenital and acquired toxoplasmosis affects eyes. The ocular symptoms of toxoplasmosis include weakened or blurred vision, eyeballs pain, ocular sensitivity to light, etc. The harmful effects of toxoplasmosis to pregnant women and immunocompromised patients have been delineated. Some of the disease manifestations include jaundice, rash, asphyxia, etc. The review traces the diagnostic work-up and comments on common tests for toxoplasmosis, such as taking of blood serum samples. The review ends with the treatment of the disease and of its ocular manifestations in particular, for example application of intravitreous injection. The prevention of the infection is extremely important for pregnant women, immunocompromised patients and patients with AIDS.

  9. Effects of C-nitropyrazoles and C-nitroazoles on ocular blood flow and retinal function recovery after ischemic insult%C-硝基吡唑类和C-硝基吡咯类对局部缺血损伤后眼血流量和视网膜功能恢复的作用

    Bo XUAN; Tao WANG; George CY CHIOU; Igor L'vovich DALINGER; Tatyana Konstantinovna SHKINEVA; Svyatoslav Arkadievich SHEVELEV


    AIM: Effects of C-nitropyrazoles and C-nitroazoles on ocular blood flow and retinal.function recovery after ischemia have been studied. METHODS: The compounds were tested on ocular blood flow of ocular hyperten sive (40 mmHg) rabbit eyes with colored microsphere technique. They were also tested on the retinal function recovery after ischemia of rat eyes with electroretinography. RESULTS: All compounds (DC-1 through DC-17)showed significant increase in retinal function recovery after ischemia in the range of 26 % to 120 %(P<0.05). Among five compounds (DC-1 through DC-5) studied, four compounds (DC-2 through DC-5) in creased the blood flow in ehoroid, iris, and ciliary body, but not in retina. DC-1 did not show significant increase of blood flow in any of these ocular tissues. CONCLUSION: C-Nitropyrazoles can facilitate significant retinal function recovery after ischemic insult through the increase of ocular blood flow. Since rabbit's retina is scarce in vasculature, it did not show significant change in blood flow by C-nitropyrazoles as expected. Among all 17 compounds, DC-5 seems to be the most potent compound.

  10. Adult Ocular Toxocariasis Mimicking Ciliary Body Malignancy

    Ahmad M. Mansour


    Full Text Available Purpose. To discuss an unusual presentation of ocular toxocariasis. Methods. Case report. Results. A 40-year-old woman presented with decreased vision in the left eye with a long history of recurrent red eye from uveitis. Eosinophilia and positive ELISA titers for Toxocara canis favored the diagnosis of ocular toxocariasis. Over 3 months, an anterior scleral mass had a rapid growth raising the possibility of medulloepithelioma, which rarely can mimic uveitic syndromes. Surgical plan changed from local excision to enucleation. Histopathology demonstrated a large homogeneous mass of chronic inflammatory cells with inflammation of the overlying thinned out sclera, medial rectus insertion, and limbal cornea. The triad of peripheral granuloma, eosinophilia, and positive blood serology established the diagnosis of ocular toxocariasis. Conclusions. Ocular toxocariasis can mimic ocular malignancy such as medulloepithelioma in adults and rarely presents as an anterior scleral mass.

  11. Amniotic membrane transplantation for acute ocular burns.

    Clare, Gerry; Suleman, Hanif; Bunce, Catey; Dua, Harminder


    Ocular surface burns can be caused by chemicals (alkalis and acids) or by direct heat. Amniotic membrane transplantation (AMT) performed in the acute phase (day 0 to day 7) of an ocular surface burn is reported to relieve pain, accelerate healing and reduce scarring and blood vessel formation. The surgery involves applying a patch of amniotic membrane (AM) over the entire ocular surface up to the eyelid margins. To assess the effects of AMT on the eyes of people having suffered acute ocular surface burns. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 6), MEDLINE (January 1946 to June 2012), EMBASE (January 1980 to June 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to June 2012), the metaRegister of Controlled Trials (mRCT) (, ( and the WHO International Clinical Trials Registry Platform (ICTRP) ( We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 11 June 2012. We included randomised trials of medical therapy and AMT applied in the first seven days after an ocular surface burn compared to medical therapy alone. Two authors independently assessed the risk of bias of included studies and extracted relevant data. We contacted trial investigators for missing information. We summarised data using risk ratios (RRs) and mean differences (MDs) as appropriate. We included one RCT of 100 participants with ocular burns that were randomised to treatment with AMT and medical therapy or medical therapy alone. A subset of patients (n = 68) who were treated within the first seven days of the injury met the inclusion criteria and were included in the analysis. The remaining 32 eyes were excluded. The included subset consisted of 36 moderate (Dua classification II-III) and 32 severe (Dua

  12. Direct Cytoskeleton Forces Cause Membrane Softening in Red Blood Cells

    Rodríguez-García, Ruddi; López-Montero, Iván; Mell, Michael; Egea, Gustavo; Gov, Nir S.; Monroy, Francisco


    Erythrocytes are flexible cells specialized in the systemic transport of oxygen in vertebrates. This physiological function is connected to their outstanding ability to deform in passing through narrow capillaries. In recent years, there has been an influx of experimental evidence of enhanced cell-shape fluctuations related to metabolically driven activity of the erythroid membrane skeleton. However, no direct observation of the active cytoskeleton forces has yet been reported to our knowledge. Here, we show experimental evidence of the presence of temporally correlated forces superposed over the thermal fluctuations of the erythrocyte membrane. These forces are ATP-dependent and drive enhanced flickering motions in human erythrocytes. Theoretical analyses provide support for a direct force exerted on the membrane by the cytoskeleton nodes as pulses of well-defined average duration. In addition, such metabolically regulated active forces cause global membrane softening, a mechanical attribute related to the functional erythroid deformability. PMID:26083919

  13. Ocular complications of orbital venography.

    Safer, J N; Guibor, P


    Three ocular complications directly related to orbital venography are described, one resulting in permanent loss of vision,. The patient had lymphangioma of the orbit which evidently had bled secondary to increased venous pressure and injection of contrast bolus. Both of the 2 patients with transient visual disturbances had diabetic retinopathy. The common factor is felt to be an imparied vascular bed which cannot meet the stress of increased venous pressure and contrast medium injection. Conditions which predispose to ocular-orbital stasis and/or hemorrhage are discussed.

  14. [Ocular perfusion pressure and its relevance for glaucoma].

    Schmidl, D; Werkmeister, R; Garhöfer, G; Schmetterer, L


    Ocular perfusion pressure is defined as the difference between arterial and venous pressure in ocular vessels. In practice, mean arterial pressure is used to substitute for arterial pressure in ocular vessels while intraocular pressure gives an estimate for ocular venous pressure. This results in a value that is easy to calculate and which is of importance since several studies have shown that it is correlated to the prevalence, incidence and progression of primary open angle glaucoma. Today, ocular perfusion pressure is used to estimate individual risks. Since no target value for ocular perfusion pressure can be defined, direct therapeutic intervention is difficult. Still, it has to be kept in mind that lowering intraocular pressure automatically leads to an increase in ocular perfusion pressure. The present article also points out problems and limitations in the concept of ocular perfusion pressure and suggests possible solutions for these problems in the future.

  15. Ocular manifestations of candidemia

    Oude Lashof, A.M.L.; Rothova, A.; Sobel, J.D.; Ruhnke, M.; Pappas, P.G.; Viscoli, C.; Schlamm, H.T.; Oborska, I.T.; Rex, J.H.; Kullberg, B.J.


    BACKGROUND: Ocular candidiasis is a major complication of candidemia. The incidence, risk factors, and outcome of eye involvement during candidemia are largely unknown. We prospectively studied the ocular manifestations of candidemia in a large, worldwide, randomized multicenter trial that compared

  16. Diagnosis of Carrion's disease by direct blood PCR in thin blood smear negative samples.

    Juana del Valle Mendoza

    Full Text Available Bartonella bacilliformis is the etiologic agent of Carrion's disease. This disease has two well established phases, the most relevant being the so called Oroya Fever, in which B. bacilliformis infect the erythrocytes resulting in severe anemia and transient immunosuppression, with a high lethality in the absence of adequate antibiotic treatment. The presence of B. bacilliformis was studied in 113 blood samples suspected of Carrion's disease based on clinical criteria, despite the absence of a positive thin blood smear, by two different PCR techniques (using Bartonella-specific and universal 16S rRNA gene primers, and by bacterial culture. The specific 16S rRNA gene primers revealed the presence of 21 B. bacilliformis and 1 Bartonella elizabethae, while universal primers showed both the presence of 3 coinfections in which a concomitant pathogen was detected plus Bartonella, in addition to the presence of infections by other microorganisms such as Agrobacterium or Bacillus firmus. These data support the need to implement molecular tools to diagnose Carrion's disease.

  17. Diagnosis of Carrion’s Disease by Direct Blood PCR in Thin Blood Smear Negative Samples

    Tinco Valdez, Carmen; Pons, Maria J.; del Valle, Luis J.; Oré, Verónica Casabona; Michelena, Denisse Champin; Mayra, Jorge Bazán; Gavidea, Víctor Zavaleta; Vargas, Martha; Ruiz, Joaquim


    Bartonella bacilliformis is the etiologic agent of Carrion's disease. This disease has two well established phases, the most relevant being the so called Oroya Fever, in which B. bacilliformis infect the erythrocytes resulting in severe anemia and transient immunosuppression, with a high lethality in the absence of adequate antibiotic treatment. The presence of B. bacilliformis was studied in 113 blood samples suspected of Carrion’s disease based on clinical criteria, despite the absence of a positive thin blood smear, by two different PCR techniques (using Bartonella-specific and universal 16S rRNA gene primers), and by bacterial culture. The specific 16S rRNA gene primers revealed the presence of 21 B. bacilliformis and 1 Bartonella elizabethae, while universal primers showed both the presence of 3 coinfections in which a concomitant pathogen was detected plus Bartonella, in addition to the presence of infections by other microorganisms such as Agrobacterium or Bacillus firmus. These data support the need to implement molecular tools to diagnose Carrion’s disease. PMID:24651298

  18. Validity of direct identification and antibiotic susceptibility of microrganisms from bottles of blood culture

    Carmela Mazzone


    Full Text Available The blood culture is a very important laboratory test: if bacteremia or sepsis are suspected, the diagnosis of the pathogen and antibiotic therapy may be achieved making use of it. Identification and antibiotic susceptibility test carried out directly from the bottle may give important information in a shorter time. The introduction of the automatic instrumentation has improved the discovering of pathogens in the blood, however the elapsing time between the positive detection and the microbiological report is still along.The aim of our work was to verify the validity of the direct use of blood culture broth in which growth of microorganisms has been detected, which could reduce the response time of the bacteremia diagnosis. During the period February - July 2009, a total of 150 blood cultures were analysed:we compared the results obtained both by direct method and by reference method. 20 Gram positive microrganisms and 13 Gram negative microrganisms were respectively isolated and identified. The identification of Gram-negative and Gram-positive microrganisms showed an agreement of 100% between the direct and the reference method. For antibiotic susceptibility tests, among the Gram positive has reported 1.3% very major error, 2.9% major error and 1.4% minor error, while the Gram negative, respectivety 0.3%, 1.4%, 0%. The use of direct identification and susceptibility testing from positive blood cultures, can improve the response time and better efficiency in diagnostic procedures.

  19. Direct detection of red blood cell fragments: a new flow cytometric method to evaluate hemolysis in blood pumps.

    Linneweber, J; Chow, T W; Takano, T; Maeda, T; Nonaka, K; Schulte-Eistrup, S; Kawahito, S; Elert, O; Moake, J L; Nosé, Y


    Pump induced hemolysis is presently evaluated by measuring plasma free hemoglobin (fHb). However, this method has disadvantages because quantification of fHb depends on hematocrit (HCT) and hemoglobin (Hb) levels. The aim of this work was to devise a hemoglobin independent method, capable of quantifying cell trauma directly by measuring the number of red blood cell (RBC) fragments. Whole blood flow cytometry was used to quantify circulating RBC fragments derived from a roller pump (Sarns, Inc. Model 2 M 6,002) and a centrifugal pump (Gyro C1E3, Kyocera Corp.). The pumps were tested in a mock circuit for 2 hr (5 L/min flow against 100 mm Hg pressure head). Red blood cell fragments were quantified by a phycoerythrin (PE) labeled glycophorin A antibody specific for erythrocytes. Red blood cell fragments were smaller than the intact RBC population and overlapped in size with the platelet population (based on forward- and side-light scattering measurements). For the roller pump, the values for RBC fragments increased from 1,090 +/- 260/microl at 0 min to 14,880 +/- 5,900/microl after 120 min. In contrast, using the centrifugal pump, there was little increase in RBC fragments (from 730 +/- 270/microl at 0 min to 1,400 +/- 840/microl after 120 min). Flow cytometry can be used for the rapid, sensitive, hemoglobin independent evaluation of pump induced RBC trauma.

  20. A Digital Method for the Detection of Blood Flow Direction in Ultrasonic Doppler Systems

    P. Acevedo–Contla.


    Full Text Available Doppler ultrasound systems are widely used to study blood flow and diagnosis of vascular diseases. An important characteristic of these systems is the ability to detect the direction of the blood flow. Most Doppler ultrasound systems apply a quadrature demodulation technique on the ultrasonic transducer output signal. Therefore additional treatment is necessary to separate forward and reverse flow signals. This work presents a digital method to convert signals in quadrature into directional signals using a Fast Fourier Transform (FFT approach. Validation of the method has been achieved using simulated Doppler ultrasound signals.

  1. Effects of Topical Bimatoprost 0.01% and Timolol 0.5% on Circadian IOP, Blood Pressure and Perfusion Pressure in Patients with Glaucoma or Ocular Hypertension: A Randomized, Double Masked, Placebo-Controlled Clinical Trial.

    Francesco Oddone

    Full Text Available To compare the 24-hour (24h effects on intraocular pressure (IOP and cardiovascular parameters of timolol 0.5% and bimatoprost 0.01% in open angle glaucoma and ocular hypertensive subjects.In this prospective, randomized, double masked, crossover, clinical trial, after washout from previous medications enrolled subjects underwent 24h IOP, blood pressure (BP and heart rate (HR measurements and were randomized to either topical bimatoprost 0.01% at night plus placebo in the morning or to timolol 0.5% bid. After 8 weeks of treatment a second 24h assessment of IOP, BP and HR was performed and then subjects switched to the opposite treatment for additional 8 weeks when a third 24h assessment was performed. The primary endpoint was the comparison of the mean 24h IOP after each treatment. Secondary endpoints included the comparisons of IOP at each timepoint of the 24h curve and the comparison of BP, HR, ocular perfusion pressure and tolerability.Mean untreated 24h IOP was 20.3 mmHg (95%CI 19.0 to 21.6. Mean 24h IOP was significantly lower after 8 weeks of treatment with bimatoprost 0.01% than after 8 weeks of treatment with timolol 0.5% bid (15.7 vs 16.8 mmHg, p = 0.0003. Mean IOP during the day hours was significantly reduced from baseline by both drugs while mean IOP during the night hours was reduced by -2.3 mmHg (p = 0.0002 by bimatoprost 0.01% plus placebo and by -1.1 mmHg by timolol 0.5% bid (p = 0.06. Timolol 0.5% significantly reduced the mean 24h systolic BP from baseline, the diastolic BP during the day hours, the HR during the night hours, and the mean 24h systolic ocular perfusion pressure.Both Bimatoprost 0.01% and Timolol 0.5% are effective in reducing the mean 24h IOP from an untreated baseline but Bimatoprost 0.01% is more effective than timolol 0.5% throughout the 24h. Timolol 0.5% effect on IOP is reduced during the night hours and is associated with reduced BP, HR and ocular perfusion pressure.EU Clinical Trial Register and Eudra

  2. Effects of Topical Bimatoprost 0.01% and Timolol 0.5% on Circadian IOP, Blood Pressure and Perfusion Pressure in Patients with Glaucoma or Ocular Hypertension: A Randomized, Double Masked, Placebo-Controlled Clinical Trial

    Tanga, Lucia; Berardo, Francesca; Ferrazza, Manuela; Michelessi, Manuele; Roberti, Gloria


    Purpose To compare the 24-hour (24h) effects on intraocular pressure (IOP) and cardiovascular parameters of timolol 0.5% and bimatoprost 0.01% in open angle glaucoma and ocular hypertensive subjects. Methods In this prospective, randomized, double masked, crossover, clinical trial, after washout from previous medications enrolled subjects underwent 24h IOP, blood pressure (BP) and heart rate (HR) measurements and were randomized to either topical bimatoprost 0.01% at night plus placebo in the morning or to timolol 0.5% bid. After 8 weeks of treatment a second 24h assessment of IOP, BP and HR was performed and then subjects switched to the opposite treatment for additional 8 weeks when a third 24h assessment was performed. The primary endpoint was the comparison of the mean 24h IOP after each treatment. Secondary endpoints included the comparisons of IOP at each timepoint of the 24h curve and the comparison of BP, HR, ocular perfusion pressure and tolerability. Results Mean untreated 24h IOP was 20.3 mmHg (95%CI 19.0 to 21.6). Mean 24h IOP was significantly lower after 8 weeks of treatment with bimatoprost 0.01% than after 8 weeks of treatment with timolol 0.5% bid (15.7 vs 16.8 mmHg, p = 0.0003). Mean IOP during the day hours was significantly reduced from baseline by both drugs while mean IOP during the night hours was reduced by -2.3 mmHg (p = 0.0002) by bimatoprost 0.01% plus placebo and by -1.1 mmHg by timolol 0.5% bid (p = 0.06). Timolol 0.5% significantly reduced the mean 24h systolic BP from baseline, the diastolic BP during the day hours, the HR during the night hours, and the mean 24h systolic ocular perfusion pressure. Conclusion Both Bimatoprost 0.01% and Timolol 0.5% are effective in reducing the mean 24h IOP from an untreated baseline but Bimatoprost 0.01% is more effective than timolol 0.5% throughout the 24h. Timolol 0.5% effect on IOP is reduced during the night hours and is associated with reduced BP, HR and ocular perfusion pressure. Trial

  3. Ocular tuberculosis: current perspectives

    Shakarchi FI


    Full Text Available Faiz I Shakarchi1,21Ibn Al-Haetham Teaching Eye Hospital, 2Department of Opthalmology, Medical College, Al-Mustansiriya University, Baghdad, IraqAbstract: The World Health Organization currently estimates that nearly two billion people, or one-third of the world’s population, are infected by tuberculosis, and that roughly 10% of the infected people are symptomatic. Tuberculosis affects the lungs in 80% of patients, while in the remaining 20% the disease may affect other organs, including the eye. Uveitis can be seen concurrently with tuberculosis, but a direct association is difficult to prove. Ocular tuberculosis is usually not associated with clinical evidence of pulmonary tuberculosis, as up to 60% of extrapulmonary tuberculosis patients may not have pulmonary disease. The diagnosis of tuberculous uveitis is often problematic and in nearly all reported cases, the diagnosis was only presumptive. Tuberculous uveitis is a great mimicker of various uveitis entities and it can be considered in the differential diagnosis of any type of intraocular inflammation. It is still unknown if ocular manifestations result from a direct mycobacterium infection or hypersensitivity reaction and this is reflected on the management of tuberculous uveitis. Prevalence of tuberculosis as an etiology of uveitis may reach up to 10% in endemic areas. Tuberculous uveitis is a vision-threatening disease that inevitably leads to blindness if not properly diagnosed and treated. The aim of this review is to illustrate the various clinical features and management of presumed tuberculous uveitis. The current review focuses on the diagnostic criteria, significance of tuberculin skin test, and use of systemic corticosteroids in the management of tuberculous uveitis as recommended in recent publications.Keywords: tuberculosis, uveitis, choroiditis, tuberculin skin test

  4. Thermography in ocular inflammation

    Kawali, Ankush A


    Background and Objectives: The purpose of this study was to evaluate ocular inflammatory and non-inflammatory conditions using commercially available thermal camera. Materials and Methods: A non-contact thermographic camera (FLIR P 620) was used to take thermal pictures of seven cases of ocular inflammation, two cases of non-inflammatory ocular pathology, and one healthy subject with mild refractive error only. Ocular inflammatory cases included five cases of scleritis, one case of postoperative anterior uveitis, and a case of meibomian gland dysfunction with keratitis (MGD-keratitis). Non-inflammatory conditions included a case of conjunctival benign reactive lymphoid hyperplasia (BRLH) and a case of central serous chorio-retinopathy. Thermal and non-thermal photographs were taken, and using analyzing software, the ocular surface temperature was calculated. Results: Patient with fresh episode of scleritis revealed high temperature. Eyes with MGD-keratitis depicted lower temperature in clinically more affected eye. Conjunctival BRLH showed a cold lesion on thermography at the site of involvement, in contrast to cases of scleritis with similar clinical presentation. Conclusion: Ocular thermal imaging is an underutilized diagnostic tool which can be used to distinguish inflammatory ocular conditions from non-inflammatory conditions. It can also be utilized in the evaluation of tear film in dry eye syndrome. Its applications should be further explored in uveitis and other ocular disorders. Dedicated “ocular thermographic” camera is today's need of the hour. PMID:24347863

  5. Thermography in ocular inflammation

    Ankush A Kawali


    Full Text Available Background and Objectives: The purpose of this study was to evaluate ocular inflammatory and non-inflammatory conditions using commercially available thermal camera. Materials and Methods: A non-contact thermographic camera (FLIR P 620 was used to take thermal pictures of seven cases of ocular inflammation, two cases of non-inflammatory ocular pathology, and one healthy subject with mild refractive error only. Ocular inflammatory cases included five cases of scleritis, one case of postoperative anterior uveitis, and a case of meibomian gland dysfunction with keratitis (MGD-keratitis. Non-inflammatory conditions included a case of conjunctival benign reactive lymphoid hyperplasia (BRLH and a case of central serous chorio-retinopathy. Thermal and non-thermal photographs were taken, and using analyzing software, the ocular surface temperature was calculated. Results: Patient with fresh episode of scleritis revealed high temperature. Eyes with MGD-keratitis depicted lower temperature in clinically more affected eye. Conjunctival BRLH showed a cold lesion on thermography at the site of involvement, in contrast to cases of scleritis with similar clinical presentation. Conclusion: Ocular thermal imaging is an underutilized diagnostic tool which can be used to distinguish inflammatory ocular conditions from non-inflammatory conditions. It can also be utilized in the evaluation of tear film in dry eye syndrome. Its applications should be further explored in uveitis and other ocular disorders. Dedicated "ocular thermographic" camera is today′s need of the hour.

  6. Cluster bomb ocular injuries

    Ahmad M Mansour


    Full Text Available Purpose: To present the visual outcomes and ocular sequelae of victims of cluster bombs. Materials and Methods: This retrospective, multicenter case series of ocular injury due to cluster bombs was conducted for 3 years after the war in South Lebanon (July 2006. Data were gathered from the reports to the Information Management System for Mine Action. Results: There were 308 victims of clusters bombs; 36 individuals were killed, of which 2 received ocular lacerations and; 272 individuals were injured with 18 receiving ocular injury. These 18 surviving individuals were assessed by the authors. Ocular injury occurred in 6.5% (20/308 of cluster bomb victims. Trauma to multiple organs occurred in 12 of 18 cases (67% with ocular injury. Ocular findings included corneal or scleral lacerations (16 eyes, corneal foreign bodies (9 eyes, corneal decompensation (2 eyes, ruptured cataract (6 eyes, and intravitreal foreign bodies (10 eyes. The corneas of one patient had extreme attenuation of the endothelium. Conclusions: Ocular injury occurred in 6.5% of cluster bomb victims and 67% of the patients with ocular injury sustained trauma to multiple organs. Visual morbidity in civilians is an additional reason for a global ban on the use of cluster bombs.

  7. Preparation of positive blood cultures for direct MALDI-ToF MS identification.

    Robinson, Andrew M; Ussher, James E


    MALDI-ToF MS can be used to identify microorganisms directly from blood cultures. This study compared two methods of sample preparation. Similar levels of genus- (91% vs 90%) and species-level identifications (79% vs 74%) were obtained with differential centrifugation and SDS methods. The SDS method is faster and requires minimal handling.

  8. A Change in Ocular Circulation after Photocoagulation for Retinopathy of Prematurity in a Neonate

    Tadashi Matsumoto


    Full Text Available Background: The dilation of veins and tortuosity of arteries that occur in retinopathy of prematurity (ROP are improved by therapy, and thus posttherapy changes in ocular circulation are also conceivable. We report a case of ROP in which we were able to measure the ocular circulation before and after photocoagulation therapy, using a laser speckle flowgraphy (LSFG system that is modified for neonates. Case Report: A female infant was born at 25 weeks’ gestation with a birth weight of 808 g. We performed photocoagulation in both eyes at age 15 weeks, and we measured the ocular circulation with the “LSFG-baby” system before and at 12 weeks after the photocoagulation treatment. We also measured the mean blur rate (MBR in the optic nerve head (ONH and the relative flow volume (RFV in the retinal vessels, and we examined the change rates from before to after treatment. The changing rate of the MBR-A (the mean of all values in the ONH in the right and left eyes was 76.5 and 98.5%, respectively. The vascular RFV in the severe dilation and tortuosity quadrant also tended to decrease. Conclusions: Photocoagulation improved the dilation of veins and tortuosity of arteries and reduced the ocular blood flow in this neonate with ROP. The LSFG-baby system effectively and directly revealed the optic nerve and retinal blood vessels.

  9. Miopatia ocular descendente Descending ocular myopathy

    Nunjo Finkel


    Full Text Available São relatados 4 casos de miopatia ocular descendente (MOD com história familial levantada em três gerações. Biópsia musculares e eletromiografia em um caso confirmaram o caráter miogênico da doença. A MOD nada mais seria do que uma forma clínica especial de distrofia muscular, de início tardio.Four cases of the so-called descending ocular myopathy with a family history in three generations are reported. In the first case muscular biopsy and electromyographic studies proved the myogenic nature of the process. Descending ocular myopathy seems to be just a clinical form of muscular distrophy of late onset.

  10. Epidemiology of Ocular Toxoplasmosis

    Petersen, E.; Kijlstra, A.; Stanford, M.


    Retinal infection with Toxoplasma gondii is the most important cause of posterior uveitis, whereby prevalence and incidence of ocular symptoms after infection depend on socio-economic factors and the circulating parasite genotypes. Ocular toxoplasmosis is more common in South America, Central Americ

  11. Epidemiology of Ocular Toxoplasmosis

    Petersen, E.; Kijlstra, A.; Stanford, M.


    Retinal infection with Toxoplasma gondii is the most important cause of posterior uveitis, whereby prevalence and incidence of ocular symptoms after infection depend on socio-economic factors and the circulating parasite genotypes. Ocular toxoplasmosis is more common in South America, Central Americ

  12. Ocular manifestations and outcome of treatment of Stevens-Johnson ...

    Abstract. Background: Stevens-Johnson Syndrome (SJS) is an immune-based ... and cicatrisation occur, resulting in degrees of ocular motility, tear-function, and visual defects. ... Full blood count, urinalysis and HIV tests were all normal.

  13. Ocular lesions and experimental choline deficiency Lesiones oculares y deficiencia experimental de colina

    Georgina P. Ossani


    Full Text Available Previous studies have shown ocular haemorrhages in choline-deficient rats. The aim of this paper is to study further the relationship between ocular and renal lesions and biochemical alterations in rats fed a choline-deficient diet. Fifty one weanling male Wistar rats, were divided into two groups. Thirty one of them were fed a choline-deficient diet and the rest was fed a choline-supplemented diet ad libitum. Animals from both groups were killed between the fifth and the eighth day. Urea, creatinine and homocysteine concentrations in blood were determined. Eyes were used for light microscopy study; high resolution light microscopy and the study of the retina as "rétine a plat". Kidneys were studied by light microscopy. Choline-supplemented rats did not show ocular or renal lesion. Choline-deficient rats that showed renal lesions, tubular or cortical necrosis, did not always have ocular changes. There were no ocular changes in the only choline-deficient rat without renal lesion. The ocular changes consisted mainly in haemorrhage in both cameras and ciliary and vitreous bodies. Correlations between ocular and renal lesion (r=0.72, pEstudios previos han demostrado hemorragia ocular en ratas deficientes en colina. El objetivo de este trabajo es profundizar en la relación entre las alteraciones oculares, renales y bioquímicas en ratas deficientes en colina. Cincuenta y una ratas Wistar macho recién destetadas fueron divididas en dos grupos: treinta y una fueron alimentadas con una dieta colino deficiente y el resto con colina suplementada ad-libitum. Los animales de ambos grupos fueron sacrificados entre el quinto y el octavo día. Se midió la concentración de urea, creatinina y homocisteína en sangre. Los ojos fueron estudiados por microscopía de luz, microscopía óptica de alta resolución y para el estudio de la retina como retina plana. Los riñones fueron estudiados por microscopía de luz. Las ratas suplementadas con colina no

  14. Self-directed Mindfulness Training and Improvement in Blood Pressure, Migraine Frequency, and Quality of Life

    Oberg, Erica B.; Rempe, Margaret; Bradley, Ryan


    Background: Interest in case studies has undergone a resurgence concurrent with increasing prioritization of illustrations of patient-centered care. However, substantial inclusion of the patient in these reports remains limited. Here, a doctor and patient collaborate to present her case report of self-directed mindfulness training and the subsequent changes in blood pressure, migraine frequency, and quality of life. Methods: After receiving encouragement from her naturopathic doctor, the pati...

  15. Relationships among Ocular Blood Flow Shown by Laser Speckle Flowgraphy, Retinal Arteriosclerotic Change, and Chorioretinal Circulation Time Obtained by Fluorescein Angiography

    Itokawa, Takashi; Hori, Yuichi


    Purpose. To determine the correlations among the mean blur rate (MBR) in the optic nerve head (ONH) shown by laser speckle flowgraphy (LSFG), retinal arteriosclerosis, and the circulation time obtained by fluorescein angiography (FA). Method. We evaluated 118 patients and assessed their time of choroidal flush, arm-to-retina time, and early and late phases of retinal circulation time (RT: sec) obtained by FA. The severity of retinal arteriosclerosis was classified according to the Scheie classification. The MBR values throughout the ONH (MBR-A), in the tissue (MBR-T), and in the vessels (MBR-V) were analyzed. Results. Patients with retinal vein occlusion (RVO) showed prolonged early and late phases of RT compared to other ocular diseases. Single and multiple regression analyses showed that the MBR-V and Scheie classification were significantly associated with both the choroidal flush and arm-to-retina times. The incidences of RVO and MVR-V were significantly associated with the early phase of RT, and the incidences of RVO, MBR-V, Scheie classification, and gender were revealed to be factors independently contributing to the late phase of RT. Conclusion. MBR-V in the ONH and retinal arteriosclerosis are important contributing factors for the circulation time of each stage obtained by FA.

  16. Relationships among Ocular Blood Flow Shown by Laser Speckle Flowgraphy, Retinal Arteriosclerotic Change, and Chorioretinal Circulation Time Obtained by Fluorescein Angiography

    Hironori Osamura


    Full Text Available Purpose. To determine the correlations among the mean blur rate (MBR in the optic nerve head (ONH shown by laser speckle flowgraphy (LSFG, retinal arteriosclerosis, and the circulation time obtained by fluorescein angiography (FA. Method. We evaluated 118 patients and assessed their time of choroidal flush, arm-to-retina time, and early and late phases of retinal circulation time (RT: sec obtained by FA. The severity of retinal arteriosclerosis was classified according to the Scheie classification. The MBR values throughout the ONH (MBR-A, in the tissue (MBR-T, and in the vessels (MBR-V were analyzed. Results. Patients with retinal vein occlusion (RVO showed prolonged early and late phases of RT compared to other ocular diseases. Single and multiple regression analyses showed that the MBR-V and Scheie classification were significantly associated with both the choroidal flush and arm-to-retina times. The incidences of RVO and MVR-V were significantly associated with the early phase of RT, and the incidences of RVO, MBR-V, Scheie classification, and gender were revealed to be factors independently contributing to the late phase of RT. Conclusion. MBR-V in the ONH and retinal arteriosclerosis are important contributing factors for the circulation time of each stage obtained by FA.

  17. Evaluation of three rapid diagnostic methods for direct identification of microorganisms in positive blood cultures.

    Martinez, Raquel M; Bauerle, Elizabeth R; Fang, Ferric C; Butler-Wu, Susan M


    The identification of organisms from positive blood cultures generally takes several days. However, recently developed rapid diagnostic methods offer the potential for organism identification within only a few hours of blood culture positivity. In this study, we evaluated the performance of three commercial methods to rapidly identify organisms directly from positive blood cultures: QuickFISH (AdvanDx, Wolburn, MA), Verigene Gram-Positive Blood Culture (BC-GP; Nanosphere, Northbrook, IL), and matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) with Sepsityper processing (Bruker Daltonics, Billerica, MA). A total of 159 blood cultures (VersaTREK Trek Diagnostic Systems, Cleveland, OH) positive for Gram-positive and Gram-negative bacteria as well as yeast were analyzed with QuickFISH and MALDI-TOF MS. In all, 102 blood cultures were analyzed using the BC-GP assay. For monomicrobial cultures, we observed 98.0% concordance with routine methods for both QuickFISH (143/146) and the BC-GP assay (93/95). MALDI-TOF MS demonstrated 80.1% (117/146) and 87.7% (128/146) concordance with routine methods to the genus and species levels, respectively. None of the methods tested were capable of consistently identifying polymicrobial cultures in their entirety or reliably differentiating Streptococcus pneumoniae from viridans streptococci. Nevertheless, the methods evaluated in this study are convenient and accurate for the most commonly encountered pathogens and have the potential to dramatically reduce turnaround time for the provision of results to the treating physician.

  18. The effect of intravitreal bevacizumab on ocular blood flow in diabetic retinopathy and branch retinal vein occlusion as measured by laser speckle flowgraphy

    Nitta F


    Full Text Available Fumihiko Nitta,1 Hiroshi Kunikata,1,2 Naoko Aizawa,1 Kazuko Omodaka,1 Yukihiro Shiga,1 Masayuki Yasuda,1 Toru Nakazawa1–31Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan; 2Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Sendai, Japan; 3Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Sendai, JapanBackground: This study evaluated the effect of intravitreal injection of bevacizumab (IVB on macular edema associated with diabetic retinopathy (DME or branch retinal vein occlusion (BRVOME using laser speckle flowgraphy.Methods: A comparative interventional study of 25 eyes from 22 patients with macular edema (DME group: 12 eyes; BRVOME group: 13 eyes who underwent IVB. Mean blur rate (MBR was measured in the retinal artery, retinal vein, optic nerve head (ONH, and choroid before and after IVB. Results: In the BRVOME group, there was no significant change in MBR in the retinal artery, retinal vein or ONH, but choroidal MBR decreased significantly (P=0.04. In the DME group, the MBR in the retinal artery, retinal vein, ONH, and choroid decreased significantly (P=0.02, P=0.04, P<0.001, and P=0.04, respectively. In the DME group, pre-IVB MBR in the ONH was significantly correlated with post-IVB foveal thickness (R= -0.71, P=0.002. There was no such correlation in the BRVOME group in the ONH.Conclusion: IVB had a suppressive effect on circulation in eyes with DME but not in those with BRVOME. This suggests that this noninvasive and objective biomarker may be a useful part of pre-IVB evaluations and decision-making in DME.Keywords: macular edema, mean blur rate, optic nerve head, biomarker, ocular circulation

  19. Effects of Mild Hypercapnia During Head-Down Bed Rest on Ocular Structures, Cerebral Blood Flow, aud Visual Acuity in Healthy Human Subjects

    Laurie, S. S.; Taibbi, G.; Lee, S. M. C.; Martin, D. S.; Zanello, S.; Ploutz-Snyder, R.; Hu, X.; Stenger, M. B.; Vizzeri, G.


    The cephalad fluid shift induced by microgravity has been hypothesized to cause an elevation in intracranial pressure (ICP) and contribute to the development of the Visual Impairment/Intracranial Pressure (VIIP) syndrome, as experienced by some astronauts during long-duration space flight. Elevated ambient partial pressure of carbon dioxide (PCO2) on ISS may also raise ICP and contribute to VIIP development. We seek to determine if the combination of mild CO2 exposure, similar to that occurring on the International Space Station, with the cephalad fluid shift induced by head-down tilt, will induce ophthalmic and cerebral blood flow changes similar to those described in the VIIP syndrome. We hypothesize that mild hypercapnia in the head-down tilt position will increase choroidal blood volume and cerebral blood flow, raise intraocular pressure (IOP), and transiently reduce visual acuity as compared to the seated or the head-down tilt position without elevated CO2, respectively.

  20. Congenital Ocular Motor Apraxia

    J Gordon Millichap


    Full Text Available The clinical and neuroradiological findings, and long-term intellectual prognosis in 10 patients (4 boys and 6 girls with congenital ocular motor apraxia (COMA are reviewed by researchers at Tottori University, Yonago, Japan.

  1. Ocular rosacea: a review

    Ana Carolina Cabreira Vieira


    Full Text Available Rosacea is a prevalent chronic cutaneous disorder with variable presentation and severity. Although considered a skin disease, rosacea may evolve the eyes in 58-72% of the patients, causing eyelid and ocular surface inflammation. About one third of the patients develop potentially sight-threatening corneal involvement. Untreated rosacea may cause varying degrees of ocular morbidity. The importance of early diagnosis and adequate treatment cannot be overemphasized. There is not yet a diagnostic test for rosacea. The diagnosis of ocular rosacea relies on observation of clinical features, which can be challenging in up to 90% of patients in whom accompanying roseatic skin changes may be subtle or inexistent. In this review, we describe the pathophysiologic mechanisms proposed in the literature, clinical features, diagnosis and management of ocular rosacea, as well as discuss the need for a diagnostic test for the disease.

  2. Ocular effects of radiofrequency energy.

    Elder, J A


    Radiofrequency (RF) energy has been reported to cause a variety of ocular effects, primarily cataracts but also effects on the retina, cornea, and other ocular systems. Cataracts have been observed in experimental animals when one eye was exposed to a localized, very high RF field and the other eye was the unexposed control. The results show that 2450 MHz exposures for >or=30 min at power densities causing extremely high dose rates (>or=150 W/kg) and temperatures (>or=41 degrees C) in or near the lens caused cataracts in the rabbit eye. However, cataracts were not observed in the monkey eye exposed to similar exposure conditions, reflecting the different patterns of energy absorption (SAR, specific absorption rate) distribution, due to their different facial structure. Since the monkey head is similar in structure to the human head, the nonhuman primate study showed that the incident power density levels causing cataracts in rabbits and other laboratory animals cannot be directly extrapolated to primates, including human beings. It is reasonable to assume that an SAR that would induce temperatures >or=41 degrees C in or near the lens in the human eye would produce cataracts by the same mechanism (heating) that caused cataracts in the rabbit lens; however, such an exposure would greatly exceed the currently allowable limits for human exposure and would be expected to cause unacceptable effects in other parts of the eye and face. Other ocular effects including corneal lesions, retinal effects, and changes in vascular permeability, have been observed after localized exposure of the eye of laboratory animals to both continuous wave (CW) and pulsed wave (PW) exposures, but the inconsistencies in these results, the failure to independently confirm corneal lesions after CW exposure, the failure to independently confirm retinal effects after PW exposure, and the absence of functional changes in vision are reasons why these ocular effects are not useful in defining an

  3. Ocular Fundus Photography as an Educational Tool.

    Mackay, Devin D; Garza, Philip S


    The proficiency of nonophthalmologists with direct ophthalmoscopy is poor, which has prompted a search for alternative technologies to examine the ocular fundus. Although ocular fundus photography has existed for decades, its use has been traditionally restricted to ophthalmology clinical care settings and textbooks. Recent research has shown a role for nonmydriatic fundus photography in nonophthalmic settings, encouraging more widespread adoption of fundus photography technology. Recent studies have also affirmed the role of fundus photography as an adjunct or alternative to direct ophthalmoscopy in undergraduate medical education. In this review, the authors examine the use of ocular fundus photography as an educational tool and suggest future applications for this important technology. Novel applications of fundus photography as an educational tool have the potential to resurrect the dying art of funduscopy.

  4. Ultrasonography in ocular trauma.

    Dastevska-Djosevska, Emilija


    Ultrasonography is a non-invasive, simple and effective diagnostic method which enables visualization and evaluation of intraocular injury degree in cloudy eye media. The basic aim of this investigation was to find out the frequency of various types of ocular injuries using ultrasonography and to make an analysis of their frequency in relation to gender and age. This retrospective study included 182 patients hospitalized at the Clinic of Ophthalmology in Skopje due to mechanical eye trauma. The patients underwent ultrasonography on the Alcon Ultrascan Imagining System apparatus and Sonomed EZ Scan AB 5500+. B scan technique was used primarily, while the A scan had a positive and correlative role. Ocular trauma was more present in males (85.2%) compared to females (14.8%). 49.5% of the patients had open, and 50.5% had closed globe injuries. The most represented age group in ocular injuries was the age ranged from 51 to 60 years. There was no significant difference between the type of mechanical injury and the age (Chi-Squares=5.52 p=0.47895025). Ultrasonography showed that the most frequent pathologic result, both in open and closed globe injuries, was vitreous hemorrhage. Ultrasonography has an irreplaceable role in the clinical evaluation and management of ocular trauma. It showed that the most frequent finding in ocular trauma was vitreous haemorrhage, and the male gender was more frequently exposed to ocular trauma.

  5. Iodine-125 radioimmunoassay for the direct detection of benzodiazepines in blood and urine

    Goddard, C.P.; Stead, A.H.; Mason, P.A.; Law, B.; Moffat, A.C.; McBrien, M.; Cosby, S.


    A radioimmunoassay (RIA) for the direct detection of benzodiazepines in blood and urine is described. It is based on a commercially available antiserum and an easily synthesised radio-iodinated derivative of clonazepam that allows the use of relatively simple gamma-counting procedures. The assay can detect low therapeutic levels of all of the benzodiazepines currently available in the UK in samples of blood and urine (1-50 ng ml/sup -1/, depending on the drug); no prior sample preparation is required. It is inexpensive, rapid, simple to perform and is broadly specific for the benzodiazepine class of drugs. The assay offers a most suitable means of screening large numbers of samples of forensic interest for the presence of the benzodiazepines.

  6. Single-tube-genotyping of gastric cancer related SNPs by directly using whole blood and paper-dried blood as starting materials

    Huan Huang; Ying Bu; Guo-Hua Zhou


    AIM: To demonstrate an inexpensive method for typing gastric cancer related single nucleotide polymorphisms (SNPs) using whole blood or paper-dried blood as starting materials.METHODS: PCR amplification is directly carried out from the whole blood or paper-dried blood sample without any DNA extraction step. Before PCR, a blood sample, four primers, and all of biological reagents necessary for PCR were added at a time; After PCR, the amplified products were directly separated by slab gel electrophoresis or microchip CE without any purification. SNP typing was performed by tetra-primer PCR with two inner primers specific to each allele and two outer primers defining the length of allele-specific amplicons. Genotypes were directly discriminated by the size of amplicons specific to each allele, thereby avoiding any post-PCR process.RESULTS: Using a special PCR buffer, inhibitory substances in blood (including the anticoagulant in blood) and filter paper were effectively suppressed;a "true" single-tube-genotyping is thus realized. We successfully determined genotypes IL-1B-511 and IL-1B-31 polymorphisms at the gene IL-1B by using whole-blood and paper-dried blood samples as starting materials respectively. The method is so sensitive that 0.5-1.0 μL of blood sample is enough to give a satisfactory typing results. The genotyping results were confirmed by RFLP-PCR using purified genome DNA,indicating that amplification specificity was not affected by inhibitory components (including coagulants) in blood or filter paper.CONCLUSION: Compared with SNP typing methods based on purified DNA, the proposed method is laborsaving, simple, inexpensive, and less cross-contaminated.It is promising to use this method to type other SNPs.

  7. Detection by ELISA of bluetongue antigen directly in the blood of experimentally infected sheep.

    Stanislawek, W L; Lunt, R A; Blacksell, S D; Newberry, K M; Hooper, P T; White, J R


    An antigen-capture ELISA (Ag-ELISA) was developed to detect bluetongue virus (BTV) antigen directly from blood samples. Four blood preparations [whole blood, buffy coat, washed red blood cells (RBC) and plasma] taken pre-inoculation and on days 6 to 9 post-inoculation (PI) were used in the ELISA to study antigenaemia in forty sheep, each experimentally infected with one of 20 South African BTV serotypes. Seventeen of the 20 serotypes were detected and 27 of the 40 sheep were at some stage Ag-ELISA positive. Over the period of sampling, Ag-ELISA positive results were most frequently returned from whole blood taken on days 6 and 7 PI. However in some instances the quantity and/or duration of BTV antigenaemia was greater in buffy coat and washed RBC preparations. In a selection of samples examined, positive Ag-ELISA results were generally obtained when samples had an infectious virus titre in eggs of > 10(3.2) egg lethal doses (ELD50/ml). The appearance and duration of detectable antigenaemia was compared with the development of clinical signs and antibody responses of infected sheep. On days 6 and 7 PI the presence of fever (> 40 degrees C) was indicative to the likelihood of detectable antigenaemia. After day 5 PI antigenaemia declined and clinical signs of swollen face and inflamed feet appeared together with the first detectable antibody response. The Ag-ELISA, when used in conjunction with clinical observations and serologic data, should be useful as a rapid diagnostic procedure for bluetongue disease.

  8. Advanced feeder-free generation of induced pluripotent stem cells directly from blood cells.

    Trokovic, Ras; Weltner, Jere; Nishimura, Ken; Ohtaka, Manami; Nakanishi, Mahito; Salomaa, Veikko; Jalanko, Anu; Otonkoski, Timo; Kyttälä, Aija


    Generation of validated human induced pluripotent stem cells (iPSCs) for biobanking is essential for exploring the full potential of iPSCs in disease modeling and drug discovery. Peripheral blood mononuclear cells (PBMCs) are attractive targets for reprogramming, because blood is collected by a routine clinical procedure and is a commonly stored material in biobanks. Generation of iPSCs from blood cells has previously been reported using integrative retroviruses, episomal Sendai viruses, and DNA plasmids. However, most of the published protocols require expansion and/or activation of a specific cell population from PBMCs. We have recently collected a PBMC cohort from the Finnish population containing more than 2,000 subjects. Here we report efficient generation of iPSCs directly from PBMCs in feeder-free conditions in approximately 2 weeks. The produced iPSC clones are pluripotent and transgene-free. Together, these properties make this novel method a powerful tool for large-scale reprogramming of PBMCs and for iPSC biobanking.

  9. Influence of ocular perfusion pressure fluctuation on glaucoma

    Min-Zi Ren


    Full Text Available AIM:To investigate the influence of ocular perfusion pressure fluctuation on glaucoma. METHODS:Forty patients with primary open angle glaucoma from January 2013 to June 2015 in our hospital were used as observation group and 40 families were used as control group. Circadian fluctuation of intraocular pressure, blood pressure and ocular perfusion pressure in 24h were determined to obtain systolic ocular perfusion pressure(SOPP, diastolic ocular perfusion pressure(DOPPand mean ocular perfusion pressure(MOPP. Pearson linear correlation was used to analyze the correlation of circadian MOPP fluctuation with cup-disc ratio, mean defect(MDand the picture standard deviation(PSD. RESULTS:The fluctuation of MOPP, SOPP and DOPP of observation group were significantly higher than those of control group(Pr=-0.389, 95%CI:-0.612~-0.082; P=0.011, was positively correlated with PSD(r=0.512, 95%CI:0.139 ~0.782; P=0.008; no correlation was found between it and the vertical cup-disc ratio(r=0.115, 95%CI:0.056~0.369; P=0.355. CONCLUSION:Ocular perfusion pressure fluctuations in patients with primary open angle glaucoma may reflect the severity of the disease and may make the situation aggravating. Therefore through perfusion pressure monitor in 24h may help us understand the ocular blood flow and the development of primary open-angle glaucoma.

  10. The nucleus of endothelial cell as a sensor of blood flow direction

    Eugene Tkachenko


    Hemodynamic shear stresses cause endothelial cells (ECs to polarize in the plane of the flow. Paradoxically, under strong shear flows, ECs disassemble their primary cilia, common sensors of shear, and thus must use an alternative mechanism of sensing the strength and direction of flow. In our experiments in microfluidic perfusion chambers, confluent ECs developed planar cell polarity at a rate proportional to the shear stress. The location of Golgi apparatus and microtubule organizing center was biased to the upstream side of the nucleus, i.e. the ECs polarized against the flow. These in vitro results agreed with observations in murine blood vessels, where EC polarization against the flow was stronger in high flow arteries than in veins. Once established, flow-induced polarization persisted over long time intervals without external shear. Transient destabilization of acto-myosin cytoskeleton by inhibition of myosin II or depolymerization of actin promoted polarization of EC against the flow, indicating that an intact acto-myosin cytoskeleton resists flow-induced polarization. These results suggested that polarization was induced by mechanical displacement of EC nuclei downstream under the hydrodynamic drag. This hypothesis was confirmed by the observation that acute application of a large hydrodynamic force to ECs resulted in an immediate downstream displacement of nuclei and was sufficient to induce persistent polarization. Taken together, our data indicate that ECs can sense the direction and strength of blood flow through the hydrodynamic drag applied to their nuclei.

  11. Perturbation of blood flow as a mechanism of anti-tumour action of direct current electrotherapy.

    Jarm, Tomaz; Cemazar, Maja; Steinberg, Fritz; Streffer, Christian; Sersa, Gregor; Miklavcic, Damijan


    Anti-tumour effects of direct current electrotherapy are attributed to different mechanisms depending on the electrode configuration and on the parameters of electric current. The effects mostly arise from the electrochemical products of electrolysis. Direct toxicity of these products to tumour tissue is, however, not a plausible explanation for the observed tumour growth retardation in the case when the electrodes are placed into healthy tissue surrounding the tumour and not into the tumour itself. The hypothesis that the anti-tumour effectiveness of electrotherapy could result from disturbed blood flow in tumours was tested by the measurement of changes in blood perfusion and oxygenation in tumours with three different methods (in vivo tissue staining with Patent Blue Violet dye, polarographic oximetry, near-infrared spectroscopy). The effects induced by electrotherapy were evaluated in two experimental tumour models: Sa-1 fibrosarcoma in A/J mice and LPB fibrosarcoma in C57B1/6 mice. We found that perfusion and oxygenation were significantly decreased after electrotherapy. Good agreement between the results of different methods was observed. The effect of electrotherapy on local perfusion of tumours is probably the prevalent mechanism of anti-tumour action for the particular type of electrotherapy used in the study. The importance of this effect should be considered for the optimization of electrotherapy protocols in experimental and clinical trials. The non-invasive technique of near-infrared spectroscopy proved to be a reliable method for detecting perfusion and oxygenation changes in small solid tumours.

  12. Single-step blood direct PCR: A robust and rapid method to diagnose triplet repeat disorders.

    Singh, Inder; Swarup, Vishnu; Shakya, Sunil; Goyal, Vinay; Faruq, Mohammed; Srivastava, Achal Kumar


    DNA extraction prior to polymerase chain reaction (PCR) amplification in genetic diagnoses of triplet repeat disorders (TRDs) is tedious and labour-intensive and has the limitations of sample contamination with foreign DNA, including that from preceding samples. Therefore, we aimed to develop a rapid, robust, and cost-effective method for expeditious genetic investigation of TRDs from whole blood as a DNA template. Peripheral blood samples were collected from 70 clinically suspected patients of progressive ataxia. The conventional method using genomic DNA and single-step Blood-Direct PCR (BD-PCR) method with just 2μl of whole blood sample were tested to amplify triplet repeat expansion in genes related to spinocerebellar ataxia (SCA) types 1, 2, 3, 12 and Friedreich's ataxia (FRDA). Post-PCR, the allele sizes were mapped and repeat numbers were calculated using GeneMapper and macros run in Microsoft Excel programmes. Successful amplification of target regions was achieved in all samples by both methods. The frequency of the normal and mutated allele was concordant between both methods, diagnosing 37% positive for a mutation in either of the candidate genes. The BD-PCR resulted in higher intensities of product peaks of normal and pathogenic alleles. The nearly-accurate sizing of the normal and expanded allele was achieved in a shorter time (4-5h), without DNA extraction and any risk of cross contamination, which suggests the BD-PCR to be a reliable, inexpensive, and rapid method to confirm TRDs. This technique can be introduced in routine diagnostic procedures of other tandem repeat disorders. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Rapid Detection of Thrombin and Other Protease Activity Directly in Whole Blood

    Yu, Johnson Chung Sing

    Thrombin is a serine protease that plays a key role in the clotting cascade to promote hemostasis following injury to the endothelium. From a clinical diagnostic perspective, in-vivo thrombin activity is linked to various blood clotting disorders, as well as cardiovascular disease (DVT, arteriosclerosis, etc). Thus, the ability to rapidly measure protease activity directly in whole blood will provide important new diagnostics, and clinical researchers with a powerful tool to further elucidate the relationship between circulating protease levels and disease. The ultimate goal is to design novel point of care (POC) diagnostic devices that are capable of monitoring protease activities directly in whole blood and biological sample. A charge-changing substrate specific to the thrombin enzyme was engineered and its functionality was confirmed by a series of experiments. This led to the preliminary design, construction, and testing of two device platforms deemed fully functional for the electrophoretic separation and focusing of charged peptide fragments. The concept of using the existing charge-changing substrate platform for bacterial protease detection was also investigated. Certain strains of E coli are associated with severe symptoms such as abdominal cramps, bloody diarrhea, and vomiting. The OmpT protease is expressed on the outer membrane of E coli and plays a role in the cleavage of antimicrobial peptides, the degradation of recombinant heterologous proteins, and the activation of plasminogen in the host. Thus, a synthetic peptide substrate specific to the OmpT protease was designed and modeled for the purpose of detecting E coli in biological sample.

  14. Ocular biomechanics study: current state and perspectives

    S. Yu. Petrov


    Full Text Available Despite the fact that the eye represents a challenge for biomechanical research due to its size, over the last two decades, much data on ocular biomechanics were accumulated. Scleral and lamina cribrosa biomechanics contribute to our understanding of myopia and open-angle glaucoma; iris and trabecular meshwork biomechanics to that of angle-closure glaucoma; vitreous biomechanics to that of retinal detachment and ocular drug delivery; corneal biomechanics to that of keratoconus; and lens capsule biomechanics to that of cataract. This paper offers a general overview of recent advances in corneal, scleral, crystalline lens, and lamina cribrosa biomechanics and summarizes the results of experimental and clinical studies. Ocular biomechanics abnormalities affect etiology of many eye diseases. Ocular biomechanics plays an important role in the development of novel diagnostic methods, therapeutic and surgical procedures. Corneal biomechanics impacts etiology and pathogenesis of keratoconus as well as tonometry accuracy and explains corneal refractive surgery effect. Scleral biomechanics is associated with IOP and progressive myopia. Accommodative apparatus (ciliary body and crystalline lens is an important anatomic physiological structure. Recent studies uncovered the causes of agerelated loss of accommodation as a result of lens involution. Optic nerve head abnormalities due to IOP fluctuations are the key factor of glaucomatous neuropathy. They are directly associated with ocular biomechanics as well.

  15. Ocular biomechanics study: current state and perspectives

    S. Yu. Petrov


    Full Text Available Despite the fact that the eye represents a challenge for biomechanical research due to its size, over the last two decades, much data on ocular biomechanics were accumulated. Scleral and lamina cribrosa biomechanics contribute to our understanding of myopia and open-angle glaucoma; iris and trabecular meshwork biomechanics to that of angle-closure glaucoma; vitreous biomechanics to that of retinal detachment and ocular drug delivery; corneal biomechanics to that of keratoconus; and lens capsule biomechanics to that of cataract. This paper offers a general overview of recent advances in corneal, scleral, crystalline lens, and lamina cribrosa biomechanics and summarizes the results of experimental and clinical studies. Ocular biomechanics abnormalities affect etiology of many eye diseases. Ocular biomechanics plays an important role in the development of novel diagnostic methods, therapeutic and surgical procedures. Corneal biomechanics impacts etiology and pathogenesis of keratoconus as well as tonometry accuracy and explains corneal refractive surgery effect. Scleral biomechanics is associated with IOP and progressive myopia. Accommodative apparatus (ciliary body and crystalline lens is an important anatomic physiological structure. Recent studies uncovered the causes of agerelated loss of accommodation as a result of lens involution. Optic nerve head abnormalities due to IOP fluctuations are the key factor of glaucomatous neuropathy. They are directly associated with ocular biomechanics as well.

  16. Recent Advances in Ocular Drug Delivery Systems

    Shinobu Fujii


    Full Text Available Transport of drugs applied by traditional dosage forms is restricted to the eye, and therapeutic drug concentrations in the target tissues are not maintained for a long duration since the eyes are protected by a unique anatomy and physiology. For the treatment of the anterior segment of the eye, various droppable products to prolong the retention time on the ocular surface have been introduced in the market. On the other hand, direct intravitreal implants, using biodegradable or non-biodegradable polymer technology, have been widely investigated for the treatment of chronic vitreoretinal diseases. There is urgent need to develop ocular drug delivery systems which provide controlled release for the treatment of chronic diseases, and increase patient’s and doctor’s convenience to reduce the dosing frequency and invasive treatment. In this article, progress of ocular drug delivery systems under clinical trials and in late experimental stage is reviewed.

  17. A novel approach for direct reconstruction of parametric images for myocardial blood flow from PET imaging.

    Su, Kuan-Hao; Yen, Tzu-Chen; Fang, Yu-Hua Dean


    The aim of this study is to develop and evaluate a novel direct reconstruction method to improve the signal-to-noise ratio (SNR) of parametric images in dynamic positron-emission tomography (PET), especially for applications in myocardial perfusion studies. Simulation studies were used to test the performance in SNR and computational efficiency for different methods. The NCAT phantom was used to generate simulated dynamic data. Noise realization was performed in the sinogram domain and repeated for 30 times with four different noise levels by varying the injection dose (ID) from standard ID to 1/8 of it. The parametric images were calculated by (1) three direct methods that compute the kinetic parameters from the sinogram and (2) an indirect method, which computes the kinetic parameter with pixel-by-pixel curve fitting in image space using weighted least-squares. The first direct reconstruction maximizes the likelihood function using trust-region-reflective (TRR) algorithm. The second approach uses tabulated parameter sets to generate precomputed time-activity curves for maximizing the likelihood functions. The third approach, as a newly proposed method, assumes separable complete data to derive the M-step for maximizing the likelihood. The proposed method with the separable complete data performs similarly to the other two direct reconstruction methods in terms of the SNR, providing a 5%-10% improvement as compared to the indirect parametric reconstruction under the standard ID. The improvement of SNR becomes more obvious as the noise level increases, reaching more than 30% improvement under 1/8 ID. Advantage of the proposed method lies in the computation efficiency by shortening the time requirement to 25% of the indirect approach and 3%-6% of other direct reconstruction methods. With results provided from this simulation study, direct reconstruction of myocardial blood flow shows a high potential for improving the parametric image quality for clinical use.

  18. Artefactos en ultrasonido ocular

    Mariana Mayorquín Ruiz


    Full Text Available El ultrasonido ocular es un estudio dependiente del operador. Un buen estudio ecográfico debe tener como base el conocimiento de la anatomía y fisiología normales y de los cambios producidos en diferentes enfermedades, así como los cambios tras una cirugía ocular o trauma. El conocimiento de los fenómenos físicos producidos por el ultrasonido es la base para entender y reconocer la presencia de artefactos en el ultrasonido ocular. Esta revisión tiene como objetivo hacer un recuento de los artefactos que pueden ocasionar confusión al interpretar una imagen ecográfica, así como explicar la base física en la que se basan, reduciendo de esta manera los errores de interpretación y diagnósticos.

  19. Ocular complications of boxing.

    Bianco, M; Vaiano, A S; Colella, F; Coccimiglio, F; Moscetti, M; Palmieri, V; Focosi, F; Zeppilli, P; Vinger, P F


    To investigate the prevalence of ocular injuries in a large population of boxers over a period of 16 years, in particular, the most severe lesions that may be vision threatening. Clinical records of the medical archive of the Italian Boxing Federation were analysed. A total of 1032 boxers were examined from February 1982 to October 1998. A complete ophthalmological history was available for 956, who formed the study population (a total of 10 697 examinations). The following data were collected: age when started boxing; duration of competitive boxing career (from the date of the first bout); weight category; a thorough ocular history. The following investigations were carried out: measurement of visual acuity and visual fields, anterior segment inspection, applanation tonometry, gonioscopy, and examination of ocular fundus. Eighty age matched healthy subjects, who had never boxed, formed the control group. Of the 956 boxers examined, 428 were amateur (44.8%) and 528 professional (55.2%). The median age at first examination was 23.1 (4.3) years (range 15-36). The prevalence of conjunctival, corneal, lenticular, vitreal, ocular papilla, and retinal alterations in the study population was 40.9% compared with 3.1% in the control group (p< or =0.0001). The prevalence of serious ocular findings (angle, lens, macula, and peripheral retina alterations) was 5.6% in boxers and 3.1% in controls (NS). Boxing does not result in a higher prevalence of severe ocular lesions than in the general population. However, the prevalence of milder lesions (in particular with regard to the conjunctiva and cornea) is noteworthy, justifying the need for adequate ophthalmological surveillance.

  20. Ocular complications of boxing

    Bianco, M; Vaiano, A; Colella, F; Coccimiglio, F; Moscetti, M; Palmieri, V; Focosi, F; Zeppilli, P; Vinger, P


    Objectives: To investigate the prevalence of ocular injuries in a large population of boxers over a period of 16 years, in particular, the most severe lesions that may be vision threatening. Methods: Clinical records of the medical archive of the Italian Boxing Federation were analysed. A total of 1032 boxers were examined from February 1982 to October 1998. A complete ophthalmological history was available for 956, who formed the study population (a total of 10 697 examinations). The following data were collected: age when started boxing; duration of competitive boxing career (from the date of the first bout); weight category; a thorough ocular history. The following investigations were carried out: measurement of visual acuity and visual fields, anterior segment inspection, applanation tonometry, gonioscopy, and examination of ocular fundus. Eighty age matched healthy subjects, who had never boxed, formed the control group. Results: Of the 956 boxers examined, 428 were amateur (44.8%) and 528 professional (55.2%). The median age at first examination was 23.1 (4.3) years (range 15–36). The prevalence of conjunctival, corneal, lenticular, vitreal, ocular papilla, and retinal alterations in the study population was 40.9% compared with 3.1% in the control group (p⩽0.0001). The prevalence of serious ocular findings (angle, lens, macula, and peripheral retina alterations) was 5.6% in boxers and 3.1% in controls (NS). Conclusions: Boxing does not result in a higher prevalence of severe ocular lesions than in the general population. However, the prevalence of milder lesions (in particular with regard to the conjunctiva and cornea) is noteworthy, justifying the need for adequate ophthalmological surveillance. PMID:15665199

  1. Ocular Surface Reconstruction: Recent Innovations

    Madhavan HN


    The ocular surface is exceptionally rich in complexity and functionality. Severe ocular surface disorders/conditions, such as chemical or thermal injuries, Stevens-Johnson syndrome (SJS), ocular cicatricial pemphigoid, neurotrophic keratopathy, chronic limbitis, and severe microbial keratitis cause significant morbidities and even corneal blindness. Hypofunction may be caused by Aniridia, Neurotrophy, Endocrine, Pterygium and Chronic limbitis Approximately 6000 patients are seen in Ocular Sur...

  2. Immunogenetics of ocular inflammatory disease.

    Levinson, R D


    Ocular inflammatory disease comprises of a diverse group of clinical entities that may result from autoimmune processes, infections, or both. While many individual ocular inflammatory diseases are quite rare, ocular inflammation is one of the more common causes of visual disability, including blindness, in the developed world. Better understanding of ocular inflammatory disease is an important step in designing more sophisticated therapies that may help prevent loss of visual function for these patients.

  3. Ocular involvement of brucellosis.

    Bazzazi, Nooshin; Yavarikia, Alireza; Keramat, Fariba


    A 29-year-old male diagnosed with brucellosis a week earlier was referred to the ophthalmology clinic with visual complaints. On examination, visual acuity was 20/25, he had conjunctival injection on slit lamp examination. There was also bilateral optic disk swelling plus retinal hyperemia (optic disc hyperemia and vascular tortuosity) and intraretinal hemorrhage on funduscopy. The patient was admitted and treated with cotrimoxazole, rifampin, doxycycline and prednisolone for 2 months. Ocular manifestations subsided gradually within 6 months after treatment. Brucellosis can affect the eye and lead to serious ocular complications. Early diagnosis and prompt treatment should be considered in endemic areas.

  4. Correction of ocular dystopia.

    Janecka, I P


    The purpose of this study was to examine results with elective surgical correction of enophthalmos. The study was a retrospective assessment in a university-based referral practice. A consecutive sample of 10 patients who developed ocular dystopia following orbital trauma was examined. The main outcome measures were a subjective evaluation by patients and objective measurements of patients' eye position. The intervention was three-dimensional orbital reconstruction with titanium plates. It is concluded that satisfactory correction of enophthalmos and ocular dystopia can be achieved with elective surgery using titanium plates. In addition, intraoperative measurements of eye position in three planes increases the precision of surgery.

  5. Bedside ocular ultrasound.

    Roque, Pedro J; Hatch, Nicholas; Barr, Laurel; Wu, Teresa S


    Many ocular emergencies are difficult to diagnose in the emergency setting with conventional physical examination tools. Additionally, persistent efforts to re-examine the eye may be deleterious to a patient's overall condition. Ultrasound is an important tool because it affords physicians a rapid, portable, accurate, and dynamic tool for evaluation of a variety of ocular and orbital diseases. The importance of understanding orbital anatomy, with attention to the firm attachment points of the various layers of the eye, cannot be understated. This article describes the relevant eye anatomy, delves into the ultrasound technique, and illustrates a variety of orbital pathologies detectable by bedside ultrasound.

  6. Blood

    ... Also, blood is either Rh-positive or Rh-negative. So if you have type A blood, it's either A positive or A negative. Which type you are is important if you need a blood transfusion. And your Rh factor could be important ...

  7. Ocular Fundus Photography as a Tool to Study Stroke and Dementia.

    Cheung, Carol Y; Chen, Christopher; Wong, Tien Y


    Although cerebral small vessel disease has been linked to stroke and dementia, due to limitations of current neuroimaging technology, direct in vivo visualization of changes in the cerebral small vessels (e.g., cerebral arteriolar narrowing, tortuous microvessels, blood-brain barrier damage, capillary microaneurysms) is difficult to achieve. As the retina and the brain share similar embryological origin, anatomical features, and physiologic properties with the cerebral small vessels, the retinal vessels offer a unique and easily accessible "window" to study the correlates and consequences of cerebral small vessel diseases in vivo. The retinal microvasculature can be visualized, quantified and monitored noninvasively using ocular fundus photography. Recent clinic- and population-based studies have demonstrated a close link between retinal vascular changes seen on fundus photography and stroke and dementia, suggesting that ocular fundus photography may provide insights to the contribution of microvascular disease to stroke and dementia. In this review, we summarize current knowledge on retinal vascular changes, such as retinopathy and changes in retinal vascular measures with stroke and dementia as well as subclinical makers of cerebral small vessel disease, and discuss the possible clinical implications of these findings in neurology. Studying pathologic changes of retinal blood vessels may be useful for understanding the etiology of various cerebrovascular conditions; hence, ocular fundus photography can be potentially translated into clinical practice.

  8. Three-dimensional optical micro-angiography maps directional blood perfusion deep within microcirculation tissue beds in vivo

    Wang, Ruikang K [Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR 97237 (United States)


    Optical micro-angiography (OMAG) is a recently developed method of imaging localized blood perfusion at capillary level resolution within microcirculatory beds. This paper reports that the OMAG is capable of directional blood perfusion mapping in vivo. This is achieved simply by translating the mirror located in the reference arm back and forth while 3D imaging is performed. The mirror which moves toward the incident beam gives the blood perfusion that flows away from the beam direction and vice versa. The approach is experimentally demonstrated by imaging of a flow phantom and then cerebro-vascular perfusion of a live mouse with cranium intact.

  9. Ocular rosacea: a dermatologic perspective.

    Webster, Guy; Schaller, Martin


    As many as 50% of patients given the diagnosis of cutaneous rosacea also have ocular rosacea. Conservative figures indicate that approximately 10 million patients are affected by ocular rosacea in the United States alone. Despite this prevalence, ocular symptoms of rosacea are often improperly diagnosed, particularly when they occur in the absence of skin involvement.

  10. Mechanical interactions between ice crystals and red blood cells during directional solidification.

    Ishiguro, H; Rubinsky, B


    Experiments in which red blood cells were frozen on a directional solidification stage under a microscope show that there is a mechanical interaction between ice crystals and cells in which cells are pushed and deformed by the ice crystals. The mechanical interaction occurs during freezing of cells in physiological saline and is significantly inhibited by the addition of 20% v/v glycerol to the solution. The addition of osmotically insignificant quantities of antifreeze proteins from the winter flounder or ocean pout to the physiological saline with 20% v/v glycerol generates strong mechanical interactions between the ice and the cells. The cells were destroyed during freezing in physiological saline, survived freezing in physiological saline with glycerol, and were completely destroyed by the addition of antifreeze proteins to the solution with glycerol. The difference in cell survival through freezing and thawing appears to be related, in part, to the habit of ice crystal growing in the suspension of red blood cells and the nature of mechanical interaction between the ice crystal and the cells. This suggests that mechanical damage may be a factor during cryopreservation of cells.

  11. Diagnostic accuracy and use of nonmydriatic ocular fundus photography by emergency physicians: phase II of the FOTO-ED study.

    Bruce, Beau B; Thulasi, Praneetha; Fraser, Clare L; Keadey, Matthew T; Ward, Antoinette; Heilpern, Katherine L; Wright, David W; Newman, Nancy J; Biousse, Valérie


    During the first phase of the Fundus Photography vs Ophthalmoscopy Trial Outcomes in the Emergency Department study, 13% (44/350; 95% confidence interval [CI] 9% to 17%) of patients had an ocular fundus finding, such as papilledema, relevant to their emergency department (ED) management found by nonmydriatic ocular fundus photography reviewed by neuro-ophthalmologists. All of these findings were missed by emergency physicians, who examined only 14% of enrolled patients by direct ophthalmoscopy. In the present study, we evaluate the sensitivity of nonmydriatic ocular fundus photography, an alternative to direct ophthalmoscopy, for relevant findings when photographs are made available for use by emergency physicians during routine clinical care. Three hundred fifty-four patients presenting to our ED with headache, focal neurologic deficit, visual change, or diastolic blood pressure greater than or equal to 120 mm Hg had nonmydriatic fundus photography obtained (Kowa nonmydriatic α-D). Photographs were placed on the electronic medical record for emergency physician review. Identification of relevant findings on photographs by emergency physicians was compared with a reference standard of neuro-ophthalmologist review. Emergency physicians reviewed photographs of 239 patients (68%). Thirty-five patients (10%; 95% CI 7% to 13%) had relevant findings identified by neuro-ophthalmologist review (6 disc edema, 6 grade III/IV hypertensive retinopathy, 7 isolated hemorrhages, 15 optic disc pallor, and 1 retinal vascular occlusion). Emergency physicians identified 16 of 35 relevant findings (sensitivity 46%; 95% CI 29% to 63%) and also identified 289 of 319 normal findings (specificity 91%; 95% CI 87% to 94%). Emergency physicians reported that photographs were helpful for 125 patients (35%). Emergency physicians used nonmydriatic fundus photographs more frequently than they performed direct ophthalmoscopy, and their detection of relevant abnormalities improved. Ocular fundus

  12. Ocular manifestations of leptospirosis

    Rathinam S


    Full Text Available Leptospiral uveitis is a common entity in tropical countries. Ocular manifestations are noted in the second phase of illness, but these remain under-diagnosed mainly because of the prolonged symptom-free period that separates the systemic manifestations from detection of ocular manifestations.Varying ophthalmic presentations and the intrinsic nature of different types of uveitis to mimic one another also challenge the accuracy of the diagnosis. Of the individual ocular signs, the combination of acute, non-granulomatous, panuveitis, hypopyon, vasculitis, optic disc edema, membranous vitreous opacities and absence of choroiditis or retinitis have high predictive value for the clinical diagnosis of leptospiral uveitis. Geographic location of the patient, occupation, socio-economic status, risk factors related to exposure, past history of fever or jaundice also aid in diagnosis.Steroids are the mainstay of treatment for leptospiral uveitis. Depending upon the severity and anatomical location of inflammatory lesion, topical, peri-ocular and/or systemic steroids are given. The prognosis is generally good, even when the inflammation is severe.


    Mulla Summaiya A


    Full Text Available Background: Isolation of common pathogens involved in ocular infection and their in-vitro susceptibility to commonly used ocular antibiotics, as well as the trends in antibiotic resistance developed by these pathogens were investigated. Material/Methods: All patients with suspected bacterial ocular infections presenting between march 2010 and feb 2011 were examined under slit lamp microscope and samples were collected by using aseptic techniques. All samples were processed for direct microscopy, culture and identification by standard methods. Susceptibility testing was done by Kirby-Bauer method as per CLSI guideline. Results: Out of 116 patients with ocular infections 130 samples were collected, from which 38 different organisms were isolated. Gram-positive cocci 21 (55%, gram-negative cocco-bacilli 5(31% and gram-negative bacilli 12 (32% were isolated. Coagulase negative Staphylococci (37% and Pseudomonas species (21% were the most commonly-isolated. Gatifloxacin has highest efficacy (89% against all isolates. Majority of gram positive cocci were susceptible to vancomycin, gatifloxacin, cefazolin, gram negative cocco-bacilli to amikacin, tobramycin, fluoroquinolone and gram negative bacilli to gatifloxacin. Conclusion: Majority of ocular infection is caused by gram positive organisms which were susceptible to vancomycin followed by gram negative organisms susceptible to amikacin, fluoroquinolone, gram negative cocco-bacilli to amikacin and tobramycin, and gatifloxacin effective against both type of organisms. The information provided in this article help the clinician in formulating rationale-based empirical antibiotic treatment of bacterial ocular infections. [National J of Med Res 2012; 2(1.000: 22-24

  14. Direct Fluorescent Detection of Blood Potassium by Ion-Selective Formation of Intermolecular G-Quadruplex and Ligand Binding.

    Yang, Le; Qing, Zhihe; Liu, Changhui; Tang, Qiao; Li, Jishan; Yang, Sheng; Zheng, Jing; Yang, Ronghua; Tan, Weihong


    G-quadruplex analogues have been widely used as molecular tools for detection of potassium ion (K(+)). However, interference from a higher concentration of sodium ion (Na(+)), enzymatic degradation of the oligonucleotide, and background absorption and fluorescence of blood samples have all limited the use of G-quadruplex for direct detection of K(+) in blood samples. Here, we reported, for the first time, an intermolecular G-quadruplex-based assay capable of direct fluorescent detection of blood K(+). Increased stringency of intermolecular G-quadruplex formation based on our screened G-rich oligonucleotide (5'-TGAGGGA GGGG-3') provided the necessary selectivity for K(+) against Na(+) at physiological ion level. To increase long-term stability of oligonucleotide in blood, the screened oligonucleotide was modified with an inverted thymine nucleotide whose 3'-terminus was connected to the 3'-terminus of the upstream nucleotide, acting as a blocking group to greatly improve antinuclease stability. Lastly, to avoid interference from background absorption and autofluorescence of blood, a G-quadruplex-binding, two-photon-excited ligand, EBMVC-B, was synthesized and chosen as the fluorescence reporter. Thus, based on selective K(+) ion-induced formation of intermolecular G-quadruplex and EBMVC-B binding, this approach could linearly respond to K(+) from 0.5 to 10 mM, which matches quite well with the physiologically relevant concentration of blood K(+). Moreover, the system was highly selective for K(+) against other metal ions, including Na(+), Ca(2+), Mg(2+), Zn(2+) common in blood. The practical application was demonstrated by direct detection of K(+) from real blood samples by two-photon fluorescence technology. To the best of our knowledge, this is the first attempt to exploit molecular G-quadruplex-based fluorescent sensing for direct assay of blood target. As such, we expect that it will promote the design and practical application of similar DNA-based sensors in

  15. Post-test probability for neonatal hyperbilirubinemia based on umbilical cord blood bilirubin, direct antiglobulin test, and ABO compatibility results.

    Peeters, Bart; Geerts, Inge; Van Mullem, Mia; Micalessi, Isabel; Saegeman, Veroniek; Moerman, Jan


    Many hospitals opt for early postnatal discharge of newborns with a potential risk of readmission for neonatal hyperbilirubinemia. Assays/algorithms with the possibility to improve prediction of significant neonatal hyperbilirubinemia are needed to optimize screening protocols and safe discharge of neonates. This study investigated the predictive value of umbilical cord blood (UCB) testing for significant hyperbilirubinemia. Neonatal UCB bilirubin, UCB direct antiglobulin test (DAT), and blood group were determined, as well as the maternal blood group and the red blood cell antibody status. Moreover, in newborns with clinically apparent jaundice after visual assessment, plasma total bilirubin (TB) was measured. Clinical factors positively associated with UCB bilirubin were ABO incompatibility, positive DAT, presence of maternal red cell antibodies, alarming visual assessment and significant hyperbilirubinemia in the first 6 days of life. UCB bilirubin performed clinically well with an area under the receiver-operating characteristic curve (AUC) of 0.82 (95 % CI 0.80-0.84). The combined UCB bilirubin, DAT, and blood group analysis outperformed results of these parameters considered separately to detect significant hyperbilirubinemia and correlated exponentially with hyperbilirubinemia post-test probability. Post-test probabilities for neonatal hyperbilirubinemia can be calculated using exponential functions defined by UCB bilirubin, DAT, and ABO compatibility results. • The diagnostic value of the triad umbilical cord blood bilirubin measurement, direct antiglobulin testing and blood group analysis for neonatal hyperbilirubinemia remains unclear in literature. • Currently no guideline recommends screening for hyperbilirubinemia using umbilical cord blood. What is New: • Post-test probability for hyperbilirubinemia correlated exponentially with umbilical cord blood bilirubin in different risk groups defined by direct antiglobulin test and ABO blood group

  16. Radiolabeled red blood cells for the direct measurement of the blood flow kinetics in experimental tumors after photodynamic therapy

    Paquette, Benoit; Rousseau, Jacques; Ouellet, Rene; van Lier, Johan E.


    Red blood cells from BALB/c mice were labeled with short-lived (gamma) -emitting 99mTc and injected in EMT-6 tumor-bearing animals as a probe for the blood circulation. 99mTc-concentrations in light-exposed versus non-treated tumors were established for different photosensitizers at various dye doses and time intervals post-photodynamic therapy. At minimal dye doses for tumor cure, Photofrin IITM induced a doubling of the tumor radioactivity within the first hour post-PDT, followed by a marked decrease in the 99mTc-concentration at 24 hours post PDT. This pattern is characteristic of extensive hemorrhage followed by occlusion of the blood vessels. Under similar conditions the mono- and tetrasulfonated zinc phthalocyanines induced tumor response without prolonged effects on the tumor radioactivity levels. Accordingly, with the latter sensitizers, indirect cell kill via obstruction of the blood supply does not appear to constitute a major factor in eliciting a tumor response.

  17. Asymptotic analysis of blood flow in stented arteries: time dependency and direct simulations***

    Pichon Gostaf Kirill


    Full Text Available This work aims to extend in two distinct directions results recently obtained in [10]. In a first step we focus on the possible extension of our results to the time dependent case. Whereas in the second part some preliminary numerical simulations aim to give orders of magnitudes in terms of numerical costs of direct 3D simulations. We consider, in the first part, the time dependent rough problem for a simplified heat equation in a straight channel that mimics the axial velocity under an oscillating pressure gradient. We derive first order approximations with respect to ϵ, the size of the roughness. In order to understand the problem and set up correct boundary layer approximations, we perform a time periodic fourier analysis and check that no frequency can interact with the roughness. We show rigorously on this toy problem that the boundary layers remain stationary in time (independent on the frequency number. Finally we perform numerical tests validating our theoretical approach. In the second part, we determine actual limits, when running three-dimensional blood flow simulations of the non-homogenized stented arteries. We solve the stationary Stokes equations for an artery containing a saccular aneurysm. Consecutive levels of uniform mesh refinement, serve to relate spatial resolution, problem scale, and required computation time. Test computations are presented for femoral side aneurysm, where a simplified ten-wire stent model was placed across the aneurysm throat. We advocate the proposed stent homogenization model, by concluding that an actual computation power is not sufficient to run accurate, direct simulations of a pulsatile flow in stented vessels.

  18. Transcranial direct current stimulation transiently increases the blood-brain barrier solute permeability in vivo

    Shin, Da Wi; Khadka, Niranjan; Fan, Jie; Bikson, Marom; Fu, Bingmei M.


    Transcranial Direct Current Stimulation (tDCS) is a non-invasive electrical stimulation technique investigated for a broad range of medical and performance indications. Whereas prior studies have focused exclusively on direct neuron polarization, our hypothesis is that tDCS directly modulates endothelial cells leading to transient changes in blood-brain-barrier (BBB) permeability (P) that are highly meaningful for neuronal activity. For this, we developed state-of-the-art imaging and animal models to quantify P to various sized solutes after tDCS treatment. tDCS was administered using a constant current stimulator to deliver a 1mA current to the right frontal cortex of rat (approximately 2 mm posterior to bregma and 2 mm right to sagittal suture) to obtain similar physiological outcome as that in the human tDCS application studies. Sodium fluorescein (MW=376), or FITC-dextrans (20K and 70K), in 1% BSA mammalian Ringer was injected into the rat (SD, 250-300g) cerebral circulation via the ipsilateral carotid artery by a syringe pump at a constant rate of ~3 ml/min. To determine P, multiphoton microscopy with 800-850 nm wavelength laser was applied to take the images from the region of interest (ROI) with proper microvessels, which are 100-200 micron below the pia mater. It shows that the relative increase in P is about 8-fold for small solute, sodium fluorescein, ~35-fold for both intermediate sized (Dex-20k) and large (Dex-70k) solutes, 10 min after 20 min tDCS pretreatment. All of the increased permeability returns to the control after 20 min post treatment. The results confirmed our hypothesis.

  19. Influence of direct or indirect contact for the cytotoxicity and blood compatibility of spider silk.

    Kuhbier, J W; Coger, V; Mueller, J; Liebsch, C; Schlottmann, F; Bucan, V; Vogt, P M; Strauss, S


    Spider silk became one of the most-researched biomaterials in the last years due to its unique mechanical strength and most favourable chemical composition for tissue engineering purposes. However, standardized analysis of cytocompatibility is missing. Therefore, the aim of this study was to investigate hemolysis, cytotoxicity of native spider silk as well as influences on the cell culture medium. Changes of cell culture medium composition, osmolarity as well as glucose and lactate content were determined via ELISA measurement. Possible hemolysis and cytotoxicity in vitro of spider silk were performed via measurement of hemoglobin release of human red blood cells or relative metabolic activity of L929 fibroblasts, respectively, according to international standard procedures. In ELISA measurement, no significant changes in medium composition could be found in this study. Spider silk was not hemolytic in direct and indirect testing. However, a borderline cytotoxicity according to definitions was found in indirect cytotoxicity testing. Nevertheless, in direct cytotoxicity testing, relative metabolic activity measurement revealed that spider silk is not cytotoxic under these conditions. This is the first study to conduct standardized tests regarding cytotoxicity and hemolysis of native spider silk, which might be considered inert in cell culture. As neither hemolysis nor cytotoxicity was found in direct contact in standardized procedures, safety in biomedical applications may be assumed. The indirect cytotoxicity seems to play a minor role in vivo. However, a borderline toxicity was revealed, suggesting potential leachables not yet identified. Displays one of the weaving frames used in this study after seeding with the single drop technique described herein.

  20. Multiple transfused thalassemia major: Ocular manifestations in a hospital-based population

    Taneja Rashi


    Full Text Available Purpose: To study the ocular manifestations in multiple transfused beta-thalassemia major patients and assess the ocular side-effects of iron chelating agents. Materials and Methods: In this prospective observational study, 45 multiple transfused beta-thalassemia major children between six months and 21 years of age were enrolled and assigned groups according to the treatment regimens suggested. Group A received only blood transfusions, Group B blood transfusions with subcutaneous desferrioxamine, Group C blood transfusions with desferrioxamine and oral deferriprone and Group D blood transfusions with deferriprone. Ocular status at the time of enrolment was documented. Subjects were observed quarterly for one year for changes in ocular status arising due to the disease process and due to iron chelation therapy. Children with hemoglobinopathies other than beta-thalassemia major, congenital ocular anomalies and anemia due to other causes were excluded. Results: Ocular involvement was observed in 58% of patients. Lenticular opacities were the most common ocular finding (44%, followed by decreased visual acuity (33%. An increased occurrence of ocular changes was observed with increase of serum ferritin and serum iron levels as well as with higher number of blood transfusions received. Desferrioxamine seemed to have a protective influence on retinal pigment epithelium (RPE mottling. Occurrence of lenticular opacities and RPE degeneration correlated positively with use of desferrioxamine and deferriprone respectively. Follow-up of patients for one year did not reveal any change in ocular status. Conclusion: Regular ocular examinations can aid in preventing, delaying or ameliorating the ocular complications of thalassemia.

  1. Normal and system lupus erythematosus red blood cell interactions studied by double trap optical tweezers: direct measurements of aggregation forces

    Khokhlova, Maria D.; Lyubin, Eugeny V.; Zhdanov, Alexander G.; Rykova, Sophia Yu.; Sokolova, Irina A.; Fedyanin, Andrey A.


    Direct measurements of aggregation forces in piconewton range between two red blood cells in pair rouleau are performed under physiological conditions using double trap optical tweezers. Aggregation and disaggregation properties of healthy and pathologic (system lupus erythematosis) blood samples are analyzed. Strong difference in aggregation speed and behavior is revealed using the offered method which is proposed to be a promising tool for SLE monitoring at single cell level.

  2. Ocular allergy and keratoconus

    Namrata Sharma


    Full Text Available Keratoconus is the most common corneal ectatic disorder, the cause of which is largely unknown. Many factors have been implicated, and the ocular allergy is being one of them. The commonly proposed pathogenesis includes the release of inflammatory mediators due to eye rubbing which may alter the corneal collagen and lead to corneal ectasias. The onset of keratoconus is often early in cases associated with allergy and routine corneal topography may detect subtle forms of keratoconus. These cases may require early keratoplasty and are at an increased risk of having acute corneal hydrops. Surgical outcomes are similar to primary keratoconus cases. However, post-operative epithelial breakdown may be a problem in these cases. Control of allergy and eye rubbing is the best measure to prevent corneal ectasias in cases of ocular allergy.

  3. [Conjunctival microbiota in patients with ocular allergy].

    Libório, Alexandre Mattoso; Nishiwaki-Dantas, Maria Cristina; Mimica, Lycia Mara Jenne; Dantas, Paulo Elias Correa; Lima, Ana Luísa Höfling de


    To evaluate de presence of conjunctival aerobic microbiota in patients with ocular allergy as compared to a control group. One hundred and thirty-three patients were evaluated from April to June 2001 and divided into 2 groups. Sixty-three patients with allergic conjunctivitis (without medication) were in group A and 70 patients from the general outpatient clinic were in group B (control group). Samples from the conjunctival sac of the right eye were collected and cultured in solid media (blood, chocolate and Sabouraud agar). In group A, 30 cultures (47.7%) were positive and 6 (8.6%) in group B. Seven bacteria were isolated from group A and 4 from group B. Statistical analysis revealed significant association between positive cultures and allergic conjunctivitis. Bacterial microbiota was more frequently found in patients with ocular allergy.

  4. Miopatia ocular descendente

    Nunjo Finkel


    Full Text Available São relatados 4 casos de miopatia ocular descendente (MOD com história familial levantada em três gerações. Biópsia musculares e eletromiografia em um caso confirmaram o caráter miogênico da doença. A MOD nada mais seria do que uma forma clínica especial de distrofia muscular, de início tardio.

  5. Ocular sparganosis from Assam

    Nath, Reema; Gogoi, Rajendra Nath


    Sparganosis is caused by plerocercoid larvae of the Pseudophyllidea tapeworms of the genus Spirometra. Though prevalent in East Asian and south east Asian countries like China, Japan, Korea, Taiwan, Vietnam, Thailand; yet very few cases are reported from India. We report a case of migrating sub-conjunctival ocular sparganosis mimicking scleritis which later on developed into orbital cellulitis from Dibrugarh, Assam, North-eastern part of India. This case is reported for its rarity. PMID:25709957

  6. 眼前节内眼模拟手术诱发血眼屏障破坏的大鼠动物模型%Rat model of blood-ocular barrier breakdown induced by anterior segment intraocular analogic surgery

    谢茂松; 郑永征; 徐国兴


    目的 建立眼前节内眼模拟手术诱发血眼屏障破坏的大鼠动物模型.方法 清洁级健康成年雄性Sprague-Dawley大鼠150只,随机分为对照组和模型组,每组75只.按1 ml/kg的剂量腹腔注射盐酸氯胺酮-盐酸甲苯噻嗪混合液麻醉大鼠.磷酸盐缓冲液灌注袋连接三通管.三通管一端连接24G静脉留置针,手术显微镜下在3点时钟位从角巩缘前透明角膜30°斜行穿刺入前房,退出针头,留置套管;另一端连接24G静脉留置针套管,与测压计相连测量大鼠眼压.大鼠眼压波动于0~12 mm Hg(1 mm Hg=0.133 kPa)之间,波动30次/min,重复60次.采用氧氟沙星滴眼液滴眼.建模后第1、2、3、5、7天,采用免疫组织化学法检测大鼠白蛋白;定量检测大鼠房水、视网膜中伊凡思蓝(EB)浓度.结果 免疫组织化学染色结果显示,建模后第1、2、3、5、7天对照组白蛋白阳性染色均局限于虹膜和视网膜血管内,脉络膜弥漫性着色.建模后第1天,模型组白蛋白阳性染色主要位于虹膜和视网膜神经层血管周围;建模后第2、3天,阳性染色扩散到虹膜和视网膜全层;建模后第5、7天,阳性染色主要局限于虹膜和视网膜血管内.模型组房水中EB浓度在建模后第1、2、3、5天,均较对照组高(t=25.781,37.433,25.150,19.171;P<0.01);建模后第7天,与对照组接近(t=1.303,P=0.209).模型组视网膜EB浓度在建模后第1、2、3天,均较对照组高(t=11.997,14.622,23.014;P<0.01);建模后第5、7天,与对照组接近(t=2.027,0.756; P=0.058,0.459).结论 通过模拟眼前节内眼手术损伤因素,可建立内眼手术诱发的血眼屏障破坏的大鼠动物模型.%Objective To establish a rat model of blood ocular barrier breakdown induced by anterior segment intraocular analogic surgery. Methods One hundred and fifty healthy adult male rats were randomly divided into control group and model group,75 rats in each group.The rats were

  7. Ocular injury in hurling.

    Flynn, T H


    OBJECTIVES: To describe the clinical characteristics of ocular injuries sustained in hurling in the south of Ireland and to investigate reasons for non-use of protective headgear and eye wear. METHODS: Retrospective review of the case notes of 310 patients who attended Cork University Hospital or Waterford Regional Hospital between 1 January 1994 and 31 December 2002 with ocular injuries sustained during a hurling match. A confidential questionnaire on reasons for non-use of protective headgear and eye wear was completed by 130 players. RESULTS: Hurling related eye injuries occurred most commonly in young men. Fifty two patients (17%) required hospital admission, with hyphaema accounting for 71% of admissions. Ten injuries required intraocular surgical INTERVENTION: retinal detachment repair (5); macular hole surgery (1); repair of partial thickness corneal laceration (1); repair of globe perforation (1); enucleation (1); trabeculectomy for post-traumatic glaucoma (1). Fourteen eyes (4.5%) had a final best corrected visual acuity (BCVA) of <6\\/12 and six (2%) had BCVA <3\\/60. In the survey, 63 players (48.5%) reported wearing no protective facemask while playing hurling. Impairment of vision was the most common reason cited for non-use. CONCLUSIONS: Hurling related injury is a significant, and preventable, cause of ocular morbidity in young men in Ireland. The routine use of appropriate protective headgear and faceguards would result in a dramatic reduction in the incidence and severity of these injuries, and should be mandatory.

  8. [Direct proteome profiling of human blood serum in the experiment with 5-day dry immersion].

    Pastushkova, L Kh; Pakharukova, N A; Trifonova, O P; Dobrokhotov, I V; Valeeva, O A; Larina, I M


    Purpose of the investigation was to determine changes in blood plasma proteome in healthy human subjects (n = 14, 19 to 26 y.o.) in an experiment with dry immersion (DI). Plasma samples were drawn 7 and 2 days before the exposure, on DI days 2, 3 and 5, and on days 1, 3, 7 and 15 after the experiment. Previous to direct MALDI-TOF mass-spectrometric profiling, serum samples were pre-fractionated and enriched with magnetic particles MB WCX (WCX--a weak cation exchanger) on ClinProt (Bruker Daltonics). In each spectrum, 175 MS-peaks were detected on average within the mass range from 1000 to 17,000 Da with the signal/noise ratio = 5. Student's criterion (p experiment. Significant increases of the peak area of apolipoprotein CI (reduced form with segregated threonine and proline) and C4 enzymes of the complement system, and fibrinogen on the first day after the experiment can be related to changes in motor activities of the subjects.

  9. Direct blood dry LAMP: a rapid, stable, and easy diagnostic tool for Human African Trypanosomiasis.

    Kyoko Hayashida


    Full Text Available Loop-mediated isothermal amplification (LAMP is a rapid and sensitive tool used for the diagnosis of a variety of infectious diseases. One of the advantages of this method over the polymerase chain reaction is that DNA amplification occurs at a constant temperature, usually between 60-65°C; therefore, expensive devices are unnecessary for this step. However, LAMP still requires complicated sample preparation steps and a well-equipped laboratory to produce reliable and reproducible results, which limits its use in resource-poor laboratories in most developing countries. In this study, we made several substantial modifications to the technique to carry out on-site diagnosis of Human African Trypanosomiasis (HAT in remote areas using LAMP. The first essential improvement was that LAMP reagents were dried and stabilized in a single tube by incorporating trehalose as a cryoprotectant to prolong shelf life at ambient temperature. The second technical improvement was achieved by simplifying the sample preparation step so that DNA or RNA could be amplified directly from detergent-lysed blood samples. With these modifications, diagnosis of HAT in local clinics or villages in endemic areas becomes a reality, which could greatly impact on the application of diagnosis not only for HAT but also for other tropical diseases.

  10. Possible bi-directional link between ETA receptors and protein kinase C in rat blood vessels

    A. M. Northover


    Full Text Available Possible links have been investigated between activation of protein kinase C (PKC and endothelin (ET production by small blood vessels. Perfusion pressures were recorded from rat isolated mesenteric artery, with or without the small intestine attached, before and after addition to the perfusate of either ET-1, ET-3 or the PKC activator 12-deoxyphorbol 13-phenylacetate (DOPPA. Rises in perfusion pressure in response to ET-1 (10−8 Mor DOPPA (10−6 M were reduced significantly by pre-treatment with either the ETA receptor antagonist PD151242 (10−6 M or the PKC inhibitor Ro 31-8220 (10−6 M. ET-3 (10−8 M had a significant, albeit small, effect only when the gut was still attached to the mesentery. Inthis latter preparation ET-1 and DOPPA increased the permeability of villi microvessels to colloidal carbon in the perfusate. This effect of DOPPA was reduced by pre-treatment with either PD151242 or Ro 31-8220, but the effects of ET-1 were reduced significantly only by Ro 31-8220. ET-3 (10−8 M was without effect. The results suggest a possible bi-directional link between ETA receptors and PKC in the intestinal vasculature.

  11. Reproducibility of Neonate Ocular Circulation Measurements Using Laser Speckle Flowgraphy

    Tadashi Matsumoto


    Full Text Available Measuring the ocular blood flow in neonates may clarify the relationships between eye diseases and ocular circulation abnormalities. However, no method for noninvasively measuring ocular circulation in neonates is established. We used laser speckle flowgraphy (LSFG modified for neonates to measure their ocular circulation and investigated whether this method is reproducible. During their normal sleep, we studied 16 subjects (adjusted age of 34–48 weeks whose blood flow could be measured three consecutive times. While the subjects slept in the supine position, three mean blur rate (MBR values of the optic nerve head (ONH were obtained: the MBR-A (mean of all values, MBR-V (vessel mean, and MBR-T (tissue mean, and nine blood flow pulse waveform parameters in the ONH were examined. We analyzed the coefficient of variation (COV and the intraclass correlation coefficient (ICC for each parameter. The COVs of the MBR values were all ≤10%. The ICCs of the MBR values were all >0.8. Good COVs were observed for the blowout score, blowout time, rising rate, falling rate, and acceleration time index. Although the measurement of ocular circulation in the neonates was difficult, our results exhibited reproducibility, suggesting that this method could be used in clinical research.




    Full Text Available AIM: To identify the proportion of cases affected in a family with ocular colobamata . MATERIAL: Ocular colobomata present in a family METHOD: Visual acuity, Slit lamp examination, Ophthalmoscopy, Fundus Photography, B - Scan, Family members were examined. RESULTS: Family showed poor visual acuity, Iris and Choridal Coloboma without optic disc involvement and normal corneal diameter. CONCLUSION: Ocular coloboma occurring in patients of my study is family and genetically determined.

  13. Ocular neuropathy in peripheral neuropathies.

    Evliyaoglu, Ferhat; Karadag, Remzi; Burakgazi, Ahmet Z


    Ocular movements and coordination require complex and integrated functions of somatic and autonomic nervous systems. Neurological disorders affecting these nervous systems may cause ocular dysfunction involving extraocular muscles and pupils. In this article, the prevalence, clinical presentations, and management of ocular neuropathy related to certain peripheral neuropathies, including diabetic neuropathy, Guillain-Barré syndrome (GBS), chronic inflammatory neuropathies, human immunodeficiency virus (HIV)-associated neuropathy, and hereditary neuropathies, are examined in detail. Copyright © 2012 Wiley Periodicals, Inc.

  14. [Blood flow measurement in arteriovenous fistula. Comparison of 2 ultrasonic methods, direct and indirect by compression of the fistula].

    Deklunder, G; Goullard, L; Lecroart, J L; Foulard, M; Houdas, Y


    Measuring blood flow in arteriovenous fistulae in patients under chronic dialysis is of interest to evaluate the repercussions of the fistula on the heart. The apparently simplest method is direct measurement of the mean blood flow velocity by the pulsed doppler technique and ot the cross-section area by ultrasonography, the product of these two values being the blood flow rate. Another method has been proposed, which consists of measuring the cardiac output before and after compression of the fistula, the difference between the two values being supposed to represent the blood flow rate in the fistula. A comparative study of these two methods was conducted in 17 patients aged from 2 to 21 years (mean: 14 years). The direct method gave a figure of 475 ml.min-1.m-2 (SD = 240), while the figure obtained with the indirect method was 471 ml.min-1.m-2 (SD = 227); the difference was statistically not significant. In terms of concept, however, the indirect method is open to much more severe criticism than the direct method, and whenever possible the latter should be preferred when measuring blood flow in arteriovenous fistulae.

  15. Direct Trace Element Analysis of Liquid Blood Samples by In-Air Ion Beam Analytical Techniques (PIXE-PIGE).

    Huszank, Robert; Csedreki, László; Török, Zsófia


    There are various liquid materials whose elemental composition is of interest in various fields of science and technology. In many cases, sample preparation or the extraction can be complicated, or it would destroy the original environment before the analysis (for example, in the case of biological samples). However, multielement direct analysis of liquid samples can be realized by an external PIXE-PIGE measurement system. Particle-induced X-ray and gamma-ray emission spectroscopy (PIXE, PIGE) techniques were applied in external (in-air) microbeam configuration for the trace and main element determination of liquid samples. The direct analysis of standard solutions of several metal salts and human blood samples (whole blood, blood serum, blood plasma, and formed elements) was realized. From the blood samples, Na, P, S, Cl, K, Ca, Fe, Cu, Zn, and Br elemental concentrations were determined. The focused and scanned ion beam creates an opportunity to analyze very small volume samples (∼10 μL). As the sample matrix consists of light elements, the analysis is possible at ppm level. Using this external beam setup, it was found that it is possible to determine elemental composition of small-volume liquid samples routinely, while the liquid samples do not require any preparation processes, and thus, they can be analyzed directly. In the case of lower concentrations, the method is also suitable for the analysis (down to even ∼1 ppm level) but with less accuracy and longer measurement times.

  16. Direct Susceptibility Testing with Positive BacT/Alert Blood Cultures by Using MicroScan Overnight and Rapid Panels

    Waites, Ken B.; Brookings, E S; Moser, S. A.; Zimmer, B. L.


    Studies were conducted on a method of direct inoculation of MicroScan dried overnight and of rapid panels with positive aerobic blood cultures obtained from the BacT/Alert to determine antimicrobial susceptibilities. Inocula were limited to specimens that appeared unimicrobic on Gram stain. Results were compared to those obtained from panels inoculated following subculture. For 133 gram-negative bacilli, there were 94.7 and 93.5% categorical agreements between direct and standard methods for ...

  17. Microbial identification and automated antibiotic susceptibility testing directly from positive blood cultures using MALDI-TOF MS and VITEK 2.

    Wattal, C; Oberoi, J K


    The study addresses the utility of Matrix Assisted Laser Desorption/Ionisation Time-Of-Flight mass spectrometry (MALDI-TOF MS) using VITEK MS and the VITEK 2 antimicrobial susceptibility testing (AST) system for direct identification (ID) and timely AST from positive blood culture bottles using a lysis-filtration method (LFM). Between July and December 2014, a total of 140 non-duplicate mono-microbial blood cultures were processed. An aliquot of positive blood culture broth was incubated with lysis buffer before the bacteria were filtered and washed. Micro-organisms recovered from the filter were first identified using VITEK MS and its suspension was used for direct AST by VITEK 2 once the ID was known. Direct ID and AST results were compared with classical methods using solid growth. Out of the 140 bottles tested, VITEK MS resulted in 70.7 % correct identification to the genus and/ or species level. For the 103 bottles where identification was possible, there was agreement in 97 samples (94.17 %) with classical culture. Compared to the routine method, the direct AST resulted in category agreement in 860 (96.5 %) of 891 bacteria-antimicrobial agent combinations tested. The results of direct ID and AST were available 16.1 hours before those of the standard approach on average. The combined use of VITEK MS and VITEK 2 directly on samples from positive blood culture bottles using a LFM technique can result in rapid and reliable ID and AST results in blood stream infections to result in early institution of targeted treatment. The combination of LFM and AST using VITEK 2 was found to expedite AST more reliably.

  18. Blood perfusion values of laser speckle contrast imaging and laser Doppler flowmetry: is a direct comparison possible?

    Binzoni, Tiziano; Humeau-Heurtier, Anne; Abraham, Pierre; Mahe, Guillaume


    Laser Doppler flowmetry (LDF) and laser speckle contrast imaging (LSCI) allow the monitoring of microvascular blood perfusion. The relationship between the measurements obtained by these two techniques remains unclear. In the present contribution, we demonstrate, experimentally and theoretically, that skin blood flow measurements obtained by LDF and LSCI techniques cannot be compared directly even after "classical" normalization procedure. This technical problem is generated by the nonlinear relationship existing between LDF and LSCI flow data. The experiments have been performed on five healthy voluntary subjects (forearm) by using repeated ischemia/reperfusion cycles to induce the necessary skin blood flow changes. LDF and LSCI data were simultaneously acquired on the same region of interest. Considering the importance of this problem from the clinical point of view, it is concluded that the definition of new corrected algorithms for LSCI is probably a mandatory step that must be taken into account if LDF and LSCI blood flow have to be compared.

  19. Direct Urease Test and Acridine Orange Staining on Bactec Blood Culture for Rapid Presumptive Diagnosis of Brucellosis

    P Maleknejad


    Full Text Available Brucellosis is one of the most common zoonotic diseases in Iran and human brucellosis is endemic in all parts of the country. Growth of Brucella is slow and blood culture of these bacteria by use of classical methods is time-consuming. Furthermore, in endemic area culture is required for definitive diagnosis. In the present study, direct urease test and acridine orange staining were tried on the BACTEC blood culture broths for early presumptive identification of Brucella growth. Blood cultures were attempted in 102 seropositive patients. In the forty one blood cultures positive for Brucella, coccobacilli were seen in broth smears stained with acridine orange stain, and also were urease test positive, thus providing presumptive identification of Brucella growth. Urease test was negative and bacteria were not seen in the broth smears of the remaining 61 broths negative for Brucella growth. Because of simplicity, reliability and reproducibility, these tests can be routinely incorporated in the laboratory for diagnosis of brucellosis.

  20. A new approach to determine the susceptibility of bacteria to antibiotics directly from positive blood culture bottles in two hours.

    March, Gabriel A; García-Loygorri, María C; Simarro, María; Gutiérrez, María P; Orduña, Antonio; Bratos, Miguel A


    The rapid identification and antibiotic susceptibility test of bacteria causing bloodstream infections are given a very high priority by clinical laboratories. In an effort to reduce the time required for performing antibiotic susceptibility test (AST), we have developed a new method to be applied from positive blood culture bottles. The design of method was performed using blood culture bottles prepared artificially with five strains which have a known susceptibility. An aliquot of the blood culture was subcultured in the presence of specific antibiotics and bacterial counts were monitored using the Sysmex UF-1000i flow cytometer at different times up to 180min. Receiver operating curve (ROC) analysis allowed us to find out the cut-off point for differentiating between sensitive and resistant strains to the tested antibiotic. This procedure was then validated against standard commercial methods on a total of 100 positive blood culture bottles from patients. First, bacterial identification was performed by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF-MS) directly from positive blood culture bottles as we have previously reported. Secondly, antibiotic susceptibility test was performed in the same way that was carried out in artificially prepared blood culture bottles. Our results indicate that antibiotic susceptibility test can be determined as early as 120min since a blood culture bottle is flagged as positive. The essential agreement between our susceptibility test and commercial methods (E-test, MicroScan and Vitek) was 99%. In summary, we conclude that reliable results on bacterial identification and antibiotic susceptibility test performed directly from positive blood culture bottles can be obtained within 3h.




    An instrument consisting merely of a semiconductor laser in its own housing was used to measure the blood perfusion in tissue. Use is made of the feedback of Doppler-scattered light to the photodiode in the laser housing. A recording perfusion of a finger under occlusion of blood flow in the arm is

  2. The ocular retardation (or{sup J}) mouse has an ochre mutation in the homeobox gene Chx10: Direct evidence for Chx10 as a major determinant of retinal development

    McInnes, R.R.; Novak, J.; Ploder, L. [Genetics Hospital for Sick Children, Toronto (Canada)] [and others


    The recessive mutation or causes microphthalmia, progressive destruction of the retina, and absence of the optic nerve. There is a significant disruption of neuroretinal differentiation and layer formation, and the number of proliferating retinal progenitor cells is dramatically reduced (by 45% at E10 & 90% at E16). To identify the or gene, we localized the or{sup J} allele (in strain 129 mice) to chromosome 12. We then positioned or by a backcross between or{sup J} and Mus castaneus, defining the distances D12Mit91-14cM-or-4cM-D12Mit6, and placing or in the same interval of chromosome 12 as Chx10. No recombinants were obtained between or and Chx10 in 170 informative progeny, establishing close linkage and making Chx10 a candidate gene for or. On the basis of its expression pattern, we proposed that Chx10 confers neuroretinal identity on the early retinal progenitors of the developing eye, and participates in retinal lamination. To allow mutation analysis of Chx10, we cloned the strain 129 Chx10 gene (5 coding exons over {approximately}30 kb). Multiple PCR amplifications and direct sequencing of axon 3 of or{sup J} mice revealed a homozygous mutation (TAC {yields} TAA) (not present in strain 129 controls) that converts Tyr 29 of the homeobox to a premature stop; this result was confirmed by restriction analysis of the PCR products, since the mutation destroys an Accl site. We conclude that (1) mutations in Chx10 cause murine ocular retardation, (2) the Chx10 homeodomain protein has a critical role in mammalian retinal formation, possibly as a transcription regulator of neuroblast differentiation and division, and (3) CHx10 mutations may cause microphthalmia in man.

  3. Blood vessel endothelium-directed tumor cell streaming in breast tumors requires the HGF/C-Met signaling pathway.

    Leung, E; Xue, A; Wang, Y; Rougerie, P; Sharma, V P; Eddy, R; Cox, D; Condeelis, J


    During metastasis to distant sites, tumor cells migrate to blood vessels. In vivo, breast tumor cells utilize a specialized mode of migration known as streaming, where a linear assembly of tumor cells migrate directionally towards blood vessels on fibronectin-collagen I-containing extracellular matrix (ECM) fibers in response to chemotactic signals. We have successfully reconstructed tumor cell streaming in vitro by co-plating tumors cells, macrophages and endothelial cells on 2.5 μm thick ECM-coated micro-patterned substrates. We found that tumor cells and macrophages, when plated together on the micro-patterned substrates, do not demonstrate sustained directional migration in only one direction (sustained directionality) but show random bi-directional walking. Sustained directionality of tumor cells as seen in vivo was established in vitro when beads coated with human umbilical vein endothelial cells were placed at one end of the micro-patterned 'ECM fibers' within the assay. We demonstrated that these endothelial cells supply the hepatocyte growth factor (HGF) required for the chemotactic gradient responsible for sustained directionality. Using this in vitro reconstituted streaming system, we found that directional streaming is dependent on, and most effectively blocked, by inhibiting the HGF/C-Met signaling pathway between endothelial cells and tumor cells. Key observations made with the in vitro reconstituted system implicating C-Met signaling were confirmed in vivo in mammary tumors using the in vivo invasion assay and intravital multiphoton imaging of tumor cell streaming. These results establish HGF/C-Met as a central organizing signal in blood vessel-directed tumor cell migration in vivo and highlight a promising role for C-Met inhibitors in blocking tumor cell streaming and metastasis in vivo, and for use in human trials.Oncogene advance online publication, 28 November 2016; doi:10.1038/onc.2016.421.

  4. Ophthalmic use of blood-derived products.

    Nugent, Ryan B; Lee, Graham A


    There is a wide spectrum of blood-derived products that have been used in many different medical and surgical specialties with success. Blood-derived products for clinical use can be extracted from autologous or allogeneic specimens of blood, but recombinant products are also commonly used. A number of blood derivatives have been used for a wide range of ocular conditions, from the ocular surface to the retina. With stringent preparation guidelines, the potential risk of transmission of blood-borne diseases is minimized. We review blood-derived products and how they are improving the management of ocular disease.

  5. Ocular abnormalities in multi-transfused beta-thalassemia patients

    Reza Jafari


    Full Text Available Aims: The aim of this study was to assess ocular changes in thalassemia patients who have received multiple transfusions and chelate binding therapy in order to avoid iron accumulation. Settings and Design: A cross-sectional study. Subjects and Methods: A total of 54 thalassemia major patients were selected as case group, and 54 age- and sex-matched healthy subjects were regarded as a control group. Ocular examination included visual acuity, refraction testing, slit lamp examination, funduscopy, tonometry, perimetry, tear break-up time test, and color vision testing were performed for all the participants. We computed the frequency and duration of blood transfusion, the mean serum ferritin level, pretransfusion hemoglobin concentration, and type, duration, and daily dose of chelation therapy for thalassemia patients based on their records. Statistical Analysis Used: All data analysis was performed using SPSS, version 19. Results: All the thalassemic patients were asymptomatic, but abnormal ocular findings (dry eye (33.3%, cataract (10.2%, retinal pigment epithelium degeneration (16.7%, color vision deficiency (3.7%, and visual field defects (33.7% were seen in 68.5% of thalassemic group. The prevalence of ocular abnormalities in normal group was 19.4%, which was significantly lower than that in thalassemia patients (P = 0.000. No significant correlation was found between ocular abnormalities and mean serum ferritin level (P = 0.627 and mean hemoglobin concentration (P = 0.143. Correlation of number of blood transfusion with the presence of ocular abnormalities was found to be statistically significant (P = 0.005. Conclusions: As life expectancy for beta-thalassemia patients extends, regular ophthalmological evaluation to detect early changes in their ocular system is recommended.

  6. Ocular defects in cerebral palsy

    Katoch Sabita


    Full Text Available There is a high prevalence of ocular defects in children with developmental disabilities. This study evaluated visual disability in a group of 200 cerebral palsy (CP patients and found that 68% of the children had significant visual morbidity. These findings emphasize the need for an early ocular examination in patients with CP.

  7. Fetal ocular measurements by MRI.

    Li, Xiao Bing; Kasprian, Gregor; Hodge, Jacqueline C; Jiang, Xiao Li; Bettelheim, Dieter; Brugger, Peter C; Prayer, Daniela


    To present fetal magnetic resonance imaging (MRI) ocular measurement ranges by gestational age (GA) in normal and growth-restricted fetuses. A total of 298 pregnant women from the 18th to the 39th week of gestation were imaged using MRI. Ocular measurements including binocular distance (BOD), interocular distance (IOD), transverse ocular diameter (OD) and anterior-posterior (AP) OD were measured. The curve estimation analyses for linear, logarithmic and quadratic models were performed. The ocular measurements of the fetuses with intrauterine growth restriction (IUGR) were compared with that of the normal fetuses. The fetal eye resembles an ellipsoid with significantly longer OD and shorter AP (t = - 22.07, p < 0.001). The quadratic model was the best model in predicting growth of the fetal BOD, IOD, OD and AP. The ocular measurements of the fetuses with IUGR were significantly different from that of the normal fetuses (BOD: t = 3.58, p < 0.001; IOD: t = 5.73, p < 0.001; OD: t = 3.52, p < 0.001; AP: t = 2.19, p < 0.05). Fetal ocular growth can be readily assessed by fetal MRI. Using the normative data provided in this study, fetal ocular anomalies may be detected. Ocular size is frequently reduced in the condition of IUGR, with potential pathologic impact on postnatal vision.

  8. Evaluation of hemolysis in microcatheter directed blood infusion at different flow rates for transarterial salvage reperfusion: In-vitro study.

    Froelich, Jens J; Ray, Udayan; Monkhorst, Jessica; Marwick, Thomas H; Hardikar, Ashutosh; Harle, Robin; Carr, Michael W


    Microcatheter directed blood reperfusion is an endovascular salvage option for acute cerebral artery occlusions. It has not been investigated whether this technique may be associated with hemolysis. Analysis of hemolysis during blood infusion through different microcatheters and infusion rates to assess related risks. Four microcatheters with different inner diameters were perfused with blood samples at three infusion rates. Hemolytic markers including lactate-dehydrogenase (LDH) and haptoglobin were analyzed. Samples before and after blood infusion were compared using Student's t-test. Flow-related degree of hemolysis was analyzed with regression analysis. Resulting shear stress was calculated and correlated with LDH and haptoglobin. Significant increase of LDH and decrease of haptoglobin was found after blood reperfusion through small microcatheters at progressive flow rates (phemolysis was found with larger diameter microcatheters at all flow rates (p>0.05). Correlation between shear stress, LDH and haptoglobin was r=0.86 and r=0.75, respectively. Progressive hemolysis occurs during blood perfusion of small lumen microcatheters at increasing flow rates. This phenomenon may be related to turbulent flow, exposure time and increased shear stress. Larger microcatheters did not induce hemolysis and may be the preferred choice for stroke reperfusion.

  9. Techniques used for the screening of hemoglobin levels in blood donors: current insights and future directions

    Chaudhary R


    Full Text Available Rajendra Chaudhary,1 Anju Dubey,2 Atul Sonker3 1Department of Transfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, 2Department of Transfusion Medicine, T.S. Misra Medical College and Hospital, 3Department of Transfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India Abstract: Blood donor hemoglobin (Hb estimation is an important donation test that is performed prior to blood donation. It serves the dual purpose of protecting the donors’ health against anemia and ensuring good quality of blood components, which has an implication on recipients’ health. Diverse cutoff criteria have been defined world over depending on population characteristics; however, no testing methodology and sample requirement have been specified for Hb screening. Besides the technique, there are several physiological and methodological factors that affect accuracy and reliability of Hb estimation. These include the anatomical source of blood sample, posture of the donor, timing of sample and several other biological factors. Qualitative copper sulfate gravimetric method has been the archaic time-tested method that is still used in resource-constrained settings. Portable hemoglobinometers are modern quantitative devices that have been further modified to reagent-free cuvettes. Furthermore, noninvasive spectrophotometry was introduced, mitigating pain to blood donor and eliminating risk of infection. Notwithstanding a tremendous evolution in terms of ease of operation, accuracy, mobility, rapidity and cost, a component of inherent variability persists, which may partly be attributed to pre-analytical variables. Hence, blood centers should pay due attention to validation of test methodology, competency of operating staff and regular proficiency testing of the outputs. In this article, we have reviewed various regulatory guidelines, described the variables that affect the measurements and compared the validated

  10. Ocular hemodynamics in patients with rhegmatogenous retinal detachment

    N. H. Zavgorodnya


    Full Text Available Aim. In case of retinal detachment atrophic processes lead to irreversible loss of functions within 4–6 days, it happens on underlying low ocular blood flow. In order to evaluate the degree of violation of regional hemodynamics in patients with retinal detachment two groups of patients were examined: the main group (52 patients with rhegmatogenous retinal detachment and the control group (24 myopic patients with lattice form of peripheral chorioretinal dystrophy. Methods and results. Doppler and reography results had been compared, significant decrease of blood flow in patients with retinal detachment was found. No differences between affected and fellow eye in these patients, close negative correlation between the level of ocular blood flow and the degree of myopia in the control group. Conclusion. This demonstrates the feasibility of actions to improve regional blood flow in patients operated on for retinal detachment.

  11. Ocular safety limits for 1030nm femtosecond laser cataract surgery

    Wang, Jenny; Sramek, Christopher; Paulus, Yannis M.; Lavinsky, Daniel; Schuele, Georg; Anderson, Dan; Dewey, David; Palanker, Daniel V.


    Application of femtosecond lasers to cataract surgery has added unprecedented precision and reproducibility but ocular safety limits for the procedure are not well-quantified. We present an analysis of safety during laser cataract surgery considering scanned patterns, reduced blood perfusion, and light scattering on residual bubbles formed during laser cutting. Experimental results for continuous-wave 1030 nm irradiation of the retina in rabbits are used to calibrate damage threshold temperatures and perfusion rate for our computational model of ocular heating. Using conservative estimates for each safety factor, we compute the limits of the laser settings for cataract surgery that optimize procedure speed within the limits of retinal safety.

  12. Ocular involvement in pemphigus vulgaris.

    Akhyani, Maryam; Keshtkar-Jafari, Alireza; Chams-Davatchi, Cheyda; Lajevardi, Vahide; Beigi, Sara; Aghazadeh, Nessa; Rayati Damavandi, Maede; Arami, Shabnam


    Pemphigus vulgaris (PV) is an autoimmune disorder affecting the skin and mucous membranes. Ocular involvement in PV has been reported but its prevalence and clinical characteristics are not well defined. This prospective cross-sectional study of 103 PV patients was designed to determine the prevalence, clinical types and epidemiological trends of ocular involvement in a population of Iranian patients with PV. Ocular involvement was present in 17 (16.5%) patients. Conjunctivitis was the most prevalent type of ocular involvement (9/17, 52.9%), followed by erosion of the palpebral conjunctiva (7/17, 41.2%). Erosion of the bulbar conjunctiva was noted in only one patient (5.9%). The most commonly reported symptoms were eye irritation (76.5%) and redness (76.5%). No significant relation was found between ocular involvement and disease activity (partial remission or relapse). Mucoid discharge was significantly more common in patients with conjunctival erosions as compared to patients with conjunctivitis (P = 0.038). We conclude that ocular involvement is not rare in PV; 16.5% of PV patients develop ocular disease independent of the disease activity and extension. Conjunctivitis is the most common type of involvement, however, palpebral conjunctival erosion is more frequent than previously realized.

  13. Direct determination of tin in whole blood and urine by GF AAS.

    De Azevedo, S V; Moreira, F R; Campos, R C


    The aim of this work was to develop a procedure for the determination of tin in whole blood and urine by GF AAS with a minimum sample pre-treatment, using Pd/Mg as chemical modifier. The analyses of tin were conducted using an atomic absorption spectrometer with Zeeman background correction. The laboratory staff volunteered blood and urine samples for the experimental studies and application of the methodology. Samples were just diluted with 0.2% v/v Triton X-100, and pyrolysis and atomization temperatures of 1300 and 2200 °C were used. External calibration was performed with matrix matched calibration solutions. Limits of detection of 2.7 and 0.8 μgL(-1) were reached for blood and urine, respectively. The method was applied to the determination of Sn in blood and urine of eleven subjects not occupationally exposed, working in a laboratory of toxicology in a large Brazilian city, and the results ranged from 7.4 to 11.2 μgL(-1) and ≤0.8 to 2.2 μgL(-1), for blood and urine, respectively. Accuracy was assessed by analysis of standard reference materials for tin in blood (Contox I, lot TM144-1097, Kaulson Laboratories, USA) and urine (Seronorm, lot 0511545, Sero AS, Norway). Results showed good agreement between experimental and reference values according to the Student's t test at 95% of confidence. Copyright © 2012 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  14. Features of blood pressure in student-athletes from different directions of the training process.

    Kalenichenko Aleksej Vladimirovich


    Full Text Available Performed blood pressure (BP and hemodynamics of 85 students: 30 non-athletes (group I, 27 athletes power enforcement types (group II and 28 - endurance sports (group III. It was found that the second and third groups had higher systolic and mean arterial pressure than in the I group. There are differences in blood pressure reactivity to changes in body position, mental and physical activity among the various groups studied. It is shown that the formation of moderate hypertension in group III is carried out by increasing peripheral vascular resistance, and II - at the expense of increased cardiac output.

  15. Sports related ocular injuries.

    Mishra, Avinash; Verma, Ashok K


    Every year > 600,000 sports and recreation related eye injuries occur, out of which roughly 13,500 of these result in permanent loss of sight. Up to 90% of these sports related eye injuries are preventable by using adequate eye protection equipment. Protective eyewear is made of polycarbonate, a highly impact-resistant plastic which is now easily available as prescription and non-prescription eyewear and all players should be encouraged to use them. The medical officers by educating their patients regarding the risks of eye injuries in various sports and the confirmed benefits of using protective equipment have the potential to prevent injury to over thousands of eyes every year. The medical fraternity can also play a very important role in educating the coaches, parents, and children and thus put an end to unnecessary blindness and vision loss from sports related ocular injuries, therefore ensuring a lifetime of healthy vision.

  16. Ocular histoplasmosis syndrome.

    Diaz, Rocio I; Sigler, Eric J; Rafieetary, Mohammad R; Calzada, Jorge I


    Ocular histoplasmosis syndrome (OHS) is a chorioretinal disorder with a distinct fundus appearance that is commonly found in regions endemic for Histoplasma capsulatum. Choroidal neovascularization (CNV) secondary to OHS is considered one of the principal causes of central vision loss among young adults in endemic areas. Although there is no consensus regarding its pathogenesis, evidence points to Histoplasma capsulatum as the most probable etiology. Once considered an intractable hemorrhagic maculopathy, CNVs are now treatable. Extrafoveal CNVs are successfully treated with laser photocoagulation. Subfoveal and juxtafoveal CNVs are managed with anti-vascular endothelial growth factor therapy, photodynamic therapy, or a combination of both. Modern imaging technologies such as spectral-domain optical coherence tomography have improved our diagnostic abilities, making it easier to monitor disease activity and CNV regression. We review the epidemiology, pathogenesis, clinical manifestations, differential diagnosis, and current treatment of this disease.

  17. Fifty-eight cases of ocular ischemic diseases caused by carotid artery stenosis

    LUO Rong-jiang; LIU Shao-rui; LI Xiao-min; ZHUO Ye-hong; TIAN Zhen


    Background The blood supply to the eye comes from the retinal central vascular system of the ophthalmic artery and the ciliary vascular system. The ophthalmic artery stems from the ipsilateral internal carotid artery. If occlusion or stenosis occurs in the carotid artery, the blood perfusion to the ophthalmic artery becomes insufficient, leading to signs and symptoms of anterior and posterior ocular ischemia. The objective of this study was to evaluate the clinical characteristics and risk factors of ocular ischemic diseases caused by carotid artery stenosis.Methods This study was a retrospective review of 145 patients with carotid artery stenosis. Fifty-eight patients who had symptoms of ocular ischemic disease caused by carotid artery stenosis formed group A and the other 87 patients who only had carotid artery stenosis formed group B. We analyzed the causes and course of disease, and relative risk factors,by comparing the two groups.Results The degree of carotid artery stenosis in group A was higher than that in group B. And group A had a greater decrease of ophthalmic artery flow. Male, hypertension, hyperlipidemia, and smoking were significantly related to carotid artery stenosis. Amaurosis fugax was the most common ocular symptom in group A. The ocular ischemic diseases mainly included ischemic optic neuropathy, central/branch retinal artery occlusion, ophthalmoplegia externa, and ocular ischemic syndrome.Conclusions Carotid artery stenosis correlates with ocular ischemic diseases. Ophthalmologists must observe for ocular symptoms, which were the onset symptoms in some patients.

  18. Ocular manifestations of feline herpesvirus.

    Andrew, S E


    Feline herpesvirus-1 (FHV-1) infection is ubiquitous in the domestic cat population worldwide. The most common clinical ocular manifestations of infection with FHV-1 are conjunctivitis and keratitis. This paper reviews the pathogenesis of feline herpesvirus-1 and discusses the various clinical ocular manifestations, diagnostic techniques and treatment of FHV-1-induced diseases. Ocular manifestations include: conjunctivitis, keratitis, stromal keratitis, keratoconjunctivitis sicca, ophthalmia neonatorium, symblepharon, corneal sequestrum, eosinophilic keratitis and anterior uveitis. Diagnostic techniques discussed include: virus isolation, fluorescent antibody testing, serum neutralising titers, ELISA and polymerase chain reaction. Various therapies are also discussed.

  19. Ocular myasthenia gravis: A review

    Akshay Gopinathan Nair


    Full Text Available Myasthenia gravis (MG is a disease that affects the neuro-muscular junction resulting in classical symptoms of variable muscle weakness and fatigability. It is called the great masquerader owing to its varied clinical presentations. Very often, a patient of MG may present to the ophthalmologist given that a large proportion of patients with systemic myasthenia have ocular involvement either at presentation or during the later course of the disease. The treatment of ocular MG involves both the neurologist and ophthalmologist. Thus, the aim of this review was to highlight the current diagnosis, investigations, and treatment of ocular MG.

  20. Ocular neuromyotonia after radiation therapy

    Lessell, S.; Lessell, I.M.; Rizzo, J.F. III


    Ocular neuromyotonia is a paroxysmal monocular deviation that results from spasm of eye muscles secondary to spontaneous discharges from third, fourth, or sixth nerve axons. We observed this rare disorder in four patients who had been treated with radiation for tumors in the region of the sella turcica and cavernous sinus. Based on these cases and four others identified in the literature it would appear that radiation predisposes to a cranial neuropathy in which ocular neuromyotonia may be the major manifestation. Radiation appears to be the most common cause of ocular neuromyotonia.

  1. Direct identification and susceptibility testing of positive blood cultures using high speed cold centrifugation and Vitek II system.

    Bazzi, Ali M; Rabaan, Ali A; Fawarah, Mahmoud M; Al-Tawfiq, Jaffar A


    Compared to routine isolated colony-based methods, direct testing of bacterial pellets from positive blood cultures reduces turnaround time for reporting of antibiotic susceptibility. The aim of this study was to compare the accuracy, and precision, of a rapid method for direct identification and susceptibility testing of blood cultures with the routine method used in our laboratory, using Vitek 2. A total of 60 isolates were evaluated using the candidate and the routine method. The candidate method had 100% accuracy for the identification of Gram negative bacteria, Staphylococcus and Enterococcus, 50% for Streptococcus and 33.3% for Corynebacterium species. Susceptibility testing of Gram negative isolates yielded 98-100% essential agreement. For Staphylococcus and Enterococcus isolates, essential agreement was 100% for 17 antibiotics except for moxifloxacin. Direct testing of blood culture samples with Vitek 2 produced reliable identification and susceptibility results 18-24h sooner for aerobic/anaerobic facultative Gram-negative bacteria and Gram-positive Staphylococcus and Enterococcus strains.


    Bharat Kumar


    Full Text Available AIM This study is designed to enumerate various causes of ocular trauma, clinical spectrum of presentation and to evaluate the visual outcome after appropriate management. MATERIALS AND METHODS A prospective study was conducted on total of 136 patients from the places in and around Kakinada, East Godavari District of Andhra Pradesh, India. A detailed work up of all patients including slit lamp biomicroscopy, direct, indirect ophthalmoscopy and ultra sonography B scan was done. RESULTS Observations from the study were analyzed, discussed and compared with the existing studies in the literature. Mean age group of patients belong to young adults between 20-30 years (57.9%, males (81% affected more than females. Illiterates, Agricultural labourers, Industrial workers affected more. Road Traffic Accidents (25.73%, industrial injuries (22.05% and agricultural hazards (19.11% being the major cause of unilateral eye injury. Closed globe injuries (80.88% more common than Open globe injuries (19.12. CONCLUTIONS Ophthalmic injuries due to innumerable causes results in various types of ocular trauma, leading to untold misery, visual impairment and economic burden to the family, society and country as a whole. Health education regarding use of preventive measures, seeking early treatment and appropriate rehabilitation are very much recommended to reduce the burden of morbidity due to ocular trauma.

  3. Direct blood culturing on solid medium outperforms an automated continuously monitored broth-based blood culture system in terms of time to identification and susceptibility testing.

    Idelevich, E A; Grünastel, B; Peters, G; Becker, K


    Pathogen identification and antimicrobial susceptibility testing (AST) should be available as soon as possible for patients with bloodstream infections. We investigated whether a lysis-centrifugation (LC) blood culture (BC) method, combined with matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) identification and Vitek 2 AST, provides a time advantage in comparison with the currently used automated broth-based BC system. Seven bacterial reference strains were added each to 10 mL human blood in final concentrations of 100, 10 and 1 CFU/mL. Inoculated blood was added to the Isolator 10 tube and centrifuged at 3000 g for 30 min, then 1.5 mL sediment was distributed onto five 150-mm agar plates. Growth was observed hourly and microcolonies were subjected to MALDI-TOF MS and Vitek 2 as soon as possible. For comparison, seeded blood was introduced into an aerobic BC bottle and incubated in the BACTEC 9240 automated BC system. For all species/concentration combinations except one, successful identification and Vitek 2 inoculation were achieved even before growth detection by BACTEC. The fastest identification and inoculation for AST were achieved with Escherichia coli in concentrations of 100 CFU/mL and 10 CFU/mL (after 7 h each, while BACTEC flagged respective samples positive after 9.5 h and 10 h). Use of the LC-BC method allows skipping of incubation in automated BC systems and, used in combination with rapid diagnostics from microcolonies, provides a considerable advantage in time to result. This suggests that the usefulness of direct BC on solid medium should be re-evaluated in the era of rapid microbiology.

  4. Impact of Microbiome on Ocular Health

    Kugadas, Abirami; Gadjeva, Mihaela


    The ocular surface is continuously exposed to the environment and, therefore, it is surprising that it harbors only few commensals with low degree of diversity. This unique aspect of the ocular surface physiology prompts the question whether there are core ocular commensal communities and how they affect ocular immunity. The purpose of this review is to provide an overview of what is known about the ocular surface commensals in health and disease and what we would like to learn in the near fu...

  5. Hematobiochemical alterations and direct blood polymerase chain reaction detection of Theileria annulata in naturally infected crossbred cows

    Anita Ganguly


    Full Text Available Aim: The aim was to determine hemato-biochemical changes and rapid diagnosis of Theileria annulata in naturally infected crossbred cows. Materials and Methods: Blood samples from lactating crossbred cows (n=40 between 3 and 7 years of age and showing clinical signs of tropical theileriosis were collected, with or without anticoagulant, and analyzed for tropical theileriosis by direct smear, direct blood polymerase chain reaction (PCR detection of merozoite-piroplasm surface antigen (Tams1 gene specific amplicon, estimation of hematological and biochemical parameters. Healthy crossbred cows (n=6, examined free from hemoprotozoan infections were included as control. Results: The infected crossbred cows revealed significantly (p<0.001 lower values of total erythrocytic counts (4.46±0.2× 106/μL, hemoglobin (Hb 6.025±0.39 g%, packed cell volume (17.05±1.1%, mean corpuscular volume (37.94±1.70 fL and mean corpuscular Hb (13.5±0.48 pg; p<0.002 compared with healthy control. The serum samples of infected cows revealed profound (p<0.05 hyponatremia (Na 133.21±2.36 mEq/l and hypocalcemia (Ca 8.39±0.34 mg%. Infected crossbred cows showed a significant increase (p<0.05 of mean serum activity of alanine aminotransferase (61.45±13.36 U/L, aspartate aminotransferase (146.1±20.97 U/L, blood urea nitrogen (28.26±3.90 mg%, creatinine (1.55±0.13 mg%, direct bilirubin (0.33±0.04 mg%; p<0.001 and lactate dehydrogenase (3001.32±167.0 U/L; p<001. Blood direct PCR revealed a 721-bp fragment amplified from the target gene encoding 30-kDa major merozoite surface antigen of T. annulata using specific primer pairs. This assay was positive for all the infected animals. Conclusion: The assessments of hemato-biochemical parameters in T. annulata infected crossbred cows may be useful in understanding disease pathogenesis, prognosis and corrective measures for supportive therapy. Moreover, blood direct PCR can reliably be used for rapid detection of T. annulata

  6. Ocular manifestations of pigmentary disorders.

    Park, S; Albert, D M; Bolognia, J L


    Disorders of pigmentation can result from either an abnormal number of melanocytes, as in nevus of Ota and vitiligo, or an abnormal amount of melanin production, as in albinism. Melanin-producing cells are found in the skin, mucous membranes, uveal tract, and retinal pigment epithelium of the eye and the stria vascularis of the inner ear. Thus, many of the hereditary or congenital pigmentary disorders of the skin are associated with similar pigmentary abnormalities in the eye, such as iris heterochromia or changes in pigmentation of the fundus; however, more commonly, the associated eye finding is a defect in ocular motility, i.e., strabismus and nystagmus, suggesting a concomitant defect in neurologic development. In albinos, the observed neurologic abnormality in the visual pathway and foveal hypoplasia are hypothesized to be related directly to the lack of melanin in the pigment epithelium during development. In acquired disorders of pigmentation, in particular, vitiligo, Vogt-Koyanagi-Harada syndrome, and onchocerciasis, there is a frequent association with uveitis, suggesting an inflammatory cause for the cutaneous pigmentary changes.


    SHEN Xi; XU Ge-zhi; JIAO Qin; LI Xia; SHI Ruo-fei


    Objective To describe the ocular complications of 62 patients with active atopic dermatitis( AD) during the period of 2003 2006. Methods Routine ophthalmic examinations, including slit-lamp microscope, indirect ophthalmoscope or Goldmann three-mirror lens, A-scan and B-scan ultrasound, ultrasound biomicroscope (UBM) and corneal topography, as well as tear film break-up time (BUT) and Schirmer tests were carried out. Results Cataract (28 eyes), keratoconjunctivitis (42 eyes), superficial punctate keratopathy (45 eyes) and tear function abnormality ( 76 eyes) were major ocular complications in AD patients. Retinal detachment (6 eyes) was the most severe ocular complication in the AD patients. Conclusion Ocular complications are common in AD patients and a very careful examination of eyes is essential in treating AD patients. If the eyes can be examed carefully and in time, some operations and severe complications can be avoidable, especially for the patients with retinal breaks or retinal detachment.

  8. Ocular complications of malaria treatment


    Oct 8, 2011 ... parenteral quinine are employed with consequent untoward effects. This article reports two cases of severe ocular toxicity, including mimicry of ... 2003 at the Ebony Eye Specialist Clinic Onitsha with a week history of double ...

  9. Ocular Surface Temperature in Age-Related Macular Degeneration

    Andrea Sodi


    Full Text Available Background. The aim of this study is to investigate the ocular thermographic profiles in age-related macular degeneration (AMD eyes and age-matched controls to detect possible hemodynamic abnormalities, which could be involved in the pathogenesis of the disease. Methods. 32 eyes with early AMD, 37 eyes with atrophic AMD, 30 eyes affected by untreated neovascular AMD, and 43 eyes with fibrotic AMD were included. The control group consisted of 44 healthy eyes. Exclusion criteria were represented by any other ocular diseases other than AMD, tear film abnormalities, systemic cardiovascular abnormalities, diabetes mellitus, and a body temperature higher than 37.5°C. A total of 186 eyes without pupil dilation were investigated by infrared thermography (FLIR A320. The ocular surface temperature (OST of three ocular points was calculated by means of an image processing technique from the infrared images. Two-sample t-test and one-way analysis of variance (ANOVA test were used for statistical analyses. Results. ANOVA analyses showed no significant differences among AMD groups (P value >0.272. OST in AMD patients was significantly lower than in controls (P>0.05. Conclusions. Considering the possible relationship between ocular blood flow and OST, these findings might support the central role of ischemia in the pathogenesis of AMD.

  10. Ocular disease in American crocodiles (Crocodylus acutus) in Costa Rica.

    Rainwater, Thomas R; Millichamp, Nicholas J; Barrantes, Luz Denia Barrantes; Barr, Brady R; Montero, Juan R Bolaños; Platt, Steven G; Abel, Mike T; Cobb, George P; Anderson, Todd A


    Beginning in early 2006, an ocular disease of unknown etiology was routinely observed in American crocodiles (Crocodylus acutus) inhabiting the highly polluted Tarcoles River in west-central Costa Rica. We examined the nature and incidence of ocular disease in Tarcoles crocodiles and assessed the possible association between the disease and accumulation of chemical pollutants in diseased individuals. During 12-15 September and 12-13 December 2007, crocodiles were captured and examined for ocular disease and sampled to determine environmental contaminant accumulation. Three of 11 (27.3%) crocodiles captured (all males) exhibited unilateral ocular disease, primarily characterized by corneal opacity and scarring, anterior synechia, and phthisis bulbi. Multiple pollutants were detected in crocodile caudal scutes (organochlorine pesticides [OCPs] and metals), crocodile blood (OCPs), and sediments (OCPs and metals) from the Tarcoles, but no associations were found between contaminant accumulation and the incidence of eye disease. On the basis of the limited number of diseased animals examined and the potential exposure of crocodiles to pathogens and other pollutants not targeted in this study, we cannot rule out infection or chemical toxicosis as causes of the eye lesions. However, circumstantial evidence suggests that the observed ocular disease is likely the result of injury-induced trauma (and possibly secondary infection) inflicted during aggressive encounters (e.g., territorial combat) among large adult crocodiles living at relatively high densities.

  11. Umbilical blood flow patterns directly after birth before delayed cord clamping.

    Boere, I; Roest, A A W; Wallace, E; Ten Harkel, A D J; Haak, M C; Morley, C J; Hooper, S B; te Pas, A B


    Delayed umbilical cord clamping (DCC) affects the cardiopulmonary transition and blood volume in neonates immediately after birth. However, little is known of blood flow in the umbilical vessels immediately after birth during DCC. The objective is to describe the duration and patterns of blood flow through the umbilical vessels during DCC. Arterial and venous umbilical blood flow was measured during DCC using Doppler ultrasound in uncomplicated term vaginal deliveries. Immediately after birth, the probe was placed in the middle of the umbilical cord, pattern and duration of flow in vein and arteries were evaluated until cord clamping. Thirty infants were studied. Venous flow: In 10% no flow was present, in 57% flow stopped at 4:34 (3:03-7:31) (median (IQR) min:sec) after birth, before the cord was clamped. In 33%, flow continued until cord clamping at 5:13 (2:56-9:15) min:sec. Initially, venous flow was intermittent, increasing markedly during large breaths or stopping and reversing during crying, but then became continuous. Arterial flow: In 17% no flow was present, in 40% flow stopped at 4:22 (2:29-7:17) min:sec, while cord pulsations were still palpable. In 43% flow continued until the cord was clamped at 5:16 (3:32-10:10) min:sec. Arterial flow was pulsatile, unidirectional towards placenta or bidirectional to/from placenta. In 40% flow became continuous towards placenta later on. During delayed umbilical cord clamping, venous and arterial umbilical flow occurs for longer than previously described. Net placental transfusion is probably the result of several factors of which breathing could play a major role. Umbilical flow is unrelated to cessation of pulsations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  12. Arterial blood gas analysis of samples directly obtained beyond cerebral arterial occlusion during endovascular procedures predicts clinical outcome.

    Flores, Alan; Sargento-Freitas, Joao; Pagola, Jorge; Rodriguez-Luna, David; Piñeiro, Socorro; Maisterra, Olga; Rubiera, Marta; Montaner, Joan; Alvarez-Sabin, Jose; Molina, Carlos; Ribo, Marc


    Real-time intra-procedure information about ischemic brain damage degree may help physicians in taking decisions about pursuing or not recanalization efforts. We studied gasometric parameters of blood samples drawn through microcatheter in 16 stroke patients who received endovascular reperfusion procedures. After crossing the clot with microcatheter, blood sample was obtained from the middle cerebral artery (MCA) segment distal to occlusion (PostOcc); another sample was obtained from carotid artery (PreOcc). An arterial blood gas (ABG) study was immediately performed. We defined clinical improvement as National Institutes of Health Stroke Scale (NIHSS) decrease of ≥4. The ABG analysis showed differences between PreOcc and PostOcc blood samples in mean oxygen partial pressure (Pre-PaO2: 78.9 ± 16 .3 vs. 73.9 ± 14 .9 mmHg; P  70 mmHg that better predicted further clinical improvement. Patients with Post-PaO2 > 70 mmHg had higher chances of clinical improvement (81.8% vs. 0%; P = .002) and lower disability (median mRS:3 vs. 6; P= .024). In the logistic regression the only independent predictor of clinical improvement was Post-PaO2 > 70 (OR: 5.21 95% CI: 1.38-67.24; P = .013). Direct local blood sampling from ischemic brain is feasible during endovascular procedures in acute stroke patients. A gradient in oxygenation parameters was demonstrated between pre- and post-occlusion blood samples. ABG information may be used to predict clinical outcome and help in decision making in the angio-suite. Copyright © 2011 by the American Society of Neuroimaging.

  13. Ocular toxocariasis. A case presentation

    Mariela Julia Curbelo Gómez


    Full Text Available A clinical case on ocular toxocariasis is presented. The clinical manifestations were pain and red eye in a four year-old child. A prior acute uveitis in the LE was found in the physical ocular exam. Vitrea band that was out of the superior edge of papila and a marginal granuloma were found in the eyes fundus. The patient was admitted and treated with oral corticoids and oral antihelmintics

  14. Air bags and ocular injuries.

    Stein, J.D.; Jaeger, E A; Jeffers, J B


    PURPOSE: This investigation retrospectively examined ocular injuries associated with air bag deployment to gain a better appreciation of potential risk factors in motor vehicle accidents. National statistics regarding the efficacy of air bags were reviewed. METHODS: Review of the literature from 1991 to 1998 identified 44 articles describing 97 patients with air-bag-induced ocular injuries. Variables extracted from each case were age, sex, height, position in the car, eye wear, vehicle impact...

  15. [Ocular metastasis heralding gastric adenocarcinoma].

    Chekrine, T; Tawfiq, N; Bouchbika, Z; Benchakroun, N; Jouhadi, H; Sahraoui, S; Benider, A


    Ocular metastasis is a rare presenting feature of gastric adenocarcinoma. We report a 48-year-old woman who presented with a decrease in visual acuity of the right eye leading to the discovery of an ocular metastasis. Diagnostic work-up identified a gastric adenocarcinoma with pulmonary metastases. She received four cycles of chemotherapy combining epirubicin, cisplatin and fluorouracil. The patient died 6 months after the diagnosis of respiratory failure.

  16. Cicatricial changes in ocular pemphigus

    Chirinos-Saldaña, P; Zuñiga-Gonzalez, I; Hernandez-Camarena, J C; Navas, A; Ramirez-Luquin, T; Robles-Contreras, A; Jimenez-Martinez, M C; Ramirez-Miranda, A; Bautista-de Lucio, V M; Graue-Hernandez, E O


    Purpose To describe the clinical characteristics of ocular involvement in patients with pemphigus at an ophthalmological referral center. Methods A retrospective review was conducted on patients with the immunopathological diagnosis of pemphigus examined between 1 January 2000 and 1 April 2010. Uncorrected distance visual acuity (UDVA), best corrected distance visual acuity (BCVA), ocular symptoms, and ocular surface inflammatory and scarring changes were assessed. Results A total of 15 patients were identified, with a mean age of 68.27±14.35 years, and 80% (n=12) were female. Extraocular involvement was reported in one patient. All of the eyes showed cicatricial changes in the conjunctiva. In all, 6 eyes (20%) were classified as stage I; 12 eyes (40%) as stage II; 10 eyes (33%) as stage III; and 2 eyes (7%) as stage IV. A statistically significant association was found between BCVA and the severity of ocular involvement. The mean BCVA logMAR was 1.66 (20/914), with a range from logMAR 0 (20/20) to logMAR 4 (NLP). Other ocular diseases were found in 8 (53.3%), systemic diseases in 10 (66.7%), and the use of pemphigus-inducing drugs in 10 patients (66.7%). Conclusions The present report represents the largest series of ocular involvement in pemphigus confirmed by immunopathology. The clinical manifestations varied from conjunctival hyperemia to corneal scarring and perforation. There was a strong association between scarring changes and low BCVA. Ocular and systemic diseases as well as the use of pemphigus-inducing drugs may predispose to ocular cicatricial changes observed in this series. PMID:24480839

  17. Trauma ocular y politrauma Ocular trauma and multitrauma

    Dunia Cruz Izquierdo


    Full Text Available Se realizó una revisión sobre el trauma ocular y su manejo en pacientes politraumatizados. Entre las causas más frecuentes de trauma ocular se encuentran los accidentes domésticos, laborales, juegos, actividades recreativas y deportivas. Involucran en un alto por ciento a niños y jóvenes, y predomina el sexo masculino en casi todos los trabajos revisados. No solo en Cuba sino en el mundo, el trauma ocular es fuente importante de ceguera unilateral o bilateral. Se presenta un breve compendio de los términos y definiciones actuales que son utilizados para el manejo del trauma ocular, su clasificación y la ventaja que ofrece aplicar el Puntaje del Trauma Ocular, OTS (Ocular Trauma Score, para el pronóstico de la agudeza visual final de acuerdo a los hallazgos clínicos encontrados en la evaluación inicial. Se hace referencia a los pacientes con politrauma y los aspectos a tener en cuenta por el oftalmólogo para tomar conducta cuando estos presentan heridas penetrantes o perforantes y tienen compromiso vital. En estos casos se hace necesaria la colaboración urgente de múltiples especialistas para primero mantener al paciente con vida y luego disminuir las complicaciones que repercuten en su pronóstico visual.A review was made on the ocular trauma and its management in multitrauma patients. The most common causes comprise domestic and occupational accidents, games, recreational and sport activities. It involves more frequently a high percentage of young people, with male prevalence in almost all the reviewed papers. Ocular trauma is an important source of unilateral or bilateral blindness not only in Cuba but worldwide as well. A brief summary of the current terms and definitions used to manage ocular trauma, their classification and the advantage of the Ocular Trauma Score (OTS to know the possible final visual acuity, according to the clinical findings at the emergency room, were presented. Reference was also made to the multitrauma

  18. In vitro and in vivo ocular safety and eye surface permanence determination by direct and Magnetic Resonance Imaging of ion-sensitive hydrogels based on gellan gum and kappa-carrageenan.

    Fernández-Ferreiro, Anxo; González Barcia, Miguel; Gil-Martínez, María; Vieites-Prado, Alba; Lema, Isabel; Argibay, Barbara; Blanco Méndez, José; Lamas, Maria Jesus; Otero-Espinar, Francisco Javier


    Gellan gum, kappa-carrageenan and alginates are natural polysaccharides able to interact with different cations that can be used to elaborate ion-activated in situ gelling systems for different uses. The interaction between fluid solutions of these polysaccharides and cations presents into the tear made these biopolymers very interesting to elaborate ophthalmic drug delivery systems. The main purpose of this study is to evaluate the ability of mixtures of these polymers to obtain ion-activated ophthalmic in situ gelling systems with optimal properties for ocular use. To achieve this purpose different proportion of the biopolymers were analyzed using a mixture experimental design evaluating their transparency, mechanical properties and bioadhesion in the absence and presence of simulated tear fluid. Tear induces a rapid sol-to-gel phase transition in the mixtures forming a consistent hydrogel. The solution composed by 80% of gellan gum and 20% kappa-carrageenan showed the best mechanical and mucoadhesive properties. This mixture was evaluated for rheological behavior, microstructure, cytotoxicity, acute corneal irritancy, ex-vivo and in vivo ocular toxicity and in vivo corneal contact time using Magnetic Resonance Images (MRI) techniques. Result indicates that the system is safe at ophthalmic level and produces an extensive ocular permanence higher than 6h.

  19. Ocular allergy latin american consensus

    Myrna Serapião dos Santos


    Full Text Available PURPOSE: To establish current definition, classification and staging, and to develop diagnosis and treatment recommendations for ocular allergy, by using Delphi approach. METHODS: Ten Latin American experts on ocular allergy participated in a 4-round Delphi panel approach. Four surveys were constructed and answered by panelists. A two-thirds majority was defined as consensus. Definition, classification, staging and diagnosis and treatment recommendations were the main outcomes. RESULTS: "Ocular allergy" was proposed as the general term to describe ocular allergic diseases. Consensus regarding classification was not reached. Signs and symptoms were considered extremely important for the diagnosis. It was consensus that a staging system should be proposed based on the disease severity. Environmental control, avoidance of allergens and the use of artificial tears were recommended as first line treatment. The secondary treatment should include topical anti-histamines, mast cell stabilizers and multi actions drugs. Topical non-steroidal anti-inflammatory and vasoconstrictors were not recommended. Topical corticosteroids were recommended as third line of treatment for the most severe keratoconjunctivitis. Consensus was not reached regarding the use of systemic corticosteroids or immunosuppressant. Surgical approach and unconventional treatments were not recommended as routine. CONCLUSION: The task of creating guidelines for ocular allergies showed to be very complex. Many controversial topics remain unsolved. A larger consensus including experts from different groups around the world may be needed to further improve the current recommendations for several aspects of ocular allergy.

  20. Ocular toxicity of targeted therapies.

    Renouf, Daniel J; Velazquez-Martin, Juan P; Simpson, Rand; Siu, Lillian L; Bedard, Philippe L


    Molecularly targeted agents are commonly used in oncology practice, and many new targeted agents are currently being tested in clinical trials. Although these agents are thought to be more specific and less toxic then traditional cytotoxic chemotherapy, they are associated with a variety of toxicities, including ocular toxicity. Many of the molecules targeted by anticancer agents are also expressed in ocular tissues. We reviewed the literature for described ocular toxicities associated with both approved and investigational molecularly targeted agents. Ocular toxicity has been described with numerous approved targeted agents and also seems to be associated with several classes of agents currently being tested in early-phase clinical trials. We discuss the proposed pathogenesis, monitoring guidelines, and management recommendations. It is important for oncologists to be aware of the potential for ocular toxicity, with prompt recognition of symptoms that require referral to an ophthalmologist. Ongoing collaboration between oncologists and ocular disease specialists is critical as the use of molecularly targeted agents continues to expand and novel targeted drug combinations are developed.

  1. Ocular Effects of Sulfur Mustard

    Yunes Panahi


    Full Text Available Purpose: To review current knowledge about ocular effects of sulfur mustard (SM and the associated histopathologic findings and clinical manifestationsMethods: Literature review of medical articles (human and animal studies was accomplished using PubMed, Scopus and ISI databases. A total of 274 relevant articles in English were retrieved and reviewed thoroughly.Results: Eyes are the most sensitive organs to local toxic effects of mustard gas. Ocular injuries are mediated through different toxic mechanisms including: biochemical damages, biomolecular and gene expression modification, induction of immunologic and inflammatory reactions, disturbing ultrastructural architecture of the cornea, and long-lasting corneal denervation. The resulting ocular injuries can roughly be categorized into acute or chronic complications. Most of the patients recover from acute injuries, but a minority of victims will suffer from chronic ocular complications. Mustard gas keratopathy (MGK is a devastating late complication of SM intoxication that proceeds from limbal stem cell deficiency (LSCD.Conclusion: SM induces several different damaging changes in case of ocular exposure; hence leading to a broad spectrum of ocular manifestations in terms of severity, timing and form. Unfortunately, no effective strategy has been introduced yet to inhibit or restore these damaging changes.

  2. Ocular allergic inflammation: interaction between the cornea and conjunctiva.

    Fukuda, Ken; Nishida, Teruo


    Severe ocular allergic diseases such as vernal keratoconjunctivitis are characterized not only by conjunctival allergic inflammation, including infiltration of T helper 2 cells and eosinophils into the conjunctiva, but also by various corneal disorders such as persistent epithelial defects and shield ulcer. Although the cornea and conjunctiva are thought to influence each other during ocular allergic inflammation, direct evidence for interaction between these tissues in vivo has been lacking. Eosinophils and eosinophil-derived factors are implicated in the pathogenesis of corneal lesions associated with ocular allergy, with cytotoxic granule proteins such as major basic protein and matrix metalloproteinase 9 derived from eosinophils having been detected in shield ulcer. Major basic protein exhibits cytotoxic effects in cultured corneal epithelial cells and inhibits corneal epithelial wound healing in organ culture, whereas matrix metalloproteinase 9 can degrade the corneal epithelial basement membrane. In vitro studies have revealed that cytokines and other inflammatory mediators directly impair the barrier function of corneal epithelial cells and increase the expression of chemokines and adhesion molecules by corneal stromal fibroblasts, effects that may enhance allergic inflammation. We have recently shown that removal of the corneal epithelium augmented late-phase clinical signs and conjunctival eosinophilia, whereas conjunctival inflammation delayed corneal epithelial wound healing, in a rat model of ocular allergy. Conjunctival allergic inflammation and corneal epithelial disorders thus interact with each other in vivo to generate a vicious cycle, interruption of which might provide the basis for novel approaches to the treatment of severe ocular allergy.


    Sant Cassia, Emma V; Boswood, Adrian; Tordiffe, Adrian S W


    Blood pressure measurement reveals important insights into the health of conscious and anesthetized individuals. This is of particular interest in cheetahs (Acinonyx jubatus), which in captivity are known to suffer from chronic diseases that may be associated with hypertension and which often require immobilization for transport or veterinary treatment. Invasive testing methods are considered the gold standard but are not practical in many settings. Consequently, it is important to evaluate the use of noninvasive methods in this species. Measurements for systolic, diastolic, and mean arterial pressure obtained using high-definition oscillometry (HDO) at the coccygeal artery were compared to simultaneous direct measurements obtained via catheterization of the femoral or dorsal pedal artery in eight anesthetized captive cheetahs during nine anesthetic events. Overall, HDO and direct measurements agreed most closely for mean arterial pressure, and the poorest agreement was observed for systolic pressure. There was a tendency for low diastolic pressures to be underestimated and for high diastolic pressures to be overestimated. Across all three parameters, HDO measurements from the tail overestimated directly measured pressures in the femoral artery and underestimated those in the dorsal pedal artery. HDO agreed most closely with directly measured dorsal pedal pressures. Mean arterial pressure showed the greatest precision (standard deviation of 10.2 mm Hg) and lowest bias (-1.2 mm Hg), with 75.9% of readings within 10 mm Hg of the direct dorsal pedal pressure. Agreement with systolic pressure was hindered by a high bias (-10.4 mm Hg), but if a correction factor of +10 mm Hg was applied to all systolic measurements, agreement was improved and 65.7% of readings were within 10 mm Hg of the direct pressure. When compared to criteria defined by the American College of Veterinary Internal Medicine for validation of blood pressure devices, results were favorable, but a

  4. Rapid detection of Enterococcus spp. direct from blood culture bottles using Enterococcus QuickFISH method: a multicenter investigation.

    Deck, Melissa K; Anderson, Erica S; Buckner, Rebecca J; Colasante, Georgia; Davis, Thomas E; Coull, James M; Crystal, Benjamin; Latta, Phyllis Della; Fuchs, Martin; Fuller, Deanna; Harris, Will; Hazen, Kevin; Klimas, Lisa L; Lindao, Daniel; Meltzer, Michelle C; Morgan, Margie; Shepard, Janeen; Stevens, Sharon; Wu, Fann; Fiandaca, Mark J


    The performance of a diagnostic method for detection and identification of Enterococcus spp. directly from positive blood culture was evaluated in a clinical study. The method, Enterococcus QuickFISH BC, is a second-generation peptide nucleic acid (PNA) fluorescence in situ hybridization (FISH) test, which uses a simplified, faster assay procedure. The test uses fluorescently labeled PNA probes targeting 16S rRNA to differentiate Enterococcus faecalis from other Enterococcus spp. by the color of the cellular fluorescence. Three hundred fifty-six routine blood culture samples were tested; only 2 discordant results were recorded. The sensitivities for detection of Enterococcus faecalis and non-faecalis Enterococcus were 100% (106/106) and 97.0% (65/67), respectively, and the combined specificity of the assay was 100%. The combined positive and negative predictive values of the assay were 100% (171/171) and 98.9% (185/187), respectively.

  5. Direct effect of cadmium on blood pressure and adrenergic system in the cat

    Revis, N.W.; Bingham, G.


    The dose-response effect of cadmium on systolic and diastolic pressure were measured in the cat after injecting a bolus of cadmium intravenously. In animals treated with 100, 125, or 150 ug cadmium/kg BW systolic and diastolic pressure were both significantly increased. These increases were gradual as the dose Cd was increased from 75 to 125 ug. In an attempt to determine the mechanism associated with cadmium-induced hypertension in the cat the effect of this element on the adrenergic system was studied. The effect of ..cap alpha.. and BETA agonists on cadmium-induced increase in blood pressure were determined by the injection of either propranolol or phentolamine at 20 mg/kg BW. The hypertensive effect of 125 ug Cd was abolished by phentolamine but not by propranolol suggesting, that Cd may induce the release of norepinephrine from storage sites. In support of this suggestion we observed in cats treated with 125 ug Cd a significant increase in plasma norepinephrine which was not affected by propranolol or phentolamine injections. However reserpine pretreatment abolished both the increase in plasma norepinephrine and the cadmium-induced hypertensive effect. The data suggest that the associated mechanism of cadmium-induced hypertension may be related to the effect of this element of the release of norepinephrine. Increases in the extracellular levels of this neurotransmitter in turn provokes a rise in blood pressure through its interaction with the receptors of vascular smooth muscle cells. 38 references, 7 figures, 1 table.

  6. Development of a direct blood-based PCR system to detect BLV provirus using CoCoMo primers.

    Takeshima, Shin-Nosuke; Watanuki, Sonoko; Ishizaki, Hiroshi; Matoba, Kazuhiro; Aida, Yoko


    Bovine leukemia virus (BLV), the etiologic agent of enzootic bovine leucosis, has caused pandemic outbreaks worldwide. Because transcription of the BLV is quickly blocked after infection, detecting integrated provirus at host genome is an important method of identifying whether an animal is infected. The aim of the present study was to develop a novel direct blood-based PCR system to detect the BLV provirus with high specificity and at low cost. The assay was based on the BLV-CoCoMo degenerate primers, which amplify all known BLV strains. Cattle blood samples (n = 182) were collected from the same BLV-positive farm and subjected to BLV-CoCoMo-direct-PCR to detect the BLV provirus. The proviral load was then estimated. This novel PCR method showed 100 % specificity. The BLV-CoCoMo-direct-PCR can be used in a variety of laboratory situations because it does not require expensive equipment/reagents, DNA purification, or a second round of PCR. Therefore, the method is extremely cost-effective and the risk of a false-positive result due to DNA contamination is very low.

  7. Crohn’s Disease Ocular Manifestations

    Koev Kr.


    Full Text Available Crohn’s disease is an inflammatory bowel disease which causes inflammation of the digestive tract. Crohn’s disease most frequently affects the ileum and the colon. In the active stage of the disease signs and symptoms may include diarrhea, abdominal pain and cramping, blood in the stools, reduced appetite and weight loss. In patients with severe Crohn’s disease the following signs and symptoms may be observed: fever, fatigue, arthritis, eye inflammation, oral ulcers, skin disorders, inflammation of the liver or bile ducts or delayed growth. Heredity and dysfunctions of the immune system are considered to cause the development of Crohn’s disease. About 10% of people with inflammatory bowel disease have also ocular problems. The most common ocular manifestations of Crohn’s disease are uveitis, iritis, episcleritis, keratopathy, keratoconjunctivitis and retinal vasculitis. Untreated uveitis may cause glaucoma and vision loss. Uveitis and iritis are four times more common in women than in men. In patients in the active stage of the disease, episcleritis also flares. Symptoms of episcleritis include inflammation, bright red spots on the sclera and localized pain. Keratoconjunctivitis in Crohn’s disease is caused by decreased tear production or increased tear film evaporation. Dry eyes can cause itching, burning or infection. Keratopathy usually causes no pain or vision loss, therefore in most cases no treatment is needed. In retinal vasculitis tortuosity of retinal veins, retinal edema at the posterior pole and intraretinal blood near blood vessels are observed. Intravenous fluorescein angiography shows intraretinal neovascularisation and haemorrhage in the posterior pole.

  8. Silk film biomaterials for ocular surface repair

    Lawrence, Brian David

    Current biomaterial approaches for repairing the cornea's ocular surface upon injury are partially effective due to inherent material limitations. As a result there is a need to expand the biomaterial options available for use in the eye, which in turn will help to expand new clinical innovations and technology development. The studies illustrated here are a collection of work to further characterize silk film biomaterials for use on the ocular surface. Silk films were produced from regenerated fibroin protein solution derived from the Bombyx mori silkworm cocoon. Methods of silk film processing and production were developed to produce consistent biomaterials for in vitro and in vivo evaluation. A wide range of experiments was undertaken that spanned from in vitro silk film material characterization to in vivo evaluation. It was found that a variety of silk film properties could be controlled through a water-annealing process. Silk films were then generated that could be use in vitro to produce stratified corneal epithelial cell sheets comparable to tissue grown on the clinical standard substrate of amniotic membrane. This understanding was translated to produce a silk film design that enhanced corneal healing in vivo on a rabbit injury model. Further work produced silk films with varying surface topographies that were used as a simplified analog to the corneal basement membrane surface in vitro. These studies demonstrated that silk film surface topography is capable of directing corneal epithelial cell attachment, growth, and migration response. Most notably epithelial tissue development was controllably directed by the presence of the silk surface topography through increasing cell sheet migration efficiency at the individual cellular level. Taken together, the presented findings represent a comprehensive characterization of silk film biomaterials for use in ocular surface reconstruction, and indicate their utility as a potential material choice in the

  9. Fibrin Sealant Foam Sprayed Directly on Liver Injuries Decreases Blood Loss in Resuscitated Rats


    based on the dry fibrin sealant dressing concept. This material could potentially be intro- duced into a body cavity by a trocar , spread throughout...Special Operations Command, Biomedical Initiatives Steering Committee. The foam material and funding for a research technician was provided by the...was performed to evaluate the effectiveness of FSF when sprayed directly on a severe liver injury in rats. MATERIALS AND METHODS Thirty-six Sprague

  10. Purinergic Receptors in Ocular Inflammation

    Ana Guzman-Aranguez


    Full Text Available Inflammation is a complex process that implies the interaction between cells and molecular mediators, which, when not properly “tuned,” can lead to disease. When inflammation affects the eye, it can produce severe disorders affecting the superficial and internal parts of the visual organ. The nucleoside adenosine and nucleotides including adenine mononucleotides like ADP and ATP and dinucleotides such as P1,P4-diadenosine tetraphosphate (Ap4A, and P1,P5-diadenosine pentaphosphate (Ap5A are present in different ocular locations and therefore they may contribute/modulate inflammatory processes. Adenosine receptors, in particular A2A adenosine receptors, present anti-inflammatory action in acute and chronic retinal inflammation. Regarding the A3 receptor, selective agonists like N6-(3-iodobenzyl-5′-N-methylcarboxamidoadenosine (CF101 have been used for the treatment of inflammatory ophthalmic diseases such as dry eye and uveoretinitis. Sideways, diverse stimuli (sensory stimulation, large intraocular pressure increases can produce a release of ATP from ocular sensory innervation or after injury to ocular tissues. Then, ATP will activate purinergic P2 receptors present in sensory nerve endings, the iris, the ciliary body, or other tissues surrounding the anterior chamber of the eye to produce uveitis/endophthalmitis. In summary, adenosine and nucleotides can activate receptors in ocular structures susceptible to suffer from inflammatory processes. This involvement suggests the possible use of purinergic agonists and antagonists as therapeutic targets for ocular inflammation.

  11. Commensal ocular bacteria degrade mucins.

    Berry, M; Harris, A; Lumb, R; Powell, K


    Antimicrobial activity in tears prevents infection while maintaining a commensal bacterial population. The relation between mucin and commensal bacteria was assessed to determine whether commensals possess mucinolytic activity, how degradation depends on mucin integrity, and whether mucins affect bacterial replication. Bacteria were sampled from healthy eyes and contact lenses from asymptomatic wearers. Intracellular mucins were extracted and purified from cadaver conjunctivas, and surface mucins from extended wear contact lenses. After exposure to bacteria, changes in mucin hydrodynamic volume (proteolytic cleavage) and subunit charge (oligosaccharide degradation) were assayed by size exclusion and ion exchange chromatography. The effect of mucin on bacterial replication was followed for up to 24 hours from the end of incubation with purified ocular mucins. Ocular bacteria decreased the hydrodynamic volume of intracellular and contact lens adherent mucins, irrespective of glycosylation density. A decrease in mucin sialylation was observed after exposure to commensal bacteria. Subunit charge distributions were generally shifted to lesser negative charge, consistent with loss of charged epitopes. Subunits with high negative charge, observed after digesting lightly adhering contact lens mucins with bacteria, suggest preferential cleavage sites in the mucin molecule. The presence of purified ocular mucin in the medium inhibited bacterial growth. Bacteria in the healthy ocular surface possess mucinolytic activity on both intact and surface processed mucins, targeted to discrete sites in the mucin molecule. Inhibition of bacterial growth by ocular mucins can be seen as part of the mucosal control of microbiota.

  12. Ocular comparative anatomy of the family Rodentia.

    Rodriguez-Ramos Fernandez, Julia; Dubielzig, Richard R


    There is little information regarding ocular anatomy and histology in many of the rodent species. Histological analyses for morphologic features were performed in 31 globes from 18 rodent species submitted to and archived at the Comparative Ocular Pathology Laboratory of Wisconsin. The following measurements were taken: thickness of the cornea, corneal epithelium, corneal stroma, Descemet's membrane, and retina. H&E sections were evaluated for the following anatomical features: presence of pigmented epithelial cells in the peripheral cornea, presence and location of Schlemm's canal, presence of iridal sphincter and dilator and ciliary body muscles, presence of pars plicata and plana, presence of retinal vessels, presence of lamina cribrosa, and presence of tapetum lucidum. The springhaas was the only rodent in our collection that presented a well-developed tapetum lucidum fibrosum. The presence of retinal vessels was variable: vessels were observed in all of the members of the mouse-related clade, except the springhaas and the beaver, in all of the squirrel-related clade members, and in none of the Ctenohystrica. In the flying squirrels, blood vessels extended to the outer limiting membrane in the photoreceptor layer. Beavers, chinchillas, capybara, and guinea pigs lacked vessels within the retina; however, they had vessels within the optic nerve head. Ground squirrels have an optic nerve head, which is linear in the horizontal plane and an asymmetric retina. The tree-dwelling squirrels have a rounded but still elongated optic nerve, and the flying squirrel has a round optic nerve head like all the other rodents.

  13. [Direct proteomic profiling of human urine and blood serum in an experiment with 5-day dry immersion].


    Changes in proteome of urine and blood serum obtained from 14 healthy humans (age 21-29 yrs) medically certified for an experiment with dry immersion were analyzed. Urine and serum samples were pre-fractionated and enriched with magnetic particles MB-WCX and MB-HIC, respectively, on robot ClinProt (Bruker Daltonics) for direct mass-spectrometry profiling by MALDI-TOF. As a result, 143 protein peaks on the average were identified in urine samples. It was shown that a high variation coefficient in 23.7% of protein peaks, i.e. double technical, points to the most plastic fraction of the urine proteome. In blood serum, 175 peaks were identified in a sample on the average. Comparison of baseline and immersion mass-spectra of the blood proteome revealed significant differences. Increased peak areas of several protein fragments--C3 and C4 fragments of complement system, high-molecular kininogen and fibrinogen--can be ascribed to human body adaptation to the experimental conditions.

  14. Quantamatrix Multiplexed Assay Platform system for direct detection of bacteria and antibiotic resistance determinants in positive blood culture bottles.

    Wang, H Y; Uh, Y; Kim, S; Lee, H


    Rapid and accurate identification of the causative pathogens of bloodstream infections (BSIs) is crucial for initiating appropriate antimicrobial therapy, which decreases the related morbidity and mortality rates. The aim of this study was to evaluate the usefulness of a newly developed multiplexed, bead-based bioassay system, the Quantamatrix Multiplexed Assay Platform (QMAP) system, obtained directly from blood culture bottles, to simultaneously detect the presence of bacteria and identify the genes for antibiotic resistance. The QMAP system was used to evaluate 619 blood culture bottles from patients with BSIs and to compare the results of conventional culture methods. Using conventional bacterial cultures as the reference standard, the sensitivity, specificity, positive predictive value, and negative predictive value of the QMAP system for detection of bacterial pathogens in positive blood culture (PBC) samples were 99.8% (n=592, 95% CI 0.9852-1.000, p system for identification of the genes for antibiotic resistance were 99.4% (n=158, 95% CI 0.9617-0.9999, p system takes about 3 hr, while culture methods can take 48-72 hr. Therefore, analysis using the QMAP system is rapid and reliable for characterizing causative pathogens in BSIs. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  15. Ocular injuries in industrial technical workers in Delta State, Nigeria

    O.T.Edema; A.E.Omoti; F.B.Akinsola; P.A.Aigbotsua


    Objective: To identify the types and causes of eye injury in industrial workers. Methods: A cross sectional study of the pattern of ocular injuries in Delta state of Nigeria was carried out over 3 months. Five hundred workers were interviewed and examined using the Snellen's chart, pen-torch, direct ophthalmoscope, magnifying loupe and the Perkin's hand-held applanation tonometer. Results: All the 500 workers were males. One hundred and twenty-three workers (24.6%) reported a history of ocular injury at work. The most common causative agents were sand dust, 53 workers (25.1%); cake dust, 27 workers (12.8%) and chemicals, 32 workers (15.1%). The main types of ocular injury were corneal/ conjunctival foreign bodies, 79 workers (64.2%); burns, 35 workers (28.5%) and blunt injury, 9 workers (7.3%). Only 36 (7.2%) workers used protective eye devices at work. Thirteen workers (2.6%) developed monocular blindness from ocular injury. Conclusion: Ocular injury at work is common and few workers wear protective devices at work in industries in Delta state, Nigeria. Industrial workers should have regular eye services and wear eye safety devices at work.

  16. Direct generation of induced pluripotent stem cells from human nonmobilized blood.

    Kunisato, Atsushi; Wakatsuki, Mariko; Shinba, Haruna; Ota, Toshio; Ishida, Isao; Nagao, Kenji


    The use of induced pluripotent stem cells (iPSCs) is an exciting frontier in the study and treatment of human diseases through the generation of specific cell types. Here we show the derivation of iPSCs from human nonmobilized peripheral blood (PB) and bone marrow (BM) mononuclear cells (MNCs) by retroviral transduction of OCT3/4, SOX2, KLF4, and c-MYC. The PB- and BM-derived iPSCs were quite similar to human embryonic stem cells with regard to morphology, expression of surface antigens and pluripotency-associated transcription factors, global gene expression profiles, and differentiation potential in vitro and in vivo. Infected PB and BM MNCs gave rise to iPSCs in the presence of several cytokines, although transduction efficiencies were not high. We found that 5 × 10(5) PB MNCs, which corresponds to less than 1 mL of PB, was enough for the generation of several iPSC colonies. Generation of iPSCs from MNCs of nonmobilized PB, with its relative efficiency and ease of harvesting, could enable the therapeutic use of patient-specific pluripotent stem cells.

  17. Direct emergence of the dorsospinal artery from the aorta and spinal cord blood supply. Case reports and literature review

    Siclari, Francesca [The Johns Hopkins Medical Institutions, Division of Interventional Neuroradiology, Department of Radiology and Radiological Sciences, Baltimore, MD (United States); University of Geneva, Division of Clinical Anatomy, Geneva (Switzerland); Fasel, Jean H.D. [University of Geneva, Division of Clinical Anatomy, Geneva (Switzerland); Gailloud, Philippe [The Johns Hopkins Medical Institutions, Division of Interventional Neuroradiology, Department of Radiology and Radiological Sciences, Baltimore, MD (United States)


    Direct emergence of a dorsospinal artery from the aorta is a rare anatomic variant, of which a total of seven cases have been reported. This report offers an additional angiographic observation and reviews the literature. Two observations of common intercostal trunks documented during spinal angiography are described. In the first observation, the common intercostal trunk provided complete blood supply to two adjacent vertebral levels (T11 and T12). In other words, the trunk included an intercostal branch and a dorsospinal branch for each level. In the second observation, the common intercostal trunk provided an intercostal branch for each level (T9 and T10), but only one dorsospinal branch (T10). An isolated dorsospinal artery (DA) originated separately from the aorta at the T9 level, and provided a significant contribution to the anterior spinal axis. The two reported cases illustrate the concept of ''complete'' versus ''incomplete'' common intercostal trunks. In instances where an incomplete trunk is documented, a separate DA originating directly from the aorta must be looked for. A review of the literature indicates a tendency for isolated DAs to participate in the blood supply to the spinal cord. (orig.)

  18. An Unconventional Approach To Reducing Retinal Degeneration After Traumatic Ocular Injury


    abnormal retinal pericyte vasospasms after ocular trauma in mice, and their relationship to: retinal macrophage activity, and oral administration of L...specifically for blast-type ocular injury. Our hypotheses are based upon evidence that the vascular effects contribute to neurodegeneration after...the effects of oral administration of L-Arginine—a nitric oxide (NO) precursor—on ameliorating these vascular contributions. Blood flow control has

  19. Antimicrobial susceptibility testing of Gram-positive and -negative bacterial isolates directly from spiked blood culture media with Raman spectroscopy.

    Dekter, H E; Orelio, C C; Morsink, M C; Tektas, S; Vis, B; Te Witt, R; van Leeuwen, W B


    Patients suffering from bacterial bloodstream infections have an increased risk of developing systematic inflammatory response syndrome (SIRS), which can result in rapid deterioration of the patients' health. Diagnostic methods for bacterial identification and antimicrobial susceptibility tests are time-consuming. The aim of this study was to investigate whether Raman spectroscopy would be able to rapidly provide an antimicrobial susceptibility profile from bacteria isolated directly from positive blood cultures. First, bacterial strains (n = 133) were inoculated in tryptic soy broth and incubated in the presence or absence of antibiotics for 5 h. Antimicrobial susceptibility profiles were analyzed by Raman spectroscopy. Subsequently, a selection of strains was isolated from blood cultures and analyzed similarly. VITEK®2 technology and broth dilution were used as the reference methods. Raman spectra from 67 antibiotic-susceptible strains showed discriminatory spectra in the absence or at low concentrations of antibiotics as compared to high antibiotic concentrations. For 66 antibiotic-resistant strains, no antimicrobial effect was observed on the bacterial Raman spectra. Full concordance with VITEK®2 data and broth dilution was obtained for the antibiotic-susceptible strains, 68 % and 98 %, respectively, for the resistant strains. Discriminative antimicrobial susceptibility testing (AST) profiles were obtained for all bacterial strains isolated from blood cultures, resulting in full concordance with the VITEK®2 data. It can be concluded that Raman spectroscopy is able to detect the antimicrobial susceptibility of bacterial species isolated from a positive blood culture bottle within 5 h. Although Raman spectroscopy is cheap and rapid, further optimization is required, to fulfill a great promise for future AST profiling technology development.

  20. Gene therapy in ocular diseases

    Singh Vijay


    Full Text Available Gene therapy is a novel form of drug delivery that enlists the synthetic machinery of the patient′s cells to produce a therapeutic agent. Genes may be delivered into cells in vitro or in vivo utilising viral or non-viral vectors. Recent technical advances have led to the demonstration of the molecular basis of various ocular diseases. Ocular disorders with the greatest potential for benefit of gene therapy include hereditary diseases such as retinitis pigmentosa, tumours such as retinoblastoma or melanoma, and acquired proliferative and neovascular retinal disorders. Gene transfer into ocular tissues has been demonstrated with growing functional success and may develop into a new therapeutic tool for clinical ophthalmology in future.

  1. Cerebellum and Ocular Motor Control

    Amir eKheradmand


    Full Text Available An intact cerebellum is a prerequisite for optimal ocular motor performance. The cerebellum fine-tunes each of the subtypes of eye movements so they work together to bring and maintain images of objects of interest on the fovea. Here we review the major aspects of the contribution of the cerebellum to ocular motor control. The approach will be based on structural-functional correlation, combining the effects of lesions and the results from physiologic studies, with the emphasis on the cerebellar regions known to be most closely related to ocular motor function: 1 the flocculus/paraflocculus for high-frequency (brief vestibular responses, sustained pursuit eye movements and gaze-holding, 2 the nodulus/ventral uvula for low-frequency (sustained vestibular responses, and 3 the dorsal oculomotor vermis and its target in the posterior portion of the fastigial nucleus (the fastigial oculomotor region for saccades and pursuit initiation.

  2. Ivermectin treatment of ocular onchocerciasis.

    Taylor, H R


    Ivermectin, a recently developed macrocyclic lactone with broad antiparasitic activity, has been shown by a series of clinical trials to be safe and effective in the treatment of human infection with Onchocerca volvulus. Although it is rapidly microfilaricidal, it does not cause a severe reaction as is seen with diethylcarbamazine treatment. In patients with onchocerciasis, a single oral dose of ivermectin (150 micrograms/Kg) repeated once a year leads to a marked reduction in skin microfilaria counts and ocular involvement, although ivermectin has no known long-lasting effects on the adult worms. With treatment there is no significant exacerbation of either anterior or posterior segment eye disease even in those with severe ocular disease. Treatment leads to a marked and prolonged improvement in ocular status. Because of its safety and efficacy, ivermectin can be used on a mass scale and promises to revolutionize the treatment of onchocerciasis.

  3. The Ocular Surface Chemical Burns

    Medi Eslani


    Full Text Available Ocular chemical burns are common and serious ocular emergencies that require immediate and intensive evaluation and care. The victims of such incidents are usually young, and therefore loss of vision and disfigurement could dramatically affect their lives. The clinical course can be divided into immediate, acute, early, and late reparative phases. The degree of limbal, corneal, and conjunctival involvement at the time of injury is critically associated with prognosis. The treatment starts with simple but vision saving steps and is continued with complicated surgical procedures later in the course of the disease. The goal of treatment is to restore the normal ocular surface anatomy and function. Limbal stem cell transplantation, amniotic membrane transplantation, and ultimately keratoprosthesis may be indicated depending on the patients’ needs.

  4. Clinical Study on Ocular Trauma in Children

    Zicai Huang; Hongni Li; Yixia Huang; Zhongxia Zhou


    Purpose: To investigate the clinical characteristics of ocular trauma in children and put forward the major treatment and prevention of ocular trauma in children.Methods: To analyze the clinical data by 77 eyes in 77 cases of ocular trauma in children from April 1999 to February 2002. Results: The male and female were in the ratio of 2.21: 1. Right eye ocular traumas were more than left ones. Ocular penetrating trauma was 83.12% and blunt trauma 12.99%. 41 cases (53.25%) were injured by themselves while 33 cases by others. 90.91% patients came from the countryside.Conclusion: The rate of blindness of children with ocular trauma could be reduced by prompt treatment. The study indicated that ocular trauma preventive publicity should be faced in the countryside in order to improve the understanding of the severity of ocular trauma and treat it as a social problem.


    ... with ocular abnormalities which often impact on their development and education. ... Age appropriate visual acuities were checked, ocular examination was done ... Cortical Visual Impairment (CVI) in 28(75.7%) subjects CVI, refractive errors ...

  6. Direct detection of extended-spectrum beta-lactamases (CTX-M) from blood cultures by LC-MS/MS bottom-up proteomics

    F. Fleurbaaij; W.H.F. Goessens (Wil); H.C. van Leeuwen (Hans); M. Kraakman (Margriet); S.T. Bernards; P. Hensbergen (Paul); E. Kuijper


    textabstractRapid bacterial species identification and antibiotic susceptibility testing in positive blood cultures have an important impact on the antibiotic treatment for patients. To identify extended-spectrum beta-lactamases (ESBL) directly in positive blood culture bottles, we developed a

  7. Air bags and ocular injuries.

    Stein, J D; Jaeger, E A; Jeffers, J B


    This investigation retrospectively examined ocular injuries associated with air bag deployment to gain a better appreciation of potential risk factors in motor vehicle accidents. National statistics regarding the efficacy of air bags were reviewed. Review of the literature from 1991 to 1998 identified 44 articles describing 97 patients with air-bag-induced ocular injuries. Variables extracted from each case were age, sex, height, position in the car, eye wear, vehicle impact speed, visual acuity, and specific ocular injuries. Corneal abrasions occurred in 49% of occupants, hyphemas in 43%, vitreous or retinal hemorrhages in 25%, and retinal tears or detachments in 15%. The globe was ruptured in 10 patients. Patients involved in higher-speed accidents (over 30 mph) sustained a greater percentage of vitreous or retinal hemorrhages and traumatic cataracts, while those at slower speeds were more prone to retinal tears or detachments. In a subset of 14 patients with serious ocular injuries, the impact speed of 11 patients was recorded at 30 mph or less. Slower speed may be a risk factor for some ocular injuries. Occupant height was not a significant factor. National statistics confirm that air bags reduce fatalities in motor vehicle accidents. However, children sitting in the front seat without a seat belt and infants in passenger-side rear-facing car seats are at risk for fatal injury. Air bags combined with seat belts are an effective means of reducing injury and death in adults during motor vehicle accidents. However, this study has documented a wide variety of ocular injuries associated with air bag deployment. It is hoped that researchers can develop modifications that continue to save lives while minimizing additional harm.

  8. [Adverse ocular effects of vaccinations].

    Ness, T; Hengel, H


    Vaccinations are very effective measures for prevention of infections but are also associated with a long list of possible side effects. Adverse ocular effects following vaccination have been rarely reported or considered to be related to vaccinations. Conjunctivitis is a frequent sequel of various vaccinations. Oculorespiratory syndrome and serum sickness syndrome are considered to be related to influenza vaccinations. The risk of reactivation or initiation of autoimmune diseases (e. g. uveitis) cannot be excluded but has not yet been proven. Overall the benefit of vaccination outweighs the possible but very low risk of ocular side effects.

  9. Iris mammillations in ocular melanocytosis.

    Swann, Peter G


    Hyperpigmentation of the ocular tissues and of the skin around the eye is uncommon. In ocular melanosis, the episclera, uveal tract and the angle of the anterior chamber may be involved. Heterochromia iridis may be present, if the iris is affected. In oculodermal melanocytosis or the naevus of Ota, hyperpigmentation of the skin follows the distribution of the first and second divisions of the fifth cranial nerve. This report documents a patient with episcleral pigment, heterochromia iridis and numerous tiny pigmented nodules on the iris (mammillations). The possible significance of these findings is discussed.

  10. Ocular complications of diabetes mellitus

    Nihat Sayin; Necip Kara; Gokhan Pekel


    Diabetes mellitus (DM) is a important health problemthat induces ernestful complications and it causessignificant morbidity owing to specific microvascularcomplications such as, retinopathy, nephropathy andneuropathy, and macrovascular complications such as,ischaemic heart disease, and peripheral vasculopathy.It can affect children, young people and adults and isbecoming more common. Ocular complications associatedwith DM are progressive and rapidly becoming theworld's most significant cause of morbidity and arepreventable with early detection and timely treatment.This review provides an overview of five main ocularcomplications associated with DM, diabetic retinopathyand papillopathy, cataract, glaucoma, and ocular surfacediseases.

  11. Blood Stage Plasmodium falciparum Exhibits Biological Responses to Direct Current Electric Fields

    Coronado, Lorena M.; Montealegre, Stephania; Chaverra, Zumara; Mojica, Luis; Espinosa, Carlos; Almanza, Alejandro; Correa, Ricardo; Stoute, José A.; Gittens, Rolando A.


    The development of resistance to insecticides by the vector of malaria and the increasingly faster appearance of resistance to antimalarial drugs by the parasite can dangerously hamper efforts to control and eradicate the disease. Alternative ways to treat this disease are urgently needed. Here we evaluate the in vitro effect of direct current (DC) capacitive coupling electrical stimulation on the biology and viability of Plasmodium falciparum. We designed a system that exposes infected erythrocytes to different capacitively coupled electric fields in order to evaluate their effect on P. falciparum. The effect on growth of the parasite, replication of DNA, mitochondrial membrane potential and level of reactive oxygen species after exposure to electric fields demonstrate that the parasite is biologically able to respond to stimuli from DC electric fields involving calcium signaling pathways. PMID:27537497

  12. An investigation into diabetic patients knowledge of diabetes and its ocular complications in the Western Cape

    P. C. Clarke-Farr


    Full Text Available This paper presents the findings of a study which evaluated the knowledge of a sample of diabetic patients about their disease and its ocular complications. A comprehensive questionnaire was provided to diabetic patients in the Cape Town metropolitan district and its surrounds. Specifically, the questionnaire aimed to determine the patient’s knowledge of diabetes, their knowledge of the ocular complications of diabetes, the options for its management and treatment as well as a section considering other general information relating to diabetes and its ocular complications. Their subject knowledge about diabetes and its ocular complications was relatively limited as only 42% of respondents knew about the existence of two types of diabetes. Twenty nine percent of respondents believed that diabetes would not affect their eyes. Although 76% of the patients felt it very important to measure their blood sugar and 80% rated blood sugar control as very important, only 37% of the respondents measured their blood sugar on a daily basis. A particular concern was that although 96% of the respondents felt that it was important to have their eyes checked regularly, only 30% of the respondents stated that they had actually had their eyes checked every year. The results of this investigation support the need for diabetic patients to receive better patient education about diabetes and its ocular complications. Furthermore, attention needs to be paid to expanding patient access to diabetic screenings and ocular examinations in order to manage this condition effectively.

  13. Tumor ocular metastásico Metastatic ocular tumor

    Martha G Domínguez Expósito


    Full Text Available El carcinoma metastásico del ojo es considerado la neoplasia maligna que más frecuente se encuentra de forma intraocular. Solo cerca del 10 % de las personas que tienen una o más lesiones metastásicas intraoculares son detectadas clínicamente antes de la muerte. A menudo, el carcinoma metastásico ocular es diagnosticado por el oftalmólogo ante la presencia de síntomas oculares. Las lesiones están localizadas con preferencia en coroides. Nos motivo a realizar la presentación de este caso la presencia de lesiones intraoculares múltiples tumorales metastásicos en un paciente cuyo síntoma de presentación fue la disminución de la agudeza visualThe eye metastatic carcinoma is considered the most frequently found intraocular malignant neoplasia. Only 10 % of the persons with one or more metastatic intraocular injuries are clinically detected before death. The metastatic ocular carcinoma is often diagnosed by the ophthalmologist in the presence of ocular symptoms. The injuries are preferably located in the choroid. The appearance of multiple metastatic intraaocular tumoral injuries in a patient whose chief complaint was the reduction of visual acuity motivated us to presente this case

  14. Persian Traditional Medicine and Ocular Health

    Namdar, Hasan; Emaratkar, Elham; Hadavand, Mohammad Bagher


    The Persian Traditional Medicine (PTM) system pays special attention to disease prevention. In PTM, physicians believe that overeating may cause accumulation of unhealthy substances in the body and diseases called “Emtela.” With respect to ocular health, foods can be categorized as beneficial and harmful. Harmful foods such as beef, geese, eggplant, cauliflower, and cheese can cause reduced vision. Dehydrating foods such as walnut and salty fish and hot foods such as garlic, onion, and pepper can cause dry eye. Food items that have beneficial effects on ocular health include thyme and saffron and fruits such as grape, fig, apple, plum, and berries. PTM stipulates that one should not drink water with meals or immediately afterwards, since drinking cold (icy) water causes difficulty in absorption of nutrients. Gulping water may have harmful effects on the eyes; therefore, PTM physicians recommend drinking water at a suitable temperature. It is not safe to drink water first at the morning. Sleeping right after eating is harmful too. Avicenna believes that sleeping on one’s belly after a full meal is very harmful for the eyes. Galen says that old people need deep and continuous sleep more than others. From the view of PTM, moving eyes in different directions, making delicate expressions, trying to look at delicate and find pictures and reading small letters would remove ocular fatigue. There have been mentions of local medicine for improving vision as well; for instance, fennel extracts, pomegranate juice, and honey which are suitable for vision improvement. Local administration of pomegranate blossoms is suitable for treating inflammatory reactions. PMID:27800504

  15. Follicular lymphoma of the ocular adnexal region

    Rasmussen, Peter Kristian; Ralfkiaer, E.; Prause, J.U.


    with ocular adnexal follicular lymphoma were identified. Fourteen (58%) of the patients were females. The median age was 63 years (range: 42–96 years). Eleven (46%) of the patients had primary ocular adnexal lymphoma, seven (29%) had an ocular adnexal lesion in conjunction with a concurrent systemic lymphoma...

  16. Dendrimers as a promising tool in ocular therapeutics: Latest advances and perspectives.

    Rodríguez Villanueva, Javier; Navarro, Manuel Guzmán; Rodríguez Villanueva, Laura


    Dendrimers have called the attention of scientists in the area of drug and gene delivery over the last two decades for their versatility, complexity and multibranching properties. Some strategies for optimizing drug pharmacokinetics and site-specific targeting using dendrimers have been proposed. Among them, those related to treating and managing ocular diseases are of special interest. Ocular therapies suffer from significant disadvantages, including frequent administration, poor penetration and/or rapid elimination. This review provides an overview of the recent and promising progress in the dendrimers field, focusing on both the anterior and posterior segments of the eye ocular targets, the use of dendrimers as a strategy for overcoming obstacles to the traditional treatment of ocular diseases and an outlook on future directions. Finally, a first approach to ocular safety with dendrimers is intended that accounts for the state-of-the-art science to date.

  17. Mediators of ocular angiogenesis

    Yureeda Qazi; Surekha Maddula; Balamurali K. Ambati


    Angiogenesis is the formation of new blood vessels from pre-existing vasculature. Pathologic angiogenesis in the eye can lead to severe visual impairment. In our review, we discuss the roles of both pro-angiogenic and anti-angiogenic molecular players in corneal angiogenesis, proliferative diabetic retinopathy, exudative macular degeneration and retinopathy of prematurity, highlighting novel targets that have emerged over the past decade.

  18. Defected red blood cell membranes and direct correlation with the uraemic milieu: the connection with the decreased red blood cell lifespan observed in haemodialysis patients

    Stamopoulos, D.; Grapsa, E.; Manios, E.; Gogola, V.; Bakirtzi, N.


    Together with impaired production of erythropoietin and iron deficiency, the decreased lifespan of red blood cells (RBCs) is a main factor contributing to the chronic anaemia observed in haemodialysis (HD) patients. Atomic force microscopy is employed in this work to thoroughly survey the membrane of intact RBCs (iRBCs) of HD patients in comparison to those of healthy donors, aiming to obtain direct information on the structural status of RBCs that can be related to their decreased lifespan. We observed that the iRBC membrane of the HD patients is overpopulated with extended circular defects, termed ‘orifices’, that have typical dimension ranging between 0.2 and 1.0 μm. The ‘orifice’ index—that is, the mean population of ‘orifices’ per top membrane surface—exhibits a pronounced relative increase of order 54 ± 12% for the HD patients as compared to healthy donors. Interestingly, for the HD patients, the ‘orifice’ index, which relates to the structural status of the RBC membrane, correlates strongly with urea concentration, which is a basic index of the uraemic milieu. Thus, these results indicate that the uraemic milieu downgrades the structural status of the RBC membrane, possibly triggering biochemical processes that result in their premature elimination from the circulation. This process could decrease the lifespan of RBCs, as observed in HD patients.

  19. In vivo diffuse correlation spectroscopy investigation of the ocular fundus

    Cattini, Stefano; Staurenghi, Giovanni; Gatti, Antonietta; Rovati, Luigi


    Diffuse correlation spectroscopy (DCS) measurements in vivo recorded from rabbits' ocular fundus are presented. Despite the complexity of these ocular tissues, we provide a clear and simple demonstration of the DCS abilities to analyze variations in physiological quantities of clinical interest. Indeed, the reported experimental activities demonstrate that DCS can reveal both choroidal-flow and temperature variations and detect nano- and micro-aggregates in ocular fundus circulation. Such abilities can be of great interest both in fundamental research and practical clinical applications. The proposed measuring system can be useful in: (a) monitoring choroidal blood flow variations, (b) determining the end-point for photo-dynamic therapy and transpupillary thermo therapy and, (c) managing the dye injection and determining an end-point for dye-enhanced photothrombosis. Moreover, it could allow both diagnoses when the presence of nano- and micro-aggregates is related to specific diseases and verifying the effects of nanoparticle injection in nanomedicine. Even though the reported results demonstrate the applicability of DCS to investigate ocular fundus, a detailed and accurate investigation of the limits of detection is beyond the scope of this article.

  20. Clinical characteristics and risk factors of ocular candidiasis.

    Nagao, Miki; Saito, Takashi; Doi, Shoichi; Hotta, Gou; Yamamoto, Masaki; Matsumura, Yasufumi; Matsushima, Aki; Ito, Yutaka; Takakura, Shunji; Ichiyama, Satoshi


    Ocular candidiasis is a major complication of Candida bloodstream infection (BSI). This study was performed to reveal the clinical characteristics of ocular candidiasis. Of the 220 patients with Candida BSI, 204 cases received ophthalmology consultations between January 2005 and December 2011 at 2 teaching hospitals. Fifty-four (26.5%) cases had findings consistent with the diagnosis of ocular candidiasis. Of these 54 cases, 43 (79.6%) were diagnosed within 7 days after a positive blood culture. Among ocular candidiasis cases, more cases were due to Candida albicans (P =0.034 odds ratio [OR]; 3.68 95% confidence interval [CI] 1.11-12.2) and had higher β-d-glucan values (P = 0.001 OR; 9.99 95% CI 2.60-21.3). We need to consider fundoscopic examination to be performed within the first 7 days of therapy, especially for those patients who have C. albicans BSIs and higher β-d-glucan values. Additionally, follow-up fundoscopic examination should be considered before stopping therapy for high-risk patients.

  1. Ocular Toxoplasmosis: Lessons from Brazil

    • A new attention to post-natally acquired infections. Previously, most attention was focused on infection during pregnancy, and the risk of congenital disease, with the feeling that infection in older individuals was benign, without a substantial risk of disease morbidity, such as ocular involvemen...

  2. Ocular toxoplasmosis associated with scleritis

    Yogish S Kamath


    Full Text Available We report an atypical presentation of Toxoplasma retinochoroiditis with associated scleritis in a young and immunocompetent patient. The diagnosis was done on the basis of Polymerase chain reaction of vitreous sample, and the clinical response to specific treatment. This case highlights the unusual presentation of ocular toxoplasmosis as scleritis.

  3. Imaging the ocular motor nerves.

    Ferreira, T.; Verbist, B.M.; Buchem, M. van; Osch, T. van; Webb, A.


    The ocular motor nerves (OMNs) comprise the oculomotor, trochlear and the abducens nerves. According to their course, they are divided into four or five anatomic segments: intra-axial, cisternal, cavernous and intra-orbital and, for the abducens nerve, an additional interdural segment. Magnetic reso

  4. Ocular Vestibular Evoked Myogenic Potentials

    Felipe, Lilian


    Full Text Available Introduction Diagnostic testing of the vestibular system is an essential component of treating patients with balance dysfunction. Until recently, testing methods primarily evaluated the integrity of the horizontal semicircular canal, which is only a portion of the vestibular system. Recent advances in technology have afforded clinicians the ability to assess otolith function through vestibular evoked myogenic potential (VEMP testing. VEMP testing from the inferior extraocular muscles of the eye has been the subject of interest of recent research. Objective To summarize recent developments in ocular VEMP testing. Results Recent studies suggest that the ocular VEMP is produced by otolith afferents in the superior division of the vestibular nerve. The ocular VEMP is a short latency potential, composed of extraocular myogenic responses activated by sound stimulation and registered by surface electromyography via ipsilateral otolithic and contralateral extraocular muscle activation. The inferior oblique muscle is the most superficial of the six extraocular muscles responsible for eye movement. Therefore, measurement of ocular VEMPs can be performed easily by using surface electrodes on the skin below the eyes contralateral to the stimulated side. Conclusion This new variation of the VEMP procedure may supplement conventional testing in difficult to test populations. It may also be possible to use this technique to evaluate previously inaccessible information on the vestibular system.

  5. Chlorpromazine induced ocular myasthenia gravis

    Nitya S


    Full Text Available Drug induced bilateral ptosis is a very rare adverse drug reaction. Here we report a case of ten year old male child with chlorpromazine induced bilateral ptosis due to ocular myasthenia. [Int J Basic Clin Pharmacol 2013; 2(5.000: 653-654

  6. Therapeutical Management for Ocular Rosacea

    Gloria López-Valverde


    Full Text Available Purpose: The purpose of this study is to describe a case of ocular rosacea with a very complex evolution. Rosacea is a chronic dermatological disease that may affect the ocular structures up to 6-72% of all cases. This form is often misdiagnosed, which may lead to long inflammatory processes with important visual consequences for affected patients. Therefore, an early diagnosis and an adequate treatment are important. Methods: We report the case of a 43-year-old patient who had several relapses of what seemed an episode of acute bacterial conjunctivitis. Two weeks later, he developed a corneal ulcer with a torpid evolution including abundant intrastromal infiltrators and calcium deposits. He was diagnosed with ocular rosacea and treated with systemic doxycycline and topical protopic. Results: A coating with amniotic membrane was placed in order to heal the ulcer, but a deep anterior lamellar keratoplasty to restore the patient’s vision because of the corneal transparency loss was necessary. Conclusions: Ocular rosacea includes multiple ophthalmic manifestations ranging from inflammation of the eyelid margin and blepharitis to serious corneal affectations. A delayed diagnosis can result in chronic inflammatory conditions including keratinization and loss of corneal transparency, which lead to important visual sequelae for affected patients.

  7. Identification of bacteria directly from positive blood culture samples by DNA pyrosequencing of the 16S rRNA gene.

    Motoshima, Maiko; Yanagihara, Katsunori; Morinaga, Yoshitomo; Matsuda, Junichi; Hasegawa, Hiroo; Kohno, Shigeru; Kamihira, Shimeru


    Rapid identification of the causative bacteria of sepsis in patients can contribute to the selection of appropriate antibiotics and improvement of patients' prognosis. Genotypic identification is an emerging technology that may provide an alternative method to, or complement, established phenotypic identification procedures. We evaluated a rapid protocol for bacterial identification based on PCR and pyrosequencing of the V1 and V3 regions of the 16S rRNA gene using DNA extracted directly from positive blood culture samples. One hundred and two positive blood culture bottles from 68 patients were randomly selected and the bacteria were identified by phenotyping and pyrosequencing. The results of pyrosequencing identification displayed 84.3 and 64.7 % concordance with the results of phenotypic identification at the genus and species levels, respectively. In the monomicrobial samples, the concordance between the results of pyrosequencing and phenotypic identification at the genus level was 87.0 %. Pyrosequencing identified one isolate in 60 % of polymicrobial samples, which were confirmed by culture analysis. Of the samples identified by pyrosequencing, 55.7 % showed consistent results in V1 and V3 targeted sequencing; other samples were identified based on the results of V1 (12.5 %) or V3 (31.8 %) sequencing alone. One isolate was erroneously identified by pyrosequencing due to high sequence similarity with another isolate. Pyrosequencing identified one isolate that was not detected by phenotypic identification. The process of pyrosequencing identification can be completed within ~4 h. The information provided by DNA-pyrosequencing for the identification of micro-organisms in positive blood culture bottles is accurate and could prove to be a rapid and useful tool in standard laboratory practice.

  8. Direct analysis of site-specific N-glycopeptides of serological proteins in dried blood spot samples.

    Choi, Na Young; Hwang, Heeyoun; Ji, Eun Sun; Park, Gun Wook; Lee, Ju Yeon; Lee, Hyun Kyoung; Kim, Jin Young; Yoo, Jong Shin


    Dried blood spot (DBS) samples have a number of advantages, especially with respect to ease of collection, transportation, and storage and to reduce biohazard risk. N-glycosylation is a major post-translational modification of proteins in human blood that is related to a variety of biological functions, including metastasis, cell-cell interactions, inflammation, and immunization. Here, we directly analyzed tryptic N-glycopeptides from glycoproteins in DBS samples using liquid chromatography-tandem mass spectrometry (LC-MS/MS) without centrifugation of blood samples, depletion of major proteins, desalting of tryptic peptides, and enrichment of N-glycopeptides. Using this simple method, we identified a total of 41 site-specific N-glycopeptides from 16 glycoproteins in the DBS samples, from immunoglobulin gamma 1 (IgG-1, 10 mg/mL) down to complement component C7 (50 μg/mL). Of these, 32 N-glycopeptides from 14 glycoproteins were consistently quantified over 180 days stored at room temperature. The major abundant glycoproteins in the DBS samples were IgG-1 and IgG-2, which contain nine asialo-fucosylated complex types of 16 different N-glycopeptide isoforms. Sialo-non-fucosylated complex types were primarily detected in the other glycoproteins such as alpha-1-acid glycoprotein 1, 2, alpha-1-antitypsin, alpha-2-macroglobulin, haptoglobin, hemopexin, Ig alpha 1, 2 chain C region, kininogen-1, prothrombin, and serotransferrin. We first report the characterization of site-specific N-glycoproteins in DBS samples by LC-MS/MS with minimal sample preparation.

  9. Effect of Vestibular Impairment on Cerebral Blood Flow Response to Dynamic Roll Tilt

    Serrador, J. M.; Black, F. O.; Schlgel, Todd T.; Lipsitz, L. A.; Wood, S. J.


    Change to upright posture results in reductions in cerebral perfusion pressure due to hydrostatic pressure changes related to gravity. Since vestibular organs, specifically the otoliths, provide information on position relative to gravity, vestibular inputs may assist in adaptation to the upright posture. The goal of this study was to examine the effect of direct vestibular stimulation on cerebral blood flow (CBF). To examine the role of otolith inputs we screened 165 subjects for vestibular function and classified subjects as either normal or impaired based on ocular torsion. Ocular torsion, an indication of otolith function, was assessed during sinusoidal roll tilt of 20 degrees at 0.01 Hz (100 sec per cycle). Subjects with torsion one SD below the mean were classified as impaired while subjects one SD above the mean were considered normal. During one session subjects were placed in a chair that was sinusoidally rotated 25 degrees in the roll plane at five frequencies: 0.25 & 0.125 Hz for 80 sec, 0.0625 Hz for 160 sec and 0.03125 Hz and 0.015625 Hz for 320 sec. During testing, CBF (transcranial Doppler), blood pressure (Finapres), and end tidal CO2 (Puritan Bennet) were measured continuously. Ocular torsion was assessed from infrared images of the eyes. All rotations were done in the dark with subjects fixated on a red LED directly at the center of rotation. In the normal group, dynamic tilt resulted in significant changes in both blood pressure and cerebral blood flow velocity that was related to the frequency of stimulus. In contrast the impaired group did not show similar patterns. As expected normal subjects demonstrated significant ocular torsion that was related to stimulus frequency while impaired subjects had minimal changes. These data suggest that vestibular inputs have direct effects on cerebral blood flow regulation during dynamic tilt. Supported by NASA.

  10. Study of fluid dynamics reveals direct communications between lymphatic vessels and venous blood vessels at lymph nodes of mice.

    Takeda, Kazu; Mori, Shiro; Kodama, Tetsuya


    Cancer cells metastasize to lymph nodes, with distant metastasis resulting in poor prognosis. The role of lymph node metastasis (LNM) in the spread of cancer to distant organs remain incompletely characterized. The visualization of flow dynamics in the lymphatic and blood vessels of MXH10/Mo-lpr/lpr mice, which develop systemic swelling of lymph nodes up to 10mm in diameter, has revealed that lymph nodes have the potential to be a direct source of systemic metastasis. However, it is not known whether these fluid dynamics characteristics are universal phenomena present in other strains of laboratory mice. Here we show that the fluid dynamics observed in MXH10/Mo-lpr/lpr mice are the same as those observed in C57BL/6J, BALB/cAJcl and NOD/ShiJic-scidJcl mice. Furthermore, when fluorescent solution was injected into a tumor-bearing lymph node, the flow dynamics observed in the efferent lymphatic vessels and thoracoepigastric vein depended on the type of tumor cell. Our results indicate that fluid dynamics in the lymphatic and blood vessels of MXH10/Mo-lpr/lpr mice are generalized phenomena seen in conventional laboratory mice. We anticipate our results can facilitate studies of the progression of lymphatic metastasis to hematogenous metastasis via lymph nodes and the early diagnosis and treatment of LNM.


    Starkov, A V; Syropyatov, B Ya; Sobin, F V; Pullina, N A


    The influence of newly synthesized compound--thiazoline ammonium 4-chlorophenyl-2-hydroxy-4-oxo-2-butenoate (FS-169), which has a direct anticoagulant--on the indices of coagulation activity has been studied in rabbit blood plasma with the aid of an APG4-02-P coagulometer. It is established that FS-169 reliably extends the partial thromboplastin time by 122.2% (p < 0.001) and the prothrombin time by 49.1% (p = 0.001), increases the prothrombin index by 30.9% (p = 0.001), and decreases the prothrombin ratio and international normalized ratio by 40.0% (p = 0.001). At the same time FS-169 does not influence the thrombin time FS-169.

  12. Topical ocular delivery of fluoroquinolones.

    Pawar, Pravin; Katara, Rajesh; Mishra, Sushil; Majumdar, Dipak K


    Topical fluoroquinolones are used in ophthalmology to treat ocular infections. They are bactericidal and inhibit bacterial DNA replication by inhibiting DNA gyrase and topoisomerase. Fluoroquinolones possess two ionizable groups: a carboxylic group (pKa1 = 5.5 - 6.34) and a heterocyclic group (pKa2 = 7.6 - 9.3), in the nucleus, which acquire charge at pH above and below the isoelectric point (pI = 6.75 - 7.78). At isoelectric point, fluoroquinolones remain unionized and show enhanced corneal penetration but exhibit reduced aqueous solubility and the drug may precipitate from aqueous solution. Aqueous ophthalmic solutions of fluoroquinolones are obtained by using hydrochloride or mesylate salt which is acidic and irritating to the eyes. Hence, pH of the solution is kept between 5 and 7 to ensure aqueous solubility and minimum ocular irritation. This review gives an overview of various physicochemical and formulation factors affecting the ocular delivery of fluoroquinolones and strategies for getting higher ocular bioavailability for ocular delivery of fluoroquinolones. These strategies could be employed to improve efficacy of fluoroquinolones in eye preparation. Broad-spectrum antibacterials, such as the ophthalmic fluoroquinolones, are powerful weapons for treating and preventing potentially sight-threatening infections. The fourth-generation fluoroquinolones have quickly assumed an outstanding place in the ophthalmic applications. Especially valuable for their broad-spectrum coverage against Gram-positive and Gram-negative organisms, these agents have become the anti-infective of preference for many ophthalmologists. Moxifloxacin seems to be a promising powerful molecule among all fluoroquinolones for treatment of bacterial infections.

  13. Microsurgical anatomy of the ocular motor nerves.

    Zhang, Yi; Liu, Hao; Liu, En-Zhong; Lin, You-Zhi; Zhao, Shi-Guang; Jing, Guo-Hua


    This study was designed to provide anatomic data to help surgeons avoid damage to the ocular motor nerves during intraorbital operations. The microsurgical anatomy of the ocular motor nerves was studied in 50 adult cadaveric heads (100 orbits). Dissections were performed with a microscope. The nerves were exposed and the neural and muscular relationships of each portion of the nerve were examined and measured. The superior division of the oculomotor nerve coursed between the optic nerve and the superior rectus muscle after it left the annular tendon, and its branches entered into the superior rectus muscle and levator muscle. A mean of five fibers (range 3-7) innervated the superior rectus muscle, and a mean of one fiber (range 1-2) followed a medial direction (84%) or went straight through the superior rectus muscle (16%). The inferior division of the oculomotor nerve branched into the medial rectus, inferior rectus and inferior oblique muscles. The trochlear nerve ended on the orbital side of the posterior one-third of the superior oblique muscle in 76 specimens. The abducens nerve ended on the posterior one-third of the lateral rectus muscle in 86 specimens. If the belly of the lateral rectus muscle was divided into three superior-inferior parts, the nerve commonly entered into the middle one-third in 74 specimens. Based on the observed data, microanatomical relationships of the orbital contents were revised.

  14. Fluid transport phenomena in ocular epithelia.

    Candia, Oscar A; Alvarez, Lawrence J


    This article discusses three largely unrecognized aspects related to fluid movement in ocular tissues; namely, (a) the dynamic changes in water permeability observed in corneal and conjunctival epithelia under anisotonic conditions, (b) the indications that the fluid transport rate exhibited by the ciliary epithelium is insufficient to explain aqueous humor production, and (c) the evidence for fluid movement into and out of the lens during accommodation. We have studied each of these subjects in recent years and present an evaluation of our data within the context of the results of others who have also worked on electrolyte and fluid transport in ocular tissues. We propose that (1) the corneal and conjunctival epithelia, with apical aspects naturally exposed to variable tonicities, are capable of regulating their water permeabilities as part of the cell-volume regulatory process, (2) fluid may directly enter the anterior chamber of the eye across the anterior surface of the iris, thereby representing an additional entry pathway for aqueous humor production, and (3) changes in lens volume occur during accommodation, and such changes are best explained by a net influx and efflux of fluid.

  15. Identification of blood culture isolates directly from positive blood cultures by use of matrix-assisted laser desorption ionization-time of flight mass spectrometry and a commercial extraction system: analysis of performance, cost, and turnaround time.

    Lagacé-Wiens, Philippe R S; Adam, Heather J; Karlowsky, James A; Nichol, Kimberly A; Pang, Paulette F; Guenther, Jodi; Webb, Amanda A; Miller, Crystal; Alfa, Michelle J


    Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry represents a revolution in the rapid identification of bacterial and fungal pathogens in the clinical microbiology laboratory. Recently, MALDI-TOF has been applied directly to positive blood culture bottles for the rapid identification of pathogens, leading to reductions in turnaround time and potentially beneficial patient impacts. The development of a commercially available extraction kit (Bruker Sepsityper) for use with the Bruker MALDI BioTyper has facilitated the processing required for identification of pathogens directly from positive from blood cultures. We report the results of an evaluation of the accuracy, cost, and turnaround time of this method for 61 positive monomicrobial and 2 polymicrobial cultures representing 26 species. The Bruker MALDI BioTyper with the Sepsityper gave a valid (score, >1.7) identification for 85.2% of positive blood cultures with no misidentifications. The mean reduction in turnaround time to identification was 34.3 h (P blood cultures and 26.5 h in a more practical setting where conventional identification or identification from subcultures was required for isolates that could not be directly identified by MALDI-TOF. Implementation of a MALDI-TOF-based identification system for direct identification of pathogens from blood cultures is expected to be associated with a marginal increase in operating costs for most laboratories. However, the use of MALDI-TOF for direct identification is accurate and should result in reduced turnaround time to identification.

  16. Toxicidad ocular medicamentosa Ocular toxicity induced by medication

    A. Garralda


    Full Text Available En el presente trabajo se analiza la toxicidad ocular inducida por cuatro grupos de fármacos sistémicos: tamoxifeno, cloroquina y derivados, anticolinérgicos y tamsulosina. El objetivo principal es dar unas normas prácticas que sirvan para el manejo diario de los pacientes sometidos a estos tratamientos, más que profundizar en los mecanismos de acción de cada uno de ellos.This paper analyses ocular toxicity induced by four groups of systemic medicines: tamoxifen, chloroquine and derivatives, anticholinergics and tamsulosin. Our main aim is to provide some practical rules that will be of use in the everyday management of patients receiving these treatments, rather than to examine the mechanisms by which each of these medicines act.

  17. Contribution of laboratory methods in diagnosing clinically suspected ocular toxoplasmosis in Brazilian patients.

    Mattos, Cinara C B; Meira, Cristina S; Ferreira, Ana I C; Frederico, Fábio B; Hiramoto, Roberto M; Almeida, Gildásio C; Mattos, Luiz C; Pereira-Chioccola, Vera L


    This prospective study evaluated the value of laboratorial diagnosis in ocular toxoplasmosis analyzing peripheral blood samples from a group of Brazilian patients by immunologic and molecular methods. We analyzed blood samples from 184 immunocompetent patients with ocular disorders divided into 2 groups: Group I, composed of samples from 49 patients with ocular toxoplasmosis diagnosed by clinical features; Group II, samples from 135 patients with other ocular diseases. Samples were assayed by conventional polymerase chain reaction (cnPCR), real-time PCR (qPCR) for Toxoplasma gondii, indirect immunofluorescence reaction (IF), avidity test (crude tachyzoite lysate as antigen), and excreted-secreted tachyzoite proteins as antigen (ESA-ELISA). cnPCR and qPCR profiles were concordant in all samples. Positive PCR was shown in 40.8% of group I patients. The majority of the positive blood samples (75%) were taken from patients with toxoplasmic retinochoroiditis scars, and the others (25%), from patients with retinal exudative lesions. Despite that 86 of the 135 patients from Group II had asymptomatic toxoplasmosis, all DNA blood samples had negative PCR. Concordant results were shown in the data obtained by serologic methods. Around 24% of the patients with ocular toxoplasmosis had high antibody titers determined by ESA-ELISA and IF. Anti-ESA antibodies are shown principally in patients with active infection. Collectively, these data demonstrate the presence of tachyzoites in the blood of patients with chronic infection, supporting the idea of recurrent disease. Circulating parasites in blood of immunocompetent individuals may be associated with the reactivation of the ocular disease.

  18. An innovative impression technique for fabrication of a custom made ocular prosthesis

    Sunil Chandra Tripuraneni


    Full Text Available Various impression and fitting techniques have been described in the past for restoring ocular defects. The present article describes a new direct impression technique for recording and rehabilitating ocular defects, by custom-made ocular prosthesis. All the techniques described in the history, mainly concentrated in recording the tissue surface of the defect, which made it difficult to contour the palpebral surface resulting in the poor esthetics of the prosthesis. The present impression technique uses heavy bodied polyvinyl siloxane impression material, which facilitates accurate recording of the tissue surface and the palpebral surface of the defect, resulting in the fabrication of functionally and esthetically acceptable prosthesis.

  19. An innovative impression technique for fabrication of a custom made ocular prosthesis

    Tripuraneni, Sunil Chandra; Vadapalli, Sriharsha Babu; Ravikiran, P; Nirupama, N


    Various impression and fitting techniques have been described in the past for restoring ocular defects. The present article describes a new direct impression technique for recording and rehabilitating ocular defects, by custom-made ocular prosthesis. All the techniques described in the history, mainly concentrated in recording the tissue surface of the defect, which made it difficult to contour the palpebral surface resulting in the poor esthetics of the prosthesis. The present impression technique uses heavy bodied polyvinyl siloxane impression material, which facilitates accurate recording of the tissue surface and the palpebral surface of the defect, resulting in the fabrication of functionally and esthetically acceptable prosthesis. PMID:26265651

  20. Ocular infections due to Non-Tuberculous Mycobacteria

    Lalitha P


    Full Text Available PURPOSE: To investigate the types and causes of non-tuberculous ocular infections and study their response to topical antibiotic therapy. METHOD: A single center, retrospective review of 18 patients with non-tuberculous mycobacterial ocular infections, seen over a 3 year period was done. Laboratory diagnosis was established by growth on blood agar, LJ medium and Ziehl-Nielsen acid fast stain. RESULTS: Out of 18 patients, six had post corneal graft infection, six had corneal ulcers, three had endogenous endophthalmitis, one had post operative endophthalmitis and two cases were of post surgical wound infection. History of trauma was reported in two cases and surgery in nine cases. M.chelonae was grown in blood agar for all patients. For corneal infections fortified genatmicin and fortified amikacin topical eye drops were given while the cases of endophthalmitis received intravitreal amikacin. Response to treatment was poor in 16 cases (88.9%. Only two cases of corneal ulcer improved after prolonged treatment. There was a misdiagnosis of Corynebacterium spp. on Gram stain in the initial cases. Majority of the isolates were sensitive to gentamicin (72.2% followed by amikacin (44.4%. CONCLUSIONS: Early clinical recognition and prompt laboratory diagnosis together with aggressive topical antibiotic therapy may shorten morbidity and improve the clinical outcome of non-tuberculous mycobacterial ocular infection.

  1. [Ocular toxocariasis--case report].

    Moraru, Andreea; Panfil, Madălina; Totolici, Geanina; Brănişteanu, Daniel; Costin, Dănut; Schmitzer, Speranţa


    Ocular Toxocariasis is a parasitosis caused by Toxocara catis/canis larvae localized in the eye. The most frequent clinical manifestations are the central retinal granuloma, peripheral retinal granuloma and chronic endophthalmitis. Secondary complications due to the presence of parasite in the posterior segment of the eye may have significant consequences on visual function. We present the case of a 23 years old patient, admitted for progressive decrease of the right eye BCVA during the last 6 months. After performing clinical examination and serological tests we established the diagnosis of ocular Toxocariasis. The patient presented a particular form of the disease consisting in the presence of both a central retinal granuloma and a peripheral one. We performed 23G pars plana vitrectomy and membrane peeling. VA improved as soon as the first month after surgery.

  2. Ocular Surface Reconstruction: Recent Innovations

    Madhavan HN


    Full Text Available The ocular surface is exceptionally rich in complexity and functionality. Severe ocular surface disorders/conditions, such as chemical or thermal injuries, Stevens-Johnson syndrome (SJS, ocular cicatricial pemphigoid, neurotrophic keratopathy, chronic limbitis, and severe microbial keratitis cause significant morbidities and even corneal blindness. Hypofunction may be caused by Aniridia, Neurotrophy, Endocrine, Pterygium and Chronic limbitis Approximately 6000 patients are seen in Ocular Surface Clinic every year; almost 80% have some form of dry eyes. About 125 new patients of Stevens Johnson Syndrome are seen in a year of which approximately 25% may benefit from Cultured Epithelial Transplant and 75 new patients of thermal/chemical injury in a year of which almost 80% will benefit from Stem Cell Transplantation. Of the 128 severe vernal keratoconjunctivitis which were seen in the ocular surface clinic, 10% require stem cell transplantation. Nearly 30 new cases of Ocular cicatrical pemphigoid every year are seen and they may need stem cell transplantation. In addition, several patients with persistent epithelial defects may benefit from limbal stem cell transplantation to alleviate, maintain conjunctivalization regression and corneal avascularity limbal deficiency, and restore vision. Even if granted that this statistics is for a single large ophthalmic hospital, for a large country as India with 1.1 billion populations, the number of patients requiring corneal stem cell transplantation is enormous. Stem cells in the palisades of Vogt participate in regeneration and preservation of corneal transparency and avascularity. The diminished regenerative capacity seen in LSCD is characterized by persistent epithelial defects, erosion and ulceration, conjunctivalization and neovascularization, and chronic inflammation. Standard corneal transplantation for restoration of corneal clarity and avascularity is a contraindication in the surgical management

  3. Tuberculose ocular: relato de casos

    Costa Daniella Socci da


    Full Text Available Os autores relatam dois casos de tuberculose ocular presumida com comprometimento coroidiano. No primeiro caso, um paciente de 43 anos, HIV positivo, com tuberculose pulmonar miliar e tuberculoma cerebral, apresenta um granuloma coroidiano único na região macular do olho esquerdo. No segundo caso, uma paciente de 12 anos, HIV negativa, com tuberculose pulmonar apresenta coroidite multifocal e comprometimento do segmento anterior do olho esquerdo. Ambos os pacientes evoluíram favoravelmente com o tratamento específico, apresentando completa resolução das lesões. As lesões oculares da tuberculose são diversas e devemos continuar atentos a esta enfermidade.

  4. Freeze drying of red blood cells: the use of directional freezing and a new radio frequency lyophilization device.

    Arav, Amir; Natan, Dity


    Red blood cell (RBC) units are administered routinely into patients expressing a wide range of acute and chronic conditions (e.g., anemia, traumatic bleeding, chronic diseases, and surgery). The modern blood banking system has been designed to answer this need and assure a continuous, high quality blood supply to patients. However, RBCs units can be stored under hypothermic conditions for only up to 42 days, which leads to periodic shortages. Cryopreservation can solve these shortages, but current freezing methods employ high glycerol concentrations, which need to be removed and the cells washed prior to transfusion, resulting in a long (more than 1 hour) and cumbersome washing step. Thus, frozen RBCs have limited use in acute and trauma situations. In addition, transportation of frozen samples is complicated and costly. Freeze drying (lyophilization) of RBCs has been suggested as a solution for these problems, since it will allow for a low weight sample to be stored at room temperature, but reaching this goal is not a simple task. We studied the effect of different solutions (IMT2 and IMT3) containing trehalose and antioxidants or trehalose and human serum albumin, respectively, on freezing/thawing and freeze drying of RBCs. In addition, we evaluated the effect of cells concentrations and cooling rates on the post thaw and post rehydration recoveries of the RBCs. Finally, we developed a new radio frequency (RF) lyophilization device for a more rapid and homogeneous sublimation process of the frozen RBCs samples. Recovery and free Hb were measured as well as oxygen association/dissociation and cell's deformability. We found that IMT3 (0.3 M trehalose and 10% HSA) solution that was directionally frozen at a rapid interface velocity of 1 mm/sec (resulting in a cooling rate of 150°C/min) yielded the best results (better than IMT2 solution and slow interface velocity). Freeze thawing gave 100% survival, while freeze drying followed by rehydration with 20% dextran-40k

  5. Topical ocular delivery of NSAIDs.

    Ahuja, Munish; Dhake, Avinash S; Sharma, Surendra K; Majumdar, Dipak K


    In ocular tissue, arachidonic acid is metabolized by cyclooxygenase to prostaglandins which are the most important lipid derived mediators of inflammation. Presently nonsteroidal anti-inflammatory drugs (NSAIDs) which are cyclooxygenase (COX) inhibitors are being used for the treatment of inflammatory disorders. NSAIDs used in ophthalmology, topically, are salicylic-, indole acetic-, aryl acetic-, aryl propionic- and enolic acid derivatives. NSAIDs are weak acids with pKa mostly between 3.5 and 4.5, and are poorly soluble in water. Aqueous ophthalmic solutions of NSAIDs have been made using sodium, potassium, tromethamine and lysine salts or complexing with cyclodextrins/solubilizer. Ocular penetration of NSAID demands an acidic ophthalmic solution where cyclodextrin could prevent precipitation of drug and minimize its ocular irritation potential. The incompatibility of NSAID with benzalkonium chloride is avoided by using polysorbate 80, cyclodextrins or tromethamine. Lysine salts and alpha-tocopheryl polyethylene glycol succinate disrupt corneal integrity, and their use requires caution. Thus a nonirritating ophthalmic solution of NSAID could be formulated by dissolving an appropriate water-soluble salt, in the presence of cyclodextrin or tromethamine (if needed) in mildly acidified purified water (if stability permits) with or without benzalkonium chloride and polyvinyl alcohol. Amide prodrugs met with mixed success due to incomplete intraocular hydrolysis. Suspension and ocular inserts appear irritating to the inflamed eye. Oil drop may be a suitable option for insoluble drugs and ointment may be used for sustained effect. Recent studies showed that the use of colloidal nanoparticle formulations and the potent COX 2 inhibitor bromfenac may enhance NSAID efficacy in eye preparations.

  6. Topical Ocular Delivery of NSAIDs

    Ahuja, Munish; Avinash S Dhake; Sharma, Surendra K; Dipak K Majumdar


    In ocular tissue, arachidonic acid is metabolized by cyclooxygenase to prostaglandins which are the most important lipid derived mediators of inflammation. Presently nonsteroidal anti-inflammatory drugs (NSAIDs) which are cyclooxygenase (COX) inhibitors are being used for the treatment of inflammatory disorders. NSAIDs used in ophthalmology, topically, are salicylic-, indole acetic-, aryl acetic-, aryl propionic- and enolic acid derivatives. NSAIDs are weak acids with pKa mostly between 3.5 a...

  7. Ocular dirofilariasis in Dubai, UAE.

    Mittal, Mamta; Sathish, K R; Bhatia, Prashant G; Chidamber, B S


    A rare occurrence of ocular subconjunctival dirofilariasis in a 53-year-old healthy Indian male working in Dubai, UAE presenting with an acute red eye is reported. Surgical excision under topical anesthesia was carried out uneventfully in the outpatient clinic. The live worm removed from the subconjunctival space was identified as Dirofilaria repens on the basis of microscopic examination and histopathology. Surgical excision of subconjunctival dirofilariasis is safe in an outpatient setting and curative precluding the need for further systemic antihelminthics.

  8. Unusual Presentation of Cutaneous Leishmaniasis: Ocular Leishmaniasis

    Masoud Doroodgar


    Full Text Available The leishmaniases are parasitic diseases that are transmitted to humans by infected female sandflies. Cutaneous leishmaniasis (CL is one of 3 main forms of the disease. CL is the most common form of the disease and is endemic in many urban and rural parts of Iran and usually caused by two species of Leishmania: L. major and L. tropica. We report a case of unusual leishmaniasis with 25 lesions on exposed parts of the body and right eyelid involvement (ocular leishmaniasis. The patient was a 75-year-old male farmer referred to health care center in Aran va Bidgol city. The disease was diagnosed by direct smear, culture, and PCR from the lesions. PCR was positive for Leishmania major.

  9. Unusual Presentation of Cutaneous Leishmaniasis: Ocular Leishmaniasis

    Doroodgar, Masoud; Doroodgar, Moein


    The leishmaniases are parasitic diseases that are transmitted to humans by infected female sandflies. Cutaneous leishmaniasis (CL) is one of 3 main forms of the disease. CL is the most common form of the disease and is endemic in many urban and rural parts of Iran and usually caused by two species of Leishmania: L. major and L. tropica. We report a case of unusual leishmaniasis with 25 lesions on exposed parts of the body and right eyelid involvement (ocular leishmaniasis). The patient was a 75-year-old male farmer referred to health care center in Aran va Bidgol city. The disease was diagnosed by direct smear, culture, and PCR from the lesions. PCR was positive for Leishmania major. PMID:28210511

  10. Ocular pressure waveform reflects ventricular bigeminy and aortic insufficiency

    Jean B Kassem


    Full Text Available Ocular pulse amplitude (OPA is defined as the difference between maximum and minimum intraocular pressure (IOP during a cardiac cycle. Average values of OPA range from 1 to 4 mmHg. The purpose of this investigation is to determine the source of an irregular IOP waveform with elevated OPA in a 48-year-old male. Ocular pressure waveforms had an unusual shape consistent with early ventricular contraction. With a normal IOP, OPA was 9 mmHg, which is extraordinarily high. The subject was examined by a cardiologist and was determined to be in ventricular bigeminy. In addition, he had bounding carotid pulses and echocardiogram confirmed aortic insufficiency. After replacement of the aortic valve, the bigeminy resolved and the ocular pulse waveform became regular in appearance with an OPA of 1.6-2.0 mmHg. The ocular pressure waveform is a direct reflection of hemodynamics. Evaluating this waveform may provide an additional opportunity for screening subjects for cardiovascular anomalies and arrhythmias.

  11. Transforming ocular surface stem cell research into successful clinical practice

    Virender S Sangwan


    Full Text Available It has only been a quarter of a century since the discovery of adult stem cells at the human corneo-scleral limbus. These limbal stem cells are responsible for generating a constant and unending supply of corneal epithelial cells throughout life, thus maintaining a stable and uniformly refractive corneal surface. Establishing this hitherto unknown association between ocular surface disease and limbal dysfunction helped usher in therapeutic approaches that successfully addressed blinding conditions such as ocular burns, which were previously considered incurable. Subsequent advances in ocular surface biology through basic science research have translated into innovations that have made the surgical technique of limbal stem cell transplantation simpler and more predictable. This review recapitulates the basic biology of the limbus and the rationale and principles of limbal stem cell transplantation in ocular surface disease. An evidence-based algorithm is presented, which is tailored to clinical considerations such as laterality of affliction, severity of limbal damage and concurrent need for other procedures. Additionally, novel findings in the form of factors influencing the survival and function of limbal stem cells after transplantation and the possibility of substituting limbal cells with epithelial stem cells of other lineages is also discussed. Finally this review focuses on the future directions in which both basic science and clinical research in this field is headed.

  12. Microbiota conjuntival em pacientes com alergia ocular Conjunctival microbiota in patients with ocular allergy

    Alexandre Mattoso Libório


    Full Text Available OBJETIVO: Avaliar a presença de microbiota aeróbia da conjuntiva de portadores de alergia ocular e comparar a um grupo controle. MÉTODOS: Foram examinados 133 pacientes no período de abril a junho de 2001 divididos em 2 grupos. O grupo A foi composto de 63 portadores de conjuntivite alérgica (sem uso de medicação e o grupo B de 70 pacientes do ambulatório geral (controle. Foram coletadas amostras do fundo de saco conjuntival do olho direito de todos os pacientes e o material foi semeado em meios sólidos de cultura (ágar sangue, chocolate e Sabouraud. RESULTADOS: No grupo A, 30 culturas (47,7% foram positivas e no grupo B, 6 (8,6%. Sete bactérias foram isoladas no grupo A e 4 no B. A análise estatística revelou associação significante entre a positividade dos cultivos e conjuntivite alérgica. CONCLUSÃO: Microbiota bacteriana foi mais freqüentemente encontrada nos pacientes com alergia ocular.PURPOSE: To evaluate de presence of conjunctival aerobic microbiota in patients with ocular allergy as compared to a control group. METHODS: One hundred and thirty-three patients were evaluated from April to June 2001 and divided into 2 groups. Sixty-three patients with allergic conjunctivitis (without medication were in group A and 70 patients from the general outpatient clinic were in group B (control group. Samples from the conjunctival sac of the right eye were collected and cultured in solid media (blood, chocolate and Sabouraud agar. RESULTS: In group A, 30 cultures (47.7% were positive and 6 (8.6% in group B. Seven bacteria were isolated from group A and 4 from group B. Statistical analysis revealed significant association between positive cultures and allergic conjunctivitis. CONCLUSION: Bacterial microbiota was more frequently found in patients with ocular allergy.

  13. Opportunistic ocular infections in AIDS

    Shikha Baisakhiya DOMS; FGO


    As the number of HIV infected patients is multiplying exponentially day by day so are the associated ocular complications.The increasing longevity of individuals with HIV disease has resulted in greater numbers of pa-tients with ocular opportunistic infection.By the means of this article we describe various opportunistic ocular infections in AIDS and their clinical manifestations,discussed under four headings;1 )adnexal manifestation;2)anterior segment manifestation;3)posterior segment manifestation;4)neuro ophthalmic manifestation . Herpes zoster ophthalmicus,molluscum contagiosum and Kaposi sarcoma are common adnexal manifestations. Molluscum contagiosum being the commonest.Varicella Zoster Virus (VZV)and herpes simplex virus (HSV) most commonly cause infectious keratitis in HIV-positive patients .As compared to the immunocompetent indi-viduals the frequency of bacterial and fungal keratitis is not more in HIV patients,but it tends to be more se-vere.Posterior segment structures involved in HIV-positive patients include the retina,choroid,and optic nerve head.The herpesvirus family is implicated most commonly in infections of the retina and choroid in HIV positive patients.CMV is the most common cause of retinitis and the commonest intraocular infection in AIDS. Atypical presentations resistance to conventional treatment and higher rate of recurrence make the diagnosis and therapeutic intervention more difficult and challenging.In addition,in one eye,several infections may occur at the same time,rendering the situation more difficult.

  14. Transplant related ocular surface disorders: Advanced techniques for ocular surface rehabilitation after ocular complications secondary to hematopoietic stem cell transplantation.

    Stahl, Erin D; Mahomed, Faheem; Hans, Amneet K; Dalal, Jignesh D


    HSCT has been linked to the development of an assortment of ocular surface complications with the potential to lead to permanent visual impairment if left untreated or if not treated early in the course of disease. Strategies for therapy include maintenance of lubrication and tear preservation, prevention of evaporation, decreasing inflammation, and providing epithelial support. The ultimate aim of treatment is to prevent permanent ocular sequelae through prompt ophthalmology consultation and the use of advanced techniques for ocular surface rehabilitation. We describe several rehabilitation options of ocular surface complications occurring secondarily during the post-HSCT course.

  15. Impact of Microbiome on Ocular Health.

    Kugadas, Abirami; Gadjeva, Mihaela


    The ocular surface is continuously exposed to the environment and, therefore, it is surprising that it harbors only few commensals with low degree of diversity. This unique aspect of the ocular surface physiology prompts the question whether there are core ocular commensal communities and how they affect ocular immunity. The purpose of this review is to provide an overview of what is known about the ocular surface commensals in health and disease and what we would like to learn in the near future. In addition, we discuss how microbiota at sites other than the eye may influence ocular immune responses. The information discussed in the review has been gathered using PubMed searches for literature published from January 1982 to December 2015. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Fast agitated directly suspended droplet microextraction technique for the rapid analysis of eighteen organophosphorus pesticides in human blood.

    Kumari, Rupender; Patel, Devendra K; Panchal, Smita; Jha, Rakesh R; Satyanarayana, G N V; Asati, Ankita; Ansari, Nasreen G; Pathak, Manoj K; Kesavachandran, C; Murthy, Ramesh C


    A new sample preparation technique named as fast agitated directly suspended droplet microextraction (FA-DSDME) was proposed as an improved version of directly suspended droplet microextraction (DSDME) for the extraction and pre-concentration of wide-range organophosphorus pesticides (OPPs) from human blood prior to liquid chromatography tandem mass spectrometric (LC-MS/MS) analysis. In this method, instead of protecting the unwanted rupturing of extraction droplet (organic solvent), it was deliberately splintered into fine droplets by providing automated high-speed agitation to the biphasic extraction system (extraction solvent and sample solution). Fine organic droplets were then recollected into one, not by using a centrifuge machine but just by giving a very slow stirring to the bottom of the extraction system. The present method has surmounted the problem of prolonged extraction time associated with old DSDME. Under optimum extraction conditions, the method showed good sensitivity with low detection limits ranging from 0.0009 to 0.122μgL(-1). Mean recoveries were achieved in the range of 86-109% at three levels of spiking concentration (low, middle and high) from linearity range of individual analyte. Intra-day and inter-day precisions were ≤4.68 and ≤9.57 (%RSD) respectively. Enrichment factor (EF) for each analyte varied from 30 to 132 which prove the ability of this technique to pre-concentrate the extracted analytes up to a good extent. The sample matrices have shown an insignificant influence on method's sensitivity. The proposed method may find immense use in epidemiological, toxicological, regulatory and forensic laboratories. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Innate immunity of the ocular surface.

    Ueta, Mayumi; Kinoshita, Shigeru


    The ocular surface epithelium serves a critical function as the defensive front line of the innate immune system. While the detection of microbes is arguably its most important task, an exaggerated host defense reaction to endogenous bacterial flora may initiate and perpetuate inflammatory mucosal responses. The ability of cells to recognize pathogen-associated molecular patterns (PAMPs) mainly depends on the expression of a family of Toll-like receptors (TLRs). A healthy ocular surface is not inflammatory, even though ocular surface epithelium is in constant contact with bacteria and bacterial products. In this study, we show that human ocular surface epithelial cells, both corneal and conjuctival epithelial cells, respond to viral double-stranded RNA mimic polyI:C to produce pro-inflammatory cytokines through TLR3, while they fail to respond functionally to lipopolysaccharide, a TLR4 ligand. Moreover, human ocular surface epithelium responds to flagellins from ocular pathogenic, but not ocular non-pathogenic bacteria, to produce pro-inflammatory cytokines through TLR5. Thus, ocular surface epithelial cells selectively respond to microbial components and induce limited inflammation; immune-competent cells can recognize microbial components through TLRs and induce the inflammation. The unique innate immune response of the ocular surface epithelium may contribute to its coexistence with commensal bacteria. Inflammatory bowel disease is thought to result from an abnormal response to the gut microbiota. Thus, we also considered the possibility of an association between ocular surface inflammation and a disordered innate immune response. IkappaBzeta is important for TLR signaling, in mice, its knock-out produced severe, spontaneous ocular surface inflammation, the eventual loss of goblet cells, and spontaneous perioral inflammation, suggesting that dysfunction/abnormality of innate immunity can lead to ocular surface inflammation. Copyright 2009 Elsevier Inc. All

  18. Detection of carbapenemase activity directly from blood culture vials using MALDI-TOF MS: a quick answer for the right decision.

    Carvalhaes, Cecilia G; Cayô, Rodrigo; Visconde, Marina F; Barone, Talita; Frigatto, Eliete A M; Okamoto, Debora; Assis, Diego M; Juliano, Luiz; Machado, Antonia M O; Gales, Ana C


    Recently, matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) was successfully applied for the detection of carbapenemase activity directly from Gram-negative colonies. Based on this principle, we evaluated the performance of MALDI-TOF MS for rapid detection of carbapenemase activity directly from positive blood culture vials. A total of 100 blood culture vials were randomly selected. MALDI-TOF MS carbapenemase assay results were confirmed by the detection of carbapenemase-encoding genes. A total of 110 bacterial isolates were recovered. The MALDI-TOF MS carbapenemase assay identified 21 of 29 (72.4%) of the carbapenemase-producing isolates directly from the blood culture vials, especially those encoding KPC-2 (100%) and SPM-1 (100%), after a 4 h incubation period. Although the majority of OXA-23-producing Acinetobacter baumannii isolates were not identified on day 1, all isolates were identified as carbapenemase producers directly from the colony on the next day. The MALDI-TOF MS carbapenemase assay is a feasible and rapid test to identify carbapenemase activity directly from blood culture vials. It may contribute to faster readjustment of empirical antimicrobial therapy and implementation of infection control measures. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail:

  19. Ocular involvement in patients with spondyloarthritis.

    Bacchiega, Ana Beatriz Santos; Balbi, Gustavo Guimarães Moreira; Ochtrop, Manuella Lima Gomes; de Andrade, Francisco Assis; Levy, Roger Abramino; Baraliakos, Xenofon


    Ocular inflammatory diseases can present as isolated conditions but also as part of systemic inflammatory diseases. Anterior uveitis is closely related to SpA and shares the common genetic background of HLA-B27. Other ocular manifestations, such as episcleritis and scleritis, may also occur, although less frequently. Therefore, ocular involvement has been included as one of the important clinical features of SpA in the recently published classification criteria for axial and peripheral disease. However, there are a wide variety of aetiologies for ocular diseases and this must be considered in assessment of SpA.

  20. Thoracic type Ia endoleak: direct percutaneous coil embolization of the aortic arch at the blood entry site after TEVAR and double-chimney stent-grafts

    Bangard, Christopher; Franke, Mareike; Maintz, David; Chang, De-Hua [University Hospital, University of Cologne, Department of Radiology, Cologne (Germany); Pfister, Roman [University Hospital, University of Cologne, Department of Internal Medicine III, Cologne (Germany); Deppe, Antje-Christin [University Hospital, University of Cologne, Department of Cardiothoracic Surgery, Cologne (Germany); Matoussevitch, Vladimir [University Hospital, University of Cologne, Department of Vascular Surgery, Cologne (Germany)


    To introduce a novel percutaneous technique to stop blood entry at the lesser aortic arch curvature by coil embolisation in type Ia endoleak after TEVAR. A 61-year-old Marfan patient presented with type Ia endoleak of the aortic arch and a growing aortic arch pseudoaneurysm after TEVAR. Multiple preceding operations and interventions made an endovascular approach unsuccessful. Direct percutaneous puncture of the aneurysmal sac would have cured the sign, but not the cause of blood entry at the lesser curvature of the aortic arch. Direct CT-guided percutaneous puncture of the blood entry site in the aortic arch with fluoroscopically guided coil embolisation using detachable extra-long coils was successfully performed. Three weeks after the intervention, the patient developed fever because of superinfection of the pseudoaneurysm. The blood cultures and CT-guided mediastinal aspirate were sterile. After intravenous administration of antibiotics, the fever disappeared and the patient recovered. Six-month follow-up showed permanent closure of the endoleak and a shrinking aneurysmal sac. Direct percutaneous puncture of the aortic arch at the blood entry site of a thoracic type Ia endoleak after TEVAR and double-chimney stent-grafts with coil embolisation of the wedge-shaped space between the lesser aortic curvature and the stent-graft is possible. (orig.)

  1. Blood culture gram stain, acridine orange stain and direct sensitivity-based antimicrobial therapy of bloodstream infection in patients with trauma

    Behera B


    Full Text Available Purpose: The purpose of this study was to ascertain if the simple practice of Gram stain, acridine orange stain and direct sensitivity determination of positive blood culture bottles could be used to guide early and appropriate treatment in trauma patients with clinical suspicion of sepsis. The study also aimed to evaluate the error in interpreting antimicrobial sensitivity by direct method when compared to standard method and find out if specific antibiotic-organism combination had more discrepancies. Findings from consecutive episodes of blood stream infection at an Apex Trauma centre over a 12-month period are summarized. Materials and Methods: A total of 509 consecutive positive blood cultures were subjected to Gram staining. AO staining was done in BacT/ALERT-positive Gram-stain negative blood cultures. Direct sensitivity was performed from 369 blood culture broths, showing single type of growth in Gram and acridine orange staining. Results of direct sensitivity were compared to conventional sensitivity for errors. Results: No ′very major′ discrepancy was found in this study. About 5.2 and 1.8% minor error rates were noted in gram-positive and gram-negative bacteria, respectively, while comparing the two methods. Most of the discrepancies in gram-negative bacteria were noted in β lactam - β lactamase inhibitor combinations. Direct sensitivity testing was not reliable for reporting of methicillin and vancomycin resistance in Staphylococci. Conclusions: Gram stain result together with direct sensitivity testing is required for optimizing initial antimicrobial therapy in trauma patients with clinical suspicion of sepsis. Gram staining and AO staining proved particularly helpful in the early detection of candidaemia.

  2. Ocular morbidity among refugees in Southwest Ethiopia.

    Gelaw, Yeshigeta; Abateneh, Aemero


    Low vision and blindness are recognized as one of the major public health problems worldwide, especially in developing countries. The prevalence and cause of blindness and low vision vary from region to region, among different age and population groups in a country or geographical region. The objective of this study is thus to determine the causes of blindness and ocular morbidity among refugees in Southwest Ethiopia. A cross-sectional clinic based study was conducted on 1,054 refugees in Southwest Ethiopia. A basic anterior and posterior segment examination was done by ophthalmologists with Magnifying Loupe 2.5X and Direct Ophthalmoscope. Data were analyzed using SPSS version 16.0. The most common causes of ocular morbidity identified were trachoma 547(21.2%), cataract 501(19.4%), refractive error 353(13.7%), conjunctivitis 240(9.3%), glaucoma 130(5.1%) and climatic droplet keratopathy 112(4.4%). The overall prevalence of blindness was 26.2% and the prevalence of childhood blindness was 0.7%. The prevalence was higher among females (16.9%) than males (9.3%) and age groups 60 years and above (15.9%) than other age groups (10.3%) (Pcauses of blindness were cataract 112(40.6%), trachomatous corneal opacity 58(21.0%) and glaucoma 49(17.8%). The commonest cause of low vision was cataract 102(37.6%) followed by trachomatous corneal opacity 49(18.1%) and refractive error 35(12.9%). There is a very high burden of blinding eye diseases among refugees. Integrated multidisciplinary intervention strategies for the prevention and control of blindness and low vision in the study settings should be initiated.

  3. Valoración de las lesiones oculares producidas en los accidentes de tráfico Assessment of ocular injuries due to traffic accidents

    J.A. Menéndez


    five years -from 2002 to 2006-, analyzing the following variables: the proportion represented by traffic accidents (TAs; the kind of injury sustained in the TAs; the average length of sick leave; the most frequent after-effects; and the overall average punctuation given to these ocular after-effects. Results: TAs represent the cause of a quarter of the ocular after-effects we see. The most frequent injuries produced in an accident are cranioencephalic traumatisms, direct ocular contusions, and cervical sprains. We have met a high percentage of cases (22% in which we have not found objective injuries that can justify the pains claimed by the injured, or rather the pains are not evidently connected with the TAs suffered. Conclusions: TAs are one of the most frequent causes of ocular after-effects (diplopias, decreases of visual acuity..., with an average punctuation of 15 points and an average length of sick leave of 71 days, existing an important percentage of unjustified claims. It is considered as necessary the revision of the present scale of the Law 34/2003 rectifying errors and defects that it presents and including typically post-traumatic ocular after-effects, which are not registered presently, to facilitate the assessment of ocular after-effects.

  4. Comparative evaluation of Vitek 2 identification and susceptibility testing of Gram-negative rods directly and isolated from BacT/ALERT-positive blood culture bottles.

    Munoz-Dávila, M J; Yagüe, G; Albert, M; García-Lucas, T


    The performance of Vitek 2 was evaluated for the identification and susceptibility testing of Gram-negative bacilli directly from positive blood cultures bottles. Direct inoculation of the positive blood cultures with the Vitek cards ID-GN and AST-NO58 was compared with the standard inoculation method based on the sub-culture of the positive blood culture to agar. A total of 142 blood cultures were included in the study; of those, 119 were from patients' clinical samples, while 23 were artificially prepared with strains showing different mechanisms of resistance. A total of 136 (95.8%) strains were correctly identified to the species level, only 2 (1.4%) were mis-identified and 4 (2.8%) were not identified. Susceptibility results were available for all isolates tested against 17 antibiotics, thus, resulting in a total of 2,414 isolate/anti-microbial combinations. The error rate was 2.8% (67/2,414) overall; 0.6% (14/2,414) very major errors, 0.1% (3/2,414) major errors and 2.1% (50/2,414) minor errors. The direct method detected 88.5% (22/25) of the strains producing extended-spectrum beta-lactamases (ESBLs). The susceptibility agreement among the added strains with ESBL, AMPc hyperproduction, resistance to ceftazidime, carbapenems and cefepime was very high. Direct identification and susceptibility testing gave rapid and reliable results, reducing by 24 h the turnaround time of the microbiology laboratory.

  5. Fatty acid profiling of raw human plasma and whole blood using direct thermal desorption combined with gas chromatography-mass spectrometry

    Akoto, Lawrence; Vreuls, Rene J. J.; Irth, Hubertus; Pel, Roel; Stellaard, Frans


    Gas chromatography (GC) has in recent times become an important tool for the fatty acid profiling of human blood and plasma. An at-line procedure used in the fatty acid profiling of whole/intact aquatic micro-organisms without any sample preparation was adapted for this work. A direct thermal

  6. Fatty acid profiling of raw human plasma and whole blood using direct thermal desorption combined with gas chromatography–mass spectrometry

    Akoto, L.; Vreuls, R.J.J.; Irth, H.; Pel, R.; Stellaard, F.


    Gas chromatography (GC) has in recent times become an important tool for the fatty acid profiling of human blood and plasma. An at-line procedure used in the fatty acid profiling of whole/intact aquatic micro-organisms without any sample preparation was adapted for this work. A direct thermal

  7. Miasis ocular por Oestrus ovis

    María Beltrán F


    Full Text Available Se presentan tres casos de miasis ocular (dos adultos y un niñoprocedentes de zonas ganaderas de la provincia de Huaura,departamento de Lima,que acudieron al Hospital Regional de Huacho por presentar el ojo rojo,fotofobia, edema palpebral y sensación de cuerpo extraño;se extrajeron larvas adheridas al canto interno del ojo,las cuales se recibieron en el Instituto Nacional de Salud y fueron identificadas como Oestrus ovis .

  8. Interferometry for ocular microtremor measurement.

    Boyle, G; Coakley, D; Malone, J F


    The eyes of all normal subjects undergo a continuous, low-amplitude, high-frequency tremor called ocular microtremor (OMT). A number of potential clinical applications of OMT have been identified, including the prediction of outcome in coma. To date, OMT has been investigated primarily with an eye-contacting piezoelectric probe. We describe a laser-based, noncontacting, interferometric technique for the measurement of OMT. The technique employs an in-plane-sensitive, phase-modulating speckle interferometer to detect the movement of the sclera, or white of the eye.

  9. [Ocular changes in Down's syndrome].

    Koraszewska-Matuszewska, B; Pieczara, E; Samochowiec-Donocik, E; Nawrocka, L


    The authors analyzed the kind of ocular changes and methods of therapy in 34 children, aged 5 months to 14 years, treated in the clinic in the years 1982-1992. The most frequent change was congenital cataract. The other signs observed were: Brushfield's spots, alternate esotropia, nystagmus, partial optic atrophy, retinal detachment, congenital glaucoma, ectropion and keratoconus. Occurrence of several anomalies were frequent. The adequate surgical treatment was applied depending on the kind of changes. Cataract extraction was made by aspiration method. Visual acuity improved in 58.8% of eyes.

  10. Ocular abnormality in myotonic dystrophy.

    Ginsberg, J; Hamblet, J; Menefee, M


    A 61-year-old white woman with terminal myotonic dystrophy exhibited advanced peripheral and central retinopathy. Retinal lesions were characterized by hyperpigmentation, common, though nonspecific, in myotonic dystrophy. They resemble both heredo (tapetoretinal) and idiopathic involutional degenerations but rarely cause severe visual impairment. Neither the type nor degree of retinopathy appears to correlate with other ocular features or with the stage of the underlying disease. Our histologic observations confirm and extend those previously described. Electron microscopy suggests a primary disorder of mitochondria which may also affect smooth muscle and the myocardium.

  11. Ocular dirofilariasis in Dubai, UAE

    Mittal Mamta


    Full Text Available A rare occurrence of ocular subconjunctival dirofilariasis in a 53-year-old healthy Indian male working in Dubai, UAE presenting with an acute red eye is reported. Surgical excision under topical anesthesia was carried out uneventfully in the outpatient clinic. The live worm removed from the subconjunctival space was identified as Dirofilaria repens on the basis of microscopic examination and histopathology. Surgical excision of subconjunctival dirofilariasis is safe in an outpatient setting and curative precluding the need for further systemic antihelminthics.

  12. Raman Spectroscopy of Ocular Tissue

    Ermakov, Igor V.; Sharifzadeh, Mohsen; Gellermann, Warner

    The optically transparent nature of the human eye has motivated numerous Raman studies aimed at the non-invasive optical probing of ocular tissue components critical to healthy vision. Investigations include the qualitative and quantitative detection of tissue-specific molecular constituents, compositional changes occurring with development of ocular pathology, and the detection and tracking of ocular drugs and nutritional supplements. Motivated by a better understanding of the molecular mechanisms leading to cataract formation in the aging human lens, a great deal of work has centered on the Raman detection of proteins and water content in the lens. Several protein groups and the hydroxyl response are readily detectable. Changes of protein compositions can be studied in excised noncataractous tissue versus aged tissue preparations as well as in tissue samples with artificially induced cataracts. Most of these studies are carried out in vitro using suitable animal models and conventional Raman techniques. Tissue water content plays an important role in optimum light transmission of the outermost transparent ocular structure, the cornea. Using confocal Raman spectroscopy techniques, it has been possible to non-invasively measure the water to protein ratio as a measure of hydration status and to track drug-induced changes of the hydration levels in the rabbit cornea at various depths. The aqueous humor, normally supplying nutrients to cornea and lens, has an advantageous anterior location for Raman studies. Increasing efforts are pursued to non-invasively detect the presence of glucose and therapeutic concentrations of antibiotic drugs in this medium. In retinal tissue, Raman spectroscopy proves to be an important tool for research into the causes of macular degeneration, the leading cause of irreversible vision disorders and blindness in the elderly. It has been possible to detect the spectral features of advanced glycation and advanced lipooxydation end products in

  13. Cyclosporine for Ocular Inflammatory Diseases

    Kaçmaz, R. Oktay; Kempen, John H.; Newcomb, Craig; Daniel, Ebenezer; Gangaputra, Sapna; Nussenblatt, Robert B.; Rosenbaum, James T.; Suhler, Eric B.; Thorne, Jennifer E.; Jabs, Douglas A.; Levy-Clarke, Grace A.; Foster, C. Stephen


    Purpose To evaluate the clinical outcomes of cyclosporine treatment for non-infectious ocular inflammation Design Retrospective cohort study Participants Three hundred seventy-three patients with non-infectious ocular inflammation managed at four tertiary ocular inflammation clinics in the United States observed to use cyclosporine as a single non-corticosteroid immunosuppressive agent to their treatment regimen, between 1979-2007 inclusive. Methods Participants were identified from the Systemic Immunosuppressive Therapy for Eye Diseases Cohort Study. Demographic and clinical characteristics, including dosage of cyclosporine and main outcome measures were obtained for every eye of every patient at every visit via medical record review by trained expert reviewers. Main Outcome Measures: Control of inflammation, sustained control after reducing corticosteroid dosages, and discontinuation of therapy because of toxicity. Results Of the 373 patients (681 eyes) initiating cyclosporine monotherapy, 33.4% by six months and 51.9% by one year gained sustained, complete control of inflammation over at least two visits spanning at least 28 days. Approximately 25% more improved to a level of slight inflammatory activity by each of these time points. Corticosteroid-sparing success (completely controlled inflammation for at least 28 days with prednisone 10 mg/day or less) was achieved by 22.1% by six months and 36.1% within one year. Toxicity led to discontinuation of therapy within one year by 10.7% of the population. Patients over 55 years of age were over 3-fold more likely to discontinue therapy because of toxicity than patients ages 18-39 years. Doses of 151-250 mg/day tended to be more successful than lower doses, and were not associated with a higher discontinuation for toxicity rate; higher doses did not appear to offer a therapeutic advantage. Conclusion Cyclosporine, with corticosteroid therapy as indicated, was modestly effective for controlling ocular inflammation

  14. Iatrogenic Cushing syndrome caused by ocular glucocorticoids in a child.

    Messina, Maria Francesca; Valenzise, Mariella; Aversa, Salvatore; Arrigo, Teresa; De Luca, Filippo


    A boy aged 7.6 years presented to our Unit of Paediatric Endocrinology for evaluation of obesity. Progressive weight gain (10 kg) started 6 months earlier after an accidental penetrating orbital injury on the right eye. During this period the child has been treated with oral betamethasone (0.5 mg/day) for 1 month and dexamethasone 2% ocular drops (2 hourly by day) for 6 months. Physical examination showed he was 113.5 cm in height (-1.5 SD), weight 36.0 kg, blood pressure 110/90 mmHg (90th centile), body mass index 28 (+5 SD), truncal obesity, buffalo hump, "moon-face", increased lanugo hair and supraclavicular fullness. Endocrinological work-up revealed undetectable levels of basal adrenocorticotropic hormone (ACTH), basal and ACTH-stimulated cortisol and 24 h urine excretion cortisol, confirming the diagnosis of iatrogenic Cushing syndrome. The abrupt withdrawal of ocular glucocorticoids by the parents evoked two adrenal crises; 4 months later the patient recovered. In conclusion, we would alert doctors that every formulation of glucocorticoids, no ocular drops excluded, can determine severe systemic side effects and iatrogenic Cushing syndrome.

  15. No evidence for a direct effect of von Willebrand factor's ABH blood group antigens on von Willebrand factor clearance

    Groeneveld, D J; van Bekkum, T; Cheung, K L; Dirven, R J; Castaman, G; Reitsma, P H; van Vlijmen, B; Eikenboom, J


    BACKGROUND: One of the major determinants of von Willebrand factor (VWF) plasma levels is ABO blood group status, and individuals with blood group O have ~ 25% lower plasma levels. The exact mechanism behind this relationship remains unknown, although effects on clearance have been postulated. OBJEC

  16. Fungal keratitis associated with ocular rosacea.

    Jain, Vandana; Shome, Debraj; Sajnani, Manoj; Natarajan, Sundaram


    In order to report fungal keratitis in patients of ocular rosacea, a retrospective review of all cases of fungal keratitis was undertaken. Cases in which ocular rosacea coexisted were identified and included in the study. The clinical course of patients thus identified was studied from the medical records and outcomes were evaluated. A total of three cases of fungal keratitis with coexisting ocular rosacea were identified. All three patients were known cases of acne rosacea with an intermittent, irregular treatment for the same. Previous history of contact lens use, ocular surgery or trauma was not present in any of the cases. Microbiological evaluation revealed Aspergillus flavus as the causative organism in two patients and an unidentified hyaline fungus in the third. Patients received simultaneous therapy for fungal keratitis and ocular rosacea. The ocular surface completely stabilized and the infiltrate resolved in all three cases. The chronic ocular surface changes and induced inflammation in ocular rosacea, along with the instillation of topical steroids for therapy, may create an environmental milieu favorable for fungal keratitis. Microbiological evaluation should be considered, even in cases of suspected sterile keratitis, prior to treatment with topical steroids, so as to prevent the possible worsening of an associated infective corneal condition.

  17. An increase in circulating B cell-activating factor in childhood-onset ocular myasthenia gravis.

    Motobayashi, Mitsuo; Inaba, Yuji; Nishimura, Takafumi; Kobayashi, Norimoto; Nakazawa, Yozo; Koike, Kenichi


    Myasthenia gravis is a B cell-mediated autoimmune disorder. The pathophysiology of childhood-onset ocular myasthenia gravis remains unclear. We investigated serum B cell-activating factor levels and other immunological parameters in child patients with ocular myasthenia gravis. Blood samples were obtained from 9 children with ocular myasthenia gravis and 20 age-matched controls. We assayed serum concentrations of B cell-activating factor, anti-acetylcholine receptor antibody titers, 7 types of cytokines (interleukins-2, -4, -6, -10, and -17A; interferon-γ; tumor necrosis factor-α) as well as the percentages of peripheral blood CD4+, CD8+, and CD19+ cells. Serum B cell-activating factor levels were significantly higher before immunosuppressive therapy in patients with childhood-onset ocular myasthenia gravis than in controls and decreased after immunosuppressive therapy. A significant positive correlation was observed between serum B cell-activating factor levels and anti-acetylcholine receptor antibody titers in patients with myasthenia gravis. Serum B cell-activating factor concentrations did not correlate with the percentages of CD4+, CD8+, and CD19+ cells or the CD4+/CD8+ ratio. No significant differences were observed in the levels of the 7 different types of cytokines examined, including interleukin-17A, between preimmunosuppressive therapy myasthenia gravis patients and controls. Circulating B cell-activating factor may play a key role in the pathophysiology of childhood-onset ocular myasthenia gravis. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Ocular diseases: immunological and molecular mechanisms

    Jing Song


    Full Text Available Many factors, such as environmental, microbial and endogenous stress, antigen localization, can trigger the immunological events that affect the ending of the diverse spectrum of ocular disorders. Significant advances in understanding of immunological and molecular mechanisms have been researched to improve the diagnosis and therapy for patients with ocular inflammatory diseases. Some kinds of ocular diseases are inadequately responsive to current medications; therefore, immunotherapy may be a potential choice as an alternative or adjunctive treatment, even in the prophylactic setting. This article first provides an overview of the immunological and molecular mechanisms concerning several typical and common ocular diseases; second, the functions of immunological roles in some of systemic autoimmunity will be discussed; third, we will provide a summary of the mechanisms that dictate immune cell trafficking to ocular local microenvironment in response to inflammation.

  19. Clinical and immunological responses in ocular demodecosis.

    Kim, Jae Hoon; Chun, Yeoun Sook; Kim, Jae Chan


    The purpose of this study was to investigate clinical and immunological responses to Demodex on the ocular surface. Thirteen eyes in 10 patients with Demodex blepharitis and chronic ocular surface disorders were included in this study and treated by lid scrubbing with tea tree oil for the eradication of Demodex. We evaluated ocular surface manifestations and Demodex counts, and analyzed IL-1β, IL-5, IL-7, IL-12, IL-13, IL-17, granulocyte colony-stimulating factor, and macrophage inflammatory protein-1β in tear samples before and after the treatment. All patients exhibited ocular surface manifestations including corneal nodular opacity, peripheral corneal vascularization, refractory corneal erosion and infiltration, or chronic conjunctival inflammatory signs before treatment. After treatment, Demodex was nearly eradicated, tear concentrations of IL-1β and IL-17 were significantly reduced and substantial clinical improvement was observed in all patients. In conclusion, we believe that Demodex plays an aggravating role in inflammatory ocular surface disorders.

  20. Custom ocular prosthesis: A palliative approach

    Prachi Thakkar


    Full Text Available The goal of palliative care is the achievement of the best quality of life for patients and their families. Eyes are generally the first features of the face to be noticed. Loss of an eye is a traumatic event which has a crippling effect on the psychology of the patient. Several ocular and orbital disorders require surgical intervention that may result in ocular defects. An ocular prosthesis is fabricated to restore the structure, function, and cosmetics of the defects created by such conditions. Although an implant eye prosthesis has a superior outcome, due to economic factors it may not be a feasible option for all patients. Therefore, a custom-made ocular prosthesis is a good alternative. This case report presents a palliative treatment for a patient with an enucleated eye by fabricating a custom ocular prosthesis which improved his psychological, physical, social, functional, emotional and spiritual needs.

  1. Anterior Segment Imaging in Combat Ocular Trauma

    Denise S. Ryan


    Full Text Available Purpose. To evaluate the use of ocular imaging to enhance management and diagnosis of war-related anterior segment ocular injuries. Methods. This study was a prospective observational case series from an ongoing IRB-approved combat ocular trauma tracking study. Subjects with anterior segment ocular injury were imaged, when possible, using anterior segment optical coherence tomography (AS-OCT, confocal microscopy (CM, and slit lamp biomicroscopy. Results. Images captured from participants with combat ocular trauma on different systems provided comprehensive and alternate views of anterior segment injury to investigators. Conclusion. In combat-related trauma of the anterior segment, adjunct image acquisition enhances slit lamp examination and enables real time In vivo observation of the cornea facilitating injury characterization, progression, and management.

  2. Desferrioxamine-related ocular toxicity: A case report

    Sumu Simon


    Full Text Available A 29-year-old lady receiving repeated blood transfusions for β thalassemia since childhood, presented with rapidly deteriorating symptoms of night blindness and peripheral visual field loss. She was recently commenced on high-dose intravenous desferrioxamine for reducing the systemic iron overload. Clinical and investigative findings were consistent with desferrioxamine-related pigmentary retinopathy and optic neuropathy. Recovery was partial following cessation of desferrioxamine. This report highlights the ocular side-effects of desferrioxamine mesylate and the need to be vigilant in patients on high doses of desferrioxamine.

  3. Ocular microtremor in oculomotor palsy.

    Bolger, C; Bojanic, S; Sheahan, N F; Coakley, D; Malone, J F


    Ocular microtremor (OMT) is a high frequency tremor of the eyes present in all individuals. Recent reports suggest that OMT may be a useful indicator of brainstem function. However, the actual origin of ocular microtremor remains controversial. This study aims to provide evidence that OMT has a neurogenic origin. The OMT activity of five subjects with unilateral oculomotor nerve palsy and one subject with complete unilateral internal and external ophthalmoplegia were recorded from both eyes of each subject using the piezoelectric strain gauge technique, with the normal eye acting as a control. Five parameters of OMT activity were studied in each subject: the peak count, the power of the high frequency peak, the percentage power between 60 and 100 Hz, the percentage power between 70 and 80 Hz, and the 10 dB cut-off point. In the five subjects with oculomotor nerve palsy, the mean peak count in the normal eye was 88.4 Hz (SD+/-16.9) and in the affected eye was 59 Hz (SD+/-8.6), P < 0.0096. There was also a fall in the peak power, the power between 60 and 100 Hz, and the power between 70 and 80 Hz. In subject six, who had complete opthalmoplegia, there was no evidence of OMT activity in the denervated eye. These results suggest that innervation of the extraocular muscles is necessary for normal OMT activity, and OMT therefore has a neurogenic origin.

  4. Ocular manifestations of Hansen's disease.

    Sekhar, G C; Vance, G; Otton, S; Kumar, S V; Stanley, J N; Rao, G N


    A detailed ophthalmic evaluation including slitlamp biomicroscopy, measurement of corneal sensitivity using Cochet and Bonnet aesthesiometer, Schirmer's test and Goldmann applanation tonometry was carried out in 89 patients of Hansen's disease attending the leprosy clinic with or without ocular symptoms and willing to undergo eye evaluation. Thirty-one patients had lepromatous leprosy (8 with erythema nodosum leprosum), 56 patients had borderline disease (13 with reversal reactions) and 2 had tuberculoid disease. In addition to the well documented changes of lagophthalmos (6.7%), uveitis (7.3%) and cataracts (19%), we noted prominent corneal nerves in 133 eyes (74.7%), beaded corneal nerves in 19 eyes (10.7%), corneal scarring in 10 eyes (5.6%), corneal hypoaesthesia in 51 eyes (28%) and dry eye in 18 eyes (13%). Beaded corneal nerves and/or stomal infiltrates occurred mainly in the lepromatous group (75%). Ocular hypotony (IOP less than 12 mm Hg) was not seen more frequently in Hansen's as compared to age and sex matched controls with refractive errors or cataracts (33.7%, vs. 37.8%, p = 0.33). Our study highlights the primary corneal involvement with corneal neuropathy as the predominant feature of Hansen's disease.

  5. Imaging the ocular motor nerves

    Ferreira, Teresa [Department of Radiology, Leiden University Medical Center (Netherlands)], E-mail:; Verbist, Berit [Department of Radiology, Leiden University Medical Center (Netherlands)], E-mail:; Buchem, Mark van [Department of Radiology, Leiden University Medical Center (Netherlands)], E-mail:; Osch, Thijs van [C.J. Gorter for High-Field MRI, Department of Radiology, Leiden University Medical Center (Netherlands)], E-mail:; Webb, Andrew [C.J. Gorter for High-Field MRI, Department of Radiology, Leiden University Medical Center (Netherlands)], E-mail:


    The ocular motor nerves (OMNs) comprise the oculomotor, trochlear and the abducens nerves. According to their course, they are divided into four or five anatomic segments: intra-axial, cisternal, cavernous and intra-orbital and, for the abducens nerve, an additional interdural segment. Magnetic resonance imaging is the imaging method of choice in the evaluation of the normal and pathologic ocular motor nerves. CT still plays a limited but important role in the evaluation of the intraosseous portions at the skull base and bony foramina. We describe for each segment of these cranial nerves, the normal anatomy, the most appropriate image sequences and planes, their imaging appearance and pathologic conditions. Magnetic resonance imaging with high magnetic fields is a developing and promising technique. We describe our initial experience with a Phillips 7.0 T MRI scanner in the evaluation of the brainstem segments of the OMNs. As imaging becomes more refined, an understanding of the detailed anatomy is increasingly necessary, as the demand on radiology to diagnose smaller lesions also increases.

  6. Imaging the ocular motor nerves.

    Ferreira, Teresa; Verbist, Berit; van Buchem, Mark; van Osch, Thijs; Webb, Andrew


    The ocular motor nerves (OMNs) comprise the oculomotor, trochlear and the abducens nerves. According to their course, they are divided into four or five anatomic segments: intra-axial, cisternal, cavernous and intra-orbital and, for the abducens nerve, an additional interdural segment. Magnetic resonance imaging is the imaging method of choice in the evaluation of the normal and pathologic ocular motor nerves. CT still plays a limited but important role in the evaluation of the intraosseous portions at the skull base and bony foramina. We describe for each segment of these cranial nerves, the normal anatomy, the most appropriate image sequences and planes, their imaging appearance and pathologic conditions. Magnetic resonance imaging with high magnetic fields is a developing and promising technique. We describe our initial experience with a Phillips 7.0T MRI scanner in the evaluation of the brainstem segments of the OMNs. As imaging becomes more refined, an understanding of the detailed anatomy is increasingly necessary, as the demand on radiology to diagnose smaller lesions also increases.

  7. Ocular biomarkers of Alzheimer's disease.

    Heaton, George R; Davis, Benjamin M; Turner, Lisa A; Cordeiro, Maria F


    Alzheimer's disease (AD) is a devastating neurodegenerative disease characterised clinically by a progressive decline in executive functions, memory and cognition. Classic neuropathological hallmarks of AD include intracellular hyper-phosphorylated tau protein which forms neurofibrillary tangles (NFT), and extracellular deposits of amyloid β (Aβ) protein, the primary constituent of senile plaques (SP). The gradual process of pathogenic amyloid accumulation is thought to occur 10-20 years prior to symptomatic manifestation. Advance detection of these deposits therefore offers a highly promising avenue for prodromal AD diagnosis. Currently, the most sophisticated method of 'probable AD' diagnosis is via neuroimaging or cerebral spinal fluid (CSF) biomarker analysis. Whilst these methods have reported a high degree of diagnostic specificity and accuracy, they fall significantly short in terms of practicality; they are often highly invasive, expensive or unsuitable for large-scale population screening. In recent years, ocular screening has received substantial attention from the scientific community due to its potential for non-invasive and inexpensive central nervous system (CNS) imaging. In this appraisal we build upon our previous reviews detailing ocular structural and functional changes in AD (Retinal manifestations of Alzheimer's disease, Alzheimer's disease and Retinal Neurodegeneration) and consider their use as biomarkers. In addition, we present an overview of current advances in the use of fluorescent reporters to detect AD pathology through non-invasive retinal imaging.

  8. The association between nuclear receptors and ocular diseases.

    Liu, Ke; Zou, Chang; Qin, Bo


    Nuclear hormone receptors (NRs) are one of the most abundant transcription factors in the human cells. They regulate expression of genes via interactions with corresponding ligands, co-activators, and co-repressors. These molecular pathways play important roles in the development, cell differentiation, and physiologic and metabolic processes. Increasingly, targeting nuclear receptors is becoming a promising strategy for new drug development. The aim of this review is to discuss the association between nuclear receptors and eye development, and expand their role in various ocular diseases such as keratitis, cataract, glaucoma, uveitis, retinopathy, and ophthalmic tumors. Recent studies in this area are highlighted as well as future research directions and potential clinical applications. Finally, various strategies will be elucidated to inspire more targeted therapies for ocular diseases through the use of nuclear receptors.

  9. Componentes oculares em anisometropia The ocular components in anisometropia

    David Tayah


    Full Text Available OBJETIVO: Comparar as correlações dos componentes oculares (comprimento axial, comprimento do segmento anterior, poder médio da córnea, profundidade da câmara vítrea e poder refrativo equivalente com o erro refrativo total do olho portador da menor e da maior ametropia em anisométropes. MÉTODOS: Foi realizado um "survey" analítico conduzido em população de 68 anisométropes de duas ou mais dioptrias atendida no Ambulatório da Clinica Oftalmológica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo Os anisométropes foram submetidos à refração estática objetiva e subjetiva, ceratometria e biometria ultra-sônica. RESULTADOS: Não houve diferença significativa entre os valores dos componentes oculares medidos dos olhos portadores da menor e da maior ametropia. Os olhos portadores da menor ametropia apresentaram as mesmas correlações significantes observadas em olhos emétropes, ou seja, correlação da refração com comprimento do segmento anterior e comprimento axial, e correlação do comprimento axial com poder corneano e profundidade da câmara vítrea. Os olhos portadores da maior ametropia apresentaram correlação significante da refração com o comprimento axial e do comprimento axial com a profundidade da câmara vítrea. Ainda em ambos os olhos observou-se correlação significante do poder do cristalino com a profundidade da câmara anterior. CONCLUSÃO: Os olhos portadores da menor ametropia desenvolveram as correlações mais freqüentemente observadas nos olhos emétropes. Os olhos portadores da maior ametropia não desenvolveram as mesmas correlações dos emétropes.PURPOSE: To asses the correlation between ocular components (axial length, anterior segment length, corneal power, vitreous length and equivalent power of the eye and refractive error in eyes with higher and lower ametropia of subjects with anisometropia. METHODS: An analytical survey was carried out in 68 patients

  10. Diabetic retinopathy - ocular complications of diabetesmellitus

    Martin M Nentwich; Michael W Ulbig


    In industrialized nations diabetic retinopathy is the mostfrequent microvascular complication of diabetes mellitusand the most common cause of blindness in the workingagepopulation. In the next 15 years, the number ofpatients suffering from diabetes mellitus is expected toincrease significantly. By the year 2030, about 440 millionpeople in the age-group 20-79 years are estimated to besuffering from diabetes mellitus worldwide (prevalence7.7%), while in 2010 there were 285 million people withdiabetes mellitus (prevalence 6.4%). This accounts foran increase in patients with diabetes in industrialized nations by 20% and in developing countries by 69% until the year 2030. Due to the expected rise in diabetic patients, the need for ophthalmic care of patients (i.e. , exams and treatments) will also increase and represents a challenge for eye-care providers. Development of optimized screening programs, which respect available resources of the ophthalmic infrastructure, will become even more important. Main reasons for loss of vision in patients with diabetes mellitus are diabetic macular edema and proliferative diabetic retinopathy. Incidence or progression of these potentially blinding complications can be greatly reduced by adequate control of blood glucose and blood pressure levels. Additionally, regular ophthalmic exams are mandatory for detecting ocular complications and initiating treatments such as laser photocoagulation in case of clinical significant diabetic macular edema or early proliferative diabetic retinopathy. In this way, the risk of blindness can considerably be reduced. In advanced stages of diabetic retinopathy, pars-plana vitrectomy is performed to treat vitreous hemorrhage and tractional retinal detachment. In recent years, the advent of intravitreal medication has improved therapeutic options for patients with advanced diabetic macular edema.


    Muhammad Kamran Khalid


    Full Text Available Objective: Silicone oil (SO is an invaluable tool in the management of complex retinal detachments (RDs. Injection of silicone oil is associated with a variety of ocular complications specially when it is kept for a long time and its removal is endangering retinal re-detachment. The objective of this study was to determine the frequencies of different ocular complications associated with silicone oil injection in our setup. Study Design: Case series. Place and Duration of Study: This study was conducted at Vitreo-retina division of Al-Shifa Trust Eye Hospital, Rawalpindi from January 2014 to June 2014. Material and Methods: A total of 30 patients were included in the study who underwent pars-planavitrectomy (PPV with silicone oil injection for complex retinal detachments. The patients who had reached between 3 months & 6 months of their postoperative period and were presenting with some complications related to silicone oil injection were included in the study. Their records were reviewed and pre-operative data were collected regarding state of the eye preoperatively. Then the post-operative complications were noted. The descriptive and analytical statistics of different variables were measured using SPSS-17.0 software. Results: Out of thirty patients included in our study 23 (76.7% were male and 7 (23.3% were female. The mean age was 21.53 ± 16.004 years and range was 66 years. The mean pre-operative intra-ocular pressure ( IOP was 14.0 ± 2.150 mmHg and range 8 mmHg and the mean post-operative IOP was 24.93 ± 13.889 mmHg and range 45 mmHg (p=0.001. The pre-operative PVR grade-C was absent in 12 (40% patients and was present in 18 (60% patients and post-operative PVR grade-C was absent in 24 (80% patients and was present in 6 (20% patients (p=0.004; McNemar test. Band keratopathy was seen in 8 (26.7% and corneal decompensation in 2 (6.7% patients. Emulsification of silicone oil was seen in 14 (46.7% patients. Rubeosisiridis was present in 2

  12. Nonmydriatic Ocular Fundus Photography in the Emergency Department: How It Can Benefit Neurologists.

    Bruce, Beau B


    Examination of the ocular fundus is a critical aspect of the neurologic examination. For example, in patients with headache the ocular fundus examination is needed to uncover "red flags" suggestive of secondary etiologies. However, ocular fundus examination is infrequently and poorly performed in clinical practice. Nonmydriatic ocular fundus photography provides an alternative to direct ophthalmoscopy that has been studied as part of the Fundus Photography versus Ophthalmoscopy Trial Outcomes in the Emergency Department (FOTO-ED) Study. Herein, the results of the FOTO-ED study are reviewed with a particular focus on the study's implications for the acute care of patients presenting with headache and focal neurologic deficits. In headache patients, not only optic disc edema and optic disc pallor were observed as would be expected, but also a large number of abnormalities associated with hypertension. Based upon subjects with focal neurologic deficits, the FOTO-ED study suggests that the ocular fundus examination may assist with the triage of patients presenting with suspected transient ischemic attack. Continued advances in the ease and portability of nonmydriatic fundus photography will hopefully help to restore ocular fundus examination as a routinely performed component of all neurologic examinations.

  13. An extraction method of positive blood cultures for direct identification of Candida species by Vitek MS matrix-assisted laser desorption ionization time of flight mass spectrometry.

    Lavergne, Rose-Anne; Chauvin, Pamela; Valentin, Alexis; Fillaux, Judith; Roques-Malecaze, Christine; Arnaud, Sylvie; Menard, Sandie; Magnaval, Jean-François; Berry, Antoine; Cassaing, Sophie; Iriart, Xavier


    Candida spp. are an important cause of nosocomial bloodstream infections. Currently, complete identification of yeasts with conventional methods takes several days. We report here the first evaluation of an extraction method associated with the Vitek MS matrix-assisted laser desorption ionization time of flight mass spectrometry for direct identification of Candida species from positive blood cultures. We evaluated this protocol with blood cultures that were inoculated with reference and routine isolates (eight reference strains, 30 patients isolates and six mixed cultures containing two strains of different Candida species), or from patients with candidemia (28 isolates). This method performed extremely well (97% correct identification) with blood cultures of single Candida spp. and significantly reduced the time of diagnosis. Nevertheless, subculture remains indispensable to test fungal resistance and to detect mixed infections.

  14. Racket sports. An ocular hazard.

    Vinger, P F; Tolpin, D W


    Eighty-two injuries secondary to the racket sports were studied during a 15-month period. Ordinary glasses provided considerable protection in the play of tennis and badminton, but not in the play of squash and racquet ball. Plastic safety lenses (USA Standard Practice for Occupational and Educational Eye ,nd Face Protection, approved Sept 18, 1968 by the USA Standards Institute [ANSI Z87.1-1968]) mounted in a sturdy frame (industrial or athletic) or an eye protector are necessary for squash and racquet ball. Contact lenses provide no ocular protection. Males suffered more serious injuries than females, but injuries were not related to the age or experience of the players. Eye protection is recommended for the racket sports.

  15. Human ocular Thelaziasis in Karnataka

    Prabhakar S Krishnachary


    Full Text Available Thelaziasis is an Arthropod-born disease of the eye and adnexa caused by Thelazia callipaeda, a nematode parasite transmitted by drosophilid flies to carnivores and humans. Because of its distribution mainly confined to South Asian countries and Russia, it is commonly known as Oriental Eye worm. It is often under-reported and not been given its due clinical importance. We report first case of human Thelaziasis from Hassan District, Karnataka. Five creamy-white, translucent worms were removed from the conjunctival sac of a 74-year-old male patient. Based on morphological characters, the worms were identified as nematodes belonging to the genus Thelazia and speciation was confirmed by CDC, Atlanta as callipaeda. Rarity of the disease and its ability to cause both extra and intraocular manifestations leading to ocular morbidity is the reason for presenting this case. From the available data, this is the first case report from Karnataka, India.

  16. Neurosurgical applications of ocular pneumoplethysmography.

    Bingham, W F


    Ocular pneumoplethysmography (OPG), a semiautomated form of suction ophthalmodynamometry, was used to evaluate and follow 15 patients who underwent carotid endarterectomy and two patients in whom gradual carotid artery occlusion was performed for inoperable intracranial aneurysm. Postoperative corrected ophthalmic arterial pressures (COAP's) on the operated side in the carotid endarterectomy patients averaged 12.5 mm Hg higher than before surgery, the standard deviation being 4.9 mm Hg for clinically stable patients. There was no significant change in COAP on the contralateral side. Several problems were encountered in closing down carotid clamps, the most potentially serious being a precipitous fall in COAP with the final adjustment. The current uses of OPG and similar techniques are reviewed, and potential neurosurgical applications are discussed.

  17. Characterization and localization of the rabbit ocular calcitonin gene-related peptide (CGRP)-receptor component protein (RCP).

    Rosenblatt, M I; Dahl, G P; Dickerson, I M


    To determine whether the calcitonin gene-related peptide (CGRP) receptor component protein (RCP), a novel signal transduction molecule, is required for CGRP signaling in the eye and to determine potential ocular sites of CGRP action. The cDNA for the rabbit ocular RCP homologue was cloned using a combination of reverse transcription-polymerase chain reaction (RT-PCR) and rapid amplification of cDNA ends (RACE). Function of the rabbit ocular RCP was assessed using a sensitive oocyte-based assay, which utilizes the protein kinase A (PKA)-sensitive cystic fibrosis transmembrane conductance regulator (CFTR) as a sensor of cAMP formation. RCP expression in the rabbit eye was localized using immunohistochemistry. A 2063-bp cDNA for the rabbit ocular RCP was cloned and sequenced. Expression of the rabbit RCP cDNA confers CGRP responsiveness in a sensitive oocyte-based assay. Antisense oligonucleotides made to the ocular RCP abolishes CGRP responsiveness of ciliary body and iris mRNA in the oocyte-CFTR assay. Localization of RCP protein in the rabbit eye using immunohistochemistry demonstrated RCP immunoreactivity in the ciliary body and iris blood vessels, as well as in layers of the ciliary epithelium. The rabbit ocular RCP appears to be required for signal transduction at ocular CGRP receptors and is localized to sites previously reported to bind CGRP, which affect intraocular pressure and neurogenic inflammation.

  18. Ocular allergy in the Asia Pacific region.

    Katelaris, Constance H


    Allergic conjunctivitis (AC) represents a spectrum of disorders, comprising seasonal allergic conjunctivitis (SAC), perennial allergic conjunctivitis (PAC), atopic keratoconjunctivitis (AKC), vernal keratoconjunctivitis (VKC) and giant papillary conjunctivitis. Of these ocular allergy types, SAC and PAC are the most common.The most striking difference within this group of ocular diseases is that SAC and PAC remain self-limited without ocular surface damage, while AKC and VKC can compromise the cornea, causing ulcers and scarring and can ultimately lead to vision loss. Data on AC in the Asia Pacific is scarce however some understanding of prevalence of the condition has been obtained from the International Study of Asthma and Allergies in Childhood (ISAAC) studies and more recently from the Allergies in Asia Pacific study as well as some information from individual country surveys. Unfortunately none of this data has been collected using validated survey instruments specifically designed for AC. Surveys such as ISAAC have been predominantly concerned with respiratory allergic symptoms with questions added that incorporate some ocular symptoms. These questionnaires do not detect individuals who may have AC in the absence of allergic rhinitis. Using hospital ophthalmology outpatient populations for prevalence studies of ocular allergy immediately introduces a bias towards the more severe, complex forms of the condition as patients with the milder forms of SAR and PAR will rarely present to a hospital outpatient clinic. There is a real need for the development of validated questionnaires specifically addressing ocular allergy. There are no widely accessible studies examining prevalence of the complex forms of ocular allergy (AKC, VKC) in Asia Pacific region. This review will provide an overview of ocular allergy, its classification, clinical presentation and differential diagnosis, and will also discuss what is known about the epidemiology of ocular allergy in the

  19. Ocular Dominance and Handedness in Golf Putting.

    Dalton, Kristine; Guillon, Michel; Naroo, Shehzad A


    In golf, the impact of eye-hand dominance on putting performance has long been debated. Eye-hand dominance is thought to impact how golfers judge the alignment of the ball with the target and the club with the ball, as well as how golfers visualize the line of the putt when making decisions about the force needed to hit the ball. Previous studies have all measured ocular dominance in primary gaze only, despite golfers spending a significant amount of their time in a putting stance (bent at the hips, head tilted down). Thus, the purpose of this study was to assess ocular dominance in both primary gaze (aligning the ball with the target) and putting gaze (addressing the ball and aligning the club). This study investigated measuring pointing ocular dominance in both primary and putting gaze positions on 31 golfers (14 amateur, 7 club professionals, and 10 top professionals). All players were right-handed golfers, although one reported having no hand dominance and one reported being strongly left hand dominant. The results showed that (1) primary and putting gaze ocular dominances are not equal, nor are they predictive of each other; (2) the magnitude of putting ocular dominance is significantly less than the magnitude of primary gaze ocular dominance; (3) ocular dominance is not correlated with handedness in either primary or putting gaze; and (4) eye-hand dominance is not associated with increased putting skill, although ocular dominance may be associated with increased putting success. It is important that coaches assess golfers' ocular dominance in both primary and putting gaze positions to ensure they have the most accurate information upon which to base their vision strategy decisions.

  20. Toxocariosis Ocular en Menores de Edad

    Norma Ocampo


    Full Text Available La toxocariosis es una geohelmintiosis producida por la ingestión de
    huevos de Toxocara canis y T. catis, cuyos hospederos definitivos son el perro y el gato. En el humano las larvas producen el Síndrome de Migración Larvaria Visceral y Ocular; en este último produce una enfermedad grave que puede semejar un retinoblastoma (1,2. Los niños son más susceptibles a adquirir esta infección (3. Nuestro objetivo es determinar la frecuencia de toxocariosis ocular en menores de edad con sintomatología ocular.

  1. Unusual ocular manifestations of silent sinus syndrome

    Fabricio Lopes da Fonseca


    Full Text Available Silent sinus syndrome is an acquired condition in which there is a gradual collapse of the orbital floor and inward retraction of the maxillary sinus (atelectasis of the maxillary sinus. This in turn may cause associated ocular occurrences of enophthalmos and hypotropia. This is a report of an 8 year-old boy with silent sinus syndrome and associated ocular motility disorders. The association between silent sinus syndrome and ocular motility disturbance has been recently described in the literature. However, this is an infrequent association, mainly in childhood.

  2. [Penetrating ocular trauma with intraocular foreign body].

    Musat, O; Ochinciuc, Uliana; Gutu, Tatiana; Cristescu, T R; Coman, Corina


    We present the case of a 65 years old pacient which was admitted for the sudden decrease of visual acuity in the left eye, accompanied by ocular pain and conjunctival hiperemia, simptoms appeared after an ocular trauma. After the clinical and paraclinical examination we determined the diagnosis of OS: Penetrating ocular trauma with retention of a foreign body; posttraumatic cataract. Surgical treatement was warrented and we performed OS : Facoemulsification + PFK implant in sulcus + 23 Ga posterior vitrectomy + peeling of the posterior hyaloid membrane + extraction of the foreign body + LASER endofotocoagulation + transscleral cryotherapy + SF6 gas injection. The post-operatory evolution was favorable.


    ROMAO, Elen A.; BOLELLA, Valdes R.; NARDIN, Maria Estela P.; HABIB-SIMAO, Maria Lucia; FURTADO, João Marcelo; MOYSES-NETO, Miguel


    We present a case of ocular syphilis after a renal transplantation involving progressive vision loss without clinically identifiable ocular disease. Electroretinography showed signs of ischemia, especially in the internal retina. A serological test was positive for syphilis. Lumbar puncture revealed lymphocytic meningitis and a positive serologic test for syphilis in the cerebrospinal fluid. The patient was treated with penicillin, and had a quick vision improvement. In the case of transplant recipients, clinicians should always consider the diagnosis of ocular syphilis in cases with unexplained visual acuity decrement, as this condition may cause serious complications if not treated. PMID:27253748

  4. Main Ocular Manifestations in Rheumatoid Arthritis

    Sandra Saray Quignon Santana


    Full Text Available Rheumatoid arthritis is considered an autoimmune disease in which articular and extra articular manifestations are produced and contribute to alter the functional capacity of the individual. This study consists on performing a bibliographical review showing the main ocular manifestations in patients with rheumatoid arthritis. It is our purpose to give you our experiences to the students as well as the internal medicine, ophthalmology and rheumatologist residents about this topic. The ophthalmological consultation of sick patients contributes to the prevention of ocular illnesses which are characteristic of the base disease and improve the ocular health.

  5. Blood and urine samples as useful sources for the direct detection of tuberculosis by polymerase chain reaction.

    Rebollo, María J; San Juan Garrido, Rafael; Folgueira, Dolores; Palenque, Elia; Díaz-Pedroche, C; Lumbreras, Carlos; Aguado, José M


    The aim of the study was to assess the utility of the polymerase chain reaction (PCR) assay in blood and urine for the diagnosis of tuberculosis (TB). We prospectively evaluated the usefulness of PCR performed in blood and urine samples from patients with proved or probable TB compared with a control group of patients. The PCR technique was performed using IS6110 primers. We included in the study 57 patients (43 with definite TB and 14 with probable TB) and 26 controls. Blood and urine samples were drawn at the time of microbiologic diagnosis and 3, 6, 9, and 12 months later. Cultures were positive in the early period (<1 month after treatment) in 11 of 57 patients (19%) with probable or definite TB, in comparison with 42% of patients (24/57) who yielded a positive PCR (P = 0.02). Urine samples increased the sensitivity of PCR determination in blood samples by 10%. The PCR in blood and/or urine was positive in 41% of patients with pulmonary TB, in 36% of patients with extrapulmonary TB, and in 50% of patients with disseminated TB. Mycobacterium tuberculosis was still detectable by PCR in 5 of 13 patients with cured TB after 1 or more months of antituberculous treatment. The PCR detection of M. tuberculosis in blood and urine samples is useful for the diagnosis of different clinical forms of TB, mostly in those patients in which sample extraction is difficult or requires aggressive techniques. The sensitivity of this technique could be improved studying more than 1 sample in each patient, even after initiating an antituberculous treatment.

  6. Performance of PCR-REBA assay for screening and identifying pathogens directly in whole blood of patients with suspected sepsis.

    Wang, H-Y; Kim, J; Kim, S; Park, S D; Kim, H Y; Choi, H K; Uh, Y; Lee, H


    Rapid and accurate identification of a broad range of bacterial and fungal pathogens is the key to successful management of patients with bloodstream infections (BSIs). The aim of this study was to evaluate the diagnostic performance of PCR-REBA Sepsis-ID test for the detection of BSIs pathogens. EDTA anticoagulated blood for REBA Sepsis-ID assay and blood culture samples from 882 patients with suspected sepsis were simultaneously collected from January 2014 to December 2014. Of 115 patients with positive blood culture, 64 (55·7%) were Gram-positive bacteria, 35 (30·4%) were Gram-negative bacteria, 1 (0·9%) was Candida albicans and 15 (13·0%) were polymicrobial infections. The concordance rate of blood culture system and PCR-REBA Sepsis ID test was 83·0% (95% confidence interval (CI), 79·8-84·8, P detection (P = 0·002). The results of this study suggested that PCR-REBA may be helpful when added to blood culture in the diagnosis and management of sepsis. PCR-REBA Sepsis-ID test is a useful tool for the rapid identification of pathogenic isolates in whole blood to ensure adequate treatment for the causative agents of BSIs. Although the cost of molecular diagnostic assays is higher than the cost of conventional methods, clinical and economic cost-benefit analysis is still needed. PCR-REBA may provide essential information for accelerating therapeutic decisions to ensure effective treatment with antibiotics in the acute phase of pathogen infection. © 2015 The Society for Applied Microbiology.

  7. High speed versus pulsed images for micro-particle image velocimetry: a direct comparison of red blood cells versus fluorescing tracers as tracking particles.

    Pitts, Katie L; Fenech, Marianne


    High speed photography in micro-particle image velocimetry (μPIV) using red blood cells as tracer particles and the use of fluorescing tracer particles (in conjunction with pulsed images) are directly compared by using both methods simultaneously. Measurements are taken on the same blood sample in the same microchip using both methods. This work directly and statistically compares the two methods of μPIV measurement in a controlled in vitro environment for the first time in literature. The pulsed method using fluorescing tracer particles is found to decrease the depth of correlation as expected, and to better represent the shape of the velocity profile. Two methods of velocity characterization are used (single and double parameter) and the pulsed images provide better shape representation in both cases.

  8. Perioperative visual loss in ocular and nonocular surgery

    Kathleen T Berg


    Full Text Available Kathleen T Berg, Andrew R Harrison, Michael S LeeDepartment of Ophthalmology, University of Minnesota, Minneapolis, MN, USAAbstract: Incidence estimates for perioperative vision loss (POVL after nonocular surgery range from 0.013% for all surgeries up to 0.2% following spine surgery. The most common neuro-ophthalmologic causes of POVL are the ischemic optic neuropathies (ION, either anterior (AION or posterior (PION. We identified 111 case reports of AION following nonocular surgery in the literature, with most occurring after cardiac surgery, and 165 case reports of PION following nonocular surgery, with most occurring after spine surgery or radical neck dissection. There were an additional 526 cases of ION that did not specify if the diagnosis was AION or PION. We also identified 933 case reports of central retinal artery occlusion (CRAO, 33 cases of pituitary apoplexy, and 245 cases of cortical blindness following nonocular surgery. The incidence of POVL following ocular surgery appears to be much lower than that seen following nonocular surgery. We identified five cases in the literature of direct optic nerve trauma, 47 cases of AION, and five cases of PION following ocular surgery. The specific pathogenesis and risk factors underlying these neuro-ophthalmic complications remain unknown, and physicians should be alert to the potential for loss of vision in the postoperative period.Keywords: perioperative, postoperative, vision loss, ocular surgery, nonocular surgery

  9. Effects of 8 hemodynamic conditions on direct blood pressure values obtained simultaneously from the carotid, femoral and dorsal pedal arteries in dogs.

    Monteiro, Eduardo R; Campagnol, Daniela; Bajotto, Gustavo C; Simões, Clarissa R; Rassele, Alice C


    This study aimed to evaluate the effect of 8 hemodynamic conditions on blood pressure measurements taken from the carotid, femoral and dorsal pedal arteries of dogs. Six healthy dogs. During isoflurane anesthesia, catheters were introduced into the carotid, femoral and dorsal pedal arteries of dogs to allow simultaneous monitoring of direct blood pressure in each artery. The dogs were submitted to 8 hemodynamic conditions induced by combining changes in heart rate (bradycardia, normocardia, tachycardia) with changes in blood pressure (hypotension, normotension, hypertension). Values obtained from each arterial catheter were compared and agreement between central (carotid) and peripheral (femoral and dorsal pedal) values were analyzed by the Bland-Altman method. During hypotensive conditions, systolic arterial pressure (SAP) was lower in the femoral and dorsal pedal arteries compared to the carotid artery whereas during normotensive and hypertensive conditions, SAP was higher in peripheral arteries. During hypotensive states, increases in heart rate resulted in greater bias between central and peripheral SAP whereas during normotensive states, the bias decreased as heart rate increased. Mean and diastolic arterial pressures were lower in the femoral and dorsal pedal arteries than in the carotid artery during most hemodynamic conditions. In healthy anesthetized dogs, invasive blood pressure measurements in peripheral arteries may differ significantly from measurements in a central artery. The greatest differences were observed in SAP and the magnitude of differences between central and peripheral blood pressure measurements varied according to the dog's hemodynamic condition. Copyright © 2013 Elsevier B.V. All rights reserved.

  10. Ocular gene therapy: an evaluation of recombinant adeno-associated virus-mediated gene therapy interventions for the treatment of ocular disease.

    Roy, Kamolika; Stein, Linda; Kaushal, Shalesh


    Both gene replacement therapy and alteration of host gene expression are playing increasingly important roles in the treatment of ocular diseases. Ocular gene therapy may provide alternatives to current treatments for eye diseases that are either greatly invasive and thus run the risk of complications, that offer only short-term relief from disease symptoms, or that are unable to directly treat vision loss. The success of three separate phase I clinical trials investigating a gene therapy intervention for the treatment of the retinal degenerative disorder Leber's congenital amaurosis (LCA) has unveiled the therapeutic potential of gene therapy. Preliminary results have demonstrated ocular gene transfer, using nonpathogenic recombinant adeno-associated viral (rAAV) vectors specifically, to be a safe, effective, and long-term treatment for LCA, a previously untreatable disorder. Nonpathogenic rAAV vectors offer the potential for long-term treatment. Many of the genes implicated in human ocular diseases have been identified, and animal models for such diseases have been developed, which have greatly facilitated the application of experimental rAAV-mediated gene therapy. This review highlights the key features of rAAV-mediated gene therapy that make it the most suitable gene therapy treatment approach for ocular diseases. Furthermore, it summarizes the current progress of rAAV-mediated gene therapy interventions/applications for a wide variety of ophthalmologic disorders.

  11. The investigation of infants with RhD-negative mothers: can we safely omit the umbilical cord blood direct antiglobulin test?

    James, R M; McGuire, W; Smith, D P


    Historically, the investigation of a neonate at risk of Rhesus D antigen (RhD)-associated haemolytic disease has included a direct antiglobulin test on umbilical cord blood. However, the introduction of routine antenatal anti-RhD prophylaxis has led to a significant number of false positive results and recent studies suggest that a positive cord blood direct antiglobulin test is poorly predictive of subsequent hyperbilirubinaemia. The British Committee for Standards in Haematology guidelines now recommend that a direct antiglobulin test should no longer be performed routinely on umbilical cord blood in infants born to RhD-negative mothers. We review the recent changes in antenatal management of RhD-negative mothers and their impact on the neonatal presentation of RhD-associated haemolytic disease of the newborn that underpin this recommendation. We conclude that there is convincing evidence to support the guidelines. Finally, we consider how babies born to RhD-negative mothers should be investigated and consider alternative strategies to detect neonatal hyperbilirubinaemia.

  12. Permanent magnetic field, direct electric field, and infrared to reduce blood glucose level and hepatic function in mus musculus with diabetic mellitus

    Suhariningsih; Basuki Notobroto, Hari; Winarni, Dwi; Achmad Hussein, Saikhu; Anggono Prijo, Tri


    Blood contains several electrolytes with positive (cation) and negative (anion) ion load. Both electrolytes deliver impulse synergistically adjusting body needs. Those electrolytes give specific effect to external disturbance such as electric, magnetic, even infrared field. A study has been conducted to reduce blood glucose level and liver function, in type 2 Diabetes Mellitus patients, using Biophysics concept which uses combination therapy of permanent magnetic field, electric field, and infrared. This study used 48 healthy mice (mus musculus), male, age 3-4 weeks, with approximately 25-30 g in weight. Mice was fed with lard as high fat diet orally, before Streptozotocin (STZ) induction become diabetic mice. Therapy was conducted by putting mice in a chamber that emits the combination of permanent magnetic field, electric field, and infrared, every day for 1 hour for 28 days. There were 4 combinations of therapy/treatment, namely: (1) permanent magnetic field, direct electric field, and infrared; (2) permanent magnetic field, direct electric field, without infrared; (3) permanent magnetic field, alternating electric field, and infrared; and (4) permanent magnetic field, alternating electric field, without infrared. The results of therapy show that every combination is able to reduce blood glucose level, AST, and ALT. However, the best result is by using combination of permanent magnetic field, direct electric field, and infrared.

  13. Direct observation of liposome uptake by leukocytes in vivo in skin blood vessels using intravital fluorescence microscopy

    Devoisselle, Jean-Marie; Mordon, Serge R.; Begu, Sylvie; Desmettre, Thomas


    This study aimed to observe liposome uptake by leukocytes in vivo. The study was performed on skin by using a dorsal skin-fold chamber implanted in golden hamsters using intravital microscopy. 5,6-CF-encapsulated PEGylated liposomes were injected intravenously. The skin microcirculation was observed with an intravital Eclipse E800 Nikon microscope fitted with a Xenon light source and an epi-fluorescence assembly. An ultra-high sensitivity video-camera mounted on the microscope projected the image onto a monitor, and the images were recorded for playback analysis with a digital video cassette recorder. An acute inflammatory response was obtained by removing one complete layer of skin and the underlying fascia and avascular tissue on the opposing side of the flap corresponding to an area equivalent to the window aperture. Using these model and set-up, leukocyte rolling and adhesion were easily observed and the entry of PEGylated liposomes into hamster blood leukocytes was studied for a period of 6 hours. PEGylated liposomes were clearly identified alone inside the blood flow and inside the leukocytes as soon as the inflammatory reaction appeared. This study shows for the first time that blood leukocytes in their natural milieu of whole blood are capable of interacting with, and taking up liposomes. This observation is in accordance with previous in vitro studies.

  14. Neuromuscular plasticity and rehabilitation of the ocular near response.

    Schor, Clifton M


    The near response is composed of cross-coupled interactions between convergence and other distance-related oculomotor responses including accommodation, vertical vergence, and cyclovergence. The cross-coupling interactions are analogous to the body postural reflexes that maintain balance. Near-response couplings guide involuntary motor responses during voluntary shifts of distance and direction of gaze without feedback from defocus or retinal-image disparity. They optimize the disparity stimulus for stereoscopic depth perception and can be modified by optically induced sensory demands placed on binocular vision. In natural viewing conditions, the near response is determined by passive orbital mechanics and active-adaptable tonic components. For example, the normal coupling of vertical vergence with convergence in tertiary gaze is partly a byproduct of passive orbital mechanics. Both, adapted changes of vertical vergence in response to anisophoria, produced by unequal ocular magnification (aniseikonia), and adapted changes in the orientation of Listing's plane in response to torsional disparities can be achieved by a combination of passive orbital mechanics and neural adjustments for the control of the vertical vergence and cyclovergence. Adaptive adjustments are coupled with gaze direction, convergence angle, and head tilt. Several adaptation studies suggest that it is possible to achieve non-linear changes in the coupling of both vertical vergence and cyclovergence with gaze direction. This coupling can be achieved with changes in neural control signals of ocular elevator muscles that are cross-coupled with both convergence and direction of tertiary gaze. These linear and non-linear coupling interactions can be adapted to compensate for (1) anisophoria induced by spectacle corrections for anisometropia, (2) accommodative esotropia, (3) convergence excess and insufficiency, and (4) non-concomitant deviations with ocular torticollis associated with trochlear palsy

  15. Current management and future directions for the treatment of patients hospitalized for heart failure with low blood pressure.

    Gheorghiade, Mihai; Vaduganathan, Muthiah; Ambrosy, Andrew; Böhm, Michael; Campia, Umberto; Cleland, John G F; Fedele, Francesco; Fonarow, Gregg C; Maggioni, Aldo P; Mebazaa, Alexandre; Mehra, Mandeep; Metra, Marco; Nodari, Savina; Pang, Peter S; Ponikowski, Piotr; Sabbah, Hani N; Komajda, Michel; Butler, Javed


    Although patients hospitalized with heart failure have relatively low in-hospital mortality, the post-discharge rehospitalization and mortality rates remain high despite advances in treatment. Most patients admitted for heart failure have normal or high blood pressure, but 15-25 % have low systolic blood pressure with or without signs and/or symptoms of hypoperfusion. All pharmacological agents known to improve the prognosis of patients with heart failure also reduce blood pressure, and this limits their use in patients with heart failure and low blood pressure (HF-LBP). However, patients with HF-LBP have much higher in-hospital and post-discharge mortality. In these patients, a conceptually important therapeutic target is to improve cardiac output in order to alleviate signs of hypoperfusion. Accordingly, the majority of these patients will require an inotrope as cardiac dysfunction is the cause of their low cardiac output. However, the short-term use of currently available inotropes has been associated with further decreases in blood pressure and increases in heart rate, myocardial oxygen consumption and arrhythmias. Agents that improve cardiac contractility without this undesirable effects should be developed. To the best of our knowledge, the epidemiology, pathophysiology and therapy of patients with HF-LBP have not been addressed thoroughly. In June 2010, a workshop that included scientists and clinicians was held in Rome, Italy. The objectives of this meeting were to (1) develop a working definition for HF-LBP, (2) describe its clinical characteristics and pathophysiology, (3) review current therapies and their limitations, (4) discuss novel agents in development and (5) create a framework for the design and conduct of future clinical trials.

  16. Ocular Complications of Inflammatory Bowel Disease

    Rana Mady


    the usual intestinal manifestations, leading to an earlier diagnosis. Thus, it is important to understand the clinical presentation of possible ocular manifestations in order to initiate appropriate treatment and to help prevent significant visual morbidity.

  17. The origin of ocular microtremor in man.

    Spauschus, A; Marsden, J; Halliday, D M; Rosenberg, J R; Brown, P


    A novel technique for the study of human eye movements was used to investigate the frequency components of ocular drift and microtremor in both eyes simultaneously. The tangential components of horizontal eye accelerations were recorded in seven healthy subjects using light-weight accelerometers mounted on scleral contact lenses during smooth pursuit movements, vestibulo-ocular reflexes and eccentric gaze with and without fixation. Spectral peaks were observed at low (up to 25 Hz) and high (60-90 Hz) frequencies. A multivariate analysis based on partial coherence analysis was used to correct for head movement. After correction, the signals were found to be coherent between the eyes over both low- and high-frequency ranges, irrespective of task, convergence or fixation. It is concluded that the frequency content of ocular drift and microtremor reflects the patterning of low-level drives to the extra-ocular muscle motor units.

  18. Update on ocular toxicity of ethambutol

    Priscilla Makunyane


    Full Text Available The purpose of this review is to update clinicians on available literature on the ocular toxicity of ethambutol and the type of eye care to be provided to patients treated with these medications. Ethambutol is a commonly used first-line anti-tuberculosis drug. Since its first use in the 1960s, ocular toxicity is described as related to dose and duration, and it is reversible on therapy discontinuation. However, the reversibility of the toxic optic neuropathy remains controversial. The mechanism of ocular toxicity owing to ethambutol is still under investigation. Other than discontinuing the drug, no specific treatment is available for the optic neuropathy caused by ethambutol. Doctors prescribing ethambutol should be aware of the ocular toxicity, and the drug should be used with proper patient education and ophthalmic monitoring.

  19. Ocular manifestations in systemic lupus erythematosus.

    Silpa-archa, Sukhum; Lee, Joan J; Foster, C Stephen


    Systemic lupus erythematosus (SLE) can involve many parts of the eye, including the eyelid, ocular adnexa, sclera, cornea, uvea, retina and optic nerve. Ocular manifestations of SLE are common and may lead to permanent blindness from the underlying disease or therapeutic side effects. Keratoconjunctivitis sicca is the most common manifestation. However, vision loss may result from involvement of the retina, choroid and optic nerve. Ocular symptoms are correlated to systemic disease activity and can present as an initial manifestation of SLE. The established treatment includes prompt systemic corticosteroids, steroid-sparing immunosuppressive drugs and biological agents. Local ocular therapies are options with promising efficacy. The early recognition of disease and treatment provides reduction of visual morbidity and mortality.

  20. [Ocular hypertension after surgery for retinal detachment].

    Muşat, O; Cristescu, R; Coman, Corina; Asandi, R


    This papers presents a case of a patient with retinal detachement, 3 days ago operated (posterior vitrectomy internal tamponament with silicon oil 1000) who develop increased ocular pressure following silicon oil output in the anterior chamber.

  1. Ocular morbidity in leprosy patients with lagophthalmos.

    Khandpur, S; Robertson, S J; Rao, P S S


    Lagophthalmos is a well known complication in leprosy due to the involvement of seventh cranial nerve resulting in incomplete closure of the eyelids. The real magnitude of ocular morbidity as a consequence of lagophthalmos is unknown, as several ocular complications can occur independently due to involvement of the fifth (trigeminal) nerve or due to secondary infection. Therefore, a study was designed to carefully examine the eyes of 100 consecutive leprosy patients with lagophthalmos seeking treatment at a leprosy referral centre in Delhi. Among the eyes examined, 145 had lagophthalmos. The symptomatology and anterior-posterior chamber morbidity in eyes with lagophthalmos were significantly higher as compared to unaffected eyes. Significantly, higher morbidity was seen regardless of sex or type of leprosy or deformity. Capacity building of the health professionals regarding ocular morbidity and increased emphasis on the importance of self care among patients can significantly reduce ocular morbidity.

  2. Ocular lesions in free-living raptors.

    Murphy, C J; Kern, T J; McKeever, K; McKeever, L; MacCoy, D


    In a retrospective study, records of 931 raptors admitted to the Avian Clinic at the New York State College of Veterinary Medicine and to the Owl Rehabilitation Research Foundation were evaluated to determine the prevalence, cause, and distribution of ocular lesions. Some form of ocular lesion was identified in 135 (14.5%) birds. Of these, 90% were the result of physical injury. Collisions accounted for 33% of ocular lesions; gunshot wounds accounted for 11%. Unilateral lesions were more common than bilateral lesions, with the anterior segment being most frequently involved. Hyphema was the most common clinical finding. In a prospective study involving raptors admitted to the Avian Clinic from 1980-1982, it was found that 17 of 61 birds (28%) had some form of ocular lesion. The higher prevalence in this study was attributed to a lower proportion of juvenile cases and to increased detection of subtle lesions, especially those involving the posterior segment.

  3. Use of CD25 as an immunohistochemical marker for acquired ocular toxoplasmosis

    Cristina Miyamoto


    Full Text Available PURPOSE: Toxoplasmosis is the most common cause of posterior infectious uveitis worldwide. It is often impossible to determine its congenital or acquired nature. Interleukin-2 (IL-2 in peripheral blood has been described as a possible marker for acquired toxoplasmosis. The purpose of this study is to evaluate the histopathological characteristics of ocular toxoplasmosis cases using CD25 as a marker for the expression of interleukin-2. METHODS: Ten formalin-fixed, paraffin-embedded enucleated globes from ten immunocompetent patients with clinical diagnosis of toxoplasmosis were evaluated. Four patients had the acquired form of ocular toxoplasmosis (positive IgM while six were IgM negative and IgG positive for toxoplasmosis. Histopathological slides were reviewed for the extension of the retinal necrosis, number of toxo cysts, the granulomatous inflammatory reaction, the presence of T and B cells within the choroid and the IL-2 expression. Immunohistochemistry using monoclonal antibodies was performed to observe the expression of CD4, CD8, CD20, CD25, and CD68. RESULTS: The histopathological evaluation disclosed no differences between acquired and the other ocular toxoplasmosis cases regarding the characteristics studied. However, CD25 showed a higher expression of IL-2 on the 4 acquired cases of ocular toxoplasmosis compared to the remainders. CONCLUSIONS: To the best of our knowledge, this is the first report showing that the use of CD25 as a marker for interleukin-2 could differentiate acquired ocular toxoplasmosis.

  4. Evaluation of the Merlin MICRONAUT system for rapid direct susceptibility testing of gram-positive cocci and gram-negative bacilli from positive blood cultures.

    Wellinghausen, Nele; Pietzcker, Tim; Poppert, Sven; Belak, Syron; Fieser, Nicole; Bartel, Melanie; Essig, Andreas


    Bloodstream infections are life-threatening conditions which require the timely initiation of appropriate antimicrobial therapy. We evaluated the automated Merlin MICRONAUT system for rapid direct microtiter broth antimicrobial susceptibility testing (AST) of gram-positive cocci and gram-negative bacilli from BACTEC 9240 bottles with positive blood cultures in comparison to the standard method for the Merlin MICRONAUT system. This prospective study was conducted under routine working conditions during a 9-month period. Altogether, 504 isolates from 409 patients and 11,819 organism-antibiotic combinations were evaluated for comparison of direct and standard AST methods. For gram-negative bacilli, direct and standard AST of 110 isolates was evaluated and MIC agreement was found for 98.1% of 2,637 organism-antibiotic combinations. Category (susceptible, intermediate susceptible, resistant [SIR]) agreement was found for 99.0%, with results for 0.04% of combinations showing very major errors, those for 0.2% showing major errors, and those for 0.8% showing minor errors. For gram-positive cocci, 373 isolates were evaluated and MIC agreement was found for 95.6% of 8,951 organism-antibiotic combinations. SIR agreement was found for 98.8%, with results for 0.3% of combinations showing very major errors, those for 0.4% showing major errors, and those for 0.5% showing minor errors. Although the number of tested isolates was limited (n = 33), direct AST of streptococci was performed for the first time, yielding promising results with SIR agreement for 98.6% of 363 organism-antibiotic combinations. In conclusion, direct AST of gram-negative bacilli and gram-positive cocci from positive blood cultures with the MICRONAUT system is a reliable technique that allows for the omission of repeat testing of subcultured isolates. Thereby, it reduces the time to results of blood culture testing and may have a positive impact on patient care.

  5. Evaluation of direct inoculation of the BD PHOENIX system from positive BACTEC blood cultures for both Gram-positive cocci and Gram-negative rods

    Wolffs Petra FG


    Full Text Available Abstract Background Rapid identification (ID and antibiotic susceptibility testing (AST of the causative micro-organism of bloodstream infections result in earlier targeting of antibiotic therapy. In order to obtain results of ID and AST up to 24 hours earlier, we evaluated the accuracy of direct inoculation of the Phoenix system from positive blood cultures (BACTEC by using Serum Separator Tubes to harvest bacteria from positive blood cultures. Results were compared to those of standard Phoenix procedure. Discrepancies between the two methods were resolved by using the API system, E-test or microbroth dilution. Results ID with the direct method was correct for 95.2% of all tested Enterobacteriaceae (n = 42 and 71.4% of Pseudomonas aeruginosa strains (n = 7. AST with the direct method showed a categorical agreement for Gram-negative rods (GNR of 99.0%, with 0.7% minor errors, 0.3% very major errors and no major errors. All antibiotics showed an agreement of >95%. The direct method for AST of Staphylococcus (n = 81 and Enterococcus (n = 3 species showed a categorical agreement of 95.4%, with a minor error rate of 1.1%, a major error rate of 3.1% and a very major error rate of 0.4%. All antibiotics showed an agreement of >90%, except for trimethoprim-sulfamethoxazole and erythromycin. Conclusions Inoculation of Phoenix panels directly from positive blood cultures can be used to report reliable results of AST of GNR a day earlier, as well as ID-results of Enterobacteriaceae. For Staphylococcus and Enterococcus species, results of AST can also be reported a day earlier for all antibiotics, except for erythromycin and trimethoprim-sulfamethoxazole.

  6. A Survey on Prevalence of Ocular Complications and It’s Risk Factors in Diabetic Patients of Diabetic Center of Nader Kazemi Clinic Shiraz- Iran 1998-2010

    SM Kashfi


    Full Text Available Background & Objective: With respect to an increase in diabetes prevalence, and the likelihood of ocular complications among them, this study was conducted to investigate the prevalence and risk factors and incidence of the ocular complications in patients of Nader Kazemi, Shiraz Diabetic center from 1998 to 2010.Materials & Methods: In a cross sectional study , subjects were selected based on a systematic random sampling to investigate the incidence of the ocular complications and the influence of factors such as age, sex, types of diabetes, job, education, blood triglyceride (TG and cholesterol level, Family history of diabetes, history of hypertension, history of participation in educational classes, methods of treatment, duration of diabetes and fasting blood sugar were considered on them.Results: Ocular complications were found among 229 diabetic patients (32.6%. patients having type II diabetic have more ocular complications comparing with patients with type I diabetes (P<0. 005. Factors such as job (P=0. 022, history of participation in educational classes (P<0. 001, education (P<0. 001, family history of diabetes (P<0. 001, blood triglyceride (TG (P=0. 021, duration of diabetes(P<0. 001,age (P<0. 001, method of treatment(P<0. 001and fasting blood sugar (P<0. 001 had a significant relationship with the occurrence of ocular complication. However, other risk factors such as hypertension,gender and cholesterol levels were not statistically significant relationship with the occurrence of ocular complication.Conclusion: Given the prevalence of ocular complications, educating diabetics’ patients can have a significant influence in reducing the occurrence of ocular complications.

  7. Cisticercosis ocular Ocular cysticercosis: presentation of one case

    David Botero


    Full Text Available

    Se presenta el caso de un paciente con un cisticerco retiniano, tratado sin éxito con praziquantel, quien a los cinco meses del tratamiento presentó fibrosis y desprendimiento de la retina. Se realizó intervención quirúrgica y se encontró el cisticerco vivo. Desde antes de la operación el paciente había perdido la visión por el ojo afectado. Se hace una revisión sobre oftalmocisticercosis y se recomienda tratamiento quirúrgico oportuno y no usar los antihelmínticos con efecto sobre los cisticercos, como son praziquantel y albendazol.

    One case of ocular cysticercosis with retinal involvement, in which praziquantel treatment was ineffective, is presented. Five months after the medical treatment the patient presented with retinal detachment and fibrosis, loss of vision through the affected eye and at that time the parasite was observed alive. Surgical intervention was performed and the recovered cysticercus showed viability. A review on ophtalmocysticercosis is presented and recommendations are made to treat these cases by early surgery without prior administration of anticysticercus drugs such as praziquantel or albendazole.

  8. Prosthetic management of an ocular defect

    Siddesh Kumar Chintal


    Full Text Available The disfigurement associated with the loss of an eye can cause significant physical and emotional problems. Various treatment modalities are available, one of which is implants. Although implant has a superior outcome, it may not be advisable in all patients due to economic factors. The present article describes the prosthetic management of an ocular defect with a custom-made ocular prosthesis.

  9. A case report of ocular toxocariasis

    Azira NMS; Zeehaida M


    Ocular toxocariasis is prevalent among children. The symptoms and signs may mimic other ocular pathologies such as malignancies and other infectious diseases (such as toxoplasmosis and syphilis). We presented a case of progressive blurring of vision in a single eye of a9-year-old boy. The presence of anti-toxocara antibody in serum samples helps to confirmation the diagnosis in our patient. Despite of treatment, the boy had lost his vision on the affected eye.

  10. A case report of ocular toxocariasis

    NMS Azira


    Full Text Available Ocular toxocariasis is prevalent among children. The symptoms and signs may mimic other ocular pathologies such as malignancies and other infectious diseases (such as toxoplasmosis and syphilis. We presented a case of progressive blurring of vision in a single eye of a 9-year-old boy. The presence of anti-toxocara antibody in serum samples helps to confirmation the diagnosis in our patient. Despite of treatment, the boy had lost his vision on the affected eye.

  11. Study of Ocular Changes in Pregnancy

    O K Radhakrishnan; Debapriya Datta; Jyoti Yadav; Priti Kumari; Vasundhara Phillips; Nimrita Nagdev


    Introduction: In pregnancy, women undergo a tremendous number of systemic and ocular changes. Physiological changes occur in the cardiovascular, hormonal, metabolic, hematologic and immunologic systems. Hormonal changes are among the most prominent systemic changes in pregnant women with the placenta, maternal endocrine glands and the fetal adrenal glands combining their productivity to make a high-powered hormone factory. Aims: To evaluate the various ocular changes taking place in pregnancy...

  12. Study of Ocular Changes in Pregnancy

    O K Radhakrishnan; Debapriya Datta; Jyoti Yadav; Priti Kumari; Vasundhara Phillips; Nimrita Nagdev


    Introduction: In pregnancy, women undergo a tremendous number of systemic and ocular changes. Physiological changes occur in the cardiovascular, hormonal, metabolic, hematologic and immunologic systems. Hormonal changes are among the most prominent systemic changes in pregnant women with the placenta, maternal endocrine glands and the fetal adrenal glands combining their productivity to make a high-powered hormone factory. Aims: To evaluate the various ocular changes taking place in pregnancy...

  13. Ocular teratogens: old acquaintances and new dangers.

    Tandon, A; Mulvihill, A


    Recent research into animal studies has contributed significantly to understanding the pathophysiology of some well-known teratogens, such as alcohol. Techniques, such as positron emission tomography (PET) and retinal synaptogenesis studies, have helped determine the specific areas in the developing brain and ocular structures, which are targeted by various teratogens. In this article, we also highlight a few newer agents, such as benzodiazepines, with potential for ocular malformation and morbidity in the developing foetus.

  14. Changes in ocular flow induced by hypo- and hypercapnia relate to static visual acuity in humans

    Nami Someya


    Full Text Available We investigated whether the change in ocular blood flow, induced by hypo- and hypercapnia, is related to static visual acuity. Eleven healthy subjects (26±5 years underwent three treatments. A three-treatment three-period crossover design was used. In the hypocapnia treatment (HYPO, the subjects controlled their minute ventilation (VE to a target of 25 L/min for 6 min. In the hypercapnia treatment (HYPER, the subjects inspired high-fraction CO2 gas (FICO2 = 4% for 6 min. In the control treatment (CON, VE was not manipulated. We measured choroidal and retinal blood flow by laser speckle flowmetry as ocular blood flow, and static visual acuity using the Landolt C chart. End-tidal partial pressure of CO2 differed significantly among HYPO, HYPER and CON (21±1, 48±1, and 42±1 mmHg, respectively. Retinal blood flow decreased significantly from the baseline in HYPO (-22±5%, but increased significantly in HYPER (+3±9% compared to CON. Decimal visual acuity was significantly lower in HYPO than in the CON (0.21±0.1 vs. 0.24±0.1 P<0.05. These results suggest that changes in ocular blood flow induced by changes in arterial CO2 partial pressure influences visual acuity.

  15. Antibiotic resistance in ocular bacterial pathogens

    S Sharma


    Full Text Available Bacterial infections of the eye are common and ophthalmologists are spoilt for choice with a variety of antibiotics available in the market. Antibiotics can be administered in the eye by a number of routes; topical, subconjunctival, subtenon and intraocular. Apart from a gamut of eye drops available, ophthalmologists also have the option of preparing fortified eye drops from parenteral formulations, thereby, achieving high concentrations; often much above the minimum inhibitory concentration (MIC, of antibiotics in ocular tissues during therapy. Antibiotic resistance among ocular pathogens is increasing in parallel with the increase seen over the years in bacteria associated with systemic infections. Although it is believed that the rise in resistant ocular bacterial isolates is linked to the rise in resistant systemic pathogens, recent evidence has correlated the emergence of resistant bacteria in the eye to prior topical antibiotic therapy. One would like to believe that either of these contributes to the emergence of resistance to antibiotics among ocular pathogens. Until recently, ocular pathogens resistant to fluoroquinolones have been minimal but the pattern is currently alarming. The new 8-fluoroquinolone on the scene-besifloxacin, is developed exclusively for ophthalmic use and it is hoped that it will escape the selective pressure for resistance because of lack of systemic use. In addition to development of new antibacterial agents, the strategies to halt or control further development of resistant ocular pathogens should always include judicious use of antibiotics in the treatment of human, animal or plant diseases.

  16. Acceleration of the direct identification of Staphylococcus aureus versus coagulase-negative staphylococci from blood culture material: a comparison of six bacterial DNA extraction methods.

    Loonen, A J M; Jansz, A R; Kreeftenberg, H; Bruggeman, C A; Wolffs, P F G; van den Brule, A J C


    To accelerate differentiation between Staphylococcus aureus and coagulase-negative staphylococci (CNS), this study aimed to compare six different DNA extraction methods from two commonly used blood culture materials, i.e. BACTEC and BacT/ALERT. Furthermore, we analysed the effect of reduced blood culture incubation for the detection of staphylococci directly from blood culture material. A real-time polymerase chain reaction (PCR) duplex assay was used to compare the six different DNA isolation protocols on two different blood culture systems. Negative blood culture material was spiked with methicillin-resistant S. aureus (MRSA). Bacterial DNA was isolated with automated extractor easyMAG (three protocols), automated extractor MagNA Pure LC (LC Microbiology Kit M(Grade)), a manual kit MolYsis Plus and a combination of MolYsis Plus and the easyMAG. The most optimal isolation method was used to evaluate reduced bacterial incubation times. Bacterial DNA isolation with the MolYsis Plus kit in combination with the specific B protocol on the easyMAG resulted in the most sensitive detection of S. aureus, with a detection limit of 10 CFU/ml, in BacT/ALERT material, whereas using BACTEC resulted in a detection limit of 100 CFU/ml. An initial S. aureus or CNS load of 1 CFU/ml blood can be detected after 5 h of incubation in BacT/ALERT 3D by combining the sensitive isolation method and the tuf LightCycler assay.

  17. Feasibility of Non-Mydriatic Ocular Fundus Photography in the Emergency Department: Phase I of the FOTO-ED Study

    Bruce, Beau B.; Lamirel, Cédric; Biousse, Valérie; Ward, Antionette; Heilpern, Katherine L.; Newman, Nancy J.; Wright, David W.


    Objectives Examination of the ocular fundus is imperative in many acute medical and neurologic conditions, but direct ophthalmoscopy by non-ophthalmologists is underutilized, poorly performed, and difficult without pharmacologic pupillary dilation. The objective was to examine the feasibility of non-mydriatic fundus photography as a clinical alternative to direct ophthalmoscopy by emergency physicians (EPs). Methods Adult patients presenting to the emergency department (ED) with headache, acute focal neurologic deficit, diastolic blood pressure ≥ 120 mmHg, or acute visual change had ocular fundus photographs taken by nurse practitioners using a non-mydriatic fundus camera. Photographs were reviewed by a neuro-ophthalmologist within 24 hours for findings relevant to acute ED patient care. Nurse practitioners and patients rated ease, comfort, and speed of non-mydriatic fundus photography on a 10-point Likert scale (10 best). Timing of visit and photography were recorded by automated electronic systems. Results Three hundred fifty patients were enrolled. There were 1,734 photographs taken during 230 nurse practitioner shifts. Eighty-three percent of the 350 patients had at least one eye with a high quality photograph, while only 3% of patients had no photographs of diagnostic value. Mean ratings were ≥ 8.7 (standard deviation [SD] ≤ 1.9) for all measures. The median photography session lasted 1.9 minutes (interquartile range [IQR] 1.3 to 2.9 minutes), typically accounting for less that 0.5% of the patient’s total ED visit. Conclusions Non-mydriatic fundus photography taken by nurse practitioners is a feasible alternative to direct ophthalmoscopy in the ED. It is performed well by non-physician staff, is well-received by staff and patients, and requires a trivial amount of time to perform. PMID:21906202

  18. Feasibility of nonmydriatic ocular fundus photography in the emergency department: Phase I of the FOTO-ED study.

    Bruce, Beau B; Lamirel, Cédric; Biousse, Valérie; Ward, Antionette; Heilpern, Katherine L; Newman, Nancy J; Wright, David W


    Examination of the ocular fundus is imperative in many acute medical and neurologic conditions, but direct ophthalmoscopy by nonophthalmologists is underutilized, poorly performed, and difficult without pharmacologic pupillary dilation. The objective was to examine the feasibility of nonmydriatic fundus photography as a clinical alternative to direct ophthalmoscopy by emergency physicians (EPs). Adult patients presenting to the emergency department (ED) with headache, acute focal neurologic deficit, diastolic blood pressure ≥ 120 mm Hg, or acute visual change had ocular fundus photographs taken by nurse practitioners using a nonmydriatic fundus camera. Photographs were reviewed by a neuroophthalmologist within 24 hours for findings relevant to acute ED patient care. Nurse practitioners and patients rated ease, comfort, and speed of nonmydriatic fundus photography on a 10-point Likert scale (10 best). Timing of visit and photography were recorded by automated electronic systems. A total of 350 patients were enrolled. There were 1,734 photographs taken during 230 nurse practitioner shifts. Eighty-three percent of the 350 patients had at least one eye with a high-quality photograph, while only 3% of patients had no photographs of diagnostic value. Mean ratings were ≥ 8.7 (standard deviation [SD] ≤ 1.9) for all measures. The median photography session lasted 1.9 minutes (interquartile range [IQR] = 1.3 to 2.9 minutes), typically accounting for less that 0.5% of the patient's total ED visit. Nonmydriatic fundus photography taken by nurse practitioners is a feasible alternative to direct ophthalmoscopy in the ED. It is performed well by nonphysician staff, is well-received by staff and patients, and requires a trivial amount of time to perform. © 2011 by the Society for Academic Emergency Medicine.

  19. An integrated direct loop-mediated isothermal amplification microdevice incorporated with an immunochromatographic strip for bacteria detection in human whole blood and milk without a sample preparation step.

    Lee, Dohwan; Kim, Yong Tae; Lee, Jee Won; Kim, Do Hyun; Seo, Tae Seok


    We have developed an integrated direct loop-mediated isothermal amplification (Direct LAMP) microdevice incorporated with an immunochromatographic strip (ICS) to identify bacteria contaminated in real samples. The Direct LAMP is a novel isothermal DNA amplification technique which does not require thermal cycling steps as well as any sample preparation steps such as cell lysis and DNA extraction for amplifying specific target genes. In addition, the resultant amplicons were colorimetrically detected on the ICS, thereby enabling the entire genetic analysis process to be simplified. The two functional units (Direct LAMP and ICS) were integrated on a single device without use of the tedious and complicated microvalve and tubing systems. The utilization of a slidable plate allows us to manipulate the fluidic control in the microchannels manually and the sequential operation of the Direct LAMP and ICS detection could be performed by switching the slidable plate to each functional unit. Thus, the combination of the direct isothermal amplification without any sample preparation and thermal cycling steps, the ICS based amplicon detection by naked eyes, and the slidable plate to eliminate the microvalves in the integrated microdevice would be an ideal platform for point-of-care DNA diaganotics. On the integrated Direct LAMP-ICS microdevice, we could analyze Staphylococcus aureus (S. aureus) and Escherichia coli O157:H7 (E. coli O157:H7) contaminated in human whole blood or milk at a single-cell level within 1h.

  20. Intraocular pressure and its correlation with blood gas parameters in crested caracaras (Caracara plancus anesthetized with isoflurane and sevoflurane Pressão intra-ocular e sua correlação com parâmetros hemogasométricos em caracarás (Caracara plancus anestesiados com isofluorano e sevofluorano

    A.P. Ribeiro


    Full Text Available The intraocular pressure (IOP and its correlations with arterial carbon dioxide partial pressure (PaCO2 and arterial pH were studied in five crested caracaras (Caracara plancus anesthetized with isoflurane (ISO and sevoflurane (SEV. Baseline IOP values were measured in both eyes (M0. Brachial artery was previously catheterized to obtain blood gas and cardiorespiratory analysis. Anesthesia was induced with 5% ISO and maintained with 2.5% for 40 minutes. IOP measurements and blood samples were evaluated in different moments until the end of the procedure. After recovering, a second anesthesia was induced with 6% SEV and maintained with 3.5%. Parameters were evaluated at the same time points of the previous procedure. IOP reduced significantly (P= 0.012 from M0 at all time points and no significative changes were observed between ISO and SEV anesthesias. Correlation between IOP and PaCO2 and between PIO and blood pH were found only for SEV. IOP and blood pH decreased in parallel with IOP, whereas values of PaCO2 increased in caracaras anesthetized with isoflurane and sevoflurane.Avaliou-se a pressão intra-ocular (PIO e estimaram-se as correlações entre PIO e pressão de dióxido de carbono (PaCO2 e pH arterial de cinco caracarás (Caracara plancus, anestesiados com isofluorano (ISO ou sevofluorano (SEV. Valores basais da PIO foram aferidos em ambos os olhos (M0. Cateterizou-se previamente a artéria braquial para obtenção de parâmetros hemogasométricos e cardiorrespiratórios. Anestesia foi induzida com ISO a 5V% e mantida por 40 minutos com 2,5V%. PIO e amostras de sangue foram avaliadas em diferentes momentos até o final do procedimento. Após recuperação, uma segunda anestesia foi realizada com SEV a 6% e mantida com 3,5%. Os parâmetros foram aferidos nos mesmos momentos estabelecidos previamente. A PIO decresceu significativamente (P=0,012 de M0 em todos os momentos e não houve diferença estatística entre ISO e SEV. Correla

  1. Impact of methods used to express levels of circulating fatty acids on the degree and direction of associations with blood lipids in humans.

    Sergeant, Susan; Ruczinski, Ingo; Ivester, Priscilla; Lee, Tammy C; Morgan, Timothy M; Nicklas, Barbara J; Mathias, Rasika A; Chilton, Floyd H


    Numerous studies have examined relationships between disease biomarkers (such as blood lipids) and levels of circulating or cellular fatty acids. In such association studies, fatty acids have typically been expressed as the percentage of a particular fatty acid relative to the total fatty acids in a sample. Using two human cohorts, this study examined relationships between blood lipids (TAG, and LDL, HDL or total cholesterol) and circulating fatty acids expressed either as a percentage of total or as concentration in serum. The direction of the correlation between stearic acid, linoleic acid, dihomo-γ-linolenic acid, arachidonic acid and DHA and circulating TAG reversed when fatty acids were expressed as concentrations v. a percentage of total. Similar reversals were observed for these fatty acids when examining their associations with the ratio of total cholesterol:HDL-cholesterol. This reversal pattern was replicated in serum samples from both human cohorts. The correlations between blood lipids and fatty acids expressed as a percentage of total could be mathematically modelled from the concentration data. These data reveal that the different methods of expressing fatty acids lead to dissimilar correlations between blood lipids and certain fatty acids. This study raises important questions about how such reversals in association patterns impact the interpretation of numerous association studies evaluating fatty acids and their relationships with disease biomarkers or risk.

  2. Ocular biometric changes after trabeculectomy

    Azam Alvani


    Full Text Available This review article aimed to evaluate ocular biometric changes after trabeculectomy. The PubMed database was searched using the keywords “axial length” (AL, “anterior chamber depth” (ACD, “corneal astigmatism,” “corneal topography” and “trabeculectomy.” The extracted studies were categorized based on the evaluated parameters and the biometry method (contact and non-contact. Comparable studies with respect to their sample size were combined for statistical analysis. Twenty-five studies including 690 individuals which met the inclusion criteria were selected. After trabeculectomy, a significant and persistent AL reduction, with a range of 0.1-0.19 and 0.1-0.9 mm measured with contact and non-contact methods, respectively, was observed. With respect to topographic changes, 0.38-1.4 diopters (D with-the-rule (WTR astigmatism was induced postoperatively. All studies revealed ACD reduction immediately after surgery, which gradually deepened and approximated its preoperative levels on day 14. ACD reduction was not significant after that period in the majority of cases. In conclusion, changes in ACD is of small amount and of short period, thus it can be ignored; however, reported changes in AL and keratometry are of sufficient magnitude and can affect the refractive prediction of combined cataract surgery and trabeculectomy.

  3. Ocular microtremor laser speckle metrology

    Al-Kalbani, M.; Mihaylova, E.; Collins, N.; Toal, V.; Coakley, D.; Boyle, G.


    Ocular Microtremor (OMT) is a continual, high frequency physiological tremor of the eye present in all subjects even when the eye is apparently at rest. OMT causes a peak to peak displacement of around 150nm-2500nm with a broadband frequency spectrum between 30Hz to 120Hz; with a peak at about 83Hz. OMT carries useful clinical information on depth of consciousness and on some neurological disorders. Nearly all quantitative clinical investigations have been based on OMT measurements using an eye contacting piezoelectric probe which has low clinical acceptability. Laser speckle metrology is a candidate for a high resolution, non-contacting, compact, portable OMT measurement technique. However, tear flow and biospeckle might be expected to interfere with the displacement information carried by the speckle. The paper investigates the properties of the scattered speckle of laser light (λ = 632.8nm) from the eye sclera to assess the feasibility of using speckle techniques to measure OMT such as the speckle correlation. The investigation is carried using a high speed CMOS video camera adequate to capture the high frequency of the tremor. The investigation is supported by studies using an eye movement simulator (a bovine sclera driven by piezoelectric bimorphs). The speckle contrast and the frame to frame spatiotemporal variations are analyzed to determine if the OMT characteristics are detectable within speckle changes induced by the biospeckle or other movements.

  4. Categorical evaluation of the ocular irritancy of cosmetic and consumer products by human ocular instillation procedures.

    Gao, Yang; Kanengiser, Bruce E


    The assessment of ocular irritation potential is an important part of safety testing for cosmetic and consumer products. The purpose of this investigation was to examine ocular irritancy levels elicited in humans by various categories of a specific class of cosmetic and consumer products that have a potential to enter the eye inadvertently during use. Test materials assessed belonged to one of seven categories, which included liquid makeup, shampoo, baby wash, mascara, eye makeup remover, powder eye shadow, and facial cleanser. These test materials were evaluated by human ocular instillation, followed by examinations, for which subjective perceptions of irritation were recorded, and component areas of ocular tissues were individually examined for inflammation and for the area and density of fluorescein staining patterns at 30 seconds and at 5, 15, 60, and 120 minutes post-instillation. Subjective and objective ocular irritation scores of 410 eyes were analyzed by product classification. Average score levels were determined for subjective responses, inflammation, and fluorescein staining patterns. This investigation determined that irritation levels of the evaluated test materials varied markedly with respect to product category, type of ocular irritation, and ocular tissue, demonstrating that these factors are important considerations for the prediction of the ocular irritancy of a test material.

  5. Epidemiology, pathophysiology, and the future of ocular toxoplasmosis.

    Kijlstra, Aize; Petersen, Eskild


    Despite large advances in the field of ocular toxoplasmosis, large gaps still exist in our knowledge concerning the epidemiology and pathophysiology of this potentially blinding infectious disease. Although ocular toxoplasmosis is considered to have a high health burden, still little is known about its exact prevalence and how it affects the quality of life. The epidemiology of toxoplasmosis depends on local habits throughout the globe, and changes are likely in view of increased meat consumption in developing countries and demands for higher animal welfare in the Western world. Water is increasingly seen as an important risk factor and more studies are needed to quantitate and control the role of water exposure (drinking, swimming). Tools are now becoming available to study both the human host as well as parasite genetic factors in the development of ocular toxoplasmosis. Further research on the role of Toxoplasma strains as well as basic studies on parasite virulence is needed to explain why Toxoplasma associated eye disease is so severe in some countries, such as Brazil. Although genetic analysis of the parasite represents the gold standard, further developments in serotyping using peptide arrays may offer practical solutions to study the role of parasite strains in the pathogenesis of Toxoplasma retinochoroiditis. More research is needed concerning the pathways whereby the parasite can infect the retina. Once in the retina further tissue damage may be due to parasite virulence factors or could be caused by an aberrant host immune response. Local intraocular immune responses are nowadays used for diagnostic procedures. Future developments may include the use of Raman technology or the direct visualization of a Toxoplasma cyst by optical coherence tomography (OCT). With the availability of ocular fluid specimens obtained for diagnostic purposes and the development of advanced proteomic techniques, a biomarker fingerprint that is unique for an eye with

  6. Evaluating Systemic Toxicity in Rabbits after Acute Ocular Exposure to Irritant Chemicals

    Reshma Sebastian Cherian


    Full Text Available Acute systemic toxicity via ocular exposure route is not a well understood aspect. Any material/drug/chemical that comes in contact with the eye can evade the first pass metabolism and enter the systemic circulation through the conjunctival blood vessels or via the nasolacrimal route. In this study, the effect of ocular irritant chemicals on the systemic toxicity was assessed in rabbit. Eyes of rabbits were exposed to known ocular irritant (cetyl pyridinium chloride, sodium salicylate, imidazole, acetaminophen, and nicotinamide for 24 h and scored. After a period of 72 h, blood was collected from the animals for examining the hematological and biochemical parameters. The animals were then sacrificed and the eyes were collected for histopathology and cytokine analysis by ELISA. Splenocyte proliferation was assessed by tritiated thymidine incorporation assay. The liver and brain of the treated animals were retrieved for evaluating oxidative damage. The chemicals showed moderate to severe eye irritation. Inflammation was not evident in the histopathology but proinflammatory markers were significantly high. The splenocyte proliferation capacity was undeterred. And there was minimal oxidative stress in the brain and liver. In conclusion, acute exposure of ocular irritants was incapable of producing a prominent systemic side effect in the current scenario.

  7. Real-time PCR strategy for the identification of Trypanosoma cruzi discrete typing units directly in chronically infected human blood.

    Muñoz-San Martín, Catalina; Apt, Werner; Zulantay, Inés


    The protozoan Trypanosoma cruzi is the causative agent of Chagas disease, a major public health problem in Latin America. This parasite has a complex population structure comprised by six or seven major evolutionary lineages (discrete typing units or DTUs) TcI-TcVI and TcBat, some of which have apparently resulted from ancient hybridization events. Because of the existence of significant biological differences between these lineages, strain characterization methods have been essential to study T. cruzi in its different vectors and hosts. However, available methods can be laborious and costly, limited in resolution or sensitivity. In this study, a new genotyping strategy by real-time PCR to identify each of the six DTUs in clinical blood samples have been developed and evaluated. Two nuclear (SL-IR and 18S rDNA) and two mitochondrial genes (COII and ND1) were selected to develop original primers. The method was evaluated with eight genomic DNA of T. cruzi populations belonging to the six DTUs, one genomic DNA of Trypanosoma rangeli, and 53 blood samples from individuals with chronic Chagas disease. The assays had an analytical sensitivity of 1-25fg of DNA per reaction tube depending on the DTU analyzed. The selectivity of trials with 20fg/μL of genomic DNA identified each DTU, excluding non-targets DTUs in every test. The method was able to characterize 67.9% of the chronically infected clinical samples with high detection of TcII followed by TcI. With the proposed original genotyping methodology, each DTU was established with high sensitivity after a single real-time PCR assay. This novel protocol reduces carryover contamination, enables detection of each DTU independently and in the future, the quantification of each DTU in clinical blood samples.

  8. Physician-Directed Versus Computerized Closed-Loop Control of Blood Pressure Using Phenylephrine in a Swine Model.

    Marques, Nicole Ribeiro; Whitehead, William E; Kallu, Upendar R; Kinsky, Michael P; Funston, Joe S; Wassar, Taoufik; Khan, Muzna N; Milosch, Mindy; Jupiter, Daniel; Grigoriadis, Karolos; Kramer, George C


    Vasopressors provide a rapid and effective approach to correct hypotension in the perioperative setting. Our group developed a closed-loop control (CLC) system that titrates phenylephrine (PHP) based on the mean arterial pressure (MAP) during general anesthesia. As a means of evaluating system competence, we compared the performance of the automated CLC with physicians. We hypothesized that our CLC algorithm more effectively maintains blood pressure at a specified target with less blood pressure variability and reduces the dose of PHP required. In a crossover study design, 6 swine under general anesthesia were subjected to a normovolemic hypotensive challenge induced by sodium nitroprusside. The physicians (MD) manually changed the PHP infusion rate, and the CLC system performed this task autonomously, adjusted every 3 seconds to achieve a predetermined MAP. The CLC maintained MAP within 5 mm Hg of the target for (mean ± standard deviation) 93.5% ± 3.9% of the time versus 72.4% ± 26.8% for the MD treatment (P = .054). The mean (standard deviation) percentage of time that the CLC and MD interventions were above target range was 2.1% ± 3.3% and 25.8% ± 27.4% (P = .06), respectively. Control statistics, performance error, median performance error, and median absolute performance error were not different between CLC and MD interventions. PHP infusion rate adjustments by the physician were performed 12 to 80 times in individual studies over a 60-minute period. The total dose of PHP used was not different between the 2 interventions. The CLC system performed as well as an anesthesiologist totally focused on MAP control by infusing PHP. Computerized CLC infusion of PHP provided tight blood pressure control under conditions of experimental vasodilation.

  9. Multiplex real-time PCR assay for rapid detection of methicillin-resistant staphylococci directly from positive blood cultures.

    Wang, Hye-Young; Kim, Sunghyun; Kim, Jungho; Park, Soon-Deok; Uh, Young; Lee, Hyeyoung


    Methicillin-resistant Staphylococcus aureus (MRSA) is the most prevalent cause of bloodstream infections (BSIs) and is recognized as a major nosocomial pathogen. This study aimed to evaluate a newly designed multiplex real-time PCR assay capable of the simultaneous detection of mecA, S. aureus, and coagulase-negative staphylococci (CoNS) in blood culture specimens. The Real-MRSA and Real-MRCoNS multiplex real-time PCR assays (M&D, Republic of Korea) use the TaqMan probes 16S rRNA for Staphylococcus spp., the nuc gene for S. aureus, and the mecA gene for methicillin resistance. The detection limit of the multiplex real-time PCR assay was 10(3) CFU/ml per PCR for each gene target. The multiplex real-time PCR assay was evaluated using 118 clinical isolates from various specimen types and a total of 350 positive blood cultures from a continuous monitoring blood culture system. The results obtained with the multiplex real-time PCR assay for the three targets were in agreement with those of conventional identification and susceptibility testing methods except for one organism. Of 350 positive bottle cultures, the sensitivities of the multiplex real-time PCR kit were 100% (166/166 cultures), 97.2% (35/36 cultures), and 99.2% (117/118 cultures) for the 16S rRNA, nuc, and mecA genes, respectively, and the specificities for all three targets were 100%. The Real-MRSA and Real-MRCoNS multiplex real-time PCR assays are very useful for the rapid accurate diagnosis of staphylococcal BSIs. In addition, the Real-MRSA and Real-MRCoNS multiplex real-time PCR assays could have an important impact on the choice of appropriate antimicrobial therapy, based on detection of the mecA gene.

  10. Estudio sobre traumatismos oculares Study on ocular traumas

    Ileana Miguel Pérez


    Full Text Available Se realizó estudio retrospectivo longitudinal de pacientes con traumatismos oculares mecánicos hospitalizados en el Instituto Superior de Medicina Militar "Dr. Luis Díaz Soto", desde 1988 hasta el 2002, con una casuística de 508 ojos de 479 pacientes. El procesamiento estadístico fue realizado con el mismo programa automatizado con el que se conformó la base de datos (Acces y se utilizaron de acuerdo con las características de las variables ß analizadas métodos estadísticos paramétricos y no paramétricos con una confiabilidad de un 95 % (a =0,05. Se obtiene una relación de 4:1 de predominio del sexo masculino, con una edad promedio de 27,4 años con valor mínimo de 2 años y máximo de 78 años. Los mecanismos más frecuentes de producción del accidente resultaron ser: las armas de fuego (22,7 % y la acción de martillar (21,4 %, teniendo en cuenta que el 38,2 % de los pacientes fueron militares. Las lesiones asociadas a los traumatismos más frecuentes resultaron ser el hipema y el hemovítreo, y se demostró que a medida que eran mayores disminuía considerablemente la agudeza visual final. Los traumatismos cerrados (41,3 % fueron más frecuentes y tuvieron mejores resultados visuales finales (66,7 % con visión mayor de 0.1 que el resto de los grupos de traumatismos abiertos (herida simple, contusión-herida, herida con CEIO y contusión-herida con CEIO. Las contusiones-heridas con CEIO fueron provocados en su mayoría por las armas de fuego y tuvieron los peores resultados visuales (60,5 % con visión menor de 0.1. La afectación del segmento posterior resultó ser un elemento que influyó de forma importante en los resultados visuales. Las complicaciones más frecuentes para los traumatismos cerrados fueron la hipertensión secundaria la catarata y el desprendimiento de retina. Para las heridas simples la catarata y para el resto de los traumatismos el desprendimiento de retina y la ptisis bulbi. Aproximadamente el 15 % de

  11. Multiplex Real-Time PCR Assay for Rapid Detection of Methicillin-Resistant Staphylococci Directly from Positive Blood Cultures

    Wang, Hye-young; Kim, Sunghyun; Kim, Jungho; Park, Soon-Deok; Uh, Young; Lee, Hyeyoung


    Methicillin-resistant Staphylococcus aureus (MRSA) is the most prevalent cause of bloodstream infections (BSIs) and is recognized as a major nosocomial pathogen. This study aimed to evaluate a newly designed multiplex real-time PCR assay capable of the simultaneous detection of mecA, S. aureus, and coagulase-negative staphylococci (CoNS) in blood culture specimens. The Real-MRSA and Real-MRCoNS multiplex real-time PCR assays (M&D, Republic of Korea) use the TaqMan probes 16S rRNA for Staphylo...

  12. FOXP3 is a direct target of miR15a/16 in umbilical cord blood regulatory T cells

    Liu, X.; Robinson, SN; Setoyama, T; Tung, SS; D’Abundo, L; Shah, MY; Yvon, E.; N Shah; Yang, H.; Konopleva, M; Garcia-Manero, G; McNiece, I.; Rezvani, K; Calin, GA; shpall, EJ


    Exact mechanism of action of umbilical cord blood (CB)-derived regulatory T cells (Tregs) in the prevention of GVHD remains unclear. On the basis of selective overexpression of peptidase inhibitor 16 in CB Tregs, we explored the related p53 pathway, which has been shown to negatively regulate miR15a/16 expression. Significantly lower levels of miR15a/16 were observed in CB Tregs when compared with conventional CB T cells (Tcons). In a xenogeneic GVHD mouse model, lower levels of miR15a/16 wer...

  13. Study of Ocular Changes in Pregnancy

    O K Radhakrishnan


    Full Text Available Introduction: In pregnancy, women undergo a tremendous number of systemic and ocular changes. Physiological changes occur in the cardiovascular, hormonal, metabolic, hematologic and immunologic systems. Hormonal changes are among the most prominent systemic changes in pregnant women with the placenta, maternal endocrine glands and the fetal adrenal glands combining their productivity to make a high-powered hormone factory. Aims: To evaluate the various ocular changes taking place in pregnancy in women with no other co-morbid ocular or systemic diseases and to compare ocular changes in three trimesters of pregnancy with controls of non pregnant women. Materials and Methods: The ocular changes occuring in varying stages of pregnancy in 225 pregnant women were studied and compared with 75 healthy non pregnant women. Results: Age was similar in the pregnant and non pregnant women studied. Headache was significantly more common among pregnant women when compared to non pregnant women. Diplopia was not significantly different between pregnant and non pregnant women. Intraocular pressure was significantly less among the pregnant women as compared to non pregnant women. Occurrence of conjunctival pigmentation was significantly more in pregnant women when compared to non pregnant women. There was no difference in corneal thickness when pregnant and non pregnant women were compared. Krukenberg's spindles were seen more commonly among pregnant women when compared to non pregnant women. Conclusion: Various ocular changes occur during a normal pregnancy. Knowledge of these changes can help to differentiate the physiological changes occurring in a normal pregnancy from ocular manifestation of systemic diseases. [Natl J Med Res 2016; 6(1.000: 1-4

  14. Ocular Neuromyotonia Associated with Chronic Inflammatory Demyelinating Polyneuropathy.

    Kung, Nathan H; Bucelli, Robert C; McClelland, Collin M; Van Stavern, Gregory P


    Ocular neuromyotonia (ONM) is a neuro-ophthalmic disorder characterized by episodic diplopia caused by contraction of one or more ocular muscles due to spontaneous excitation of the respective ocular motor nerve. We report a patient whose ocular neuromyotonia arose in the setting of a subacute demyelinating polyneuropathy consistent with chronic inflammatory demyelinating polyneuropathy (CIDP) and subsequently resolved following the initiation of intravenous immunoglobulin (IVIg) for her neuropathy. Our patient provides additional evidence towards the role of demyelination and ephaptic neurotransmission in ocular neuromyotonia and also represents the first reported case of ocular neuromyotonia associated with a systemic neurological condition.

  15. [Sedative measures during surgery on old patients. Result on ocular tension (author's transl)].

    Deodati, F; Lareng, L; Bertrand, E; Izard, V


    An attempt of sedative procedures associated with a locoregional anesthesia was performed on fifty old patients before cataract operation. The blood gases, the blood pressure and the heartrate were measured and the behaviour of the patient just before he awoke was examined to determinate the sedative value. A parallel study revealed a decrease of the intra ocular pressure of 2,5 mm d'Hg due to a slight decrease of the blood pressure and to the effect of the neurolep mixture: the Innovar. This method seems to be very satisfactory in Ophthalmology.

  16. Upright perception and ocular torsion change independently during head tilt

    Amir Kheradmand


    Full Text Available We maintain a stable perception of the visual world despite continuous movements of our eyes, head and body. Perception of upright is a key aspect of such orientation constancy. Here we investigated whether changes in upright perception during sustained head tilt were related to simultaneous changes in torsional position of the eyes. We used a subjective visual vertical (SVV task, modified to track changes in upright perception over time, and a custom video method to measure ocular torsion simultaneously. We tested twelve subjects in upright position, during prolonged (~15min lateral head tilts of 20 degrees, and also after the head returned to upright position. While the head was tilted, SVV drifted in the same direction as the head tilt (left tilt: -5.4±1.4 o and right tilt: +2.2±2.1 o. After the head returned to upright position, there was an SVV aftereffect with respect to the pre-tilt baseline, which was also in the same direction as the head tilt (left tilt: -3.9±0.6 o and right tilt: +2.55±1.0 o. Neither the SVV drift nor the SVV aftereffect were correlated with the changes in ocular torsion. Using the Bayesian spatial-perception model we show that the pattern of SVV drift and aftereffect in our results could be explained by a drift and an adaptation in sensory inputs that encode head orientation. The fact that ocular torsion (mainly driven by the otoliths could not account for the perceptual changes suggests that neck proprioception could be the primary source of drift in upright perception during head tilt, and subsequently the aftereffect in upright position.

  17. Special Blood Donation Procedures

    ... takes about 10 minutes. Double red blood cell donation In the so-called double red blood cell ... can be cured with apheresis. Directed or designated donation Family members or friends can donate blood specifically ...

  18. Ocular changes in primary hypothyroidism

    Pekel Hamiyet


    Full Text Available Abstract Background To determine the ocular changes related to hypothyrodism in newly diagnosed patients without orbitopathy. Findings Thirty-three patients diagnosed to have primary overt hypothyroidism were enrolled in the study. All subjects were assigned to underwent central corneal thickness (CCT, anterior chamber volume, depth and angle measurements with the Scheimpflug camera (Pentacam, Oculus and cup to disc ratio (C/D, mean retinal thickness and mean retinal nerve fiber layer (RNFL thickness measurements with optical coherence tomography (OCT in addition to ophthalmological examination preceeding the replacement therapy and at the 1st, 3rd and 6th months of treatment. The mean age of the patients included in the study were 40.58 ± 1.32 years. The thyroid hormone levels return to normal levels in all patients during the follow-up period, however the mean intraocular pressure (IOP revealed no significant change. The mean CCT was 538.05 ± 3.85 μ initially and demonstrated no statistically significant change as the anterior chamber volume, depth and angle measurements did. The mean C/D ratio was 0.29 ± 0.03 and the mean retinal thickness was 255.83 ± 19.49 μ initially and the treatment did not give rise to any significant change. The mean RNFL thickness was also stable during the control visits, so no statistically significant change was encountered. Conclusions Neither hypothyroidism, nor its replacement therapy gave rise to any change of IOP, CCT, anterior chamber parameters, RNFL, retinal thickness and C/D ratio.

  19. Direct in vivo evidence for increased proliferation of CLL cells in lymph nodes compared to bone marrow and peripheral blood

    Herndon, Thomas M; Chen, Shih-Ann; Saba, Nakhle S


    Chronic lymphocytic leukemia (CLL) is a progressive malignancy of mature B-cells that involves the peripheral blood (PB), lymph nodes (LNs) and bone marrow (BM). Although the majority of CLL cells are in a resting state, small populations of proliferating cells exist; however, the anatomical site...... of active cell proliferation remains to be definitively determined. Based on findings that CLL cells in LNs have increased expression of B-cell activation genes, we tested the hypothesis that the fraction of 'newly born' cells would be highest in the LNs. Using a deuterium oxide ((2)H) in vivo labeling...... method in which patients consumed deuterated (heavy) water ((2)H2O), we determined CLL cell kinetics in concurrently obtained samples from LN, PB and BM. The LN was identified as the anatomical site harboring the largest fraction of newly born cells, compared to PB and BM. In fact, the calculated birth...

  20. Research Progress on Ocular Surface Changes after Fem-tosecond Laser Small Incision Lenticule Extraction

    Xiangfei Chen; Yan Lu; Chunhong Wang; Zhenping Huang


    The femtosecond laser has a number of advantages,.such as short pulse time,.high instantaneous power,.high repetition rate, low monopulse energy, and small thermal effect. Fem-tosecond laser-assisted small incision lenticule extraction (SMILE) is becoming the new direction in refractive surgery, and the ocular surface changes after SMILE are attracting in-creasingly more attention. This article reviews adverse effects, including dry eye, injury of corneal nerves, and ocular sur-face inflammation,.occurring after SMILE.

  1. Ocular syphilis presenting as unilateral chorioretinitis

    Anand Pai


    Full Text Available Syphilis is a multi systemic infection caused by Treponema pallidum. Ocular manifestations of Syphilis have a myriad of presentations and severity. A 31year old male patient was referred from ophthalmology department as a case of chorioretinitis for screening for syphilis. Patient had diminished vision and redness of right eye for 2 months duration. History of premarital exposure and extramarital contact was present. Ocular examination revealed - Rt eye: conjunctival congestion and Argyll Robertson pupil; Lt eye: normal. Fundoscopy of right eye showed yellowish white retinal lesions, macular edema and hyperaemia and left eye was normal .No genital lesion, scars or cutaneous lesion was present.VDRL was reactive in 1 dilution,TPHA was positive ; HIV test was negative ; CSF revealed VDRL - Negative and TPHA -Negative.Patient was treated with Injection procaine penicillin 1.2 Million units intramuscularly daily for 21 days. The patient responded well to treatment and there was improvement in his vision. Ocular Syphilis can occur at any stage of Syphilis and may be the only presenting sign. Syphilis serology was positive confirming the disease.This case highlights the importance of syphilis with ocular manifestation - there by proving that diagnosis of syphilis based on ocular finding is clinically challenging.

  2. [Ocular ischemic syndrome--a case report].

    Zemba, M; Avram, Corina Ioana; Ochinciuc, Uliana; Stamate, Alina Cristina; Camburu, Raluca Lăcrămioara


    Ocular ischemic syndrome, also known as hypoperfusion/ hypotensive retinopathy or as ischemic oculopathy is a rare ocular disease determined by chronic arterial hypoperfusion through central retinal artery, posterior and anterior ciliary arteries. It is bilateral in 20% of the cases. Most often it appears due to severe occlusion of the carotid arteries (ICA, MCA>ECA), described in 1963 by Kearns and Hollenhorst. Occasionally it can be determined by the obstruction of ophtalmic artery or some arterities (Takayasu, giant cell arteritis). The risk factors are: age between 50-80 years, males (M:F = 2:1), arterial hypertension, diabetes, coronary diseases (5% of the cases develop ocular ischemic syndrome), vascular stroke, hemodialysis. The case we present is of an 63 years old man known with primary arterial hypertension, hypercholesterolemia, diabetes type 2 non insulin dependent and diagnosticated with ischemic cerebral stroke and bilateral obstruction of internal carotid arteries in march 2010, who is presenting for visual impairment in both eyes. The imaging investigations show important carotid occlusion and at the ophthalmologic evaluation there are ocular hypertension and rubeosis iridis at the right eye, optic atrophy at both eyes (complete in the right eye and partial in the left eye), with superior altitudinal visual field defect in left eye. The following diagnosis was established: Chronic ocular ischemic syndrome in both eyes with Neovascular glaucoma at the right eye, Anterior ischemic optic neuropathy at the left eye and laser panphotocoagulation at the right eye was started.

  3. Ocular manifestations of inflammatory bowel disease.

    Thomas, Akshay S; Lin, Phoebe


    Extraintestinal manifestations (EIMs) of inflammatory bowel disease (IBD) are numerous and can often involve the eye. This review highlights the ocular complications associated with IBD including the critical role the ophthalmologist can play in the diagnosis of IBD, the pathogenesis of IBD, its ocular complications, and the treatment of ocular inflammation associated with IBD. Polygenic and environmental influences, as well as gut microbial dysbiosis, have been implicated in the pathogenesis of IBD. IBD and its EIMs appear to respond well to TNFα-targeted biologics. IBD is thought to be caused by polygenic and environmental influences, including a dysbiotic gut microbiota. It is a systemic immune-mediated disease with varying types of ocular manifestations that can precede, occur simultaneously, or follow intestinal involvement. The diagnosis of IBD can be confused with other seronegative spondyloarthropathies as well as Behçet's disease. Treatment of IBD-associated ocular inflammation can range from corticosteroids to steroid-sparing immunosuppression such as azathioprine or methotrexate. Refractory disease can respond well to TNFα inhibitors.

  4. Ocular pharmacokinetics of thiamphenicol in rabbits.

    Aldana, I; Fos, D; Gonzalez Peñas, E; Gazzaniga, A; Gianesello, V; Ceppi Monti, N; Figini, P G; Zato, M A; Bruseghini, L; Esteras, A


    The ocular pharmacokinetics of thiamphenicol (TAP, CAS 15318-45-3) was studied in rabbits by means of the assessment of its ocular and systemic absorption, and urinary excretion after instillation of 0.5% TAP eye drops. TAP concentrations in aqueous humor, plasma and urine were evaluated by a coupled LC/GC method (detection limit = 0.1 ng/ml), because the necessity to have a technique much more sensitive than the traditional chromatographic ones available in order to quantify the very low drug concentrations in biological fluids produced by the ocular treatment, and generally by a topical administration. The intravenous route was chosen as reference and allowed the absolute bioavailability to be estimated. TAP proved to be well absorbed through the cornea with the peak aqueous humor concentration of 110 ng/ml at 45 min following the instillation. The good ocular absorption of TAP was confirmed by the plasma concentrations observed after instillation of 0.5% eye drops. In any case, these concentrations were more than 1000 times lower than those observed after the intravenous treatment at the dose normally used for infectious diseases, allowing to exclude any systemic toxicity of TAP eye drops. The absolute ocular bioavailability was 16.2% when estimated from the AUC values and 34.0% from the cumulative urinary excretion values.

  5. Impacts of Nanomedicines in Ocular Pharmacotherapy

    Jaleh Barar


    Full Text Available Introduction: The integrity of the cells/tissues in anterior and/or posterior segments of the eye plays a crucial role in biofunctions of the vision. To maintain ocular homeostasis, selective restrictiveness of the ophthalmic membranes and barriers control must act on shuttling of biomolecules. Thus, not all attempts to apply de novo nanotechnology approaches for ocular pharmacotherapy have met with the same successes as those cited here in this review, and sometimes these novel technologies tools provoke a great deal of challenges and hurdles mainly because of functional presence of these barriers. Methods: Recent published articles related to application of ocular nanomedicines were reviewed and highlighted in this review article. Results: It seems the emergence of nanomedicines have arisen great hopes for ophthalmic pharmacotherapy, in which nanostructured medicines are expected to be able to cross the restrictive barriers of the eye. Although such fast inauguration of ocular nanomedicines will literally convey new challenges in the regulatory and translational processes, it will also grant a prolific platform from which many exciting, and yet unimagined, applications of biomedical nanotechnology will emerge for pharmacotherapy of the eye. Conclusion: This review provide recent advancements on ocular nanomedicines.

  6. Ocular dermoid in Pai Syndrome: A review.

    Tormey, Peter; Bilic Cace, Iva; Boyle, Michael A


    Pai Syndrome is a rare congenital malformation syndrome of unknown cause with hypertelorism, midline cleft lip, nasal and facial polyps, ocular anomalies and the presence of distinctive lipomas adjacent to the corpus callosum. Herein, we present an infant girl with Pai Syndrome diagnosed in the first week of life with typical facial findings and associated pericallosal lipoma identified on cranial ultrasound and brain MRI. These typical features identified included median cleft of the upper lip (in her case as a forme fruste) with a cleft alveolus and a mid-anterior alveolar process congenital polyp. In addition to these findings there was mild hypertelorism and an ocular abnormality on the right eye. An ophthalmology assessment on day 5 identified the ocular lesion as a limbal dermoid. Several ocular anomalies have been reported in association with Pai Syndrome, however, dermoids have not been frequently described in this Syndrome and not before in a limbal location. Increasing identification of previously unreported ocular abnormalities in Pai Syndrome may improve diagnosis and may prove useful in future work attempting to elucidate the aetiology of this rare syndrome.

  7. The incidence of ocular candidiasis and evaluation of routine opthalmic examination in critically ill patients with candidaemia.

    Gluck, S; Headdon, W G; Tang, Dws; Bastian, I B; Goggin, M J; Deane, A M


    Despite a paucity of data regarding both the incidence of ocular candidiasis and the utility of ophthalmic examination in critically ill patients, routine ophthalmic examination is recommended for critically ill patients with candidaemia. The objectives were to estimate the incidence of ocular candidiasis and evaluate whether ophthalmic examination influenced subsequent management of these patients. We conducted a ten-year retrospective observational study. Data were extracted for all ICU patients who were blood culture positive for fungal infection. Risk factors for candidaemia and eye involvement were quantified and details regarding ophthalmic examination were reviewed. Candida species were cultured in 93 patients. Risk factors for ocular candidiasis were present in 57% of patients. Forty-one percent of patients died prior to ophthalmology examination and 2% of patients were discharged before candidaemia was identified. During examination, signs of ocular candidiasis were only present in one (2.9%) patient, who had a risk factor for ocular candidiasis. Based on these findings, the duration of antifungal treatment for this patient was increased. Ocular candidiasis occurs rarely in critically ill patients with candidaemia, but because treatment regimens may be altered when diagnosed, routine ophthalmic examination is still indicated.

  8. Photochemical toxicity of drugs intended for ocular use.

    Sahu, Roshan Kumar; Singh, Bhupendra; Saraf, Shubhini A; Kaithwas, Gaurav; Kishor, Kamal


    The present investigation was undertaken to evaluate the possible ocular phototoxicity of drugs used in ophthalmic formulations. Sulphacetamide, ketoconazole, voriconazole, diclofenac, and ketorolac were assessed in the concentrations available in the market for their ocular use. The suitable models viz Hen's Egg Test Chorioallantoic Membrane (HET-CAM) test, Isolated Chicken Eye (ICE) test, and Red Blood Cell (RBC) haemolysis test as recommended by ECVAM, ICCVAM, and OECD guidelines were performed. Results of HET-CAM and ICE tests suggest that sulphacetamide is moderately toxic in the presence of light/UV-A and very slightly irritant without irradiation. Ketoconazole and voriconazole were found slightly irritant in presence of light/UV-A and non-irritant in dark. Diclofenac and ketorolac demonstrated slight irritancy in the light and were found to be non-irritant in dark. The results suggest that some of the drugs have potential toxic effect in the presence of light. The extent of phototoxicity might get extended when used for longer time. The recommendation is that these drugs should be stored and used in the dark for a specified time and be labelled with specific instructions for patients, especially for those working longer in the sunlight.

  9. Contribution of the cornea and internal surfaces to the change of ocular aberrations with age

    Artal, Pablo; Berrio, Esther; Guirao, Antonio; Piers, Patricia


    We studied the age dependence of the relative contributions of the aberrations of the cornea and the internal ocular surfaces to the total aberrations of the eye. We measured the wave-front aberration of the eye with a Hartmann-Shack sensor and the aberrations of the anterior corneal surface from the elevation data provided by a corneal topography system. The aberrations of the internal surfaces were obtained by direct subtraction of the ocular and corneal wave-front data. Measurements were obtained for normal healthy subjects with ages ranging from 20 to 70 years. The magnitude of the RMS wave-front aberration (excluding defocus and astigmatism) of the eye increases more than threefold within the age range considered. However, the aberrations of the anterior corneal surface increase only slightly with age. In most of the younger subjects, total ocular aberrations are lower than corneal aberrations, while in the older subjects the reverse condition occurs. Astigmatism, coma, and spherical aberration of the cornea are larger than in the complete eye in younger subjects, whereas the contrary is true for the older subjects. The internal ocular surfaces compensate, at least in part, for the aberrations associated with the cornea in most younger subjects, but this compensation is not present in the older subjects. These results suggest that the degradation of the ocular optics with age can be explained largely by the loss of the balance between the aberrations of the corneal and the internal surfaces.

  10. Noninvasive optical interrogation of the ocular anterior chamber

    Blue, Robert; Uttamchandani, Deepak G.; Wilson, Clive G.


    Ophthalmic drug research and ocular diagnostics is hampered by an inability to perform continuous sampling of the aqueous humor contained within the anterior chamber by paracentesis is technically problematic and is associated with the use of local or general anesthesia. Moreover, sampling by direct injection exposes the eye to the risk of infection. We report results obtained from an optical instrumentation technique which is concerned with the direct and non-invasive measurements of optical scattering, absorbance and fluorescence produced in the aqueous humor by various compounds, thus avoiding the need for direct sampling. Light scatter in the anterior chamber arises from particulate matter, such as cell debris and chemical precipitates following eye surgery. Absorbance is caused by the presence of materials such as haemoglobin, or results from the penetration of drugs such as hydroxyquinolines applied to the cornea. Fluorescence can be used to provide a sensitive measurements of fluoroquinolines in the anterior chamber.

  11. Identification of bacteria directly from positive blood culture samples by DNA pyrosequencing of the 16S rRNA gene


    Rapid identification of the causative bacteria of sepsis in patients can contribute to the selection of appropriate antibiotics and improvement of patients' prognosis. Genotypic identification is an emerging technology that may provide an alternative method to, or complement, established phenotypic identification procedures. We evaluated a rapid protocol for bacterial identification based on PCR and pyrosequencing of the V1 and V3 regions of the 16S rRNA gene using DNA extracted directly from...

  12. Identification of pathogenic microorganisms directly from positive blood vials by matrix-assisted laser desorption/ionization time of flight mass spectrometry

    Nonnemann, Bettina; Tvede, Michael; Bjarnsholt, Thomas


    Matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS) is a promising and fast method for identifying fungi and bacteria directly from positive blood cultures. Various pre-treatment methods for MALDI-TOF MS identification have been reported for this purpose. In......-house results for identification of bacterial colonies by MALDI-TOF MS using a cut-off score of 1.5 did not reduce the diagnostic accuracy compared with the recommended cut-off score of 1.8. A 3-month consecutive study of positive blood cultures was carried out in our laboratory to evaluate whether...... the Sepsityper™ Kit (Bruker Daltonics) with Biotyper 2.0 software could be used as a fast diagnostic tool for bacteria and fungi and whether a 1.5 cut-off score could improve species identification compared with the recommended score of 1.8. Two hundred and fifty-six positive blood vials from 210 patients and 19...

  13. Comparative analysis of Gram's stain, PNA-FISH and Sepsityper with MALDI-TOF MS for the identification of yeast direct from positive blood cultures.

    Gorton, Rebecca L; Ramnarain, P; Barker, K; Stone, N; Rattenbury, S; McHugh, T D; Kibbler, C C


    Fungaemia diagnosis could be improved by reducing the time to identification of yeast from blood cultures. This study aimed to evaluate three rapid methods for the identification of yeast direct from blood cultures; Gram's stain analysis, the AdvanDX Peptide Nucleic Acid in Situ Hybridisation Yeast Traffic Light system (PNA-FISH YTL) and Bruker Sepsityper alongside matrix-assisted laser desorption ionisation time of flight mass spectrometry (MALDI-TOF MS). Fifty blood cultures spiked with a known single yeast strain were analysed by blinded operators experienced in each method. Identifications were compared with MALDI-TOF MS CHROMagar Candida culture and ITS rRNA sequence-based identifications. On first attempt, success rates of 96% (48/50) and 76% (36/50) were achieved using PNA-FISH YTL and Gram's stain respectively. MALDI-TOF MS demonstrated a success rate of 56% (28/50) when applying manufacturer's species log score thresholds and 76% (38/50) using in-house parameters, including lowering the species log score threshold to >1.5. In conclusion, PNA-FISH YTL demonstrated a high success rate successfully identifying yeast commonly encountered in fungaemia. Sepsityper(™) with MALDI-TOF MS was accurate but increased sensitivity is required. Due to the misidentification of commonly encountered yeast Gram's stain analysis demonstrated limited utility in this setting.

  14. Changes in ocular mast cell numbers and histamine distribution during experimental autoimmune uveitis.

    Lee, C H; Lang, L S; Orr, E L


    Choroidal mast cells have been implicated in experimental autoimmune uveitis (EAU), an ocular inflammatory disease induced by S-antigen. Our data confirm that choroidal mast cell numbers decrease with clinical onset of S-antigen-induced EAU in Lewis rats, and establish that the decrease is statistically significant. In addition, we find that the numbers of limbal mast cells also decrease during S-antigen-induced EAU, and that this decrease occurs earlier in the course of the disease than that observed for choroidal mast cells. Activation and degranulation of mast cells, as evidenced by decreases in mast cell number, result in the synthesis and/or release of large quantities of mast cell mediators, such as histamine. Histamine levels in EAU were found to change significantly, decreasing in the anterior portion of the eye and increasing in the choroid and retina, in concert with changes in mast cell number over the course of EAU. Mast cell mediators may actively contribute to the pathogenesis of EAU through direct enhancement of the inflammation, by stimulation of other elements of the immune system, and/or through facilitation of the blood-retinal barrier breakdown that occurs in EAU. Overall, these results add to the evidence for a mast cell role in EAU, and, in addition, show that the mast cell involvement in EAU includes the mast cells of the limbus.

  15. Human umbilical cord blood-stem cells direct macrophage polarization and block inflammasome activation to alleviate rheumatoid arthritis

    Shin, Tae-Hoon; Kim, Hyung-Sik; Kang, Tae-Wook; Lee, Byung-Chul; Lee, Hwa-Yong; Kim, Yoon-Jin; Shin, Ji-Hee; Seo, Yoojin; Won Choi, Soon; Lee, Seunghee; Shin, Kichul; Seo, Kwang-Won; Kang, Kyung-Sun


    Rheumatoid arthritis (RA) is a long-lasting intractable autoimmune disorder, which has become a substantial public health problem. Despite widespread use of biologic drugs, there have been uncertainties in efficacy and long-term safety. Mesenchymal stem cells (MSCs) have been suggested as a promising alternative for the treatment of RA because of their immunomodulatory properties. However, the precise mechanisms of MSCs on RA-related immune cells are not fully elucidated. The aim of this study was to investigate the therapeutic potential of human umbilical cord blood-derived MSCs (hUCB-MSCs) as a new therapeutic strategy for patients with RA and to explore the mechanisms underlying hUCB-MSC-mediated immunomodulation. Mice with collagen-induced arthritis (CIA) were administered with hUCB-MSCs after the onset of disease, and therapeutic efficacy was assessed. Systemic delivery of hUCB-MSCs significantly ameliorated the severity of CIA to a similar extent observed in the etanercept-treated group. hUCB-MSCs exerted this therapeutic effect by regulating macrophage function. To verify the regulatory effects of hUCB-MSCs on macrophages, macrophages were co-cultured with hUCB-MSCs. The tumor necrosis factor (TNF)-α-mediated activation of cyclooxygenase-2 and TNF-stimulated gene/protein 6 in hUCB-MSCs polarized naive macrophages toward an M2 phenotype. In addition, hUCB-MSCs down-regulated the activation of nucleotide-binding domain and leucine-rich repeat pyrin 3 inflammasome via a paracrine loop of interleukin-1β signaling. These immune-balancing effects of hUCB-MSCs were reproducible in co-culture experiments using peripheral blood mononuclear cells from patients with active RA. hUCB-MSCs can simultaneously regulate multiple cytokine pathways in response to pro-inflammatory cytokines elevated in RA microenvironment, suggesting that treatment with hUCB-MSCs could be an attractive candidate for patients with treatment-refractory RA. PMID:28005072

  16. Treatment options for ocular adnexal lymphoma (OAL

    Victoria Mary Lendrum Cohen


    Full Text Available Victoria Mary Lendrum CohenSt. Bartholomew’s and Moorfields Eye Hospital, London UKAbstract: Most lymphomas that involve the ocular adnexal structure are low grade, B cell, non-Hodgkin’s lymphomas. The treatment depends upon the grade and stage of the disease. High grade lymhoma requires treatment with systemic chemotherapy whereas the localized low grade (extranodal marginal zone lymphoma can be successfully managed with local radiotherapy. Chlamydia psittaci infection is associated with low grade ocular lymphoma; however there is wide geographic variation in the strength of this association. Blanket antibiotic therapy is not advised unless there is proof of an infective agent. The monoclonal antibody, rituximab, may be successful for CD20 positive lymphoma, although it is likely that rituximab will have better long-term results when used in combination with systemic chemotherapy.Keywords: ocular adnexal lymphoma, mucosa associated lymphoid tissue, extranodal marginal zone lymphoma, Chlamydia psittaci, rituximab, radiotherapy, chemotherapy

  17. Ocular immunopathologic findings of experimental onchocerciasis.

    Donnelly, J J; Rockey, J H; Bianco, A E; Soulsby, E J


    Ocular immunopathologic responses of inbred guinea pigs infected with Onchocerca microfilariae from domesticated animals were studied as a laboratory model of human ocular onchocerciasis. A single intracorneal infection of normal guinea pigs with microfilariae produced only minimal ocular lesions. In contrast, intracorneal infection of guinea pigs previously immunized by systemic infection with microfilariae produced intense corneal and uveal inflammation. Transfer of splenic lymphocytes from immunized donors to syngeneic normal recipients substituted effectively for the active immunization. Cell recipients produced marked corneal inflammatory reactions when challenged by a single intracorneal infection. Fresh and cryopreserved microfilariae produced identical reactions. The corneal inflammatory infiltrates were composed primarily of eosinophils, neutrophils, and plasma cells and resembled human onchocercal keratitis. Diethylcarbamazine citrate administration after a challenge intracorneal infection increased the severity of the corneal inflammatory response in immunized animals.

  18. Lymphocyte transformation in presumed ocular histoplasmosis

    Ganley, J.P.; Nemo, G.J.; Comstock, G.W.; Brody, J.A.


    Lymphocytes from individuals with inactive macular disciform lesions of presumed ocular histoplasmosis challenged with three histoplasmin antigens incorporated tritiated thymidine at a significantly higher rate than histoplasmin-stimulated lymphocytes of matched control and peripheral scar groups. This finding is consistent with the etiologic association of the disciform ocular syndrome and previous systemic infection with Histoplasma capsulatum. The disciform group had a higher mean response than the other two groups to pokeweed mitogen but not to phytohemagglutinin and had higher mean counts per minute to the specific antigens Toxoplasma gondii, Blastomyces dermatitidis, Cryptococcus neoformans, Mycobacterium tuberculosis, M battery, and M gaus, but not to Candida albicans. These data would suggest that individuals with the disciform lesion of presumed ocular histoplasmosis have a hyperreactive cellular immune response; this response may play an important role in the development of the disciform.

  19. Pediatric ocular trauma--a clinical presentation.

    Dasgupta S


    Full Text Available A year long study of ocular injuries in children below the age of 15 years was conducted in the Ophthalmology Department of a general hospital. Fortyfour cases were studied. Of these 45.45% were in the age group of 6-10 years. The male to female ratio was 5.28 : 1. Pointed objects viz. sticks, wires etc. were found to be the common causative agents; the recent trend being of bow and arrow injuries. Ocular perforation was observed in 28 cases. On follow up of all the cases with ocular trauma, only 12 patients were found to have a visual acuity better than 6/18; perception of light was absent in 7 patients. A need for increased parental awareness and supervision of children is stressed upon.

  20. Specialized Diagnostic Investigations to Assess Ocular Status in Hypertensive Diseases of Pregnancy

    Rahul Navinchandra Bakhda


    Full Text Available This review describes specialized diagnostic investigations to assess ocular status in hypertensive diseases of pregnancy. Ocular assessment can aid in early detection for prompt multidisciplinary treatment, obstetric intervention and follow-up. The investigations accurately predict the possible causes of blindness in hypertensive diseases of pregnancy. The investigations include fluorescein angiography, ophthalmodynamometry, fluorophotometry, imaging modalities, OCT, ultrasonography, doppler velocimetry and blood chemistry analysis. The review includes a summary of imaging techniques and related recent developments to assess the neuro-ophthalmic aspects of the disease. The imaging modalities have been instrumental in understanding the complex neuropathophysiological mechanisms of eclamptic seizures. The importance of blood chemistry analysis in hypertensive diseases of pregnancy has been emphasized. The investigations have made a significant contribution in improving the standards of antenatal care and reducing maternal and fetal morbidity and mortality.

  1. Pattern of ocular trauma seen in Grarbet Hospital, Butajira, Central ...

    Bernt Lindtjorn

    Objective: To evaluate the epidemiology and outcome of ocular trauma cases presented to Grarbet Hospital in central. Ethiopia .... unknown. Alcohol or drug abuse leading to ocular injury ..... childhood: demography, etiology, and prevention.

  2. Short Term Effect of Exercise on Intraocular Pressure of Ocular ...

    Short Term Effect of Exercise on Intraocular Pressure of Ocular Hypertensive Subjects. ... AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search ... Keywords: Intraocular pressure; short term exercise; ocular hypertension.

  3. Differential roles for endothelial ICAM-1, ICAM-2, and VCAM-1 in shear-resistant T cell arrest, polarization, and directed crawling on blood-brain barrier endothelium.

    Steiner, Oliver; Coisne, Caroline; Cecchelli, Roméo; Boscacci, Rémy; Deutsch, Urban; Engelhardt, Britta; Lyck, Ruth


    Endothelial ICAM-1 and ICAM-2 were shown to be essential for T cell diapedesis across the blood-brain barrier (BBB) in vitro under static conditions. Crawling of T cells prior to diapedesis was only recently revealed to occur preferentially against the direction of blood flow on the endothelial surface of inflamed brain microvessels in vivo. Using live cell-imaging techniques, we prove that Th1 memory/effector T cells predominantly crawl against the direction of flow on the surface of BBB endothelium in vitro. Analysis of T cell interaction with wild-type, ICAM-1-deficient, ICAM-2-deficient, or ICAM-1 and ICAM-2 double-deficient primary mouse brain microvascular endothelial cells under physiological flow conditions allowed us to dissect the individual contributions of endothelial ICAM-1, ICAM-2, and VCAM-1 to shear-resistant T cell arrest, polarization, and crawling. Although T cell arrest was mediated by endothelial ICAM-1 and VCAM-1, T cell polarization and crawling were mediated by endothelial ICAM-1 and ICAM-2 but not by endothelial VCAM-1. Therefore, our data delineate a sequential involvement of endothelial ICAM-1 and VCAM-1 in mediating shear-resistant T cell arrest, followed by endothelial ICAM-1 and ICAM-2 in mediating T cell crawling to sites permissive for diapedesis across BBB endothelium.

  4. A locked nucleic acid (LNA-based real-time PCR assay for the rapid detection of multiple bacterial antibiotic resistance genes directly from positive blood culture.

    Lingxiang Zhu

    Full Text Available Bacterial strains resistant to various antibiotic drugs are frequently encountered in clinical infections, and the rapid identification of drug-resistant strains is highly essential for clinical treatment. We developed a locked nucleic acid (LNA-based quantitative real-time PCR (LNA-qPCR method for the rapid detection of 13 antibiotic resistance genes and successfully used it to distinguish drug-resistant bacterial strains from positive blood culture samples. A sequence-specific primer-probe set was designed, and the specificity of the assays was assessed using 27 ATCC bacterial strains and 77 negative blood culture samples. No cross-reaction was identified among bacterial strains and in negative samples, indicating 100% specificity. The sensitivity of the assays was determined by spiking each bacterial strain into negative blood samples, and the detection limit was 1-10 colony forming units (CFU per reaction. The LNA-qPCR assays were first applied to 72 clinical bacterial isolates for the identification of known drug resistance genes, and the results were verified by the direct sequencing of PCR products. Finally, the LNA-qPCR assays were used for the detection in 47 positive blood culture samples, 19 of which (40.4% were positive for antibiotic resistance genes, showing 91.5% consistency with phenotypic susceptibility results. In conclusion, LNA-qPCR is a reliable method for the rapid detection of bacterial antibiotic resistance genes and can be used as a supplement to phenotypic susceptibility testing for the early detection of antimicrobial resistance to allow the selection of appropriate antimicrobial treatment and to prevent the spread of resistant isolates.

  5. Alterações oculares em pacientes com tuberculose Ocular manifestation in patients with tuberculosis

    Simone Ribeiro Araújo de Almeida


    Full Text Available OBJETIVO: Analisar os achados clínicos da tuberculose ocular e seus aspectos epidemiológicos. MÉTODOS: Foram revisados prontuários médicos de pacientes que foram atendidos no Departamento de Oftalmologia - setor de Uveíte e AIDS da Unifesp-EPM, São Paulo, Brasil, entre janeiro de 1999 e julho de 2002 e que tiveram diagnóstico de tuberculose ocular. Foram inclusos os pacientes que apresentaram PPD forte reator, epidemiologia positiva para tuberculose e lesão ocular que melhorou com tratamento específico. RESULTADOS: Foram analisados prontuários médicos de 17 pacientes, sendo 12 (70,6% do sexo feminino. A idade média foi de 54 (24-84 anos. O tempo médio entre o início dos sintomas e a primeira consulta foi de 100 dias. Os achados oculares foram inespecíficos nesta ocasião mas prevaleceram as alterações de segmento anterior e 41% dos pacientes apresentavam sinais de tuberculose sistêmica. Alterações como glaucoma, descolamento de retina e hemorragia vítrea foram responsáveis pela redução da acuidade visual. CONCLUSÃO: Embora pouco prevalente, a tuberculose ocular apresenta morbidade elevada. A inespecificidade da apresentação clínica da doença ocular pode atrasar o seu diagnóstico.PURPOSE: To analyze clinical findings of ocular tuberculosis and its epidemiological features. METHODS: Were reviewed clinical files of patients who attended the Ophthalmology - Uveitis and AIDS sector of UNIFESP-EPM, São Paulo, Brazil between January 1999 and July 2002 and had a diagnosis of ocular tuberculosis. Patients who had Mantoux test higher than 10 mm, epidemiological history of tuberculosis and ocular findings that improved after specific treatment were included. RESULTS: Seventeen medical files were analyzed, of those, 12 (70,6% were females. The mean age was 54 (24-84 years. The average time between symptoms and diagnosis was 100 days. Ocular findings at the first interview were multiple but most were at the anterior segment of

  6. Clinical and allergological analysis of ocular manifestations of sick building syndrome

    Saeki, Yusuke; Kadonosono, Kazuaki; Uchio, Eiichi


    Purpose The disease concept of sick building syndrome (SBS) is still unclear. Ocular mucous membrane irritation is one of the major symptoms of SBS. However, the immunological aspects of the ocular complications of SBS are not yet clarified. The clinical and allergological aspects of SBS cases with ocular disorders with special reference to allergic conjunctival diseases (ACD) were analyzed, especially with respect to local immunological features. Methods Twelve cases of SBS with ocular findings and 49 cases of ACD (allergic conjunctivitis [AC], atopic keratoconjunctivitis [AKC], and vernal keratoconjunctivitis [VKC]) for comparison were evaluated. The clinical findings in SBS and ACD were scored, and tear film breakup time (BUT) was measured. Cytokine (interferon-γ [IFN-γ], interleukin [IL]-2, IL-4, IL-5, IL-6, IL-8, and IL-13) concentrations in tears were analyzed by cytometric bead arrays. Eosinophil count in peripheral blood, total IgE in serum, and multiple allergen simultaneous test (MAST) for antigen-specific IgE were also measured. Results In SBS, conjunctival lesions were observed in all cases, and corneal abnormalities were found in two-thirds of the cases. Limbal lesions were observed in 2 pediatric cases. Mean serum total IgE level in SBS was significantly higher than that in AC; however, it was significantly lower than that in AKC and VKC. Eosinophil count in peripheral blood and number of positive allergens in MAST were significantly lower in SBS than in AKC and VKC. Significant elevation of tear IL-4 was observed in SBS and ACD. However, in contrast to ACD, elevation of other cytokines in tears was not observed in SBS. Mean tear BUT in SBS was in the normal range. Conclusion From these results, SBS is thought to be partially induced by an allergic response. However, clinical dissociation of the ocular clinical findings and local immunological features in tear cytokines may suggest that SBS belongs to a different entity from ACD. PMID:28352150

  7. Experimental Models of Ocular Infection with Toxoplasma Gondii


    Ocular toxoplasmosis is a vision-threatening disease and the major cause of posterior uveitis worldwide. In spite of the continuing global burden of ocular toxoplasmosis, many critical aspects of disease including the therapeutic approach to ocular toxoplasmosis are still under debate. To assist in addressing many aspects of the disease, numerous experimental models of ocular toxoplasmosis have been established. In this article, we present an overview on in vitro, ex vivo, and in vivo models ...

  8. Ocular toxoplasmosis: an update and review of the literature

    Alessandra G Commodaro


    Full Text Available Ocular toxoplasmosis is the most common cause of posterior uveitis worldwide. The infection can be acquired congenitally or postnatally and ocular lesions may present during or years after the acute infection occur. Current treatment controls ocular infection and inflammation, but does not prevent recurrences. We present a review and update on ocular toxoplasmosis and address misconceptions still found in the current medical literature.

  9. Toxocariosis Ocular en Menores de Edad

    Norma Ocampo; Liliam Cañas; Marta Hurtado; Jorge Botero; Mónica Lopera


    La toxocariosis es una geohelmintiosis producida por la ingestión de
    huevos de Toxocara canis y T. catis, cuyos hospederos definitivos son el perro y el gato. En el humano las larvas producen el Síndrome de Migración Larvaria Visceral y Ocular; en este último produce una enfermedad grave que puede semejar un retinoblastoma (1,2). Los niños son más susceptibles a adquirir esta infección (3). Nuestro objetivo es determinar la frecuencia de toxocariosis ocular en menores de edad con s...

  10. New Developments in Ocular Surface Squamous Neoplasia

    Ayşe Yağcı


    Full Text Available Ocular surface squamous neoplasia originates from conjunctiva epithelium and covers a broad spectrum of disease ranging from dysplasia to squamous cell carcinoma. Clinical features may vary from case to case. Traditional treatment of excision with no-touch technique combined with adjuvant therapies because of high recurrence rate. Main adjuvant treatments are cryotherapy and chemotherapy. In this review, clinical forms, differential diagnosis, American Joint Committee on Cancer classification and recent approaches to the management of ocular surface squamous dysplasia were described. (Turk J Ophthalmol 2014; 44: Supplement 8-14

  11. Emerging ocular biomarkers of Alzheimer disease.

    van Wijngaarden, Peter; Hadoux, Xavier; Alwan, Mostafa; Keel, Stuart; Dirani, Mohamed


    Interest in reliable biomarkers of Alzheimer disease, the leading cause of dementia, has been fuelled by challenges in diagnosing the disease and monitoring disease progression as well as the response to therapy. A range of ocular manifestations of Alzheimer disease, including retinal and lens amyloid-beta accumulation, retinal nerve fiber layer loss, and retinal vascular changes, have been proposed as potential biomarkers of the disease. Herein, we examine the evidence regarding the potential value of these ocular biomarkers of Alzheimer disease. © 2016 Royal Australian and New Zealand College of Ophthalmologists.


    Tessie Beck Martins


    Esta tese envolveu o estudo de doenças oculares e perioculares de animais domésticos, e incluiu um artigo sobre lesões de patologia cirúrgica e um artigo sobre hifema em cães e gatos submetidos à necropsia. Para o primeiro trabalho, foram examinados 33.075 laudos de exames histopatológicos realizados num laboratório de diagnóstico de patologia veterinária na Região Central do Rio Grande do Sul durante 50 anos. Destes, 540 (1,6%) eram de lesões oculares e perioculares. Por vária...

  13. Psychological aspects in ocular prosthesis users


    OBJETIVO: Avaliar os aspectos psicológicos decorrentes da anoftalmia unilateral adquirida, a luta pela recuperação estética com o uso de prótese ocular, assim como os fatores interpessoais envolvidos e a reintegração psicossocial destes pacientes. MÉTODO: Trinta pacientes portadores de anoftalmia unilateral adquirida, sem outras deformidades órbito-palpebrais e usuários de prótese ocular, sendo 16 do sexo masculino e 14 feminino, com idade variando de 12 a 66 anos, idade média 31,6 anos foram...

  14. Genetics in ocular inflammation--basic principles.

    Wallace, G R; Niemczyk, E


    The ability to identify individuals at risk of ocular disease, or to determine the potential severity of disease or response to therapy is the current focus of much research. These studies are being led by genetic analysis of individuals to determine associations with alterations in gens that may explain manifestations of particular diseases. In this review we consider the basic principles behind genetic studies in general and of ocular disease in particular. We address the methodologies being utilised, and the results derived so far. The potential and pitfalls of such studies are relevant to the concept of personalised medicine and better defined clinical trials.

  15. Modeling of mouse eye and errors in ocular parameters affecting refractive state

    Bawa, Gurinder

    Rodents eye are particularly used to study refractive error state of an eye and development of refractive eye. Genetic organization of rodents is similar to that of humans, which makes them interesting candidates to be researched upon. From rodents family mice models are encouraged over rats because of availability of genetically engineered models. Despite of extensive work that has been performed on mice and rat models, still no one is able to quantify an optical model, due to variability in the reported ocular parameters. In this Dissertation, we have extracted ocular parameters and generated schematics of eye from the raw data from School of Medicine, Detroit. In order to see how the rays would travel through an eye and the defects associated with an eye; ray tracing has been performed using ocular parameters. Finally we have systematically evaluated the contribution of various ocular parameters, such as radii of curvature of ocular surfaces, thicknesses of ocular components, and refractive indices of ocular refractive media, using variational analysis and a computational model of the rodent eye. Variational analysis revealed that variation in all the ocular parameters does affect the refractive status of the eye, but depending upon the magnitude of the impact those parameters are listed as critical or non critical. Variation in the depth of the vitreous chamber, thickness of the lens, radius of the anterior surface of the cornea, radius of the anterior surface of the lens, as well as refractive indices for the lens and vitreous, appears to have the largest impact on the refractive error and thus are categorized as critical ocular parameters. The radii of the posterior surfaces of the cornea and lens have much smaller contributions to the refractive state, while the radii of the anterior and posterior surfaces of the retina have no effect on the refractive error. These data provide the framework for further refinement of the optical models of the rat and mouse

  16. Tick-borne encephalitis virus sequenced directly from questing and blood-feeding ticks reveals quasispecies variance.

    Asghar, Naveed; Lindblom, Pontus; Melik, Wessam; Lindqvist, Richard; Haglund, Mats; Forsberg, Pia; Överby, Anna K; Andreassen, Åshild; Lindgren, Per-Eric; Johansson, Magnus


    The increased distribution of the tick-borne encephalitis virus (TBEV) in Scandinavia highlights the importance of characterizing novel sequences within the natural foci. In this study, two TBEV strains: the Norwegian Mandal 2009 (questing nymphs pool) and the Swedish Saringe 2009 (blood-fed nymph) were sequenced and phylogenetically characterized. Interestingly, the sequence of Mandal 2009 revealed the shorter form of the TBEV genome, similar to the highly virulent Hypr strain, within the 3' non-coding region (3'NCR). A different genomic structure was found in the 3'NCR of Saringe 2009, as in-depth analysis demonstrated TBEV variants with different lengths within the poly(A) tract. This shows that TBEV quasispecies exists in nature and indicates a putative shift in the quasispecies pool when the virus switches between invertebrate and vertebrate environments. This prompted us to further sequence and analyze the 3'NCRs of additional Scandinavian TBEV strains and control strains, Hypr and Neudoerfl. Toro 2003 and Habo 2011 contained mainly a short (A)3C(A)6 poly(A) tract. A similar pattern was observed for the human TBEV isolates 1993/783 and 1991/4944; however, one clone of 1991/4944 contained an (A)3C(A)11 poly(A) sequence, demonstrating that quasispecies with longer poly(A) could be present in human isolates. Neudoerfl has previously been reported to contain a poly(A) region, but to our surprise the re-sequenced genome contained two major quasispecies variants, both lacking the poly(A) tract. We speculate that the observed differences are important factors for the understanding of virulence, spread, and control of the TBEV.

  17. Degenerative effects in rat eyes after experimental ocular hypertension

    G. Scarsella


    Full Text Available This study was used to evaluate the degenerative effects on the retina and eye-cup sections after experimental induction of acute ocular hypertension on animal models. In particular, vascular events were directly focused in this research in order to assess the vascular remodeling after transient ocular hypertension on rat models. After local anaesthesia by administration of eye drops of 0.4% oxibuprocaine, 16 male adult Wistar rats were injected in the anterior chamber of the right eye with 15 µL of methylcellulose (MTC 2% in physiological solution. The morphology and the vessels of the retina and eye-cup sections were examined in animals sacrificed 72 h after induction of ocular hypertension. In retinal fluorescein angiographies (FAGs, by means of fluorescein isothiocyanate-coniugated dextran (FITC, the radial venules showed enlargements and increased branching, while the arterioles appeared focally thickened. The length and size of actually perfused vessels appeared increased in the whole superficial plexus. In eye-cup sections of MTC-injected animals, in deep plexus and connecting layer there was a bigger increase of vessels than in controls. Moreover, the immunolocalization of astrocytic marker glial fibrillary acidic protein (GFAP revealed its increased expression in internal limiting membrane and ganglion cell layer, as well as its presence in Müller cells. Finally, the pro-angiogenic factor vascular endothelial growth factor (VEGF was found to be especially expressed by neurones of ganglion cell layer, both in control and in MTC-injected eyes. The data obtained in this experimental model on the interactions among glia, vessels and neurons should be useful to evaluate if also in glaucomatous patients the activation of vessel-adjacent glial cells might play key roles in following neuronal dysfunction.

  18. Comments on frontonasal dysplasia, ocular hypertelorism and dystopia canthorum.

    Peterson, M Q; Cohen, M M; Sedano, H O; Frerichs, C T


    The mean canthal index values of patients with frontonasal dysplasia are tested for differences in facies A, B, C, and D. A general discussion of ocular hypertelorism and dystopia canthorum is presented. Ocular hypertelorism is considered a sign which may occur in a variety of disorders. Quantitative methods for determining ocular hypertelorism are critically reviewed.

  19. 21 CFR 886.4360 - Ocular surgery irrigation device.


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ocular surgery irrigation device. 886.4360 Section... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4360 Ocular surgery irrigation device. (a) Identification. An ocular surgery irrigation device is a device intended to be suspended over...

  20. Ocular Complications in Survivors of the Ebola Outbreak in Guinea.

    Hereth-Hebert, Esther; Bah, Mamadou Oury; Etard, Jean François; Sow, Mamadou Saliou; Resnikoff, Serge; Fardeau, Christine; Toure, Abdoulaye; Ouendeno, Alexis Niouma; Sagno, Isaac Ceougna; March, Laura; Izard, Suzanne; Lama, Pierre Louis; Barry, Moumié; Delaporte, Eric


    The Ebola outbreak of 2013-2016 severely affected West Africa and resulted in 2544 deaths and 1270 survivors in Guinea, the country where it began. This Ebola virus was the Zaire strain of the virus family Filoviridae. In this outbreak the case fatality rate was about 67%. The survivors, declared cured after 2 negative blood polymerase chain reaction (PCR) results, face psychosocial disorders and rheumatic, ear-nose-throat, neurocognitive, and ophthalmologic complications. The goal of this study was to detect and describe ocular complications afflicting these survivors and to observe their occurrence and recurrences. Prospective observational cohort study. This prospective observational multicenter cohort study was initiated in March 2015. The cohort study included 341 survivors followed up in the infectious disease ward of Conakry, Forecariah, and Nzérékoré as of May 2016. The patients received multidisciplinary medical follow-up expected to last at least 1 year that included an eye examination as part of complete, free treatment. Systematic examination of 341 patients revealed 46 cases of uveitis (13.5%), 6 cases of episcleritis (1.8%), and 3 cases of interstitial keratitis (0.9%). Uveitis was most frequently unilateral (78.3%) and anterior (47.8%) and occurred within the 2 months after discharge from the Ebola treatment center. Moreover, uveitis relapses were found up to 13 months after the negative PCR result for Ebola in the blood. Nearly 1 out of 6 survivors presented ocular disorders after discharge from the Ebola treatment center. An ophthalmologic follow-up for Ebola-infected patients should start, if possible, during the acute phase of the disease and last more than 1 year. Treatment guidelines need to be urgently developed and implemented. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Performance Evaluation of the Verigene Gram-Positive and Gram-Negative Blood Culture Test for Direct Identification of Bacteria and Their Resistance Determinants from Positive Blood Cultures in Hong Kong.

    Gilman K H Siu

    Full Text Available A multicenter study was conducted to evaluate the diagnostic performance and the time to identifcation of the Verigene Blood Culture Test, the BC-GP and BC-GN assays, to identify both Gram-positive and Gram-negative bacteria and their drug resistance determinants directly from positive blood cultures collected in Hong Kong.A total of 364 blood cultures were prospectively collected from four public hospitals, in which 114 and 250 cultures yielded Gram-positive and Gram-negative bacteria, and were tested with the BC-GP and BC-GN assay respectively. The overall identification agreement for Gram-positive and Gram-negative bacteria were 89.6% and 90.5% in monomicrobial cultures and 62.5% and 53.6% in polymicrobial cultures, respectively. The sensitivities for most genus/species achieved at least 80% except Enterococcus spp. (60%, K.oxytoca (0%, K.pneumoniae (69.2%, whereas the specificities for all targets ranged from 98.9% to 100%. Of note, 50% (7/14 cultures containing K.pneumoniae that were missed by the BC-GN assay were subsequently identified as K.variicola. Approximately 5.5% (20/364 cultures contained non-target organisms, of which Aeromonas spp. accounted for 25% and are of particular concern. For drug resistance determination, the Verigene test showed 100% sensitivity for identification of MRSA, VRE and carbapenem resistant Acinetobacter, and 84.4% for ESBL-producing Enterobacteriaceae based on the positive detection of mecA, vanA, blaOXA and blaCTXM respectively.Overall, the Verigene test provided acceptable accuracy for identification of bacteria and resistance markers with a range of turnaround time 40.5 to 99.2 h faster than conventional methods in our region.

  2. Eclectic Ocular Comorbidities and Systemic Diseases with Eye Involvement: A Review

    María D. Pinazo-Durán


    Full Text Available Coexistence of several ocular diseases is more frequent than suspected. In spite of the refractive errors, one or more of the following can be detected simultaneously: glaucoma, cataracts, uveitis, age-related macular degeneration, and dry eyes. In addition, as people age, ocular comorbidities are much more usually seen. Specific diseases are openly acknowledged to affect the eyes and vision, such as diabetes mellitus, hypertension blood pressure, arthritis, hyperthyroidism, neurodegenerative disorders, hematologic malignancies, and/or systemic infections. Recent advances in early diagnosis and therapy of the ophthalmic pathologies have reinforced patient options to prevent visual impairment and blindness. Because of this, it is essential not to overlook sight-threatening conditions such as the ocular comorbidities and/or the eye involvement in the context of systemic disorders. Moreover, the important role of the multidisciplinary cooperation to improve and sustain management of patients affected with eclectic ocular comorbidities and/or systemic disorders with eye repercussion is specifically addressed. This review intends to shed light on these topics to help in making opportune diagnosis and appropriately managing the affected patients.


    Srinivasan Shanmugam


    Full Text Available BACKGROUND Headache or cephalgia is one of the commonest symptoms causing pain in head above eyes or the ears, behind the head in the occipital region or in the back of the upper neck causing pain as well as disability to an individual. WHO reports around 47% of adults worldwide will have experienced headache in the last year. Headache maybe primary or secondary. Tension headache is more common type of primary headache. Almost, 90% of adults have tension headache and it is more common in females than males. Migraine headache is third most prevalent disorder worldwide and ranked as seventh highest cause of disability. Migraine headaches are the second most common type of primary headaches, whereas cluster headache, a relatively uncommon type of primary headache affecting less than 1 in every 1000 adults. 1 Many people suffer from mixed headache disorder in which tension headache or secondary headache may trigger migraine. Headache on 15 or more days in every month affects 1.7-4% of the world adult population. Hospital-based studies of migraine shows India is home over 16% of world inhabitants suffering from migraine. MATERIALS AND METHODS In our study, total screening of 1200 cases was done with headache symptomatology reported to Eye OPD directly as well as referred from ENT, Medical, NeuroMedical, Surgical, Neurosurgical, Psychiatry, Orthopaedics and Trauma Ward. A detailed clinical examination and ophthalmological examination was done in 1200 cases. RESULTS Sexual prevalence in our study indicated female with increased prevalence of 46.67% compared to male of 36%. Among 30 cases of migrainous headache with or without aura, the sexual prevalence in our study has female-to-male ratio as 2:1 (female - 20 cases and male - 10 cases. No cluster headache disorder was reported in our study. Among the tension headache presented with ocular manifestations like association of the refractive error, redness, burning sensation, the female prevalence among

  4. Revascularization and tissue regeneration of an empty root canal space is enhanced by a direct blood supply and stem cells.

    Srisuwan, Tanida; Tilkorn, Daniel J; Al-Benna, Sammy; Abberton, Keren; Messer, Harold H; Thompson, Erik W


    Regenerative endodontics is an innovative treatment concept aiming to regenerate pulp, dentin and root structures. In the diseased or necrotic tooth, the limitation in vascular supply renders successful tissue regeneration/generation in a whole tooth challenging. The aim of this study is to evaluate the ability of vascularized tissue to develop within a pulpless tooth using tissue engineering techniques. A pulpless tooth chamber, filled with collagen I gel containing isolated rat dental pulp cells (DPC) and angiogenic growth factors, was placed into a hole created in the femoral cortex or into its own tooth socket, respectively. The gross, histological and biochemical characteristics of the de novo tissue were evaluated at 4 and 8 weeks post-transplantation. Tooth revascularization and tissue generation was observed only in the femur group, confirming the important role of vascular supply in tissue regeneration. The addition of cells and growth factors significantly promoted connective tissue production in the tooth chamber. Successful revascularization and tissue regeneration in this model demonstrate the importance of a direct vascular supply and the advantages of a stem cell approach. © 2012 John Wiley & Sons A/S.

  5. Systematic analysis of ocular trauma by a new proposed ocular trauma classification

    Bhartendu Shukla


    Full Text Available Purpose: The current classification of ocular trauma does not incorporate adnexal trauma, injuries that are attributable to a nonmechanical cause and destructive globe injuries. This study proposes a new classification system of ocular trauma which is broader-based to allow for the classification of a wider range of ocular injuries not covered by the current classification. Methods: A clinic-based cross-sectional study to validate the proposed classification. We analyzed 535 cases of ocular injury from January 1, 2012 to February 28, 2012 over a 4-year period in an eye hospital in central India using our proposed classification system and compared it with conventional classification. Results: The new classification system allowed for classification of all 535 cases of ocular injury. The conventional classification was only able to classify 364 of the 535 trauma cases. Injuries involving the adnexa, nonmechanical injuries and destructive globe injuries could not be classified by the conventional classification, thus missing about 33% of cases. Conclusions: Our classification system shows an improvement over existing ocular trauma classification as it allows for the classification of all type of ocular injuries and will allow for better and specific prognostication. This system has the potential to aid communication between physicians and result in better patient care. It can also provide a more authentic, wide spectrum of ocular injuries in correlation with etiology. By including adnexal injuries and nonmechanical injuries, we have been able to classify all 535 cases of trauma. Otherwise, about 30% of cases would have been excluded from the study.

  6. Ocular Immune Privilege in the Year 2010: Ocular Immune Privilege and Uveitis

    Taylor, Andrew W.; Kaplan, Henry J.


    The phrase “immune privilege” was coined by Peter Medawar to describe the absence of an immune response to allografts placed into the anterior chamber of the eye or brain. We now understand that immune privilege is more than a passive microenvironment with a distinctive anatomical structure that holds back immunity. The ocular microenvironment actively engages the immune system with immunosuppressive biochemical mechanisms. The unique characteristics of ocular immune privilege appear designed...

  7. DNA nanoparticles as ocular drug delivery platform

    de Vries, Jan Willem


    The field of DNA nanotechnology has progressed rapidly in recent years and now offers facile fabrication of a large variety of nanostructures of different shapes and geometries. In this thesis, short nucleic acid sequences are functionalized with hydrophobic units to form the basis of an ocular drug

  8. Pattern of Ocular Injuries in Owo, Nigeria

    Charles Oluwole Omolase


    Full Text Available Purpose: To determine the pattern of ocular injuries in patients presenting to the eye clinic and the accident and emergency department of Federal Medical Center, Owo, Ondo State, Nigeria. Methods: This prospective study was conducted between January and December 2009. Federal Medical Center, Owo is the only tertiary hospital in Ondo State, Nigeria. The eye center located at this medical center was the only eye care facility in the community at the time of this study. All patients were interviewed with the aid of an interviewer-administered questionnaire and underwent a detailed ocular examination. Results: Of 132 patients included in the study, most (84.1% sustained blunt eye injury while (12.1% had penetrating eye injury. A considerable proportion of patients (37.9% presented within 24 hours of injury. Vegetative materials were the most common (42.4% offending agent, a minority of patients (22% was admitted and none of the patients had used eye protection at the time of injury. Conclusion: In the current series, blunt eye injury was the most common type of ocular trauma. The community should be educated and informed about the importance of preventive measures including protective eye devices during high risk activities. Patients should be encouraged to present early following ocular injury.

  9. Ocular malignant lymphoma. A clinical pathological study

    Panda A


    Full Text Available Eleven histologically proved cases of ocular malignant lymphoma diagnosed and managed during the year 1974-81 are reported. The follow-up period ranges from 2-7 years. The difficulties in diagnosis, treatment and prognosis are discussed.

  10. Ocular myasthenia gravis coincident with thyroid ophthalmopathy

    Yaman A


    Full Text Available Graves' disease and myasthenia gravis are both auto-immune diseases and the coexistence of these two diseases is well recognized. Myasthenia gravis is more frequent in patients with thyroid disease. Here we present a case of thyroid ophthalmopathy and ocular myasthenia.

  11. Candidate genes in ocular dominance plasticity

    M.L. Rietman; J.-P. Sommeijer; C.N. Levelt; J.A. Heimel; A.B. Brussaard; J.G.G. Borst; Y. Elgersma; N. Galjart; G.T. van der Horst; C.M. Pennartz; A.B. Smit; B.M. Spruijt; M. Verhage; C.I. de Zeeuw


    Many studies have been devoted to the identification of genes involved in experience-dependent plasticity in the visual cortex. To discover new candidate genes, we have reexamined data from one such study on ocular dominance (OD) plasticity in recombinant inbred BXD mouse strains. We have correlated

  12. Ocular rosacea: common and commonly missed.

    Vieira, Ana Carolina; Mannis, Mark J


    Rosacea is a prevalent disorder that may be disfiguring and cause significant ocular morbidity, if not diagnosed and managed appropriately. Ocular rosacea, in particular, is often left undiagnosed as no specific test is available to confirm the diagnosis. Accurate diagnosis is further complicated because symptoms of ocular rosacea are not always specific to the disorder alone. Other ophthalmic disorders may present with similar findings. Further challenges exist because the severity of ocular symptoms is often not related to the severity of cutaneous findings in rosacea. Isolating a disease marker may facilitate earlier diagnosis and treatment, and could also contribute to better understanding of disease pathogenesis. The glycomics of tear fluid and saliva in patients with rosacea shows promise as an initial step in the search for a biomarker specific to the disease. We have previously found potentially important disease biomarkers in roseatic tear and saliva samples. Further investigation should prove important in the early stages of developing a set of markers for accurate disease identification.

  13. Ocular surface squamous neoplasia in Ibadan, Nigeria

    Oluyemi Fasina


    Conclusion: OSSN occurs in younger individuals, and is strongly associated with HIV infection in our environment. Early diagnosis and intervention can prevent severe ocular morbidity. Wide surgical excision with intra-operative cryotherapy and adjuvant treatment with topical MMC post-operatively seem to give good outcome in our patients.

  14. Ocular findings in the chronic renal failure

    P Dahal


    Full Text Available BACKGROUND The aim of the study was to evaluate the ocular signs in chronic renal failure (CRF in diabetes and hypertensive patients. MATERIALS AND METHODS Two hundred and thirty eight cases were enrolled in the study from the nephrology unit of College Of Medical Science, Bharatpur, Nepal and examined in the department of Ophthalmology. The study duration was carried out over 2 years from January 2011 to December 2012. RESULT The number of cases in each grade of CRF were mild 80 (26.67%, moderate 84 (28%, severe 75 (25%, end stage renal disease 61 (20.33%. In all the groups the commonest cause of CRF were Hypertension (HTN 123 out of 300(41% and diabetes 98(32.67%. The commonest ocular symptoms in CRF was blurring of vision 68%. CONCLUSION Many important ocular findings like vitreous haemorrage, retinal detachment, neovascular glaucoma and cataract are the presentation in chronic renal failure, which can cause marked vision loss. Hence proper awareness should be provided to the people in time to prevent these ocular complications.DOI: Journal of College of Medical Sciences-Nepal, 2014, Vol.10(2; 18-26

  15. Main Ocular Manifestations in Rheumatoid Arthritis Principales manifestaciones oculares en la artritis reumatoide

    Osbel Alfonso Sánchez


    Full Text Available Rheumatoid arthritis is considered an autoimmune disease in which articular and extra articular manifestations are produced and contribute to alter the functional capacity of the individual. This study consists on performing a bibliographical review showing the main ocular manifestations in patients with rheumatoid arthritis. It is our purpose to give you our experiences to the students as well as the internal medicine, ophthalmology and rheumatologist residents about this topic. The ophthalmological consultation of sick patients contributes to the prevention of ocular illnesses which are characteristic of the base disease and improve the ocular health.La artritis reumatoide se considera una enfermedad autoinmune, la cual produce manifestaciones articulares y extraarticulares que contribuyen a alterar la capacidad funcional del individuo. En esta revisión se muestran las principales manifestaciones oculares en pacientes con diagnóstico de dicha enfermedad. Se describen experiencias válidas para estudiantes y residentes de medicina interna, oftalmología y reumatología y se realiza la valoración de la interconsulta oftalmológica de los pacientes enfermos en la prevención de afecciones oculares propias de la enfermedad de base y su contribución al mejoramiento de su salud ocular.

  16. Diffuse corneal abrasion after ocular exposure to laundry detergent pod.

    Whitney, Rachel E; Baum, Carl R; Aronson, Paul L


    Although ocular injury from alkaline household cleaning products is well described, there is less known about the significance and extent of injury with ocular exposure to detergent pods. We report a 12-month-old with diffuse corneal abrasion caused by ocular contact with a laundry detergent pod. In addition to the known risks with aspiration with detergent pods, the potential for severe ocular injury is important for parents and clinicians to recognize. Children with ocular exposure to detergent pods should seek immediate medical care.

  17. MALDI-TOF identification of Gram-negative bacteria directly from blood culture bottles containing charcoal: Sepsityper® kits versus centrifugation-filtration method.

    Riederer, Kathleen; Cruz, Kristian; Shemes, Stephen; Szpunar, Susan; Fishbain, Joel T


    Matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry has dramatically altered the way microbiology laboratories identify clinical isolates. Direct blood culture (BC) detection may be hampered, however, by the presence of charcoal in BC bottles currently in clinical use. This study evaluates an in-house process for extraction and MALDI-TOF identification of Gram-negative bacteria directly from BC bottles containing charcoal. Three hundred BC aliquots were extracted by a centrifugation-filtration method developed in our research laboratory with the first 96 samples processed in parallel using Sepsityper® kits. Controls were colonies from solid media with standard phenotypic and MALDI-TOF identification. The identification of Gram-negative bacteria was successful more often via the in-house method compared to Sepsityper® kits (94.7% versus 78.1%, P≤0.0001). Our in-house centrifugation-filtration method was further validated for isolation and identification of Gram-negative bacteria (95%; n=300) directly from BC bottles containing charcoal.

  18. Doenças oculares em neonatos

    Endriss Daniela


    Full Text Available Objetivo: Identificar as principais doenças oculares numa população de neonatos assistidos pelo Sistema Único de Saúde em maternidades de referência no Estado de Pernambuco, orientando o seguimento e tratamento necessário. Métodos: Realizou-se estudo de corte transversal numa população de recém-nascidos em três maternidades públicas, no período de abril a outubro de 2000. Procedeu-se ao exame oftalmológico durante visitas semanais, orientando-se o seguimento e tratamento dos casos com alterações oculares ou fatores de risco. Resultados: Examinaram-se 3280 recém-nascidos: 1403 (42,8% na Maternidade da Encruzilhada (CISAM, 1232 (37,5% na Maternidade do Hospital Barão de Lucena (MHBL e 645 (19,7% na Maternidade do Hospital Agamenon Magalhães (MHAM. 387 eram pré-termo (11,8% dos casos. Encaminharam-se ao serviço especializado 701 neonatos (21,4% do total examinado com alterações oculares ou com fatores de risco. Destes, 46,4% eram pré-têrmo e 37,9% receberam oxigenoterapia, observando-se maior número porcentual na MHBL (45,4%. Observou-se conjuntivite em 3,0% dos olhos, leucocoria em 0,4% e hemorragia subconjuntival em 2,0%. À fundoscopia, encontraram-se hemorragias retinianas em 7,8% dos casos, com acometimento macular em 4,3%. Conclusões: As doenças oculares mais freqüentes foram: hemorragias retinianas e conjuntivites. Os principais fatores de risco observados foram: prematuridade e doenças infecciosas neonatais. Os autores enfatizam que o exame ocular deve ser realizado rotineiramente nos neonatos.


    Janićijević Katarina


    Full Text Available Introduction/Aim: The goal of our study was to analyze the epidemiological`s characteristics of ocular hypertension, as well as the influence of chronic risk factors on glaucoma development (conversion in glaucoma. We tried to make some entries for solving this complex ophthalmological problem. Material /Methods: From 2009 to 2015, a retrospective control study was performed on 121 patient with diagnoses of bilateral ocular hypertension and without disease progression/conversion of glaucoma (by standard protocols of diagnosis and basic procedures on tertiary level at Clinic of Ophthalmology, Clinical Centre of Kragujevac, Serbia.. The authors analyzed epidemiological characteristics: sex, age groups, positive/negative family history and personal history with chronic risk factors (one and/or two of ocular hypertension. The data obtained from this study were statistically analyzed in SPSS program, version 20.00. Results: As for the patients, 69 of them (57.02% were male and 52 female (42.98%. Dominant age group was between 40-49 (42.15% and then group between 50-59 (40.50% years of age. Anamnesis data indicated the absence of family anamnesis 71 (58.68%. Risk factors for ocular hypertension were presented in 103 (85.13% patients, 18 of them (14.87% did not respond. One risk factor - cardiovascular disease was noted in 83 (68.59%, with two risk factors - cardiovascular diseases and diabetes mellitus in 20 patients (16.53% and with PEX syndroma at other respondents. Conclusion: Ocular hypertension is not a common disease, but with risk factors, such as older age, positive family history, and chronic risk factors syndicated, represents a serious clinical and social problem, so the question remains for ophthalmologists - pro or against therapy? Those in favor of therapy would state the safety and protection from conversion/progression of glaucoma; but those  against therapy would only mention adequate monitoring of patients.

  20. Epidemiological aspects of ocular superglue injuries

    Seyed Ali Tabatabaei


    Full Text Available AIM: To report the frequency, associated risk factors and characteristics of cases referred to Farabi Eye Hospital with ocular superglue injuries. METHODS: In a descriptive cross-sectional study conducted between December 2012 and February 2013, patients with ocular superglue injuries were evaluated. Age, sex, educational level, location, time, mechanism, type, site and time of eye injury were gathered through interview using a customized questionnaire. All participants had given consent to undergo thorough eye examination. RESULTS: Over the course of three months, 105 patients with ocular superglue injuries enrolled in the study, including 56(53.3% men and 49(46.7% women with the mean age of 24.7±11.6 (range, 2 to 53y. The right eye, left eye and both eyes were involved in 52%, 42% and 6% of the patients, respectively. Most of injuries had occurred at home (72.4% and at night (55%. More than half of patients (52.4% did not take any primary aids following the ocular injury. Patient carelessness (78.1%, childhood curiosity and lack of parental supervision (11.4%, storing superglue in inappropriate places and inadvertently using superglue as eye drops due to poor vision (2.9%, inadequate awareness of superglue applications [used to stick on artificial nails (3.8%, artificial eyelashes (1.9% and broken tooth (1%] and being assaulted with glue (1% were common risk factors. CONCLUSION: The frequency of ocular superglue injuries in patients referred to Farabi Eye Hospital is relatively high. This finding underlines the importance of public education and awareness about superglue injuries to the eye and taking protective measures and safety strategies in order to prevent these injures.

  1. Congenital Ocular Dystopia from Orbitofrontal Bone Dysplasia.

    Swanson, Jordan W; Bartlett, Scott P


    Several patients with ocular dystopia and craniofacial differences have been found to have orbital dysplasia and a frontal bone defect. This deformity is characteristically different from differential diagnoses of encephalocele, sphenoid dysplasia, craniofacial dysostoses, or atypical clefting. The authors retrospectively reviewed the craniofacial registries of two pediatric centers for patients presenting with ocular dystopia or orbitofrontal anomalies between 2000 and 2014. The features and treatment of these patients were analyzed. Four patients with congenital orbitofrontal bone dysplasia were identified, three with unilateral and one with bilateral frontal bone defects. Clinical signs of hypoglobus and vertical ocular dystopia of an average of 5.0 mm on the affected side were noted shortly after birth. The transversely oriented bony defect had an average surface area of 3.9 cm in unilateral cases and 10.7 cm in bilateral cases. Patients showed a characteristic orbital vertical elongation with an average orbital height-to-width ratio of 1.30-in excess of the average normal 1.14 by 14 percent-and inferior rim displacement. Cranial contour demonstrated frontal bossing and borderline dolichocephaly. Fronto-orbital reconstruction was performed in three patients, using cranial bone grafting to obliterate the orbital roof defect and elevate the orbital floor, which was successful in reducing ocular dystopia and preserving vision in each patient. One patient followed for 11 years postoperatively has a durable result with no surgical revision. Orbitofrontal bone dysplasia has not been previously reported, and includes a frontal bone defect and ocular dystopia. Single-stage fronto-orbital reconstruction appears to adequately correct it. Therapeutic, IV.

  2. Ocular toxicity of authentic lunar dust

    Meyers Valerie E


    Full Text Available Abstract Background Dust exposure is a well-known occupational hazard for terrestrial workers and astronauts alike and will continue to be a concern as humankind pursues exploration and habitation of objects beyond Earth. Humankind’s limited exploration experience with the Apollo Program indicates that exposure to dust will be unavoidable. Therefore, NASA must assess potential toxicity and recommend appropriate mitigation measures to ensure that explorers are adequately protected. Visual acuity is critical during exploration activities and operations aboard spacecraft. Therefore, the present research was performed to ascertain the ocular toxicity of authentic lunar dust. Methods Small (mean particle diameter = 2.9 ± 1.0 μm, reactive lunar dust particles were produced by grinding bulk dust under ultrapure nitrogen conditions. Chemical reactivity and cytotoxicity testing were performed using the commercially available EpiOcularTM assay. Subsequent in vivo Draize testing utilized a larger size fraction of unground lunar dust that is more relevant to ocular exposures (particles Results In vitro testing indicated minimal irritancy potential based on the time required to reduce cell viability by 50% (ET50. Follow-up testing using the Draize standard protocol confirmed that the lunar dust was minimally irritating. Minor irritation of the upper eyelids was noted at the 1-hour observation point, but these effects resolved within 24 hours. In addition, no corneal scratching was observed using fluorescein stain. Conclusions Low-titanium mare lunar dust is minimally irritating to the eyes and is considered a nuisance dust for ocular exposure. No special precautions are recommended to protect against ocular exposures, but fully shielded goggles may be used if dust becomes a nuisance.

  3. Human ocular torsion during parabolic flights: an analysis with scleral search coil

    Cheung, B. S.; Money, K.; Howard, I.; Kirienko, N.; Johnson, W.; Lackner, J.; Dizio, P.; Evanoff, J.


    Rotation of the eyes about the visual axis is known as ocular torsion. A lateral inclination (a "roll") of the head induces ocular torsion in the opposite direction, a response known as ocular counterrolling. For six subjects, we recorded the static (head still) and dynamic (head in oscillatory roll motion) ocular torsion in normal 1 g condition and also during the microgravity and hypergravity periods of parabolic flight, using the electromagnetic scleral search coil technique. With the head still, the direction and magnitude of torsion that occurred in response to microgravity and hypergravity differed substantially from one individual to another, but there was a significant difference in torsional magnitude between the microgravity and hypergravity periods, for all static head positions including the upright position. Under normal 1 g conditions, counterrolling compensated for about 16% of (voluntary) static head roll, while dynamic counterroll was much larger, up to 36% of head roll at 0.55 Hz. With increasing frequency of head oscillation between 0.33 Hz and 0.55 Hz, the gain of counterrolling increased and there was no change in the phase relationship. The gain of dynamic counterroll (in response to voluntary head rolling) was not significantly less in hypogravity, suggesting that on the ground at these frequencies the contribution of gravity and gravity receptors to this reflex is redundant: this reflex is probably driven by the semicircular canals. In some subjects, the torsional displacement in microgravity is accompanied by micro-torsional oscillatory motion.

  4. Contribution of color signals to ocular following responses.

    Matsuura, Kiyoto; Kawano, Kenji; Inaba, Naoko; Miura, Kenichiro


    Ocular following responses (OFRs) are elicited at ultra-short latencies (signals in OFRs in monkeys. To make physiologically isoluminant sinusoidal color gratings, we estimated the physiologically isoluminant points using OFRs and found that the physiologically isoluminant points were nearly independent of the spatiotemporal frequency of the gratings. We recorded OFRs induced by the motion of physiologically isoluminant color gratings and found that OFRs elicited by the motion of color gratings had different spatiotemporal frequency tuning from those elicited by the motion of luminance gratings. Additionally, OFRs to isoluminant color gratings had smaller peak responses, suggesting that color signals weakly contribute to OFRs compared with luminance signals. OFRs to the motion of stimuli composed of luminance and color signals were also examined. We found that color signals largely contributed to OFRs under low luminance signals regardless of whether color signals moved in the same or opposite direction to luminance signals. These results provide evidence of the multichannel visual computations underlying motor responses. We conclude that, in everyday situations, color information contributes cooperatively with luminance information to the generation of ocular tracking behaviors. © 2016 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

  5. Evaluation of BD MAX Staph SR Assay for Differentiating Between Staphylococcus aureus and Coagulase-Negative Staphylococci and Determining Methicillin Resistance Directly From Positive Blood Cultures.

    Lee, Jaewoong; Park, Yeon Joon; Park, Dong Jin; Park, Kang Gyun; Lee, Hae Kyung


    We evaluated the performance of the BD MAX StaphSR Assay (SR assay; BD, USA) for direct detection of Staphylococcus aureus and methicillin resistance not only in S. aureus but also in coagulase-negative Staphylococci (CNS) from positive blood cultures. From 228 blood culture bottles, 103 S. aureus [45 methicillin-resistant S. aureus (MRSA), 55 methicillin-susceptible S. aureus (MSSA), 3 mixed infections (1 MRSA+Enterococcus faecalis, 1 MSSA+MRCNS, 1 MSSA+MSCNS)], and 125 CNS (102 MRCNS, 23 MSCNS) were identified by Vitek 2. For further analysis, we obtained the cycle threshold (Ct) values from the BD MAX system software to determine an appropriate cutoff value. For discrepancy analysis, conventional mecA/mecC PCR and oxacillin minimum inhibitory concentrations (MICs) were determined. Compared to Vitek 2, the SR assay identified all 103 S. aureus isolates correctly but failed to detect methicillin resistance in three MRSA isolates. All 55 MSSA isolates were correctly identified by the SR assay. In the concordant cases, the highest Ct values for nuc, mecA, and mec right-extremity junction (MREJ) were 25.6, 22, and 22.2, respectively. Therefore, we selected Ct values from 0-27 as a range of positivity, and applying this cutoff, the sensitivity/specificity of the SR assay were 100%/100% for detecting S. aureus, and 97.9%/98.1% and 99.0%/95.8% for detecting methicillin resistance in S. aureus and CNS, respectively. We propose a Ct cutoff value for nuc/mec assay without considering MREJ because mixed cultures of MSSA and MRCNS were very rare (0.4%) in the positive blood cultures.

  6. Clinical significance of carotid and ocular bruits in cerebrovascular disease

    Hirose, Yoshikiyo; Yanagi, Tsutomu; Ito, Yasuhiro; Yasuda, Takeshi (Nagoya Daini Red Cross Hospital (Japan))


    We investigated the clinical significance of carotid and ocular bruits (CB and OB) in 250 consecutive patients with cerebrovascular disease (CVD). The incidence of bruits was compared with that in 100 age- and sex-matched neurological controls without CVD. In the CVD group, CB alone were found in 12 patients, both carotid and ocular bruits in 7, and OB alone in 2. CB were found only in 3 controls. We then evaluated CVD in the 25 patients (16 men and 9 women) who had bruits. The patients ranged from 55 to 81 years in age (mean: 70.6 years). The patients with CB alone constituted the largest group, and those with OB alone were the smallest group. CB were heard and abnormal blood flow was observed in 19/28 arteries of the 21 patients who underwent echo-flow studies. Carotid artery stenosis/occlusion was detected in 24/31 arteries (77%) in 23 patients who underwent digital subtraction angiography (DSA). Thus, the sensitivity was 0.77 and specificity of a CB 0.91. In 9/10 patients with unilateral OB, ipsilateral or contralateral carotid artery stenosis/occlusion was detected. Diminished cerebral blood flow was observed in 10/15 patients with bruits who underwent SPECT. Of these 8 had reduced cerebral blood flow ipsilaterally to the bruit. Blood flow was reduced in the carotid artery territory in all of the patients, and watershed reductions were commonnest. Among the 25 patients, some showed neurological semiology of the vertebrobasilar territory in addition to that of the carotid territory. There were recurrences in 92% of the patients who had possible lesion in the territory of carotid artery. In 11 patients infarcts in the area of the cortical branch were shown using CT scans. Since bruits are more often audible in patients with CVD disease than in controls and since vascular stenosis and occlusion are detectable more frequently in these patients, bruits can serve as an important sign indicating CVD. (author).

  7. Drug-resistant genotypes and multi-clonality in Plasmodium falciparum analysed by direct genome sequencing from peripheral blood of malaria patients.

    Timothy Robinson

    Full Text Available Naturally acquired blood-stage infections of the malaria parasite Plasmodium falciparum typically harbour multiple haploid clones. The apparent number of clones observed in any single infection depends on the diversity of the polymorphic markers used for the analysis, and the relative abundance of rare clones, which frequently fail to be detected among PCR products derived from numerically dominant clones. However, minority clones are of clinical interest as they may harbour genes conferring drug resistance, leading to enhanced survival after treatment and the possibility of subsequent therapeutic failure. We deployed new generation sequencing to derive genome data for five non-propagated parasite isolates taken directly from 4 different patients treated for clinical malaria in a UK hospital. Analysis of depth of coverage and length of sequence intervals between paired reads identified both previously described and novel gene deletions and amplifications. Full-length sequence data was extracted for 6 loci considered to be under selection by antimalarial drugs, and both known and previously unknown amino acid substitutions were identified. Full mitochondrial genomes were extracted from the sequencing data for each isolate, and these are compared against a panel of polymorphic sites derived from published or unpublished but publicly available data. Finally, genome-wide analysis of clone multiplicity was performed, and the number of infecting parasite clones estimated for each isolate. Each patient harboured at least 3 clones of P. falciparum by this analysis, consistent with results obtained with conventional PCR analysis of polymorphic merozoite antigen loci. We conclude that genome sequencing of peripheral blood P. falciparum taken directly from malaria patients provides high quality data useful for drug resistance studies, genomic structural analyses and population genetics, and also robustly represents clonal multiplicity.

  8. Alergia ocular: un reto diagnóstico Ocular allergy: a diagnostic challenge

    Ricardo Cardona Villa


    Full Text Available El ojo es uno de los órganos más sensibles y está permanentemente expuesto a diversos agentes ambientales. Dado que la conjuntiva es un tejido inmunológicamente activo, no es sorprendente que sea un sitio común de respuestas alérgicas. Las alergias oculares son un grupo de enfermedades que afectan la superficie conjuntival y están asociadas usualmente a reacciones de hipersensibilidad tipo 1. Pueden ser divididas en varias categorías: conjuntivitis alérgica estacional, conjuntivitis alérgica perenne, queratoconjuntivitis vernal y queratoconjuntivitis atópica. La inflamación de la superficie ocular produce prurito, lagrimeo, edema conjuntival y fotofobia. Como en otras enfermedades alérgicas, se puede desarrollar una condición crónica, acompañada de remodelación de los tejidos oculares. Las estrategias para el tratamiento de la alergia ocular han aumentado exponencialmente y los clínicos disponen de un inventario cada vez mayor de agentes dirigidos a la protección del ojo contra la inflamación. En este trabajo presentamos una revisión sobre las principales formas de alergia ocular, haciendo énfasis en el cuadro clínico, el diagnóstico y las nuevas opciones terapéuticas disponibles en la actualidad. The eye, one of the most sensitive organs, is permanently exposed to different environmental agents. Since the conjunctiva is an immunologically active tissue, it is not surprising for it to be a common site for allergic responses. Ocular allergies constitute a group of diseases affecting the conjunctival surface; they are usually associated with type 1 hypersensitivity reactions. This disorder can be divided into several categories: seasonal allergic conjunctivitis, perennial allergic conjunctivitis, vernal keratoconjunctivitis and atopic keratoconjunctivitis. Ocular surface inflammation results in itching, tearing, conjunctival edema, and photophobia. As is the case with other allergic diseases, a chronic situation can also

  9. Ocular ultraviolet radiation exposure of welders.

    Tenkate, Thomas D


    (a location to approximate ocular exposure). UVR exposures for non-welding workers were also quite substantial, with mean 8-hour doses on the outside of safety spectacles being around 36 mJ/cm2 (12×MPE) on the bridge and around 27 mJ/cm2 (9×MPE) on the sides. Exposures measured on the outside of clothing was substantial (eg, mean 8-hour UVR dose for welders was around 9795 mJ/cm (2)(3265 ×MPE), with mean ambient UVR levels of 16.4 mJ/cm (2)(5.5×MPE). The high ambient and "body" exposures measured in the study by Tenkate & Collins (3) are not unexpected, however, the levels measured within the welding helmets are of concern considering this represents UVR that has penetrated or by-passed standard protection measures. It has been shown that UVR is able to infiltrate welding helmets by entering from the back and through the sides and top (5). This type of infiltration is likely to occur when welders are in close proximity to each other and the welder is receiving exposure from other welder's emissions. In addition, facial/ocular exposure is also likely to occur when welders flip-up their welding helmet and undertake other work (eg, set-up, handle materials etc). For many welders, the proportion of their welding time per day compared to these other activities has been measured at around 20% (6), which means that if welders flip-up their helmet and leave it flipped-up, their eyes and faces are directly exposed to ambient UVR and that of nearby welders for a large part of the work day. Wearing safety spectacles underneath welding helmets is a recommended practice (7), however, workers report wearing safety spectacles, particularly underneath welding helmets, is uncomfortable, with visibility impacted due to fogging and sweat (8, 9). The use of auto-darkening helmets is one solution to eliminating the practice of flipping-up the helmet. The Slagor et al paper (1, p451) also states that "we do not know whether welders are more or less exposed to UVR than outdoor workers

  10. Nanocarriers for treatment of ocular neovascularization in the back of the eye: new vehicles for ophthalmic drug delivery.

    Shen, Hsin-Hui; Chan, Elsa C; Lee, Jia Hui; Bee, Youn-Shen; Lin, Tsung-Wu; Dusting, Gregory J; Liu, Guei-Sheung


    Pathologic neovascularization of the retina is a major cause of substantial and irreversible loss of vision. Drugs are difficult to deliver to the lesions in the back of the eye and this is a major obstacle for the therapeutics. Current pharmacological approach involves an intravitreal injection of anti-VEGF agents to prevent aberrant growth of blood vessels, but it has limitations including therapeutic efficacy and side-effects associated with systemic exposure and invasive surgery. Nanotechnology provides novel opportunities to overcome the limitations of conventional delivery system to reach the back of the eye through fabrication of nanostructures capable of encapsulating and delivering small molecules. This review article introduces various forms of nanocarrier that can be adopted by ocular drug delivery systems to improve current therapy. The application of nanotechnology in medicine brings new hope for ocular drug delivery in the back of the eye to manage the major causes of blindness associated with ocular neovascularization.

  11. Drug Transport by the Blood-Aqueous Humor Barrier of the Eye.

    Lee, Jonghwa; Pelis, Ryan M


    The ocular barriers (cornea, blood-retinal barrier, and blood-aqueous humor barrier) make treating eye diseases with therapeutic drugs challenging. The tight capillary endothelium of the iris and the ciliary body epithelium form the blood-aqueous humor barrier. The iris and ciliary body (iris-ciliary body) express a variety of drug transporters in the ATP-binding cassette and solute carrier (SLC) families. ATP-binding cassette family drug transporters that are present in the iris-ciliary body include P-glycoprotein, breast cancer resistance protein, and several multidrug resistance-associated proteins. SLC family drug transporters that are present in the iris-ciliary body include organic anion transporters, organic anion transporting polypeptides, bile acid transporters (apical sodium-dependent bile salt transporter and sodium taurocholate cotransporter), organic cation transporters (novel organic cation transporter and multidrug and toxin extrusion transporter) and peptide transporters. Freshly dissected iris-ciliary body preparations actively accumulate a variety of substrates of SLC drug transporters that are expressed in the tissue. The ciliary body in vitro supports active transport in the aqueous humor-to-blood direction of several substrates of organic anion transporters and multidrug resistance-associated proteins, consistent with the subcellular localization of these transporters in the ciliary body epithelium. In vivo data suggest that drug transporters in the iris-ciliary body reduce the permeation of drugs in the direction of blood-to-aqueous humor, thereby reducing ocular drug bioavailability, and are also involved in active drug elimination from the aqueous humor. An understanding of the influence on pharmacokinetics of drug transporters in the blood-aqueous humor barrier should help improve drug delivery and efficacy in the eye. Copyright © 2016 by The American Society for Pharmacology and Experimental Therapeutics.

  12. Relationship between carotid artery stenosis and ischemic ocular diseases

    Qian Chen


    Full Text Available AIM: To investigate the relationship between carotid artery stenosis and ischemic ocular diseases.METHODS: The clinical data of 30 cases(37 eyesof patients with ischemic eye diseases were collected from November 2010 to May 2014, and they were accepted the fundus fluorescein angiography(FFA, transcranial Doppler(TCDultrasonic blood vessels of the eye, neck vascular color Doppler flow imaging(CDFI, the neck CT angiography(CTAand carotid artery digital subtraction angiography(DSAexamination, and then the ischemic eye disease patients with ocular symptoms were analyzed. The peak systolic velocity(PSVand resistance index(RIof ophthalmic artery and central retinal artery were compared. Correlation between the internal carotid artery intima-media thickness(IMTand ophthalmic artery, central retinal artery PSV and RI correlation risk; ipsilateral internal carotid artery plaque and ophthalmic artery PSV and RI; PSV and RI associated ipsilateral internal carotid artery plaque and central retinal artery were analyzed. RESULTS: Eye symptoms: a black dim, reduced vision, the eyes flash, and around the eye pain were 75.7%, 83.8%, 51.4% and 32.4%; The eye signs: the dilatation of retinal vein, retinal hemorrhage, arterial stenosis and cotton spot and the contralateral side were regarded as main signs. Ophthalmic artery PSV and RI value of the differences were statistically significant(PPP>0.05; The ipsilateral internal carotid artery plaque and ophthalmic artery PSV had no correlation with RI values(P>0.05; PSV and RI and the ipsilateral internal carotid artery plaque and central retinal artery had no correlation(P>0.05.CONCLUSION: The incidence of ischemic eye diseases and internal carotid artery stenosis is associated with very close, the clinical can regard the degree of internal carotid artery stenosis as an important basis for diagnosis and treatment of eye diseases.

  13. Isolated ocular lichen planus in a child.

    Igras, Estera; Kennedy, Susan; MacDermott, Emma Jane; Murphy, Conor C


    Lichen planus (LP) is an autoimmune inflammatory condition of the skin and mucous membranes, of unknown aetiology, that infrequently involves the eye. Ocular LP has not been described in children. We present the case of an 8-year-old girl with severe, filamentous dry eyes and persistent conjunctival hyperemia with bilateral progressive conjunctival symblepharon. Her conjunctival biopsy showed heavy linear fibrinogen deposits along the basement membrane without IgG, IgA, IgM, or C3 deposition, consistent with LP. No skin or other mucosal lesions were present, suggesting a diagnosis of isolated conjunctival LP. Oral and topical cyclosporine combined with methotrexate and low-dose oral steroids led to sustained disease remission. To our knowledge, this is the first case of isolated ocular LP in a child.

  14. [Ocular hypertension in herpes simplex keratouveitis].

    Burcea, M; Avram, Corina-Ioana; Stamate, Alina-Cristina; Malciolu, R; Oprea, S; Zemba, M


    The herpes simplex virus is one of the most common pathogens in humans, who are seropositive for the virus in 90% of the cases at the adult age. It determines reccurent infections in more than a third of the population and these infections depend on the immune response of the host. Ocular infections of newborns are due to the herpes simplex virus type 2, meanwhile type 1 is found predominantly at adults; almost all ocular structures can be affected. HSV-1 in the most frequent etiologic agent in infectious anterior uveitis (with the varicelo-zosterian virus) and it is responsible for 6-10% of all cases of anterior uveitis. More than half of the keratouveitides due to HSV will develop intraocular hypertension and open-angle secondary glaucoma, during reccurences and most of them will resolve after proper control of inflammation.

  15. Ocular Surface as Barrier of Innate Immunity

    Bolaños-Jiménez, Rodrigo; Navas, Alejandro; López-Lizárraga, Erika Paulina; de Ribot, Francesc March; Peña, Alexandra; Graue-Hernández, Enrique O; Garfias, Yonathan


    Sight is one of the most important senses that human beings possess. The ocular system is a complex structure equipped with mechanisms that prevent or limit damage caused by physical, chemical, infectious and environmental factors. These mechanisms include a series of anatomical, cellular and humoral factors that have been a matter of study. The cornea is not only the most powerful and important lens of the optical system, but also, it has been involved in many other physiological and pathological processes apart from its refractive nature; the morphological and histological properties of the cornea have been thoroughly studied for the last fifty years; drawing attention in its molecular characteristics of immune response. This paper will review the anatomical and physiological aspects of the cornea, conjunctiva and lacrimal apparatus, as well as the innate immunity at the ocular surface. PMID:26161163

  16. The formulation of drug for ocular administration.

    Aiache, J M; el Meski, S; Beyssac, E; Serpin, G


    The different barriers that slow the penetration of active ingredients administered by the ocular route are described, and some novel dosage forms designed for this route are discussed. Both precorneal and corneal factors considerably restrict ocular penetration. The low bioavailability of classical ophthalmic dosage forms can be improved by several approaches, particularly by increasing the time the active ingredients remain in contact with the eye tissues. The new dosage forms are reviewed according to their type and their drug release mechanisms. The characteristics, advantages, and limitations of each are outlined. The potential of these dosage forms can be expected to enhance development. They offer prolonged effectiveness, reproducibility, fewer unwanted side effects, and improved tolerance.

  17. Partial unilateral lentiginosis with ocular involvement.

    Schaffer, J V; Lazova, R; Bolognia, J L


    Partial unilateral lentiginosis (PUL) is an unusual pigmentary disorder characterized by numerous lentigines grouped within an area of normal skin; the pigmented macules are often in a segmental distribution with a sharp demarcation at the midline. We report the first case of ocular involvement in a patient with this diagnosis. The patient, a 30-year-old Peruvian woman, had multiple brown macules on the left upper face in primarily a V1 and V2 distribution with a sharp demarcation at the midline of the forehead. The lesions first appeared near the hairline when she was 5 years of age, and then began to extend onto the face. She also had a discrete area of brown pigmentation on the left lateral bulbar conjunctiva. Because the patient had been previously diagnosed by several dermatologists as having either a speckled lentiginous nevus or a nevus of Ota, we draw attention to the entity PUL and the possibility of ocular involvement.

  18. Ocular preservatives: associated risks and newer options.

    Kaur, Indu Pal; Lal, Shruti; Rana, Cheena; Kakkar, Shilpa; Singh, Harinder


    Presence of a preservative in an ocular medication has often been considered a culprit in damaging the epithelium. However, the inclusion of a preservative is equally necessary, especially in multiple-dose containers, in order to protect against dangerous organisms accidentally gaining access during instillation. Benzalkonium chloride (BAK), chlorobutanol, chlorhexidine acetate (CHA), and phenylmercuric nitrate or acetate are some commonly used preservatives in eye preparations. New preservatives with a wide range of activity and good safety profiles have been introduced in the market, such as stabilized oxychloro complex (SOC), sofZia, and sodium perborate. In the present review, we discuss various conventional and newly proposed and patented preservative molecules for ocular use. Reasons for discontinuing traditional preservatives and the need for less-toxic molecules are discussed at length, along with newer options coming up in this area.


    E. Yu. Markovа


    Full Text Available In case of viral infections, ophthalmologists, pediatricians and general practitioners should all be aware of ocular manifestations of these diseases. According to our observations, despite the presence of corneal disorders, in 95 percent of children changes were reversible and in 1.5 months visual acuity was high. Only in five percent of cases despite the intensive therapy, patients had bacterial complications, causing a decrease in visual acuity.The combined  efforts of infectious disease specialists and ophthalmologists as well as timely and proper treatment are required to reduce the inflammation symptoms and prevent complications. By adding Ophtalmoferon® medication to the complex therapy of ocular surface diseases we observed its high therapeutic efficacy and a good safety profile. This medication is available in the form of ready-to-use eye drops, unlike other antiviral agents, improving  its compliance in outpatients.

  20. Cost-Effectiveness Analysis of Multiplex PCR with Magnetic Resonance Detection versus Empiric or Blood Culture-Directed Therapy for Management of Suspected Candidemia.

    Walker, Brandon; Powers-Fletcher, Margaret V; Schmidt, Robert L; Hanson, Kimberly E


    Candida bloodstream infections (BSI) are associated with significant morbidity, mortality, and increased health care costs. Early treatment is essential, because delayed therapy detrimentally impacts clinical outcomes. The FDA recently approved the first culture-independent direct molecular detection method for Candida BSIs (T2Candida). The speed and sensitivity of this assay give it the potential to improve patient care, but the reagents and instrumentation are expensive. We used an analytic decision tree model to compare the cost-effectiveness of T2Candida-directed antifungal therapy (T2DT) to that of either empirical therapy (ET) or blood culture-directed therapy (BCDT). The costs included those of T2Candida testing, antifungal treatment, and hospital length of stay. The effectiveness measure was survival status at hospital discharge. T2DT was less costly and more effective than BCDT but was less costly and less effective than ET with an echinocandin (incremental cost-effectiveness ratio, $111,084 per additional survivor). One-way sensitivity analyses demonstrated that the cost-effectiveness of T2DT was highly dependent on Candida BSI prevalence and the cost of antifungal therapy and T2Candida test reagents. The use of T2DT reduced the number of unnecessarily treated patients by 98% relative to that with ET. Reduced drug exposure might lessen the possibility of drug-related adverse events and may also prevent the development of antifungal resistance or emergence of drug-resistant Candida species. The greatest benefit of T2Candida appears to be the ability to confidently withhold or stop empirical antifungal therapy in low-to-moderate-risk patients who are unlikely to benefit from treatment. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  1. Manifestaciones oculares de las enfermedades sistémicas Ocular manifestations of systemic diseases

    J. Andonegui


    Full Text Available Existe un gran número de enfermedades sistémicas que pueden presentar en algún momento de su evolución manifestaciones oculares. Estas alteraciones pueden provocar sintomatología por sí mismas, pueden ayudar a diagnosticar la enfermedad sistémica que las originó o pueden servir para monitorizar el curso evolutivo de la misma. Se destacan las principales características de una serie de enfermedades sistémicas asociadas a patología ocular que serán estudiadas en detalle a lo largo de esta monografía.A great number of systemic diseases can exhibit ocular manifestations during their evolution. These ocular alterations may cause symptoms by themselves, but can also be useful in diagnosing or monitoring the evolution of the systemic condition. The main characteristics of several systemic diseases exhibiting some kind of ocular sign are highlighted. These diseases will be described in detail in this issue.

  2. Blood sugar test - blood

    ... blood glucose level ( hypoglycemia ) may be due to: Hypopituitarism (a pituitary gland disorder) Underactive thyroid gland or ... tonic-clonic seizure Glucagon blood test Glucagonoma Hyperthyroidism Hypopituitarism Hypothyroidism Insulinoma Low blood sugar Multiple endocrine neoplasia ( ...

  3. Analysis of ocular toxicity of fluconazole and voriconazole eyedrops using HET-CAM

    A. Fernández-Ferreiro


    Full Text Available Abstract: Purpose: The objective of the study is to provide toxicological information through the HET-CAM test of Fluconazole and Voriconazole eye drops prepared commonly in Pharmacy Servi - ces for the treatment of fungal keratitis. Method: Experimental Study. The ocular toxicity of topical voriconazole 10 mg/ml and fluconazole 2 mg/ml were evalua ted by the hen‘s egg test (HET on the chorioallantoic membrane (CAM. The effects on blood vessels were based on its behavior during 300 seconds and processes that may occur at each time, then we calculated the irritation index (is, irritation score. Results and conclusions: Both eye drops, voriconazol and fluconazole have been proven to be safe, since the IS that we obtained was zero for both samples and did not present significant signs of irritation. Therefore, these eyedrops are conside red suitable for ocular use from a toxicological point of view.

  4. [Larva migrans syndrome or ocular toxocariasis].

    Pizzi, D R; Maffrand, R A; De Lisa, I S; Pizzi, H L; Plaza Ontiveros, R G


    Thirteen cases of ocular toxocariasis attended in the Oftalmology Service of the Pediatric Hospital "Niño Jesús", from Córdoba; and in the Parasitology and Micology Cathedra of the Medicine Collegue of the University of Córdoba were studied from July 1993 till July 1995. The authors determine the needs of taking into account this parasitosis; above all in children and with the antecedent of contact with pets.

  5. [Epstein Barr and cytomegaloviruses in ocular pathology].

    Magdei, Corina; Cuşnir, Valeriu; Bârcâ, Ludmila


    Epstein-Barr virus (EBV) and Citomegalovirus (CMV) are Herpesviridae family representative and presents a real danger for human. A very high infect risk of population farther the danger The ocular pathology induced by them can affect all media and tunics of optic analyzer. An etiologic differentiation is necessary for the mentioned viruses induced diseases. The etiologic differentiation has like purpose the enforcement of an effective and optimal antiviral and immunomodulating therapy.

  6. Vitamin D in ocular and systemic health

    Solani D. Mathebula


    Full Text Available Accumulated data supports the argument that vitamin D possesses several biological and molecular actions apart from its role in calcium absorption and facilitation of gene expression. Vitamin D deficiency has been an associated risk factor for cardiovascular disease,metabolic syndrome and ocular complications. The aim of this review is to summarise the most relevant data regarding these associations and to try to clarify whether, and to what extent, oral vitamin D supplementation could be used as a beneficial intervention in such diseases.Vitamin D is produced in skin exposed to sunlight UVB radiation and is then metabolised by the kidney into calciferol, which is an active form. The main function of vitamin D is to promote calcium and phosphorus absorption, and studies have shown that a lack of itplays an important role in ocular conditions, such as age-related macular degeneration and diabetic retinopathy. Recent studies have suggested that vitamin D may protect the diabetic retina; however, other vitamin D-associated conditions (diabetes, hypertension and cardiovascular diseases may result in secondary ocular manifestations and the potential forsight-threatening complications. The purpose of this review is to describe the current literature on the role of vitamin D in ocular and systemic wellness. However, more research is needed to determine if increasing levels of this vitamin can assist in preventing age-related macular degeneration or diabetic retinopathy. Since vitamin D is a circulating steroid hormone, its receptors are found in almost every cell in the human body, and this suggests that vitamin D might have a very broad role for overall health. However, there is still demand for further research to clarify the clinical use of vitamin D in the prevention and treatment of various chronic diseases.

  7. Neuroretinitis in ocular bartonellosis: a case series

    Raihan AR; Zunaina E; Wan-Hazabbah WH; Adil H; Lakana-Kumar T


    Abdul-Rahim Raihan,1 Embong Zunaina,1,2 Wan-Hitam Wan-Hazabbah,1,2 Hussein Adil,1,2 Thavaratnam Lakana-Kumar1 1Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia; 2Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, MalaysiaAbstract: We report a case series of neuroretinitis in ocular bartonellosis and describe the serologic verification for Bartonella henselae. This is a retrospective interventional case series of fo...

  8. Progress of anti-vascular endothelial growth factor therapy for ocular neovascular disease: benefits and challenges

    Xu Jianjiang; Li Yimin; Hong Jiaxu


    Objective This review aims to summarize the progress of current clinical studies in ocular angiogenesis treated with antivascular endothelial growth factor (VEGF) therapy and to discuss the benefits and challenges of the treatment.Data sources Pubmed,Embase and the Cochrane Library were searched with no limitations of language and year of publication.Study selection Clinical trials and case studies presented at medical conferences and published in peer-reviewed literature in the past decade were reviewed.Results Anti-VEGF agents have manifested great potential and promising outcomes in treating ocular neovascularization,though some of them are still used as off-label drugs.Intravitreal injection of anti-VEGF agents could be accompanied by devastating ocular or systemic complications,and intimate monitoring in both adult and pediatric population are warranted.Future directions should be focused on carrying out more well-designed large-scale controlled trials,promoting sustained duration of action,developing safer and more efficient generation of anti-VEGF agents.Conclusions Anti-VEGF treatment has proved to be beneficial in treating both anterior and posterior neovascular ocular diseases.However,more safer and affordable antiangiogenic agencies and regimens are warranted to be explored.

  9. Ocular pathology in congenital heart disease.

    Mansour, A M; Bitar, F F; Traboulsi, E I; Kassak, K M; Obeid, M Y; Megarbane, A; Salti, H I


    To describe the ocular findings in subjects with congenital heart disease (CHD). In a prospective study, the same observer examined 240 consecutive patients with CHD admitted to the medical centre. Two independent geneticists performed identification of syndromes. The commonest anatomic cardiac anomalies were ventricular or atrial septal defects (62), tetralogy of Fallot (39), pulmonary stenosis (25), and transposition of the great arteries (24). The heart lesions were divided physiologically into volume overload (90), cyanotic (87), and obstructive (63). In all, 105 syndromic subjects included the velocardiofacial syndrome (18), Down's syndrome (17), CHARGE association (6), DiGeorge syndrome (5), Williams syndrome (3), Edwards syndrome (3), Noonan syndrome (3), VACTERL association (2), and Patau syndrome (trisomy 13) (2). The paediatric team recognized 51 patients as syndromic. Two independent geneticists recognized additional 54 patients as syndromic. Positive eye findings were present in 55% (132) and included retinal vascular tortuosity (46), optic disc hypoplasia (30), trichomegaly (15), congenital ptosis (12), strabismus (11), retinal haemorrhages (8), prominent eyes (7), and congenital cataract (6). There was a strong correlation between the retinal vascular tortuosity and both a low haematocrit (P=0.000) and a low arterial oxygen saturation (P=0.002). Patients with CHD are at a high risk for ocular pathology and need screening for various ocular abnormalities.

  10. Experimental models of autoimmune inflammatory ocular diseases

    Fabio Gasparin


    Full Text Available Ocular inflammation is one of the leading causes of blindness and loss of vision. Human uveitis is a complex and heterogeneous group of diseases characterized by inflammation of intraocular tissues. The eye may be the only organ involved, or uveitis may be part of a systemic disease. A significant number of cases are of unknown etiology and are labeled idiopathic. Animal models have been developed to the study of the physiopathogenesis of autoimmune uveitis due to the difficulty in obtaining human eye inflamed tissues for experiments. Most of those models are induced by injection of specific photoreceptors proteins (e.g., S-antigen, interphotoreceptor retinoid-binding protein, rhodopsin, recoverin, phosducin. Non-retinal antigens, including melanin-associated proteins and myelin basic protein, are also good inducers of uveitis in animals. Understanding the basic mechanisms and pathogenesis of autoimmune ocular diseases are essential for the development of new treatment approaches and therapeutic agents. The present review describes the main experimental models of autoimmune ocular inflammatory diseases.




    Full Text Available Purpose: To evaluate the demography, aetiology, type and outcome of paediatric ocular trauma in tertiary centre in Malaysia. Method: We retrospectively studied 118 eyes from 117 patients over a period of 36 months (January 2006 to December 2008. All ocular injuries in patients aged 12 and below seen in the Ophthalmology Department for the first time were included in thisstudy. Results: Mean age of patients was 6.1±3.0 years. 68 cases (58.2% occurred in pre-school children, whereas 49 (41.9% in school-aged children. Boys accounted for 65.8% of cases. There was no predilection for either right or the left eye. 47% of cases (56 patients occurred in Malay. Most of the injuries took place at home when the children were alone (p<0.05. Sharp objects were the commonest cause (45 cases, 38.1%. The majority of cases (103, 87.3% were considered preventable. The frequency of open and closed globe injury was similar. Hyphema was more common in closed globe injury compared to open globe injury (p<0.05. Other associated injuries such as cataract, vitreous hemorrhage and retinal hemorrhage are similar between the two groups. Visual outcome is generally poor with only 34 eyes (28.8% had no visual impairment. Conclusion: Ocular trauma in children is an important cause of visual loss. Most cases occurred at home and were preventable. Prevention through education is the best approach.

  12. Ocular Complications of Leprosy in Yemen

    Salem, Raga A. A.


    Objectives: This study was conducted to identify the main ocular- and vision-threatening complications of leprosy in Yemen. Methods: This is a cross-sectional observational study which took place from February to July 2010. Leprosy patients attending the Skin and Venereal Diseases Hospital in the City of Light in Taiz, Yemen, who consented to participate in the study, were enrolled. Detailed demographic and medical histories were taken and clinical examination findings were recorded. A detailed eye examination, including visual acuity (VA), slit-lamp, and fundus examinations, was conducted on each patient by a qualified ophthalmologist. Results: A total of 192 patients (180 male, 12 female, with a male to female ratio of 15:1) were included in the study. The majority of the patients (157; 81.8%) were over 40 years. Over two-thirds of the patients (129; 67.2%) had had leprosy for more than 20 years. Ocular complications were found in 97% of cases; 150 (39.1%) of the patients’ eyes had at least one pathology. Eyelid involvement was the most common problem observed in 102 (26.5%) patients. Half of the eyes (192; 50%) had a VA of <6/60. The main cause of blindness among these patients was corneal opacity detected in 69 out of 192 patients (35.9%). Conclusion: Ocular complications are frequent among leprosy patients in Yemen. They are true vision-threatening lesions. It is important to prevent these lesions through early diagnosis and adequate treatment. PMID:23275842

  13. Neuroretinitis in ocular bartonellosis: a case series

    Raihan AR


    Full Text Available Abdul-Rahim Raihan,1 Embong Zunaina,1,2 Wan-Hitam Wan-Hazabbah,1,2 Hussein Adil,1,2 Thavaratnam Lakana-Kumar1 1Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia; 2Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, MalaysiaAbstract: We report a case series of neuroretinitis in ocular bartonellosis and describe the serologic verification for Bartonella henselae. This is a retrospective interventional case series of four patients who presented in the ophthalmology clinic of Hospital Universiti Sains Malaysia from June 2012 to March 2013. All four patients had a history of contact with cats and had fever prior to ocular symptoms. Each patient presented with neuroretinitis characterized by optic disc swelling with macular star. Serology analysis showed strongly positive for B. henselae in all of the patients. All patients were treated with oral azithromycin (except case 4, who was treated with oral doxycycline, and two patients (case 1 and case 3 had poor vision at initial presentation that warranted the use of oral prednisolone. All patients showed a good visual outcome except case 3. Vision-threatening ocular manifestation of cat scratch disease can be improved with systemic antibiotics and steroids.Keyword: cat scratch disease

  14. Dry-Weight: A Concept Revisited in an Effort to Avoid Medication-Directed Approaches for Blood Pressure Control in Hemodialysis Patients

    Weir, Matthew R.


    Background and objectives: Achieving and maintaining dry-weight appears to be an effective but forgotten strategy in controlling and maintaining normotension among hypertensive patients on hemodialysis. Methods: Qualitative review of literature to define dry-weight and its utility in achieving blood pressure control. Results: The concept of dry-weight has evolved over time and its definition has changed. One such definition defines dry-weight as the lowest tolerated postdialysis weight achieved via gradual change in postdialysis weight at which there are minimal signs or symptoms of hypovolemia or hypervolemia. Although clinical examination does not perform well in detecting latent increase in dry-weight, several technologies such as relative plasma volume monitoring and body impedance analysis are emerging that may help in assessing dry-weight in the future. Sodium restriction is a modifiable risk factor that can lead to better blood pressure (BP) control. However, dietary sodium restriction requires lifestyle modifications that are difficult to implement and even harder to sustain over the long term. Restricting dialysate sodium is a simpler but underexplored strategy that can reduce thirst, limit interdialytic weight gain, and assist the achievement of dry-weight. Achievement of dry-weight can improve interdialytic BP, reduce pulse pressure, and limit hospitalizations. Conclusions: Avoiding medication-directed control of BP may enhance the opportunity to probe dry-weight, facilitate removal of volume, and limit the risk for pressure-volume overload, which may be a significant concern leading to myocardial remodeling in the hemodialysis patient. Probing dry-weight among patients with ESRD has the potential to improve dismal cardiovascular outcomes. PMID:20507951

  15. Age or ischemia uncouples the blood flow response, tissue acidosis, and direct current potential signature of spreading depolarization in the rat brain.

    Menyhárt, Ákos; Zölei-Szénási, Dániel; Puskás, Tamás; Makra, Péter; Bari, Ferenc; Farkas, Eszter


    Spreading depolarization (SD) events contribute to lesion maturation in the acutely injured human brain. Neurodegeneration related to SD is thought to be caused by the insufficiency of the cerebral blood flow (CBF) response; yet the mediators of the CBF response, or their deficiency in the aged or ischemic cerebral cortex, remain the target of intensive research. Here, we postulated that tissue pH effectively modulates the magnitude of hyperemia in response to SD, the coupling of which is prone to be dysfunctional in the aged or ischemic cerebral cortex. To test this hypothesis, we conducted systematic correlation analysis between the direct current (DC) potential signature of SD, SD-associated tissue acidosis, and hyperemic element of the CBF response in the isoflurane-anesthetized, young or old, and intact or ischemic rat cerebral cortex. The data demonstrate that the amplitude of the SD-related DC potential shift, tissue acidosis, and hyperemia are tightly coupled in the young intact cortex; ischemia and old age uncouples the amplitude of hyperemia from the amplitude of the DC potential shift and acidosis; the duration of the DC potential shift, hyperemia and acidosis positively correlate under ischemia alone; and old age disproportionally elongates the duration of acidosis with respect to the DC potential shift and hyperemia under ischemia. The coincidence of the variables supports the view that local CBF regulation with SD must have an effective metabolic component, which becomes dysfunctional with age or under ischemia. Finally, the known age-related acceleration of ischemic neurodegeneration may be promoted by exaggerated tissue acidosis.NEW & NOTEWORTHY The hyperemic element of the cerebral blood flow response to spreading depolarization is effectively modulated by tissue pH in the young intact rat cerebral cortex. This coupling becomes dysfunctional with age or under ischemia, and tissue acidosis lasts disproportionally longer in the aged cortex, making

  16. "Eurocode International Blood Labeling System" enables unique identification of all biological products from human origin in accordance with the European Directive 2004/23/EC.

    Knels, Ralf; Mönig, Hans-Joachim; Wittmann, Georg; von Versen, Rüdiger; Pruss, Axel


    Due to their limited availability and compatibility, biological products must be exchanged between medical institutions. In addition to a number of national systems and agreements which strive to implement a unique identification and classification of blood products, the ISBT 128 was developed in 1994, followed by the Eurocode in 1998. In contrast to other coding systems, these both make use of primary identifiers as stipulated by the document ISO/IEC 15418 of the International Organization for Standardization (ISO), and thus provide a unique international code. Due to their flexible data structures, which make use of secondary identifiers, both systems are able to integrate additional biological products and their producers. Tissue and cells also constitute a comparable risk to the recipient as that of blood products in terms of false labeling and the danger of infection. However, in contrast to blood products, the exchange of tissue and cells is much more intensively pursued at the international level. This fact is recognised by Directives 2004/23/EC and 2006/86/EC of the European Union (EU), which demand a standardized coding system for cells and tissue throughout the EU. The 2008 workshop agreement of the European Committee for Standardization (CEN) was unique identification by means of a Key Code consisting of country code corresponding to ISO 3166-1, as well as competent authority and tissue establishment. As agreed at the meeting of the Working Group on the European Coding System for Human Tissues and Cells of the Health and Consumers Directorate-General of the European Commission (DG SANCO) held on 19 May 2010 in Brussels, this Key Code could also be used with existing coding systems to provide unique identification and allow EU traceability of all materials from one donation event. Today Eurocode already uses country codes according to ISO 3166-1, and thus the proposed Key Code can be integrated into the current Eurocode data structure and does not need to

  17. Dry Eye Management: Targeting the Ocular Surface Microenvironment.

    Zhang, Xiaobo; M, Vimalin Jeyalatha; Qu, Yangluowa; He, Xin; Ou, Shangkun; Bu, Jinghua; Jia, Changkai; Wang, Junqi; Wu, Han; Liu, Zuguo; Li, Wei


    Dry eye can damage the ocular surface and result in mild corneal epithelial defect to blinding corneal pannus formation and squamous metaplasia. Significant progress in the treatment of dry eye has been made in the last two decades; progressing from lubricating and hydrating the ocular surface with artificial tear to stimulating tear secretion; anti-inflammation and immune regulation. With the increase in knowledge regarding the pathophysiology of dry eye, we propose in this review the concept of ocular surface microenvironment. Various components of the microenvironment contribute to the homeostasis of ocular surface. Compromise in one or more components can result in homeostasis disruption of ocular surface leading to dry eye disease. Complete evaluation of the microenvironment component changes in dry eye patients will not only lead to appropriate diagnosis, but also guide in timely and effective clinical management. Successful treatment of dry eye should be aimed to restore the homeostasis of the ocular surface microenvironment.

  18. Laser exposure analysis for a near-infrared ocular interferometer

    Primeau, Brian C.; Goldstein, Goldie L.; Greivenkamp, John E.


    Ocular interferometry has potential value in a variety of ocular measurement applications, including measuring ocular thicknesses, topography of ocular surfaces or the wavefront of the eye. Of particular interest is using interferometry for characterizing corneal shape and irregular corneal features, making this technology attractive due to its inherent accuracy and spatial resolution. A particular challenge of designing an ocular interferometer is determining safe laser exposure levels to the eye, including both the retina and anterior segment. Described here are the laser exposure standards relevant in the interferometer design and the corresponding calculations and results. The results of this work can be used to aid in the design of similar laser-based systems for ocular evaluation.

  19. Dry Eye Management: Targeting the Ocular Surface Microenvironment

    Zhang, Xiaobo; Jeyalatha M, Vimalin; Qu, Yangluowa; He, Xin; Ou, Shangkun; Bu, Jinghua; Jia, Changkai; Wang, Junqi; Wu, Han; Liu, Zuguo


    Dry eye can damage the ocular surface and result in mild corneal epithelial defect to blinding corneal pannus formation and squamous metaplasia. Significant progress in the treatment of dry eye has been made in the last two decades; progressing from lubricating and hydrating the ocular surface with artificial tear to stimulating tear secretion; anti-inflammation and immune regulation. With the increase in knowledge regarding the pathophysiology of dry eye, we propose in this review the concept of ocular surface microenvironment. Various components of the microenvironment contribute to the homeostasis of ocular surface. Compromise in one or more components can result in homeostasis disruption of ocular surface leading to dry eye disease. Complete evaluation of the microenvironment component changes in dry eye patients will not only lead to appropriate diagnosis, but also guide in timely and effective clinical management. Successful treatment of dry eye should be aimed to restore the homeostasis of the ocular surface microenvironment. PMID:28661456

  20. Ivermectin treatment of patients with severe ocular onchocerciasis.

    Taylor, H R; Semba, R D; Newland, H S; Keyvan-Larijani, E; White, A; Dukuly, Z; Greene, B M


    The treatment of onchocerciasis with diethylcarbamazine and suramin is associated with an exacerbation of ocular disease. This occurs more frequently in patients with severe onchocercal ocular disease. We assessed ocular changes following ivermectin treatment in 39 patients with severe ocular onchocerciasis. Patients were treated with 100, 150, or 200 micrograms/kg of ivermectin at either 1 or 2 year intervals and followed for 3 years. There was no evidence for an acute exacerbation of either anterior or posterior segment eye disease, and there was a marked improvement in ocular status in the group as a whole. There was a significant decrease in onchocercal involvement which was maintained for at least 3 years. Annual treatment with ivermectin can be used safely in patients with severe ocular disease and is beneficial over a prolonged period of time.

  1. Study of ocular aberrations with age.

    Athaide, Helaine Vinche Zampar; Campos, Mauro; Costa, Charles


    Aging has various effects on visual system. Vision deteriorate, contrast sensitivity decreases and ocular aberrations apparently make the optical quality worse across the years. To prospective evaluate ocular aberrations along the ages. Three hundred and fifteen patients were examined, 155 were male (39.36%) and 160 were female (60.63%). Ages ranged from 5 to 64 year-old, the study was performed from February to November, 2004. Patients were divided into 4 age-groups according to IBGE (Instituto Brasileiro de Geografia e Estatística) classification: 68 patients from 5 to 14 year-old, 55 patients from 15 to 24 year-old, 116 from 25 to 44 year-old and 76 from 45 to 67 year-old. All patients had the following characteristics: best corrected visual acuity > 20/25, emmetropia or spherical equivalent < 3.50 SD, refractive astigmatism < 1.75 CD on cycloplegic refraction, normal ophthalmologic exam and no previous ocular surgeries. This protocol was approved by Federal University of São Paulo Institutional Review Board. Total optical aberrations were measured by H-S sensor LadarWave Custom Cornea Wavefront System (Alcon Laboratories Inc, Orlando, FLA, USA) and were statistically analysed. Corneal aberrations were calculated using CT-View software Version 6.89 (Sarver and Associates, Celebration, FL, USA). Lens aberrations were calculated by subtraction. High-order (0.32 e 0.48 microm) and ocular spherical aberrations (0.02 e 0.26 microm) increased respectively in child and middle age groups. High order (0.27 microm) and corneal spherical aberrations (0.05 microm) did not show changes with age. Lens showed a statistically significant spherical aberration increase (from -0.02 to 0.22 microm). Vertical (from 0.10 to -0.07 microm) and horizontal coma (from 0.01 to -0.12 microm) presented progressively negative values with aging. High-order and spherical aberrations increased with age due to lens contribution. The cornea did not affect significantly changes observed on ocular

  2. Study of ocular manifestations in children of thalassemia

    Dhara K. Gosai


    Conclusion: Most of the ocular changes of beta thalassemia are attributed to the course and severity of the disease. Reduction in serum iron and serum Ferritin levels by iron- chelating agents and regular ocular examination to look for side-effects of such agents can aid in preventing or delaying ocular complications. [Int J Res Med Sci 2014; 2(2.000: 695-698

  3. Study of ocular manifestations in children of thalassemia

    Dhara K. Gosai; K. M. Mehariya; Jigarkumar B. Gosai


    Background: Purpose of current study was to study the ocular manifestations in beta-thalassemia major patients and assess the ocular side-effects of iron chelating agents. Methods: Cross sectional study included 45 beta Thalassemia major patients from age group of 6months to 12 years were taken. Full medical history, thorough physical examinations were done to all patients groups, and ophthalmological examination to determine the prevalence of ocular manifestations for all patient groups a...

  4. Ocular rosacea: a review Rosácea ocular: revisão

    Ana Carolina Cabreira Vieira


    Full Text Available Rosacea is a prevalent chronic cutaneous disorder with variable presentation and severity. Although considered a skin disease, rosacea may evolve the eyes in 58-72% of the patients, causing eyelid and ocular surface inflammation. About one third of the patients develop potentially sight-threatening corneal involvement. Untreated rosacea may cause varying degrees of ocular morbidity. The importance of early diagnosis and adequate treatment cannot be overemphasized. There is not yet a diagnostic test for rosacea. The diagnosis of ocular rosacea relies on observation of clinical features, which can be challenging in up to 90% of patients in whom accompanying roseatic skin changes may be subtle or inexistent. In this review, we describe the pathophysiologic mechanisms proposed in the literature, clinical features, diagnosis and management of ocular rosacea, as well as discuss the need for a diagnostic test for the disease.A rosácea é uma condição cutânea crônica, que possui apresentações clínicas variáveis. Apesar de considerada uma doença dermatológica, os olhos podem ser acometidos em 58-72% dos casos, causando inflamação palpebral e da superfície ocular. Aproximadamente um terço dos pacientes desenvolve acometimento corneano, podendo causar baixa visual significativa. Diagnóstico precoce e tratamento adequado são de extrema importância, devido à significativa morbidade ocular que a doença pode causar. Não há, até o momento, um teste diagnóstico para rosácea. O diagnóstico da rosácea ocular depende da observação das manifestações clínicas, o que pode ser bastante desafiador em até 90% dos pacientes, em que os achados cutâneos são discretos ou inexistentes. Nesta revisão, descrevemos os mecanismos fisiopatológicos propostos na literatura, manifestações clínicas, diagnóstico e tratamento da rosácea ocular, assim como abordamos a necessidade de um teste diagnóstico.

  5. Ferritin blood test

    Serum ferritin level; Iron deficiency anemia - ferritin ... The amount of ferritin in the blood (serum ferritin level) is directly related to the amount of iron stored in your body. Iron is needed to make healthy red blood cells. These ...

  6. Cornea and ocular surface treatment.

    De Miguel, Maria P; Alio, Jorge L; Arnalich-Montiel, Francisco; Fuentes-Julian, Sherezade; de Benito-Llopis, Laura; Amparo, Francisco; Bataille, Laurent


    In addition to being a protective shield, the cornea represents two thirds of the eye's refractive power. Corneal pathology can affect one or all of the corneal layers, producing corneal opacity. Although full corneal thickness keratoplasty has been the standard procedure, the ideal strategy would be to replace only the damaged layer. Current difficulties in corneal transplantation, mainly immune rejection and shortage of organ supply, place more emphasis on the development of artificial corneas. Bioengineered corneas range from prosthetic devices that solely address the replacement of the corneal function, to tissue-engineered hydrogels that allow regeneration of the tissue. Recently, major advances in the biology of corneal stem cells have been achieved. However, the therapeutic use of these stem cell types has the disadvantage of needing an intact stem cell compartment, which is usually damaged. In addition, long ex vivo culture is needed to generate enough cell numbers for transplantation. In the near future, combination of advanced biomaterials with cells from abundant outer sources will allow advances in the field. For the former, magnetically aligned collagen is one of the most promising ones. For the latter, different cell types will be optimal: 1) for epithelial replacement: oral mucosal epithelium, ear epidermis, or bone marrow- mesenchymal stem cells, 2) for stromal regeneration: adipose-derived stem cells and 3) for endothelial replacement, the possibility of in vitro directed differentiation of adipose-derived stem cells towards endothelial cells provides an exciting new approach.

  7. Perfil de tolerancia ocular de un cosmético para bebe in vivo Ocular tolerance profile of a cosmetic product for babies in vivo

    Flor Ángela Tobón Marulanda


    Full Text Available Introducción: el estudio realizado previo al mercadeo de un cosmético para satisfacer la necesidad de obtener el registro sanitario, contribuye a garantizar su seguridad y eficacia para prevenir un problema de salud pública. Objetivo: describir el riesgo ocular latente por un champú mediante pruebas in vivo. Métodos: se realizó un estudio clínico hermenéutico y reflexivo, bajo la observación directa macroscópica en términos de efectos clínicos; determinación de los efectos promedios en 6 conejos mediante la escala de valores según la OCDE y estudio histopatológico de una muestra de tejido del ojo. Resultados: el 50 % de los animales mostraron el nivel 1 de lesión ocular; el 16,67 % el nivel 2 y el 33,33 % el nivel 3. Ninguno de los animales mostró el nivel 4 (lesión máxima. El análisis del promedio de los efectos clínicos y el análisis histopatológico confirman la sensibilidad del conejo como referente experimental aplicable para los bebés. Conclusiones: el champú podría producir efectos oculares leves, pero el posible riesgo ocular debe ser advertido hasta que no se demuestre su inocuidad.Introduction: the study that is performed for health registration before marketing any cosmetic product assures its safety and efficacy to prevent a public health problem. Objective: to describe the possible eye risk caused by a shampoo for babies through in vivo testing. Methods: a clinical exploratory and hermeneutic study based on direct macroscopic observation of clinical effects; determination of average effects in 6 rabbits by the OECD value scale and a histopathological study of a sample of eye tissue. Results: fifty percent of rabbits showed level 1 ocular injury; 16.67 % suffered level 2 whereas 33.33 % had level 3. None of the animals reached level 4 (maximum level in injuries. The analysis of the average clinical effects and the histopathological study confirmed the sensitivity of the rabbit as experimental reference that

  8. Development of a rapid and simplified protocol for direct bacterial identification from positive blood cultures by using matrix assisted laser desorption ionization time-of- flight mass spectrometry.

    Jakovljev, Aleksandra; Bergh, Kåre


    Bloodstream infections represent serious conditions carrying a high mortality and morbidity rate. Rapid identification of microorganisms and prompt institution of adequate antimicrobial therapy is of utmost importance for a successful outcome. Aiming at the development of a rapid, simplified and efficient protocol, we developed and compared two in-house preparatory methods for the direct identification of bacteria from positive blood culture flasks (BD BACTEC FX system) by using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI TOF MS). Both methods employed saponin and distilled water for erythrocyte lysis. In method A the cellular pellet was overlaid with formic acid on the MALDI TOF target plate for protein extraction, whereas in method B the pellet was exposed to formic acid followed by acetonitrile prior to placing on the target plate. Best results were obtained by method A. Direct identification was achieved for 81.9 % and 65.8 % (50.3 % and 26.2 % with scores >2.0) of organisms by method A and method B, respectively. Overall concordance with final identification was 100 % to genus and 97.9 % to species level. By applying a lower cut-off score value, the levels of identification obtained by method A and method B increased to 89.3 % and 77.8 % of organisms (81.9 % and 65.8 % identified with scores >1.7), respectively. Using the lowered score criteria, concordance with final results was obtained for 99.3 % of genus and 96.6 % of species identifications. The reliability of results, rapid performance (approximately 25 min) and applicability of in-house method A have contributed to implementation of this robust and cost-effective method in our laboratory.

  9. Correlation between vestibulo-ocular reflex and optokinetic afternystagmus in normal subjects and in patients with vestibular system disorders.

    Dellepiane, M; Medicina, M C; Barettini, L; Mura, A C


    Optokinetic afternystagmus follows optokinetic nystagmus as an expression of the central velocity storage integrator discharge and its fast phase is beating in the same direction as the previous optokinetic nystagmus. We investigated the correlation between vestibulo-ocular reflex and optokinetic afternystagmus in normal subjects and in patients with bilateral vestibular disorders. The aim of this study was to determine the possible role of optokinetic afternystagmus as a diagnostic test for identifying functional vestibular disorders. The subjects were examined by electronystagmography and vestibulo-ocular reflex, optokinetic nystagmus stare type as well as optokinetic afternystagmus were recorded. They were restrained in a rotatory drum chair, both the chair and the drum could be rotated, independently or coupled. For vestibulo-ocular reflex analysis, we studied post-rotatory-nystagmus from a velocity of 90 degrees s. Optokinetic nystagmus was recorded at a drum velocity of 30 degrees s and the registration continued in total darkness, after the illumination was switched off, to study optokinetic afternystagmus. We considered vestibulo-ocular reflex and optokinetic nystagmus gain, vestibulo-ocular reflex and optokinetic afternystagmus constant of time (tc) defined as the time necessary for the slow phase eye velocity to be reduced to 37% of its initial value. Results demonstrated that vestibulo-ocular reflex gain and ct showed a significant difference only in patients with reduced vestibular reflexia, while optokinetic nystagmus gain was greater only in patients with increased reflexia; optokinetic afternystagmus ct was different from the control group only in patients with hyporeflexia. In conclusion, our results suggest that vestibulo-ocular reflex and optokinetic afternystagmus ct are clinically more useful than the gain alone in testing vestibular disorders with hyporeflexia. On the other hand, we propose a new mathematical and statistical approach to study

  10. Albinism: Particular attention to the ocular motor system

    Richard W Hertle


    Full Text Available The purpose of this report is to summarize an understanding of the ocular motor system in patients with albinism. Other than the association of vertical eccentric gaze null positions and asymmetric, (a periodic alternating nystagmus in a large percentage of patients, the ocular motor system in human albinism does not contain unique pathology, rather has "typical" types of infantile ocular oscillations and binocular disorders. Both the ocular motor and afferent visual system are affected to varying degrees in patients with albinism, thus, combined treatment of both systems will maximize visual function.

  11. Albinism: particular attention to the ocular motor system.

    Hertle, Richard W


    The purpose of this report is to summarize an understanding of the ocular motor system in patients with albinism. Other than the association of vertical eccentric gaze null positions and asymmetric, (a) periodic alternating nystagmus in a large percentage of patients, the ocular motor system in human albinism does not contain unique pathology, rather has "typical" types of infantile ocular oscillations and binocular disorders. Both the ocular motor and afferent visual system are affected to varying degrees in patients with albinism, thus, combined treatment of both systems will maximize visual function.

  12. Further observations of ocular pathology in Down's syndrome.

    Ginsberg, J; Ballard, E T; Buchino, J J; Kinkler, A K


    We studied the eyes of two children with proven trisomy 21 and updated the microscopic ocular findings. The ocular malformations, generally of a minor nature, comprise a variety of nonspecific hyperplasia or hamartomata, hypoplasias, tissue defects and heterotopias, and involve virtually every portion of the globe. Ocular and extraocular abnormalities in Down's syndrome do not correlate well embryologically, cytogenetically or in regard to incidence or severity. The type of ocular anomalies usually encountered in trisomy 21 suggests that the globe was affected by the chromosomal anomaly rather late in its development.

  13. Plasticity of the human otolith-ocular reflex

    Wall, C. 3rd; Smith, T. R.; Furman, J. M.


    The eye movement response to earth vertical axis rotation in the dark, a semicircular canal stimulus, can be altered by prior exposure to combined visual-vestibular stimuli. Such plasticity of the vestibulo-ocular reflex has not been described for earth horizontal axis rotation, a dynamic otolith stimulus. Twenty normal human subjects underwent one of two types of adaptation paradigms designed either to attenuate or enhance the gain of the semicircular canal-ocular reflex prior to undergoing otolith-ocular reflex testing with horizontal axis rotation. The adaptation paradigm paired a 0.2 Hz sinusoidal rotation about a vertical axis with a 0.2 Hz optokinetic stripe pattern that was deliberately mismatched in peak velocity. Pre- and post-adaptation horizontal axis rotations were at 60 degrees/s in the dark and produced a modulation in the slow component velocity of nystagmus having a frequency of 0.17 Hz due to putative stimulation of the otolith organs. Results showed that the magnitude of this modulation component response was altered in a manner similar to the alteration in semicircular canal-ocular responses. These results suggest that physiologic alteration of the vestibulo-ocular reflex using deliberately mismatched visual and semicircular canal stimuli induces changes in both canal-ocular and otolith-ocular responses. We postulate, therefore, that central nervous system pathways responsible for controlling the gains of canal-ocular and otolith-ocular reflexes are shared.

  14. [Quantification of ocular dominance for better management of eye disease].

    Chaumillon, R; Alahyane, N; Senot, P; Vergne, J; Lemoine, C; Doré-Mazars, K; Blouin, J; Vergilino-Perez, D; Guillaume, A


    The dominant eye is defined as the one we unconsciously choose when we have to perform monocular tasks. In the field of clinical neuro-ophthalmology, it is well-established that ocular dominance plays a key role in several eye diseases. Furthermore, the accurate quantification of ocular dominance is crucial with regard to certain surgical techniques. However, classical preoperative tests cannot determine the amount of ocular dominance. In order to obtain further insight into the phenomenon of ocular dominance, we study its influence at behavioral and neurophysiological levels (experiments 1 and 2). Based on these new data, we suggest a method to improve quantification of ocular dominance (experiment 3). We demonstrate that ocular dominance has an influence on hand movements and on interhemispheric transfer time. Moreover, we show that an analysis of the dynamics of saccades allows us to sort out participants with strong or weak ocular dominance. In conclusion, this better understanding of the phenomenon of ocular dominance, coupled with the analysis of saccadic dynamics, might, in the short or medium term, lead to the establishment of a quick and straightforward battery of tests allowing determination of the amount of ocular dominance for each patient. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  15. Effect of Transcranial Direct Current Stimulation over the Primary Motor Cortex on Cerebral Blood Flow: A Time Course Study Using Near-infrared Spectroscopy.

    Takai, Haruna; Tsubaki, Atsuhiro; Sugawara, Kazuhiro; Miyaguchi, Shota; Oyanagi, Keiichi; Matsumoto, Takuya; Onishi, Hideaki; Yamamoto, Noriaki


    Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that is applied during stroke rehabilitation. The purpose of this study was to examine diachronic intracranial hemodynamic changes using near-infrared spectroscopy (NIRS) during tDCS applied to the primary motor cortex (M1). Seven healthy volunteers were tested during real stimulation (anodal and cathodal) and during sham stimulation. Stimulation lasted 20 min and NIRS data were collected for about 23 min including the baseline. NIRS probe holders were positioned over the entire contralateral sensory motor area. Compared to the sham condition, both anodal and cathodal stimulation resulted in significantly lower oxyhemoglobin (O2Hb) concentrations in the contralateral premotor cortex (PMC), supplementary motor area (SMA), and M1 (pstimulation was significantly lower than that during the sham condition (pstimulation was lower than that during anodal stimulation (pstimulation was significantly higher than the concentrations during both cathodal stimulation and the sham condition (p<0.05). The factor of time did not demonstrate significant differences. These results suggest that both anodal and cathodal tDCS cause widespread changes in cerebral blood flow, not only in the area immediately under the electrode, but also in other areas of the cortex.

  16. Profound retinal ischaemia after ranibizumab administration in an eye with ocular ischaemic syndrome

    Kofoed, Peter Kristian; Munch, Inger Christine; Larsen, Michael


    Abstract. Purpose: To report the result of ranibizumab administration in an eye with ocular ischaemic syndrome. Methods: Fluorescein angiography, ocular pneumoplethysmography and retinal vessel calibre measurement. Results: An 85-year-old man with ocular ischaemic syndrome demonstrated vision loss...

  17. BESTROPHINOPATHY: A Spectrum of Ocular Abnormalities Caused by the c.614T>C Mutation in the BEST1 Gene

    Toto, L.; Boon, C.J.F.; Antonio, L. Di; Parodi, M. Battaglia; Mastropasqua, R.; Antonucci, I.; Stuppia, L.; Mastropasqua, L.


    PURPOSE: To describe the variable ocular phenotype associated with a heterozygous mutation in the BEST1 gene. METHODS: Clinical and genetic assessment was performed in five members of the same family. Molecular genetic analysis of the BEST1 gene was performed by direct sequencing. Extensive

  18. A simplified technique for in situ excision of cornea and evisceration of retinal tissue from human ocular globe.

    Parekh, Mohit; Ferrari, Stefano; Di Iorio, Enzo; Barbaro, Vanessa; Camposampiero, Davide; Karali, Marianthi; Ponzin, Diego; Salvalaio, Gianni


    could lead to distracted, unclear vision. The cornea comprises of 5 layers; a) epithelium, b) Bowman's layer, c) stroma, d) Descemet's membrane and e) endothelium. All layers should function properly to ensure clear vision(4,5,6). The choroid is the intermediate tunic between the sclera and retina, bounded on the interior by the Bruch's membrane and is responsible for blood flow in the eye. The choroid also helps to regulate the temperature and supplies nourishment to the outer layers of the retina(5,6). The retina is a layer of nervous tissue that covers the back of the ocular globe (Suppl. Figure 1) and consists of two parts: a photoreceptive part and a non-receptive part. The retina helps to receive the light from the cornea and lens and converts it into the chemical energy eventually transmitted to the brain with help of the optic nerve(5,6). The aim of this paper is to provide a protocol for the dissection of corneal and retinal tissues from human ocular globes. Avoiding cross-contamination with adjacent tissues and preserving RNA integrity is of fundamental importance as such tissues are indispensable for research purposes aimed at (i) characterizing the transcriptome of the ocular tissues, (ii) isolating stem cells for regenerative medicine projects, and (iii) evaluating histological differences between tissues from normal/affected subjects. In this paper we describe the technique we currently use to remove the cornea, the choroid and retinal tissues from an ocular globe. Here we provide a detailed protocol for the dissection of the human ocular globe and the excision of corneal and retinal tissues. The accompanying video will help researchers to learn an appropriate technique for the retrieval of precious human tissues which are difficult to find regularly.

  19. Successful treatment with oral mizoribine in refractory ocular manifestation of mucosal pemphigus vulgaris: A unique response to different immunosuppressive drugs.

    Oyama, Noritaka; Togashi, Ari; Nomura, Erika; Kaneko, Fumio


    Pemphigus vulgaris (PV) is an acquired autoimmune disease in which the disease characteristic antibodies are directed against the desmosomal transmembrane glycoprotein, desmoglein 3 (Dsg 3), resulting in flaccid blisters and erosions of skin and mucous membrane. Among various affected sites, ocular involvement may often persist or relapse even after remission of other mucocutaneous lesions, and also represent a higher morbidity. We describe such an example case of mucosal PV, whose oral and ocular manifestations were responded specifically to oral cyclosporine and mizoribine, respectively. To our knowledge, this is the first case of the site-specific efficacy of mizoribine in PV.

  20. Mudanças oculares durante a gestação Ocular changes during pregnancy

    Enéias Bezerra Gouveia


    Full Text Available A gestação pode causar várias alterações no funcionamento do olho humano, tanto nas condições sistêmicas quanto em doenças oculares, sendo seus efeitos divididos em três categorias: alterações fisiológicas, mudanças em doenças oculares pré-existentes e alterações patológicas. O presente texto propõe uma revisão bibliográfica sobre o tema. Os autores pesquisaram os bancos de dados do PubMed (MEDLINE e LILACS.Pregnancy can cause several alterations in human eye function in healthy condition as well in ocular disease; these effects on the eyes are divided into three categories: physiologic alterations, ocular diseases changes already existing before the pregnancy, and pathological alterations. The present text proposes a bibliographical revision on the theme. The authors researched PubMed (MEDLINE and LILACS databases.