RESUMO
Idiopathic nodular glomerulosclerosis (ING) is characterized as diffuse nodular glomerulosclerotic lesions, closely resembling Kimmelstiel-Wilson lesions without diabetic mellitus. We report here three Japanese cases of ING and discuss the previous reports. The patients were 75-, 48- and 84-year-old males with a history of long-term hypertension. Laboratory examination revealed moderate proteinuria and mild renal dysfunction. Diabetes mellitus was excluded by repeated clinical and laboratory investigations. Renal histology revealed nodular glomerulosclerosis, and both afferent and efferent arteriolosclerosis in all patients. In electron microscopy, the glomerular basement membrane was markedly thick in all patients. A low-protein diet and potent anti-hypertensive treatment using angiotensin-converting enzyme inhibitors were initiated in all patients and urinary protein excretion significantly reduced without the progression of renal dysfunction. We reviewed 42 previously reported cases and our three cases. The analysis revealed that common clinical features of ING are being male (82.2%) of relatively advanced age (mean age 61.3 years), with hypertension (82.2%), mild renal dysfunction (mean serum creatinine 2.9 mg/dl) and moderate urinary protein excretion (mean 4.05 g/day). Common histopathological findings of ING are nodular glomerulosclerosis (100%), arterio-arteriolosclerosis (91.2 and 89.7%) and glomerular basement membrane thickening (85.7%). In conclusion, ING is one of the phenotypes of arteriosclerotic renal disease without diabetes mellitus. Severe arterio-arteriolosclerosis may contribute to the progression to glomerular nodular formation in ING. The combination of renin-angiotensin system inhibition and a low protein diet can be beneficial for the reduction of urinary protein excretion.
Assuntos
Nefropatias Diabéticas/patologia , Rim/patologia , Idoso , Idoso de 80 Anos ou mais , Nefropatias Diabéticas/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
Renal deterioration often occurs in cases of infectious endocarditis (IE), but, IE- associated nephritis with rapidly progressive glomerulonephritis (RPGN) is rare. Patients with severe infection (e.g., IE) sometimes show positivity for cytoplasmic antineutrophil cytoplasmic antibodies (C-ANCA). Therefore, diagnosis and treatment are very difficult in cases of RPGN with IE and positivity for C-ANCA. Such cases are rare, only 12 have been reported in the English literature. Herein, we describe the case of a 50-year-old man who presented with RPGN with IE and tested positively for C-ANCA. He was referred to our hospital because of leg edema, purpura and renal dysfunction. Laboratory tests revealed serum creatinine elevation and positivity for C-ANCA and proteinase 3-specific (PR3)-ANCA. RPGN and acute renal failure were diagnosed. Hemodialysis and steroid therapy were started. Streptococcus oralis was isolated by blood culture. Transthoracic echocardiography revealed grade III mitral valve insufficiency with two vegetations. Therefore, IE was diagnosed. The steroid therapy was stopped, and antibiotic therapy was begun. Because there was no improvement, surgical therapy was performed. The operation was successful, but the patient died of brain hemorrhage. Our experience in this case indicates C/PR3-ANCA positive RPGN must be ruled out in patients with infectious disease, particularly IE, together with renal symptoms, and renal biopsy should be performed.
Assuntos
Anticorpos Anticitoplasma de Neutrófilos/imunologia , Endocardite Bacteriana/complicações , Glomerulonefrite/imunologia , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/etiologia , Anticorpos Anticitoplasma de Neutrófilos/sangue , Ecocardiografia , Endocardite Bacteriana/sangue , Endocardite Bacteriana/imunologia , Evolução Fatal , Glomerulonefrite/sangue , Glomerulonefrite/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência da Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/etiologia , Insuficiência da Valva Mitral/cirurgiaRESUMO
PURPOSE: To determine factors that control ocular enlargement in experimental form-deprivation myopia and to clarify the mechanism of form-deprivation myopia. METHODS: After the left eyes of 20 chicks were monocularly occluded for 2 weeks, protein, basic fibroblast growth factor (bFGF) and transforming growth factor (TGF)-beta 2 contents in samples of constant area (circular button, diameter = 8.5 mm) in the retina-retinal pigment epithelium (RPE)-choroid and the sclera in the posterior region of control and myopic eyes were determined by enzyme-linked immunosorbent assay. RESULTS: The bFGF content (per circular button) and bFGF concentration (per mg protein) were significantly lower in the sclera in the posterior region of the myopic eyes than in control eyes. The bFGF content and concentration were similar in the retina-RPE-choroid in myopic and control eyes. The TGF-beta 2 content and concentration were significantly higher in myopic eyes in both the retina-RPE-choroid and the sclera (P < 0.05). CONCLUSIONS: These results are consistent with the possibility that bFGF and TGF-beta 2 regulate ocular enlargement or respond to myopiagenic mechanisms in form-deprivation myopia.
Assuntos
Olho/metabolismo , Fator 2 de Crescimento de Fibroblastos/biossíntese , Miopia/metabolismo , Fator de Crescimento Transformador beta/biossíntese , Animais , Galinhas , Modelos Animais de Doenças , Masculino , Privação SensorialRESUMO
PURPOSE: To investigate the response to mechanical stress of vascular endothelial growth factor (VEGF) production by cultured retinal pigment epithelial (RPE) cells. METHODS: A pulsatile stretch device was used in vitro. RPE cells of the second passage were seeded onto flexible-bottomed culture plates; then, at subconfluent culture, the plates were subjected to pulsatile stretch. Culture plates prepared in the same way but not subjected to stretch were used as controls. After stretching for 1 hour or 24 hours, conditioned medium for measurement of VEGF production by RPE cells was collected using a mouse VEGF immunoassay. To study the expression of VEGF in RPE cells, passaged-cultured RPE cells were exposed to pulsatile stretch for 0, 1, 3, or 14 hours. Total cytoplasmic RNA was then prepared from the RPE cells. Northern blot analysis was performed for VEGF, with G3PDH used as an internal control. RESULTS: The expression and secretion of VEGF in RPE cells were increased by pulsatile stretching. CONCLUSIONS: Results indicate that stretching of the RPE could result in increased production of VEGF, with associated risk for neovascularization and changes in the blood-retinal barrier.
Assuntos
Fatores de Crescimento Endotelial/biossíntese , Linfocinas/biossíntese , Epitélio Pigmentado Ocular/metabolismo , Animais , Northern Blotting , Células Cultivadas , Primers do DNA/química , Fatores de Crescimento Endotelial/genética , Linfocinas/genética , Epitélio Pigmentado Ocular/citologia , RNA Mensageiro/metabolismo , Ratos , Ratos Long-Evans , Estresse Mecânico , Fator A de Crescimento do Endotélio Vascular , Fatores de Crescimento do Endotélio VascularRESUMO
Human thyroid xenografts and the autologous bone marrow (BM) cells from five patients with Graves' disease (GD) were simultaneously xenografted into severe combined immunodeficient (SCID) mice to study the role of BM cells for the perpetuation of human GD autoimmunity and hyperthyroidism. All SCID mice engrafted with thyroid tissue (TH) alone, TH + autologous peripheral blood mononuclear cells, and TH + autologous BM cells produced similar amounts of human IgG; however, the production in TH + BM-engrafted mice peaked later than that of mice without BM. Production of thyroperoxidase antibody and thyroglobulin antibody in TH + BM-bearing SCID mice peaked in later weeks after xenografting than in those without BM. Moreover, human Graves' hyperthyroidism was actually reconstituted in TH + BM-transplanted mice; this was confirmed by (A) significantly higher levels and longer periods of secreting thyroid-stimulating antibody than those in mice without BM engraftment. (B) persistent hyperthyroxinemia up to the end of the experiment. (C) extremely high radioidine uptake of the xenografted thyroid tissue, and (D) histological findings of the maintenance of hyperplastic change of the xenografted thyroid epithelial cells. Human BM stem cells (CD34) were identified only in mice with TH + BM xenografts when analyzed by immunohistochemistry. In conclusion, (A) we have developed an animal model for human hyperthyroid GD by simultaneous xenotransplantation of GD thyroid tissue plus autologous BM cells into SCID mice, and (B) BM cells have a crucial role for perpetuating human GD autoimmunity and hyperthyroidism in this system.
Assuntos
Transplante de Medula Óssea , Doença de Graves , Camundongos SCID/fisiologia , Glândula Tireoide/transplante , Transplante Heterólogo , Adulto , Animais , Anticorpos/análise , Células Sanguíneas/patologia , Sobrevivência Celular , Feminino , Citometria de Fluxo , Doença de Graves/imunologia , Doença de Graves/patologia , Doença de Graves/fisiopatologia , Humanos , Imunoglobulina G/análise , Linfócitos/patologia , Masculino , Camundongos , Camundongos SCID/sangue , Pessoa de Meia-Idade , Células-Tronco/fisiologia , Glândula Tireoide/imunologia , Glândula Tireoide/patologia , Transplante AutólogoRESUMO
We cooled the surface of the cornea to reduce the thermal damage by the excimer laser ablation and referred to this method as "cooling photorefractive keratectomy" (cooling PRK). We performed conventional PRK and cooling PRK on rabbits' eyes and measured the thermal change during laser ablation. We also examined the degree of subepithelial haze and the tissues with a light microscope and an electron microscope. Normal corneal temperature of live rabbit corneas was about 32 degrees C and it rose to 41 degrees C after 300 laser shots. However, when we cooled the rabbit corneas to 24 degrees C with continuous irrigation of chilled BSS PLUS solution before laser ablation, the temperature rose only to 34 degrees C after the same ablation. Slit-lamp evaluation showed that more severe corneal haze occurred with the conventional PRK procedure. At 2 weeks postoperatively, the mean haze score was 1.77 +/- 0.87 in the conventional PRK and 0.87 +/- 0.38 in the cooling PRK (P < 0.01). Light-microscopy examination showed epithelial hyperplasia and fibroblasts, type III collagen, and heat shock protein-70 in the subepithelium of corneas with conventional PRK procedure than with cooling PRK. Under the electron microscope, more disruption of the layers of fibroblasts and collagen fibrils was observed in the conventional PRK procedure than that of the cooling PRK. In conclusion, the cooling of the corneal surface in PRK effectively reduces tissue damage related to subepithelial haze and may enable us to reduce the degree of myopic regression.
Assuntos
Temperatura Baixa , Córnea/cirurgia , Ceratectomia Fotorrefrativa/métodos , Animais , Temperatura Corporal , Colágeno/metabolismo , Colágeno/ultraestrutura , Córnea/metabolismo , Córnea/patologia , Córnea/efeitos da radiação , Opacidade da Córnea/etiologia , Opacidade da Córnea/patologia , Opacidade da Córnea/prevenção & controle , Epitélio Corneano/patologia , Fibroblastos/patologia , Técnica Indireta de Fluorescência para Anticorpo , Proteínas de Choque Térmico HSP70/metabolismo , Temperatura Alta/efeitos adversos , Hiperplasia/patologia , Lasers de Excimer , Coelhos , Lesões Experimentais por Radiação/etiologia , Lesões Experimentais por Radiação/patologia , Lesões Experimentais por Radiação/prevenção & controleRESUMO
The aim of the present work was to evaluate the neurochemical effects of early unilateral visual deprivation as a model of impaired visual maturation. For this purpose, binding to the different ionotropic glutamate receptor subtypes was quantified in vision-related and vision-unrelated brain structures of control and unilaterally deprived newborn rats. At post-natal (PN) day 10, male Sprague-Dawley rats underwent either unilateral eyeball enucleation (enucleation group, n = 12) or sham operation (control group, n = 12). In each group, brains were obtained either at post-natal day 20 (n = 6) or post-natal day 30 (n = 6) and processed for quantitative in vitro autoradiography selective for NMDA, kainate, and AMPA glutamate-binding sites, as well as for the presynaptic adenosine A1 receptor as a control of the deafferentation efficacy. In control animals, quantitative autoradiography revealed an increase in NMDA (e.g. +45% in superior colliculus) and kainate receptor binding (e.g. +55% in visual cortex, layer IV) from post-natal day 20 to post-natal day 30, associated with stable levels of AMPA receptor binding, in the vision-related structures. In the deafferented visual structures, monocular enucleation induced a marked decrease in A1 site density (e.g. -38 to -52%, in the superficial layer of superior colliculi, at PN day 20 and PN day 30, respectively) in parallel with a mild increase in both NMDA (e.g. +8 to 9%, in superior colliculi and visual cortex, layer IV at PN day 30, respectively) and AMPA (e.g. +16%, in layer IV of the visual cortex at PN day 30). Superimposed on marked bilateral decreases at PN day 30 in the enucleated rats, kainate receptor binding also revealed a slight but significant decrease (-5%) in the deafferented superior colliculus as compared to the non-deafferented side. The present findings (different time-courses of, and differential effects of deafferentation on, the NMDA, kainate and AMPA glutamate receptor subtypes throughout the visual brain structures) further support the involvement of these receptors in distinctive roles during maturation of the visual system.
Assuntos
Encéfalo/metabolismo , Receptores de AMPA/metabolismo , Receptores de Ácido Caínico/metabolismo , Receptores de N-Metil-D-Aspartato/metabolismo , Animais , Animais Recém-Nascidos , Autorradiografia , Enucleação Ocular , Ácido Caínico/metabolismo , Masculino , N-Metilaspartato/metabolismo , Ratos , Ratos Sprague-Dawley , Receptores Purinérgicos P1/metabolismo , Córtex Visual/metabolismo , Ácido alfa-Amino-3-hidroxi-5-metil-4-isoxazol Propiônico/metabolismoRESUMO
PURPOSE: To evaluate angiographic findings of retrobulbar arteries and veins in severely myopic patients. METHODS: We examined 416 severely myopic eyes (213 patients) with refractive errors greater than -8.25 diopters using indocyanine green videoangiography. A control group of 74 eyes (37 patients) had refractive errors within plano +/- 3 diopters. Four severely myopic patients underwent computed tomographic angiography to identify the entire intraorbital course of retrobulbar veins. RESULTS: Of 416 severely myopic eyes, 231 (55.5%) exhibited retrobulbar arteries, which were tortuous and pulsatile behind the posterior pole of the globe. Retrobulbar arteries connected directly with choroidal arteries temporal to the macular area. In 17 of these 231 eyes, retrobulbar arteries were also observed nasal to the optic nerve head, continuous with the Zinn-Haller ring around the optic nerve head and directly connected with choroidal arteries. In 39 severely myopic eyes (31 patients), indocyanine green angiography disclosed retrobulbar veins, most of which coursed vertically just behind the posterior pole of the globe. These retrobulbar veins originated as an inferior vascular network of the inferior orbital vein and drained into the superior orbital vein in the upper orbit. CONCLUSION: Retrobulbar arteries observed in this study were temporal and nasal short posterior ciliary arteries. Only the lateral collateral vein, which was one of the collateral channels between the superior and inferior orbital veins, was visible in severely myopic eyes. Indocyanine green angiography is useful in evaluating retrobulbar vascular structure in severely myopic eyes.
Assuntos
Corantes , Angiofluoresceinografia , Verde de Indocianina , Miopia/complicações , Órbita/irrigação sanguínea , Adolescente , Adulto , Idoso , Feminino , Fundo de Olho , Humanos , Masculino , Microcirculação/fisiologia , Pessoa de Meia-Idade , Miopia/fisiopatologia , Órbita/diagnóstico por imagem , Fluxo Sanguíneo Regional/fisiologia , Artéria Retiniana/diagnóstico por imagem , Artéria Retiniana/fisiologia , Veia Retiniana/diagnóstico por imagem , Veia Retiniana/fisiologia , Tomografia Computadorizada por Raios X , Acuidade VisualRESUMO
The pathogenesis of Graves' ophthalmopathy (GO) is still unclear and the possible role of TSH receptor antibody in the development of GO is controversial. However, the recent availability of severe combined immunodeficient (SCID) mice has provided a means to study of human autoimmune thyroid disease in an in vivo environment. In the present study, we xenografted human retroorbital (RO) tissues from 9 patients with GO into 9 SCID mice and the autologous peripheral blood mononuclear cells (PBMC) from 5 of 9 GO patients were engrafted into 5 separate SCID mice to reconstitute the immunological environment of human GO. Mice blood samples were taken every 2 weeks for the measurements of human IgG, thyroglobulin antibody (Tg-Ab), thyroperoxidase (TPO)-Ab, thyroid-stimulating antibody (TSAb), and interferon-gamma (IFN-gamma). Eight weeks after xenografting, mice were killed; RO tissues were analyzed histologically, SCID mice with RO tissues from 2 of 9 GO patients produced human IgG peaking at 6-8 weeks after xenografting. TPO-Abs and TG-Abs were detectable in low titer in mice with RO tissue xenografts from 3/9 and 4/9 GO patients, respectively. The mean level of IFN-gamma in SCID mice with GO RO xenografts was higher than that of a control subject (RO tissue from a non-GO patient). TSAbs were actually produced from 7 of 9 mice xenografted with GO RO tissues, and reached their peaks at 2-8 weeks after xenografting; autologous PBMC (alone, without RO tissues)-engrafted SCID mice did not produce any detectable level of TSAb. The control mouse did not produce any detectable levels of human IgG, TPO-Ab, Tg-Ab, or TSAb. Immunohistochemical analysis of orbital mononuclear cell infiltrates revealed a predominance of T lymphocytes, with a small percentage of B lymphocytes in GO RO tissue graft. In conclusion, we have successfully reconstituted the SCID mice with human lymphocytes of RO tissues from patients with GO. Autoreactive B cell clones responsible for secreting TSAb exist in GO RO tissue and may be a key factor in the initiation and/or the progression of GO.
Assuntos
Doença de Graves/imunologia , Imunoglobulinas Estimuladoras da Glândula Tireoide/imunologia , Transplante Heterólogo/imunologia , Adulto , Idoso , Animais , Autoanticorpos/imunologia , Transplante de Células , Feminino , Doença de Graves/patologia , Testes de Hemaglutinação , Humanos , Imunoglobulinas Estimuladoras da Glândula Tireoide/análise , Imuno-Histoquímica , Interferon gama/análise , Interferon gama/imunologia , Iodeto Peroxidase/imunologia , Masculino , Camundongos , Camundongos SCID , Pessoa de Meia-Idade , Neutrófilos/imunologia , Órbita , Receptores da Tireotropina/imunologia , Tireoglobulina/análise , Tireoglobulina/imunologiaRESUMO
We studied the effects of exogenous human IFN-gamma or neutralizing monoclonal antibody (mAb) to IFN-gamma on xenografted human Graves' thyroid tissue in severe combined immunodeficient (SCID) mice to investigate a possible role of IFN-gamma in the pathogenesis of human Graves' disease. Human thyroid tissues from four patients with Graves' disease were xenografted into SCID mice. Two weeks after xenografting, mice were divided into three groups with human IgG levels similar to each other. Mice in the first group were treated with human IFN-gamma daily for 6 weeks; mice in the second (similar) group were treated with an mAb to IFN-gamma; mice in the third group were given mouse IgG only (control group). Blood samples were taken every 2 weeks for human IgG and thyroid-specific autoantibodies (Tg-Ab, TPO-Ab, and thyroid-stimulating antibody). After 6 weeks' treatment, mice were killed, and the thyroid xenograft was examined for thyrocyte HLA-DR expression. Human IgGs were produced equally in all three groups; mice treated with IFN-gamma showed significantly lower amounts of thyroid autoantibodies than those in the control group. Thyrocyte HLA-DR expression was markedly increased in xenografts from mice with IFN-gamma administration. On the other hand, anti-IFN-gamma mAb injection caused only slight suppression of HLA-DR expression on xenografted thyroid cells. In conclusion, IFN-gamma may down-regulate the production of thyroid-specific autoantibodies but not human IgG, at least under these circumstances; there thus may be specific inhibitory effects of IFN-gamma against thyroid-specific autoantibody production of intrathyroidal plasma cells, and this animal model may help to elucidate the possible role of cytokines in the pathogenesis of Graves' disease.
Assuntos
Autoanticorpos/biossíntese , Doença de Graves/imunologia , Interferon gama/farmacologia , Glândula Tireoide/imunologia , Animais , Anticorpos Monoclonais/farmacologia , Doença de Graves/etiologia , Doença de Graves/patologia , Antígenos HLA-DR/metabolismo , Humanos , Imunoglobulina G/biossíntese , Interferon gama/antagonistas & inibidores , Interferon gama/fisiologia , Camundongos , Camundongos SCID , Testes de Neutralização , Proteínas Recombinantes , Glândula Tireoide/patologia , Glândula Tireoide/transplante , Transplante HeterólogoRESUMO
We investigated the effects of cyclic guanosine 3',5'-monophosphate (cGMP) on type 2 iodothyronine deiodinase (D2) in cultured rat glial cells. Rat glial cells were cultured in Dulbecco's modified Eagle's medium supplemented with 15% fetal bovine serum. When cells were cultured in the presence of 8-bromo cGMP (8-Br cGMP), an analogue of cGMP, D2 activity was increased in a time- and concentration-dependent manner. Lineweaver-Burk plots revealed that the stimulation of D2 activity by 8-Br cGMP (10(-3) M) was associated with fivefold increase in maximum velocity but without a significant change in Michaelis-Menten constant, suggesting that cGMP increases D2 activity via new enzyme synthesis. Both atrial natriuretic peptide (ANP) and C-type natriuretic peptide (CNP) are well known to increase the intracellular cGMP level via their guanylate cyclase-linked receptors in rat glial cells. In the present study, ANP (10(-6) M) and CNP (10(-6) M) significantly increased the D2 activity in rat glial cells (1.9-fold [ANP] or 2.3-fold [CNP] compared with control activity, respectively). Northern blot analysis demonstrated that D2 mRNA level increased in the presence of 8-Br cGMP (10(-3) M), and reached a plateau (six-fold) after 4 hours of incubation. The increment of D2 mRNA level by 8-Br cGMP was comparable with the increase of the D2 activity by this agent. Our data suggest that cGMP induces rat D2 activity, at least in part, at the pretranslational level, and that ANP and CNP increase D2 activity most likely via their guanylate cyclase-linked receptors in rat glial cells.
Assuntos
Fator Natriurético Atrial/farmacologia , GMP Cíclico/farmacologia , Iodeto Peroxidase/efeitos dos fármacos , Peptídeo Natriurético Tipo C/farmacologia , Neuroglia/efeitos dos fármacos , 8-Bromo Monofosfato de Adenosina Cíclica/farmacologia , Animais , Sequência de Bases , Bovinos , Células Cultivadas , Indução Enzimática , Iodeto Peroxidase/biossíntese , Dados de Sequência Molecular , Neuroglia/enzimologia , RNA Mensageiro/biossíntese , Ratos , Ratos WistarRESUMO
AIMS: To delineate the entire Zinn-Haller arterial ring angiographically in vivo. METHODS: 382 highly myopic eyes (210 patients) with refractive errors greater than -8.25 D were examined using indocyanine green (ICG) videoangiography. A control group of 80 eyes (40 patients) had refractive errors within plano +/- 3D. RESULTS: The Zinn-Haller ring was visible in 206 of 382 highly myopic eyes (53.9%) by ICG angiography. Although only a part of the Zinn-Haller ring was visible in 162 of 206 eyes, in the remaining 44 eyes it was observed almost completely around the optic nerve head. No anastomotic channels between lateral and medial short posterior ciliary arteries were filled by ICG angiography. In 22 of the 44 eyes (50.0%) the Zinn-Haller ring was supplied by branches of the lateral and medial short posterior ciliary arteries; in seven eyes, it was supplied only by the lateral short posterior ciliary artery; and in seven eyes, it was supplied only by the medial short posterior ciliary artery. In none of the control subjects was the Zinn-Haller ring visible by ICG angiography. CONCLUSIONS: The Zinn-Haller ring observed by ICG angiography was not a complete collateral circle between lateral and medial posterior ciliary arteries. Also, the patterns in supply vessels to the Zinn-Haller ring varied. ICG angiography made possible the detailed observation of the Zinn-Haller ring in human eyes in vivo.
Assuntos
Verde de Indocianina , Miopia/patologia , Disco Óptico/irrigação sanguínea , Adolescente , Adulto , Idoso , Angiografia/métodos , Criança , Artérias Ciliares/diagnóstico por imagem , Artérias Ciliares/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Disco Óptico/diagnóstico por imagem , Gravação em VídeoRESUMO
AIMS: To evaluate angiographic features of myopic crescents using fluorescein angiography (FA) and indocyanine green angiography (IA). METHODS: FA and IA angiograms of 88 highly myopic eyes (47 consecutive patients) were reviewed. The follow up period ranged from 5-28 years. RESULTS: FA revealed two zones of the myopic crescent: a consistently hypofluorescent inner zone and an outer zone with delayed choroidal filling. IA revealed dislocation of the Zinn-Haller ring to the border between the two zones. Myopic crescent enlargement occurred in 68.1%. Only the outer zone increased significantly in most of the eyes with enlarged crescents. CONCLUSIONS: The inner zone might develop as a result of mechanical stretching, and the outer zone might be the result a secondary circulatory disturbance and mechanical stretching.
Assuntos
Miopia/patologia , Adolescente , Adulto , Idoso , Criança , Corantes , Feminino , Angiofluoresceinografia/métodos , Seguimentos , Humanos , Verde de Indocianina , Masculino , Pessoa de Meia-IdadeRESUMO
AIMS: To determine the incidence and predisposing findings for choroidal neovascularisation (CNV) in a large series of highly myopic patients. METHODS: The medical records of 218 consecutive patients (325 eyes) with myopic fundus changes in the macula were reviewed. The incidence of CNV during a follow up of at least 3 years of highly myopic patients and identification of predisposing findings for the development of myopic CNV were examined. RESULTS: Among 325 highly myopic eyes examined, 33 eyes (10.2%) developed myopic CNV. The incidence was higher (34.8%) among the fellow eyes of patients with pre-existing CNV than among eyes of patients without pre-existing CNV (6.1%). CNV developed in 3.7% with diffuse chorioretinal atrophy, in 20.0% with patchy atrophy, and in 29.4% with lacquer cracks. CONCLUSION: Approximately one in 10 highly myopic eyes developed myopic CNV in average 130.2 months. Patchy atrophy and lacquer cracks were shown to be important predisposing findings for CNV development.
Assuntos
Neovascularização de Coroide/patologia , Miopia/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Atrofia/patologia , Criança , Corioide/patologia , Neovascularização de Coroide/etiologia , Angiofluoresceinografia/métodos , Humanos , Pessoa de Meia-Idade , Miopia/complicações , Retina/patologiaRESUMO
PURPOSE: To evaluate the effect of cooling on pain, corneal haze, and refractive outcome after excimer laser photorefractive keratectomy (PRK). SETTING: Tokyo Medical and Dental University Hospital, Tokyo, Japan. METHODS: The corneal surface was cooled before, during, and after laser ablation using a method called cooling PRK. Thirty-eighty highly myopic eyes of 38 patients whose spherical errors ranged from -8.00 to -18.75 diopters (D) were randomized into 2 groups: 16 eyes with conventional PRK and 22 eyes with cooling PRK. Postoperative pain was measured using the Visual Analogue Scale (VAS). Refraction, visual acuity, and complications were followed for up to 2 years. All data were analyzed and compared between groups to evaluate the cooling effect on PRK. RESULTS: One day postoperatively, patients in the cooling PRK group had significantly less pain (P < .01). At 3 months, the haze score in the cooling PRK group was significantly less than in the conventional PRK group (P < .01). The residual refractive error was not significantly different between the 2 groups until 2 years, when it was greater in the conventional PRK (mean -5.09 D +/- 2.11 [SD]) than the cooling PRK group (-4.64 +/- 2.27 D). Ten eyes (62.5%) in the conventional PRK group and 15 eyes (68.2%) in the cooling PRK group were within +/- 1.00 D of the intended refraction. There were no serious complications in the cooling PRK group. Two eyes in the conventional PRK group had severe corneal haze and lost 2 Snellen lines of best corrected visual acuity. CONCLUSION: Corneal cooling on PRK effectively reduced postoperative pain, corneal haze, and myopic regression.
Assuntos
Temperatura Baixa , Córnea/cirurgia , Hipotermia Induzida , Miopia/cirurgia , Ceratectomia Fotorrefrativa/métodos , Adulto , Método Duplo-Cego , Feminino , Humanos , Lasers de Excimer , Masculino , Medição da Dor , Dor Pós-Operatória/prevenção & controle , Complicações Pós-Operatórias/prevenção & controle , Estudos Prospectivos , Refração Ocular , Segurança , Acuidade VisualRESUMO
The synthesis of L-galactosylceramide is described. Data are presented indicating that this enantiomorph of D-galactocerebroside is not cleaved by galactocerebroside-beta-galactosidase obtained from mammalian tissues. The synthesis of L-glucosylceramide and beta-D-glucothiocerebroside are outlined. These compounds are also refractory to catabolism by glycosidases in mammalian tissues that catalyze the hydrolysis of naturally occurring cerebrosides. L-Hexosyl- and thioanalogs of cerebrosides and perhaps psychosines as well may be helpful for investigating the pathogenesis of Krabbe's disease and Gaucher's disease.
Assuntos
Cerebrosídeos/metabolismo , Galactosilceramidas/metabolismo , Animais , Encéfalo/enzimologia , Modelos Animais de Doenças , Galactose/metabolismo , Galactosilceramidase/metabolismo , Doença de Gaucher , Glucosilceramidas/metabolismo , Humanos , Intestino Delgado/enzimologia , Leucodistrofia de Células Globoides , Ratos , Ratos EndogâmicosRESUMO
PURPOSE: Nitric oxide (NO) relaxes ciliary smooth muscle, and endothelin-1 (ET-1) is reported to regulate ciliary muscle tone. Despite the physiological significance of nitric oxide and ET-1, very few studies have attempted to characterize the mutual modes of action of these mediators in this tissue. Thus, the present experiments were designed to investigate a possible relaxation mechanism of nitric oxide in bovine ciliary muscle that has been contracted by ET-1. METHODS: The effects of sodium nitroprusside (SNP), as a nitric oxide donor, methylene blue, as an inhibitor of guanylate cyclase, and 8-bromo-cyclic GMP on the bovine ciliary muscle contracted with ET-1 were examined. The changes in cyclic GMP level and relaxation, in response to SNP alone or in combination with 3-isobutyl-1-methylxanthine (IBMX) as a nonselective inhibitor of phosphodiesterases, were also determined. RESULTS: Sodium nitroprusside (SNP) produced a concentration-dependent relaxation, which was significantly (p < 0.005) augmented by 10(-5) M 3-isobutyl-1-methylxanthine (IBMX) and significantly (p < 0.005) attenuated by 3 x 10(-5) M methylene blue as an inhibitor of guanylate cyclase. The relaxation in response to SNP was accompanied by an increase in the cyclic 3':5' guanosine monophosphate (cyclic GMP) level, which was again significantly (p < 0.05) augmented by 10(-5) M IBMX and significantly (p < 0.005) attenuated by 3 x 10(-5) M methylene blue. The exogenously applied 8-bromo-cyclic GMP relaxed the ciliary muscle strips during the contraction caused by ET-1. CONCLUSIONS: These results lead us to assume that NO generated from SNP is closely related to cyclic GMP production via the activation of guanylate cyclase and, in turn, causes a relaxation response in the bovine ciliary muscle contracted with ET-1.
Assuntos
Corpo Ciliar/efeitos dos fármacos , GMP Cíclico/metabolismo , Endotelina-1/farmacologia , Contração Muscular/efeitos dos fármacos , Relaxamento Muscular , Óxido Nítrico/farmacologia , 1-Metil-3-Isobutilxantina/farmacologia , Animais , Bovinos , Corpo Ciliar/metabolismo , Corpo Ciliar/fisiologia , GMP Cíclico/análogos & derivados , GMP Cíclico/farmacologia , Combinação de Medicamentos , Guanilato Ciclase/antagonistas & inibidores , Técnicas In Vitro , Azul de Metileno/farmacologia , Nitroprussiato/farmacologia , Inibidores de Fosfodiesterase/farmacologiaRESUMO
The absorption and metabolism of [(32)P]inorganic phosphate (Pi) by suspension cultured cells of Catharanthus roseus was studied. The cells absorbed 46 % of the Pi from fresh medium during the first day after inoculation. More than 90% of the Pi had been absorbed by the end of the culture period (10 days). Free Pi in the cells decreased with growth and more than 85% of the absorbed [(32)P]Pi was found as organic phosphates at the stationary phase. A large proportion of the absorbed Pi was incorporated into nucleic acids (45%) and phospholipids (30%), 5-10% into nucleotides and less than 3 % into sugar phosphates and proteins.
RESUMO
The time varying properties have been investigated of respiratory components in fluctuations of the pupil diameter (PDF) of the human eye. PDF and instantaneous lung volume were simultaneously measured for 45 minutes under natural binocular viewing conditions. The short-term Fourier transform and the autoregressive signal modeling together with the recursive least squares algorithm have been applied for the estimation of nonstationary power spectra. Data analysis showed a bursting type non-stationarity in the appearance of the respiratory component in PDF.
Assuntos
Modelos Biológicos , Pupila/fisiologia , Respiração/fisiologia , Adulto , Algoritmos , Processamento Eletrônico de Dados , Análise de Fourier , Humanos , Análise dos Mínimos Quadrados , Medidas de Volume Pulmonar , Valores de Referência , Processamento de Sinais Assistido por Computador , Fatores de TempoRESUMO
We report a 62-year-old male patient who had variant angina and isolated adrenocorticotropic hormone (ACTH) deficiency. His serum sodium concentration was low and vasopressin was inappropriately high for the low plasma osmolality. Serum free thyroxine (FT4) was low and thyroid stimulating hormone (TSH) was high with positive anti-thyroperoxidase antibodies, compatible with Hashimoto's thyroiditis. Treatment with Amrodipine and hydrocortisone relieved chest symptoms and hyponatremia, and hypothyroidism was also normalized. It is suggested that coronary artery spasm may be related to cortisol deficiency and/or inappropriately high vasopressin secretion and that hypothyroidism was ameliorated because the reduced responsiveness to TSH returned to normal due to hydrocortisone supplement.