Asymmetric vitreomacular traction and symmetrical full thickness macular hole formation.

BACKGROUND: A Full Thickness Macular Hole (FTMH) is often associated with vitreomacular traction, and this can be asymmetric with vitreomacular traction on one side of the hole but not the other. In cross-section, the elevated retinal rim around a developed FTMH is seen as a drawbridge elevation, and this drawbridge elevation may be used as a measure of morphological change. Examination of the drawbridge elevation of the retinal rim in FTMH with asymmetric vitreomacular traction may help to clarify the role of vitreomacular traction in the development of FTMH. METHOD: Cases of FTMH were identified with an initial OCT scan showing vitreomacular traction on one side of the hole only and that had a follow-up OCT scan showing progression of the hole. A tangent to the retinal surface at a distance of 700 microns from the axis of the hole was used as a marker of the drawbridge elevation of the retinal rim around the macular hole. Comparisons of the drawbridge elevation and change in drawbridge elevation between the sides with and without initial vitreomacular traction were made. RESULTS: There was no significant difference between the drawbridge elevation, or change in drawbridge elevation, on the side of the hole with initial vitreomacular traction compared to the side without initial traction. CONCLUSION: There is some intrinsic mechanism within the retina to link the morphological changes on the two sides of a FTMH. A bistable hypothesis of FTMH formation and closure is postulated to explain this linkage.

Movement of the inner retina complex during the development of primary full-thickness macular holes: implications for hypotheses of pathogenesis.

BACKGROUND: The inner retinal complex is a well-defined layer in spectral-domain OCT scans of the retina. The central edge of this layer at the fovea provides anatomical landmarks that can be observed in serial OCT scans of developing full-thickness macular holes (FTMH). Measurement of the movement of these points may clarify the mechanism of FTMH formation. METHOD: This is a retrospective study of primary FTMH that had a sequence of two OCT scans showing progression of the hole. Measurements were made of the dimensions of the hole, including measurements using the central edge of the inner retinal complex (CEIRC) as markers. The inner retinal separation (distance between the CEIRC across the centre of the fovea) and the Height-IRS (average height of CEIRC above the retinal pigment epithelium) were measured. RESULTS: Eighteen cases were identified in 17 patients. The average increase in the base diameter (368 microns) and the average increase in minimum linear dimension (187 microns) were much larger than the average increase in the inner retinal separation (73 microns). The average increase in Height-IRS was 103 microns. CONCLUSION: The tangential separation of the outer retina to produce the macular hole is much larger than the tangential separation of the inner retinal layers. A model based on the histology of the Muller cells at the fovea is proposed to explain the findings of this study.

Estimating the mechanical properties of retinal tissue using contact angle measurements of a spreading droplet.

When a drop of liquid is placed on the surface of a soft material, the surface deformation and the rate of spreading of the triple contact point is dependent on the mechanical properties of the substrate. This study seeks to use drop spreading behavior to infer the mechanical properties of soft biological materials. As an illustration of the value of this technique we have compared the spreading behavior of a liquid droplet on two viscoelastic, soft materials, namely, an elastomer and a low concentration agar gel. The ratio of the mechanical properties of these soft materials obtained in this way is confirmed by atomic force microscopy (AFM) nanoindentation. By comparing the spreading behavior of a liquid on the retina with that of the same liquid on each of two viscoelastic materials, we can then estimate the elastic moduli of the retina: an estimate that is extremely difficult to carry out using AFM.

Tensile properties of human collagen fibrils and fascicles are insensitive to environmental salts.

To carry out realistic in vitro mechanical testing on anatomical tissue, a choice has to be made regarding the buffering environment. Therefore, it is important to understand how the environment may influence the measurement to ensure the highest level of accuracy. The most physiologically relevant loading direction of tendon is along its longitudinal axis. Thus, in this study, we focus on the tensile mechanical properties of two hierarchical levels from human patellar tendon, namely: individual collagen fibrils and fascicles. Investigations on collagen fibrils and fascicles were made at pH 7.4 in solutions of phosphate-buffered saline at three different concentrations as well as two HEPES buffered solutions containing NaCl or NaCl + CaCl2. An atomic force microscope technique was used for tensile testing of individual collagen fibrils. Only a slight increase in relative energy dissipation was observed at the highest phosphate-buffered saline concentration for both the fibrils and fascicles, indicating a stabilizing effect of ionic screening, but changes were much less than reported for radial compression. Due to the small magnitude of the effects, the tensile mechanical properties of collagen fibrils and fascicles from the patellar tendon of mature humans are essentially insensitive to environmental salt concentration and composition at physiological pH.

Tuning the elastic modulus of hydrated collagen fibrils.

Systematic variation of solution conditions reveals that the elastic modulus (E) of individual collagen fibrils can be varied over a range of 2-200 MPa. Nanoindentation of reconstituted bovine Achilles tendon fibrils by atomic force microscopy (AFM) under different aqueous and ethanol environments was carried out. Titration of monovalent salts up to a concentration of 1 M at pH 7 causes E to increase from 2 to 5 MPa. This stiffening effect is more pronounced at lower pH where, at pH 5, e.g., there is an approximately 7-fold increase in modulus on addition of 1 M KCl. An even larger increase in modulus, up to approximately 200 MPa, can be achieved by using increasing concentrations of ethanol. Taken together, these results indicate that there are a number of intermolecular forces between tropocollagen monomers that govern the elastic response. These include hydration forces and hydrogen bonding, ion pairs, and possibly the hydrophobic effect. Tuning of the relative strengths of these forces allows rational tuning of the elastic modulus of the fibrils.

Atomic Force Microscopy on Biological Materials Related to Pathological Conditions.

Atomic force microscopy (AFM) is an easy-to-use, powerful, high-resolution microscope that allows the user to image any surface and under any aqueous condition. AFM has been used in the investigation of the structural and mechanical properties of a wide range of biological matters including biomolecules, biomaterials, cells, and tissues. It provides the capacity to acquire high-resolution images of biosamples at the nanoscale and allows at readily carrying out mechanical characterization. The capacity of AFM to image and interact with surfaces, under physiologically relevant conditions, is of great importance for realistic and accurate medical and pharmaceutical applications. The aim of this paper is to review recent trends of the use of AFM on biological materials related to health and sickness. First, we present AFM components and its different imaging modes and we continue with combined imaging and coupled AFM systems. Then, we discuss the use of AFM to nanocharacterize collagen, the major fibrous protein of the human body, which has been correlated with many pathological conditions. In the next section, AFM nanolevel surface characterization as a tool to detect possible pathological conditions such as osteoarthritis and cancer is presented. Finally, we demonstrate the use of AFM for studying other pathological conditions, such as Alzheimer's disease and human immunodeficiency virus (HIV), through the investigation of amyloid fibrils and viruses, respectively. Consequently, AFM stands out as the ideal research instrument for exploring the detection of pathological conditions even at very early stages, making it very attractive in the area of bio- and nanomedicine.

AFM relative stiffness measurement of the plasticising effect of a non-ionic surfactant on plant leaf wax.

An AFM relative stiffness technique was applied to reconstituted Beta vulgaris L. wax films. Consecutive force arrays (n=100) made on the waxy surface at the same locations showed that there was no relative change in surface elasticity and this information was used as a reference to further experimental measurements. A surfactant solution was subsequently dropped on the waxy surface and the same array of indents was made at the same location as the reference test. The plant wax surface showed a reduction in its surface elasticity properties. The study has demonstrated that the AFM technique could be used to undertake a systematic assessment of the plasticising effects of agrochemicals on native and reconstituted plant wax films.

Gallium incorporation into phosphate based glasses: Bulk and thin film properties.

The osteogenic ions Ca2+, P5+, Mg2+, and antimicrobial ion Ga3+ were homogenously dispersed into a 1.45 µm thick phosphate glass coating by plasma assisted sputtering onto commercially pure grade titanium. The objective was to deliver therapeutic ions in orthopaedic/dental implants such as cementeless endoprostheses or dental screws. The hardness 4.7 GPa and elastic modulus 69.7 GPa, of the coating were comparable to plasma sprayed hydroxyapatite/dental enamel, whilst superseding femoral cortical bone. To investigate the manufacturing challenge of translation from a target to vapour condensed coating, structural/compositional properties of the target (P51MQ) were compared to the coating (P40PVD) and a melt-quenched equivalent (P40MQ). Following condensation from P51MQ to P40PVD, P2O5 content reduced from 48.9 to 40.5 mol%. This depolymerisation and reduction in the P-O-P bridging oxygen content as determined by 31P NMR, FTIR and Raman spectroscopy techniques was attributed to a decrease in the P2O5 network former and increases in alkali/alkali-earth cations. P40PVD appeared denser (3.47 vs. 2.70 g cm-3) and more polymerised than it's compositionally equivalent P40MQ, showing that structure/ mechanical properties were affected by manufacturing route.

Core (Polystyrene)-Shell [Poly(glycerol monomethacrylate)] Particles.

A set of water-swollen core-shell particles was synthesized by emulsion polymerization of a 1,3-dioxolane functional monomer in water. After removal of the 1,3-dioxolane group, the particles' shells were shown to swell in aqueous media. Upon hydrolysis, the particles increased in size from around 70 to 100-130 nm. A bicinchoninic acid assay and ζ-potential measurements were used to investigate the adsorption of lysozyme, albumin, or fibrinogen. Each of the core-shell particles adsorbed significantly less protein than the noncoated core (polystyrene) particles. Differences were observed as both the amount of difunctional, cross-linking monomer and the amount of shell monomer in the feed were changed. The core-shell particles were shown to be resistant to protein adsorption, and the degree to which the three proteins adsorbed was dependent on the formulation of the shell.

Complex wavefront-guided retreatments with the Alcon CustomCornea platform after prior LASIK.

PURPOSE: To report the results of complex wavefront-guided LASIK retreatments. METHODS: Twenty eyes (15 patients) with histories of conventional LASIK surgery and significant visual complaints of glare and halos due to higher order aberrations were treated. Wavefront-guided retreatments were performed with the LADARVision CustomCornea system (Alcon, Ft Worth, Tex). Pre- and postoperative topographies, wavefront measurements, and subjective reports were analyzed. RESULTS: Postoperatively, patients had an expanded optical zone, many with improved centration. Lower and higher order aberrations decreased following wavefront-guided ablation. Mean higher order root-mean-square decreased from 1.01 +/- 0.25 microm preoperatively to 0.84 +/- 0.23 microm postoperatively. Mean coma decreased from 0.59 +/- 0.26 microm to 0.43 +/- 0.21 microm. Mean spherical aberration decreased from 0.66 +/- 0.25 microm to 0.54 +/- 0.27 microm. Subjective reports of glare and halo symptoms improved in all patients. CONCLUSIONS: CustomCornea wavefront-guided treatments are effective in reducing lower and higher order aberrations, expanding optical zones, and improving subjective reports of adverse aberration sequelae such as glare and halos.

Poly(vinyl alcohol) hydrogel as a biocompatible viscoelastic mimetic for articular cartilage.

The prevalence of suboptimal outcome for surgical interventions in the treatment of full-thickness articular cartilage damage suggests that there is scope for a materials-based strategy to deliver a more durable repair. Given that the superficial layer of articular cartilage creates and sustains the tribological function of synovial joints, it is logical that candidate materials should have surface viscoelastic properties that mimic native articular cartilage. The present paper describes force spectroscopy analysis by nano-indentation to measure the elastic modulus of the surface of a novel poly(vinyl alcohol) hydrogel with therapeutic potential as a joint implant. More than 1 order of magnitude decrease in the elastic modulus was detected after adsorption of a hyaluronic acid layer onto the hydrogel, bringing it very close to previously reported values for articular cartilage. Covalent derivatization of the hydrogel surface with fibronectin facilitated the adhesion and growth of cultured rat tibial condyle chondrocytes as evidenced morphologically and by the observance of metachromatic staining with toluidine blue dye. The present results indicate that hydrogel materials with potential therapeutic benefit for injured and diseased joints can be engineered with surfaces with biomechanical properties similar to those of native tissue and are accepted as such by their constituent cell type.

The Effect of Polysialic Acid Expression on Glioma Cell Nano-mechanics.

Polysialic acid (polySia) is an important carbohydrate bio-polymer that is commonly over-expressed on tumours of neuroendocrine origin and plays a key role in tumour progression. polySia exclusively decorates the neural cell adhesion molecule (NCAM) on tumour cell membranes, modulating cell-cell interactions, motility and invasion. In this preliminary study, we examine the nano-mechanical properties of isogenic C6 rat glioma cells-transfected cells engineered to express the enzyme polysialyltransferase ST8SiaII, which synthesises polySia (C6-STX cells) and wild-type cells (C6-WT). We demonstrate that polySia expression leads to reduced elastic and adhesive properties but also more viscoelastic compared to non-expressing wild-type cells. Whilst differences in cell elasticity between healthy and cancer cells are regularly assigned to changes in the cytoskeleton, we show that in this model system, the change in properties at the nano-level is due to the polySia on the transfected cell membrane surface.

Establishing analysis parameters for spherical aberration after wavefront LASIK.

PURPOSE: To compare preoperative and postoperative spherical aberration, coma, and other higher order aberrations from wavefront LASIK at varying pupil analysis diameters and different myopic corrections, and to determine acceptable parameters for wavefront measurements. DESIGN: Nonrandomized retrospective chart review. PARTICIPANTS: Twenty-one eyes of 12 patients who had CustomCornea LASIK with the LADARVision 4000 (Alcon, Fort Worth, TX). METHODS: Wavefront analyses were performed before and 3 months after CustomCornea LASIK using a 6.5-mm central optical zone and blend zone to 9.0 mm. Wavefront measurements were made with pupil analysis diameters of 5.5, 6.0, 6.5, and 7.0 mm. Myopic corrections were divided into 3 spherical equivalent subgroups: low (<3 diopters [D]), medium (3-6 D), and high (>6 D). Main outcome measures were compared based on myopic subgroup within each analysis diameter. Results were analyzed with analysis of variance and paired t tests. MAIN OUTCOMES MEASURES: Spherical aberration, coma, and other higher order aberrations. RESULTS: There were no significant increases in coma or other higher order aberrations postoperatively or with larger analysis diameters. There was a significant increase in postoperative differences in spherical aberration between 6.5 and 7.0 mm for the >6-D myopic correction subgroup (P = 0.03). Differences between other 0.5-mm intervals and other subgroups were not significant. CONCLUSIONS: The largest difference between preoperative and postoperative spherical aberration occurred at the analysis diameter 0.5 mm greater than the laser optical zone for the subgroup with high myopic correction. To detect larger degrees of induced spherical aberrations, analysis diameters 0.5 mm larger than the central laser optical zone should be considered.

Reversal of laser in situ keratomileusis-induced ectasia with intraocular pressure reduction.

A 40 year-old woman had laser in situ keratomileusis for --7.75 --0.75 x 20 in the right eye. Preoperative examinations, including topography, pachymetry, and intraocular pressures (IOPs), were normal, and best spectacle-corrected visual acuity (BSCVA) was 20/20 in each eye. By 4 months postoperatively, the uncorrected visual acuity and BSCVA in the right eye had decreased to 20/40. Corneal topography of that eye was consistent with ectasia. One drop per day of timolol 0.5% (Timoptic XE) was prescribed. Five months postoperatively, the IOP had decreased and BSCVA and topography had improved. At 11 months, BSCVA returned to 20/20 and corneal topography normalized. Topographic difference maps were used to monitor corneal shape changes. In this case, early reduction in IOP completely reversed the ectasia.

Biphasic surface amorphous layer lubrication of articular cartilage.

The biphasic nature of articular cartilage has been acknowledged for some time and is known to play an important role in many of the biomechanical functions performed by this unique tissue. From the lubrication point of view however, a simple biphasic model is unable to account for the extremely low friction coefficients that have been recorded experimentally, particularly during start-up. In addition, research over the last decade has indicated the presence of a surface amorphous layer on top of articular cartilage. Here, we present results from a finite element model of articular cartilage that includes a thin, soft, biphasic surface amorphous layer (BSAL). The results of this study show that a thin BSAL, with lower elastic modulus, dramatically altered the load sharing between the solid and liquid phases of articular cartilage, particularly in the near-surface regions of the underlying bulk cartilage and within the surface amorphous layer itself where the fluid load support exceeded 85%. By transferring the load from the solid phase to the fluid phase, the biphasic surface layer improves lubrication and reduces friction, whilst also protecting the underlying cartilage surface by 'shielding' the solid phase from elevated stresses. The increase in lubrication effectiveness is shown to be greatest during short duration loading scenarios, such as shock loads.

Tattoo ink nanoparticles in skin tissue and fibroblasts.

Tattooing has long been practised in various societies all around the world and is becoming increasingly common and widespread in the West. Tattoo ink suspensions unquestionably contain pigments composed of nanoparticles, i.e., particles of sub-100 nm dimensions. It is widely acknowledged that nanoparticles have higher levels of chemical activity than their larger particle equivalents. However, assessment of the toxicity of tattoo inks has been the subject of little research and ink manufacturers are not obliged to disclose the exact composition of their products. This study examines tattoo ink particles in two fundamental skin components at the nanometre level. We use atomic force microscopy and light microscopy to examine cryosections of tattooed skin, exploring the collagen fibril networks in the dermis that contain ink nanoparticles. Further, we culture fibroblasts in diluted tattoo ink to explore both the immediate impact of ink pigment on cell viability and also to observe the interaction between particles and the cells.

Nano-scale observations of tattoo pigments in skin by atomic force microscopy.

In this study, we have shown how particles in carbon black tattoo ink accumulate in the human skin dermis using fine-resolution atomic force microscopy, with which a single ink particle in the collagenous network can be imaged. This information further demonstrates that tattoo inks are nano-particles. Further, we have deposited a commercially available tattoo ink on a glass slide and calculated a range of volumes for single ink particles.

Investigation of Plasma Treatment on Micro-Injection Moulded Microneedle for Drug Delivery.

Plasma technology has been widely used to increase the surface energy of the polymer surfaces for many industrial applications; in particular to increase in wettability. The present work was carried out to investigate how surface modification using plasma treatment modifies the surface energy of micro-injection moulded microneedles and its influence on drug delivery. Microneedles of polyether ether ketone and polycarbonate and have been manufactured using micro-injection moulding and samples from each production batch have been subsequently subjected to a range of plasma treatment. These samples were coated with bovine serum albumin to study the protein adsorption on these treated polymer surfaces. Sample surfaces structures, before and after treatment, were studied using atomic force microscope and surface energies have been obtained using contact angle measurement and calculated using the Owens-Wendt theory. Adsorption performance of bovine serum albumin and release kinetics for each sample set was assessed using a Franz diffusion cell. Results indicate that plasma treatment significantly increases the surface energy and roughness of the microneedles resulting in better adsorption and release of BSA.

Multi-scale mechanical characterization of highly swollen photo-activated collagen hydrogels.

Biological hydrogels have been increasingly sought after as wound dressings or scaffolds for regenerative medicine, owing to their inherent biofunctionality in biological environments. Especially in moist wound healing, the ideal material should absorb large amounts of wound exudate while remaining mechanically competent in situ. Despite their large hydration, however, current biological hydrogels still leave much to be desired in terms of mechanical properties in physiological conditions. To address this challenge, a multi-scale approach is presented for the synthetic design of cyto-compatible collagen hydrogels with tunable mechanical properties (from the nano- up to the macro-scale), uniquely high swelling ratios and retained (more than 70%) triple helical features. Type I collagen was covalently functionalized with three different monomers, i.e. 4-vinylbenzyl chloride, glycidyl methacrylate and methacrylic anhydride, respectively. Backbone rigidity, hydrogen-bonding capability and degree of functionalization (F: 16 ± 12-91 ± 7 mol%) of introduced moieties governed the structure-property relationships in resulting collagen networks, so that the swelling ratio (SR: 707 ± 51-1996 ± 182 wt%), bulk compressive modulus (Ec: 30 ± 7-168 ± 40 kPa) and atomic force microscopy elastic modulus (EAFM: 16 ± 2-387 ± 66 kPa) were readily adjusted. Because of their remarkably high swelling and mechanical properties, these tunable collagen hydrogels may be further exploited for the design of advanced dressings for chronic wound care.

Large mass on base of tongue. Diagnosis: lingual thyroid.

Our patient's tongue mass hadn't bothered her until she became pregnant; that's when it got larger and caused problems swallowing and breathing. A simple test confirmed our suspicions.