Inter-joint sharing of total support moments in the lower extremities during gait in narrow-heeled shoes of different heights.

The study aimed to investigate the influence of the base and height of shoe heels on the total support moment (Ms) and individual joint contributions during gait. Fifteen healthy females walked barefoot and with narrow-heeled shoes (heel heights: 3.9, 6.3 and 7.3 cm) while kinematic and kinetic data were measured. Compared with the barefoot condition, the subjects maintained unaltered Ms in the sagittal plane in shod conditions. This was achieved by increasing the knee extensor moment to compensate for the diminished ankle plantarflexor moments in medium and high heel conditions. In the frontal plane, subjects in shod conditions had to sustain an increased Ms for balance control during late single-leg stance with increased knee abductor and ankle pronator moments as a result of the reduced base of the heels. The results will be helpful for future shoe designs to reduce fall risks and prevent relevant musculoskeletal problems.

Alport syndrome with recurrent herpes simplex virus keratitis.

PURPOSE: To report a case of Alport syndrome with recurrent herpes simplex virus (HSV) keratitis. METHODS: Case report and review of the literature. RESULTS: A 29-year-old man with Alport syndrome suffered from 4 consecutive episodes of HSV keratitis within 2 years. A type IV collagen defect in basement membranes plays an important role in the pathogenesis of Alport syndrome. The relationship between HSV keratitis and Alport syndrome is discussed. After remission from HSV keratitis, the patient underwent bilateral phacoemulsification and posterior-chamber intraocular lens implantation for anterior lenticonus and an anterior polar cataract. After surgery, the uncorrected visual acuity was 20/20 in both eyes. CONCLUSIONS: We assume that the underlying basement membrane defects in Alport syndrome may account for the recurrent episodes of HSV keratitis in this patient. In addition, phacoemulsification and posterior-chamber intraocular lens implantation, rather than correction of refractive errors, provide a safe and efficient therapeutic choice for the management of anterior lenticonus, with or without associated cataract in patients with Alport syndrome.

Paecilomyces lilacinus scleritis with secondary keratitis.

PURPOSE: To report a case of Paecilomyces lilacinus scleritis with secondary keratitis after initially diagnosed immune-based scleritis. METHODS: An 82-year-old man was diagnosed with immune-based scleritis and treated with oral cyclophosphamide 50 mg twice daily. However, multiple scleral abscesses and a fibrinoid aqueous reaction developed 3 months later. Infectious scleritis was suspected. The culture from the necrotic sclera grew P. lilacinus. Despite treatment with antimicrobials, the infection progressed to the cornea. The medication included topical natamycin suspension 5% and fluconazole 2 mg/mL hourly, as well as oral itraconazole 100 mg daily. Debridement of the necrotic tissue and intracameral injection with amphotericin-B were performed. RESULTS: The infection resolved 4 months later, although its resolution was accompanied by development of phthisis bulbi, and the visual acuity remained light perception. CONCLUSION: Infection by P. lilacinus can occur in a patient with scleritis. Infectious scleritis is a particular risk in cases involving diabetes mellitus, prior scleritis, previous surgery, and immunosuppression. Early detection of the microorganism and aggressive treatment are necessary to eradicate such an infection; however, the prognosis for vision recovery can remain poor despite treatment.

Zebrafish Her8a is activated by Su(H)-dependent Notch signaling and is essential for the inhibition of neurogenesis.

Understanding how diversity of neural cells is generated is one of the main tasks of developmental biology. The Hairy/E(spl) family members are potential targets of Notch signaling, which has been shown to be fundamental to neural cell maintenance, cell fate decisions, and compartment boundary formation. However, their response to Notch signaling and their roles in neurogenesis are still not fully understood. In the present study, we isolated a zebrafish homologue of hairy/E(spl), her8a, and showed this gene is specifically expressed in the developing nervous system. her8a is positively regulated by Su(H)-dependent Notch signaling as revealed by a Notch-defective mutant and injection of variants of the Notch intracellular regulator, Su(H). Morpholino knockdown of Her8a resulted in upregulation of proneural and post-mitotic neuronal markers, indicating that Her8a is essential for the inhibition of neurogenesis. In addition, markers for glial precursors and mature glial cells were down-regulated in Her8a morphants, suggesting Her8a is required for gliogenesis. The role of Her8a and its response to Notch signaling is thus similar to mammalian HES1, however this is the converse of what is seen for the more closely related mammalian family member, HES6. This study not only provides further understanding of how the fundamental signaling pathway, Notch signaling, and its downstream genes mediate neural development and differentiation, but also reveals evolutionary diversity in the role of H/E(spl) genes.

Stenotrophomonas maltophilia keratitis and scleritis.

BACKGROUND: Stenotrophomonas maltophilia is a seldom-reported pathogen in ocular infections. The report describes six cases of Stenotrophomonas maltophilia (S. maltophilia) keratitis and scleritis. To our knowledge, this is the foremost report of S. maltophilia scleritis. METHODS: Laboratory reports of patients diagnosed with S. maltophilia ocular infections were collected from the ophthalmic department of Chang-Gung memorial hospital from January 1, 2000, through December 31, 2003. On evaluation of risk factors, isolates, antibiotic sensitivities, and response to the treatment ensued. RESULTS: Of the 6 reported cases, 5 related bacterial keratitis and 2 scleritis. (One case reported S. maltophilia keratitis and secondary scleritis.) The primary risk factor in such cases is ocular surgery. The organism cultured was the single isolate in three cases (50%). The susceptibility test showed that 50%, 83%, and 100% of the isolates were sensitive to ceftazidime, a combination of trimethoprim and sulfamethoxazole, and ciprofloxacin respectively. DISCUSSION: Ocular surface compromise such as penetrating keratoplasty was a primary risk factor of S. maltophilia keratitis in our study. The results of isolates and the antibiotic sensitivities were different from previously published results. Our cases responded well to antibiotic therapy and antibiotic therapy combined with conjunctival autografting. One case of S. maltophilia keratitis and secondary scleritis had a poor prognosis, arguably associated with a co-infection of Mycobacteria chelonae.