Setting spatial conservation priorities despite incomplete data for characterizing metapopulations.

Management of spatially structured species poses unique challenges. Despite a strong theoretical foundation, practitioners rarely have sufficient empirical data to evaluate how populations interact. Rather, assumptions about connectivity and source-sink dynamics are often based on incomplete, extrapolated, or modeled data, if such interactions are even considered at all. Therefore, it has been difficult to evaluate whether spatially structured species are meeting conservation goals. We evaluated how estimated metapopulation structure responded to estimates of population sizes and dispersal probabilities and to the set of populations included. We then compared outcomes of alternative management strategies that target conservation of metapopulation processes. We illustrated these concepts for Chinook salmon (Oncorhynchus tshawytscha) in the Snake River, USA. Our description of spatial structure for this metapopulation was consistent with previous characterizations. We found substantial differences in estimated metapopulation structure when we had incomplete information about all populations and when we used different sources of data (three empirical, two modeled) to estimate dispersal, whereas responses to population size estimates were more consistent. Together, these findings suggest that monitoring efforts should target all populations occasionally and populations that play key roles frequently and that multiple types of data should be collected when feasible. When empirical data are incomplete or of uneven quality, analyses using estimates produced from an ensemble of available datasets can help conservation planners and managers weigh near-term options. Doing so, we found trade-offs in connectivity and source dominance in metapopulation-level responses to alternative management strategies that suggest which types of approaches may be inherently less risky.

Gender differences in the effect of fish oil on appetite, inflammation and nutritional status in haemodialysis patients.

BACKGROUND: Haemodialysis patients show signs of chronic inflammation and reduced appetite, which is associated with a worse clinical status and an increased mortality risk. Fish oil has anti-inflammatory properties and may be useful as a therapeutic treatment. There is limited evidence to indicate the feasibility and efficacy of this intervention in dialysis patients. The present study aimed to compare the effect of 12 weeks of supplementation with fish oil on markers of appetite and inflammation in male and female haemodialysis patients. METHODS: The study was conducted in 28 haemodialysis patients. All patients were prescribed 3 g of fish oil per day for 12 weeks. Changes in appetite, plasma fatty acid profiles and inflammatory markers were measured at baseline and at 12 weeks. RESULTS: The mean (SD) increase in percent plasma eicosapentaenoic acid was statistically significant [1.1 (0.8) to 4.1 (2.2), P < 0.001], which was a strong indicator of good adherence. There were trends towards reductions in peptide YY (-9%; P = 0.078) and an increase in subjective sensations of hunger (+12%; P = 0.406), which reflects an increase in motivation to eat. Males (n = 13) experienced a more marked increase in hunger compared to females (+23% versus -6%), which was associated with maintenance in C-reactive protein and interleukin-6, and a reduction in soluble intercellular adhesion molecule-1. CONCLUSIONS: The results obtained demonstrate meaningful trends towards improvements in subjective appetite and certain inflammatory markers (although no change in dietary intake) and this effect was more pronounced in males. However, the levels of some inflammatory markers increased in females and this requires further study. The high level of adherence achieved indicates that an intervention requiring patients to consume four fish oil capsules per day is achievable. This was a short-term study and the effects need to be confirmed in a randomised controlled trial.

The relationship between subjective appetite sensations, markers of inflammation and appetite in dialysis patients.

BACKGROUND: Poor appetite is a marker of morbidity and mortality in haemodialysis patients, making it an important area for research. Visual analogue scales (VAS) can capture a range of subjective sensations related to appetite (such as hunger, desire to eat or fullness), but have not been commonly used to measure appetite in dialysis patients. The present study aimed to explore the association between retrospective ratings of appetite using VAS and a range of clinical variables, as well as biomarkers of appetite in haemodialysis patients. METHODS: Twenty-eight haemodialysis patients [mean age 61 +/- 17 years, 50% male, median dialysis vintage 19.5 (4-101) months] rated their appetite using VAS for hunger, fullness and desire to eat and a five-point categorical scale measuring general appetite. Blood levels of the appetite peptides leptin, ghrelin and peptide YY were also measured. RESULTS: Hunger ratings measured by VAS were significantly (P < 0.05) correlated with a range of clinical, nutritional and inflammatory markers: age (r = -0.376), co-morbidities, (r = -0.380) Patient-Generated Subjective Global Assessment score (r = -0.451), weight (r = -0.375), fat-free mass (r = -0.435), C-reactive protein (r = -0.383) and intercellular adhesion molecule (r = -0.387). There was a consistent relationship between VAS and appetite on a five-point categorical scale for questions of hunger, and a similar trend for desire to eat, but not for fullness. Neither method for measuring subjective appetite correlated with appetite peptides. CONCLUSIONS: Retrospective ratings of hunger on a VAS are associated with a range of clinical variables and further studies are warranted to support their use as a method for measuring appetite in dialysis patients.

Corneal repair following keratectomy. A comparison between conventional surgery and laser photoablation.

We have used the fluorescent dye dichlorotriazinyl aminofluorescein (DTAF) to demonstrate corneal remodeling following keratectomy in the rabbit. The dye was applied to the surface of 3.5 mm diameter anterior keratectomy wounds produced by either lamellar dissection or photoablation with an excimer laser (193 nm) to a depth of 15, 50 or 75 microns. Stromal wounds that had been ablated in 12 concentric steps to produce a graded profile with a central depth of 15 or 30 microns were also studied. The repair process was followed for periods of up to 6 months. These results were compared to wounds of similar dimensions in which an intrastromal keratectomy was performed and the anterior stromal surface replaced. Sections examined by fluorescence microscopy showed that connective tissue was deposited beneath the epithelium of all anterior keratectomy wounds irrespective of their mode of induction or depth. The deposition of this new tissue, and an associated thickening of the epithelium over the wound surface, appeared to be complete by 1 month and tended to restore the original surface contour. The synthesis of connective tissue, but not the hyperplasia of the epithelium, was reduced by local steroid treatment. In contrast, an intrastromal keratectomy only stimulated the deposition of small amounts of new connective tissue at the wound junction without as marked a thickening of the overlying epithelium. These observations emphasize the importance of the epithelium in moderating repair after stromal loss, and suggest that remodeling may result in corneal haze and a change in the desired refraction if refractive surgery is attempted by anterior keratectomy.

The road to extinction is paved with good intentions: negative association of fish hatcheries with threatened salmon.

Hatchery programmes for supplementing depleted populations of fish are undergoing a worldwide expansion and have provoked concern about their ramifications for populations of wild fish. In particular, Pacific salmon are artificially propagated in enormous numbers in order to compensate for numerous human insults to their populations, yet the ecological impacts of this massive hatchery effort are poorly understood. Here we test the hypothesis that massive numbers of hatchery-raised chinook salmon reduce the marine survival of wild Snake River spring chinook, a threatened species in the USA. Based on a unique 25-year time-series, we demonstrated a strong, negative relationship between the survival of chinook salmon and the number of hatchery fish released, particularly during years of poor ocean conditions. Our results suggest that hatchery programmes that produce increasingly higher numbers of fish may hinder the recovery of depleted wild populations.

Contrast sensitivity and reading through multifocal intraocular lenses.

Multifocal intraocular lenses are intended to increase depth of focus for patients with cataracts, but optical considerations predict reduced retinal-image contrast. We evaluated visual performance through multifocal intraocular lenses by measuring contrast sensitivity functions and reading speed for age-matched groups with multifocal and monofocal intraocular lenses and two normal control groups. Contrast sensitivity functions of the patients with multifocal lenses did not differ significantly for optical distances differing by 2.5 diopters, indicating substantial depth of focus. Normal and monofocal contrast sensitivity functions were nearly identical, and both were about a factor of two higher than multifocal contrast sensitivity functions. Patients with multifocal lenses showed deficits in reading speed only for low-contrast text (less than 30%) and small letters (0.2 degree and 1.0 degree).

Clinical use of the 193-nm excimer laser in the treatment of corneal scars.

Phototherapeutic keratectomy using a 193-nm excimer laser was performed at four centers on 33 sighted patients with corneal opacity and/or irregular astigmatism. Pathologic conditions included anterior stromal and superficial scarring from postinfectious and posttraumatic causes, including inactive herpes simplex virus, anterior corneal dystrophies, recurrent erosions, granular dystrophy, and band keratopathy. Most patients received peribulbar anesthesia and underwent removal of the epithelium prior to laser ablation. A majority of patients had a reduction in the amount of corneal scarring and approximately half had improved visual acuity. No intraocular reaction or changes in endothelial counts were seen, and some patients avoided the need for penetrating keratoplasty. Reepithelialization usually occurred within 4 or 5 days and we noted no significant scarring secondary to use of the laser. It was difficult to eliminate preexisting irregular astigmatism despite the use of surface modulators, such as methylcellulose. A hyperopic shift secondary to corneal flattening was encountered in approximately 50% of the patients. A combination of myopic ablation, followed immediately by a secondary hyperopic steepening, may minimize this refractive change. The 193-nm excimer laser is an effective new tool in the treatment of selected patients with superficial corneal opacity from a variety of conditions.

Multifocal intraocular lenses.

Current multifocal intraocular lens designs incorporate refractive or diffractive optical principles to achieve increased depth of focus. Information about four basic design concepts is presented. Early clinical results with two of these, the IOLAB Nuvue two-zone refractive multifocal and the 3M diffractive multifocal, are summarized.

Hyperplastic precorneal membranes. Extending the spectrum of neurotrophic keratitis.

Neurotrophic keratitis is a recognized complication of the neurosurgical treatment of trigeminal neuralgia. Following a retrogasserian rhizotomy, our patient developed, in addition to the anterior segment abnormalities anticipated with neurotrophic keratitis, an actively growing hyperplastic precorneal membrane originating from the limbal area and overlying intact corneal epithelium. Growth of the membrane continued towards the visual axis until all but the central 3 mm of the corneal epithelium was covered. This previously undescribed observation may indicate that the epithelium of the conjunctival and limbal areas are maintained and regulated by a different physiologic mechanism than that of the central corneal epithelium following sensory deafferentation. The significance of the membrane is discussed in context with the X, Y, Z hypothesis of corneal epithelial maintenance.

X-ray diffraction and transmission electron microscopy of Morquio syndrome type A cornea: a structural analysis.

PURPOSE: This case report describes the structural characterization of the corneal stroma from a patient with Morquio syndrome type A. METHODS: A left penetrating keratoplasty was performed, and the cornea was examined using transmission electron microscopy and synchrotron x-ray diffraction. The interfibrillar proteoglycans were visualized in the electron microscope by using cuprolinic blue. RESULTS: Stromal collagen fibrils showed a bimodal distribution of diameters: 70% had a distribution comparable to that in normal tissue (20-30 nm) and 30% contained larger fibrils (30-42 nm) as seen by electron microscopy. Both electron microscopy and x-ray diffraction showed that the bulk numeric density of fibrils per unit area in cross-section (number density) was higher than normal in the Morquio syndrome cornea. The arrangement of proteoglycans throughout most of the Morquio syndrome cornea appeared normal, but many of the filaments were twice their normal length. In the anterior stroma, very large proteoglycan filaments (< or = 400 nm long) were found. Other ultrastructural differences also were noted, including abnormal keratocytes and long spacing collagen. CONCLUSION: The variation in fibril diameter and number density were modeled to account for only a 5% decrease in light scattering compared with the normal cornea. The extensive corneal clouding seen in the Morquio syndrome cornea cannot therefore be attributed to the variation in fibril diameters; collagen-free areas and expanded cells seem to be the most likely cause.

Mycobacterium chelonei keratitis in a soft-contact-lens wearer.

A 29-year-old woman who had successfully used extended-wear soft contact lens for 7 years was found to have a corneal ulcer due to Mycobacterium chelonei. Unique to this presentation was the lack of a history of severe corneal trauma, prior surgery or immunocompromised tissue. Despite in-vitro resistance of the organism to amikacin sulfate, topical therapy with this antibiotic led to a complete cure without the need for surgical intervention.

Corneal endothelial decompensation after argon laser iridotomy.

Focal corneal edema overlying the site of argon laser iridotomy followed by generalized corneal decompensation developed in six eyes of five patients. The average interval between the iridotomy and the development of focal edema was 3 years, with generalized edema appearing an average of 3.5 months later. Light, scanning and transmission electron microscopy of tissue removed at the time of corneal transplantation showed abnormalities characteristic of Fuchs' dystrophy in two patients. Possible contributing factors include episodes of intraocular pressure elevation, cornea guttata and the use of high total amounts of energy during laser iridotomy.

Infectious crystalline keratopathy.

Crystalline deposits developed in the anterior third of the stroma in a 60-year-old woman. The deposits resolved only after aggressive treatment with intravenously given penicillin and topical erythromycin and vancomycin hydrochloride. Review of reported cases indicated that infectious crystalline keratopathy is caused by chronic colonization of the stroma by bacteria, usually streptococci of the viridans group. Local tissue trauma, concomitant use of topical corticosteroids, an intact overlying epithelium and use of a bandage-type soft contact lens are factors in the development of the infection. Patients with crystalline formations in this setting should undergo early lamellar biopsy for histologic examination, culture and sensitivity testing, followed by aggressive therapy with appropriate antibiotics.

Corneal toxic changes after cataract extraction.

Over an 18-month period 10 patients (12 eyes) presented with severe corneal toxic changes after cataract extraction. Defined stages in the keratopathy included punctate epithelial keratopathy, pseudodendrite, central epithelial ulcer and central stromal ulcer. Periods of up to 13 months were required for resolution of the defects. Axial scarring and nonhealing epithelial defects resulted in a final visual acuity of counting fingers and hand movement in two patients. We believe that exposure during the postoperative period to benzalkonium chloride contained in ophthalmic medications represents the most likely cause of the toxic changes and that no single ophthalmic medication can be held responsible. The past ocular histories of the patients included chronic open-angle glaucoma, dry eye syndrome and anterior membrane dystrophy. Prior exposure to benzalkonium-containing antiglaucoma medications, tear film deficiencies or abnormalities of epithelial adhesion may have predisposed the corneas in these patients to the development of benzalkonium-related toxic changes.

Scheie's syndrome: the architecture of corneal collagen and distribution of corneal proteoglycans.

Processes that modulate the regular architecture and, hence, transparency of the cornea are poorly understood, although proteoglycans are thought to be involved. Scheie's syndrome displays corneal opacification and systemic accumulation of glycosaminoglycans. The manifestations of these two occurrences were examined in relation to the corneal stroma. Collagen architecture was investigated by transmission electron microscopy and synchroton x-ray diffraction. Cuprolinic blue staining located sulfated glycosaminoglycan deposits that disrupted the extracellular matrix. Unlike normal cornea, which contained collagen fibrils of remarkably uniform diameter (26.0 +/- 2.4 nm), there was a large range of fibril sizes in the Scheie's syndrome stroma (19.9 to 52.0 nm). Moreover, the distribution of fibril diameters appeared bimodal. X-ray diffraction confirmed the discovery of abnormally large stromal collagen. The results suggest a link in Scheie's syndrome between proteoglycan content/distribution and stromal disruption, and between stromal disruption and corneal opacification.