Corneal dystrophies: pathophysiological, genetic, clinical, and therapeutic considerations.

Corneal dystrophies represent a group of progressive, genetically transmitted disorders with variable pathological, histological, and clinical manifestations. Recent ophthalmological examination techniques and genetic investigation methods have brought benefits in the deepening of these conditions. However, many aspects remain unknown, so the results of treatments are unsatisfactory. The aim of this article was to recall the clinical, genetic, histological and treatment types of these conditions.

An atypical Bacillus anthracis infection in a bull-A potential occupational health hazard.

Bacillus anthracis infecting cattle is usually identified based on the typical symptom: sudden death. Bacillus anthracis causing atypical symptoms may remain undiagnosed and represent a potential occupational health hazard for, that is veterinarians and producers, butchers and tanners. In the year 2004, one case of sudden death in a dairy farm in southern Finland was diagnosed as bovine anthrax. Four years later 2008, an atypical case of anthrax was diagnosed in the same holding. The bull was taken to the Production Animal Hospital of the Faculty of Veterinary Medicine, University of Helsinki because of fever, loss of appetite and a symmetrically swollen scrotal sac. Penicillin treatment cured the fever but not the swollen scrotum. Before the intended therapeutic castration, a punctuate consisting of 10 ml fluid collected into a syringe from the scrotal sac was cultivated on blood agar at 37°C. After 24 hr, an almost pure culture of a completely non-hemolytic Bacillus cereus-like bacteria was obtained. The strain was identified as B. anthracis using Ba-specific primers by the Finnish Food Safety Authority (RUOKAVIRASTO). After the diagnosis, the bull was euthanized and destroyed, the personnel were treated with prophylactic antibiotics and the clinic was disinfected. In this particular case, treatment with water, Virkon S and lime seemed to be effective to eliminate endospores and vegetative cells since no relapses of anthrax have occurred in 10 years. This case is the last reported anthrax case in Finland.

[Transient visual loss due to neurological cause]. / Pierderea tranzitorie a vederii de cauza neurologica.

Acute decrease of mono or binocular vision although it is not a common clinical symptom, is of major importance, with serious implications for the patient and physician, requiring a comprehensive approach in terms of clinical, laboratory and therapeutic. It is an attempt that often proves difficulty by lack of access to specific investigations and the lack of neuroophthalmology specialists. In most cases, the sudden decrease of vision occurs in the stroke of the eye by occlusion of central retinal artery or one of its branch, occlusion of vein, occlusion of optic nerve vessels or by demyelinating processes of the optic nerve. Rapid diagnosis of eye disease by appropriate clinical or paraclinical investigations, leads to prompt treatment with decreased risk of complications, but in many cases it requires preventive measures.

[Tardive juvenile glaucoma]. / Glaucom juvenil tardiv.

The authors present the case of a young woman with the diagnosis of late juvenile glaucoma. The treatment began in the very moment of the diagnosis but the lack of compliance, as well as the associated risk factors, led to a evolution difficult to control only through medical therapy, which is why we also used laser and surgical treatment. At present, the anatomical and functional status is stable but the long-term prognosis is reserved.

Environment driven cereulide production by emetic strains of Bacillus cereus.

The impacts of growth media and temperature on production of cereulide, the emetic toxin of Bacillus cereus, were measured for seven well characterised strains selected for diversity of biochemical and genetic properties and sources of origin. All strains carried cereulide synthase gene, ces, on a megaplasmid of ca. 200 kb and all grew up to 48-50 degrees C, but produced cereulide only up to 39 degrees C. On tryptic soy agar five strains, originating from foods, food poisonings and environment, produced highest amounts of cereulide at 23 to 28 degrees C, whereas two strains, from human faeces, produced cereulide similarly from 23 to 39 degrees C, with no clear temperature trend. These two strains differed from the others also by producing more cereulide on tryptic soy agar if supplemented with 5 vol.% of blood, whereas the other five strains produced similarly, independent on the presence of blood. On oatmeal agar only one strain produced major amounts of cereulide. On skim milk agar, raw milk agar, and MacConkey agar most strains grew well but produced only low amounts of cereulide. Three media components, the ratio [K+]:[Na+], contents of glycine and [Na+], appeared of significance for predicting cereulide production. Increase of [K+]:[Na+] (focal variable) predicted (P < 0.001) high cereulide provided that the contents of glycine and [Na+] (additional variables) were kept constant. The results show that growth medium and temperature up and downregulate cereulide production by emetic B. cereus in a complex manner. The relevance of the findings to production of cereulide in the gut and to the safety of amino acids as additives in foods containing live toxinogenic organisms is discussed.

[Choroid metastasis in a patient with pulmonary adenocarcinoma]. / Metastaze coroidiene într-un caz de adenocarcinom bronhopulmonar --caz clinic.

The authors present the case of a patient with multifocal bilateral choroid metastatic carcinoma in the general medium of a bronchi-pulmonary adenocarcinoma T4N2M1. The ophthalmologic diagnosis of intraocular metastases led to the discovery of the systemic affliction, yet unfortunately in a late stage. The purpose of this paper is to draw the attention of the specialist in order to diagnose in an evolutionary stage that allows at least a prolonged survival rate, if not the maintenance of functionality.

[Acute endophthalmitis--surgical treatment or conservative therapy]. / Endoftalmita acuta--tratament chirurgical sau atitudine conservatoare?

Acute endophthalmitis is an ophthalmological emergency. Immediate therapy is recommended in order to maintain a normal anatomic and functional ocular globe, according to the most recent guidelines. Surgical therapy and intravitreal drug injection represent standard treatments.