Anticancer properties of chimeric HDAC and kinase inhibitors.

Histone deacetylases (HDACs) are epigenetic regulators of chromatin condensation and decondensation and exert effects on the proliferation and spread of cancer. Thus, HDAC enzymes are promising drug targets for the treatment of cancer. Some HDAC inhibitors such as the hydroxamic acid derivatives vorinostat or panobinostat were already approved for the treatment of hematologic cancer diseases, and are under intensive investigation for their use in solid tumors. But there are also drawbacks of the clinical application of HDAC inhibitors like intrinsic or acquired drug resistance and, thus, new HDAC inhibitors with improved activities are sought for. Kinase inhibitors are very promising anticancer drugs and often showed synergistic anticancer effects in combination with HDAC inhibitors. Several hybrid molecules with HDAC and kinase inhibitory structural motifs were disclosed with even improved anticancer activities when compared with co-application of HDAC and receptor tyrosine kinase inhibitors. Chimeric inhibitors with HDAC inhibitory activities exert a rapidly growing field of research and only in this year several new dual HDAC/kinase inhibitors were disclosed. This review briefly summarizes the status and future perspective of the most advanced and promising dual HDAC/kinase inhibitors and their potential as anticancer drug candidates.

Electron microscopic evaluation of anterior lens epithelium in patients with idiopathic congenital cataract.

PURPOSE: To investigate the ultrastructure of the lens epithelial cells (LECs) in patients with idiopathic congenital cataract. METHODS: This is a prospective interventional study. The anterior lens capsules (aLC: basement membrane and associated LECs) were taken from 16 eyes of 12 consecutive patients who were diagnosed as having idiopathic congenital cataracts. The aLCs were obtained from cataract surgery and prepared for transmission electron microscopy (TEM). RESULTS: Some significant ultrastructural changes were observed in all aLCs of the participants. The anterior LECs showed alterations in different areas which were partly cuboidal and partly squamous in shape. The LECs had euchromatic nucleus and included some vacuoles in the cytoplasms as a remarkable alteration. The sizes of these intraepithelial cell vacuoles were changeable. CONCLUSIONS: We identified remarkable changes in LECs of the eyes with idiopathic congenital cataract by TEM. It can be assumed that oxidative damage may be associated with these ultrastructural changes in LECs of the eyes with idiopathic congenital cataracts.

Males' attitudes towards violence against women and the affecting factors.

PURPOSE: The present study aims to identify the attitudes of men living in two different cities of Turkey towards violence against women and to investigate the variables affecting their attitudes towards violence. DESIGN AND METHODS: This descriptive and cross-sectional study was conducted in two factories in Agri and Kahramanmaras cities between October and November 2019. FINDINGS: Participants' ISKEBE Violence against Women Attitude Scale mean score was 98.14 ± 20.30, Attitudes towards Body subscale mean score was 64.73 ± 11.99, and Attitudes towards Identity subscale mean score was 33.41 ± 10.45. Of all the participants, 32.6% demonstrated positive attitudes towards violence against women, and 67.4% demonstrated negative attitudes towards violence against women. PRACTICE IMPLICATIONS: Knowing males' attitudes towards violence against women can contribute to the development of violence policies towards women.

Laser in situ keratomileusis for treatment of fully or partially refractive accommodative esotropia.

PURPOSE: To evaluate the efficacy and safety of laser in situ keratomileusis (LASIK) in partially refractive accommodative esotropia (pRAE) and fully refractive accommodative esotropia (fRAE). METHODS: Forty-two eyes of 21 patients who had LASIK for correcting hyperopic refractive error were evaluated. Refractive errors, uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), ocular alignment, and stereopsis were recorded before and after LASIK. RESULTS: Sixteen patients with fRAE and 5 with pRAE were evaluated. Mean age at the time of surgery was 19.00+/-3.79 years. Mean follow-up time was 12.19+/-4.51 months. For the fRAE group, the mean preoperative angle of deviation without spectacle correction was +19.13+/-5.87 prism diopters (PD); all were orthophoric with spectacles. Postoperatively, all these patients achieved less than 10 PD of deviation without spectacles. For the pRAE group, the mean preoperative angle of deviation was +32.60+/-9.81 PD and +14.60+/-6.14 PD without and with spectacles, respectively. Postoperatively, the mean angle of deviation was +13.60+/-5.72 PD and +12.80+/-5.40 PD without and with spectacles, respectively. For all 21 patients, the preoperative mean spherical equivalent (SE) with cycloplegia was +4.94+/-1.43 diopters (D); it was +1.49D+/-0.70 D postoperatively. Three eyes lost 1 line of BCVA and 3 eyes gained 1 line. No intraoperative complication was recorded. CONCLUSIONS: LASIK is a safe and effective method for treating refractive error and creating orthophoria in fRAE. In pRAE, it eliminates the refractive component of deviation safely and effectively.

Effect of accelerated corneal crosslinking on ocular response analyzer waveform-derived parameters in progressive keratoconus.

PURPOSE: To evaluate the effect of accelerated corneal crosslinking on corneal biomechanics with an ocular response analyzer in patients with progressive keratoconus. METHODS: In this retrospective study, 50 eyes of 45 patients with progressive keratoconus who underwent accelerated corneal crosslinking were evaluated with ocular response analyzer waveform parameters before and one year after corneal crosslinking. Paired two-tailed Student's t-test was performed to compare the parameters before vs. after corneal crosslinking. RESULTS: Mean patient age was 17.6 ± 3.6 (range 9-25) years. A significant increase was observed in p1 area, p2 area, h2, and dive2 values. No significant difference in corneal hysteresis, corneal resistance factor, or other waveform-derived parameters was observed at one year postoperatively. CONCLUSION: For estimating the effect of accelerated corneal crosslinking on corneal biomechanics, parameters such as p1 area, p2 area, h2, and dive2 are more sensitive than corneal hysteresis and corneal resistance factor. These results may help us to find out which corneal crosslinking method is most effective for stiffening the cornea.

Improvement in psychiatric symptoms after strabismus surgery in adolescent patients in long-term follow-up.

AIMS: To assess the psychological effects of preoperative primary eye position and surgical correction of strabismus in adolescent patients. METHODS: Eighty-three adolescent patients with exotropia were included in this observational and prospective study. Patients with preoperative manifest exotropia formed the manifest exotropia group. Patients with intermittent exotropia that had orthophoria with overcorrecting minus lenses and recently increased frequency of manifest phase were indicated for surgery and formed the latent deviation group. All patients were scored with the Turkish version of the Social Appearance Anxiety Scale (SAAS), depression subscale of Hospital Anxiety and Depression Scale (HAD-D) Brief Fear of Negative Evaluation Scale (BFNE), state anxiety subscale of State-Trait Anxiety Inventory (STAI-S) and trait anxiety subscale of State-Trait Anxiety Inventory (STAI-T) before and 1 year after strabismus surgery. RESULTS: The mean preoperative scores of the HAD-D, SAAS, BFNE, STAI-S and STAI-T before strabismus surgery were significantly higher in the manifest exotropia group than in the latent deviation group (p≤0.001 for all). Surgical correction significantly improved the outcomes of all scales in the manifest exotropia group (p≤0.001 for all). Outcomes of the STAI-S and STAI-T significantly improved in the latent deviation group after the surgery (p=0.008, p=0.006, respectively), whereas outcomes of the HAD-D, SAAS and BFNE did not improve (p=0.079, p=0.071, p=0.127, respectively). The mean postoperative scores of all scales did not differ between the two groups (p>0.05 for all). CONCLUSIONS: Strabismus has psychological consequences in adolescent patients, and the visible eye deviation caused by strabismus is a strong indicator of psychological distress.

Does blunt ocular trauma induce corneal astigmatism?

PURPOSE: To determine the effect of blunt ocular trauma on refractive astigmatism. METHODS: Eighty-six eyes of 86 patients with known previous refractive status exposed to blunt ocular trauma were included in the study. Trauma-induced astigmatism (TIA) was calculated using vector analysis. In eyes with TIA, central corneal thickness was assessed by ultrasound pachymetry, and corneal topographies were obtained. Anterior-chamber angles were examined by Goldmann 3-mirror lens to find microhemorrhages, scarring, or recession. Patients were followed up between 8 and 12 months (average, 9.2 months). RESULTS: In 18 eyes (21%), TIA was detected. Six (7%) of these eyes had lenticular astigmatism caused by traumatic lens subluxation. In the remaining 12 eyes (14%), corneal topography showed regular astigmatic patterns, which were symmetrical in 3 eyes and asymmetric in the remaining 9. The etiologic factor was a game marble in 6 eyes and a stone in the remaining 6. The mean central corneal thickness was 535.75 microm (range, 498-570 microm) in these 12 eyes. In 9 of these 12 eyes, recession or scarring in the anterior-chamber angle was detected at 1 edge of the steepest axis. CONCLUSIONS: Blunt trauma can induce astigmatism. Hard and small objects are more likely to induce astigmatism.

Toxic Anterior Segment Syndrome Outbreak after Cataract Surgery Triggered by Viscoelastic Substance.

PURPOSE: The purpose of this study is to present toxic anterior segment syndrome (TASS) outbreak at our clinic and discuss possible causes of TASS. MATERIALS AND METHODS: Thirty-four eyes of 34 patients developed TASS in a consecutive 2 weeks period were included in this study. Both anterior segment and fundus examinations were performed before and after uncomplicated cataract surgery. During the follow-up period, clinical features and all possible causes were evaluated including perioperative products and processing such as sterilization technique of surgical instruments, irrigating solutions, drugs, viscoelastic substance (VES), and intraocular lens. RESULTS: Patients had corneal edema, anterior chamber reactions, and decreased vision. No patient had purulent secretion, chemosis, lid involvement, and pain. At first 2 postoperative days, patients treated as infectious endophthalmitis by topical and oral antibiotics and then TASS was suspected, and patients treated completely with topical steroids. Suspected cause for TASS was VES substance, 2% sodium hyaluronate which had newly been used as VES product in phacoemulsification surgery. No new case has occurred after stopped usage of this VES product. CONCLUSION: As far as we know, this is the largest report of TASS outbreak in the shortest period from the same clinic caused by VES. Suboptimal products of surgical materials can be the cause of TASS. Close monitoring of each surgical step and elimination of causative agent can prevent the outbreaks of TASS.

Effect of accelerated corneal crosslinking on ocular response analyzer waveform-derived parameters in progressive keratoconus / Efeito do crosslimking corneano acelerado nos parâmetros derivados da forma de onda do analisador de resposta ocular no ceratocone progressivo

ABSTRACT Purpose: To evaluate the effect of accelerated corneal crosslinking on corneal biomechanics with an ocular response analyzer in patients with progressive keratoconus. Methods: In this retrospective study, 50 eyes of 45 patients with progressive keratoconus who underwent accelerated corneal crosslinking were evaluated with ocular response analyzer waveform parameters before and one year after corneal crosslinking. Paired two-tailed Student's t-test was performed to compare the parameters before vs. after corneal crosslinking. Results: Mean patient age was 17.6 ± 3.6 (range 9-25) years. A significant increase was observed in p1 area, p2 area, h2, and dive2 values. No significant difference in corneal hysteresis, corneal resistance factor, or other waveform-derived parameters was observed at one year postoperatively. Conclusion: For estimating the effect of accelerated corneal crosslinking on corneal biomechanics, parameters such as p1 area, p2 area, h2, and dive2 are more sensitive than corneal hysteresis and corneal resistance factor. These results may help us to find out which corneal crosslinking method is most effective for stiffening the cornea.

RESUMO Objetivo: Avaliar o efeito do cross-linking corneano acelerado na biomecânica corneana com analisador de resposta ocular em pacientes com ceratocone progressivo. Métodos: Neste estudo retrospectivo, 50 olhos de 45 pacientes com ceratocone progressivo submetidos à cross-linking corneano acelerado foram avaliados com os parâmetros da forma de onda do analisador de resposta ocular antes e um ano após o tratamento com cross-linking corneano. O teste t de Student pareado bicaudal foi realizado para comparar os parâmetros antes e depois do cross-linking corneano. Resultados: A média de idade dos pacientes foi de 17,6 ± 3,6 (variação de 9 a 25) anos. Um aumento significativo foi observado nos valores de p1area, p2area, h2 e dive2. Nenhuma diferença significativa foi encontrada na histerese da córnea, fator de resistência da córnea ou outros parâmetros derivados da forma de onda foi observada em um ano de pós-operatório. Conclusão: Para estimar o efeito do cross-linking corneano acelerado na biomecânica corneana, parâmentros como p1area, p2area, h2 e dive2 são mais sensíveis que histerese da córnea e fator de resistência corneana. Esses resultados podem nos ajudar a descobrir qual método cross-linking corneano é mais eficaz no enrijecimento da córnea.

Ocular alignment and results of strabismus surgery in neurologically impaired children.

AIM: To evaluate ocular alignment and surgical results of strabismus surgery in neurologically impaired children. METHODS: Files of 33 neurologically impaired squint children were evaluated. Twelve patients had cerebral palsy(CP), 4 had CP with mental retardation, therest had mental-motor retardation of unknown cause. Cycloplegic refractions, type and angle of strabismus, surgeries performed were recorded. RESULTS: Mean follow-up was 34.0±16.5 months. Twenty-three patients had esodeviation, the remaining had exodeviation. In 19 patients, angle of deviations measured at different visits were highly variable. Twelve patients with stable angle of deviations or with unstable but high angle deviations had horizontal muscle surgery. Mean horizontal deviation decreased from 43.75±10,69 D to 12.83±8.38 D with surgery. CONCLUSION: In neurologically impaired strabismic children, surgery is effective in patients with stable deviations or unstable but high angle deviations. Decision for surgery should be made after a long follow up period.