[Choroidal metastasis from a breast carcinoma. Diagnosis and follow-up with optical coherence tomography and fluorescein angiography and autofluorescence with HRA-II (Heidelberg Retina Angiograph)]. / Metástasis coroideas de carcinoma de mama. Diagnóstico y seguimiento mediante tomografía de coherencia óptica y angiofluoresceingrafía y autofluorescencia con HRA-II (Heidelberg Retina Angiograph).

CLINICAL CASE: A 69-year-old woman developed choroidal metastasis from a breast carcinoma 2 years after the initial diagnosis, surgery and chemotherapy. After treatment with palliative chemotherapy and external radiotherapy, we used fluorescein angiography (FA) and optical coherence tomography (OCT) to evaluate the resolution of the serous retinal detachment, as well as a later relapse in the optic nerve. DISCUSSION: OCT is useful in the follow-up of choroidal metastasis after treatment. However, OCT imaging is limited by the initial choroidal location of metastasis. The autofluorescence can detect exudative tumoral activity even without obvious changes in OCT or FA.

[Combined hamartoma of the retina and retinal pigment epithelium diagnosed by retinal angiography and optical coherence tomography]. / Hamartoma combinado de retina y epitelio pigmentario retiniano. Diagnóstico mediante tomografía de coherencia óptica y angiofluoresceingrafía.

CLINICAL CASE: This report is based on the case of a 35-year-old woman who developed a combined hamartoma of the retina and retinal pigment epithelium in her right eye. The diagnosis was determined based on the fundus examination: hyperplasia of the retinal pigment epithelium cells, tortuosity of the vessels and epiretinal membrane. DISCUSSION: Optical coherence tomography and retinal angiography are important to rule out malignant melanoma of the choroid and retinoblastoma. Regular follow-up is essential because reduction in visual acuity can be related to an epiretinal membrane, neovascular membrane or vitreous hemorrhage.

Vimentin isoform expression in the human retina characterized with the monoclonal antibody 3CB2.

The antigen recognized by the monoclonal antibody 3CB2 (3CB2-Ag and 3CB2 mAb) is expressed by radial glia and astrocytes in the developing and adult vertebrate central nervous system (CNS) of vertebrates as well as in neural stem cells. Here we identified the 3CB2-Ag as vimentin by proteomic analysis of human glial cell line U-87 extracts (derived from a malignant astrocytoma). Indeed, the 3CB2 mAb recognized three vimentin isoforms in glial cell lines. In the human retina, 3CB2-Ag was expressed in Müller cells, astrocytes, some blood vessels, and cells in the horizontal cell layer, as determined by immunoprecipitation and immunofluorescence. Three populations of astrocytes were distinguishable by double-labeling immunohistochemistry: vimentin+/GFAP+, vimentin-/GFAP+, and vimentin+/GFAP-. Hence, we conclude that 1) the 3CB2-Ag is vimentin; 2) vimentin isoforms are differentially expressed in normal and transformed astrocytes; 3) human retinal astrocytes display molecular heterogeneity; and 4) the 3CB2 mAb is a valuable tool to study vimentin expression and its function in the human retina.

Isolation of chick retina cones and study of their diversity based on oil droplet colour and nucleus position.

The chick retina has four morphological cone types that differ not only in shape, but also in the visual pigment in the outer segment, in the colour of the oil droplet in the inner segment and in synaptic connectivity. Neither the type of droplet nor the visual pigment has been definitively established for the four cone types. The main aim of the present work has been the isolation of entire live photoreceptors in order to study the oil droplet colour in each cone type and to quantify each type. We have improved an earlier retinal cell isolation method and obtained large numbers of entire cones. Principal cones (27% of the cones) possess a yellow or colourless droplet. Accessory cones (27% of the cones) all contain a small pale green droplet. Straight cones (44% of the cones) have a red, orange, yellow, or colourless droplet. Oblique cones (1.66% of the cones) all have a colourless droplet. We have found that straight cones with a red, orange, or yellow droplet differ in terms of the position of the nucleus and their percentage and conclude that they are distributed in three rows in the outer nuclear layer (ONL) of the central retina. Our study of 4,6-diamidino-2-phenylindole-stained retinal sections has revealed three rows of nuclei instead of the two currently thought to form the ONL. Together, our results show a larger cone diversity than previously known, suggest a larger functional diversity and provide an efficient method for isolating entire chick photoreceptors.

[Short- and medium-term intraocular pressure lowering effects of combined phacoemulsification and non-penetrating deep sclerectomy without scleral implant or antifibrotics]. / Control tensional a corto y medio plazo de facoesclerectomía profunda no perforante sin implante escleral ni antimetabolito.

PURPOSE: To examine the short- and medium-term intraocular pressure (IOP) lowering effects of combined phacoemulsification and non-penetrating deep sclerectomy without the use of scleral implant or antifibrotics in open-angle glaucoma (primary and pseudoexfoliative) and coexisting cataract in eyes with no known risk factors for bleb failure. METHODS: Retrospective study of 15 eyes of 12 patients with medically uncontrolled open-angle glaucoma or open-angle glaucoma treated with two or more drugs and coexisting cataract with no known risk factors for glaucoma surgery failure. All patients received combined phacoemulsification and non-penetrating deep sclerectomy without scleral implant or antifibrotics performed by the same surgeon. Nd-YAG perforation of the trabeculodescemetic membrane and/or needling with mitomycin-C was performed postoperatively for IOP control. Main outcome measures were postoperative IOP, percentage of eyes with IOP < 17 mmHg, complications and final visual acuity (VA). Median follow-up was 12.0 months (SD: 0.6) and ranged from 1 to 30 months. RESULTS: Mean preoperative IOP with medical treatment was 21.80 mmHg (SD: 5.14) and decreased to 14.42 mmHg (SD: 2.15) at 12-month visit. Mean antiglaucoma medication preoperative was 1.93 (SD: 0.70) and was reduced to 0.13 (DE: 0.35) postoperative. At 12-month visit, 80% had an IOP lower than 17 mmHg with a mean VA gain of 2.50 Snellen lines. Conjuntival wound leakage was the most frequent complication (20%; 3/15). CONCLUSIONS: Primary combined phacoemulsification and non-penetrating deep sclerectomy without collagen implant or antifibrotics in primary open-angle glaucoma with coexisting cataract, significantly lowers IOP in the short- and medium term in low-risk cases for glaucoma surgery failure, allowing for rapid visual improvement with a low complication rate.

[Panuveitis as a possible ophthalmic complication of Kikuchi-Fujimoto disease]. / Panuveítis como posible manifestación oftalmológica de la enfermedad de Kikuchi-Fujimoto.

CLINICAL CASE: A 37 year old female with histologically proven Kikuchi-Fujimoto disease is presented. She developed panuveitis, vasculitis and subretinal macular infiltrate, probably as a recurrence of the disease. Immunosuppressive treatment (methotrexate) was initiated in the absence of response to systemic steroid therapy and threat to vision owing to macular involvement. DISCUSSION: Ophthalmic complications of Kikuchi-Fujimoto disease are unusual. We discuss differential diagnosis and emphasize the aggresiveness of our case.

[Tuberculous peripheral multifocal choroiditis]. / Coroiditis multifocal periférica tuberculosa.

CASE REPORT: A healthy 57 year-old woman with past untreated pulmonary tuberculosis, disclosed a bilateral uveitic syndrome characte rized by iritis, vitreitis, multiple peripheral retinal punched-out lesions, and cystoid macular edema. Systemic evaluation was unremarkable except for a 30 mm tuberculin skin test. Relapses occurred after oral and periocular corticosteroids were interrupted, but the inflammation completely disappeared after a 6 month course of isoniazid, rifampicin and pyrazinamide. DISCUSSION: Intraocular tuberculosis should be considered as a treatable cause of peripheral multifocal choroiditis, after ruling out other etiologies.

Induction of apoptosis by the bis-Pt(III) complex [Pt(2)(2-mercaptopyrimidine)(4)Cl(2)].

We analyzed both the cytotoxicity and the type of cell death produced by the novel binuclear Pt(III) compound Pt-Spym ([Pt(2)(2-mercaptopyrimidine)(4)Cl(2)]) in kidney human fibroblasts and in human tumor cell lines (HeLa, CH1, CH1cisR and HL-60). The data showed that Pt-Spym displayed higher cytotoxicity against these tumor cells than cisplatin. In contrast, Pt-Spym had low toxicity against normal human fibroblasts. Interestingly, Pt-Spym circumvented cisplatin resistance in CH1cisR cells. We also observed that Pt-Spym induced the characteristic changes attributed to apoptosis in cells with normal levels of p53 protein (CH1 and CH1cisR) and with low levels of p53 protein (HeLa), but not in cells lacking p53 (HL-60). Interestingly, Western blot data indicated that apoptosis induction by Pt-Spym in HeLa, CH1, and CH1cisR cells was not associated with drastic changes in p53 levels. However, cis-DDP strongly decreased p53 levels in CH1 and CH1cisR cells and abolish p53 protein in HeLa cells. Altogether, these results suggest that induction of apoptosis by Pt-Spym requires the presence of p53 protein.

Endothelin-1 increases isoprenaline-enhanced cyclic AMP levels in cerebral cortex.

We examined the effect of ET-1 on cyclic AMP levels in rat cerebral cortex. The peptide caused a concentration-dependent increase of [(3)H]cyclic AMP accumulation after 10 min of treatment. This effect was due to adenosine accumulation since it was inhibited by the treatment with adenosine deaminase. ET-1, apart from being able to increase cyclic AMP, also potentiated the cyclic AMP generated by isoprenaline in the presence of adenosine deaminase. Experiments performed in the presence of BQ-123 or BQ-788, specific ET(A) or ET(B) receptor antagonists respectively indicated that ET(B) was the receptor involved. This effect was dependent on extracellular and intracellular calcium concentration. These findings suggest that ET-1 plays a modulatory role in cyclic AMP generation systems in cerebral cortex.

Endoglin overexpression modulates cellular morphology, migration, and adhesion of mouse fibroblasts.

Endoglin is the gene mutated in hereditary hemorrhagic telangiectasia type 1 (HHT1), a dominantly inherited vascular disorder. Endoglin glycoprotein is a component of the transforming growth factor type beta (TGF-beta) receptor system which is highly expressed by endothelial cells, and at lower levels on fibroblasts and smooth muscle cells, suggesting the involvement of these lineages in the HHT1 vascular dysplasia. Overexpression of endoglin in mouse NCTC929 fibroblasts led to decreased migration in chemotactic and wound healing assays, as well as changes in the cellular morphology. When plated on uncoated surfaces, endoglin transfectants formed intercellular clusters, endoglin being not specifically localized to the cell-cell junctions, but homogenously distributed on the cellular surface. Although the expression of alpha5beta1 integrin and of an activation epitope of beta1 integrin were unchanged, a polyclonal antibody to alpha5beta1 integrin was able to inhibit cluster formation, suggesting the involvement of integrin ligand/s. In fact, coating with fibronectin, laminin, or an RGD-containing 80 kDa fragment of fibronectin were able to prevent the cellular clustering. Furthermore, synthesis of plasminogen activator inhibitor 1 (PAI-1), and to a weak extent that of fibronectin, were inhibited in endoglin transfectants. Thus, the presence of endoglin in mouse NCTC929 fibroblasts is associated with reduced production of certain extracellular matrix (ECM) components, which might explain their altered morphology, migration and intercellular cluster formation.

Platelet-activating factor stimulation of p125(FAK) and p130(Cas) tyrosine phosphorylation in brain.

The effect of platelet-activating factor (PAF) on protein tyrosine phosphorylation was studied in rat brain slices. PAF induced a time- and concentration-dependent increase in tyrosine phosphorylation of a doublet of approximately 125 kDa. These proteins were identified by immunoprecipitation as p125(FAK) and p130(Cas), using monoclonal antibodies. This effect was mediated by PAF receptors, as shown by its inhibition by the action of a PAF antagonist. The tyrosine phosphorylation evoked by PAF was dependent, at least in part, on external calcium. The involvement of protein kinase C was demonstrated by the synergistic effect of TPA on PAF-stimulated tyrosine phosphorylation. The finding that PAF stimulates tyrosine phosphorylation of both focal adhesion protein p125(FAK) and p130(Cas) suggests that PAF might modulate the integrin mediated signal transduction in the brain.