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1.
Biomedicines ; 9(4)2021 Mar 31.
Article in English | MEDLINE | ID: mdl-33807479

ABSTRACT

Collagen cleavage by matrix metalloproteinase (MMP) is considered a major cause of dental resins long term failure. Most MMP inhibitors display significant toxicity and are unsuitable for dental resins' applications. Here we report a study of a new class of inhibitors that display the unique property of being co-polymerizable with other vinyl compounds present in commercial dental resins, limiting their release and potential toxicity. Computational affinity towards the active site of different MMP-1; -2; -8; -9 and -13 of several compounds showed interesting properties and were synthesized. These free compounds were tested concerning their toxicity upon contact with two different cell types, with no substantial decrease in cell viability at high concentrations. Even so, compound's safety can be further improved upon copolymerization with commercial dental resins, limiting their release.

2.
J Appl Stat ; 48(2): 373-392, 2021.
Article in English | MEDLINE | ID: mdl-35707688

ABSTRACT

An important feature in dentistry is teeth gloss. During an intervention, the doctor applies a resin and a polishing to achieve the lowest roughness and the highest gloss possible. This work aims to evaluate the effect of four polishing protocols in teeth surface roughness and gloss when combined with two different resins and eventually indicate the best combination (treatment). An atomic force microscope is used for measuring the in vitro roughness of a dental surface surrogate. We consider a shared parameters approach for linking the information carried by those two correlated variables. The model fitted to the gloss considers some features of the roughness, namely the information conveyed by a set of spatial structured random effects, specific to each treatment, and the within treatment variance, which allows interpreting how the heterogeneity and the variability of the surface roughness impacts a tooth gloss. The statistical model here developed is an alternative to the "traditional" two-way ANOVA used in dentistry journals. The results, using the recent R-NIMBLE package in R, show that variability characteristics of the surface's roughness are central for explaining differences among the gloss achieved after each treatment and not just the mean roughness of that surface.

3.
J Funct Biomater ; 12(1)2020 Dec 22.
Article in English | MEDLINE | ID: mdl-33375049

ABSTRACT

Surface properties of composites such as roughness and color impact periodontal health and aesthetic outcomes. Novel bulk-fill composites with improved functionality are being introduced and, in light of the existing variety of finishing/polishing procedures, research of their surface properties is warranted. Sixty discs were prepared from bulk-fill composites (Filtek™ Bulk Fill Posterior Restorative and Fill-Up™) and incremental-fill Filtek™ Z250. They were further divided according to different polishing procedures (n = 5): three multi-step polishing procedures or finishing with a bur (control). Surface roughness (Ra) was measured using an atomic force microscope (The AFM Workshop TT-AFM). A spectrophotometer (Spectroshade Micro Optic) was used to determine color stability, after exposure to a coffee solution. Data were analyzed using two-way MANOVA (significance level of 5%). Resin composite type, polishing procedure, and their interaction had a statistically significant effect on surface roughness (p < 0.001) and color change (p < 0.001). Fill-Up™ exhibited the highest surface roughness and greatest color change. Differences in color change were statistically significant (p < 0.001). Filtek™ Bulk Fill registered the lowest surface roughness and color change, after the three-step polishing procedure. Both parameters were significantly correlated (ρ = 0.754, p < 0.001) and found to be material dependent and polishing-procedure dependent. Higher surface roughness relates to greater color changes.

4.
Biomolecules ; 10(5)2020 05 05.
Article in English | MEDLINE | ID: mdl-32380782

ABSTRACT

Matrix metalloproteinases are enzymes that degrade the extracellular matrix. They have different substrates but similar structural organization. Matrix metalloproteinases are involved in many physiological and pathological processes and there is a need to develop inhibitors for these enzymes in order to modulate the degradation of the extracellular matrix (ECM). There exist two classes of inhibitors: endogenous and synthetics. The development of synthetic inhibitors remains a great challenge due to the low selectivity and specificity, side effects in clinical trials, and instability. An extensive review of currently reported synthetic inhibitors and description of their properties is presented.


Subject(s)
Matrix Metalloproteinase Inhibitors/chemistry , Matrix Metalloproteinases/metabolism , Tissue Inhibitor of Metalloproteinases/metabolism , Animals , Drug Discovery/methods , Humans , Matrix Metalloproteinase Inhibitors/adverse effects , Matrix Metalloproteinase Inhibitors/pharmacokinetics , Tissue Inhibitor of Metalloproteinases/chemistry
5.
Cells ; 9(5)2020 04 26.
Article in English | MEDLINE | ID: mdl-32357580

ABSTRACT

The extracellular matrix (ECM) is a macromolecules network, in which the most abundant molecule is collagen. This protein in triple helical conformation is highly resistant to proteinases degradation, the only enzymes capable of degrading the collagen are matrix metalloproteinases (MMPs). This resistance and maintenance of collagen, and consequently of ECM, is involved in several biological processes and it must be strictly regulated by endogenous inhibitors (TIMPs). The deregulation of MMPs activity leads to development of numerous diseases. This review shows MMPs complexity.


Subject(s)
Matrix Metalloproteinases/metabolism , Matrix Metalloproteinases/physiology , Collagen/metabolism , Extracellular Matrix/metabolism , Extracellular Matrix/physiology , Humans , Matrix Metalloproteinase Inhibitors/metabolism , Proteolysis , Structure-Activity Relationship
6.
Clin Oral Investig ; 24(8): 2691-2700, 2020 Aug.
Article in English | MEDLINE | ID: mdl-31713743

ABSTRACT

OBJECTIVES: This study aims to evaluate the cytocompatibility of three provisional restoration materials and predict neurotoxic potential of their monomers. These materials are Tab 2000® (methyl methacrylate based), ProTemp 4™ (bis-acrylic based) and Structur 3® (urethane dimethacrylate based). MATERIALS AND METHODS: Resin samples were incubated in a cell culture medium and the cytotoxic effects of these extracts were studied in 3T3 fibroblast cells through MTT and crystal violet assays as well as ROS assessment. The presence of relevant leached monomers was determined by HPLC. Additionally, the blood-brain barrier (BBB) permeability to these resin-based monomers was predicted using ACD/Labs algorithms model. RESULTS: Cell survival rates were compared with the resin extracts, and Structur 3® was statistically significant different from the others (p < 0.001) at all-time incubation periods. All materials induced a dose-dependent loss of cell viability; however, only Structur 3 extracts were cytotoxic against 3T3 fibroblasts. The highest cytotoxic effect (77%, p < 0.001) was observed at 24 h incubation period, which may be associated with the presence of urethane dimethacrylate (UDMA) leached monomers. Furthermore, the computational model showed that most monomers under study are expectedly capable of crossing the BBB. CONCLUSIONS: Our results showed that Structur 3® is not cytocompatible with our cell model and UDMA is a potential neurotoxic compound. CLINICAL RELEVANCE: These results indicate that only ProTemp 4™ and Tab 2000® are safe for provisional restorations.


Subject(s)
Dental Materials/toxicity , Composite Resins , Materials Testing , Methacrylates , Polyurethanes
7.
FEMS Microbiol Ecol ; 93(5)2017 05 01.
Article in English | MEDLINE | ID: mdl-28449125

ABSTRACT

During wine fermentations, Saccharomyces cerevisiae starts to excrete antimicrobial peptides (AMPs) into the growth medium that induce death of non-Saccharomyces yeasts at the end of exponential growth phase (24-48 h). Those AMPs were found to derive from the glycolytic enzyme glyceraldehyde-3-phosphate dehydrogenase (GAPDH). On the other hand, the early death of non-Saccharomyces yeasts during wine fermentations was also found to be mediated by a cell-to-cell contact mechanism. Since GAPDH is a cell-wall-associated protein in S. cerevisiae, we put forward the hypothesis that the GAPDH-derived AMPs could accumulate on the cell surface of S. cerevisiae, thus inducing death of non-Saccharomyces yeasts by cell-to-cell contact. Here we show that 48-h grown (stationary phase) cells of S. cerevisiae induce death of Hanseniaspora guilliermondii and Lachancea thermotolerans by direct cell-to-cell contact, while 12-h grown cells (mid-exponential phase) do not. Immunological tests performed with a specific polyclonal antibody against the GAPDH-derived AMPs revealed their presence in the cell wall of S. cerevisiae cells grown for 48 h, but not for 12 h. Taken together, our data show that accumulation of GAPDH-derived AMPs on the cell surface of S. cerevisiae is one of the factors underlying death of non-Saccharomyces yeasts by cell-to-cell contact.


Subject(s)
Antimicrobial Cationic Peptides/metabolism , Glyceraldehyde-3-Phosphate Dehydrogenases/metabolism , Hanseniaspora/metabolism , Microbial Interactions/physiology , Saccharomyces cerevisiae/enzymology , Saccharomycetales/metabolism , Cell Membrane/metabolism , Fermentation , Saccharomyces cerevisiae/metabolism , Wine/microbiology
8.
Appl Microbiol Biotechnol ; 101(1): 159-171, 2017 Jan.
Article in English | MEDLINE | ID: mdl-27502415

ABSTRACT

We recently found that Saccharomyces cerevisiae (strain CCMI 885) secretes antimicrobial peptides (AMPs) derived from the glycolytic enzyme glyceraldehyde 3-phosphate dehydrogenase (GAPDH) that are active against various wine-related yeast and bacteria. Here, we show that several other S. cerevisiae strains also secrete natural biocide fractions during alcoholic fermentation, although at different levels, which correlates with the antagonistic effect exerted against non-Saccharomyces yeasts. We, therefore, term this biocide saccharomycin. The native AMPs were purified by gel-filtration chromatography and its antimicrobial activity was compared to that exhibited by chemically synthesized analogues (AMP1 and AMP2/3). Results show that the antimicrobial activity of the native AMPs is significantly higher than that of the synthetic analogues (AMP1 and AMP2/3), but a conjugated action of the two synthetic peptides is observed. Moreover, while the natural AMPs are active at pH 3.5, the synthetic peptides are not, since they are anionic and cannot dissolve at this acidic pH. These findings suggest that the molecular structure of the native biocide probably involves the formation of aggregates of several peptides that render them soluble under acidic conditions. The death mechanisms induced by the AMPs were also evaluated by means of epifluorescence microscopy-based methods. Sensitive yeast cells treated with the synthetic AMPs show cell membrane disruption, apoptotic molecular markers, and internalization of the AMPs. In conclusion, our work shows that saccharomycin is a natural biocide secreted by S. cerevisiae whose activity depends on the conjugated action of GAPDH-derived peptides. This study also reveals that S. cerevisiae secretes GAPDH-derived peptides as a strategy to combat other microbial species during alcoholic fermentations.


Subject(s)
Disinfectants/pharmacology , Microbial Viability/drug effects , Saccharomyces cerevisiae/metabolism , Apoptosis , Cell Membrane/drug effects , Chromatography, Gel , Disinfectants/chemistry , Disinfectants/isolation & purification , Endocytosis , Hydrogen-Ion Concentration , Solubility
9.
FEMS Microbiol Lett ; 362(14)2015 Jul.
Article in English | MEDLINE | ID: mdl-26109361

ABSTRACT

The roles of cell-to-cell contact and antimicrobial peptides in the early death of Lachanchea thermotolerans CBS2803 during anaerobic, mixed-culture fermentations with Saccharomyces cerevisiae S101 were investigated using a commercially available, double-compartment fermentation system separated by cellulose membranes with different pore sizes, i.e. 1000 kDa for mixed- and single-culture fermentations, and 1000 and 3.5-5 kDa for compartmentalized-culture fermentations. SDS-PAGE and gel filtration chromatography were used to determine an antimicrobial peptidic fraction in the fermentations. Our results showed comparable amounts of the antimicrobial peptidic fraction in the inner compartments of the mixed-culture and 1000 kDa compartmentalized-culture fermentations containing L. thermotolerans after 4 days of fermentation, but a lower death rate of L. thermotolerans in the 1000 kDa compartmentalized-culture fermentation than in the mixed-culture fermentation. Furthermore, L. thermotolerans died off even more slowly in the 3.5-5 kDa than in the 1000 kDa compartmentalized-culture fermentation, which coincided with the presence of less of the antimicrobial peptidic fraction in the inner compartment of that fermentation than of the 1000 kDa compartmentalized-culture fermentation. Taken together, these results indicate that the death of L. thermotolerans in mixed cultures with S. cerevisiae is caused by a combination of cell-to-cell contact and antimicrobial peptides.


Subject(s)
Antifungal Agents/metabolism , Fermentation , Peptides/metabolism , Saccharomyces cerevisiae/cytology , Saccharomyces cerevisiae/physiology , Saccharomycetales/physiology , Wine/microbiology , Colony Count, Microbial , Electrophoresis, Polyacrylamide Gel , Ethanol/metabolism , Industrial Microbiology , Saccharomyces cerevisiae/growth & development
10.
J Hazard Mater ; 284: 27-34, 2015 Mar 02.
Article in English | MEDLINE | ID: mdl-25463214

ABSTRACT

Recently, the scientific community became aware of the potential ability of nanoparticles to cause toxicity in living organisms. Therefore, many of the implications for aquatic ecosystems and its effects on living organisms are still to be evaluated and fully understood. In this study, the toxicity of nanodiamonds (NDs) was assessed in the freshwater bivalve (Corbicula fluminea) following exposure to different nominal concentrations of NDs (0.01, 0.1, 1, and 10 mg l(-1)) throughout 14 days. The NDs were characterized (gravimetry, pH, zeta potential, electron microscopy, and atomic force microscopy) confirming manufacturer information and showing NDs with a size of 4-6 nm. Oxidative stress enzymes activities (glutathione-S-transferase, catalase) and lipid peroxidation were determined. The results show a trend to increase in GST activities after seven days of exposure in bivalves exposed to NDs concentrations (>0.1 mg l(-1)), while for catalase a significant increase was found in bivalves exposed from 0.01 to 1.0 mg l(-1) following an exposure of 14 days. The histological analysis revealed alterations in digestive gland cells, such as vacuolization and thickening. The lipid peroxidation showed a trend to increase for the different tested NDs concentrations which is compatible with the observed cellular damage.


Subject(s)
Corbicula/drug effects , Diamond/chemistry , Nanoparticles/chemistry , Oxidative Stress , Animals , Biological Assay , Carbon/chemistry , Catalase/metabolism , Cell Membrane/drug effects , Gastrointestinal Tract/drug effects , Glutathione Transferase/metabolism , Hydrogen-Ion Concentration , Lipid Peroxidation , Microscopy, Atomic Force , Microscopy, Electron, Transmission , Particle Size , Time Factors , Water Pollutants, Chemical/analysis
11.
Appl Microbiol Biotechnol ; 98(2): 843-53, 2014 Jan.
Article in English | MEDLINE | ID: mdl-24292082

ABSTRACT

Saccharomyces cerevisiae plays a primordial role in alcoholic fermentation and has a vast worldwide application in the production of fuel-ethanol, food and beverages. The dominance of S. cerevisiae over other microbial species during alcoholic fermentations has been traditionally ascribed to its higher ethanol tolerance. However, recent studies suggested that other phenomena, such as microbial interactions mediated by killer-like toxins, might play an important role. Here we show that S. cerevisiae secretes antimicrobial peptides (AMPs) during alcoholic fermentation that are active against a wide variety of wine-related yeasts (e.g. Dekkera bruxellensis) and bacteria (e.g. Oenococcus oeni). Mass spectrometry analyses revealed that these AMPs correspond to fragments of the S. cerevisiae glyceraldehyde 3-phosphate dehydrogenase (GAPDH) protein. The involvement of GAPDH-derived peptides in wine microbial interactions was further sustained by results obtained in mixed cultures performed with S. cerevisiae single mutants deleted in each of the GAPDH codifying genes (TDH1-3) and also with a S. cerevisiae mutant deleted in the YCA1 gene, which codifies the apoptosis-involved enzyme metacaspase. These findings are discussed in the context of wine microbial interactions, biopreservation potential and the role of GAPDH in the defence system of S. cerevisiae.


Subject(s)
Antimicrobial Cationic Peptides/metabolism , Glyceraldehyde-3-Phosphate Dehydrogenase (Phosphorylating)/metabolism , Microbial Interactions , Saccharomyces cerevisiae/growth & development , Saccharomyces cerevisiae/metabolism , Wine/microbiology , Antibiosis , Ethanol/metabolism , Fermentation , Mass Spectrometry
12.
Biosens Bioelectron ; 25(7): 1742-7, 2010 Mar 15.
Article in English | MEDLINE | ID: mdl-20096557

ABSTRACT

Molecularly imprinted polymers (MIPs) of poly(ethylene glycol dimethacrylate) and poly(N-isopropylacrylamide-co-ethylene glycol dimethacrylate) were synthesized for the first time in supercritical carbon dioxide (scCO(2)), using Boc-L-tryptophan as template. Supercritical fluid technology provides a clean and one-step synthetic route for the preparation of affinity polymeric materials with sensing capability for specific molecules. The polymeric materials were tested as stationary HPLC phases for the enantiomeric separation of L- and D-tryptophan. HPLC results prove that the synthesized MIPs are able to recognize the template molecule towards its enantiomer which opens up potential applications in chromatographic chiral separation.


Subject(s)
Biosensing Techniques/instrumentation , Chromatography, High Pressure Liquid/instrumentation , Chromatography, Supercritical Fluid/instrumentation , Molecular Probe Techniques/instrumentation , Polymers/analysis , Tryptophan/chemistry , Biosensing Techniques/methods , Chromatography, High Pressure Liquid/methods , Chromatography, Supercritical Fluid/methods , Computer-Aided Design , Equipment Design , Equipment Failure Analysis , Isomerism , Reproducibility of Results , Sensitivity and Specificity
15.
Article in English | MEDLINE | ID: mdl-17404423

ABSTRACT

The physiological roles of insulin and nitric oxide (NO) have been recently recognized by several studies. A diversity of chemical modifications of insulin is reported both in vivo and in vitro. S-nitrosation, the covalent linkage of NO to cysteine free thiol is recognized as an important post-translational regulation in many proteins. Here we report the in vitro synthesis of an S-nitrosothiol of bovine insulin A- and B-chains. These compounds were characterized by their HPLC chromatographic behavior, monitored by UV visible spectroscopy and electron spray ionization mass spectrometry. The experimental results indicate that each A- and B-chain were S- nitrosated with only one NO group. Stability and solubility of these synthesized derivatives is described for physiological purposes. In this work, nitroso A- and B-chains of insulin were synthesized in vitro in order to better understand the possible interactions between insulin and NO that may be involved in the etiology of insulin resistance.


Subject(s)
Chromatography, High Pressure Liquid , Insulin/chemistry , Nitric Oxide/chemistry , Spectrometry, Mass, Electrospray Ionization/methods , Animals , Cattle , Insulin Resistance/physiology , Nitrosation
17.
Biochemistry ; 44(34): 11628-35, 2005 Aug 30.
Article in English | MEDLINE | ID: mdl-16114900

ABSTRACT

The aldehyde oxidoreductase from Desulfovibrio gigas belongs to the family of molybdenum hydroxylases. Besides a molybdenum cofactor which constitutes their active site, these enzymes contain two [2Fe-2S](2+,1+) clusters which are believed to transfer the electrons provided by the substrate to an acceptor which is either a FAD group or an electron-transferring protein. When the three metal centers of D. gigas AOR are simultaneously paramagnetic, splittings due to intercenter spin-spin interactions are visible when the EPR spectra are recorded at low temperatures. By studying quantitatively these interactions with a model based on the X-ray crystal structure, which takes into consideration the interactions between the magnetic moments carried by all the metal sites of the system, it is possible to determine the location of the reducible sites of the [2Fe-2S] clusters. When combined with the electron-transfer pathways proposed on the basis of the X-ray crystal structure, the results provide a detailed description of the electron-transfer system of D. gigas AOR.


Subject(s)
Aldehyde Oxidoreductases/chemistry , Aldehyde Oxidoreductases/metabolism , Desulfovibrio gigas/enzymology , Iron-Sulfur Proteins/chemistry , Iron-Sulfur Proteins/metabolism , Animals , Binding Sites , Computer Simulation , Electron Spin Resonance Spectroscopy , Flavin-Adenine Dinucleotide/metabolism , Milk/enzymology , Oxidation-Reduction , Xanthine Oxidase/chemistry , Xanthine Oxidase/metabolism
18.
J Magn Reson ; 170(2): 213-9, 2004 Oct.
Article in English | MEDLINE | ID: mdl-15388083

ABSTRACT

Correlation of the g-tensor of a paramagnetic active center of a protein with its structure provides a unique experimental information on the electronic structure of the metal site. To address this problem, we made solid films containing metalloprotein (Desulfovibrio gigas cytochrome c(3)) microcrystals. The microcrystals in a liquid crystalline polymer medium (water/hydroxypropylcellulose) were partially aligned by a shear flow. A strong orientation effect of the metalloprotein was observed by EPR spectroscopy and polarizing optical microscopy. The EPR spectra of partially oriented samples were simulated, allowing for molecular orientation distribution function determination. The observed effect results in enhanced sensitivity and resolution of the EPR spectra and provides a new approach towards the correlation of spectroscopic data, obtained by EPR or some other technique, with the three-dimensional structure of a protein or a model compound.


Subject(s)
Cellulose/analogs & derivatives , Cytochrome c Group/chemistry , Desulfovibrio/enzymology , Electron Spin Resonance Spectroscopy/methods , Crystallization , Polymers , Riboflavin/chemistry , Solutions
19.
J Biol Inorg Chem ; 9(2): 145-51, 2004 Mar.
Article in English | MEDLINE | ID: mdl-14669076

ABSTRACT

We report the characterization of the molecular properties and EPR studies of a new formate dehydrogenase (FDH) from the sulfate-reducing organism Desulfovibrio alaskensis NCIMB 13491. FDHs are enzymes that catalyze the two-electron oxidation of formate to carbon dioxide in several aerobic and anaerobic organisms. D. alaskensis FDH is a heterodimeric protein with a molecular weight of 126+/-2 kDa composed of two subunits, alpha=93+/-3 kDa and beta=32+/-2 kDa, which contains 6+/-1 Fe/molecule, 0.4+/-0.1 Mo/molecule, 0.3+/-0.1 W/molecule, and 1.3+/-0.1 guanine monophosphate nucleotides. The UV-vis absorption spectrum of D. alaskensis FDH is typical of an iron-sulfur protein with a broad band around 400 nm. Variable-temperature EPR studies performed on reduced samples of D. alaskensis FDH showed the presence of signals associated with the different paramagnetic centers of D. alaskensis FDH. Three rhombic signals having g-values and relaxation behavior characteristic of [4Fe-4S] clusters were observed in the 5-40 K temperature range. Two EPR signals with all the g-values less than two, which accounted for less than 0.1 spin/protein, typical of mononuclear Mo(V) and W(V), respectively, were observed. The signal associated with the W(V) ion has a larger deviation from the free electron g-value, as expected for tungsten in a d(1) configuration, albeit with an unusual relaxation behavior. The EPR parameters of the Mo(V) signal are within the range of values typically found for the slow-type signal observed in several Mo-containing proteins belonging to the xanthine oxidase family of enzymes. Mo(V) resonances are split at temperatures below 50 K by magnetic coupling with one of the Fe/S clusters. The analysis of the inter-center magnetic interaction allowed us to assign the EPR-distinguishable iron-sulfur clusters with those seen in the crystal structure of a homologous enzyme.


Subject(s)
Desulfovibrio/enzymology , Formate Dehydrogenases/metabolism , Iron/chemistry , Molybdenum/metabolism , Pterins/chemistry , Sulfur/chemistry , Tungsten/metabolism , Chromatography, Gel , Chromatography, High Pressure Liquid , Desulfovibrio/chemistry , Desulfovibrio/growth & development , Electromagnetic Fields , Electron Spin Resonance Spectroscopy , Electrophoresis, Polyacrylamide Gel , Formate Dehydrogenases/chemistry , Molecular Weight , Oxidation-Reduction , Spectrophotometry, Ultraviolet , Sulfates/metabolism
20.
Binocul Vis Strabismus Q ; 18(1): 35-48; discussion 49-50, 2003.
Article in English | MEDLINE | ID: mdl-12597768

ABSTRACT

BACKGROUND: A V-pattern esotropia with bilateral overaction of the inferior oblique (IO) is a common finding. The clinical characteristics of this condition in a large series are not available. Also, data is lacking about the surgical outcome of graded bilateral inferior oblique recessions. Lastly, it is not known whether patients with a V pattern below 15 prism diopters (pd) should have IO weakening when horizontal eye muscle surgery is to be performed. SUBJECTS AND METHODS: Seventy-eight consecutive patients without complicating factors were fully evaluated and submitted to bilateral graded recessions of the IO. In Group 1, 59 patients had a V pattern of 15 pd or more; 55 were also operated for a horizontal imbalance. In Group 2, 19 patients in whom a horizontal surgery was required and who also had a V pattern of less than 15 pd, also had a bilateral graded recession of the IO performed. RESULTS: Preoperative findings: In Group 1, the distribution of V patterns showed 88.1% in the range 15 to 35 pd. A bilateral overaction of the IO, a bilateral underaction of the superior oblique (SO), and elevation in adduction OU were present in 62.7% of the patients. A vertical imbalance was observed in 20.3%. In Group 2, a bilateral overaction of the IO, a bilateral underaction of the SO, and elevation in adduction OU were noticed in 42.1% of the patients. A vertical deviation was seen in 26.3%. After surgery, in Group 1, 83% had less than 15 pd of V pattern or less than 10 pd of A pattern. Surgery reduced a presurgical vertical imbalance, but created a vertical deviation in some cases devoid of hypertropia before surgery. After surgery in Group 2, a full correction or undercorrection was obtained in 63.1% of the patients and an overcorrection to an A pattern in 21.0% Surgery was also prone to induce a vertical deviation. Binocularity: There was an improvement of the fusional status with surgery, (ascertained with the Worth Four Dot Test and major amblyoscope measurement), in patients of both Groups 1 and 2. CONCLUSION: In V-pattern esotropia cases of 15 pd or more the vast majority were in the range 15-35 pd. Overaction of both IO, underaction of both SO, and elevation in adduction OU constituted a triad of co-occurrent signs present in a significant number of patients. A vertical imbalance was detected in 1/5 of the cases. A good outcome (collapse of the V pattern) was obtained with bilateral graded recession of the IO, but this surgery can create a vertical imbalance. In cases of V pattern less than 15 pd, and requiring horizontal surgery, weakening of both IO's can be advised.


Subject(s)
Esotropia/surgery , Oculomotor Muscles/surgery , Ophthalmologic Surgical Procedures/methods , Child , Child, Preschool , Female , Humans , Infant , Male , Retrospective Studies , Treatment Outcome , Vision, Binocular
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