Inflammatory markers in the tears of patients with ocular surface disease.

PURPOSE: To determine the concentration of interleukins (IL-1beta and -6) and matrix metalloproteinase 9 (pro-MMP-9) in the tears of patients with different ocular surface diseases and to examine the possible relationship between the disorders and molecular inflammation. METHODS: 77 patients diagnosed as having different ocular surface disorders and 18 normal control subjects were studied. Patients were routinely examined and separated into 5 groups: (1) control, (2) blepharitis, (3) ocular allergic disease, (4) dry eye and (5) conjunctivochalasis. Ten microliters of tears were collected by a Weck cell sponge. The concentrations of IL-1beta, IL-6 and pro-MMP-9 were measured by enzyme-linked immunosorbent assay, and the MMP-9 activity was evaluated with gelatin zymography. RESULTS: Levels of IL-1beta and IL-6 in tear fluid were significantly higher in conjunctivochalasis (p = 0.0062 and p = 0.0134) than in the control group. Pro-MMP-9 levels were significantly elevated in blepharitis (p = 0.013), in allergic eye disease, in dry eye and in conjunctivochalasis (all p < 0.001), in comparison to controls. CONCLUSIONS: Pro-MMP-9 levels in tears are elevated in all of the studied pathologies especially in ocular allergy and conjunctivochalasis. However, IL-1beta and IL-6 were only found to be overexpressed in conjunctivochalasis. These findings illustrate the selective implication of different molecules in each disorder.

Corneal lamellar dissection by using suture threads in porcine eyes.

PURPOSE: Lamellar dissection is one of the most delicate maneuvers in corneal surgery. We describe a new method that uses Ferrara ring instrumentation. METHODS: A 360 degrees tunnel is created at half of the stromal depth in porcine corneas. A suture (nylon 6-0 or Vicryl 6-0) was passed through the tunnel by using the Ferrara spatula. By means of alternate traction on the end of the suture thread, complete lamellar dissection was achieved. RESULTS: Light microscopy examination of the cornea confirmed that the dissection had a constant thickness and dissection depth. Scanning electron microscopy showed a homogeneous stromal surface without irregularities. CONCLUSIONS: This technique permits a homogeneous and safe lamellar dissection, which may prove useful in specific surgical procedures of the cornea.

Consumo de glucosa in vivo inducido por insulina en individuos sanos / In vivo glucose consumption induced by insulin in normal controls

El desarrollo del clamp glicémico ha significado un importante avance en el estudio de la sensibilidad insulínica in vivo. En el presente trabajo se determinó el consumo de glucosa inducido por insulina por medio del clamp euglicémico hiperinsulinémico en 8 sujetos sanos: edad 45 ñ 7 años e índice de masa corporal (IMC) 25 ñ 6 kg/m*. Se realizaron correlaciones por análisis de regresión lineal simple, determinándose su significancia estadística por "t" de student. Los individuos presentaron una glicemia basal de 95 ñ 10 mg/dl con una concentración de insulina sérica de 9 ñ 3 uU/ml. La glicemia de la última media hora del clamp fue de 94 ñ 10 mg/dl y las insulinemias 73 ñ 12 uU/ml. Los coeficientes de variación de la glicemia e igual período del clamp estuvieron en el rango de 3 a 11%. El metabolismo de la glucosa inducido por la insulina (M), fue de 6,67 ñ 3,13 mg/kg/min y la eficiencia en la utilización de glucosa (MCR) 7,23 ñ 3,54 ml/kg/min. Por otro lado, el índice de sensibilidad a la insulina (M/Ins x 100) tuvo un valor de 9,52 ñ 5,23 (mg/kg/min). (uU/ml) x 100. Los estudios de correlación mostraron una asociación lineal entre M y MCR (r = 0,978; p < 0,0002) entre M y M/Ins x 100 (r = 0,965; p < 0,0002) y entre MCR y M/Ins x 100 (r = 0,945; p < 0,0002). Nuestros resultados confirman que el clamp euglicémico hiperinsulínico es una técnica reproducible y aplicable a la investigación clínica