The correlation of computed tomography in the evaluation of septoplasty patients.

BACKGROUND: Septoplasty is one of the frequently applied nasal surgical procedures. There is still no gold standart objective method to evaluate the patients whom suffers from nasal blockage. To evaluate the septoplasty candidate with a Paranasal Computerised Tomography (PNCT) is one of the most discussed topic in the otorhinolaryngology surgical philosophy. OBJECTIVES: In this study, we aim to interpret the value of nasal valve areas measured by PNCT for both septoplasty candidates and the control population. We believe that this information could be useful for the evaluation of patients before undergoing a septoplasty procedure. MATERIAL AND METHODS: 600 coronal and axial tomography sections performed between May 2014 and February 2018 at the University Of Gaziantep Radiology Dept. were assessed. These tomography sections were divided into two groups called the septoplasty and the control. The septoplasty group was made up of three hundred paranasal sinus tomography images scanned before patients' septoplasty operations. The control group was created by screening 300 maxillofacial tomography's which were taken due to the suspicion of trauma at the University Of Gaziantep Emergency Clinic between May 2014 and January 2018. RESULTS: There were 192 (64%) patients with left nasal septal deviation and 108 (36%) patients with right nasal septal deviation. The Independent Sample T-Test revealed that the mean internal nasal valve angle in the left septoplasty group was significantly lower than that of the control group (P < 0.005). A comparison of the right side nasal values revealed a significant statistical change according to the Independent Sample T-Test between the value of the right septoplasty and the control groups (P < 0.005). CONCLUSION: The sectional areas of nasal tomography images may show different values. However, it is still difficult to say that the clinical application of tomography images could be used as one of the indication criteria for the septoplasty procedure.

Elbow problems in paraplegic spinal cord injured patients: frequency and related risk factors--a preliminary controlled study.

STUDY DESIGN: Cross-sectional controlled study. OBJECTIVES: To evaluate the elbow joint with ultrasound in paraplegic patients, determine the related factors and compare it with healthy controls. SETTING: A training and research rehabilitation hospital in Istanbul. METHODS: A total of 30 paraplegic patients and 20 healthy controls were included in the study. Patients demographic data, pain in the elbow joint, level and duration of injury, ambulation status, type of wheelchair used, daily duration of wheelchair and other ambulation equipment usage, transfers being dependent or independent, daily number of push-ups were recorded. Elbow joints were evaluated with ultrasound for presence of fluid and thickness of the triceps tendon. RESULTS: Mean triceps tendon thickness values of the right side were larger in spinal cord injury (SCI) patients when compared with those of healthy controls'. Joint effusion on the right elbow joint was also found to be more common in SCI patients than in normal subjects. Triceps tendon thickness measurements were not found to be correlated with demographic and clinical factors. Seven paraplegic patients (23%) reported that they have pain in the elbow. CONCLUSION: In this preliminary study, our results showed that right elbow effusion was more frequent and right triceps tendon was thicker in SCI patients when compared with healthy subjects.

Comparison of culture, microscopic smear and molecular methods in diagnosis of tuberculosis.

OBJECTIVE: Tuberculosis (TB) is a public health problem worldwide, with the highest mortality . The development of nucleic acid-based tests for detection of Mycobacterium tuberculosis complex (MTBC) has significantly increased sensitivity compared to conventional smear microscopy and provides results within a matter of hours compared to weeks for solid culture, which is the current gold standart. The aim of this study was to compare the culture, microscopic smear and molecular method in the diagnosis of TB. METHODS: Seven hundred ninety specimens belonging to clinically suspected cases of TB were studied retrospectively. The specimens were grouped as respiratory and non-respiratory and the groups were compared for mycobacterial detection assays. The culture and the molecular diagnostic GeneXpert MTB/RIF (GX) assay method were compared. RESULTS: When culture was used as the reference standart, 32 (4.05%) specimens were positive for MTBC. Of the 32 culture positive clinical specimens 24 (3.03%) were respiratory and 8 (1.01%) were non-respiratory specimens. All 24 of the 24 respiratory specimens were positive by the GX test, Seven of the eight non-respiratory specimens positive for culture were positive by GX assay. Five of the seven hundred fifty-eight samples of culture negative were positive with GX assay. Sensitivity and specificity of GX were found to be 96.8 % and 99.3 %, respectively. CONCLUSIONS: Molecular methods to acquire time in diagnosis as well as the increase in linearity gives a different perspective to the diagnosis of tuberculosis. The GX assay has a diagnostic utility for rapid diagnosis of TB.

Preparation, DNA binding, and in vitro cytotoxicity of a pair of enantiomeric platinum(II) complexes, [(R)- and (S)-3-aminohexahydroazepine]dichloroplatinum(II). Crystal structure of the S enantiomer.

A pair of enantiomeric Pt(II) complexes, [Pt(R-ahaz)Cl2] and [Pt(S-ahaz)Cl2] (ahaz = 3-aminohexahydroazepine), has been investigated for their ability to bind enantioselectively to DNA. Improved synthetic procedures were developed for preparing both the ligands and the Pt complexes. The structure of the complex of the S enantiomer was determined by X-ray crystallographic methods. Crystals of [Pt(S-ahaz)Cl2] are orthorhombic, space group P2(1)2(1)2(1), with a = 6.917(1) A, b = 11.167(1) A, c = 12.373(2) A, Z = 4, and the structure was refined to R = 0.023 (1505F). Molecular modeling techniques were used to investigate the role of steric interactions between the ligand and DNA in influencing the bifunctional binding of the two enantiomers, and it was found that the S enantiomer should bind more readily. The binding of the S enantiomer, to calf thymus DNA, was indeed found to be slightly greater than that for the R enantiomer though slightly less than that for cis-DDP. Assays of the proportion of monofunctional adducts showed that a substantially greater proportion of monofunctional adducts remained for the R enantiomer and cisplatin than for the S enantiomer. Each of the enantiomers was subjected to in vitro cytotoxicity assays using cultures of human bladder (BL13/0), lung and resistant lung (PC9 and PC9cisR), and prostate (DU145) cancer cells. The R enantiomer was found to be slightly more cytotoxic in the bladder cell line and may be less cytotoxic in the lung cell line but there were no significant differences in the resistant cell line nor in the prostate cell line. The two enantiomers were taken up equally by the bladder cancer cells.

The use of sucralfate suspension in the treatment of oral and genital ulceration of Behçet disease: a randomized, placebo-controlled, double-blind study.

OBJECTIVE: To determine the efficacy of topically applied sucralfate suspension in the treatment of oral and genital ulceration of Behçet disease. DESIGN AND SETTING: A randomized, placebo-controlled, double-blind study at a university referral center. PATIENTS: Forty patients with Behcet disease were included in the study. INTERVENTION: Patients were given topical sucralfate or placebo 4 times a day for 3 months and examined clinically at biweekly intervals. MAIN OUTCOMES MEASURES: For each lesion, the mean frequency, healing time, and pain were evaluated during the pretreatment, treatment, and follow-up periods. No patients were given any concurrent disease-specific or immunosuppressive topical and systemic drugs during the 9-month study period. RESULTS: Of the 40 patients included in the study, the results in 30 patients (16 patients treated with sucralfate and 14 patients treated with placebo, ranging in age from 16 to 52 years [mean+/-SD age, 34.3+/-8.1 years]) were evaluable for efficacy. Treatment with sucralfate decreased significantly the mean frequency, healing time, and pain of oral ulceration and healing time and pain of genital ulceration compared with the pretreatment period. The effectiveness of sucralfate on the frequency and healing time of oral ulceration continued during the post-treatment period. In the placebo group, no significant difference was found in measured parameters of oral and genital ulceration except the pain of the oral ulceration between the pretreatment and treatment periods. CONCLUSION: Our results showed that topical sucralfate suspension is an easy, safe, inexpensive, and effective treatment for oral and genital ulceration in patients with Behçet disease.

Laser in situ keratomileusis to correct hyperopia from +4.25 to +8.00 diopters.

OBJECTIVE: To evaluate the efficacy and predictability of laser in situ keratomileusis (LASIK) for hyperopia in a prospective study of 54 eyes of 29 patients. METHODS: Before LASIK, 44 eyes (81.48%) had a spectacle-corrected visual acuity of 20/20 or better, and 54 eyes (100%) had 20/40 or better. Surgery was performed under topical anesthesia using the Keracor 116 excimer laser and Chiron automated corneal shaper. Mean follow-up was 19 months. RESULTS: Mean baseline uncorrected hyperopia was +6.50 +/- 1.33 D (range, +4.25 to +8.00 D). Mean uncorrected manifest spherical equivalent refraction was +0.44 +/- 1.95 D at 18 months after LASIK. Twenty-one eyes (38.8%) were within +/-0.50 D of emmetropia, 41 eyes (75.92%) were within +/-1.00 D, and 47 eyes (87.03%) were within +/-2.00 at 18 months after LASIK. Uncorrected visual acuity was 20/20 or better in eight eyes (14.81%) and 20/40 or better in 36 eyes (66.66%) 18 months after LASIK. Regression and undercorrection of more than 2.00 D occurred in seven eyes (12.9%) between the 3 and 6 month examinations; three of these seven eyes (42.8%) required retreatment to correct residual hyperopia. Three eyes (6.8%) lost two or more lines of spectacle-corrected visual acuity. CONCLUSION: Excimer laser keratomileusis in situ with the Keracor 116 appears to be an effective and safe procedure to decrease low and moderate hyperopia, but the predictability of the procedure needs improvement.

Serum homocysteine level is increased and correlated with endothelin-1 and nitric oxide in Behçet's disease.

BACKGROUND/AIMS: Behçet's disease (BD) is a systemic inflammatory vasculitis of young adults with unknown aetiology, characterised by endothelial dysfunction and occlusion in both deep venous and retinal circulation. Ocular involvement occurs in 70% of cases and is characterised by periphlebitis, periarteritis, vascular occlusion, and thrombosis leading to blindness despite vigorous treatment. Endothelin-1 (ET-1) is a vasoconstricting peptide while nitric oxide (NO) is a relaxing molecule and both are released by endothelium for blood flow regulation. Homocysteinaemia is a newly defined term connected to the increased risk of atherothrombotic and atherosclerotic systemic and retinal vascular occlusive diseases, and its role in the course of BD has not been previously described. The authors aimed to detect serum total homocysteine (tHcy), ET-1, and NO in BD and to assess if tHcy, ET-1, and NO are associated with ocular BD or disease activity. METHODS: 43 consecutive patients with ocular (n = 27) or non-ocular (n = 16) BD (36.95 (SD 9.80) years, 22 male, 21 female) satisfying international criteria, and 25 age and sex matched healthy control subjects (37.88 (8.73) years, 13 male, 12 female) without a history of systemic or retinal venous thrombosis were included in this study. Patients were examined by two ophthalmologists with an interest in BD. Serum tHcy, ET-1, and NO concentrations were measured in both groups. Hyperhomocysteinaemia was defined as a tHcy level above the 95th percentile in the control group. Patients were divided into active and inactive period by acute phase reactants including alpha(1) antitrypsin, alpha(2) macroglobulin, erythrocyte sedimentation rate, and neutrophil count. RESULTS: The overall mean serum tHcy, ET-1, and NO levels were significantly higher in patients with BD than in control subjects (tHcy = 15.83 (4.44) v 7.96 (2.66) ng/ml, p <0.001; ET-1 = 17.47 (4.33) v 5.74 (2.34) micromol/ml, p <0.001; NO = 37.60 (10.31) v 27.08 (7.76) micromol/l, p <0.001). Serum tHcy, ET-1, and NO levels were significantly higher in active patients than in inactive patients and control subjects. In addition, among patients with ocular BD, the mean tHcy levels were significantly increased and correlated with ET-1 and NO levels when compared with non-ocular disease and control subjects. All acute phase reactant levels were significantly higher in active period than in inactive stage and controls. CONCLUSIONS: Elevated tHcy may be responsible for the endothelial damage in BD and may be an additional risk factor for the development of retinal vascular occlusive disease, contributing to the poor visual outcome in these patients. Assessment of tHcy may be important in the investigation and management of patients with BD, especially with ocular disease.

Effects of NG-nitro L-arginine and corticosteroids on aqueous humor levels of nitric oxide and cytokines after cataract surgery.

PURPOSE: To assess the efficacy of nitric oxide synthesis (NOS) inhibitor, topical steroids, and nonsteroidal anti-inflammatory drugs on aqueous levels of nitric oxide (NO) and cytokines after cataract surgery. SETTING: Research Laboratory, Inonu University Turgut Ozal Medical Center, Malatya, Turkey. METHODS: Fifteen rabbits had intercapsular phacoemulsification and were randomly divided into 3 treatment groups: Group 1 was treated with topical prednisolone acetate 1% drops 5 times a day for 1 week; Group 2, flurbiprofen 0.03% drops 5 times a day for 1 week; Group 3, a 0.1 cc subconjunctival injection of NG-nitro L-arginine (L-NAME) (150 mg/kg) 1 day and 3 days after surgery. Three rabbits serving as controls received a subconjunctival injection of an equal volume of balanced salt solution (BSS) at the same times as the L-NAME injections. Aqueous humor specimens were collected from each eye to determine NO and cytokine levels including interleukin-1-beta (IL-1 beta), interleukin-2R (IL-2R), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha). RESULTS: The levels of IL-1 beta and IL-6 were higher in Group 2 and the control group than in Groups 1 and 3 at all times. The differences were not statistically significant (P < .05). Nitric oxide and TNF-alpha levels in Groups 1 and 3 were significantly lower than in Groups 2 and the controls 1, 3, and 7 days postoperatively (P < .05). CONCLUSION: These findings suggest a strong inhibitory effect of NOS inhibitors and corticosteroids on aqueous levels of TNF-alpha and NO and no inhibitory effect on IL-1 beta and IL-6 levels after cataract surgery.

Computerized videokeratography and keratometry in determining intraocular lens calculations.

PURPOSE: To compare the accuracy of standard keratometry and computerized videokeratography (CVK) in determining intraocular lens (IOL) power calculations. METHODS: Using the EyeSys Corneal Analysis System, we prospectively obtained CVK maps on 75 eyes of 69 patients scheduled to have phacoemulsification with implantation of a posterior chamber intraocular lens. Using manifest refraction obtained at 6 weeks postoperatively, we optimized the calculations for the Hoffer Q, Holladay, and SRK/T formulas for standard keratometric and the following six CVK values: average curvatures at the 1 mm, 2 mm, and 3 mm zones, the keratometric equivalent at the 3 mm zone, and the Stiles-Crawford weighted averages over the 3 mm and 6 mm zones. The accuracy of these parameters was determined by calculating the mean absolute error and percentage of patients with accuracy within < or = 0.5 diopter (D), < or = 1.0 D, and < or = 2.0 D. RESULTS: Keratometrically derived data were slightly more accurate than the CVK-derived values. The average difference in mean absolute error between the keratometric and CVK values was 0.13 D for the Hoffer Q formula, 0.11 D for the Holladay, and 0.08 D for the SRK/T. CONCLUSIONS: In this population of patients, we found the CVK-derived corneal curvature values to be slightly less accurate than standard keratometry in predicting IOL power. However, CVK provides important corneal curvature data for IOL calculations in patients with abnormal or surgically altered corneal surfaces.

Significance of corneal topography in predicting patient complaints after photorefractive keratectomy.

PURPOSE: To evaluate the sensitivity and specificity of postoperative corneal topography to predict potential patient complaints after photorefractive keratectomy (PRK). SETTING: Doheny Eye Institute, Los Angeles, California, USA. METHODS: Postoperative tangential corneal topographic maps, in 0.5 and 1.0 diopter (D) relative scales, were obtained from patients (n = 34) at least 4 months after PRK. Topographies of complaining (n = 18) and noncomplaining patients (n = 16) were analyzed by 6 masked examiners with 2 different experience levels in PRK (experts, n = 2; beginners, n = 4), who assigned the topographies to 1 of the 2 groups. RESULTS: Topographies of complainers (sensitivity) and noncomplainers (specificity) were correctly classified in 53.2% overall and in 44.0% and 63.5% (P = .06) in complainers and noncomplainers, respectively. Experienced examiners were not significantly more accurate than inexperienced examiners (46.3% and 56.6%, respectively; P = .09). Images of 1.0 D scales received significantly more correct responses than those of 0.5 D scales (56.4% and 50.0% respectively; P = .03). The reproducibility between images for the same patient in both scales was significantly better for the experienced examiners than the inexperienced examiners (kappa coefficient 0.73 and 0.51, respectively; P = .05). CONCLUSIONS: Subjective analysis of postoperative corneal topography alone is not sufficient to predict potential patient complaints after PRK. Topographic findings should be interpreted only in the context of a complete clinical examination.

Comparative external versus endoscopic dacryocystorhinostomy: results in 115 patients (130 eyes).

BACKGROUND: Epiphora is an annoying symptom, embarrassing the patient both socially and functionally. The two widely accepted treatment modalities of epiphora resulting from obstruction of the nasolacrimal ductus are external and endoscopic dacryocystorhinostomy (DCR). OBJECTIVE: The aim was to compare the results, operative time, and complications of external and videoendoscopic endonasal DCR performed between December 1994 and December 1998. METHODS: In group 1, conventional primary external DCR with or without silicone tube intubation was performed in 79 patients (66 women and 13 men) with unilateral dacryocystitis. In group 2, endoscopic primary endonasal DCR with hammer-chisel removal of bone located over the lacrimal sac was performed in 51 eyes of 36 patients, 33 women and 3 men (15 bilateral procedures). RESULTS: The follow-up period was 6 to 48 months (mean 25 months) after surgery. The age range was from 4 to 76 years (mean 38.5 years). The success rates of external and endoscopic hammer-chisel DCR were found to be 89.8% and 88.2%, respectively. A lower complication rate was observed in the endoscopic group, with minimal morbidity and shorter operative time compared with the external approach. CONCLUSIONS: Hammer-chisel endoscopic DCR is practical, less traumatic, less time-consuming, and cosmetically more convenient than the external approach. The success rate of the endoscopic DCR procedure is comparable with that of traditional external DCR, and it also allows simultaneous correction of any intranasal pathology.

Interpupillary index: a new parameter for hypo-hypertelorism.

AIM: To establish a new clinical index to evaluate the presence of hypo-hypertelorism with greater accuracy. MATERIAL AND METHODS: After screening a wide range of population, 310 elementary school children (185 boys, 125 girls) aged 7-15 years were included in this study. For this cross-sectional study, a millimetre ruler was used. The anatomical interpupillary distance was measured by a modified Viktorin's method. In addition, inner and outer intercanthal distances were obtained. The data were analyzed by Student's t-test for two independent samples using SPSS for Windows. There were children with clinical hypertelorism (n = 92, group 1), children with large fronto-occipital circumference (FOC) (n = 101, group 2), and age- and sex-matched normal controls (n = 117, group 3). Due to variations in FOC among healthy subjects, we introduced a new practical concept for evaluation of interpupillary distance, namely the interpupillary index, the simple product obtained by dividing the interpupillary distance by the FOC, multiplied by 100. RESULTS: The overall idiopathic benign macrocephalic children (group 2) had significantly (p < 0.001) larger interpupillary distances (6.13 +/- 0.36 cm) and FOCs (56.99 +/- 1.46 cm) than those of normal controls (5.70 +/- 0.26cm and 52.82 +/- 1.22 cm, respectively). But, the difference between the combined product of interpupillary distance and FOC, the interpupillary index, was not significant (10.76 +/- 0.50 and 10.79 +/- 0.35, respectively) (p > 0.05). On the other hand, the children with hypertelorism had significantly (p < 0.001) larger interpupillary distances (6.47 +/- 0.29cm) and FOCs (54.90 +/- 2.18cm) when compared with the controls. In addition, the interpupillary index was significantly (p < 0.001) higher (11.80 +/- 0.45) than both macrocephalic children (10.76 +/- 0.50) and controls (10.79 +/- 0.35). Intercanthal distances and intercanthal index of hyperteloric children were also significantly (p<0.001) larger than both macrocephalic children and controls. CONCLUSION: This new index offers a new concept for more accurate evaluation of the presence of ocular hypo-hypertelorism.

The levels of plasma interleukin-2 and soluble interleukin-2R in Behçet's disease: a marker of disease activity.

It is well known that patients with Behçet's disease (BD) have an activated immune system, probably mediated by soluble factors in the circulation. The purpose of our study was to examine the roles of plasma interleukin-2 (IL-2) and soluble interleukin-2 receptor (sIL-2R) in the pathogenesis of BD. Thirty-two patients with BD diagnosed according to the Criteria of the International Study Group for Behçet's Disease and 20 age-matched healthy persons were included in the study. The plasma levels of cytokines were measured by ELISA. Plasma levels of IL-2 and sIL-2R were increased in BD over controls, but the differences were not statistically significant. sIL-2R levels in patients with active disease were significantly higher than in either patients with inactive disease (p < 0.001) or the control group (p < 0.05). Our results suggest that the level of sIL-2R in BD seems to be related to disease activity.

Effects of transforming growth factor-beta 2, interleukin 6 and fibronectin on corneal epithelial wound healing.

PURPOSE: The aim of this study was to compare the effects of topically applied transforming growth factor-beta 2 (TGF-beta 2) and interleukin 6 (IL-6), alone and combined with fibronectin, on the rate of corneal wound healing in rabbits. METHODS: Twenty-eight rabbits were used for the experiment. After the right eye of each rabbit was debrided with n-heptyl alcohol, the animals were divided into four treatment groups (six rabbits per group) and one control group (four rabbits). The debrided eyes were treated, beginning immediately after wounding and continuing every 2 hours from 8 a.m. to 8 p.m. for 48 hours. Group 1 received TGF-beta 2; group 2 IL-6; group 3, TFR-beta 2 and purified fibronectin; group 4, IL-6 and fibronectin; control group, balanced salt solution. At set intervals each eye was stained with fluorescein and photographed; epithelial defects were measured with a computer-assisted digitizer. The healing rate was calculated by linear regression analysis. RESULTS: The mean healing rates in groups 1, 2, 3, 4, and controls were respectively 1.65 +/- 0.16, 1.68 +/- 0.11, 1.99 +/- 0.12, 2.23 +/- 0.09, and 0.93 +/- 0.18 mm2/h. Mean epithelial healing rates for all drug-treatment groups were significantly faster than controls. The healing rates of groups 3 and 4 were significantly faster than groups 1 and 2. CONCLUSIONS: We conclude that cytokines, in combination with extracellular matrix proteins, facilitate corneal epithelial wound healing in vivo, possibly by making corneal epithelial cells more sensitive to fibronectin receptors.

Increased corneal thickness in active Behçet's disease.

PURPOSE: To measure central corneal thickness (CCT) in patients with Behçet's disease (BD), particularly in the active disease. MATERIALS AND METHODS: We measured CCT by ultrasound pachymetry in 64 patients with Behçet's disease and in 20 healthy controls. Forty-one of the patients with BD had ocular involvement and 23 none; 19 of the 41 with ocular involvement were in an active period and 22 had inactive disease. RESULTS: The mean CCT in the group with active ocular involvement was significantly higher (589+/-27 microm) than in the control group (553+/-21 microm) (p = 0.003), the group with inactive ocular involvement (560+/-26 microm) (p < 0.001), and the group with no ocular involvement (558+/-25 microm) (p < 0.001). After appropriate treatment of patients with active ocular involvement, the mean CCT returned nearly to normal (563+/-20 microm) and the difference from controls was not significant. There was no significant difference for the mean CCT between controls and the patients with no ocular involvement or with inactive ocular involvement. CONCLUSIONS: Behçet's patients with active ocular involvement have a thicker CCT than patients with inactive ocular involvement. There was no difference in CCT between controls and patients with no ocular involvement. The CCT of patients with active ocular involvement returned to nearly normal after treatment. CCT must be taken into account when developing a managing and following approach for Behcet's patients with active ocular involvement.

Decreased nitric oxide production in primary open-angle glaucoma.

PURPOSE: Raised intraocular pressure (IOP) is the major risk factor responsible for optic nerve damage in primary open-angle glaucoma (POAG). The trabecularmeshwork acts as a valve in aqueous outflow and relaxes with nitric oxide (NO) agonists. Since NO is synthesized by endothelium and smooth muscle elsewhere in the body, this study investigated the NO levels in the aqueous humor of patients with POAG compared with cataract patients. MATERIALS AND METHODS: Aqueous humor samples were taken by paracentesis from 16 consecutive patients with POAG (9 male and 7 female; mean age 69.0+/-3.4 yrs) and 14 age and sex-matched controls with cataract (8 male and 6 female; mean age 66.7+/-4.1 yrs) during elective surgery. As an indicator for NO, aqueous total nitrite levels (end - product of NO) were measured by Greiss reaction. The Mann-Whitney U test was used for statistical analysis and P <0.05 was considered significant. RESULTS: The mean age and sex in two groups were comparable. The mean aqueous humor NO levels were significantly (P = 0.001) lower in patients with glaucoma (72.72+/-11.21 micromol/L) than in patients with cataract and no glaucoma (86.92+/-11.23 micromol/L). CONCLUSIONS: Decreased NO production in patients with POAG indicates that NO-producing cells may be lost as the disease progresses. The control of NO levels in the eye might be a therapeutic target in glaucoma.

Effect of nitric oxide synthase inhibition in experimental Pseudomonas keratitis in rabbits.

PURPOSE: The aim of this study was to assess the efficacy of the nitric oxide synthase inhibitor L-NG-nitro-arginine-methyleser (L-NAME) in the treatment of experimental Pseudomonas keratitis. METHODS: Twelve young New Zealand white rabbits were given intrastromal injections of Pseudomonas aeruginosa strains. Twenty-four hours later, the rabbits were randomly divided into four groups: group 1 was treated with topical 0.3% ciprofloxacin drops and a single subconjunctival injection of L-NAME (150 mg/kg); group 2 received topical 0.3% ciprofloxacin drops alone; group 3 received a single subconjunctival injection of L-NAME alone; group 4, the control group, was treated with topical balanced salt solution (BSS) drops. One drop of either ciprofloxacin of BSS was applied at each treatment interval. Twenty-six hours after the start of treatment, the eyes were examined by slit lamp to assess inflammation. Aqueous humor specimens were collected from each eye to measure the nitric oxide concentration. Corneas were removed to count bacteria results. RESULTS: Slit lamp examination cell scores were significantly lower for groups 1 and 3 than groups 2 and 4 eyes (p = 0.002 to p = 0.004). No viable bacteria were detected in the corneas of groups 1 and 2. Group 3 corneas had significantly fewer bacteria (6.33 +/- 0.42 x 10(3)) than group 4 (5.94 +/- 0.16 x 10(4)) (p < 0.05). Nitric oxide levels in the aqueous humor were significantly lower for group 1 eyes than for groups 2, 3, or 4 (p = 0.02, p = 0.01, and p = 0.003, respectively). CONCLUSIONS: We conclude that nitric oxide synthase inhibitors may be a useful adjunct but are not a replacement for traditional antibiotic drop therapy.

Bilateral myopia following blunt trauma to one eye.

PURPOSE: To evaluate bilateral myopia following blunt trauma to one eye. CASE REPORT: Traumatic myopia is a rare transient situation which may be seen in the injured eye or both eyes after blunt ocular trauma. We examined one case with transient myopia in the left eye which had been exposed to a blunt ocular injury. Myopia was also observed in the right eye 12 hours after the trauma. The right eye and left eye had reverted to emmetropia respectively two and six weeks after trauma. DISCUSSION: The myopia may have been due to ciliary spasm arising from stimulation of the efferent autonomic system in the right eye and ciliary body edema in the left eye. CONCLUSIONS: To our knowledge, this is the first reported case developing bilateral transient myopia after the blunt trauma to only one eye.

Effects of L-NAME and timolol on aqueous IL-1beta, IL-6, IL-8, TNF-alpha and NO levels after Nd:YAG laser iridotomy in rabbits.

PURPOSE: Pro-inflammatory cytokines are produced by tissues and play a vital role in the host inflammatory response and uveitis. Nitric oxide (NO) can be produced in large amounts as a response to experimentally-induced uveitis or cytokines. In this study, we measured the levels of pro-inflammatory cytokines such as interleukin (IL)-1beta, IL-6, IL-8, tumor necrosis factor (TNF)-alpha and free-radical in aqueous humor after Nd:YAG laser iridotomy in rabbits, and investigated whether timolol maleate an anti-glaucoma drug, or a NO synthase inhibitor, NG-nitro-L-arginine methyl esther (L-NAME) had an inhibitory effect on these molecules, since L-NAME is a known anti-inflammatory agent in rabbits. METHODS: Bilateral experimental Nd:YAG laser iridotomy (power 7.5 mJ, mode single burst, aiming beam 4) was performed on 18 rabbits under general plus topical anesthesia. Aqueous humor samples were taken by clear corneal paracentesis preoperatively, and 1 and 24 h postoperatively. Six rabbits (12 eyes) were given bilateral topical timolol maleate 0.5% (Timoptic) drop b.i.d. (group 1), six rabbits (12 eyes) received bilateral 0.1 ml subconjuntival injections of L-NAME (150 mg/kg) (group 2), and six rabbits (12 eyes) were treated with topical balanced salt solution (BSS) b.i.d. (control). RESULTS. Preoperative cytokine and NO levels were comparable in the three groups, with no significant differences. In addition, there was no significant difference in baseline cytokine levels between the right and left eyes. In all groups, pre- and postoperative mean IL-1beta levels were below the detection limit of the assay (<5.0 pg/ml). In the control group, postoperative mean IL-6, IL-8 and NO levels were significantly higher after Nd:YAG laser iridotomy than before (for each, p < 0.01). Timolol and L-NAME both inhibited the rise in IL-8 and TNF-alpha levels. Timolol also inhibited the rise in IL-6 but not NO. L-NAME had an inhibitory effect against NO, but not IL-6. CONCLUSIONS: L-NAME has an inhibitory effect on IL-8, TNF-alpha and NO, but not on IL-6. Timolol had inhibitory effects on IL-6, IL-8 and TNF-alpha, but not on NO. These preliminary experimental results might help in assssing the effect of Nd:YAG laser iridotomy in aqueous humor, and to understand the inhibitory effects of timolol and L-NAME against these molecules.

Comparison of the effects of argon and neodymium:YAG laser iridotomy on cytokines in the rabbit aqueous humor.

PURPOSE: We compared the effects in rabbits of iridotomy using the argon or Nd:YAG laser on cytokines such as interleukin 1-beta (IL-1beta), interleukin 6 (IL-6), interleukin 8 (IL-8), and tumor necrosis factor-alpha (TNF-alpha). METHODS: Twenty pigmented rabbits (20 eyes) underwent argon and Nd:YAG iridotomy under general and topical anesthesia. Group 1 (10 right eyes) was treated with the argon laser and group 2 (10 right eyes) with the Nd:YAG laser, using an equal number of shots and the same laser parameters for each group. Left eyes in both groups were evaluated as controls. Aqueous humor specimens were collected from each eye preoperatively and 1 and 3 days postoperatively. RESULTS: Aqueous IL-6 and TNF-alpha levels rose more on day 1 in the Nd:YAG group than the argon group. IL-6 and TNF-alpha levels were significantly higher on days 1 and 3 than the pre-operative and control levels (p<0.05). TNF-alpha levels on day 1 were significantly lower in the Nd:YAG than the argon group. There were no significant differences between the two laser groups for IL-6 on days 1 and 3. IL-1beta and IL-8 did not change CONCLUSIONS: Our findings suggest that cytokines, particularly IL-6 and TNF-alpha, may be inflammatory mediators in the early inflammation following argon and Nd:YAG laser iridotomies. These results also indicate that cytokines contribute to the acute effects of Nd:YAG and argon laser applications on inflammation.