[Role of Intraoperative Indirect Channelography in Glaucoma Stent Implantation]. / Bedeutung der intraoperativen indirekten Kanalografie bei der Glaukomstentimplantation.

Several glaucoma stents are available to surgically reduce the intraocular pressure in primary open-angle glaucoma (POAG). In comparison to conjunctival opening procedures, the advantages of microinvasive glaucoma surgery (MIGS) are relatively atraumatic ab-interno procedures through a paracentesis, conjunctival sparing for later filtrating surgery, and possible combined cataract surgery. In this overview, the principle of intraoperative indirect channelography as a decision criterion for the individual selection of glaucoma stent implantation is presented. Through a paracentesis a slight hypotony was induced and retrograde blood filling of Schlemm's canal was observed gonioscopically. Good blood filling was an indicator for an intact drainage system through the collector channels and the episcleral veins. In these patients a trabecular bypass stent system can be placed in Schlemm's canal of the anterior chamber angle to improve drainage of aqueous humour and reduce the intraocular pressure (IOP). In patients with a negative intraoperative indirect channelography, which can be recognized through an absent or insufficient retrograde blood filling of Schlemm's canal, an alternative drainage path should be considered by using supraciliary or subconjunctival glaucoma stents. A significant mean IOP reduction of 17 to 36% can be achieved with a reduction of local glaucoma therapy. Relevant complications with choroidal detachment and decreased visual acuity due to postoperative hypotony are rare.

Functional significance of thermosensitive transient receptor potential melastatin channel 8 (TRPM8) expression in immortalized human corneal endothelial cells.

Human corneal endothelial cells (HCEC) maintain appropriate tissue hydration and transparency by eliciting net ion transport coupled to fluid egress from the stroma into the anterior chamber. Such activity offsets tissue swelling caused by stromal imbibition of fluid. As corneal endothelial (HCE) transport function is modulated by temperature changes, we probed for thermosensitive transient receptor potential melastatin 8 (TRPM8) functional activity in immortalized human corneal endothelial cells (HCEC-12) and freshly isolated human corneal endothelial cells (HCEC) as a control. This channel is either activated upon lowering to 28 °C or by menthol, eucalyptol and icilin. RT-PCR and quantitative real-time PCR (qPCR) verified TRPM8 gene expression. Ca(2+) transients induced by either menthol (500 µmol/l), eucalyptol (3 mmol/l), or icilin (2-60 µmol/l) were identified using cell fluorescence imaging. The TRP channel blocker lanthanum III chloride (La(3+), 100 µmol/l) as well as the TRPM8 blockers BCTC (10 µmol/l) and capsazepine (CPZ, 10 µmol/l) suppressed icilin-induced Ca(2+) increases. In and outward currents induced by application of menthol (500 µmol/l) or icilin (50 µmol/l) were detected using the planar patch-clamp technique. A thermal transition from room temperature to ≈ 18 °C led to Ca(2+) increases that were inhibited by a TRPM8 blocker BCTC (10 µmol/l). Other thermosensitive TRP pathways whose heterogeneous Ca(2+) response patterns are suggestive of other Ca(2+) handling pathways were also detected upon strong cooling (≈10 °C). Taken together, functional TRPM8 expression in HCEC-12 and freshly dissociated HCEC suggests that HCE function can adapt to thermal variations through activation of this channel subtype.

Structural Problems Demand Structural Solutions: Addressing Domestic and Family Violence.

Despite the global recognition of domestic and family violence (DFV) as an outcome of unequal power relations between men and women, dominant frameworks for addressing DFV do not target the structural nature of the problem. Drawing on research conducted in partnership with the Federation of Community Legal Centres in Australia, we argue that a distinction needs to be made between what is genuinely structural change and what is system reform. Using intersectional feminist and decolonial theory and praxis, we reflect on what a structural approach to DFV could look like: one that confronts and actively tries to change the structural conditions that give rise to women's individual and collective vulnerability and victimization.