Combined simultaneous photorefractive keratectomy and collagen cross-linking in keratoconus suspect patients.

PURPOSE: To evaluate the safety and efficacy of combined simultaneous photorefractive keratectomy (PRK) with collagen cross-linking (CXL) in keratoconus suspects (KCS). METHODS: This was a retrospective, non-randomized study of KCS patients who underwent combined simultaneous PRK with CXL. The efficacy, safety, refractive outcomes, and corneal wavefront aberration changes were assessed after the surgery and compared with existing preoperative data. RESULTS: Fifty-six eyes of 28 patients, including 20 females (71.4%), with a mean age of 30.92±4.09 years, were enrolled. The mean follow-up was 19.46±8.48 months (range: 7-35). At the conclusion of the study, mean uncorrected distance visual acuity LogMAR improved from 0.89±0.44 preoperatively to 0.04±0.09 postoperatively (P<0.001). In addition, a statistically significant corneal flattening was observed postoperatively, with a decrease in manifest refraction. A statistically significant increase was found in higher-order aberrations (P<0.001), horizontal coma (P<0.001), and spherical aberration (P<0.001) compared with preoperatively. Postoperatively, 41% exhibited refractive astigmatism of 0.50 diopter (D) or less; 83.8% showed 1.00 D or less. CONCLUSION: The results of our study indicate that combined simultaneous PRK with CXL can be a safe and effective method for treating refractive instability in KCS patients.

Corneal biomechanical properties after soft contact lens wear measured on a dynamic Scheimpflug analyzer: A before and after study.

OBJECTIVES: To evaluate the corneal biomechanics before and after daily use of contact lenses (CLs), measured by Scheimpflug-based devices. METHODS: This prospective clinical study includes participants who were scheduled to use CLs daily for refractive error. The biomechanical parameters were measured by the Corneal Visualization Scheimpflug Technology (Corvis ST) before and one month after using the soft CLs. RESULTS: Twenty-three subjects (46 eyes), including 16 female (76.2%) with a mean age of 28±7.29 years, were enrolled. There was no significant difference among biomechanical factors measured before and after contact lens wear (P>0.05). Using regression analysis of the biomechanical markers, we found a statistically significant association between second applanation length (A2 length) (P=0.001), highest concavity radius (HCR) (P=0.05), deflection amplitude ratio (DA_ratio) (P=0.05) and integrated radius (P<0.001) with age. Regarding spherical equivalent, we found a statistically significant association between central corneal thickness (CCT) (P=0.05), A2 length (P=0.03) and stiffness parameter at first applanation (SPA1) (P=0.02). CONCLUSIONS: We did not find a significant difference in terms of corneal biomechanical parameters between baseline and month 1; but regression analyses showed a statistically significant association between A2 length, HCR, DA_ratio, integrated radius, CCT and SPA1 and certain subject characteristics.

Electrical conductivity of tissue at frequencies below 1 MHz.

A two-pronged approach, review and measurement, has been adopted to characterize the conductivity of tissues at frequencies below 1 MHz. The review covers data published in the last decade and earlier data not included in recent reviews. The measurements were carried out on pig tissue, in vivo, and pig body fluids in vitro. Conductivity data have been obtained for skeletal and myocardial muscle, liver, skull, fat, lung and body fluids (blood, bile, CSF and urine). A critical analysis of the data highlights their usefulness and limitations and enables suggestions to be made for measuring the electrical properties of tissues.

Variation of the dielectric properties of tissues with age: the effect on the values of SAR in children when exposed to walkie-talkie devices.

In vitro dielectric properties of ageing porcine tissues were measured in the frequency range of 50 MHz-20 GHz, and the total combined uncertainties of the measurements were assessed. The results show statistically significant reduction with age in both permittivity and conductivity of 10 out of 15 measured tissues. At microwave frequencies, the observed variations are mainly due to the reduction in the water content of tissues as an animal ages. The results obtained were then used to calculate the SAR values in children of age 3 and 7 years when they are exposed to RF induced by walkie-talkie devices. No significant differences between the SAR values for the children of either age or for adults were observed.

Dielectric properties of porcine cerebrospinal tissues at microwave frequencies: in vivo, in vitro and systematic variation with age.

The dielectric properties of pig cerebrospinal tissues were measured in vivo and in vitro, in the frequency range of 50 MHz-20 GHz. The total combined measurement uncertainty was calculated at each frequency point and is reported over representative frequency regions. Comparisons were made for each tissue between the two sets of data and with the literature of the past decade. The in vitro study was extended to include tissue from pigs weighing approximately 10, 50 and 250 kg to re-visit the question of the variation of dielectric properties with age. White matter and spinal chord showed significant variation as function of animal age, no age-related variations were recorded for grey matter.

Dielectric measurement: error analysis and assessment of uncertainty.

The advantages and limitations of using partial differential analysis to assess the methodological uncertainty associated with the measurement of the dielectric properties of a material are discussed and an alternative pragmatic approach is proposed. It relies on repeat measurements of the dielectric properties of reference liquids and an analysis to estimate random and systematic uncertainties. Examples of measurement uncertainty are provided for well-defined monomolecular materials and for less homogeneous materials at microwave frequencies. All examples relate to measurement with an open-ended coaxial probe but the methodology is not specific to this technique. Examination of the components of uncertainty in the dielectric properties of biological tissue shows that, where the system is free of methodological bias, random fluctuations originating from sampling and natural inhomogeneity dominate the uncertainty budget. In such cases, the mean value of the measured parameter and the standard error of the mean can be taken as a good measure of the true value and its associated uncertainty.

A regression model for correcting intraocular lens power after refractive surgery independent of preoperative data.

PURPOSE: To find a method of calculating intraocular lens (IOL) power that may be independent of preoperative data in eyes that have previously undergone myopic laser in situ keratomileusis (LASIK). METHODS: In 148 eyes of 75 patients, before and 6 months after LASIK, IOL power was calculated with SRK/T formula utilizing the spherical equivalent as the desired target refraction. Assuming that LASIK does not alter the crystalline lens refractive properties, IOL calculation error (CER) was estimated with this formula: CER = [pre-LASIK IOL power]/[post-LASIK IOL power]. Then the authors used postoperative biometry and Orbscan II corneal topography data in multiple regression models to find the best variables to predict the CER. Predicted amount of error which is calculated independent of preoperative data could be used to correct the post-LASIK calculated IOL: [corrected post-LASIK IOL power] = CER x [post-LASIK IOL power]. RESULTS: A regression model with these predictors was found: axial length in millimeters (L), radius of the anterior corneal surface best fitted sphere in millimeters divided by radius of the posterior corneal surface best fitted sphere in millimeters (AntBFS/PostBFS), corneal central 5 millimeters mean power in diopters divided by corneal central 3 millimeters mean power in diopters (mean 5 mm/mean 3 mm), the post-LASIK IOL power, and the post-LASIK simulated K reading. The model R square was 0.88. CONCLUSIONS: There is correlation between post-LASIK biometry values and IOL power correction factor. This study presents a new model for further investigation.

Infants and young children modeling method for numerical dosimetry studies: application to plane wave exposure.

Numerical dosimetry studies require the development of accurate numerical 3D models of the human body. This paper proposes a novel method for building 3D heterogeneous young children models combining results obtained from a semi-automatic multi-organ segmentation algorithm and an anatomy deformation method. The data consist of 3D magnetic resonance images, which are first segmented to obtain a set of initial tissues. A deformation procedure guided by the segmentation results is then developed in order to obtain five young children models ranging from the age of 5 to 37 months. By constraining the deformation of an older child model toward a younger one using segmentation results, we assure the anatomical realism of the models. Using the proposed framework, five models, containing thirteen tissues, are built. Three of these models are used in a prospective dosimetry study to analyze young child exposure to radiofrequency electromagnetic fields. The results lean to show the existence of a relationship between age and whole body exposure. The results also highlight the necessity to specifically study and develop measurements of child tissues dielectric properties.

Effect of selective or combined inhibition of integrins alpha(IIb)beta(3) and alpha(v)beta(3) on thrombosis and neointima after oversized porcine coronary angioplasty.

BACKGROUND: Thrombosis and neointima formation limit the efficacy of coronary angioplasty (PTCA). Clinical trials have implicated the adhesion molecules integrin alpha(IIb)beta(3) and integrin alpha(v)beta(3) in these processes. The roles of these molecules in vascular smooth muscle cell adhesion, platelet aggregation, and the thrombotic and neointimal response to oversize porcine PTCA was investigated by use of a selective alpha(IIb)beta(3) antagonist (lamifiban), a selective alpha(v)beta(3) antagonist (VO514), and a combined alpha(IIb)beta(3)/alpha(v)beta(3) antagonist (G3580). METHODS AND RESULTS: In vitro, both alpha(v)beta(3) inhibitors caused dose-dependent inhibition of porcine vascular smooth muscle cell adhesion to vitronectin but not to collagen type IV, fibronectin, or laminin, whereas selective alpha(IIb)beta(3) inhibition had no effect. Intravenous infusions of either alpha(IIb)beta(3) inhibitor in swine profoundly inhibited ex vivo platelet aggregation to ADP, whereas selective alpha(v)beta(3) inhibition had no effect. In a porcine PTCA model, intravenous infusions of the integrin antagonists were administered for 14 days after oversized balloon angioplasty injury. After PTCA, there was regional upregulation of integrin alpha(v)beta(3) in the developing neointima, as assessed by immunohistochemistry. Six hours after PTCA, obstruction of lumen by thrombus was reduced significantly by alpha(IIb)beta(3) inhibition compared with either control or alpha(v)beta(3) inhibition (mean control, 18.7%; VO514, 18.5%; lamifiban, 6.4%; G3580, 7.9%). Twenty-eight days after PTCA, there was a significant reduction of neointima with inhibitors of either integrin (mean intima/media ratio: control, 3.08; VO514, 1.33; lamifiban, 0.97; G3580, 1.32). CONCLUSIONS: We conclude that both integrin alpha(IIb)beta(3) and integrin alpha(v)beta(3) participate in neointima development after experimental angioplasty.

An investigation of the effects of TETRA RF fields on intracellular calcium in neurones and cardiac myocytes.

PURPOSE: This study aimed to determine whether Terrestrial Trunked Radio (TETRA) fields can affect intracellular calcium signalling in excitable cells. MATERIALS AND METHODS: Intracellular calcium concentration ([Ca(2 +) ](i)) was measured in cultured rat cerebellar granule cells and cardiac myocytes during exposure to TETRA fields (380.8875 MHz pulse modulated at 17.6 Hz, 25% duty cycle). [Ca(2 +) ](i) was measured as fura-PE3, fluo-3 or fluo-4 fluorescence by digital image analysis. RESULTS: Granule cells exposed at specific absorption rates (SARs) of 5, 10, 20, 50 or 400 mW x kg(-1) showed no significant changes in resting [Ca(2 +) ](i). Increases in [Ca(2 +) ](i) in response to potassium-induced depolarization were significantly different from sham controls in TETRA-exposed cells, but the majority of the difference was attributable to initial biological variation between cell cultures. No difference was found between fura-PE3 (UV excitation) and fluo-3 (visible light excitation) measurements in these cells. Exposure to TETRA (50 or 400 mW x kg(-1)) had no significant effect on either the rate or amplitude of spontaneous Ca(2 +) transients in cardiac myocytes. The cells showed normal responses to salbutamol (50 microM) and acetylcholine (10 microM). CONCLUSIONS: Overall, these results showed no evidence of any consistent or biologically relevant effect of TETRA fields on [Ca(2 + )](i) in granule cells and cardiac myocytes at any of the SAR tested.

Oligodeoxynucleotide targeted to the alphav gene inhibits alphav integrin synthesis, impairs osteoclast function, and activates intracellular signals to apoptosis.

The alphav integrin subunit is highly expressed in osteoclasts where it dimerizes with beta1 and beta3 subunits to form receptors for vitronectin and bone sialoproteins. Inhibition of osteoclast adhesion and function has previously been achieved by alphavbeta3 antibodies or Arg-Gly-Asp-containing peptides which have the disadvantages of blocking a single receptor type, or of being rather nonspecific, respectively. Here we show that alphav integrin expression in rabbit osteoclasts can be inhibited by partially phosphorothioated antisense oligodeoxynucleotide (ODN) spanning the adenine-uracil-guanine (AUG) translational start site of the human/rabbit alphav gene, a procedure which offers the advantage of affecting all the alphav receptors with high efficiency. The alphav antisense ODN caused a dose-dependent, substrate-specific reduction of osteoclast adhesion and bone resorption. Control ODNs, such as sense, inverted, and mismatch, were without effect, providing evidence of specificity of the antisense reagent. It is likely as a consequence of loss of substrate interaction, the antisense ODN induced osteoclast retraction and apoptosis, increase of the cyclin/cyclin-dependent kinase complex inhibitor p21WAF1/CIP1, and inhibition of the cell survival gene, bcl-2. Although the expression of the cell death-promoting gene, bax, remained unchanged, a reduction of the bcl-2/bax ratio, known to underlie the intracellular signal to apoptosis, was observed. This finding led us to hypothesize that these changes could provide a link between reduction of alphav synthesis and osteoclast programmed death. In conclusion, this study provides novel insights into the use of alphav antisense ODN as an efficacious mechanism for blocking osteoclast function and underscores for the first time the involvement of integrins in bone cell apoptosis. In vivo studies may verify potential application of this ODN as alternative therapy for bone diseases.

An antisense oligonucleotide targeting the alphaV integrin gene inhibits adhesion and induces apoptosis in breast cancer cells.

The aim of this study was to show the anti-adhesive potential of an antisense oligodeoxynucleotide (ODN) approach when designed to suppress the cellular function of the alphaV integrin subunit in breast cancer cells. The alphaV integrins play major roles in favouring breast cancer spreading. In this study, we inhibited alphaV subunit synthesis in the human breast carcinoma cell line, MDA-MB231, by a partially phosphorothioated antisense oligodeoxynucleotide (5543-ODN). The alphaV antisense 5543-ODN reduced alphaV, but not actin, mRNA transcription and protein expression by 55% and 65% respectively (1 microM, 72 h). Control sense and mismatch reagents were inactive. The antisense, but not the sense and mismatch, 5543-ODN induced dose- and time-dependent inhibition of MDA-MB231 adhesion to serum, vitronectin, fibrinogen and fibronectin substrates but was inactive on adhesion to laminin. Thus, the alphaV integrin was located in adhesion structures, which were disrupted by treatment with the alphaV antisense 5543-ODN. Antisense treated cells also showed evidence of programmed cell death with the appearance of apoptotic bodies. MDA-MB231 cells express a mutant form of the pro-apoptotic factor p53; however, no changes in the expression of p53 were observed by Western blotting. Immunofluorescence did reveal an increased nuclear translocation of p53 suggesting activation of the protein, but such a translocation did not lead to significant changes in either the expression of the cyclin dependent kinase inhibitor, p21(WAF1/CIP1) the cell survival factor Bcl-2 or the pro-apoptotic factor Bax.

Nuclease stability as dominant factor in the antiviral activity of oligonucleotides directed against HSV-1 IE110.

The anti-herpes simplex virus type 1 (anti-HSV-1) efficacy of a series of oligonucleotides was determined as a function of their chemical structure. All oligonucleotides consisted of the same sequence directed against the translation initiation codon of the HSV-1 immediate early gene. The oligonucleotides were modified with phosphorothioate linkage patterns according to various protection strategies against nucleolytic degradation. We show that nuclease resistance is the dominant factor that determines the antiviral efficacy in this series. A minimal protection strategy, consisting of end-capping and pyrimidine protection, has proven to be particularly useful, because it not only yields nuclease-resistant oligonucleotides but also minimizes non-sequence-specific effects.

Changes in the dielectric properties of rat tissue as a function of age at microwave frequencies.

The dielectric properties of ten rat tissues at six different ages were measured at 37 degrees C in the frequency range of 130 MHz to 10 GHz using an open-ended coaxial probe and a computer controlled network analyser. The results show a general decrease of the dielectric properties with age. The trend is more apparent for brain, skull and skin tissues and less noticeable for abdominal tissues. The variation in the dielectric properties with age is due to the changes in the water content and the organic composition of tissues. The percentage decrease in the dielectric properties of certain tissues in the 30 to 70 day old rats at cellular phone frequencies have been tabulated. These data provide an important input in the provision of rigorous dosimetry in lifetime-exposure animal experiments. The results provide some insight into possible differences in the assessment of exposure for children and adults.

Dielectric properties of rat embryo and foetus as a function of gestation.

The dielectric properties of rat embryos/foetuses have been acquired at several stages of gestation at 37 °C and in the frequency range of 40 MHz-20 GHz. Measurements were carried out on homogenized tissues, as trial experiments did not show any systematic difference between the dielectric data of intact and homogenized tissues at microwave frequencies. The results showed that dielectric properties of the foetus are generally higher than adult muscle and brain. The measured data also showed some decline for both permittivity and conductivity as the foetus grew from 18 to 20 days old; however, these changes were not statistically significant. Data were also collected for placenta and amniotic fluid which were in good agreement with those recently obtained from human tissues. Finally, tabulated numerical dielectric data for rat foetal tissues are presented for a wide range of medical and telecommunication frequencies.

Dielectric properties of porcine glands, gonads and body fluids.

Dielectric properties of porcine glandular tissues and gonads (in vivo) and body fluids (in vitro) have been obtained in the frequency range of 50 MHz to 20 GHz. The experimental data were fitted to a two term Cole-Cole expression. The data presented complement the available dielectric properties of tissues in the literature and can be used in numerical simulations of the exposure of people to electromagnetic fields.

Comparative Study of Two Silicone Hydrogel Contact Lenses used as Bandage Contact Lenses after Photorefractive Keratectomy.

BACKGROUND: Silicon hydrogel bandage contact lenses are used to enhance epithelial healing, control surface-generated pain, and prevent epithelial erosions after refractive surgery. Considering the importance of faster reepithelialization in preventing complications of photorefractive keratectomy (PRK) and the fact that the features and specifications of these commercially-available lenses are different and their performance as a postoperative bandage lenses would be different also, the aim of this study was comparison the efficacy of senofilcon A and lotrafilcon A after PRK. METHODS: In this prospective study, 44 patients with PRK in both eyes randomly received a silicon hydrogel contact lens of senofilcon A in one eye and lotrafilcon A in other eye. Then the epithelial defect size, visual acuity and subjective level of pain and discomfort were measured for both eyes and compared on day 1, 3 and 5 postoperatively. RESULTS: There was no statistical difference in rate of reepithelialization between senofilcon A and lotrafilcon A (P > 0.05). The mean pain and discomfort index was significantly lower in eyes with senofilcon A (P < 0.05). The mean subjective visual scores were similar with both bandage contact lenses (BCLs) (P > 0.05). CONCLUSION: Silicon hydrogel BCLs are safe and effective for corneal reepithelialization and have great therapeutic outcome on visual outcomes after PRK. But, senofilcon A had better effect on postoperative pain and discomfort which made it superior than lotrafilcon A. However for more conclusive results, it is recommended to study larger sample size with evaluation the possible factors responsible for the obtained findings regarding postoperative pain and discomfort.

Dielectric properties of human placenta, umbilical cord and amniotic fluid.

The dielectric properties of freshly delivered human placenta, umbilical cord and amniotic fluid have been acquired at 37 °C and in the frequency range of 200 MHz-10 GHz. The experimental data were fitted to a Cole-Cole expression. The results show that dielectric properties of the umbilical cord are significantly higher than placenta due to the presence of high water content Wharton's jelly. The results also demonstrate large differences in the dielectric properties of amniotic and cerebrospinal fluids. The data presented can be used in numerical simulations of the exposure of pregnant women to electromagnetic fields.

Exposure to radio frequency electromagnetic fields from wireless computer networks: duty factors of Wi-Fi devices operating in schools.

The growing use of wireless local area networks (WLAN) in schools has prompted a study to investigate exposure to the radio frequency (RF) electromagnetic fields from Wi-Fi devices. International guidelines on limiting the adverse health effects of RF, such as those of ICNIRP, allow for time-averaging of exposure. Thus, as Wi-Fi signals consist of intermittent bursts of RF energy, it is important to consider the duty factors of devices in assessing the extent of exposure and compliance with guidelines. Using radio packet capture methods, the duty factor of Wi-Fi devices has been assessed in a sample of 6 primary and secondary schools during classroom lessons. For the 146 individual laptops investigated, the range of duty factors was from 0.02 to 0.91%, with a mean of 0.08% (SD 0.10%). The duty factors of access points from 7 networks ranged from 1.0% to 11.7% with a mean of 4.79% (SD 3.76%). Data gathered with transmit time measuring devices attached to laptops also showed similar results. Within the present limited sample, the range of duty factors from laptops and access points were found to be broadly similar for primary and secondary schools. Applying these duty factors to previously published results from this project, the maximum time-averaged power density from a laptop would be 220 µW m(-2), at a distance of 0.5 m and the peak localised SAR predicted in the torso region of a 10 year old child model, at 34 cm from the antenna, would be 80 µW kg(-1).

Assessment of exposure to electromagnetic fields from wireless computer networks (wi-fi) in schools; results of laboratory measurements.

Laboratory measurements have been carried out with examples of Wi-Fi devices used in UK schools to evaluate the radiofrequency power densities around them and the total emitted powers. Unlike previous studies, a 20 MHz bandwidth signal analyzer was used, enabling the whole Wi-Fi signal to be captured and monitored. The radiation patterns of the laptops had certain similarities, including a minimum toward the torso of the user and two maxima symmetrically opposed across a vertical plane bisecting the screen and keyboard. The maxima would have resulted from separate antennas mounted behind the top left and right corners of the laptop screens. The patterns for access points were more symmetrical with generally higher power densities at a given distance. The spherically-integrated radiated power (IRP) ranged from 5 to 17 mW for 15 laptops in the 2.45 GHz band and from 1 to 16 mW for eight laptops in the 5 GHz band. For practical reasons and because access points are generally wall-mounted with beams directed into the rooms, their powers were integrated over a hemisphere. These ranged from 3 to 28 mW for 12 access points at 2.4 GHz and from 3 to 29 mW for six access points at 5 GHz. In addition to the spherical measurements of IRP, power densities were measured at distances of 0.5 m and greater from the devices, and consistent with the low radiated powers, these were all much lower than the ICNIRP reference level.