Moxifloxacin modifies corneal fibroblast-to-myofibroblast differentiation

Background and Purpose

Fibroblast-to-myofibroblast differentiation is associated with scarring, an important issue in corneal surgery. Moxifloxacin (MOX), commonly applied to prevent post-operative infection, would benefit more if it modifies fibroblast-to-myofibroblast differentiation other than antimicrobial activity. Our purpose was to explore whether MOX has anti-fibrotic effect in human corneal fibroblasts (HCFs).

Experimental Approach

HCFs were incubated in MOX-containing medium concurrently with TGF-β1 (co-treatment), before (pretreatment) or after (post-treatment) adding TGF-β1. HCF contractility was evaluated with a type I collagen gel contraction assay. Expression of α-smooth muscle actin (α-SMA), Smad2, phospho-Smad2-Ser467, Smad4 and Smad7 was determined by immunoblotting. Formation of α-SMA-positive filaments and distribution of active Smad2 were observed under confocal microscopy. Expression of TGF-β receptor types I (TGFBR1) and II (TGFBR2) was assessed with flow cytometry.

Key Results

MOX did not affect gel contractility or α-SMA filament formation in HCFs without TGF-β1 stimulation. MOX did, however, retard HCF-containing gel contractility and α-SMA filament formation following TGF-β1 stimulation in the pretreatment and co-treatment groups but not in the post-treatment group. MOX blocked the expression of Smad2, phospho-Smad2-Ser467 and TGFBR1 under TGF-β1 incubation. Additionally, MOX enhanced Smad7 expression in TGF-β1-incubated HCFs, but did not interfere with TGF-β-triggered Smad2 nuclear translocation or Smad4 expression.

Conclusions and Implications

MOX inhibited TGF-β-induced fibroblast-to-myofibroblast differentiation via blocking TGFBR1 and enhancing Smad7 expression. MOX should be used before or during surgery to achieve these effects. These results suggest a de novo mechanism by which MOX participates in corneal wound healing.     

Overall quality of life and difficulty paying for ostomy supplies in the Veterans Affairs ostomy health-related quality of life study: an exploratory analysis

PURPOSE: To explore whether there was a significant relationship between difficulty paying for ostomy supplies and overall quality of life among a sample of ostomates receiving care from the Veterans Health Administration (VHA). METHODS: The data were collected as part of the Veterans Affairs (VA) Ostomy Health-Related Quality of Life Study, in which 511 respondents (239 cases, 272 controls) completed a survey instrument that included the modified City of Hope Quality of Life (mCOH-QOL) Ostomy questionnaire, SF-36V, and sociodemographic items. Responses from the 239 cases (ie, patients with intestinal stomas) were used in this analysis. The modified City of Hope Quality of Life Ostomy questionnaire item, "How good is your overall quality of life?," was the dependent variable for this analysis. The primary independent variable was the response (yes/no) to the item, "If you pay for any of the (ostomy) costs, is it difficult for you?" A hierarchical regression model was used to examine whether difficulty paying was significantly related to overall quality of life after adjusting for age, income, race/ethnicity, and physical health. RESULTS: After accounting for the proportion of variance explained by age, income, race/ethnicity, and physical health, the additional proportion of variance explained by difficulty paying was statistically significant. Individuals reporting difficulty paying had a roughly 1 point lower (ie, beta-coefficient = -1.052; SE = 0.481) overall quality of life score on the 11-point scale. CONCLUSIONS: We found a significant association between difficulty paying for ostomy supplies and overall quality of life. Although the cross-sectional study design does not allow causal inference, the results suggest a relationship that merits further examination.     

Outcomes and costs of abciximab versus eptifibatide for percutaneous coronary intervention

BACKGROUND: Patients undergoing percutaneous coronary intervention (PCI) with stent placement are often prescribed glycoprotein IIb/IIIa inhibitors. However, drug selection is often based on clinicians' preference and cost because few studies have directly compared abciximab and eptifibatide. OBJECTIVE: To compare clinical outcomes and total hospital costs of abciximab and eptifibatide in patients undergoing stent placement during PCI in a real-world setting. METHODS: A retrospective cohort analysis was conducted of 960 patients administered abciximab or eptifibatide for intracoronary stent placement between 1999 and 2001 at a tertiary care hospital. The primary outcome was bleeding, defined as major, moderate, or minor according to published criteria. Secondary outcomes included in-hospital death, myocardial infarction, revascularization, and the triple composite endpoint of those outcomes, thrombocytopenia, length-of-stay, and total hospital costs. Pearson's chi(2) analysis, Fisher's exact test, and ANOVA were used for statistical analysis. RESULTS: The frequency of bleeding complications based on severity was similar between abciximab and eptifibatide: major (2.4% vs 2.8%), moderate (12.4% vs 10.5%), and minor (4.0% vs 3.9%), respectively (p = 0.86). Secondary clinical outcomes were also similar between groups (p > 0.05). Total costs for hospitalization were significantly greater for abciximab compared with eptifibatide ($16,383 +/- 6799 vs $14,115 +/- 6285; p < 0.001). Drug acquisition costs were also significantly greater for abciximab compared with eptifibatide ($508 +/- 159 vs $465 +/- 263; p = 0.003). CONCLUSIONS: In patients undergoing stent placement during PCI, abciximab and eptifibatide are comparable in terms of safety and effectiveness despite significant differences in hospitalization and acquisition costs.     

借助伸腱装置动力结构变化的肌腱移植矫正钮扣状畸形

目的:介绍一种矫正纽扣状畸形方法,认识该术式特点。方法:选择1995-01/2005-12在北华大学第一临床医学院手外科进行指背腱膜中央束重建的患者20例,男15例,女5例;年龄18~46岁。将伤指的外侧腱沿其纵轴分为两部分,其中背侧半(内侧束)在中节以远切断,掌侧半(外侧束)在近指根部水平切断。移位外侧腱的外侧束通过Cleland's韧带及部分屈肌腱鞘在远侧指间关节伸直条件下缝合固定。采用掌长肌腱之一半腱束游离移植。在中节指骨基底偏背侧用克氏针横行钻一骨孔,使掌长肌腱通过,移植腱在背侧交叉后,将移植腱与中央腱及两侧束编织缝合,使侧束、中央束及移植腱三者融为一体重建近侧指间关节的伸指功能。采用Caroli评定标准评估疗效,分3级:优、良、可。采用外侧腱外侧束的腱固定术来维持远侧指间关节关节的伸直位,在中央腱止点利用移植腱与中央腱、侧束近端缝合重建近侧指间关节的伸指功能。结果:本组共20例,按Caroli评定标准,优15例,良4例,可1例,优良率为95%。结论:该术式的最大特点是将伸腱装置复杂的动力结构变得简单化,易于掌握,是肌腱组织移植矫正创伤后钮扣状畸形的一种有效方法。     

Successful carotid endarterectomy in a patient with an aberrant branch from the common carotid artery

We report a patient who had an 80% asymptomatic stenosis in the distal right common carotid artery with an incidental finding of an aberrant branch arising from the right common carotid artery. He underwent an elective right carotid endarterectomy with an uneventful recovery. This is the first case in the literature of a successful endarterectomy in a patient with a common carotid anomaly and it emphasises the importance of careful dissection for unexpected anatomy.     

Effects of repetitive superficial chemical peels on facial sebum secretion in acne patients

BACKGROUND: Glycolic acid and Jessner's solution are popular superficial chemical peel agents for the treatment of facial acne, and increased sebum secretion is one of the major aetiological factors of acne. OBJECTIVE: To compare the effects of 30% glycolic acid peels and Jessner's solution peels on sebum secretion in facial acne patients. METHODS: Thirty-eight patients with mild to moderate facial acne were included. Twenty-seven patients were treated with 30% glycolic acid peels and 11 patients with Jessner's solution peels. Each peel was performed twice with an interval of 2 weeks. Before and 2 weeks after each peel, sebum levels of forehead, nose, chin and cheeks were measured by using a Sebumeter (SM810 Courage & Khazaka, Cologne, Germany). RESULTS: The sebum levels were not significantly changed by two peels treatments of 30% glycolic acid peels or Jessner's solution peels on the facial skins of patients with facial acne. CONCLUSIONS: The two types of peels, 30% glycolic acid peels and Jessner's solution peels, did not affect sebum secretion of the facial skins of patients with facial acne after the two peels treatments. The accumulative effects of more than two peels treatments using these modalities need further evaluation.     

Development of the Diary for Irritable Bowel Syndrome Symptoms to Assess Treatment Benefit in Clinical Trials: Foundational Qualitative Research

Background

Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder characterized by abdominal pain and alterations in bowel habits. Three subtypes are defined on the basis of stool patterns: diarrhea-predominant IBS, constipation-predominant IBS, and alternating or mixed IBS.

Automated diagnosis of fetal alcohol syndrome using 3D facial image analysis

OBJECTIVES: Use three-dimensional (3D) facial laser scanned images from children with fetal alcohol syndrome (FAS) and controls to develop an automated diagnosis technique that can reliably and accurately identify individuals prenatally exposed to alcohol. METHODS: A detailed dysmorphology evaluation, history of prenatal alcohol exposure, and 3D facial laser scans were obtained from 149 individuals (86 FAS; 63 Control) recruited from two study sites (Cape Town, South Africa and Helsinki, Finland). Computer graphics, machine learning, and pattern recognition techniques were used to automatically identify a set of facial features that best discriminated individuals with FAS from controls in each sample. RESULTS: An automated feature detection and analysis technique was developed and applied to the two study populations. A unique set of facial regions and features were identified for each population that accurately discriminated FAS and control faces without any human intervention. CONCLUSION: Our results demonstrate that computer algorithms can be used to automatically detect facial features that can discriminate FAS and control faces.