Evaluation of arteriovenous crossing sheathotomy for branch retinal vein occlusion by fluorescein videoangiography and image analysis

PURPOSE: We quantitatively evaluated the effects of arteriovenous (A/V) crossing sheathotomy on retinal circulation in patients with branch retinal vein occlusion (BRVO) accompanied by macular edema. DESIGN: Interventional case series. METHODS: In 18 consecutive patients (18 eyes) with BRVO accompanied by macular edema who underwent A/V crossing sheathotomy between August 1999 and April 2002, changes in retinal circulation after the surgery were evaluated by fluorescein videoangiography with a scanning laser ophthalmoscope and by image analysis using dye dilution technique. At a venule distal to the responsible A/V crossing site and a normal venule, the circulation time (T50) from the beginning of filling to 50% filling of the peak intensity was calculated. The time difference (DeltaT50) between T50 at the point on the affected venule and that at the point on the normal venule, which represents the filling delay at the venule distal to the A/V crossing site, was compared between before and early after the surgery. RESULTS: The preoperative DeltaT50 was 1.36 +/- 1.15 seconds (mean +/- SD), and the postoperative DeltaT50 was 0.72 +/- 0.77 seconds (P =.035, paired t test). In 11 of the 18 eyes, DeltaT50 decreased by 20% or more after the surgery. In the other 7 eyes, DeltaT50 was unchanged or slightly increased after the surgery. CONCLUSIONS: Although a randomized controlled study is needed to confirm the effectiveness of A/V crossing sheathotomy on visual function, this technique could be effective for improving the delay in perfusion in the affected venule.     

Evaluation of radial optic neurotomy for central retinal vein occlusion by indocyanine green videoangiography and image analysis

PURPOSE: To evaluate the effects of radial optic neurotomy (RON) on retinal circulation in patients with central retinal vein occlusion (CRVO) by indocyanine green (ICG) videoangiography and a computer-assisted image analysis. DESIGN: An interventional case series. METHODS: RON was performed in 15 eyes of 15 patients with CRVO. Within 72 hours before the surgery and at 3 months after the surgery, ICG videoangiography was performed with a scanning laser ophthalmoscope, and the images were transferred to a computer. Two measurement points were selected, one on a main retinal artery close to the optic disk and the other on the corresponding retinal vein. At each point, fluorescence intensities were serially measured, and dye dilution curves were obtained. Retinal circulation times (DeltaT(50)) before and after the surgery were calculated. RESULTS: Mean preoperative DeltaT(50) was 6.46 +/- 1.36 seconds, and mean postoperative DeltaT(50) was 6.80 +/- 2.50 seconds. In 8 of 15 eyes, T(50) decreased by 6.8% to 29.6% after the surgery. In the seven eyes that developed chorioretinal anastomosis (CRA) at the site of RON, DeltaT(50) decreased after the surgery. In contrast, DeltaT(50) decreased postoperatively in only one of the eight eyes without CRA. Best-corrected visual acuity improved significantly after the surgery in the group of eyes with improvement in DeltaT(50), but not in the group of eyes without improvement in DeltaT(50). CONCLUSIONS: Some degree of retinal circulation improvement occurred in approximately half of these eyes, which appears to be correlated with the development of CRA.     

Time-Frequency Analysis of Electronystagmogram Signals in Patients with Congenital Nystagmus

Purpose To evaluate the usefulness of the short-time Fourier transform (STFT) in the analysis of temporal congenital nystagmus characteristics.Methods We carried out an observational case series in patients with congenital nystagmus. An electronystagmogram (ENG) recording was performed for 300s in 13 consecutive subjects with congenital nystagmus (age: 7–68 years). Digitized ENG signals (12 bits, 100Hz) were divided into 2-s segments with a Hanning window, and a Fourier transform was carried out for each segment. The power spectrum obtained for each segment was graphically reconstructed as a function of time. The results were compared among the patients.Results Clear periodicity in the time-frequency distribution was observed in 3 of the 13 patients (23%). One of the three patients was diagnosed with periodic alternating nystagmus, but the other two patients showed periodicity without alternation of beat direction. No significant difference was observed in clinical characteristics, except for sex, between patients who showed periodicity and those who did not.Conclusions Some patients with congenital nystagmus showed clear periodicity in the nystagmus waveform without alternation of beat direction. The STFT is a useful tool to evaluate the temporal characteristics of congenital nystagmus in clinics. Jpn J Ophthalmol 2004;48:262–267 © Japanese Ophthalmological Society 2004An erratum to this article can be found at     

Differential gene expressions during immortalization of normal human fibroblasts and endothelial cells transfected with human telomerase reverse transcriptase gene

It is widely accepted that telomerase, which compensates for telomere shortening, is finally activated in almost all kinds of human malignant neoplasms, and ectopic expression of telomerase may endow some kinds of human somatic cells with indefinite proliferation capacity, i.e., immortality. To clarify the intrinsic responses required in acquiring immortality, we investigated the chronological changes in the expression levels of the cell cycle and apoptosis-related genes by real-time RT-PCR in human normal fibroblasts and endothelial cells after hTERT transfection. We found that fibroblast MJ90 required intrinsic responses including reversible upregulation of cell-cycle promoting genes and down-regulation of apoptosis-inducing genes in early phase after transfection, whereas the endothelial cell HUE142-2 did not. In addition, the microarray analysis of the fibroblast strains revealed that the dysregulated genes during cellular immortalization were different from those reported in fibroblasts probably having acquired telomere maintenance mechanism concomitant with hTERT induction. These findings indicate that cell-type specific differential gene expression after telomerase activation may be important to acquire telomere-maintenance capacity and immortality in some non-cancerous human cells. Investigation of these molecules may elucidate the differences in the capacity of acquiring immortality in cancer and normal somatic cells in future.     

A case of serum CEA disappearance curve after resection of breast carcinoma

Carcinoembryonic antigen (CEA) elimination kinetics after tumor resection were measured in a case of breast cancer. A 45-year-old woman with a left breast carcinoma underwent surgery after neoadjuvant chemotherapy. The serum CEA level before surgery was 34.3 ng/ml. After sequential monitoring of serum CEA levels, postoperative serum CEA elimination kinetics were calculated using non-linear least square analysis with the fitting equation C(t)=(C0-Cp)exp(-kt)+Cp, where C(t) was the postoperative CEA level, t was the number days after surgery, C0 was the CEA level at postoperative time zero, Cp was the CEA at plateau, and k was the rate constant of elimination. Cp was calculated as 6.9 ng/ml, which was above the cut-off level and indicated residual malignancy. After adjuvant chemotherapy, CEA normalized to 1.8 ng/ml. In breast cancer patients with high preoperative serum CEA levels, our analytical method for CEA elimination might be useful for the detection of residual malignancies.     

Study of active substances involved in skin dysfunction induced by crowding stress. I. Effect of crowding and isolation on some physiological variables,skin function and skin blood perfusion in hairless mice

The effects of five levels of population density on various organs, the neuroendocrine system, skin function, skin blood perfusion, and blood parameters were studied in the hairless mouse. Skin barrier recovery was evaluated by measuring transepidermal water loss after tape stripping. Blood perfusion was measured by means of a laser Doppler imaging technique. The effect of a parasympathetic nerve stimulator, carpronium chloride, on skin function in the crowded animal model was also examined. A 7 d crowding (10, 15, 20 mice/cage) significantly increased the levels of corticosterone, catecholamines (norepinephrine, epinephrine and dopamine), glucose and serum lactate dehydrogenase activity in circulating blood, induced atrophy of kidney, ovary and thymus and hypertrophy of adrenal glands, and decreased body weight gain in comparison with the control (5 mice/cage). Crowding also increased epidermal thickness and epidermal proliferative activity, and decreased corneocyte size, rate of barrier recovery and skin blood perfusion. Most of these changes became more marked with increasing population density and/or longer exposure to a crowded environment. Isolation (1 mouse/cage) increased the level of norepinephrine and rate of skin blood perfusion, and significantly delayed barrier recovery. Repeated topical applications of carpronium chloride for 7 d improved the changes in skin blood perfusion, barrier recovery, kidney and ovary, and epidermal morphology induced by crowding. The crowded animal model could be useful for quantifying objectively the influence of crowded environment-induced stress on cutaneous function and blood perfusion.     

RDH5 gene mutations and electroretinogram in fundus albipunctatus with or without macular dystrophy: RDH5 mutations and ERG in fundus albipunctatus

The aim of this study was to analyze the RDH5 gene in patients with fundus albipunctatus with and without macular dystrophy, and correlate the identified mutations with the electrophysiological results. Twenty-one patients from 19 unrelated Japanese families with fundus albipunctatus were examined. Ten unrelated patients had macular dystrophy. In 18 patients, either a homozygous or a compound heterozygous mutation in the RDH5 gene was identified. The bright-flash, mixed rod-cone ERG had a negative configuration with reduced a-wave amplitudes after a short period of dark-adaptation (20 or 30 min). After a prolonged dark-adaptation period (2 or 3 h), the waveform attained normal amplitudes in patients without macular dystrophy but the a-waves were still subnormal in patients with macular dystrophy. The photopic ERG responses were significantly reduced in patients with macular dystrophy, indicating that they also had cone dystrophy. The photopic ERGs were reduced in only some of the patients without macular dystrophy. In patients without macular dystrophy, the scotopic b-wave amplitudes were nonrecordable or significantly reduced after a short dark-adaptation period but then improved to normal levels. However, they did not fully recover in some patients with macular dystrophy. Three patients with macular dystrophy in whom a RDH5 gene mutation could not be detected by our routine method had atypical ERG responses. We conclude that RDH5 gene mutations cause a progressive cone dystrophy or macular dystrophy as well as night blindness. The clinical phenotype including electrophysiological responses varied among patients with the RDH5 gene mutations.