观测大鼠视网膜微循环及白细胞运动的方法

目的:探索通过共焦激光眼底血管造影仪(HRA2)观测正常大鼠视网膜血管的形态和分布以及荧光标记的白细胞在眼底的运动情况的方法。方法:大鼠麻醉后散瞳并将其置于动物台上,荧光素钠血管造影观察大鼠视网膜血管的形态和分布,并照相和进行视频记录。另外,体外分离大鼠的外周血白细胞并用CFDA(6-carboxyfluorescein diacetate)进行荧光标记,之后通过尾静脉将其回输进入同窝另一只大鼠的体内,观察白细胞在眼底血管的运动情况。结果:通过HRA2能够清楚而有效的观察到大鼠视网膜4级以上血管的形态和分布情况,并能够观察到白细胞在眼底血管中的各种运动状态。结论:建立了一种通过HRA2观测大鼠视网膜血管及白细胞运动的方法。     

眼外伤所致继发性青光眼临床分析

目的:探讨眼外伤所致继发性青光眼的主要原因、临床表现及治疗方法。方法:对65例65眼眼外伤所致继发性青光眼的临床表现、病因及治疗方法进行分类与分析。结果:根据病因及临床表现将眼外伤所致继发性青光眼归纳为以下几类:眼内出血24眼(37%);房角挫伤20眼(31%);晶状体脱位或损伤12眼(18%);眼球穿通伤术后9眼(14%)。根据不同的原因进行治疗。随访3～6mo,眼压6～21mmHg(1mmHg=0.133kPa)55例55眼(85%),>21mmHg10例10眼(15%),有56眼(86%)视力有不同程度提高,有4眼(6%)视力下降,术后有2眼发生视网膜脱离。结论:眼外伤所致继发性青光眼除了眼压增高这一危害因素外,还有较为严重的眼内组织损伤,因此在治疗上往往比原发性青光眼更为复杂,预后也较差。     

外伤性前房积血56例临床治疗分析

目的:探讨眼球钝挫伤引起的前房积血的治疗方法。方法:对56例眼球钝挫伤前房积血患者的临床资料进行回顾性分析,采用保守治疗和手术治疗。结果:39例患者通过保守治疗,前房积血3～10d吸收;17例手术治疗,行前房穿刺冲洗术14例,行小梁切除术3例。眼压恢复正常,前房积血吸收,Ⅱ级以下原发性前房积血无并发症,视力恢复良好;Ⅱ级以上挫伤性前房积血,伴有继发性出血及并发症者,及时手术等综合治疗,视力恢复。结论:挫伤性前房积血早期治疗选择好手术方法可获得良好治疗效果。     

非接触眼压计在健康检查中对高眼压的筛查

目的:应用美国产Reichert-AT555非接触眼压计在健康普查中,发现高眼压或眼压异常者,对其进行眼科临床跟踪检查及治疗。方法:检查发现所有单眼眼压>21mmHg或双眼眼压差>8mmHg被检者,嘱其近期进行复诊,在3d内的同一时间连续测量3次,并进行相关的眼科检查。结果:已完成测量3110例;其中高眼压或眼压异常者359眼;复诊有30例被确诊为青光眼患者,进行了相应的治疗。结论:非接触眼压计具有操作简便、测量迅速、自动打印检测结果、不直接接触眼球,被检者无任何痛苦等优点逐渐被越来越多的人认可和接受,适合大规模的健康检查。     

眼动脉瘤眼部表现的临床探讨

目的:探讨眼动脉瘤所引起的眼部改变。方法:回顾性分析2003-08/2009-03首都医科大学附属北京天坛医院神经外科收治的44例眼动脉瘤患者的临床资料。结果:眼动脉瘤患者44例以眼部改变为首发者14例(32%)。视力下降者12例(27%),其中单眼者10例(23%),双眼者2例(5%);视野缺损者10例(23%)(双眼2例,单眼8例);复视者2例(5%);上睑下垂者4例(9%);误诊为球后视神经炎2例,青光眼1例。结论:眼动脉动脉瘤患者可引起眼部改变,最常见的表现为视力下降和视野缺损。     

两种方法研究大学生群体优势眼与左/右利手间的关系(英文)

目的:评估大学生群体优势眼和左/右利手间的关系。方法:受试对象为179名大学生志愿者,平均年龄为19.4±1.6岁,其中女110名(61.5%),男69名(38.5%)。优势眼由Gndogˇan和McManus两种方法测得,左或右利手则由Edinburgh Handedness Inventory Oldfield和McManus法确定,t检验评估实验的可信度。结果:Gndogˇan法测得受试者中110人(61.5%)为右眼优势,69人(38.5%)为左眼优势,无性别差异。McManus法重测相同受试者,则右/左眼优势分别为128人(71.5%)和51人(28.5%)。两法测得的结果相关,一致度κ=0.256(P<0.01)。女性受试者中,Gndogˇan法测得右/左眼优势分别为62人(56.4%)和48人(43.6%),McManus法测得的结果为右/左眼优势分别为74人(67.3%)和36人(32.7%)。Fisher检验两法测得的结果相关(P<0.05),一致度κ=0.239(P<0.01)。男性受试者中,Gndogˇan法测得右/左眼优势为48人(69.6%)和21人(30.3%),Mc-Manus法检测为54人(78.3%)和15人(21.7%)。Fisher检验两法测得结果相关(P>0.05),一致度κ=0.239(P<0.01)。Oldfield和McManus法分别测得右利手比例为91.6%(n=164)和91.1%(n=163),两者间有较高的一致度κ=0.753(P<0.01)。McManus法检测出的优势眼和左或右利手间的统计学相关性具有显著性意义(Fisher检测P<0.017;一致度评分phi=0.193(P<0.05)。结论:大学生以右利手为主,McManus法检测发现右利手似乎与有眼优势更为相关。左或右利手和优势眼似乎是研究大脑功能不对称性和大脑偏侧型的最可靠的方法。     

Transduced viral IL-10 is exocytosed from lacrimal acinar secretory vesicles in a myosin-dependent manner in response to carbachol

The purpose of this study was to determine the intracellular trafficking and release pathways for the therapeutic protein, viral IL-10 (vIL-10), from transduced acinar epithelial cells from rabbit lacrimal gland. Primary cultured rabbit lacrimal gland acinar cells (LGACs) were transduced with adenovirus serotype 5 containing viral interleukin-10 (AdvIL-10). The distribution of vIL-10 was assessed by confocal fluorescence microscopy. Carbachol (CCH)-stimulated release of vIL-10 was quantified by ELISA. vIL-10 localization and exocytosis was probed in response to treatments with agents modulating actin- and myosin-based transport. vIL-10 immunoreactivity was detected in large intracellular vesicles in transduced LGAC. vIL-10 was partially co-localized with biosynthetic but not endosomal compartment markers. vIL-10 release was sensitive to CCH, and the kinetics of release showed an initial burst phase that was similar but not identical to that of the secretory protein, β-hexosaminidase. Disassembly of actin filaments with latrunculin B significantly increased CCH-stimulated vIL-10 secretion, suggesting that vIL-10 was released from stores sequestered beneath the subapical actin barrier. That release required the activity of actin-dependent myosin motors previously implicated in secretory vesicle exocytosis was confirmed by findings that CCH-stimulated vIL-10 release was reduced by inhibition of non-muscle myosin 2 and myosin 5c function, using ML-7 and overexpression of dominant negative myosin 5c, respectively. These results suggest that the majority of vIL-10 transgene product is packaged into a subpopulation of secretory vesicles that utilize actin-dependent myosin motors for aspects of actin coat assembly, compound fusion and exocytosis at the apical plasma membrane in response to CCH stimulation.     

The role of steroids in outflow resistance

Glucocorticoid (GC)-induced ocular hypertension and secondary iatrogenic open-angle glaucoma are serious side effects of GC therapy. Its clinical presentation is similar in many ways to primary open-angle glaucoma, including increased aqueous outflow resistance and morphological and biochemical changes to the trabecular meshwork (TM). Therefore, a large number of studies have examined the effects of GCs on TM cells and tissues. GCs have diverse effects on the TM, altering TM cell functions, gene expression, extracellular matrix metabolism, and cytoskeletal structure. Some or all of these effects may be responsible for the increased outflow resistance associated with GC therapy. In contrast to GCs, several different classes of steroids appear to lower IOP. Additional research will help better define the molecular mechanisms responsible for GC-induced ocular hypertension and steroid-induced IOP lowering activity.     

Transscleral iontophoretic and intravitreal delivery of a macromolecule: Study of ocular distribution in vivo and postmortem with MRI

The distribution and clearance of macromolecules in ocular delivery are not well understood. It has been hypothesized that iontophoresis can enhance transscleral delivery of macromolecules. The objective of this study was to investigate the ocular distribution of a macromolecule after transscleral iontophoretic delivery and intravitreal injection in vivo using nuclear magnetic resonance imaging (MRI) and to compare these results. Experiments of constant current transscleral iontophoresis of 4 mA or intravitreal injection were performed on New Zealand white rabbits in vivo. Iontophoresis experiments were also performed on rabbits postmortem. Galbumin™ (Gd-labeled albumin) was the model permeant surrogate to clinical therapeutic agents. MRI was used to monitor the distribution of the molecule in the eye after ocular iontophoresis and intravitreal injection. In addition, the conjunctiva, sclera, choroid, and retina were extracted in the transscleral iontophoresis study to determine the amounts of Galbumin™ in these tissues using Inductively Coupled Plasma Optical Emission Spectroscopy (ICP-OES). The results show that iontophoresis enhanced the ocular delivery of Galbumin™. The macromolecule was mainly delivered into the conjunctiva and sclera in microgram quantities and then diffused towards the posterior section in the upper hemisphere of the eye in vivo. Both in vivo and postmortem studies show that the iontophoretic delivery of Galbumin™ into the vitreous was below the detection limit. In the intravitreal injection study, the diffusion coefficient of Galbumin™ in the vitreous humor was estimated to be close to that of free aqueous diffusion.     

Etiology of carotid cavernous fistula in Japanese

Background  A carotid cavernous fistula (CCF) develops spontaneously or after trauma, and older publications suggest that the majority of CCF cases are caused by trauma. However, more recent reports question the prevalence of CCFs caused by trauma. Methods  The clinical records of 37 consecutive patients diagnosed with a CCF were reviewed. The disease etiology, patient demographics, anatomical classification, and clinical course were investigated. Results  The CCF was spontaneous in 30 patients, and was related to head or neck trauma in seven patients. The mean age of all patients was 65.8 ± 10.5 years, and 30 (81.1%) were women. Eight had diabetes and 14 had hypertension. The major signs and symptoms were congestion (86.4%), diplopia (81.1%), bruit (59.5%), and headaches/orbital pain (62.2%). Exophthalmos (67.6%) and elevated intraocular pressure (40.5%) were also frequently noted. In the Barrow classification, seven patients were classified as type A, four as type B, three as type C, and 20 as type D. The classification could not be established in three patients who did not undergo angiography. Of note, almost all patients had consulted an ophthalmologist before the diagnosis. Conclusion  Spontaneous/low-flow CCF is more prevalent than previously reported. The role of ophthalmologists is important because the majority of patients initially consult ophthalmologists, and the signs of low-flow CCF are subtle and may be overlooked.