Improvement of visual acuity one-year after vitreous surgery in eyes with residual triamcinolone acetonide at the macular hole

PURPOSE

To investigate whether triamcinolone acetonide in the macular hole after surgery interferes with anatomic macular hole repair or visual acuity improvement.

DESIGN

Prospective, interventional case series with historical comparison.

METHODS

Pars plana vitrectomy and triamcinolone acetonide-assisted internal limiting membrane peeling were performed in 26 eyes (24 patients) with stage 3 or 4 idiopathic macular hole. The visual acuities one-year after surgery were compared between eyes with and without residual triamcinolone acetonide after surgery.

RESULTS

The macular holes were closed successfully in all 26 eyes. Nine eyes (35%) had residual triamcinolone acetonide in the macular hole at the end of the surgery and in the fovea on day 3 after surgery. The mean preoperative logarithm of the minimum angle of resolution (logMAR) visual acuity +/- standard deviation was 0.73 +/- 0.36 and improved significantly to 0.20 +/- 0.29 one-year after surgery (P = .010). In the nine eyes with residual triamcinolone acetonide, the preoperative mean logMAR triamcinolone acetonide was 0.81 +/- 0.33, which improved to 0.20 +/- 0.19 one-year after surgery (P = .013). In the remaining 17 eyes, the mean visual acuity also improved from 0.71 +/- 0.38 before surgery to 0.21 +/- 0.28 after surgery (P = .001). No significant difference was found between the groups in preoperative and postoperative logMAR visual acuities.

CONCLUSIONS

Residual triamcinolone acetonide in the macular hole does not interfere with anatomic or visual improvement.

Rapid and effective method for separation of Staphylococcus aureus from somatic cells in mastitis milk

Quantitative PCR can be an effective method for identifying the bacteria causing mastitis. However, PCR detection is hampered by the presence of inflammatory somatic cells. To eliminate this problem, we attempted to establish methods that allow the effective separation of bacterial cells from somatic cells in mastitis milk with amino-silica. Somatic cells and Staphylococcus aureus cells have different sizes, surface structures, and overall electrical charges; therefore, their adsorption and desorption behavior on amino-silica was also different. We found that although amino-silica could efficiently adsorb both somatic cells and Staph. aureus, somatic cells were adsorbed much more strongly than bacterial cells. We identified conditions under which most of the somatic cells adsorbed and only Staph. aureus desorbed from amino-silica upon addition of a desorption solution. We demonstrated that this procedure effectively eliminated somatic cells in heavily contaminated milk samples, which resulted in improved clarity of the PCR band. These results indicate that pretreatment of the samples with amino-silica made the PCR-based strategy for identifying and quantifying disease-causing bacteria applicable for all milk samples.

Technical Note: Measurement of Ferritin in Bovine Milk and Its Clinical Significance

A quantitative ELISA was developed for bovine milk ferritin with an assay limit of 0.16 ng/mL of bovine spleen ferritin. Ferritin-binding activity was detected in bovine milk samples, and this binding activity was inhibited by increasing ionic strength with the addition of 0.5 M (NH4)2SO4. Heat treatment (60 degrees C, 20 min) of bovine milk in the presence of 0.5 M (NH4)2SO4 resulted in a 15 to 58% increase in ferritin concentrations compared with untreated samples. Although the recovery of bovine spleen ferritin added to milk was still low (55 to 90%), even in the presence of increased ionic strength with 0.5 M (NH4)2SO4, recovery was improved by heat treatment at 60 degrees C for 20 min (92 to 95%). Milk ferritin concentrations in 30 milk samples from quarters of 25 cows with mastitis (mean +/- SE: 134.2 +/- 28.7 ng/mL) were significantly higher than those in 17 quarter milk samples from 17 noninfected lactating cows (7.2 +/- 1.2 ng/mL), suggesting that bovine milk contains putative ferritin-binding proteins that inhibit immunoassay for milk ferritin and that bovine milk ferritin is an indicator of IMI.

Changing trends in the number of deaths from soft tissue sarcoma in Japan, 1955-2002

The incidence and number of deaths from soft tissue sarcoma (STS) have been reported to increase in many countries. However, those in Japan have not been analysed over a long span of time. The objective of this study was to analyse the changing trends in the number of deaths from STS in Japan. We analysed the annual trends in the number of deaths from STS from 1955 to 2002 in Japan using the data from the Vital Statistics of Japan, Statistics and Information Department, Minister's Secretariat, Ministry of Health, Labour and Welfare. Until 2000, the number of deaths from STS had increased. The recent value of the annual increased ratio of deaths from STS was 0.5%[95% confidence interval (CI): -1.2-2.2%]. Men continued to have a higher number of deaths than women. The general trends in age-standardized death rates were roughly upward before 1995, although the death rates tended to decrease thereafter. The number and proportion of deaths at or after 60 years of age were increasing. The peak age group of deaths was roughly the sixties before 1982, and the seventies after 1983. The individuals in their sixties and seventies should be the focus of health promotion activities.

Farnesoid X receptor, hepatocyte nuclear factors 1alpha and 3beta are essential for transcriptional activation of the liver-specific organic anion transporter-2 gene

BACKGROUND

We isolated the human liver-specific organic anion transporter gene, LST-2 (OATP8/SLCO1B3), which is exclusively expressed in the basolateral membrane of the hepatocytes. In this study, we analyzed the transcriptional regulation of the LST-2 gene in hepatocyte-derived cells and the effect of bile acid.

METHODS

Transcriptional activity of the LST-2 gene was measured using a human LST-2 promoter-luciferase reporter plasmid under various concentrations of bile acids. Electrophoresis mobility shift assays of farnesoid X receptor (FXR), hepatocyte nuclear factor (HNF) 1alpha, and HNF3beta were performed.

RESULTS

Luciferase analysis showed that the 5'-flanking region from -180 to -20 bp is responsible for LST-2 transcriptional activity. By site-directed mutation analysis, it was revealed that the consensus binding sites for FXR, HNF1alpha, and HNF3beta play important roles in the transcriptional activity of the LST-2 gene. By electrophoresis mobility shift assay, we observed specific protein-DNA complexes of FXR, HNF1alpha, and HNF-3beta. Luciferase activity was increased fivefold when chenodeoxycholate or deoxycholate were added. Northern blot analyses revealed that the expression of LST-2 was increased by addition of chenodeoxycholate or deoxycholate in a dose-dependent manner.

CONCLUSIONS

This study demonstrated that the transcription of the LST-2 gene is regulated by three transcription factors, FXR, HNF1alpha, and HNF3beta. HNF1alpha and HNF3beta might contribute to its liver-specific expression, and FXR might play a role in its transcriptional activation by bile acids.

Classification of abomasal displacement in cows according to histopathology of the liver and clinical chemistry

Histopathological features of livers and blood chemical values in cows with abomasal displacement were investigated. Liver biopsy samples were collected during redressment operations in 92 cows with abomasal displacement, and the samples were stained with haematoxylin and eosin or periodic acid Schiff (PAS). Blood was collected for chemical tests. Livers were histopathologically divided into the following four types: normal histology cases (21%), fatty degeneration cases (36%), cloudy swelling cases (19%) and fatty degeneration cases with cloudy swelling (24%). The number of PAS-positive samples was significantly higher in the normal histology group and significantly lower in the severe fatty degeneration group and severe cloudy swelling group. Cows with fatty degeneration had significantly higher levels of serum 3-hydroxybutyric acid, non-esterified fatty acid and aspartate aminotransferase than did those with cloudy swelling or normal histology. The results indicate that the morbid conditions of cows with abomasal displacement can be classified into four types.

Spontaneous revascularization of arterial thrombosis after living donor liver transplantation

Hepatic artery thrombosis remains a significant cause of graft loss in liver transplantation. We describe a case with thrombosis of the middle hepatic artery that revascularized spontaneously. Close follow-up with duplex ultrasound enabled us to treat the patient promptly and successfully with anticoagulants and antibiotics.

Changes of immunological response after experimentally ozonated autohemoadministration in calves

Changes in subsets of peripheral blood mononuclear cells and lymphocyte blastogenesis reaction were observed after ozonated autohemoadministration (OAHA) in calves. Ten healthy calves were used in this study. After OAHA, CD8+ cells, CD14+ cells and WCl+cells increased (p<0.05). The level of lymphocyte blastogenesis stimulated by PHA decreased after OAHA. A significant increase in serum IL-6 activity was observed in OAHA calves. These results suggested that OAHA induced immunological changes in calves.

Restoration of portal vein flow by splenorenal shunt ligation and splenectomy after living-related liver transplantation

We describe here a case of living-related liver transplantation with a spontaneous splenorenal shunt. On the third postoperative day, Doppler ultrasound follow-up revealed impairment of intrahepatic portal vein flow and reoperation was performed. Intraoperatively, simple compression of the collateral veins forming the splenorenal shunt resulted in an immediate change in the portal flow pattern, which suggested the absence of a portal thrombus. Splenectomy and ligature of the more dilated collateral veins were carried out and satisfactory portal flow was restored. Although the role of splenectomy was controversial, splenectomy provided an increased portal vein flow in the present case. The uneventful postoperative course validated our decision.

Relationship between serum TNF activity and insulin resistance in dairy cows affected with naturally occurring fatty liver

To clarity the relationship between tumor necrosis factor (TNF) and insulin resistance in dairy cows affected with fatty liver, naturally occurring cases were investigated. The affected cows were classified into following three groups according to histopathologic findings of the liver: mild fat droplet deposition (group 1; n=11), severe fat droplet deposition (group 2; n=10), and cloudy swelling (group 3; n=8). Serum TNF activities in Group 2 (8.67 +/- 2.16 U/ml) and Group 3 (11.65 +/- 1.92 U/ml) were significantly higher than that in Group 1 (3.57 +/- 0.81 U/ml) (p<0.05). The insulin-tolerance tests showed that the insulin-stimulated glucose disposal rates (GDR) in Group 2 (27.6 +/- 7.8%) and Group 3 (15.8 +/- 9.1%) were significantly lower than that in Group 1 (41.7 +/- 9.8%). There was a significant negative correlation between serum TNF activity and GDR in affected cows (r=-0.56, p<0.01). These results indicate that serum TNF activity is correlated with insulin resistance in cows with fatty liver.

Calcium-bindings of wild type and mutant troponin Cs of Caenorhabditis elegans

Apparent Ca(2+)-binding constant (K(app)) of Caenorhabditis elegans troponin C (CeTnC) was determined by a fluorescence titration method. The K(app) of the N-domain Ca(2+)-binding site of CeTnC was 7.9+/-1.6 x 10(5) M(-1) and that of the C-domain site was 1.2+/-0.6 x 10(6) M(-1), respectively. Mg(2+)-dependence of the K(app) showed that both Ca(2+)-binding sites did not bind competitively Mg(2+). The Ca(2+) dissociation rate constant (k(off)) of CeTnC was determined by the fluorescence stopped-flow method. The k(off) of the N-domain Ca(2+)-binding site of CeTnC was 703+/-208 s(-1) and that of the C-domain site was 286+/-33 s(-1), respectively. From these values we could calculate the Ca(2+)-binding rate constant (k(on)) as to be 5.6+/-2.8 x 10(8) M(-1) s(-1) for the N-domain site and 3.4+/-2.1 x 10(8) M(-1) s(-1) for the C-domain site, respectively. These results mean that all Ca(2+)-binding sites of CeTnC are low affinity, fast dissociating and Ca(2+)-specific sites. Evolutional function of TnC between vertebrate and invertebrate and biological functions of wild type and mutant CeTnCs are discussed.

Inflammatory cytokines and antigen-responsive mononuclear cells in peripheral blood of cattle infected with Salmonella takoradi

To determine the immunological response in lactating dairy cows infected with Salmonella (S.) Takoradi, the relationships among distributions of peripheral blood mononuclear cell (PBMC) subpopulations, endotoxin concentrations and dynamics of inflammatory cytokines in blood were investigated. The ratio of CD4+ T cells to CD8+ T cells was significantly lower in the affected cattle than in the control cattle (p<0.05) to decrease in the number of CD4+ T cells in the infected cattle. In contrast, the numbers of gammadeltaT cells, MHC class II-positive cells were significantly higher in the affected cattle than in the control cattle (p<0.01 respectively). Endotoxemia was found in all but one of the affected cattle. Serum IL-1 and IL-6 bioactivities were significantly higher in the affected cattle than in the control cattle (IL-1, p<0.05; IL-6. p<0.01). Serum TNF-alpha activities and levels were not detected in the control and affected cattle. The activities of proinflammatory cytokines determined by the bioassay are important to the relationships between concentration of endotoxin, cytokines and clinical signs. such as leukocytosis, leukopenia, fever or bacterial shedding. Serum IL-2 levels were lower in the affected cattle than in the control cattle. Serum IFN-y was not detected in the affected cattle except one. These results by the ELISA seemed to reflect the condition of subpopulation in the PBMCs from the shedding cattle. The present results suggest that cellular immunity is suppressed while the humoral immunity is activated in acute bovine salmonellosis.

Acute phase response in naturally occurring coliform mastitis

Changes in the activities of serum cytokines and in acute phase response were observed in dairy cows with naturally occurring coliform mastitis. Seven cows with severe mastitis showed systemic and mammary inflammatory response throughout the observation period, and 11 cows with mild mastitis recovered and were able to be milked within 3 days of onset of mastitis. Serum interleukin (IL)-I and tumor necrosis factor (TNF) activities were higher in the severe group than in the mild group at the first appearance of symptoms. Elevated IL-1 activity was evident in the severe group throughout the observation period. Serum alpha-1-acidglycoprotein (alpha1AG) concentration began to rise with the beginning of mastitis in the severe group, and peaked at 9 days. Serum haptoglobin (Hp) concentrations peaked at 3 days, and decreased gradually after 3 days in the severe group. These results showed that there are dynamic changes in serum IL-1 activity and in serum alpha1AG and Hp concentrations in cows with severe coliform mastitis.

Technique for removing a bent intramedullary femoral nail: a case report

The authors present a case in which an interlocked intramedullary nail placed to secure a left femoral shaft fracture was deformed twelve months after surgery because of secondary trauma. The nail was straightened by sectioning through half of its diameter with a drill for metal under minimal soft tissue dissection, then removed and replaced with another nail. The femur subsequently healed without complications.

Normal-tension glaucoma with reversed ophthalmic artery flow

PURPOSE

To describe a case of normal-tension glaucoma with bilateral complete occlusion of the internal carotid artery.

METHODS

A 58-year-old man who had a 2-year history of normal-tension glaucoma in the left eye presented with ocular ischemic syndrome. To evaluate the orbital circulation, cerebral angiography and color Doppler imaging were performed.

RESULTS

Cerebral angiography showed bilateral complete occlusion of the internal carotid artery and collateral blood supply through the right and left ophthalmic arteries, in which the flow was reversed. Moreover, color Doppler imaging revealed lower blood flow velocities in the left central retinal and short posterior ciliary arteries, suggesting a steal phenomenon.

CONCLUSION

Normal-tension glaucoma in the present case may be caused by chronic reduction of retrobulbar blood flow resulting from a steal phenomenon.

Sprouting epidermoid cysts

Five unusually shaped (i.e. 'sprouting') epidermoid cysts in the upper lip, elbow and foot are reported. The tumours seldom produced symptoms. The maximum diameter was 25-48 mm. The complete removal including a sprouting bud is necessary. Histologically, partial to complete cyst wall rupture was recognised. A pulsion diverticulum due to variations in the thickness and strength of the cyst wall, a foreign body reaction against inner keratinous mass without obvious bacterial infection, and/or outer fibrous band(s) acting as constriction band(s), are proposed as possible causes of the 'sprouting'.

How far does an ingrown toenail enlarge?

Bizarre hypertrophy of the right great toe presented in a 50-year-old woman with an ingrown nail, as well as mild hypertrophy of the left great toe. A fingerlike overgrowth was thought to be a reactive change resulting from repetitive formation of granulation from the histopathological analysis.

A possible role of immunoglobulin E in patients with hyperthyroid Graves' disease

To investigate the possible participation of immunoglobulin E (IgE) in the autoimmune process of Graves' disease, incidence of elevation of serum IgE level, TSH receptor antibody (TRAb), and thyroid status were studied in 66 patients with hyperthyroid Graves' disease, 54 patients with Hashimoto's thyroiditis, 19 patients with bronchial asthma, and 15 patients with pollen allergy. In hyperthyroid Graves' patients, elevation of serum IgE levels (> or = 170 U/mL) was found in 19 of 66 patients (29%), 11 of whom had hereditary and/or allergic conditions. Elevations of serum IgE levels were found in 63% of patients with bronchial asthma and in 40% of patients with pollen allergy. Mean values of serum IgE were the same in patients with hyperthyroid Graves' disease and with bronchial asthma. During methimazole treatment TRAb decreased without fluctuation of IgE levels in both groups. The decrease in TRAb was significantly greater in patients with normal IgE than in patients with IgE elevation. After prednisone administration, reduction in TRAb was greater in patients with normal IgE than that in patients with IgE elevation. High incidence of IgE elevation in hyperthyroid Graves' disease and slower reduction in TRAb in association with IgE elevation suggest a difference in the autoimmune processes in Graves' disease with and without elevation of IgE.

Effects of isoprothiolane on cell growth of cultured bovine mammary epithelial cells

This study was performed to investigate the effects of isoprothiolane on cell growth and the production of interleukin (IL)-1 and IL-6 by bovine mammary epithelial cells in vitro. Isoprothiolane increased proliferation of mammary epithelial cells in a dose-dependent manner at the concentration of 0.05 to 5 microM when cultured either with or without serum-supplemented medium. In contrast, isoprothiolane (0.0005-5 microM) significantly inhibited the production of IL-1 and IL-6 by mammary epithelial cells. Moreover, the cytokines, IL-1alpha, IL-1beta, IL-6, and tumor necrosis factor (TNF)-alpha tended to inhibit the proliferation of mammary epithelial cells in a dose-dependent manner. These results indicated that isoprothiolane regulated mammary epithelial cell growth in vitro possibly by modulating the production of cytokines.