Biomechanics of the anterior human corneal tissue investigated with atomic force microscopy

PURPOSE

To investigate the biomechanics of the anterior human corneal stroma using atomic force microscopy (AFM).

METHODS

AFM measurements were performed in liquid on the anterior stroma of human corneas, after gently removing the epithelium, using an atomic force microscope in the force spectroscopy mode. Rectangular silicon cantilevers with tip radius of 10 nm and spring elastic constants of 25- and 33-N/m were used. Each specimen was subjected to increasing loads up to a maximum of 2.7 μN with scan speeds ranging between 3- and 95-μm/s. The anterior stromal hysteresis during the extension-retraction cycle was quantified as a function of the application load and scan rate. The elastic modulus of the anterior stroma was determined by fitting force curve data to the Sneddon model.

RESULTS

The anterior stroma exhibited significant viscoelasticity at micrometric level: asymmetry in the curve loading-unloading response with considerable hysteresis dependent both on the application load and scan rate (P < 0.01). The mean elastic modulus ranged between 1.14 and 2.63 MPa and was constant over the range of indentation depths between 1.0 and 2.7 μm in the stroma.

CONCLUSIONS

At microscale level, the mechanical response of the most anterior stroma is complex and nonlinear. The microstructure (fibers' packing, number of cross-links, water content) and the combination of elastic (collagen fibers) and viscous (matrix) components of the tissue influence the type of viscoelastic response. Efforts in modeling the biomechanics of human corneal tissue at micrometric level are needed.

Increased variance in germline allele-specific expression of APC associates with colorectal cancer

BACKGROUND & AIMS

Germline variations in allele-specific expression (ASE) are associated with highly penetrant familial cancers, but their role in common sporadic cancers is unclear. ASE of adenomatous polyposis coli (APC) is associated with pathogenesis of familial adenomatous polyposis. We investigated whether moderate variations in ASE of APC contribute to common forms of colorectal cancer (CRC).

METHODS

Denaturing high-performance liquid chromatography was used to analyze germline ASE of APC in blood samples from patients with CRC (cases, n = 53) and controls (n = 68). Means, medians, and variances of ASE were compared. Variants in the APC gene region also were analyzed.

RESULTS

The distribution of ASE differed significantly between groups; cases had significantly larger amounts of variance than controls (P = .0004). Risk for CRC increased proportionally with the degree of deviation from the mean. The odds ratio for individuals with levels of ASE that deviated more than 1 standard deviation from the mean was 3.97 (95% confidence interval, 1.71-9.24; P = .001); for those with levels greater than 1.645 standard deviations, the odds ratio was 13.46 (95% confidence interval, 1.76-609.40; P = .005). Sequence analysis revealed that a patient with a high level of ASE who did not have a family history of CRC carried a nonsense mutation in APC (p.Arg216X). Genotype analysis of APC associated multiple single-nucleotide polymorphisms with ASE values and/or variance among cases, but not controls. Cis variants, therefore, might account for some of the variance in ASE of APC.

CONCLUSIONS

Patients with CRC have a larger variance in germline levels of ASE in APC than controls; large distances from the mean ASE were associated with risk for common forms of CRC.

A new class of antimalarial dioxanes obtained through a simple two-step synthetic approach: rational design and structure-activity relationship studies

A new series of simple endoperoxides, characterized by a 3-methoxy-1,2-dioxane scaffold, was designed on the basis of a previously developed pharmacophore. Through a simplified and versatile scheme of synthesis, which utilizes cheap and commercially available starting materials, it was possible to obtain several structurally and stereochemically different compounds that were tested against P. falciparum. Most of compounds showed antimalarial activity in the low micromolar range and no cellular toxicity, all being significantly more active on chloroquine resistant (CQ-R) than on chloroquine sensitive (CQ-S) strains. Resulting structure-activity relationships were analyzed by means of experimental and computational techniques, validating our design rationale and tailoring it for the new scaffold. Our study demonstrated that according to the hypothesized mechanism of action, the antimalarial activity can be improved through rational structural modifications, paving the way for the development of new simplified antimalarial endoperoxides.

Long-term changes of the anterior corneal topography after photorefractive keratectomy for myopia and myopic astigmatism

PURPOSE

To analyze the anterior corneal topography changes after 8 years after photorefractive keratectomy (PRK) for the correction of myopia and myopic astigmatism.

METHODS

Sixty-six eyes (33 patients) underwent PRK using an excimer laser platform. Patients were subdivided into three groups: the low myopia (13 patients; range, -1.25 to -4.40 diopters [D]), the high myopia (13 patients; -4.50 to -9.00 D), and astigmatism (7 patients; cylinder component between -2.00 and -5.00 D) groups. The preoperative and 1-, 2-, 4-, 6-, and 8-year postoperative average corneal maps were computed for each study group. Changes inside and outside the optical zone, which was 6.00 mm in diameter for all eyes, during follow-up were further investigated.

RESULTS

The topographic central region, 2.00-mm diameter, was almost stable in all study groups, with changes < 0.39 D between 1 and 8 years. The postoperative variations at the peripheral region, 6.00- to 8.00-mm diameter, were related to the type and amount of refractive correction: a higher flattening (P < 0.05) has been assessed in the high-myopia group (-0.85 D) in comparison with the low-myopia group (-0.42 D) between 1 and 8 years. On the contrary, corneal periphery steepened (+2.22 D; P < 0.05) in the astigmatism group during follow-up, mainly at the superior and inferior emimeridians.

CONCLUSIONS

The anterior corneal topography continues to change configuration even long term after PRK. Changes are confined outside the functional optical zone of the cornea. PRK for the correction of myopia was shown not to influence the mechanical stability of the corneal tissue at 8 years after surgery.

Long-term corneal wavefront aberration variations after photorefractive keratectomy for myopia and myopic astigmatism

PURPOSE

To analyze the higher-order corneal wavefront aberration during an 8-year follow-up after photorefractive keratectomy (PRK).

SETTING

IRCCS Fondazione G.B. Bietti, Rome, Italy.

DESIGN

Case series.

METHODS

Patients having PRK using the Technolas 217C excimer laser platform were divided into 3 groups according to the preoperative refraction as follows: low myopia, high myopia, and astigmatism. The preoperative and 1-, 4-, 6-, and 8-year postoperative root mean square (RMS) values of coma, spherical aberration, and total higher-order aberrations (HOAs) were calculated with 3.5 mm and 6.0 mm simulated pupils. The mean preoperative and postoperative higher-order corneal wavefront aberration maps, point-spread functions, and radial modulation transfer functions (MTFs) were represented to describe the impact of PRK on the optical quality of the anterior cornea.

RESULTS

The study enrolled 33 patients (66 eyes). Corneal spherical aberration was statistically significantly higher after PRK for simple myopia with 3.5 mm and 6.0 mm pupils (P<.05). The postoperative increase in coma was statistically significant in the high-myopia group with both pupil sizes (P<.05). Total RMS HOAs increased postoperatively with a 6.0 mm pupil in all groups (P<.05). The mean radial MTF was almost stable in all groups between preoperatively and postoperatively.

CONCLUSIONS

Higher-order corneal wavefront aberrations stabilized 1 year after PRK to treat myopia or myopic astigmatism. The effect of induced corneal HOAs tended to increase after correction of high myopia with large pupils, although without degrading the image optical quality of the cornea over the long term.

Concentration and reference interval of trace elements in human hair from students living in Palermo, Sicily (Italy)

Trace element contents in specimens of hair collected from 137 children aged 11-13 years old, living in Palermo (Sicily, Italy) were determined by ICP-MS. This work reports analytical data for the following 19 elements: Al, As, Ba, Cd, Co, Cr, Cu, Li, Mn, Mo, Ni, Pb, Rb, Sb, Se, Sr, U, V and Zn. The most abundant chemical elements were zinc and copper (Zn > Cu), with concentrations exceeding 10 μg/g (Zn = 189.2 μg/g; Cu = 22.9 μg/g). Other elements with concentrations greater than 1 μg/g were, in order of abundance, Al>Sr>Ba>Pb. The remaining elements were all below 1 μg/g. The average elemental concentrations in hair were statistically compared by Kolmogorov-Smirnov's test taking children's gender into account. Al, Ba, Cr, Li, Rb, Sb, Sr, V and Zn were statistically different according to gender, with significance p < 0.001. This study thus confirms the need for hair analysis to differentiate female data from those of males. IUPAC coverage intervals and coverage uncertainties for trace elements in the analysed hair samples are also reported.

Microwave assisted synthesis of a small library of substituted N,N'-bis((8-hydroxy-7-quinolinyl)methyl)-1,10-diaza-18-crown-6 ethers

N,N'-bis-((8-hydroxy-7-quinolinyl)methyl)-1,10-diaza-18-crown-6 ether 1a and its analogue 1c are known as fluorescent sensors of magnesium in living cells. With the aim to investigate the effects of the substitution pattern on the photophysical properties of ligands 1 and their metal complexes, we developed an efficient microwaves enhanced one-pot Mannich reaction to double-armed diaza-crown ligands 1 carrying a variety of substituents. This new protocol is characterized by shorter reaction times, enhanced yields, and improved product purities with respect to the use of conventional conductive heating.

Evaluation of a new method for the measurement of corneal thickness in eye bank posterior corneal lenticules using Anterior Segment Optical Coherence Tomography

BACKGROUND/AIMS

To preliminarily evaluate the repeatability of central corneal thickness (CCT) measurements performed with Anterior Segment Optical Coherence Tomography (AS-OCT) on eye bank posterior corneal lenticules.

METHODS

Six donor lenticules were created with a 350 μm head microkeratome (Moria, Antony, France). All donor tissues were stored at 4°C in Eusol-C solution (Alchimia S.r.l, Ponte S. Nicolò, Italy), without the anterior cornea lamella. The CCT of each lenticule, maintained in the glass phial, was measured using a commercial AS-OCT instrument (Visante, Carl Zeiss Meditec, Dublin, California, USA) and a specially designed adaptor immediately and 4, 24 and 48 hours after dissection. Immediately after AS-OCT, CCT values were measured with the ultrasound pachymetry method used at the Eye Bank.

RESULTS

The mean donor cornea central thickness was 647±36 μm and 660 ± 38 μm (p=0.001) as measured by AS-OCT and ultrasound, respectively; immediately after dissection, CCT values of posterior lenticules were 235 ± 43 μm and 248 ± 44 μm, respectively (p=0.001). No statistically significant changes in CCT values of donor lenticules were assessed over the 48 h period with both methods. There was a high level of agreement, evidenced by Bland-Altman analysis, between the two methods of pachymetry.

CONCLUSION

AS-OCT, with the corneal tissue in the vial, was revealed to be a repeatable and reliable method for measuring posterior donor lenticule central thickness. Lenticule CCT values measured with the investigational AS-OCT method were on average 10 μm thinner than those measured with the established ultrasound method.

Differences in the availability of new anti-cancer drugs for Italian patients treated in different regions. Results of analysis conducted by the Italian Society Of Medical Oncology (AIOM)

AIMS AND BACKGROUND

Italy is divided into 20 regions. As a consequence of local autonomy, following marketing authorization by the Italian Medicines Agency, each drug for hospital use is not immediately available, because its approval needs to undergo further steps that can be different among regions. The Italian Society of Medical Oncology conducted the present study to describe the impact of the existence of sub-national pharmaceutical formularies on the disparity of access to new anti-cancer drugs among patients treated in different Italian regions.

METHODS

The availability of 8 new anti-cancer drugs at a regional level and the coherence of regional authorizations compared with national authorizations approved by the Italian Medicines Agency were analyzed as of April 2009.

RESULTS

Fourteen regions and autonomous province of Trento have a regional pharmaceutical formulary. In most cases, the regional pharmaceutical formularies include the eight analyzed drugs, with therapeutic indications coherent with national marketing authorization indications. Five drugs (bevacizumab, trastuzumab, rituximab, erlotinib, sunitinib) were included in all the existing regional pharmaceutical formularies, without restrictions, whereas three drugs (cetuximab, sorafenib, pemetrexed) were found to have restrictions in some regions.

CONCLUSIONS

The presence of multiple hierarchical levels of drug evaluation creates a potential element of disparity in the access to pharmacological therapies for Italian citizens.

Surface roughness of intraocular lenses with different dioptric powers assessed by atomic force microscopy

PURPOSE

To analyze the optic surface roughness and morphology of 2 types of hydrophobic acrylic intraocular lenses (IOLs) with various dioptric powers using atomic force microscopy (AFM).

SETTING

Technical University of Cluj-Napoca, Faculty of Mechanics, Cluj-Napoca, Romania.

METHODS

Atomic force microscopy was used to characterize the topography of 2 types of hydrophobic acrylic IOLs from a single manufacturer (SN60AT and SA30AL) with dioptric powers ranging from 10.0 diopters (D) to 30.0 D. The AFM analysis was performed in contact mode using a V-shaped silicon nitride cantilever with a pyramidal tip curvature of 15 nm and a nominal spring constant of 0.2 N/m. Detailed surface characterization of the IOL optic was obtained using 6 quantitative parameters provided by the AFM software.

RESULTS

Five of 6 roughness parameters indicated statistically significant differences (P<.05) between IOLs with different dioptric powers, with the 10.0 D IOL in both models providing the smoothest optic surface. Between models with the same dioptric power, the SN60AT model had lower values of each surface roughness parameter than the SA30AL model.

CONCLUSIONS

Atomic force microscopy was an accurate tool for assessing the surface properties of IOL optics. Manufacturing processes were responsible for introducing detectable differences in the topography of IOL biomaterials with identical copolymer constituents but different dioptric powers. Nanometric analysis may assist IOL manufacturers in developing IOLs with optimal surface characteristics.

Investigation of corneal topography after deep lamellar endothelial keratoplasty

PURPOSE

To analyze the 6-month anterior and posterior topographic changes of the cornea after deep lamellar endothelial keratoplasty.

METHODS

Orbscan topographies of 22 eyes from 21 patients with corneal decompensation were retrospectively analyzed: 11 eyes received a 9-mm scleral access incision (large-incision group) and 11 eyes received a 5-mm scleral access incision (small-incision group). All the preoperative and postoperative corneal raw data were imported into custom software which computed the average composite corneal maps and difference maps for both study groups in order to evaluate the corneal response to the surgery. The software delineated 2 concentric zones of the cornea to characterize the regional response following the surgery: the central and peripheral regions.

RESULTS

There were no significant differences (analysis of variance, <0.35 D, p>0.05) between 6-month postoperative and preoperative average anterior central corneal topographies in either group. At the end of follow-up, the average posterior curvature tangential map did not significantly differ from before surgery in either group (<0.35 D, p>0.05). However, a significant increase (>0.60 D, p<0.01) in the average posterior central astigmatic power of the cornea was found in both groups.

CONCLUSIONS

Deep lamellar endothelial keratoplasty effectively preserves the preoperative keratometric corneal topography, minimizing changes in curvature and astigmatism of the cornea. The great predictability of corneal topography following deep lamellar endothelial keratoplasty is likely to be attributed to the minimal changes that occur in the anterior stroma, the portion of the cornea that appears to be mainly responsible for maintenance of corneal shape.

Catalysis in aqueous media for the synthesis of drug-like molecules

The design of straightforward and practical chemical syntheses that satisfy economic and ecological constraints is a major challenge in R&D. Ideally, a sustainable chemical synthesis should be safe, environmentally benign, reasonable in terms of cost, and careful in the use of resources and energy. The capability to develop synthetic strategies that meet these criteria is a priority in the manufacture of fine chemicals and pharmaceuticals, considering that the health and welfare of society increasingly depend on such industries. Among the various objectives to be pursued in sustainable manufacturing, this review focuses on two main goals: (i) the minimization of waste; and (ii) the replacement of toxic and volatile organic solvents with alternative, safer solvents - specifically water. In this context, the development of methods for catalysis in alternative reaction media is recognized as one of the most important approaches in modern chemical production.