Monocular diplopia caused by ocular aberrations and hyperopic defocus

As a single aperture, approximately monofocal optical system, the human eye generally creates a single image on the retina. However, the literature contains many reports of perceptual monocular diplopia. While it is easy to understand how distortion may produce monocular diplopia, its reported high incidence in normal eyes is less easily understood. We examine a model which ascribes monocular diplopia to an interaction between defocus and ocular spherical aberration. Using a psychophysical hyperacuity-based alignment procedure we measured the transverse aberration function in 0.5 mm steps horizontally across the pupil in the eyes of three cyclopleged subjects. Ocular transverse aberration functions were derived with best refraction and with simulated myopia and hyperopia. Monocular diplopia was also measured under the same conditions. All three subjects showed significant, but different, degrees of positive spherical aberration. The measured ocular transverse aberration functions were predictably modified by the hyperopic and myopic defocus. Hyperopic defocus combined with positive (myopic) spherical aberration changes a monotonic transverse aberration function with a single inflection point into a biphasic function with two inflection points. The locations of the inflections predict the presence and magnitude of the perceived diplopia. These experimental results confirm Verhoeff's (1900) hypothesis for the ocular cause of monocular diplopia.

Genomic organization of the mouse double minute 2 gene

Transfection of the mouse double minute 2 (Mdm2) oncogene has been found to induce immortalization of primary cells and to transform cultured cells. Amplification and/or overexpression of human MDM2 has been documented in a large percentage of human cancers. Mouse and human Mdm2 cDNA have been cloned from transformed cells and the cDNA sequence of both genes have been reported previously. In this report, we present the gene structure of mouse Mdm2. Comparison of the coding sequences of the Mdm2 gene with the previously reported cDNA sequence and with Mdm2 sequences obtained from an Mdm2-bearing cosmid clone capable of inducing transformation revealed that the reported cDNA sequence was in error, and that Mdm2-induced transformation of cells does not require an activating mutation in Mdm2. Ligation-anchor PCR analysis of transcripts produced from the P1 and P2 promoters indicates that transcription initiates at sites upstream of those reported previously for both promoters.

Mice deficient for BMP2 are nonviable and have defects in amnion/chorion and cardiac development

To address the function of bone morphogenetic protein-2 (BMP2) in mammalian development, mice with a targeted deletion of the Bmp2 mature region were generated using embryonic stem cell technology. This mutation caused embryonic lethality when homozygous. Mutant embryos failed to close the proamniotic canal, which caused the malformation of the amnion/chorion. BMP2-deficient embryos also exhibited a defect in cardiac development, manifested by the abnormal development of the heart in the exocoelomic cavity. These defects are consistent with the expression of Bmp2 in the extraembryonic mesoderm cells and promyocardium. Thus BMP2 is a critical factor for both extraembryonic and embryonic development.

Subjective refraction of the peripheral field using contrast detection acuity

BACKGROUND

Although peripheral resolution acuity is relatively unaffected by uncorrected refractive error, recent investigations of peripheral vision indicate that contrast detection is optically limited. It should be possible, therefore, to perform a subjective refraction in the peripheral visual field using a contrast detection task.

METHODS

For a range of trial lenses, contrast detection acuities for vertical and horizontal gratings were measured with a two-interval forced-choice paradigm. Lens powers that maximized detection acuity were taken as the subjective refraction estimates. These powers were compared with objective refractions determined with retinoscopy and autorefractometry.

RESULTS

Contrast detection acuity varied significantly with lens power at all retinal locations tested. Defocusing by one diopter from the optimum lens power reduced detection acuity by about a factor of two at 20 degrees eccentricity, and slightly less in the far periphery. Objective retinoscopy and autorefractometry agreed with subjective measurements for most conditions tested.

CONCLUSIONS

Contrast detection acuity in the peripheral visual field varies with refractive blur, demonstrating the feasibility of performing subjective refraction in the periphery for a contrast detection task. Results suggest that visual fields measured with standard perimetry, which is based on contrast detection, may be affected by uncorrected peripheral refractive errors.

DNA mismatch repair deficient mice in cancer research

Biochemical and genetic approaches have been used to demonstrate that basic elements of a DNA mismatch repair (MMR) pathway are conserved between bacteria, yeast and mammals. Recently, mutations in the human MMR genes MSH2, MLH1, PMS1 and PMS2 have been implicated in a common form of hereditary colon cancer and in sporadic tumors of various tissues. In order to better understand the consequences of MMR deficiency in mammalian organisms, mice deficient for the Pms2, Mlh1 and Msh2 MMR gene homologues have been generated. MMR deficient mice display a general increase in spontaneous mutation rate and develop tumors during the first year of life. Additionally, loss of MMR appears to accelerate tumorigenesis in an Apc deficient background.

Disruption of muscle architecture and myocardial degeneration in mice lacking desmin

Desmin, the muscle specific intermediate filament (IF) protein encoded by a single gene, is expressed in all muscle tissues. In mature striated muscle, desmin IFs surround the Z-discs, interlink them together and integrate the contractile apparatus with the sarcolemma and the nucleus. To investigate the function of desmin in all three muscle types in vivo, we generated desmin null mice through homologous recombination. Surprisingly, desmin null mice are viable and fertile. However, these mice demonstrated a multisystem disorder involving cardiac, skeletal, and smooth muscle. Histological and electron microscopic analysis in both heart and skeletal muscle tissues revealed severe disruption of muscle architecture and degeneration. Structural abnormalities included loss of lateral alignment of myofibrils and abnormal mitochondrial organization. The consequences of these abnormalities were most severe in the heart, which exhibited progressive degeneration and necrosis of the myocardium accompanied by extensive calcification. Abnormalities of smooth muscle included hypoplasia and degeneration. The present data demonstrate the essential role of desmin in the maintenance of myofibril, myofiber, and whole muscle tissue structural and functional integrity, and show that the absence of desmin leads to muscle degeneration.

Increased bone formation in osteocalcin-deficient mice

Vertebrates constantly remodel bone. The resorption of preexisting bone by osteoclasts and the formation of new bone by osteoblasts is strictly coordinated to maintain bone mass within defined limits. A few molecular determinants of bone remodelling that affect osteoclast activity have been characterized, but the molecular determinants of osteoblast activity are unknown. To investigate the role of osteocalcin, the most abundant osteoblast-specific non-collagenous protein, we have generated osteocalcin-deficient mice. These mice develop a phenotype marked by higher bone mass and bones of improved functional quality. Histomorphometric studies done before and after ovariectomy showed that the absence of osteocalcin leads to an increase in bone formation without impairing bone resorption. To our knowledge, this study provides the first evidence that osteocalcin is a determinant of bone formation.

Involvement of mouse Mlh1 in DNA mismatch repair and meiotic crossing over

Mice that are deficient in either the Pms2 or Msh2 DNA mismatch repair genes have microsatellite instability and a predisposition to tumours. Interestingly, Pms2-deficient males display sterility associated with abnormal chromosome pairing in meiosis. Here mice deficient in another mismatch repair gene, Mlh1, possess not only microsatellite instability but are also infertile (both males and females). Mlh1-deficient spermatocytes exhibit high levels of prematurely separated chromosomes and arrest in first division meiosis. We also show that Mlh1 appears to localize to sites of crossing over on meiotic chromosomes. Together these findings suggest that Mlh1 is involved in DNA mismatch repair and meiotic crossing over.

BMP 7 is required for nephrogenesis, eye development, and skeletal patterning

In summary, the generation of BMP-7-deficient mice has provided additional evidence that this family of growth factors regulate many morphogenetic processes including but not limited to skeletal development. In particular our experiments demonstrate that BMP 7 acts as an early inducer of glomeruli formation, and that it is required for skeletal patterning and lens formation. Our results not only demonstrate that BMP 7 is involved in the differentiation of several organs during development, but also raise the hypothesis that mutations in the Bmp 7 gene itself or in the genetic pathway could be responsible for several human genetic diseases in which glomerulus formation is impaired.

Undersampling produces non-veridical motion perception, but not necessarily motion reversal, in peripheral vision

We investigated motion perception in peripheral vision (10-40 deg eccentricity) for drifting gratings above and below the Nyquist limit set by neural sampling of the retinal image. We found that psychometric functions for motion discrimination rarely exhibited worse-than-chance performance indicative of motion reversal. A series of control experiments indicated that failure to demonstrate motion reversal could not be attributed to: (1) failure to detect the contrast of the stimulus; (2) failure to detect the motion of the stimulus; (3) use of an inappropriate range of spatial frequencies. Although consistent motion reversal was not observed, additional experiments demonstrated that motion perception was nevertheless non-veridical for spatial frequencies above the Nyquist limit. These seemingly contradictory results were reconciled by the observation that aliased patterns could appear to move in several different directions, all of which were different from the direction of stimulus, but only of which was opposite to the stimulus direction. Nyquist limits inferred from motion discrimination lie near the predictions for P-ganglion cells in human retina and well above M-cell predictions, which implies the M-cell array is too sparse to account for the limits to verdical motion perception in peripheral vision.

Long-term glucose homeostasis in patients on homeparenteral nutrition

Glycated haemoglobin (Hb A1c) was used as a marker of long-term hyperglycaemia in patients receiving high glucose loads for home parenteral nutrition (HPN). Thirty-six patients received a median weekly glucose delivery of 2000 g (800-4200) at a median infusion rate of 11.8 mg/kg/min (5.0-19.2). There was no correlation between Hb A1c (median- 3.1%, range 2.0-6.3%) and glucose infusion rate or weekly glucose load. It is concluded that significant prolonged hyperglycaemia does not appear to be a problem in patients on HPN managed by this unit.

Activin signaling through activin receptor type II causes the cachexia-like symptoms in inhibin-deficient mice

Activins and inhibins, members of the transforming growth factor-beta superfamily, are involved in diverse physiological and developmental processes. We have previously shown that mice deficient in alpha-inhibin develop gonadal sex cord-stromal tumors at an early age. The tumor development is rapidly followed by a wasting syndrome that includes severe weight loss, hepatocellular necrosis around the central vein, and depletion of the parietal cells in the glandular stomach. The liver histology in inhibin-deficient mice is similar to the pathological effects of short-term treatment of rats and mice with recombinant activin A. Consistent with these findings, we have shown that the gonadal tumors in the inhibin-deficient mice secrete high levels of activins. In addition, Northern blot analysis has localized activin receptor type II (ActRII) to the liver. Based on these studies, we postulated that tumor-produced activins act through ActRII to cause the wasting syndrome in inhibin-deficient mice. To test this hypothesis and determine the significance of elevated levels of activin signaling through ActRII in vivo, we generated compound homozygous mutant mice deficient in both alpha-inhibin and ActRII. Despite the continued development of gonadal sex cord-stromal tumors and elevated serum levels of activin A and B, the compound homozygous mutant mice suffered no unusual weight loss, and the stomachs and livers of the majority of the mice were histologically normal. These results demonstrate that increased levels of activin signaling through ActRII in hepatocytes and the glandular stomach causes the hepatocellular necrosis and depletion of parietal cells in the glandular stomach as well as the severe weight loss in vivo.

Recycling selectable markers in mouse embryonic stem cells

As a result of gene targeting, selectable markers are usually permanently introduced into the mammalian genome. Multiple gene targeting events in the same cell line can therefore exhaust the pool of markers available and limit subsequent manipulations or genetic analysis. In this study, we describe the combined use of homologous and CRE-loxP-mediated recombination to generate mouse embryonic stem cell lines carrying up to four targeted mutations and devoid of exogenous selectable markers. A cassette that contains both positive and negative selectable markers flanked by loxP sites, rendering it excisable by the CRE protein, was constructed. Homologous recombination and positive selection were used to disrupt the Rep-3 locus, a gene homologous to members of the mutS family of DNA mismatch repair genes. CRE-loxP-mediated recombination and negative selection were then used to recover clones in which the cassette had been excised. The remaining allele of Rep-3 was then subjected to a second round of targeting and excision with the same construct to generate homozygous, marker-free cell lines. Subsequently, both alleles of mMsh2, another mutS homolog, were disrupted in the same fashion to obtain cell lines homozygous for targeted mutations at both the Rep-3 and mMsh2 loci and devoid of selectable markers. Thus, embryonic stem cell lines obtained in this fashion are suitable for further manipulation and analysis involving the use of selectable markers.

Double knockout of the ALL-1 gene blocks hematopoietic differentiation in vitro

The ALL-1 gene is involved in translocations with many partner genes in different types of the acute leukemias, but it is not clear whether it acts as an oncogene or whether the fusion proteins resulting from the translocations have dominant negative effects. To distinguish between these two possibilities, we analyzed the ability of wild-type AB2.1 embryonal stem (ES) cells and of single or double ALL-1 gene knockout cells derived from them to differentiate along hematopoietic lineages after withdrawal of leukemia inhibitory factor, using in vitro colony formation assays. All-1 double knockout ES cells formed a significantly greater number of colonies with faster kinetics than wild-type and ALL-1 single knockout ES cells. Parental ES cells formed lineage-restricted colonies, whereas single and double knockout ES cells developed, at high frequency, immature and/or "biphenotypic" colonies, mimicking the aberrant hematopoiesis typical of leukemic patients. These data are consistent with the possibility that loss of function of the ALL-1 gene is important in leukemogenesis.

An audit of treated epilepsy in Glasgow. West of Scotland Epilepsy Research Group

An audit of patients receiving antiepileptic drug therapy for epilepsy was carried out in 25 general practices in Glasgow. Patients were identified from computerized records of repeat prescriptions for antiepileptic drugs. Overall, 1052 (0.72%) of 145,609 screened patients had treated epilepsy. Only 5% were children, while 19% were over 65 years. Twenty-nine per cent were diagnosed by a neurologist, and in 24% no record was available of who had made the diagnosis. Fifty per cent had tonic-clonic seizures only. Partial seizures occurred in 39%, absences in 4%, and myoclonic jerks in 3%. In only 39% of case records was current seizure control documented. Seventy-four per cent and 41% of patients had surface electroencephalography and computerized tomographic brain scanning, respectively. In more than 80% of patients the presence or absence of birth injury, febrile convulsions in childhood, and a family history of epilepsy were not mentioned. Seventy-six per cent of patients were receiving anticonvulsant monotherapy. The most commonly prescribed drugs were carbamazepine (43%), phenytoin (34%), sodium valproate (22%) and phenobarbitone (15%). Eighty-four per cent had attended a hospital clinic with their epilepsy, and 19% had been admitted to hospital with seizures or complications. A standard record form for the assessment and follow-up of epileptic patients in general practice would help in providing optimal management and in facilitating the setting up of a shared-care programme.

IgA class switch in I alpha exon-deficient mice. Role of germline transcription in class switch recombination

Studies have implicated defective Ig class switch in the pathogenesis of IgA deficiency. To understand better the molecular events that regulate IgA class switch, a 1.4-kb region of the IgA locus containing the I alpha exon was replaced with a human hypoxanthine phosphoribosyltransferase minigene by gene targeting in murine embryonic stem cells. The I alpha exon-deficient mice derived from these embryonic stem cells had normal IgA levels in serum and secretions and normal numbers of IgA B cells in Peyer's patches and spleen. Further, I alpha exon-deficient B cells efficiently underwent IgA class switch in vitro, despite the absence of I alpha exon-containing germline transcripts. Notably, I alpha exon-deficient B cells did not require TGF-beta for IgA class switch since stimulation with LPS alone led to IgA expression. Nonetheless, whereas I alpha exon-deficient B cells constitutively expressed human hypoxanthine phosphoribosyltransferase transcripts, they did not produce IgA in the absence of LPS stimulation. These results demonstrate that the I alpha exon or transcripts containing the I alpha exon are not required for IgA class switch. Further, the effects of TGF-beta on I alpha locus transcription can be supplanted by expression of a heterologous minigene at that locus, but a second signal is required for the induction of IgA class switch.

Characterization of spatial aliasing and contrast sensitivity in peripheral vision

Psychometric performance was measured for contrast detection and spatial resolution tasks in foveal and peripheral vision. Objective evidence was obtained for a quantitative difference between resolution acuity and detection acuity in the peripheral field. These two types of spatial acuity differed by up to an order of magnitude (3 vs 30 c/deg at 30 deg eccentricity) and they varied with stimulus contrast in distinctly different ways. Contrast sensitivity at the resolution limit was an order of magnitude above the absolute threshold of unity and the shape of the contrast sensitivity function was significantly different from that measured for foveal vision. The results suggest that current models of eccentricity scaling of contrast sensitivity be re-evaluated to take account of the extensive aliasing zone of spatial frequencies which becomes functional in peripheral vision when the retinal image is well focused.

Chromosome engineering in mice

Chromosomal rearrangements are the major cause of inherited human disease and fetal loss. Translocations and loss of heterozygosity are important genetic changes causally involved in neoplasia. Chromosomal variants, such as deficiencies, are commonly exploited in genetic screens in organisms such as Drosophila because a small portion of the genome is functionally hemizygous. In the mouse, deficiencies are not generally available, thus genetic screens for recessive mutations are cumbersome. We report here that defined deficiencies, inversions and duplications extending to 3-4 cM can be constructed in embryonic stem cells. This was achieved by consecutive targeting of loxP recombination substrates to the end points of a genetic interval followed by Cre-induced recombination. This reconstructs a positive selectable marker which facilitates direct selection of clones with a chromosome structure specific to the relative orientation of the loxP sites. Duplication and deletion alleles have been transmitted into the mouse germ line. The availability of mice with defined regions of segmental haploidy will allow their use in genetic screens and enable accurate models of human 'chromosomal' diseases to be generated.

Murine Brca1: sequence and significance for human missense mutations

We have cloned and sequenced a mouse homologue of the human breast and ovarian cancer susceptibility gene, BRCA1. The predicted mouse Brca1 protein is composed of 1812 amino acids. The murine protein is 60% identical and 72% similar to the human BRCA1 protein. Two regions of high homology have been identified between the two proteins. First is the Cys3-His-Cys4 type zinc-finger domain that is identical between the two proteins. The second region is defined by 115 amino acids near the carboxyl end of the Brca1 protein that is 83% identical to human BRCA1 sequence. Seven of eight amino acids involved in human missense mutations that are associated with the disease were found to be conserved between the two species. In contrast, most of the amino acids that are involved in polymorphic variations were not conserved. We therefore propose that the interspecies conservation of predicted amino acid sequences can be used as an additional criterion to determine the significance of human missense mutations.

Cytoskeletal control of myogenesis: a desmin null mutation blocks the myogenic pathway during embryonic stem cell differentiation

A differentiating system based on embryonic stem (ES) cell-derived embryoid bodies (EBs) which recapitulates the in vivo cardiac, skeletal, and smooth muscle myogenesis of mouse embryos was developed and used to investigate the effects of the disruption of the desmin gene on muscle cell differentiation. Wild-type, heterozygous, and homozygous cell lines with the mutated desmin allele were evaluated. Skeletal myogenesis was totally inhibited in desmin null mutant EBs, as manifested by the absence of myotube formation, contractility, and myoD, myogenin, myf5, and myosin heavy chain expression. Smooth muscle formation was also completely blocked in the absence of desmin. On the other hand, there were no obvious effects on cardiomyocyte differentiation in these desmin null mutant EBs. However, reduced desmin expression in EBs heterozygous for the desmin mutation leads to partial inhibition of cardiac muscle formation. These data suggest that in contrast to early cardiocyte differentiation, desmin is indispensable for skeletal and smooth muscle formation.

Outcomes of hand surgery. British Society for Surgery of the Hand

The findings are presented of a conference on Outcomes of Hand Surgery organized by the audit committee of British Society for Surgery of the Hand in 1993. Measures of outcome in terms of movement, power, sensibility, pain, activities of daily living, complications and patient satisfaction are considered, and an example of a patient evaluation measure given as an appendix.

BMP-7 is an inducer of nephrogenesis, and is also required for eye development and skeletal patterning

Bone morphogenetic proteins (BMPs) are multifunctional growth factors originally identified by their ability to induce ectopic bone formation. To investigate the function of one of the BMPs, BMP-7, we have generated BMP-7-deficient mice using embryonic stem cell technology. BMP-7-deficient mice die shortly after birth because of poor kidney development. Histological analysis of mutant embryos at several stages of development revealed that metanephric mesenchymal cells fail to differentiate, resulting in a virtual absence of glomerulus in newborn kidneys. In situ hybridization analysis showed that the absence of BMP-7 affects the expression of molecular markers of nephrogenesis, such as Pax-2 and Wnt-4 between 12.5 and 14.5 days postcoitum (dpc). This identifies BMP-7 as an inducer of nephrogenesis. In addition, BMP-7-deficient mice have eye defects that appear to originate during lens induction. Finally, BMP-7-deficient mice also have skeletal patterning defects restricted to the rib cage, the skull, and the hindlimbs.