The practical and educational value of scleral buckling with chandelier illumination

PURPOSE

To compare the surgical results in cases of primary rhegmatogenous retinal detachments between standard scleral buckling (SSB) and scleral buckling with chandelier illumination (SBC) and to analyse the differences in SBC surgical results between an experienced ophthalmologist and inexperienced ophthalmologists.

METHODS

Consecutive surgical case series of 155 eyes that underwent scleral buckling were retrospectively reviewed and divided into four groups: SSB performed by an experienced ophthalmologist (n = 54), SBC performed by an experienced ophthalmologist (n = 52), SBC performed by inexperienced ophthalmologists (n = 40) and SSB performed by inexperienced ophthalmologists (n = 9). Then, these four groups were compared.

RESULTS

No significant differences were observed between SSB and SBC procedures both performed by the experienced ophthalmologist with regard to demographics, preoperative findings, contents of the surgery, intraoperative complications, retinal reattachment, postoperative findings and postoperative complications. Between SBC performed by the experienced ophthalmologist and SBC performed by the inexperienced ophthalmologists, no significant differences were found regarding intraoperative complications, retinal reattachment, postoperative findings and postoperative complications. Between SSB and SBC procedures both performed by the inexperienced ophthalmologist, a significant difference was found regarding intraoperative complications.

CONCLUSION

There were no significant differences in surgical results between SSB and SBC when both were performed by the experienced ophthalmologist. In addition, the surgical results were equal between the experienced ophthalmologist and the inexperienced ophthalmologist as far as SBC was concerned. Learning scleral buckling skills by using SBC is a reasonable course of action for inexperienced ophthalmologists.

Association between visual status and the frequency of laughter in older Japanese individuals: the JAGES cross-sectional study

Objective

Although the beneficial effects of laughter are abundantly reported, the physical function that is required as a premise for laughter has not been studied. The aim of this study is to investigate the association between visual status and frequency of laughter in a population-based sample of older adults.

Methods and analysis

We analysed cross-sectional data of community-dwelling independent individuals aged ≥65 years (n=19 452) in Japan. The outcomes were frequency of laughter and number of opportunities to laugh. We used multivariable logistic regression analysis with multiple imputations to investigate the association between visual status and laughter.

Results

The number of participants who laughed almost every day was 8197 (42.1%). After adjusting for individual covariates in the multivariable logistic regression analysis with multiple imputations, visual status was found to be significantly associated with the frequency of laugher and the number of opportunities to laugh (p for trend <0.01). Compare to 'normal vision', while excellent/very good vision was associated with increased frequency and number of opportunities to laugh (ORs: 1.72 and 1.25, respectively), poor vision decreased the frequency and number of opportunities to laugh (ORs: 0.86 and 0.87, respectively).

Conclusions

There is a link between visual impairment and laughter, with poor vision having a negative impact while good vision has a positive effect. Improving vision may lead to laughter promotion.

Blowout fracture-associated orbital cellulitis progressing to panophthalmitis: a case report

BACKGROUND

Parvimonas micra is known as a causative agent of chronic periodontal disease. This Gram-positive obligate anaerobic coccus was cultured from the ocular surface of blowout fracture-related orbital cellulitis progressing to panophthalmitis.

CASE PRESENTATION

The patient was a woman in her fifties who had panic disorder and subsequently was a victim of domestic violence. These factors led to delayed consultation. At the initial visit to an ophthalmologist, the ocular surface of the right eye was covered with pus. Swelling of the upper and lower eyelids prevented the eyelid from closing and exophthalmos, severe corneal ulcer, panophthalmitis, and no light perception were observed. Head computed tomography revealed an old blowout fracture and chronic sinusitis with orbital cellulitis. P. micra were isolated from culture of pus samples from the sinus and from the ocular surface.

CONCLUSIONS

There is a possibility that P. micra invaded the orbit via the fragile bony site and caused orbital cellulitis, severe corneal ulcer, and panophthalmitis that required enucleation. In cases of coexisting old blowout fracture and chronic sinusitis, the chronic sinusitis should be treated as quickly as possible.

Is social participation associated with good self-rated health among visually impaired older adults?: the JAGES cross-sectional study

Background

While it has been recognized that visual impairment is associated with poor self-rated health (SRH), in addition to various negative health outcomes of visual impairment, the number of older adults with visual impairment is increasing due to population aging. As increasing evidence has been found for the effectiveness of social participation on good SRH, we examined whether there was an association between social participation and SRH and investigated whether the effect differed by visual status.

Methods

Questionnaire data on self-reported visual status, social participation, socioeconomic status, and SRH were obtained in 2016. A total of 24,313 community-dwelling individuals aged 65 and over participated. We examined the association of social participation and SRH status among older adults with visual impairment. Stratified analysis and analysis with an interaction term between social participation and visual status were also conducted. Social participation was assessed by the number of participating groups (no participation, one, two, and three or more).

Results

Overall visual impairment prevalence was 9.3% (95% CI: 8.9–9.7). Among those with and without visual impairment, prevalence of poor SRH was 38.4 and 13.1%, respectively. However, the association between social participation with SRH was similar, especially for those who participated in one or two groups. For people with (PR = 0.54) and without visual impairment (PR = 0.50), those who participated in two groups showed lower prevalence ratios for poor SRH compared to people without social participation.

Conclusion

Social participation showed a beneficial association with SRH among older adults with visual impairment. Future interventions could focus on the potentially positive role of social participation on SRH among older adults with visual impairment.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02554-7.

Prevalence and factors associated with uncorrected presbyopia in a rural population of Japan: the Locomotive Syndrome and Health Outcome in Aizu Cohort Study

PURPOSE

To investigate the prevalence and factors associated with uncorrected presbyopia among rural community dwellers in Japan.

STUDY DESIGN

A population-based cross-sectional study was conducted in 2011 among community dwellers aged 40-74 years who received specific health checkups in Minamiaizu and Tadami, Fukushima Prefecture, Japan.

METHODS

Uncorrected presbyopia was considered as when the distance-corrected visual acuity in the better eye was ≥0.5 and the near-presenting visual acuity in the better eye was <0.4, regardless of distance refractive status. Multiple logistic regression analysis was employed to calculate the odds ratios (ORs) for uncorrected presbyopia and to adjust for possible confounders.

RESULTS

A total of 2054 individuals participated in the specific health checkups. In the 1156 individuals (response rate: 56.28%) analyzed in the study, the mean (SD) age was 63.0 (8.7) years, the percentage of women was higher (57.87%), and the prevalence of uncorrected presbyopia was 26.38% (95% CI 23.86%-29.03%). Multivariate analysis revealed that the factors associated with uncorrected presbyopia were older age (adjusted OR: 1.054 [95% CI: 1.034-1.075]), female sex (adjusted OR: 1.388 [95% CI: 1.006-1.915]), and distance-presenting vision impairment (adjusted OR: 2.651 [95% CI: 1.697-4.143]).

CONCLUSION

Approximately one-quarter of the participants in this study from a rural population of Japan did not have adequate near vision. It is recommended that a public health intervention should be enacted to correct presbyopia, especially in the older age group, women, and those with uncorrected refractive errors.

ELISA with recombinant rKRP42 antigen using urine samples: a tool for predicting clinical visceral leishmaniasis cases and its outbreak

We reported a highly sensitive and specific enzyme-linked immunosorbent assay (ELISA) that detects immunoglobulin G (IgG) in urine using rKRP42 antigen for the diagnosis of visceral leishmaniasis (VL). The ELISA was applied to study chronological change in antibody titers in five study areas in Rajshahi district, Bangladesh. A total of 585 subjects without a past VL history were examined at least three times in the 30-month follow-up period; of these subjects, 137 (23.4%) subjects became ELISA-positive at least one time during the study. Among the positive cases, 40 (29.2%) subjects developed clinical VL, and 31 (77.5%) of these subjects showed IgG titers of ≥ 1,000 U more than one time in the study period. Considering only the first ELISA results, 22 subjects with IgG titers of ≥ 1,000 U could be found, and 21 (95.5%) of these subjects turned out to be clinical cases. The high urinary IgG titers (≥ 1,000 U) will help predict possible clinical VL cases and thus, identify an outbreak in its earlier stage.

[Towards the elimination of onchocerciasis at the global scale: history, challenges and future prospects]

The total number of patients with onchocerciasis on the African continent was estimated in 2008 at 25720000. The control strategy for onchocerciasis has dramatically changed during the last 30 years, resulting in a decrease of patients. Vector control was mainly used until around 1990. Since then, the strategy has been transferred to "Mass Drug Administration using Ivermectin". An "Integrated Approach" for several endemic diseases has become a popular control strategy since 2005. Several tasks remain for eliminating onchocerciais: improvement of the population coverage of drug distribution, construction of monitoring systems to inspect the emergence of drug resistance, invention of anti-macrofilarial drugs to replace anti-microfilarial drugs, and reinforcement of the health authorities in African countries. The possible elimination of onchocerciasis also depends on the continued political commitment to the program by the Ministry of Health. If the ongoing control program keeps producing results at the current pace, the elimination of onchocerciasis could be achieved in the near future.

Enzyme-linked immunosorbent assay to detect urinary antibody against recombinant rKRP42 antigen made from Leishmania donovani for the diagnosis of visceral leishmaniasis

We recently reported the production of the recombinant kinesin-related protein of Leishmania donovani with a molecular weight of 42 kd (rKRP42) and the value of the antigen in serum-based ELISA for the diagnosis of visceral leishmaniasis (VL). In this study, the rKRP42 antigen was validated with ELISA using urine samples (rKRP42 urine ELISA). The urine-based ELISA showed 94% sensitivity (108 positives among 115 VL samples) and 99.6% specificity (239 negatives among 240 non-VL samples). The sensitivity and specificity are almost similar to our previous results by ELISA with acetone-treated L. donovani promastigote antigen and direct agglutination test, both methods being done by use of urine samples. A comparison of the rKRP42 urine ELISA with the commercially available urinary antigen detection kit (KAtex) using 108 VL samples showed much higher sensitivity of the ELISA (96.3%) than KAtex (55.6%). The use of the rKRP42 antigen with urine samples will facilitate epidemiologic studies.

Cell-differentiation rules that generate regular mosaic patterns: modelling motivated by cone mosaic formation in fish retina

We study characteristics of cell-differentiation rules that realize stable formation of regularly arranged checker-board patterns, exemplified by cone "mosaic" zebrafish retina, or the regular arrangement of cone photoreceptor cells. We consider the situation in which cells are arranged on a square lattice and are initially undifferentiated. Later each cell becomes one of the two differentiated states, affected by the state of the neighboring cells. The cells that undergo differentiation form a "morphogenetic cell row" which sweeps from one end to the other end of the lattice through time. This models an outward sweep of the margin of expanding mosaic region of the retina which occurs as undifferentiated photoreceptor cells become differentiated in concentric circles, joining the mosaic. We introduce an index to measure the ability of cell-differentiation rules to generate regular checker-board patterns from irregular initial patterns, and attempt to characterize the successful rules. We first show the importance of six "preservation conditions" which guarantee perfectly regular photoreceptor arrangement for all the rows after a regular row. Then we select an additional six "optimizing conditions" for responses to configuration that are consistently shown by the rules of high average scores. We also examine the effect of interaction between responses to different configurations. Finally we examine the concept of morphogenetic row precedence, i.e. that the successful rules generating a high score tend to treat the consistency with neighbors in the newly differentiated cells (those in the morphogenetic cell row) as more important that the consistency with previously differentiated neighbors.

Serum amino acids in hepatic encephalopathy--effects of branched chain amino acid infusion on serum aminogram

Encephalopathic patients with cirrhosis of the liver consistently showed elevated levels of the aromatic amino acids, phenylalanine, tyrosine and free tryptophan as well as methionine in serum, whereas levels of the branched chain amino acids, valine, leucine and isoleucine, were depressed. Comatose patients with fulminant hepatitis had markedly elevated levels of all amino acids, the results being greatly different from those of cirrhotic patients. Molar ratios of (valine + leucine + isoleucine)/(phenylalanine + tyrosine) decreased both in cirrhotics with and without encephalopathy and in cases with fulminant hepatitis. Infusion of a commercially available L-amino acid solution in a cirrhotic patient induced a strikingly abnormal aminogram documented in hepatic encephalopathy. Therefore, effects of branched chain amino acid infusion on the deranged amino acid pattern were primarily studied for the purpose of improvement in hepatic encephalopathy by normalization of serum amino acid patterns. Elevated levels of the aromatic amino acids and methionine could be apparently depressed in a cirrhotic patient by this type of infusion but not in a case of fulminant hepatitis probably because of the poor utilization of these amino acids in severely impaired liver.

Undifferentiated patterns of key carbohydrate-metabolizing enzymes in injured livers. II. Human viral hepatitis and cirrhosis of the liver

Activities of key carbohydrate-metabolizing enzymes were determined on biopsied liver tissues obtained from patients with acute and chronic viral hepatitis and postnecrotic cirrhosis of the liver. The results indicated that the activities of fetal or prototype enzymes, low-Km hexokinases, glucose-6-phosphate dehydrogenase and pyruvate kinase type M2 increased, while those of adult type liver enzymes, glucokinase, glucose-6-phosphatase, fructose-1, 6-diphosphatase and pyruvate kinase type L decreased in livers of these cases. Phosphofructokinase activity tended to increase only acute hepatitis. Principal component analysis revealed that the enzyme patterns of acute hepatitis and liver cirrhosis were most deviated from the control and closely resembled those of hepatocellular carcinomas.

Differential effects of glucagon on induction of rat liver glucose-6-phosphate dehydrogenase by liver injury and dietary change

Glucagon effectively prevented the increase in glucose-6-phosphate dehodrogenase activity of rat liver following the administration of a glucose-casein mixture without altering the amount of the diet consumed. However, the increase of the enzyme level in carbon tetrachloride-injured rat liver was virtually insensitive to glucagon. The results obtained gave further evidence for the difference between these two induction mechanisms of glucose-6-phosphate dehydrogenase.

Undifferentiated patterns of key carbohydrate-metabolizing enzymes in injured livers. I. Acute carbon-tetrachloride intoxication of rat

In acute CCL4 intoxication of rats significantly increased activities of hepatic low-Km hexokinases, glucose-6-phosphate dehydrogenase, phosphofructokinase, aldolase A and pyruvate kinase M2 with concurrently decreased activities of glucokinase, glucose-6-phosphatase, fructose-1,6-diphosphatase, aldolase B and pyruvate kinase L were observed. The resulting enzyme pattern was apparently different from that in dietary induction. Principal component analysis revealed that the degree of enzyme deviation in the injured liver was much greater than that in the regenerating liver after partial hepatectomy and was closer to that in fetal liver or hepatoma tissue.

Prevention of dietary induction of rat liver glucose-6-phosphate dehydrogenase by cyclic adenosine 3'.5'-monophosphate and its elimination by glucose prefeeding

Glucagon, epinephrine and cyclic adenosine 3',5'-monophosphate (cyclic AMP) prevented the induction of liver glucose-6-phosphate dehydrogenase (G6PD) by refeeding a glucose-casein mixture to starved rats. The prevention by these agents occurred without any change in the amount of diet consumed. When the injection of cyclic AMP and the refeeding of glucose-casein diet were initiated simultaneously, there was an inhibiton of G6PD induction depending upon the dose and frequency of cyclic AMP administration during the period of refeeding, while when cyclic AMP was given later than 12 h of the refeeding, the lag period for induction of this enzyme, there was no preventive effect. A glucose prefeeding was also found to counteract the inhibitory effect of cyclic AMP on G6PD induction by the subsequent glucose-casein refeeding. The present data together with the elimination of actinomycin D effect by the glucose prefeeding suggest that the inhibitory effect of cyclic AMP on the induction of G6PD dehydrogenase is exerted at the level of transcription.

Undifferentiated patterns of key glycolytic and gluconeogenic enzymes in epithelial cell lines derived from rat liver

Established epithelial cell lines derived from livers of 7-day (B, B-R, B-3-4-7, J-C-1, J-C-13, J-5-2-1, E-C-4 and E-C-7) and adult (AL-2, AL-3, AL-4, AL-5 and AL-6) rats were analyzed for hexokinase (HK), pyruvate kinase (PK), glucose 6-phosphate dehydrogenase (G6PD), 6-phosphogluconate dehydrogenase (6PGD), glucose 6-phosphatase (G6Pase) and fructose 1,6-diphosphatase (FDPase). None of the cell lines showed appreciable activities of adult type liver enzymes (HK Type IVs (glucokinase), PK Type L, G6Pase and FDPase). On the contrary, the activities of fetal type liver enzymes (HK Types I and II, PK Type M2 and G6PD) increased markedly as compared with dispersed cells or tissues of adult liver. 6PGD gave minimum changes in activity, and the 6PGD/G6PD ratio decreased consistently. HK Type III was found only in J-C-13, AL-5 and AL-6, while HK Type IVf (high Km) was present in all the cell lines examined. Possible explanations for the undifferentiated patterns of carbohydrate-metabolizing enzymes in the established cell lines, which have several evidence of hepatocyte origin, are presented.