Exploratory open-label clinical study to determine the S-588410 cancer peptide vaccine-induced tumor-infiltrating lymphocytes and changes in the tumor microenvironment in esophageal cancer patients

Cancer vaccines induce cancer-specific T-cells capable of eradicating cancer cells. The impact of cancer peptide vaccines (CPV) on the tumor microenvironment (TME) remains unclear. S-588410 is a CPV comprising five human leukocyte antigen (HLA)-A*24:02-restricted peptides derived from five cancer testis antigens, DEPDC1, MPHOSPH1, URLC10, CDCA1 and KOC1, which are overexpressed in esophageal cancer. This exploratory study investigated the immunologic mechanism of action of subcutaneous S-588410 emulsified with MONTANIDE ISA51VG adjuvant (median: 5 doses) by analyzing the expression of immune-related molecules, cytotoxic T-lymphocyte (CTL) response and T-lymphocytes bearing peptide-specific T-cell receptor (TCR) sequencing in tumor tissue or blood samples from 15 participants with HLA-A*24:02-positive esophageal cancer. Densities of CD8+, CD8+ Granzyme B+, CD8+ programmed death-1-positive (PD-1+) and programmed death-ligand 1-positive (PD-L1+) cells were higher in post- versus pre-vaccination tumor tissue. CTL response was induced in all patients for at least one of five peptides. The same sequences of peptide-specific TCRs were identified in post-vaccination T-lymphocytes derived from both tumor tissue and blood, suggesting that functional peptide-specific CTLs infiltrate tumor tissue after vaccination. Twelve (80%) participants had treatment-related adverse events (AEs). Injection site reaction was the most frequently reported AE (grade 1, n = 1; grade 2, n = 11). In conclusion, S-588410 induces a tumor immune response in esophageal cancer. Induction of CD8+ PD-1+ tumor-infiltrating lymphocytes and PD-L1 expression in the TME by vaccination suggests S-588410 in combination with anti-PD-(L)1 antibodies may offer a clinically useful therapy.Trial registration UMIN-CTR registration identifier: UMIN000023324.

Proton pump inhibitor after endoscopic resection for esophageal squamous cell cancer: multicenter prospective randomized controlled trial

BACKGROUND

Whether proton pump inhibitors (PPIs) relieve heartburn or precordial pain after endoscopic resection (ER) for esophageal squamous cell carcinoma (ESCC) remains unclear. The aim of this study was to investigate the efficacy of PPI therapy for these symptoms after ER for ESCC.

METHODS

We conducted a multicenter prospective randomized controlled trial among 15 hospitals in Japan. In total, 229 patients with cT1a ESCC were randomly assigned to receive PPI therapy for 5 weeks after ER (the PPI group, n = 115) or follow-up without PPI therapy (the non-PPI group, n = 114). The primary end point was the incidence of gastroesophageal reflux disease (GERD)-like symptoms after ER from a self-reported questionnaire (Frequency Scale for Symptoms of GERD). Secondary end points were ulcer healing rate at 5 weeks, incidence of pain, improvement rate of symptoms in those who started PPI therapy because of GERD-like symptoms in the non-PPI group, and adverse events.

RESULTS

No significant difference was observed in the incidence of GERD-like symptoms after ER between the non-PPI and PPI groups (30 % vs 34 %, respectively). No significant differences were observed in the ulcer healing rate at 5 weeks (84 % vs 85 %) and incidence of pain within 1 week (36 % vs 45 %). In nine of ten patients (90 %) who started PPI therapy because of GERD-like symptoms in the non-PPI group, PPI administration relieved GERD-like symptoms. No adverse events related to PPI administration were observed.

CONCLUSION

PPI therapy is not efficacious in reducing symptoms and did not promote healing of ulcers in patients undergoing ER for ESCC.

Social support and enhanced suppression of adrenocorticotropic hormone and cortisol responses to hypothalamic-pituitary-adrenal function and thyrotropin-releasing hormone tests in patients with major depressive disorder

The results of the thyrotropin-releasing hormone (TRH) stimulation test and the combined dexamethasone/corticotropin-releasing hormone (DEX/CRH) test are believed to correlate with social support status in patients with major depressive disorder. We studied 41 consecutive patients hospitalized for major depressive disorder and tested their responses to DEX/CRH and TRH on hospital days 4-7. DeltaMAX TSH and DeltaMAX cortisol were measured. Multiple regression analysis found that social support questionnaire (SSQ-A) and SSQ-B scores were significantly related to DeltaMAX cortisol and DeltaMAX TSH, respectively, at the time of admission. Social support might contribute partially to the TRH and DEX/CRH test results in patients with major depressive disorder.

Enhanced suppression of adrenocorticotropic hormone and cortisol responses to hypothalamic-pituitary-adrenal function and thyrotropin-releasing hormone tests after stressful life events in patients with major depressive disorder

BACKGROUND

It is commonly believed that there exists a relationship between the outcome of thyrotropin-releasing hormone (TRH) test, the combined dexamethasone/corticotropin-releasing hormone (DEX/CRH) test and stressful life events (SLEs) in major depressive disorder.

OBJECTIVE

SLEs influence the TRH and DEX/CRH tests in major depressive disorder when administered at the time of admission and improvement.

METHODS

The TRH and DEX/CRH tests were administered to patients hospitalized for major depressive disorders - on the 4th through the 7th hospital day and at the time of improvement. We measured DeltaMAX TSH, DeltaMAX ACTH, ACTH AUC, DeltaMAX cortisol, cortisol AUC, DeltaMAX ACTH/DeltaMAX TSH and DeltaMAX cortisol/DeltaMAX TSH.

RESULTS

SLEs were significantly negatively associated with DeltaMAX ACTH, ACTH AUC and cortisol AUC at the time of admission. However, these relationships lost significance at the time of improvement. The sample (41 patients at the time of admission, 18 patients at the time of improvement) was relatively small, which may have contributed to false-negative results.

CONCLUSION

SLEs may be negatively associated with the outcome of the DEX/CRH tests in major depressive disorder. The hypothalamic-pituitary-adrenal axis in the DEX/CRH test was modulated by SLEs.

Serotonin syndrome in a case of depression with various somatic symptoms: the difficulty in differential diagnosis

A 65-year-old female patient with major depressive disorder suffered from clonus, shivering and impaired visual acuity after 20 mg/day of paroxetine administration. The symptoms were initially regarded as further manifestations of her somatic symptoms of depression, and paroxetine was increased to 30 mg/day resulting in frequent clonus, increased shivering, serious dysarthria, ongoing impairment in visual acuity and agitation. These symptoms subsided upon paroxetine discontinuation. Ten mg/day of paroxetine rechallenge provoked dysarthria, tremor and headache, but these symptoms improved again upon paroxetine discontinuation. These findings indicate that the patient's symptoms were not somatic in origin but were in fact the symptoms of serotonin syndrome. In conclusion, the present case suggests the difficulty in diagnosing serotonin syndrome in a patient with somatic symptoms.

380 FULL-TERM DEVELOPMENT OF MOUSE EMBRYOS PRODUCED FROM RECONSTRUCTED GIANT OOCYTES BY INTRACYTOPLASMIC SPERM HEAD INJECTION

In mammals, unusually large diploid giant oocytes are ovulated occasionally, but as any fertilized embryos would be triploid, the potential of the cytoplasm to support normal development is unknown. However, if such giant oocytes possess normal cytoplasm, the oocytes or their excessive cytoplasm would have potential applications in the treatment of human infertility and would enhance the study of basic biology, such as the influence of cytoplasmic factors on genomic reprogramming. We reconstructed oocytes 2 to 9 times normal volume by electrofusion or mechanical fusion between intact and enucleated oocytes. First, we examined the in vitro developmental potential of 2- to 9-times giant oocytes after parthenogenetic activation. Second, 2-times giant oocytes were reconstructed by fusing with intact and enucleated oocytes; then we examined the in vitro and in vivo developmental potential of these giant oocytes after intracytoplasmic sperm injection (ICSI). Third, somatic cell nuclear transfer (SCNT) was carried out using enucleated giant oocytes. When the giant oocytes were activated parthenogenetically, most developed into morulae or blastocysts, irrespective of the original size. When sperm heads were injected into 2-times giant oocytes, these were fertilized and developed normally in vitro; after embryo transfer, we obtained 12 healthy offspring (3 female, 3 male, and 6 cannibalized the next day) by Caesarian section. All survivors grew to adulthood and demonstrated normal fertility. However, we failed to generate cloned mice by SCNT. In conclusion, reconstructed giant oocytes have normal potential for development after activation and fertilization. The reconstructed giant oocytes will provide us with interesting tools for basic biology, such as providing new material for the study of nuclear reprogramming and genomic imprinting, and may be important in widening the treatment options in human assisted reproductive technology.

27 CYTOPLASM OF A GERMINAL VESICLE OOCYTE CAN PROMOTE SOMATIC NUCLEAR REPROGRAMMING IN MICE

A number of studies have shown that epigenetic reprogramming is severely deficient in cloned embryos, the majority of which exhibit histone hypermethylation. Xenopus geminal vesicle (GV) oocytes have been reported to have a DNA demethylating activity (Simonsson and Gurdon 2004 Nat. Cell Biol. 6, 984–990). In an attempt to develop a new method for erasing or reprogramming the epigenetic status of the donor cell prior to nuclear transfer, we examined whether the mammalian GV oocyte cytoplasm can demethylate H3-K9 of somatic cell nuclei and improve the quality of reconstructed embryos. In the first series of experiments, cumulus nuclei were injected into enucleated GV oocytes and cultured for various times, 0 h, 3 h, 7 h, 9 h, 11 h, and 16 h, before examining the chromosome morphology of somatic nuclei together with Me-H3-K9. In the second series of experiments, permeabilized cumulus cells were immersed with GV oocyte extract and injected into enucleated MII oocytes. These reconstructed oocytes were activated and cultured until the blastocyst stage. Preparation of oocyte extracts was as follows: 200 GV oocytes were collected and zonae pellucidae removed using Tyrode's solution. These zona-free oocytes were broken down in 5 �L of HEPES medium containing the ATP-generating system (1 mM ATP, 10 mM creatine phosphate, 25 �g mL-1 creatine kinase, 100 �M GTP). Permeabilized cumulus was incubated in oocyte extract for 45 min at 37�C. The demethylation of H3-K9 was analyzed in nuclear transfer embryos at the pronucleus, 2-cell, 8-cell, morula, and blastocyst stages. In 2 experiments, we examined a total of 234 enucleated GV oocytes and 358 enucleated MII oocytes. The results of first experiment showed that histone H3-K9 begins demethylation in the somatic chromosome 1 h after injection into GV oocytes (90%) and, importantly, this state was maintained until the MII-like stage. The donor somatic chromosomes in the enucleated GV oocyte can condense and undergo stages GVI (0–3 h), MI (7 h), and AI-TI (9–11 h), and the MII (16 h)-like stage. These results clearly show that enucleated GV oocytes can carry out spindle assembly and extrude the first polar body. However, some of these chromosomes are located not only on the metaphase plate of the spindle but also on spindle poles or dispersed on the spindle. In the second experiment, reconstructed embryos with GV extract-treated somatic cells showed a strong H3-K9 demethylation that was significantly different to nontreated somatic cells at the blastocyst stage. The demethylation was expressed at a rate comparable to that observed in ICSI embryos. Although there was no increase in the frequency of development at the blastocyst stage, we found an increase in cell number at the blastocyst stage. Our findings show that the GV oocyte cytoplasm has the ability to erase methylation of H3-K9 in somatic nuclei, which suggests that the incorporation of GV mammalian oocyte components may contribute to the reprogramming of somatic cell nuclei.

66 SUCCESSFUL ESTABLISHMENT OF PLURIPOTENT ntES CELL LINES FROM AGED MICE

Nuclear transfer technique has enabled us to produce cloned animals from somatic cell nuclei in various animal species to date. Moreover, it has been demonstrated that ES cell lines have been established from cloned blastocysts by somatic cell nuclear transfer (ntES cell), irrespective of sex, strains, or organs. These cells are capable of differentiating into all 3 germ layers in vitro, or even into spermatozoa and oocytes in chimeric mice. So ntES cells have gotten a lot of attention recently in the field of regenerative medicine. However, it is unclear whether ntES cells can be established from aged individuals because, in general, the cloning success rate was higher when young donor cells were used, such as fetus cells rather than adult. To answer this question, we tried to establish ntES cell lines from aged mice and then examined their pluripotency. The donor cells were obtained from tail-tip fibroblast cells of 11-month-old to 15-month-old male and female mice. After nuclear transfer, we succeeded in establishing 8 ntES cell lines from 3 aged BDF1 males and 6 ntES cell lines from 2 aged BCF1 females. The normality of these ntES cell lines was examined after passages 5 times. Karyotypes were analyzed using SKY-Fish painting, and pluripotency was examined by chimeric mice formation, in which ntES cells were injected into fertilized ICR blastocysts. As a result, most of the ntES cell lines examined had normal karyotypes, and all of the ntES cell lines tested could contribute to somatic cells of chimeric mice. Now we are examining whether these ntES cells have germ line transmission ability in chimeric mice by natural mating.

95 OBSERVATION OF CHROMOSOME DECONDENSATION, HISTONE H3 MODIFICATION, AND HP1 PROTEIN IN MOUSE CLONED EMBRYOS FOLLOWING INHIBITION OF HISTONE DEACETYLATIONS AND CYCLIN-DEPENDENT KINASE

Low chromosome decondensation and hypoacetylation and hypermethylation of histones characterize the incomplete reprogramming of cloned embryos during the first mitotic prophase. Our study looks at the effect of histone deacetylase inhibitors (HDACi), Trichostatin A (TSA), APHA Compound 8 (APHA), and cyclin-dependent kinase inhibitor (CDKi) roscovitin (ROS), on nuclear reprogramming in cloned mouse embryos during the first mitotic prophase. Oocytes were collected from female B6D2F1 mouse cumulus cells collected from female B6D2F1 and ICR, and fibroblasts from male GFP-ICR. We performed somatic cell nuclear transfer (SCNT) using a piezo-actuated micromanipulator system; the SCNT oocytes were subsequently activated for 6 h with 5 mM SrCl2 in Ca2+-free CZB medium (CZB) supplemented individually with 100 nM TSA, 250 nM APHA, or 100 nM ROS or in combination with TSA+ROS or APHA+ROS. Activated SCNT embryos were then cultured in KSOM medium with the same concentrations of TSA, APHA, ROS, TSA+ROS, or APHA+ROS for 2 h. Following treatment, we cultured the cloned embryos in KSOM for in vitro development. In the first experiment, the levels of chromosome decondensation during the first mitotic prophase in these cloned embryos were performed, based on the ratio of nuclear volume, at 6 h and 10 h after activation. We calculated the average nuclear volume � SD for each treatment, and these were subsequently compared to control values (100%, without treatment). We next turned to examining the intensity of methyl H3-K9, acetyl H3-K9, and HP1β of cloned embryos at 6 h and 10 h after activation by immunostaining. Images of immunostained embryo nuclei were acquired using an OLYMPUS Fluoview FV 1000 confocal system. The distribution of fluorescence intensities from 5 different regions of the nucleus were determined using Fluoview FV 1.4a software. Student's t-test was used to calculate the significance of differences between groups in the experiment. We repeated each experiment 4 times to obtain 40 nuclear transfer embryos per treatment. The present results show that global histone hyperacetylation and hypomethylation can be characterized by an increase in H3-K9 acetylation and a decrease in H3-K9 methylation in the presence of HDAC inhibitors. The levels of all isoforms of HP1β, however, were not reduced following inhibition of HDAC. This was in contrast to the high decondensation observed in interphase chromatin, leading to a significant increase of pronuclear volumes and a decrease in H3-K9 methylation in cloned embryos in the presence of ROS, although we were unable to obtain hyperacetylation and HP1β did not change. From these results, we conclude that the combined inhibition of histone deacetylases and cyclin-dependent kinase for 8 h following NT caused an increase in somatic chromosome decondensation, hyperacetylation, and demethylation of histone H3-K9 during the first mitotic cell cycle in cloned mouse embryos. Our findings strongly suggest that there is no correlation of HP1β involved in hyperacetylation and demethylation of H3-K9.

54 SUCCESS OF MOUSE CLONING FROM AN OUTBRED STRAIN BY TRICHOSTATIN A TREATMENT AFTER SOMATIC NUCLEAR TRANSFER

Although the somatic cloning technique has been used for numerous applications and basic research of reprogramming in various species, the extremely low success rates have plagued this technique for a decade. Further, in mice, the clonable strains have been limited mainly to the hybrid F1 strains such as B6D2F1. Recently, we have reported a new efficient cloning technique using trichostatin A (TSA) where reconstructed oocytes are activated by 5 mM strontium with 5 nM TSA for 6 h, followed by 3 h of culture in KSOM medium containing the same concentration of TSA. After the TSA treatment, cloned embryos were cultured in KSOM medium without TSA. This TSA treatment leads to a 2–5-fold increase in success rates for mouse cloning of B6D2F1 cumulus cells. In this study, to further test the validity of this TSA cloning technique, we tried to clone the adult ICR mouse, an outbred strain, which has never been directly cloned before. Only when TSA was used did we obtain both male and female cloned mice from cumulus and fibroblast cells of adult ICR mice with 4–5% success rates, which is comparable to 6–7% of B6D2F1. Thus, the TSA cloning technique now allows us to successfully clone outbred mice, demonstrating that this technique not only improves the success rates of cloning from the hybrid strains but also enables mouse cloning from normally unclonable strains. Further, our results provide insight into the mechanism underlying why only limited strains can be cloned using the current standard cloning technique.

139 INJECTION OF SOMATIC CELL CYTOPLASM INTO OOCYTES BEFORE ICSI IMPAIRED FULL-TERM DEVELOPMENT AND INCREASED PLACENTA WEIGHT IN MICE

During the process of somatic cell nuclear transfer, cytoplasm is introduced into the enucleated oocytes, in addition to the genomic material, regardless of the electrofusion methods (Wilmut et al. 1997) or direct injection of somatic nucleus by the Honolulu method (Wakayama et al. 1998). Only 1 to 2% of cloned embryos, however, develop to term with many incidences of developmental anomalies. These cloning failures may be explained by incomplete reprogramming of the donor cell genome, although it is not yet clear whether cytoplasmic materials of the somatic cell also have an affect on development of the cloned embryo. In an attempt to answer this question, this study investigates the effects of somatic cytoplasm of different mouse strains and cytoplasm of fertilized embryos at different stage by injecting them into intact mouse oocytes before intracytoplasmic sperm injection (ICSI). Mature oocytes collected from B6D2F1 female after 14 to 16 h of hCG injection were injected with (1) B6D2F1 cumulus cell cytoplasm with different volumes (collected by 2 to 3 �m of injection pipette and piezo pulses), (2) cumulus cell cytoplasm from different mouse strains (B6D2F1, ICR, C57BL/6), (3) cytoplasm of 1- to 8-cell embryos. After subsequent culture for 1 h, B6D2F1 sperm were injected into those oocytes and examined for preimplantation developmental competence. The total number of cells, inner cell mass (ICM), and expression of Oct4 in expanded blastocysts were also examined. In order to examine the effects of somatic cytoplasm on full-term development, we transferred 2-cell embryos at 24 h or morula and blastocysts at 72 h after ICSI to the oviduct or uterus of surrogate mothers (ICR) on Day 1 or 3 of pseudopregnancy. The control group received a sham injection with PVP before ICSI. The results showed that an increase the volume of cytoplasm from 1-fold to 4-fold (equivalent with the volume of 1 cumulus cell) resulted in impairing full-term development (28 and 7%, respectively, vs. 56 to 63% in the control group, P < 0.01). There was no difference in the frequency of embryos developing to the blastocyts stage between B6D2F1 and ICR somatic cytoplasms at the same volume. However, C57BL/6 somatic cytoplasm induced the 2-cell block to B6D2F2 embryos. Fertilized embryo cytoplasm did not reduce the frequency of blastocyst stage and full-term development. Interestingly, we found that somatic cytoplasm increased the placenta weight of ICSI embryo (0.2002 � 0.03, n = 32; vs. 0.1198 � 0.02 in control group, n = 87; P < 0.01). We also obtained placenta with no fetus when the volume of somatic cytoplasm was the same size as cumulus cell. We found that an increase in the volume of somatic cytoplasm led to low expression of Oct4 in expanded blastocysts. These findings indicated that injection of somatic cytoplasm into oocytes before ICSI decreased the preimplantation development, clearly impaired full-term development, and caused placental overgrowth in fertilized embryos. This study suggested that somatic cell cytoplasmic material is one cause of the low rate of full-term development of cloned animals.

Serum prorenin levels and diabetic retinopathy in type 2 diabetes: new method to measure serum level of prorenin using antibody activating direct kinetic assay

AIM

To investigate the serum levels of prorenin and its correlation with the severity of diabetic retinopathy (DR).

METHODS

248 patients with diabetes and 108 control subjects were divided into four groups: no-DR (n = 146), no proliferative diabetic retinopathy (no-PDR) (n = 78), PDR (n = 24), and controls (n = 108). Serum levels of prorenin from all subjects were measured using the new antibody activating direct kinetic (AAD-PR) assay. The serum prorenin levels were compared among the groups.

RESULTS

The serum levels of prorenin in the control, no-DR, no-PDR, and PDR groups, respectively, were 109.1 (66.1), 194.6 (160.4), 271.5 (220.3), and 428.4 (358.4) pg/ml (mean (SD)). Prorenin in the PDR group was remarkably high compared with the control and no-DR groups (p<0.0001) and with the no-PDR group (p = 0.002). Serum levels of prorenin increased with increasingly severe retinopathy. No correlation was found between the prorenin level and the duration of disease or HbA(1c).

CONCLUSIONS

The serum levels of prorenin in patients with PDR were found to be markedly high using the AAD-PR assay. Increased levels of prorenin in diabetes may have an important role in the pathogenesis of DR.

Peroxynitrite decomposition catalyst, FP15, and poly(ADP-ribose) polymerase inhibitor, PJ34, inhibit leukocyte entrapment in the retinal microcirculation of diabetic rats

PURPOSE

Oxidative and nitrosative stress and activation of poly(ADP ribose) polymerase (PARP) play a role in the pathogenesis of diabetic complications. We evaluated the effectiveness of the peroxynitrite decomposition catalyst, FP15, and the PARP inhibitor, PJ34, in the treatment of leukocyte entrapment in the retinal microcirculation of diabetic rats.

METHODS

Diabetes was induced in rats by intraperitoneal injection of 60 mg/kg of streptozotocin. Rats were divided into four groups: controls; untreated diabetes; diabetes treated with FP15 (10 mg/kg oral gavage twice daily) and diabetes treated with PJ34 (10 mg/kg oral gavage twice daily). All experiments were performed 4 weeks after initiation of treatment. Leukocyte entrapment in the retinal microcirculation was quantitatively evaluated in vivo with acridine orange digital fluorography.

RESULTS

The density of leukocytes trapped in the retinal microcirculation 30 minutes after dye injection was significantly greater in untreated diabetes (32.1 +/- 4.7 cells/mm2) than in controls (11.3 +/- 4.5 cells/mm2) (p < 0.05). Compared with untreated diabetes, the density of trapped leukocytes significantly decreased in diabetes treated with FP15 (14.5 +/- 5.1 cells/mm2) (p < 0.0001) and diabetes treated with PJ34 (24.1 +/- 4.2 cells/mm2) (p < 0.05).

CONCLUSIONS

Treatment with FP15 and PJ34 decreased enhanced leukocyte entrapment in the retinal microcirculation during the early diabetic period. The current study suggests a role for peroxynitrite production and for PARP activation in the pathogenesis of retinal microvascular leukostasis in early diabetes.

Alteration of choroidal circulation in the foveal region in patients with type 2 diabetes

AIM

To investigate changes in choroidal blood flow (CBF) in the foveal region in patients with type 2 diabetes.

METHODS

Laser Doppler flowmetry was used to determine the CBF in the foveal region in 70 patients with type 2 diabetes and 36 age and sex matched healthy subjects (control group). The patients were classified into three groups: 33 patients (33 eyes) with no diabetic retinopathy (NDR), 20 patients (20 eyes) with non-proliferative diabetic retinopathy and no macular oedema (NPDR/MO-), and 17 patients (17 eyes) with NPDR and MO (NPDR/MO+). Optical coherence tomography was also used to measure the foveal thickness.

RESULTS

The group averaged CBF values were 13.5 (4.9), 9.4 (2.5), 10.8 (4.8), and 5.6 (2.0) (arbitrary units) in the control, NDR, NPDR/MO-, and NPDR/MO+ groups, respectively. The group averaged CBF values in the NDR group decreased (30.2%; p<0.01) compared with the control group. The average CBF value in the NPDR/MO+ group was also significantly lower (48.2%; p<0.01) compared with that in the NPDR/MO- group.

CONCLUSION

The CBF in the foveal region significantly decreases in patients with diabetes, especially those with macular oedema.

Features of abnormal choroidal circulation in central serous chorioretinopathy

AIMS

To evaluate abnormalities in the choroidal circulation in cases of central serous chorioretinopathy (CSC).

METHODS

A complete clinical ophthalmological examination was performed using simultaneous fluorescein and indocyanine green (ICG) angiography with a confocal scanning laser ophthalmoscopy and the digital images analysed in 36 consecutive patients with acute CSC. To quantify the choroidal circulation, the foveal choroidal blood flow was measured in 11 patients using laser Doppler flowmetry.

RESULTS

Fluorescein angiography showed focal leakage from the retinal pigment epithelium in all patients. ICG angiography revealed delays in arterial filling in 27 eyes (75%), and fluorescein angiography showed small hypofluorescent points around the leakage in 27 eyes (75%). Abnormal choroidal hyperfluorescence was observed in 30 eyes (83%). The choroidal blood flow in eyes with CSC was 45% lower than in fellow eyes (p<0.01).

CONCLUSION

Decreased choroidal blood flow in CSC was demonstrated for the first time. The decreased choroidal blood flow might be correlated with the small, localised hypofluorescent areas, which may indicate non-perfused areas of the choriocapillaris that are frequently seen during ICG angiography.

Inhibitory effect of losartan, an AT1 angiotensin II receptor antagonist, on increased leucocyte entrapment in retinal microcirculation of diabetic rats

BACKGROUND

The effectiveness of losartan for the treatment of leucocyte entrapment in the retinal microcirculation of diabetic rats was evaluated quantitatively.

METHODS

After diabetes was induced by injection of streptozotocin (STZ), the rats were divided into two subgroups. The first subgroup (n = 6), received no medications; the second subgroup (n = 6) was given fresh drinking water supplemented with losartan (5 mg/kg/day) for 4 weeks. Six rats that were not injected with STZ or given medications served as controls. 4 weeks after intervention, leucocyte dynamics in the retina were observed using acridine orange digital fluorography. Leucocyte entrapment in the retina was compared among the three groups.

RESULTS

In the untreated diabetic rats, the number of trapped leucocytes (6.1 (SD 1.4) cells/mm(2)) increased significantly compared with control rats (2.8 (1.2) cells/mm(2); p = 0.005) and diabetic rats treated with losartan (3.1 (0.9) cells/mm(2); p = 0.0002).

CONCLUSIONS

Losartan, an AT1 angiotensin II receptor antagonist, inhibited increased leucocyte entrapment in the diabetic retina. The authors demonstrated that losartan may have therapeutic efficacy in preventing development of diabetic retinopathy. Further clinical studies of the effect of the angiotensin receptor antagonist on preventing development of diabetic retinopathy are needed.

Scotoma and fixation patterns using scanning laser ophthalmoscope microperimetry in patients with macular dystrophy

PURPOSE

We used scanning laser ophthalmoscope microperimetry to evaluate the retinal scotoma and the fixation points in the patients with macular dystrophy.

METHODS

We studied 10 eyes of five patients with macular dystrophy (three patients with cone dystrophy and two patients with Stargardt disease). The mean patient age was 37 years (range, 13 to 64 years). An estimation of scotoma and fixation points on the retina was performed using scanning laser ophthalmoscope microperimetry.

RESULTS

All 10 eyes (100%) had one of two types of dense scotoma: type one was a dense ring scotoma (five eyes, 50%), and type two was a dense central scotoma (five eyes, 50%) that included the center of the fovea. In all eyes with a dense ring scotoma, the fixation points were stable and did not shift. In all eyes with a dense central scotoma, the fixation shifted. The logarithm of minimal angle of resolution of the visual acuity in the eyes with the dense central scotoma was significantly worse than that of eyes with the dense ring scotoma type (P =.005).

CONCLUSIONS

Scanning laser ophthalmoscope microperimetry findings demonstrate two types of dense scotoma (dense ring scotoma and dense central scotoma) in the patients with macular dystrophy. The two types of dense scotoma affect the shifting of the fixation points and the stability of fixation and may result in the difference in visual acuity in the patients with macular dystrophy.

Usefulness of endoscopic ultrasonographic analysis of variceal hemodynamics for the treatment of esophageal varices

The correlation of between the endoscopic findings of esophageal varices and endoscopic ultrasound findings of the collaterals outside the esophageal wall in patients with portal hypertension remains unclear. We investigated the relationship between esophageal varices and the collaterals by endoscopy and endoscopic ultrasound. Moreover, we investigated the correlation between the collaterals around the esophagus and recurrence of esophageal varices in patients with portal hypertension who had undergone endoscopic injection sclerotherapy. The collaterals were divided into two groups: 1; those with peri-esophageal collateral veins (peri-ECVs) adjacent to the muscularis externa of the esophagus, and 2; those with para-esophageal collateral veins (para-ECVs) distal to the esophageal wall without contact with the muscularis externa. Peri- and para-ECVs were scored as mild or severe according to the stage of development. According to endoscopy, the varix form was significantly larger in severe peri-ECVs group than in mild peri-ECVs group. In contrast, the varix form did not differ significantly between the mild and severe para-ECVs group. The prevalence of perforating veins increased according to the varix form. With regard to variceal recurrence, in patients with variceal recurrences, EUS findings included a significantly higher incidence of severe-type peri-ECVs, a significantly larger number of perforating veins, and a significantly larger diameter of perforating veins compared with patients without recurrence. Moreover, when EUS found the abnormalities when no endoscopic recurrence was found, the results were the almost same as the findings when EUS was performed at the same time when endoscopic recurrence was found. In conclusion, the presence of severe peri-ECVs and large perforating veins in the esophageal wall strongly correlates with occurrence and recurrence of esophageal varices in patients with portal hypertension. An understanding of these EUS abnormalities on the basis of hemodynamics around the esophagus is thought to be important for management of esophageal varices in patients with portal hypertension.

Suppression of conditioned fear by administration of CCKB receptor antisense oligodeoxynucleotide into the lateral ventricle

We investigated the role of CCK in the development of anxiety by determining whether CCKB receptor antisense suppressed intracellular Ca(2+) concentration in vitro or suppressed conditioned fear stress in vivo. First, for the in vitro studies, we used rat pituitary tumor GH3 cells since these cells have CCKB receptors. GH3 cells were stimulated by 10 microM CCK-4; intracellular Ca(2+) concentration was measured. The CCKB receptor antisense at 1 or 10 microM reduced the subsequent response to 10 microM CCK-4 in a time-dependent manner. Second, for the in vivo studies, the CCKB receptor antisense, sense, random sense, or saline was infused at a constant rate for 6 days into rat lateral ventricles via mini-osmotic pumps. Individual rats were then subjected to 30 min of inescapable electric footshock in a chamber with a grid floor. Twenty-four hours later, the rat was again placed in the chamber and observed for 5 min without shocks. This study showed that CCKB receptor antisense significantly suppressed intracellular Ca(2+) concentration in GH3 cells and significantly reduced freezing behavior in rats, indicating that the CCKB receptor plays an important role in anxiety.

Branch retinal vein occlusion in a Japanese patient with neurofibromatosis 1

BACKGROUND

To report an Asian patient with branch retinal vein occlusion secondary to neurofibromatosis 1.

CASE

A 64-year-old woman presented with a loss of vision in her right eye of 9-month duration. A diagnosis of neurofibromatosis 1 was made. A general medical examination showed no abnormalities except the signs of neurofibromatosis 1.

OBSERVATIONS

Fundus examination of the right eye revealed irregularities of the venous caliber, partial sheathing of the corresponding vein and macular edema. Multiple dilated and tortuous collateral channels and an arteriovenous communication bridged the perfused and nonperfused retina. Fundus examination of the left eye showed a tortuous vein in the temporal region of the fovea. Fluorescein angiography of the right eye confirmed delayed filling in a superotemporal artery and in the corresponding vein. The temporal region of the fovea had large areas of capillary loss. The collaterals were tortuous and mimicked a neovascularization. Fluorescein angiography of the left eye confirmed that the vein in the temporal part of the fovea was tortuous and not leaking. A diagnosis of branch retinal vein occlusion of the superotemporal vein was made.

CONCLUSIONS

Neurofibromatosis 1 should be considered in the differential diagnosis of retinal vascular occlusive disease without other risk factors.

[Immunohistochemical study of idiopathic and secondary epiretinal membrane]

PURPOSE

We investigated the immunohistochemical features of surgically resected idiopathic epiretinal membranes(ERMs) and secondary ERMs with regard to posterior vitreous detachment(PVD).

METHODS

Six specimens of idiopathic epiretinal membranes(3 eyes with complete PVD, 2 eyes with partial PVD, and one eye with no PVD) and 3 specimens of secondary ERMs(all eyes with complete PVD) were immunohistochemically studied. We used type I, II, III, IV collagen and fibronectin to study extracellular components, and glial fibrillary acidic protein(GFAP), S 100 protein, vimentin, and so forth to study cellular components.

RESULTS

All the specimens of idiopathic ERMs had the major components of the lamellar stained by type II collagen antibody, and one out of 3 specimens of secondary ERMs had a minor component stained by type II collagen antibody. Compared with idiopathic ERMs with complete PVD, 2 out of 3 specimens of idiopathic ERMs with partial PVD or no PVD contained rather thick collagen lamellar.

CONCLUSION

There was difference between specimens of idiopathic ERMs and specimens of secondary ERMs in staining by type II collagen antibody, supposed by vitreous, in this study. Idiopathic ERM with attached posterior vitreous membrane may cause growth of collagen.

Inhibitory effect of losartan on laser-induced choroidal neovascularization in rats

PURPOSE

To investigate the inhibitory effects of losartan, an angiotensin receptor antagonist, on angiogenesis in a rat model of laser-induced choroidal neovascularization.

METHODS

Experimental study. Fifteen Brown-Norway male rats received losartan (approximately 5 mg/kg/d) in drinking water, and 15 Brown-Norway male rats received unsupplemented drinking water 1 week before photocoagulation, and it was continued to the end of the study. Two weeks after intense laser photocoagulation, choroidal neovascularization was evaluated by fluorescein angiography and histopathologic evaluation.

RESULTS

The incidence of choroidal neovascularization formation was 99.5 +/-.2% (mean +/- standard deviation) in controls and 72.5 +/- 8.8% in losartan-treated rats (P <.01). Quantitative morphometric assessment revealed mean choroidal neovascularization lesion thickness of 54 and 44.8 microm, respectively, in controls and losartan-treated rats (P <.01).

CONCLUSION

Losartan seems to inhibit development of laser-induced choroidal neovascularization. Angiotensin receptor antagonists may be useful as prophylaxis against choroidal neovascularization associated with age-related macular degeneration.

Stereo acuity in patients with unilateral macular hole and after unilateral macular hole surgery

PURPOSE

To investigate stereo acuity levels in patients with unilateral idiopathic macular hole and after surgical intervention.

METHODS

In 31 consecutive patients with a unilateral macular hole and 46 consecutive patients who underwent successful unilateral macular hole surgery, complete ocular examinations, including orthoptic examinations and microperimetry using the scanning laser ophthalmoscope, were performed.

RESULTS

A significantly positive correlation was found between VA and stereo acuity (r = 0.87, P < 0.01). After successful surgery, stereo acuity also correlated with the presence or absence of absolute and/or relative scotoma, and was best in eyes without scotomata. Patients with unilateral idiopathic macular hole, suppression, and symptom duration of 24 months or longer had no stereoscopic vision.

CONCLUSIONS

The results indicated that in patients with unilateral idiopathic macular hole and after surgery, stereo acuity correlated with VA. Patients with unilateral macular hole should be operated upon as early as possible, resulting in better VA and better stereo acuity.

Effect of acetazolamide on outward permeability of blood-retina barrier using differential vitreous flyorophotometry

PURPOSE

To measure fluorescein (F) and fluorescein monoglucuronide (FG) concentrations in the vitreous and evaluate the effect of acetazolamide (AZM) on the outward permeability of the blood-retina barrier (BRB) using differential vitreous fluorophotometry (DVF).

METHODS

DVF was performed 180 minutes after intravenous injection of AZM (5 mg/kg) and 50 mg of sodium fluorescein in six rabbits (AZM group). DVF also was performed in six rabbits injected intravenously with only 50 mg of sodium fluorescein (control group). The F/FG ratio was calculated based on the concentrations of F and FG obtained by DVF. DVF also was performed 180 minutes after 50 mg of intravenous injection of sodium fluorescein in five rabbits given probenecid (150 mg/kg) intraperitoneally (probenecid group).

RESULTS

The average F/FG ratio was 0.36 +/- 0.17 (range, 0.22-0.66) in the AZM group, which was significantly smaller than the control value of 0.74 +/- 0.22 (range, 0.50-1.60). The average F/FG ratio at 180 minutes after injection was 1.51 +/- 0.46 (range, 0.94-2.00) in the probenecid group, which was significant higher (p < 0.05) than that of the AZM or control group.

CONCLUSIONS

This study showed that the F/FG ratio might be a good indicator of the estimated outward permeability of the BRB using DVF and that AZM may accelerate the outward active transport function of the BRB.

Dynamic observation of selective accumulation of a photosensitizer and its photodynamic effects in rat experimental choroidal neovascularization

PURPOSE

The authors investigated the selective accumulation of a photosensitizer, ATX-S10(Na), in experimental choroidal neovascularization (CNV) in rats using a highly sensitive colorchromatic charge coupled device (CCD) camera.

METHODS

To detect the development of experimental CNV in 30 rats, the animals were followed weekly with simultaneous fluorescein and indocyanine green angiography. After injecting ATX-S10(Na), the authors detected fluorescence from the photosensitizer using a highly sensitive color CCD camera. The camera was connected to a surgical microscope, under which rat fundi were observed through a coverglass in contact with the cornea. The retinas were excited with 405-435 nm light, and the light emitted from the photosensitizer passed through a 680-nm bandpass filter before being detected by the CCD camera.

RESULTS

Immediately after injection, fluorescence appeared in the retinal vessels and then the entire retina. Thirty minutes postinjection, the intensity of the fluorescence was still strong from the whole retina, and the CNV was not detected. One hour after injection, retinal fluorescence was weak but still observable; 1.5 hours postinjection, retinal fluorescence was undetectable but fluorescence was strong from the CNV. Under the optimum therapeutic conditions, CNV was effectively occluded.

CONCLUSION

ATX-S10(Na) selectively accumulates in the CNV in rats. The optimum therapeutic timing is approximately 1.5 hours postinjection of the dye in this CNV model.

New graphics models for PC based ocular surgery simulator

High-end graphics workstations (GWS) have been used for surgical simulators utilizing Computer Graphics (CG) and Virtual Reality (VR) technologies. This is because the simulators need lots of computing power, mainly for collision detection among objects modeled as a set of polygons. In this paper, we propose to use mathematical functions to model objects for collision detection. However, for graphic display we continue to use polygonal representation. Using the new model, we have developed a PC based ocular surgery simulator, which creates realistic surgery image in real-time. The computation time was found to be much lower than that in the conventional method.

Factors affecting pulsatile ocular blood flow in normal subjects

BACKGROUND

The factors that influence pulsatile ocular blood flow (POBF) were evaluated in normal subjects.

METHODS

POBF was measured in 80 normal subjects using Langham OBF computerised tonometry. The effect of age, systolic and diastolic blood pressure, refractive error, intraocular pressure, and axial length on POBF was evaluated using multiple regression analysis.

RESULTS

The mean (SD) POBF value was 593.3 (203.6) microl/min (range 290.7-1201.6). Of all the independent variables in the model, only the axial length was statistically significant (p = 0.008). The regression coefficient was negative, indicating that the axial length decreased with increasing POBF.

CONCLUSIONS

These data suggest that, in normal subjects, the POBF decreases as axial length increases. Choroidal blood flow may decrease as the axial length increases. The axial length may therefore be a major factor affecting POBF.

Involvement of RNase G in in vivo mRNA metabolism in Escherichia coli

BACKGROUND

Escherichia coli rng gene (previously called cafA) encodes a novel RNase, named RNase G, which is involved in the 5' end-processing of 16S rRNA. In rng mutant cells, a precursor form of 16S rRNA, 16.3S rRNA, is accumulated. Here we report a role of RNase G in the in vivo mRNA metabolism.

RESULTS

We found that rng:cat mutant strains overproduced a protein of about 100 kDa. N-terminal amino acid sequencing of this protein showed that it was identical to the fermentative alcohol dehydrogenase, the product of the adhE gene located at 28 min on the E. coli genetic map. The level of adhE mRNA was significantly higher in the rng:cat mutant strain than that in its parental strain, while such differences were not seen in other genes we examined. A rifampicin-chase experiment revealed that the half-life of adhE mRNA was 2.5-fold longer in the rng:cat disruptant than in the wild-type.

CONCLUSION

These results indicate that, in addition to rRNA processing, RNase G is involved in in vivo mRNA degradation in E. coli.

Pulsatile ocular blood flow study: decreases in exudative age related macular degeneration

BACKGROUND

Pulsatile ocular blood flow (POBF) is a parameter for evaluating choroidal blood flow. POBF in the patients with non-exudative and exudative age related macular degeneration (AMD) was investigated.

METHODS

POBF, pulse amplitude (PA), systolic and diastolic blood pressures, intraocular pressure (IOP), refractive error, and axial length were compared among 10 patients with non-exudative AMD, 11 patients with exudative AMD, and 69 age matched controls. A Langham OBF computerised tonometer was used with the participants in the sitting position to measure POBF and PA.

RESULTS

No significant differences were found in age, systolic and diastolic blood pressures, IOP, or refractive error between patients with exudative and non-exudative AMD and the control subjects. In the patients with exudative AMD the POBF (median, 372.7 microl/min) and PA (median, 1.2 mm Hg) were significantly lower than in the patients with non-exudative AMD (median, 607.0 microl/min (p = 0.02) and 2.2 mm Hg (p = 0.04), respectively) and control subjects (median, 547.4 microl/min (p = 0.01) and 2.0 mm Hg (p = 0.01), respectively).

CONCLUSIONS

These data show that the POBF and PA in the patients with exudative AMD are lower than in the patients with non-exudative AMD and normal subjects. Decreased choroidal blood flow may have a role in the development of choroidal neovascularisation in AMD.

Vitreous surgery simulator

OBJECTIVE

To reduce the surgical risks to patients and expose surgeons to surgical experience and complications, we have developed a practical system of vitreous surgery using virtual-reality technology.

METHODS

The system is composed of high-resolution color stereo binoculars, haptic devices, foot switches, and a high-speed graphics computer. To simulate vitreous surgery, we created several virtual patient eyes with retinal diseases such as preretinal membranes and subretinal neovascular tissue at the fovea.

RESULTS

The simulator provided the trainees with an operating environment similar to an actual one, and allowed them to learn to maneuver surgical instruments and remove proliferative tissue on the retina, under the retina, or both. This system allowed surgeons to avoid iatrogenic complications through visual signs such as retinal hemorrhage when the instrument contacted the retinal surface.

CONCLUSIONS

This simulator may not only be suitable for residents to learn ocular surgical techniques but may also allow veteran surgeons to develop new surgical methods and skills.

Suppression of conditioned fear by administration of CRF receptor antagonist CP-154,526

In order to examine the involvement of corticotropin-releasing hormone (CRF) receptor in the formation of anxiety, we investigated whether CRF receptor antagonist CP-154,526 suppressed conditioned fear stress. First, rats were individually subjected to 30 min of footshock. Twenty-four hours after footshock, the rats were again placed in the chamber and observed for 5 min without shock. CP-154,526 was administered 30 min before placing the rats in the chamber again. After that, CP-154,526 was once more administered 30 min before applying footshock. Administration of CP-154,526 30 min both before conditioned fear stress (placing the rats inside the cage but not applying footshock) and before actual footshock significantly reduced freezing behavior. These results show that CP-154,526 blocked both the acquisition and expression of conditioned fear, thus suggesting that the CRF receptor might be related to anxiety.

Cyanide-bridge Fe-Fe and Fe-Co molecular squares: structures and electrochemistry of

Cyanide-bridged iron-iron and iron--cobalt molecular squares of [Fe(II/4)(mu-CN)4(bpy)8[(PF6)4 x 4H2O (1), [Fe(II/2)Co(II/2)(mu-CN)4(bpy)8](PF6)4 x 3CHCl3 x 2CH3CN (2), and [Fe(II/2)Co(III/2)(mu-CN)4(bpy)8](PF6)6 x 2CHCl3 x 4CH3NO2 (3) (bpy =2,2'-bipyridine) were prepared. X-ray structure analyses for 1-3 were performed and their electrochemistry was studied. In 1-3, four metal ions are bridged by cyanide groups to form tetranuclear macrocycles ("molecular squares"). Each metal ion in the square is six-coordinate: four of the coordination sites are occupied by the nitrogen atoms of two of bpy ligands and the remaining cis coordination sites are occupied by cyanide-carbon or cyanide-nitrogen atoms. In 1, Fe-C (cyanide) (1.899(4)-1.927(4)A) and Fe-N(cyanide) (1.929(4)-1.950(4)A) distances are typical of low-spin Fe2+ ions. In 2, Fe-C(cyanide) and Co(2+)-N(cyanide) bond lengths are in the range 1.919(5)-1.963(5)A and 1.850(5)-2.017(5) A, respectively: in contrast, shorter bond lengths are observed for the metal to cyanide-carbon and cyanide-nitrogen (1.878(7)- 1.893(7) A) in 3. As a result, the molecular squares in 1. 2, and 3 have sides of 4.947(1)4.986(1) A, 5.001(1)-5.053(1) A, and 4.910(1)-4.918(1) A, respectively. Magnetic susceptibility measurements revealed that the Fe2+ and Co3- ions in 1 and 3 are diamagnetic, while the high-spin Co2+ ions in 2 are weakly coupled through the low-spin Fe2 ions. Cyclic voltammograms of the squares are presented, and the electrochemically generated mixed-valent species [Fe(II/2)Fe(III/2)(mu-CN)4(bpy)8]6+ was discussed in terms of the intervalence transfer band.

Effects of peroxynitrite on rabbit cornea

BACKGROUND

Nitric oxide (NO) reacts rapidly with the superoxide anion to generate peroxynitrite, which has been found in the aqueous humor in eyes with uveitis. We evaluated the functional and anatomic effects of peroxynitrite on rabbit cornea.

METHODS

One eye of each rabbit received an anterior chamber injection of 3-morpholinosydonimine N-ethylcarbamide (SIN-1), which simultaneously generates both NO and the superoxide anion. The corneal thickness was measured using an ultrasonic pachymeter before and after the injection. The eyes were fixed and the corneal specimens were prepared for electron microscopy.

RESULTS

Anterior chamber injections of SIN-1 caused a significant increase in the corneal thickness (25.1+/-3.0 microm) 30 min after injection. Transmission electron microscopy showed swollen mitochondria and large vacuoles in the cytoplasm, and scanning electron microscopy revealed obscuring of the mosaic pattern by increased ruffling of endothelial cell surface and borders.

CONCLUSION

The results suggest that peroxynitrite generated in the aqueous humor may cause corneal endothelial cell damage, which leads to transient corneal edema.

Intravitreal injection of hyaluronidase cannot induce posterior vitreous detachment in the rabbit

PURPOSE

To investigate whether intravitreal injection of hyaluronidase can induce posterior vitreous detachment (PVD) in the rabbit.

METHODS

One eye each of 12 New Zealand white rabbits received intravitreal injection via the pars plana of 20 IU of hyaluronidase (0.1 mL reconstituted in sterile balanced salt solution [BSS]) into the midvitreous cavity. The fellow eye of each rabbit received a vitreous injection of 0.1 mL of BSS. At 3 and 6 months after intravitreal injection, four and eight rabbits were killed, respectively, and the eyes were enucleated. After fixation, scanning electron microscopy was performed to study the vitreoretinal interface.

RESULTS

At 3 and 6 months after injection, scanning electron microscopy showed that the retinal surfaces in eyes that received either hyaluronidase or BSS were covered with vitreous collagen fibers. No eyes, even those that received hyaluronidase over a period of 6 months, had the smooth retinal surface consistent with a bare internal limiting lamina that suggests the development of PVD.

CONCLUSION

Hyaluronidase cannot induce PVD in the rabbit over a 6-month period after vitreous injection.

Effect of corticotropin releasing factor receptor 1 antagonist on extracellular norepinephrine, dopamine and serotonin in hippocampus and prefrontal cortex of rats in vivo

Corticotropin releasing factor (CRF) is a major mediator of adaptive responsiveness to stress. We measured changes in extracellular concentrations of catecholamine and indoleamines in freely moving rats in response to administration of CRF1 antagonist CP-154,526 by using in vivo microdialysis. Dialysis probes were placed stereotaxically in either the hippocampus or the prefrontal cortex. We examined the response in the hippocampus or the prefrontal cortex to 32.0 mg/kg i.p. administration of CP-154,526. CP-154,526 reduced the extracellular concentration of norepinephrine (NE) from 30 min to 180 min and 5-hydroxytryptamine (5-HT) from 30 min to 60 min after injection in the hippocampus. CP-154,526 did not remarkably change dopamine (DA). There were no significant differences between CP-154,526 and vehicle in NE, 5-HT and DA in the prefrontal cortex. The present results indicate that CRF1 receptor antagonist produced a decrease in dialysate concentration of NE and 5-HT, but not DA, in the hippocampus. These results suggest that the CRH-1 receptor antagonist suppresses the release of NE and 5-HT in the hippocampus.

Scanning laser ophthalmoscope correlations with biomicroscopic findings and foveal function after macular hole closure

OBJECTIVE

To investigate the relation between foveal findings and visual function in eyes with a resolved idiopathic macular hole after vitreous surgery.

METHODS

We divided 28 eyes with postoperative idiopathic macular hole resolution into 3 groups based on postoperative biomicroscopic foveal findings of complete closure, partial closure, or atrophic closure. To evaluate foveal retinal function, scanning laser ophthalmoscope (SLO) microperimetry was performed preoperatively and 6 months postoperatively.

RESULTS

Postoperatively in 18 eyes (64%), the foveal images became normal or almost normal and were classified as having complete closure, 6 eyes (21%) were classified as having partial closure, and 4 eyes (14%) as having atrophic closure. The corresponding visual acuity levels 6 months postoperatively were, respectively, 0.10, 0.35, and 0.64 (P<.01) based on LogMAR analysis. Preoperative SLO microperimetry detected an absolute scotoma at the bottom of all macular holes; postoperatively, the absolute scotoma disappeared in the 18 eyes with complete hole closure, but a relative scotoma was detected in 6 eyes. Of 6 eyes with partial closure, 1 had an absolute scotoma and 5 had a relative scotoma. An absolute scotoma was detected in 4 eyes with atrophic closure.

CONCLUSIONS

After macular hole closure, SLO findings correlate both with biomicroscopic findings and foveal function. Better anatomical foveal recovery in eyes after macular hole closure results in better improvement of vision than in eyes in which the foveal anatomical findings are not as good.

Suppression of conditioned fear by administration of CCKB receptor antagonist PD135158

In order to examine the involvement of CCK in the formation of anxiety, we have investigated whether CCKB receptor antagonist PD135158 suppressed conditioned fear stress. Rats were individually subjected to 30 min of inescapable electric footshock in a chamber with a grid floor. First, the rats were individually subjected to 30 min of footshock. Twenty-four h after the footshock, the rats were again placed in the chamber and observed for 5 min without shocks. PD135158 was administered 30 min before placing the rats in the chamber again. Secondly, PD135158 was administered 30 min before footshock. Thirdly, PD135158 was administered 5 min after footshock. Administration of PD135158 30 min before conditioned fear stress significantly reduced freezing behavior. Administration of PD135158 30 min before footshock also significantly reduced freezing behavior. But, administration of PD135158 5 min after footshock did not significantly reduce freezing behavior. PD135158 blocked not only the acquisition but also the expression of conditioned fear. These results suggest that the CCKB receptor might play an important role in conditioned fear stress and that it might be related to anxiety.

Vitreous changes after treatment of retinopathy of prematurity

PURPOSE

To investigate the vitreous findings in patients with cicatricial retinopathy of prematurity (ROP) who underwent retinal cryopexy and/or photocoagulation during the acute phase of the disease.

METHODS

Vitreous findings were evaluated in 15 patients (29 eyes) with cicatricial ROP by slit-lamp biomicroscopy and indirect ophthalmoscopy.

RESULTS

The ocular examination revealed that all eyes had extensive vitreous liquefaction that affected a large segment of the vitreous. A great deal of fibrillar condensation of the vitreous was present in membrane-like vitreous fibers that traversed the vitreous cavity to the periphery of the degenerating retina. These vitreous changes were most marked in the areas in which retinal cryopexy and/or photocoagulation had been performed. Despite advanced liquefaction, the posterior cortical vitreous was not separated from the retina in any eyes.

CONCLUSION

In eyes with ROP that underwent retinal cryopexy and/or photocoagulation during the acute phase of the disease, the vitreous was abnormal, which may contribute to vitreoretinal traction that eventually leads to retinal breaks and detachment.

Three-dimensional characteristics of macular pseudoholes using confocal laser tomography

BACKGROUND

Epiretinal membranes with macular pseudoholes are sometimes confused with full-thickness macular holes. Because both the natural course and clinical management of the two differ, an accurate differential diagnosis is needed.

PATIENTS AND METHODS

We obtained three-dimensional images of macular pseudoholes in 12 eyes using the Heidelberg retina tomograph (HRT). Another 15 eyes with a full-thickness macular hole were also studied. In addition, we measured the area and the maximum depth of both types of holes.

RESULTS

Irregular rippling undulations were frequently observed on the three-dimensional topographic maps around the pseudoholes, whereas elevated cuffs were observed around the full-thickness holes. The maximum depth of the macular pseudoholes (mean, 57 microm) was significantly shallower than that of the full-thickness macular holes (mean, 156 microm; P < 0.01).

CONCLUSION

Three-dimensional images obtained by the HRT and the measurement of the maximum depth may be useful in differentiating macular pseudoholes from full-thickness macular holes.

Posterior vitreous detachment induced by injection of plasmin and sulfur hexafluoride in the rabbit vitreous

PURPOSE

To investigate whether an injection of plasmin and sulfur hexafluoride (SF6) can induce posterior vitreous detachment (PVD) without vitrectomy.

METHODS

One eye each of 15 New Zealand white rabbits was assigned to one of three groups. Eyes in group 1 received a vitreous injection of 1 unit of human plasmin (0.1 mL reconstituted in balanced salt solution) and 0.5 mL of SF6; eyes in group 2 received a vitreous injection of plasmin alone; eyes in group 3 received a vitreous injection of SF6 alone. Seven days after injection, all animals were monitored electroretinographically and killed, and the eyes were enucleated. After fixation, scanning electron microscopy was performed.

RESULTS

In group 1 eyes, the retinal surface was smooth except for the vitreous base, which showed complete separation of the vitreous cortex from the retina, indicating PVD. In group 2 and 3 eyes, sparse collagen fibers remained on the retinal surface.

CONCLUSION

Vitreous injection of plasmin combined with SF6 can induce PVD without vitrectomy.

Wound healing of scleral self-sealing incision: a comparison of ultrasound biomicroscopy and histology findings

PURPOSE

The goal of this study was to compare the morphologic findings of wound healing in scleral self-sealing incisions using ultrasound biomicroscopy and histology.

METHODS

Using a slit-knife, we made a scleral self-sealing incision in the rabbit eye. At various time points postoperatively, ultrasound biomicroscopy was performed to evaluate wound healing; the eyes then were enucleated and studied histologically. We also performed ultrasound biomicroscopy at various time points postoperatively in patients who received a scleral self-sealing incision during cataract surgery.

RESULTS

In rabbit eyes, on days 1 and 2 postoperatively, we detected the scleral wound; thereafter, detection became increasingly difficult. On day 7 postoperatively, the wound was undetectable. By light-microscopic observation, the scleral wound was open at 1 day postoperatively. On day 2 postoperatively, fibrovascular tissue barely extended into the wound; on day 5 postoperatively, connective tissue extended through the full thickness of the wound. On day 7 postoperatively, the connective tissue became dense and aligned with the lamella. In human eyes, using ultrasound biomicroscopy, the scleral incision was detectable until 5 days postoperatively, but undetectable at 7 days postoperatively.

CONCLUSIONS

Ultrasound biomicroscopy demonstrates the stages of wound healing of scleral self-sealing incisions. We believe that careful observation is necessary for approximately 7 days following self-sealing incision cataract surgery.

[Suppression of conditioned fear by administration of CCKB receptor antagonist PD135158]

The aim of this study is to determine whether or not CCKB receptor antagonist PD135158 suppresses conditioned fear. Rats were individually subjected to 30 min of inescapable electric footshock in a chamber with a grid floor. PD135158 or the vehicle was administered 30 min before placing the rats in the shock chamber again. The rats were observed for 5 min without receiving shock. The administration of PD135158 30 min before conditioned-fear stress significantly reduced freezing behavior. PD135158 blocked the expression of conditioned fear. PD135158 was again administered 30 min before footshock. Then, the rats were individually subjected to 30 min of inescapable electric footshock in the shock chamber. Twenty-four hours after receiving footshock, the rats were again placed in the shock chamber and observed for 5 min without shock administration. The administration of PD135158 30 min before footshock significantly reduced conditioned freezing. PD135158 blocked the anxiety of conditioned fear. PD135158 blocked not only the anxiety, but also the expression of conditioned fear. These results suggest that CCKB receptor might play an important role in conditioned-fear stress. They indicate that CCKB receptor is related to anxiety.

Transient shallow anterior chamber induced by supraciliary fluid after vitreous surgery

PURPOSE

To report the mechanism of transient shallow anterior chamber after vitreous surgery for proliferative diabetic retinopathy.

METHOD

Using ultrasound biomicroscopy, we examined a patient with transient shallow anterior chamber after vitreous surgery for proliferative diabetic retinopathy.

RESULTS

On the day after surgery, slit-lamp examination disclosed a shallow anterior chamber that persisted for 1 week and deepened thereafter. Ultrasound biomicroscopy 5 days postoperatively disclosed a narrow angle in the peripheral anterior chamber and supraciliary fluid. At 14 days postoperatively, suprachoroidal fluid could not be detected, and the angle was wide.

CONCLUSION

The shallow anterior chamber in this patient was caused by supraciliary fluid after vitreous surgery.