[Effectiveness of initial antibiotic therapy for treatment of contact lens-related bacterial keratitis]

BACKGROUND

Contact lens-related microbial keratitis is a cause of potentially sight-threatening corneal opacification. Effective initial antimicrobial therapy is crucial to prevent long-term complications. This investigation was undertaken to test the effectiveness of current routine empirical antibiotic treatment regimens.

METHODS/PATIENTS

All consecutive cases of contact lens-related keratitis presenting in the outpatient clinic of the Department of Ophthalmology at the Medical University of Innsbruck between January 2010 and April 2012 were retrospectively analyzed.

RESULTS

Cultures were positive in 69 out of the 123 cases included in the study. Culture results identified 59.4 % Gram positive strains, 50.7 % Gram negative strains and 7.2 % fungal strains. Mixed infections accounted for 29 % of cases. The combination of an aminoglycoside and a second generation quinolone antibiotic was the most common initial treatment regimen (87.8 %). In vitro this regimen was less effective compared to combinations of moxifloxacin and ciprofloxacin or moxifloxacin and gentamicin.

CONCLUSION

Empirical combined regimens remain an effective treatment of contact lens-related keratitis. Fluoroquinolones proved to be inadequate for monotherapy.

Application of phage typing and pulsed-field gel electrophoresis to analyse Salmonella enterica isolates from a suspected outbreak in Lagos, Nigeria

INTRODUCTION

Inadequate potable water supply and poor sanitation predispose to food- and water-borne diseases associated with Salmonella enterica serovars in developing countries. In this study the possible source of an unprecedented upsurge of Salmonella-associated community gastroenteritis was traced using both phage-typing and pulsed-field gel electrophoresis (PFGE).

METHODOLOGY

Nineteen Salmonella Typhimurium (three sporadic isolates included) and 13 Salmonella Enteritidis isolates from clinical, animal, and environmental samples were subjected to antimicrobial susceptibility testing, phage-typing, and PFGE analysis using standard procedures.

RESULTS

Eleven (68.8%) of the 16 outbreak-related multidrug resistant S. Typhimurium belonged to DT 71 phage type with cluster PFGE type X3, representing the most prevalent strain identified among human, animal, and environmental isolates. The remaining five (31.2%) outbreak-related strains  reacted but did not conform with clear phage types (RDNC) with cluster PFGE types X1 and X2 (96.8% similarity). Sporadic strains were untypable and belonged to X4 PFGE type. However, the evaluated S. Enteritidis strains that were multidrug resistant without a definite phage type belonged to PFGE cluster type X1e and were identified among the water and human strains. None of the Typhimurium and Enteritdis isolates was resistant to the fluoroquinolone antibiotics that were evaluated.

CONCLUSION

This study emphasizes the epidemiological usefulness of PFGE typing in the detection of emerging strains of multipledrug resistant Salmonella, particularly S. Typhimurium DT71, that pose serious health implications in our environment. The study provides epidemiological links between environmental reservoirs and human infection in this community.

First certified reference materials for molecular fingerprinting of two approved probiotic Bacillus strains

At present probiotic bacteria are widely used in human and animal nutrition because they beneficially influence the balance of the intestinal flora of the host. Positive effects related to probiotics are various and include enhancement of digestion, strengthening of the immune system and stimulation of vitamin production. Moreover, implementation of probiotics is intended to reduce the use of antibiotics and improve animal growth and feed conversion. To protect human and animal health and to improve consumer confidence, a strict legislation on the use of probiotics exists within the European Union (EU). Official controls by national authorities are performed to ensure verification of compliance with feed and food law. Apart from the risk of using unauthorized strains, mislabelling is a known problem, partly because of the use of phenotyping or genotyping methods with a lack of discriminative power. In addition to official controls, private controls by food and feed producing companies are important in the frame of protection of patented strains and industrial property rights. To support these applications, IRMM has developed certified reference materials (CRMs) consisting of genomic DNA inserts of B. subtilis DSM 5749 and B. licheniformis DSM 5750, two strains that received EU approval. In this study we investigated the use of these CRMs, IRMM-311 and IRMM-312, for the detection and unambiguous discrimination of Bacillus strains by pulsed-field gel electrophoresis (PFGE). Identical fingerprints were obtained for the CRMs and control strains isolated from the feed additive Bioplus 2B. On the other hand a distinction could be made from other not approved B. licheniformis and B. subtilis strains. The reference materials discussed in this study are the first CRMs based on a whole bacterial genome and suitable for PFGE. They offer perspectives for applications in other domains such as analysis of foodborne pathogens in outbreaks or routine analysis.

Bell's theorem and the problem of decidability between the views of Einstein and Bohr

Einstein, Podolsky, and Rosen (EPR) have designed a gedanken experiment that suggested a theory that was more complete than quantum mechanics. The EPR design was later realized in various forms, with experimental results close to the quantum mechanical prediction. The experimental results by themselves have no bearing on the EPR claim that quantum mechanics must be incomplete nor on the existence of hidden parameters. However, the well known inequalities of Bell are based on the assumption that local hidden parameters exist and, when combined with conflicting experimental results, do appear to prove that local hidden parameters cannot exist. This fact leaves only instantaneous actions at a distance (called "spooky" by Einstein) to explain the experiments. The Bell inequalities are based on a mathematical model of the EPR experiments. They have no experimental confirmation, because they contradict the results of all EPR experiments. In addition to the assumption that hidden parameters exist, Bell tacitly makes a variety of other assumptions; for instance, he assumes that the hidden parameters are governed by a single probability measure independent of the analyzer settings. We argue that the mathematical model of Bell excludes a large set of local hidden variables and a large variety of probability densities. Our set of local hidden variables includes time-like correlated parameters and a generalized probability density. We prove that our extended space of local hidden variables does permit derivation of the quantum result and is consistent with all known experiments.

A possible loophole in the theorem of Bell

The celebrated inequalities of Bell are based on the assumption that local hidden parameters exist. When combined with conflicting experimental results, these inequalities appear to prove that local hidden parameters cannot exist. This contradiction suggests to many that only instantaneous action at a distance can explain the Einstein, Podolsky, and Rosen type of experiments. We show that, in addition to the assumption that hidden parameters exist, Bell tacitly makes a variety of other assumptions that contribute to his being able to obtain the desired contradiction. For instance, Bell assumes that the hidden parameters do not depend on time and are governed by a single probability measure independent of the analyzer settings. We argue that the exclusion of time has neither a physical nor a mathematical basis but is based on Bell's translation of the concept of Einstein locality into the language of probability theory. Our additional set of local hidden variables includes time-like correlated parameters and a generalized probability density. We prove that our extended space of local hidden variables does not permit Bell-type proofs to go forward.

['Microbial air pollutants'. Emission sources and preventive measures]

Already in the planning or monitoring phase, measures have to be realized for the reduction in emissions of bio-aerosols in biological waste treatment plants. For this purpose, operation-related measures (in open and partially closed plants) and technology-related measures (in closed plants with automatic ventilation) can be taken. A survey on the currently feasible measures for reduction is submitted. The realization has to be adapted to the individual site and type of plant. An enormous demand for examinations is envisaged in order to enable a qualified assessment of the emission behaviour of diverse waste air systems or process steps.

[Microbial emissions in collection of residential garbage]

Two exemplary investigations with different questions were carried out in Munich and Stuttgart by sampling bio-aerosols due to and during the collection and emptying of different types of waste bins. The emissions were regarded qualitatively and quantitatively, in order to answer the question, whether and to which amount differences of bio-aerosol emissions occurred due to the kind of wastes collected. The lowest emissions of airborne microorganisms were found during the collection of the paper waste fraction. In comparison, the amounts of them during the collection of unseparated household wastes as well as source separated bio-wastes and the remaining residual waste fraction were higher. Between the three latter, no significant differences could be found, only a tendency of higher values for the thermotolerant mould A. fumigatus during the collection of bio- and residual wastes was observed. Maybe this was caused by special features of the different sampling locations, but it could also be due to the longer collection intervals (bio- and residual wastes were partially collected every two weeks, unseparated wastes every week).

Expression of vascular endothelial growth factor and its receptors in inflamed and vascularized human corneas

PURPOSE

To help further define the possible role of vascular endothelial growth factor (VEGF) in the pathogenesis of corneal neovascularization, the expression of VEGF and of its receptors Flt-1 and Flk-1 was investigated in various inflammatory corneal diseases.

METHODS

Polyclonal antibodies to VEGF and its receptors were used for immunohistochemical staining of frozen sections of 38 human corneas with various degrees of neovascularization and inflammation. In addition, a panel of monoclonal antibodies was used to characterize the composition of the inflammatory infiltrates and to confirm the presence of neovascularization. Furthermore, VEGF concentrations were determined in vascularized corneas using a sensitive enzyme-linked immunosorbent assay.

RESULTS

VEGF was expressed by epithelial cells, by corneal endothelial cells, by vascular endothelial cells of limbal vessels and of newly formed vessels in the stroma, and weakly by keratocytes. Furthermore, VEGF expression was often markedly increased in inflamed corneas on epithelial cells and on vascular endothelial cells, particularly in the vicinity of macrophage infiltrates, and on fibroblasts in scar tissue. Correspondingly, VEGF concentrations were significantly higher in vascularized corneas compared with normal control corneas (P < 0.001). Expression of both VEGF receptors, Flt-1 and Flk-1, was increased on endothelial cells of newly formed vessels in the stroma of inflamed corneas compared with limbal vessels of normal control corneas. In addition, Flt-1 was also expressed by corneal endothelial cells and by macrophages, whereas Flk-1 expression was lacking.

CONCLUSIONS

These results demonstrate that VEGF, Flt-1, and Flk-1 are strongly expressed in inflamed and vascularized human corneas and, thus, may play an important role in corneal neovascularization.

The role of ferrioxamine E in pre-enrichment medium for determining Salmonella in environmental samples according to ISO method

The effect of a siderophoric compound, ferrioxamine E, in the pre-enrichment broth on determining of Salmonella infantis in environmental samples was tested with combination of various pre-enrichment times and enrichment temperatures of 37 and 43 degrees C. Ferrioxamine E slightly improved the determination efficiency of this bacterium but the pre-enrichment time could not be reduced below 17 hours. The enrichment temperature of 43 degrees C was better than of 37 degrees C. The mixing ratios of 1:100 or 1:1000 for samples and pre-enrichment broth were more successful than the ratio of 1:10 as recommended by ISO.

Determination of the N-methyl-D-aspartate receptor NR2B subunit blocker Ro 63-1908 in rat, cynomolgus monkey and human plasma by high-performance liquid chromatography with column switching and fluorescence detection

A HPLC method with automated column switching was developed and validated for the determination of Ro 63-1908 in rat and cynomolgus monkey plasma. Human plasma was used for calibration and was also included in the validation process. Ro 63-1908 belongs to a class of neuroprotective N-methyl-D-aspartate (NMDA) receptor blockers which were in development for the treatment of stroke and traumatic brain injury. The method involves deproteinisation of plasma samples with ethanol and direct injection of the supernatant (1.4 ml) into the HPLC column-switching system. To prevent a breakthrough of the analyte and the internal standard on the precolumn (Purospher RP-18, 75x4 mm) due to the high ethanol content, the injection solution was diluted, on-line, using an additional pump and a T-piece. 1% ammonium acetate-ethanol (100:2, v/v) was used as mobile phase for injection, as well as for on-line dilution, resulting in pre-concentration of the analyte and the internal standard on the precolumn. As Purospher RP-18 is a non-endcapped stationary phase with a special selectivity for amines, the analyte and the internal standard could then be selectively eluted with 30% acetonitrile (without any buffer in the mobile phase) and transferred to the analytical column [consisting of two coupled columns (125+250x4 mm) packed with Superspher 60 RP-select B], where they were separated by gradient elution and detected by fluorescence detection. Compared to the use of a 125 mm long precolumn and dilution of the supernatant with ammonium acetate prior to injection, the 75 mm precolumn and the on-line dilution procedure allowed about one third shorter run times (21 min) and, therefore, a higher sample throughput. The limit of quantification was 1 ng/ml using 0.4 ml plasma. The method was applied to more than 670 plasma samples from pharmacokinetic and toxicokinetic studies and is also suitable for other matrices and NMDA receptor blockers.

The effect of streptozotocin-induced diabetes mellitus on substance P and calcitonin gene-related peptide expression in the rat trigeminal ganglion

Substance P (SP) and calcitonin gene-related peptide (CGRP) constitute the main sensory peptides in the trigeminal ganglion (TG). The objective of this study was to characterize peptidergic changes in the streptozotocin-induced diabetes mellitus rat model both quantitatively and qualitatively. Diabetes mellitus was induced by a single intraperitoneal injection of streptozotocin (65 mg/kg) and the levels of SP and CGRP were measured by means of radioimmunoassay (RIA) in a time-dependent manner. Peptide immunoreactivities were characterized by high pressure liquid chromatography (HPLC). The expression of both neuropeptides was examined 5 weeks after streptozotocin injection using in situ hybridization with 35S-labelled oligonucleotides. Saline-injected rats served as controls. SP was significantly decreased in the diabetic rat TG, i.e. , a 44.6% (+/-10.9) decrease after 1 week, 40.2% (+/-11.8) after 3 weeks and 72.3% (+/-14.6) after 5 weeks. CGRP was decreased only after 5 weeks (19.6% decrease +/-3.9), whereas at later stages, both peptide levels returned to normal values. HPLC revealed one major peak coeluting with the synthetic peptides. By using in situ hybridization, a significantly increased signal of both peptide-encoding mRNAs was found (43.8%), which seems to act to restore a diabetes-associated depletion of neuropeptides in the diabetic rat TG. The decreased SP- and CGRP levels in the diabetic rat TG reflect a diabetes-associated deficit which may be clinically relevant. Diabetes mellitus is associated with a variety of ocular complications, even corneal complications, including decreased corneal sensitivity, which in many ways resemble those after interruption of the normal trophic innervation of the eye. Our results point to reduced availability of neuropeptides for corneal innervation and may thus support the idea of a partial loss of trophic influences from the trigeminal nerve in diabetics.

Determination of several N-methyl-D-aspartate receptor blockers in plasma and brain by a selective high-performance liquid chromatographic method with column switching

A general procedure is presented for the determination of several N-methyl-D-aspartate (NMDA) receptor open-channel and subtype-selective blockers, which have been evaluated and developed as neuroprotective drugs for the treatment of brain stroke and trauma. The method involves deproteination of plasma with ethanol, or homogenization of brain samples in ethanol, dilution of the supernatant with ammonium acetate and direct injection into an HPLC column-switching system. Although the investigated NMDA receptor blockers are all tertiary amines, they have quite different structures. However, they are all concentrated on the first column (Purospher RP-18, 125 x 4 mm), whereas polar interfering compounds are washed out with 1% ammonium acetate-acetic acid-acetonitrile (100:1:5, v/v/v). Due to the special selectivity of the Purospher RP-18 material, the analytes and the internal standard are then selectively eluted with 25% acetonitrile (without any buffer in the mobile phase) and transferred to the analytical column (Superspher 60 RP-select B, 250 x 4 mm), where they are separated by gradient elution and detected by UV or fluorescence detection. The low degree of interference allowed the development of sensitive methods with quantification limits of 5 ng/ml for animal plasma (0.4 ml used), 0.5 ng/ml for human plasma (1 ml used) and 50 ng/g for brain tissue (200 mg used).

Characterization of the Mycobacterium tuberculosis erp gene encoding a potential cell surface protein with repetitive structures

Using the phoA gene fusion methodology adapted to mycobacteria, several Mycobacterium tuberculosis DNA fragments encoding exported proteins were recently identified. In this paper, the molecular cloning, genomic positioning, nucleotide sequence determination and transcriptional start site mapping of a new M. tuberculosis gene, identified by this methodology, are reported. This gene was called erp (for exported repetitive protein) and has a sequence similar to that of the Mycobacterium leprae 28 kDa antigen irg gene M. tuberculosis erp gene contains a putative iron box close to the mapped transcriptional start site. The predicted Erp protein displays a typical N-terminal signal sequence, a hydrophobic domain at the C-terminus and harbours repeated amino acid motifs. These structural features are reminiscent of cell-wall-associated surface proteins from Gram-positive bacteria. We found that these repeats are conserved among M. tuberculosis isolates, and are absent from the published M. leprae irg gene sequence. In addition to being present in M. leprae, erp sequences were found in other members of the M. tuberculosis complex, but not in other mycobacteria tested. These results suggest that erp might encode a cell surface component shared by major pathogenic mycobacteria.

Mycobacterium tuberculosis is a natural mutant with an inactivated oxidative-stress regulatory gene: implications for sensitivity to isoniazid

The systems participating in detoxification of reactive oxygen intermediates in Mycobacterium tuberculosis are believed to play a dual role in the biology of this highly adapted human pathogen: (i) they may contribute to the survival of this bacterium in the host; and (ii) alterations in the gene encoding catalase/peroxidase have been linked to this organism's resistance to the front-line antituberculosis drug isoniazid. These relationships prompted us to extend investigations of the oxidative-stress-response systems in M. tuberculosis by analysing the alkyl hydroperoxide reductase gene ahpC and its putative regulator oxyR. Surprisingly, the oxyR gene was found to be inactivated by multiple lesions in M. tuberculosis H37Rv. These alterations were observed in all M. tuberculosis strains tested, and in members of the M. tuberculosis complex: Mycobacterium bovis BCG, Mycobacterium africanum, and Mycobacterium microti. The corresponding region carrying these genes in Mycobacterium leprae, an organism not sensitive to isoniazid, has a complete oxyR gene divergently transcribed from ahpC. An increase in minimal inhibitory concentration for isoniazid was observed upon transformation of M. tuberculosis H37Rv with cosmids carrying the oxyR-ahpC region of M. leprae. In keeping with the observed inactivation of oxyR, transcriptional activity of the corresponding region in M. tuberculosis was an order of magnitude lower than that of the oxyR gene from M. leprae. While the loss of this putative regulator of oxidative-stress response in M. tuberculosis is paradoxical considering the fact that survival in host macrophages is regarded as a critical feature of this pathogen, it offers a partial explanation for the exquisite sensitivity of M. tuberculosis to isoniazid.

Cloning and nucleotide sequence of Mycobacterium tuberculosis gyrA and gyrB genes and detection of quinolone resistance mutations

The emergence of multidrug-resistant strains of Mycobacterium tuberculosis has resulted in increased interest in the fluoroquinolones (FQs) as antituberculosis agents. To investigate the frequency and mechanisms of FQ resistance in M. tuberculosis, we cloned and sequenced the wild-type gyrA and gyrB genes, which encode the A and B subunits of the DNA gyrase, respectively; DNA gyrase is the main target of the FQs. On the basis of the sequence information, we performed DNA amplification for sequencing and single-strand conformation polymorphism analysis to examine the presumed quinolone resistance regions of gyrA and gyrB from reference strains (n = 4) and clinical isolates (n = 55). Mutations in codons of gyrA analogous to those described in other FQ-resistant bacteria were identified in all isolates (n = 14) for which the ciprofloxacin MIC was > 2 micrograms/ml. In addition, we selected ciprofloxacin-resistant mutants of Mycobacterium bovis BCG and M. tuberculosis Erdman and H37ra. Spontaneously resistant mutants developed at a frequency of 1 in 10(7) to 10(8) at ciprofloxacin concentrations of 2 micrograms/ml, but no primary resistant colonies were selected at higher ciprofloxacin concentrations. Replating of those first-step mutants selected for mutants with high levels of resistance which harbored gyrA mutations similar to those found among clinical FQ-resistant isolates. The gyrA and gyrB sequence information will facilitate analysis of the mechanisms of resistance to drugs which target the gyrase and the implementation of rapid strategies for the estimation of FQ susceptibility in clinical M. tuberculosis isolates.

Leukocyte adhesion molecules in rejected corneal allografts

Leukocyte adhesion molecules are believed to play a key role in the selective recruitment of different leukocyte populations to inflammatory sites. In this study, we investigated the presence and distribution of intercellular adhesion molecule-1 (ICAM-1), E-selectin (endothelial leukocyte adhesion molecule-1) and vascular cell adhesion molecule-1 (VCAM-1) in 12 rejected corneal allografts and compared the presence of these adhesion molecules with the composition of the associated inflammatory infiltrates. ICAM-1 was focally expressed on corneal epithelial cells and its expression was increased on keratocytes, corneal and vascular endothelial cells particularly at the site of dense infiltration with mononuclear leukocytes. E-selectin was present on endothelial cells of vessels in the stroma of rejected corneal allografts which were characterized by dense infiltration with T cells and macrophages. VCAM-1 was predominantly expressed on inflammatory cells of the macrophage/monocyte lineage, but only sporadically on vascular endothelial cells in the stroma of vascularized rejected corneal allografts. Our results suggest that ICAM-1, E-selectin and VCAM-1 may all be involved in the pathogenesis of corneal allograft rejection, particularly in the generation of the inflammatory infiltrates.

Leukocyte adhesion molecules in diseased corneas

PURPOSE

To help define the possible role of leukocyte adhesion molecules in the pathogenesis of corneal inflammation, we investigated the presence and distribution of intercellular adhesion molecule-1 (ICAM-1), E-selectin (endothelial leukocyte adhesion molecule-1 [ELAM-1]), and vascular cell adhesion molecule-1 (VCAM-1) in various corneal diseases.

METHODS

Monoclonal antibodies (mAbs) to ICAM-1, E-selectin, and VCAM-1 were used for immunohistochemical staining of frozen sections of 55 human corneas with various inflammatory and degenerative diseases. In addition, we used a panel of mAbs to characterize the composition and density of the inflammatory infiltrates in the diseased corneas.

RESULTS

ICAM-1 was focally expressed on epithelial cells in corneas with chronic allograft rejection, herpetic stromal keratitis, zoster keratitis, chemical burns, atopic keratitis, fungal keratitis, and bacterial keratitis. Furthermore, the expression of ICAM-1 was focally increased on keratocytes, corneal endothelial cells, and vascular endothelial cells (particularly at the site of lymphoid infiltration) in these corneas. E-selectin was present on vascular endothelial cells of limbal vessels in corneas with bacterial keratitis and also on endothelial cells of vessels in the stroma of several corneas with chronic inflammatory diseases. VCAM-1 was focally expressed on endothelial cells of vessels in the stroma of some corneas with chronic allograft rejection, herpetic stromal keratitis, chemical burns, and atopic keratitis. Interestingly, VCAM-1 was also found on inflammatory cells of the macrophage-monocyte lineage in inflamed corneas.

CONCLUSIONS

Our results demonstrate that ICAM-1, E-selectin, and VCAM-1 are expressed in diseased corneas, often in areas of inflammation.

Retinal phakomata associated with cerebral astrocytoma. An incomplete form of Bourneville-Pringle disease?

We report on a 21-year-old, male patient with unilateral retinal phakomata associated with histologically proved cerebral astrocytoma. The patient had presented with bilateral loss of vision and a left-sided hemiparesis. Ophthalmoscopy showed bilateral optic nerve atrophy, multiple punched-out areas of depigmentation and astrocytic hamartomata in the right eye. Despite the absence of classic signs of Bourneville-Pringle disease such as adenoma sebaceum, epilepsy and mental retardation, a strongly presumptive diagnosis of tuberous sclerosis could be made. This unusual case demonstrates that retinal phakomata can be the solely visible manifestation of Bourneville-Pringle disease.

[Leukocyte adhesion molecules in chronic inflammatory diseases of the cornea]

Using immunohistochemical techniques, we investigated the expression of leukocyte adhesion molecules-intercellular adhesion molecule-1 (ICAM-1), E-selectin (endothelial leukocyte adhesion molecule-1), and vascular cell adhesion molecule-1 (VCAM-1)--in various chronic inflammatory corneal diseases of different etiology. ICAM-1 was focally expressed on epithelial cells and showed an increased expression, on keratocytes, corneal endothelial cells, and vascular endothelial cells. E-selectin was present on vascular endothelial cells of several corneas, while VCAM-1 was found particularly on macrophages and only sporadically on vascular endothelial cells. Our results suggest that ICAM-1, E-selectin, and VCAM-1 may be involved in the pathogenesis of various chronic inflammatory corneal diseases, particularly in the selective recruitment of different leukocyte populations.

Effects of bright artificial light on monoamines and neuropeptides in eight different brain regions compared in a pigmented and nonpigmented rat strain

Seasonal affective disorder is a form of depression which recurs at the same time of the year. Exposure to bright artificial light at a dose of 2,500 lux is used to treat seasonal affective disorders. We exposed a pigmented (Brown Norway) and a nonpigmented (Sprague-Dawley) rat strain with bright artificial light for 21 days at two doses (2,500 and 6,100 lux) and analyzed dopamine, dihydroxyphenyl-acetic acid, 5-hydroxytryptamine (5-HT), and 5-hydroxyindole-acetic acid (5-HIAA) by high performance liquid chromatography (HPLC) and electrochemical detection in eight different brain regions. Furthermore, we measured tissue levels of substance P (SP), neurokinins (NK), vasoactive intestinal polypeptide (VIP), calcitonin gene-related peptide (CGRP), and neuropeptide Y (NPY) with radioimmunoassay. Our data obtained with light microscopy show that bright artificial light at both doses induced a massive destruction of photoreceptors in the retina of albino rats but not of the pigmented rat strain. Retinal lesion of photoreceptors resulted in increased tissue levels of all measured neuropeptides except SP in the hypothalamus and increased VIP in the ventral tegmental area/substantia nigra. Furthermore, increased 5-HT and 5-HIAA tissue levels were found in the ventral tegmental area/substantia nigra. In contrast, in the frontal cortex there was a significant reduction in 5-HIAA tissue levels and a decreased 5-HIAA/5-HT ratio, indicating decreased 5-HT metabolism. Light exposure of the pigmented rat strain revealed no changes in the measured biogenic amines and neuropeptides in any investigated brain region. Our data suggest that retinal lesion but not direct visual neurotransmission induced changes in neurotransmitters in some brain regions. We conclude that Brown Norway rats but not Sprague-Dawley rats are useful to study neurochemical effects of bright artificial light. However, Sprague-Dawley rats may be a useful tool to study biochemical mechanisms of photoreceptor damage by bright light.

Altered lectin binding sites in keratoconus corneas

We investigated the glycoconjugates in frozen sections of keratoconus corneas, using a panel of 12 biotin- or fluorescein isothiocyanate-labeled lectins. No differences between the lectin binding sites of the epithelium, endothelium and Descemet's membrane of normal and keratoconus corneas could be observed. However, in contrast to normal corneas, intense staining with peanut agglutinin (PNA) could be detected at breaks in Bowman's layer, in scar tissue and in the adjacent stroma. Furthermore, in the majority of cases binding sites for Phaseolus vulgaris erythroagglutinin (PHA-E) and increased staining with Ricinus communis agglutinin I (RCA-I) and Lens culinaris agglutinin (LCA) could also be detected in ruptures in Bowman's layer and in scar tissue. These data suggest that the scarred regions of the anterior stroma in keratoconus corneas may contain oligosaccharides with terminal D-galactose (beta 1-3)-D-N-acetylgalactosamine disaccharides (recognized by PNA), increased amounts of glycoconjugates with terminal beta-galactose residues (recognized by RCA-I), increased amounts of glycoconjugates with glucose/mannose residues (recognized by LCA), and finally, biantennary complex-type glycopeptides containing two outer galactose residues and a residue of N-acetylglucosamine (recognized by PHA-E). Since corneal scars due to causes other than keratoconus revealed lectin binding sites (particularly for PNA and to a lesser extent also for PHA-E, LCA and RCA-I) similar to those seen in scar tissue of keratoconus corneas, we conclude that it is mainly scar formation that may be responsible for the altered lectin binding sites in keratoconus.

[Newer information about several aspects of animal epidemic disinfection]

The amendment of the German Veterinary Legislation concerning the eradication of notifiable diseases demanded also an updating of the relevant disinfection measures and technologies. Some hints are given, based on own experimental results, for the choice of chemical disinfectants, on some special problems of disinfection in livestock buildings and of disinfection of animal slurry and farm-yard manure as well as on biotechnological disinfection methods and environment-friendly disinfectants.

Orbital involvement in Waldenström's macroglobulinemia: ultrasound, computed tomography and magnetic resonance findings

A case of orbital involvement in Waldenström's macroglobulinemia is presented. Orbital echography, computed tomography (CT) and magnetic resonance imaging (MRI) were performed and revealed a retrobulbar mass of the right orbit. Ultrasonography suggested a lymphoid orbital tumor. A CT scan was nonspecific, but helpful in exactly locating the tumor and excluding bony lesions. Signal intensity patterns of MRI were characterized by a low intensity on T1- and T2-weighted images. A marked enhancement of the tumor was evident after intravenous injection of a paramagnetic contrast agent (gadolinium-DTPA). Although the definite diagnosis could only be established by means of an ultrasound-guided fine-needle aspiration biopsy, MRI in connection with the history of our patient strongly suggested a diagnosis of orbital lymphoma in Waldenström's disease.

Human papillomavirus type 42: new sequences, conserved genome organization

We report the nucleotide sequence and genome organization of the human papillomavirus type 42. HPV42 DNA was isolated from vulvar papillomas. It has been detected in benign forms of proliferative lesions only. The genome of HPV42 is 7917 bp long and shows the open reading frame pattern conserved in all HPVs sequenced so far. HPV42 has no high degree of sequence homology to any of the known HPVs. It shows characteristics previously found either exclusively in HPVs associated with invasive carcinomas or exclusively in nongenital HPVs. Therefore it cannot be readily ascribed to any of the established subgroups of human papillomaviruses.

T6-positive Langerhans cells in diseased corneas

Langerhans cells (LC) in normal human corneas (with the exception of newborns) lack thymocyte antigen T6, a highly specific marker for noncorneal LC. Because corneal LC could not be induced to express T6 antigen when cultured with various cytokines including interleukin-1 (shown to modulate T6 expression on gingival LC), some authors assume that corneal LC may represent a distinct LC subpopulation that is innately inactive. In this study, 62 corneas from patients with various corneal diseases were investigated for the presence of T6 and histocompatibility antigen HLA-DR on LC in the central and pericentral epithelium. Both T6- and HLA-DR-positive LC at a high density similar to that observed in normal epidermis could be detected in the epithelium of five corneas with epidermalization after alkali burns. Furthermore T6- and HLA-DR-positive LC at smaller densities also were detected in corneas from patients with chronic herpetic stromal keratitis, zoster keratitis, chronic allograft rejection, and bacterial corneal ulcers. Although the functional significance of T6 expression on corneal LC remains to be determined, the induction of T6 antigen on corneal LC may represent an important event for the antigen-presenting function of these cells in various corneal diseases including corneal allograft rejection.

Determination of the monoamine oxidase B inhibitor Ro 19-6327 in plasma by high-performance liquid chromatography using precolumn derivatization with fluorescamine and fluorescence detection

A specific high-performance liquid chromatographic (HPLC) method using precolumn derivatization and fluorescence detection was developed for the determination of the monoamine oxidase B inhibitor Ro 19-6327 in human plasma. After extraction of the basified plasma with tert.-butyl methyl ether-1-butanol (8:2, v/v) and back-extraction into dilute phosphoric acid, the solution was neutralized with phosphate buffer and the drug derivatized with fluorescamine. The derivative was chromatographed on a reversed-phase C8 column, using phosphate buffer-acetonitrile (68:32, v/v) as mobile phase, and fluorescence detection (excitation 370 nm, emission 485 nm). The limit of quantification was 1 ng/ml using 1 ml of plasma. The recovery was 79% in the range 5-200 ng/ml and the inter-assay precision was 3.1-7.9% in the range 2-500 ng/ml. The compound proved to be stable in human plasma. Moderate instability was found in rat plasma and, surprisingly, severe instability in dog plasma. Measures for handling unstable dog plasma samples are described. An HPLC method with UV detection was used for the analysis of dog and rat plasma samples, which is also described briefly. The fluorescence method, which was five times more sensitive than the UV method, was successfully applied to a human tolerance study.

Clinicopathological findings 11 months after implantation of a functioning aqueous-drainage silicone implant

An aqueous-drainage silicone device was implanted in a 57-year-old diabetic patient with neovascular glaucoma after failure of conventional therapy. Postoperative intraocular pressure (IOP) was well controlled, ranging between 10 and 20 mm Hg without the use of supplemental agents. Despite the normal IOP, the eye became painful and amaurotic 11 months after implantation due to progression of the retinopathy accompanied by the development of severe tractional retinal detachment. Enucleation was performed and the eye underwent histopathological examination. The filtering bleb around the silicone plate of the implant on the equatorial sclera was lined with a thick layer of collagenous connective tissue. Numerous microcystic spaces could be seen in the bleb wall by light microscopy. Electron microscopy confirmed this finding; in addition, only a meshwork of collagen fibre-like bundles was visible at some areas of the innermost bleb wall. Control of IOP in spite of bleb fibrosis in this particular case may have been due to a loss of matrix components and to the formation of microcystic spaces in the bleb wall, which seem likely to be channels for the passage of aqueous humor.

Toxicity and clearance of intravitreal cefotetan

Direct intravitreal injection of antibiotics plays an important role in the management of bacterial endophthalmitis. In the present study we investigated the toxicity and clearance of intravitreally injected cefotetan in a rabbit model. No toxic ocular side effects could be detected by electroretinography (ERG) or light and electron microscopy up to and including a single intravitreal dose of 1000 micrograms. Intravitreal injection of 2000 micrograms cefotetan resulted in mild degeneration of photoreceptor outer segments and, sporadically, in cataract formation. After intravitreal injection of 4000 micrograms, moderate toxic degeneration of photoreceptors occurred, with displacement and mitochondrial swelling of inner segments. In addition, lysosomal lamellar inclusion bodies could be detected in pigment epithelial cells. After a single intravitreal injection of 1000 micrograms cefotetan, concentrations greater than the minimum necessary for the inhibition of most commonly occurring intraocular pathogens (except Pseudomonas aeruginosa and Staphylococcus epidermidis) were maintained in the vitreous humor for greater than 48 h. Cefotetan may be a potentially important drug for intravitreal injection, especially in cases of gram-negative and suspected anaerobic endophthalmitis.

Investigation of visual field defects in strabismic and anisometropic amblyopes with the Octopus program G1

Using the Octopus G1 program, we investigated the visual fields of amblyopic and healthy contralateral eyes in 21 patients with strabismic amblyopia and 14 patients with anisometropic amblyopia. All subjects had a visual acuity of 0.7-0.06. A central scotoma was detected in 85.7% of the patients with strabismic amblyopia and in 79% of those with anisometropic amblyopia. The mean maximal depth of central scotomas in subjects with strabismic amblyopia was 6.81 +/- 4.74 dB (mean +/- SD); in those with anisometropic amblyopia, it was 6.64 +/- 4.34 dB. This difference was statistically not significant. However, in patients with anisometropic amblyopia, the visual field indices MD (mean defect) and CLV (corrected loss variation) were significantly higher than in those with strabismic amblyopia (P less than 0.05 vs P less than 0.05); this was predominantly due to additional flat defects that occurred paracentrally and peripherally in subjects with anisometropic amblyopia. In both groups of patients, we found a significant negative correlation between visual acuity, on the one hand, and the maximal depth of the scotomas and the visual field indices (MD and CLV), on the other.

Corneal carcinoma

Carcinomas of the cornea have not yet been described in the literature. A 50-year-old man underwent keratoplasty because of corneal dystrophy. Microscopic examination disclosed a squamous-cell carcinoma which had spread over the entire cornea and just reached the limbus.

Late manifestation of conjunctival malignant melanoma

The patient, who is now 60, had a nevus and areas of cystic changes in the conjunctiva in her right eye, which had been present from birth to the age of 59. In 1987, rapid tumor growth aroused suspicion that malignant change could be occurring and so the nevus as well as the area of the conjunctiva containing cystic changes were excised. Histological finding: conjunctival malignant melanoma, containing compressed (densely arranged) atypical cells with pleomorphic hyperchromatic nuclei and prominent nucleoli. The biopsy specimen of the conjunctiva showed a typical nevocellular nevus with large inclusion cysts of the conjunctival epithelium.

[Spontaneous corneal rupture after strontium irradiation of a conjunctival squamous cell carcinoma]

A 87-year-old female patient with a squamous cell carcinoma of the conjunctiva was treated with local strontium-90 irradiation (with a so-called 'Dermaplatte'). In spite of a relatively low dosage, radiotherapy was followed by a corneal ulcer with consecutive rupture of the cornea. The cause of this unexpected perforation was, besides the effect of low-dose irradiation, probably a metabolic disorder of the cornea and a disturbance of the tear film due to the carcinoma which had spread on Bowman's layer of the cornea in an exophytic manner and was accompanied by a dense lymphocytic infiltration. An exenteration was performed and, at the last examination (1 year later), no local recurrence could be detected.

[Analysis of a dacrolith ]

Dacryoliths are uncommon and there are only a few reports in the literature. In a patient with recurrent stenosis of the lacrimal drainage system a lacrimal stone (dacryolith) was removed from the lacrimal sac during dacryocystorhinostomy. A histological and immunohistochemical examination was performed and keratin antibodies could be detected. In a chemical analysis calcium, sulfur and some phosphorus were determined as major constituents.

[Studies of the penetrating ability of fosfomycin into the aqueous humor and vitreous body of the eye]

Fosfomycin is an antibiotic with a new simple chemical structure and a broad spectrum of antibacterial activity, especially against staphylococci. In the study reported here, the penetration of fosfomycin into the aqueous humor and vitreous body was investigated after intravenous infusion of 4 and 8 g. The highest average concentration approximately 2 hours after administration was 28.3 micrograms/ml after the 4 g dose and 52 micrograms/ml after the 8 g dose. Both the 4 g and 8 g doses thus produced aqueous humor levels exceeding the minimum inhibitory concentrations required for most gram-positive and gram-negative organisms commonly responsible for bacterial endophthalmitis, including strains of pseudomonas aeruginosa. Extremely high aqueous humor levels of fosfomycin were observed in two patients with inflamed eyes because of a change in the blood-aqueous barrier.

[Carotinoid deposits in the retina]

In this case report a 55-year-old Turkish patient with polymorphous light eruption, who has been treated with high doses of beta-carotene and canthaxanthin for more than 6 years is described. The examination of the fundus showed dense, glistening bright yellow crystalline deposits around the maculae. The only functional impairment that could be detected was a slight decrease in visual acuity and dark adaptation.