Clinical decision making based on data from GDx: one-year observations.
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PURPOSE: To determine whether information derived from the GDx scanning laser polarimeter aids in the clinical decision-making process for patients with various types of glaucoma. METHODS: Over a 4-month period, 342 consecutive patients with primary open-angle glaucoma, ocular hypertension, angle-closure glaucoma, or secondary glaucomas or in whom the diagnosis of glaucoma was uncertain were evaluated with the GDx scanning laser. After 1 year, 153 patients with glaucoma underwent GDx analysis again. Chart review revealed that 42 of the 153 patients had a change in therapy as a result of the GDx evaluation combined with analysis of visual fields, optic disc cupping, and intraocular pressure (IOP). Outcomes were then compared. RESULTS: The group who had a change in therapy had a higher average GDx number (51.5 +/- 26.1 vs 37.0 +/- 23.5 [P = .001]) at the initial visit and higher IOP (18.2 +/- 4.6 vs 16.0 +/- 3.2 mm Hg [P = .005]). In spite of a change in therapy, at an average of 344 days later, IOP was unchanged (18.3 +/- 5.3 vs 15.7 +/- 3.2 mm Hg [P = .001]) and GDx values in the altered therapy group were higher than at baseline (57.3 +/- 27.9 vs 36.7 +/- 23.4 [P = .001]), although the differences within each group did not achieve statistical significance. CONCLUSION: GDx analysis may be helpful in determining patients at risk for damage from glaucoma, even in eyes in which cup-disc ratio and field loss have not progressed. Changing medications without significantly reducing IOP may be insufficient to halt increases in GDx numbers and may indicate a need for more aggressive therapy. (+info)
Assessment of the retinal nerve fiber layer of the normal and glaucomatous monkey with scanning laser polarimetry.
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PURPOSE: To describe and test a method for assessment of the monkey retinal nerve fiber layer (RNFL) with scanning laser polarimetry. METHODS: A scanning laser polarimeter was modified to accommodate a variable corneal polarization compensator. Corneal polarization magnitude (CPM) and corneal polarization axis (CPA) of the anterior segment birefringence of normal and glaucomatous cynomolgus monkey eyes were determined from a polarimetry image of the Henle fiber layer. Next, the variable compensator was adjusted to minimize the anterior segment birefringence. RNFL measurements were then obtained. All images were compared with simultaneous optic disc stereoscopic photographs. RESULTS: CPM was small in each of the eyes examined, ranging from 5.7 nm to 9.0 nm. CPA ranged from -62 degrees to 79 degrees. (Nasally upward CPA values were recorded as negative; nasally downward CPA values were recorded as positive.) When eye-specific compensation was used, RNFL retardation profiles mimicked the expected appearance of the RNFL in all eyes. We also observed a substantial decrease in retardation in eyes with experimental glaucoma compared with healthy fellow eyes. CONCLUSIONS: Individualized anterior segment compensation can be achieved in the monkey eye so that the measured birefringence appears to largely reflect the birefringence of the RNFL. Observed differences in retardation between healthy eyes and eyes with experimental glaucoma suggest that scanning laser polarimetry may be useful for detecting and monitoring RNFL loss in experimental primate glaucoma. (+info)
Visualization of the metaphase II meiotic spindle in living human oocytes using the Polscope enables the prediction of embryonic developmental competence after ICSI.
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BACKGROUND: Meiotic spindles in living human oocytes can be visualized by the Polscope. This study investigated the relationship between the presence/location of the spindle in metaphase II (MII) oocytes and developmental competence of embryos in vitro. METHODS: The spindles in 626 MII oocytes were examined by the Polscope and divided into six groups (A-F) based on the presence or absence of the spindles and the angle between the spindle and the first polar body. After ICSI, the fertilization and embryo development were evaluated. RESULTS: Meiotic spindles were imaged in 523 oocytes (83.5%), while 103 (16.5%) did not have a visible spindle (group F). The majority of oocytes (68.8%) had the spindle directly beneath or adjacent to the first polar body (groups A and B: 48.2 and 20.6%). Oocytes in group C (11.2%) had the spindle located between 60 and 120 degrees angle away from the first polar body, those in group D (2.4%) had the spindle located between 120 and 180 degrees angle and those in group E (1.1%) had the spindle located at 180 degrees angle to the first polar body. The fertilization and embryonic development were similar in the oocytes with spindles regardless of spindle position. However, the rate of high quality embryos was significantly higher in the oocytes (64.2%) with visible spindles than in the oocytes (35.9%) without spindle and multipronuclear proportion showed a slight tendency to increase in oocytes without spindles. (10.7 versus 5.9%, P = 0.12; NS). CONCLUSIONS: the presence of a bi-refringent meiotic spindle in human oocytes by using the Polscope can predict a higher embryonic developmental competence. However, the relative position of the spindle within the oocyte doesn't appear to influence the developmental potential of embryos. (+info)
Calcium oxalate precipitates in a renomedullary interstitial cell tumor.
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We report a case of calcium oxalate deposition in a renomedullary interstitial cell tumor (RICT) in a patient dying of full-blown AIDS. The precipitates showed birefringence using a partially polaris ed light and were stained black in Yasue's silver nitrate-rubeanic acid method. The combination of calcium oxalosis and RICT has not been reported before and might possibly be due to systemic biochemical alterations of the glycosaminoglycans as a result of profound metabolic disturbances in AIDS patients. (+info)
Scanning laser polarimetry with variable corneal compensation: identification and correction for corneal birefringence in eyes with macular disease.
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PURPOSE: In scanning laser polarimetry with variable corneal compensation (SLP-VCC), the macula is used as an intraocular polarimeter to calculate and neutralize corneal birefringence based on an intact Henle's layer. The purpose of this investigation was to validate this strategy in eyes with macular structural disease. METHODS: A nerve fiber analyzer was modified to enable the measurement of corneal polarization axis and magnitude so that compensation for corneal birefringence was eye specific. Normal subjects and patients with a variety of pathologic macular conditions underwent complete ocular examination, SLP-VCC, and direct measurement of the corneal polarization axis (CPA), with a slit-lamp-mounted corneal polarimeter. Macular birefringence patterns were classified as well defined, weak, or indeterminate bow ties. A new "screen" method is described that determines the anterior segment birefringence without relying on the presence of macular bow-tie patterns. RESULTS: Forty-seven eyes (20 normal, 27 with maculopathy) of 47 patients (mean age, 59.0 +/- 19.0 years; range, 24-88) were enrolled. The correlation between CPA measured with corneal polarimetry (CPA by P(IV) [fourth Purkinje image]) and SLP-VCC was less in eyes with macular disease (R(2) = 0.22, P = 0.024) compared with normal eyes (R(2) = 0.72, P < 0.0001). Eyes with macular disease had significantly (P = 0.007) more indeterminate macular bow ties (8/27; 29%) than did normal eyes (0/20). The magnitude of difference between CPA by P(IV) and CPA by SLP-VCC was significantly (P = 0.0007) greater in eyes with indeterminate bow-tie patterns than in weak and well-defined patterns. Although no relationship was observed between CPA and 12 retardation parameters obtained with SLP-VCC in normal eyes (P > 0.05), eyes with macular disease showed a significant association between CPA and average thickness (R(2) = 0.27, P = 0.005), ellipse average (R(2) = 0.24, P = 0.0085), superior average (R(2) = 0.24, P = 0.009), inferior average (R(2) = 0.28, P = 0.004), and superior integral (R(2) = 0.37, P = 0.0008), suggesting incomplete corneal compensation. Greater correlation between CPA by P(IV) and CPA derived by SLP-VCC was found by using the screen method (R(2) = 0.83, P < 0.0001) compared with the bow-tie method (R(2) = 0.22, P = 0.024) in eyes with maculopathy. CONCLUSIONS: Macular strategies for neutralization of corneal birefringence using SLP-VCC can fail if Henle's layer is disrupted by macular disease. The screen method provides a more robust measure of the anterior segment birefringence in some eyes with macular disease. (+info)
Casting metal nanowires within discrete self-assembled peptide nanotubes.
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Tubular nanostructures are suggested to have a wide range of applications in nanotechnology. We report our observation of the self-assembly of a very short peptide, the Alzheimer's beta-amyloid diphenylalanine structural motif, into discrete and stiff nanotubes. Reduction of ionic silver within the nanotubes, followed by enzymatic degradation of the peptide backbone, resulted in the production of discrete nanowires with a long persistence length. The same dipeptide building block, made of D-phenylalanine, resulted in the production of enzymatically stable nanotubes. (+info)
Fourier analysis of scanning laser polarimetry measurements with variable corneal compensation in glaucoma.
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PURPOSE: To apply Fourier analysis to the retinal nerve fiber layer (RNFL) thickness measurements obtained with scanning laser polarimetry (SLP), by using variable corneal compensation, and to evaluate the ability of this method to discriminate glaucomatous from normal eyes. METHODS: The study included one eye each of 55 patients with glaucoma and 52 healthy subjects. RNFL thickness measurements were obtained with a modified commercial scanning laser polarimeter (GDx Nerve Fiber Analyzer; Laser Diagnostic Technologies, Inc., San Diego, CA) so that corneal birefringence could be corrected on a subject-specific variable basis. The shape of the RNFL thickness double-hump pattern was analyzed by Fourier analysis of polarimetry data. Fourier coefficients and GDx parameters were compared between the two groups. A linear discriminant function was developed to identify and combine the most useful Fourier coefficients to separate the two groups. Receiver operating characteristic (ROC) curves were obtained for each measurement, and sensitivity values (at fixed specificities) were calculated. RESULTS: The Fourier-based linear discriminant function (LDF Fourier) resulted in a sensitivity of 84% for a specificity set at 92%. For similar specificity, the GDx software-provided parameters had sensitivities ranging from 24% to 69%. The area under ROC curve for the LDF Fourier was 0.949, significantly larger than the ROC curve area for the single best GDx software-provided parameter, superior average (0.870). CONCLUSIONS: The combination of Fourier RNFL thickness measures in an LDF, obtained using SLP with variable corneal compensation, improved the ability to discriminate glaucomatous from healthy eyes, compared with the GDx software-provided parameters. (+info)
Valinomycin and excitation-contraction coupling in skeletal muscle fibres of the frog.
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1. Experiments were carried out on intact frog skeletal muscle fibres to study the role of H+ and K+ as counter-ions during the release of Ca2+ from the sarcoplasmic reticulum (SR). A specific focus was to test whether valinomycin, a potassium ionophore, markedly reduces or abolishes H+ counter-ions fluxes across the SR membrane in response to electrical stimulation. 2. Single twitch fibres, mounted on an optical bench apparatus and stretch to long sarcomere length (3.6-4.0 microns), were activated by single action potentials (16 degrees C). Two optical signals related to excitation-contraction coupling were measured: (i) the 'second component' of the intrinsic birefringence signal, which is closely related to the myoplasmic free [Ca2+] transient, and (ii) the transient myoplasmic alkalization (delta pH) detectable from the pH indicator Phenol Red, a signal thought to reflect the movement of protons from the myoplasm into the SR in partial electrical exchange for released Ca2+. 3. Exposure of a fibre to 5 microM-valinomycin produced a slight, progressive decrease in the amplitude of the birefringence signal, approximately 5-6% per hour. This result suggests that, if anything, the peak rate at which Ca2+ is released from the sarcoplasmic reticulum is slightly decreased by valinomycin. 4. The amplitude of the Phenol Red delta pH signal, measured after exposure of a fibre to valinomycin for a period of at least 60 min, averaged 0.0020 +/- 0.0002 (+/- S.E.M.); this value is slightly smaller than, but not significantly different from (P greater than 0.05; two-tailed t test) that measured in fibres not exposed to valinomycin (0.0025 +/- 0.0002). This result does not support the idea that valinomycin, but virtue of increasing the flux of K+ into the SR, markedly reduces the flux of protons during Ca2+ release. 5. Our findings of minimal changes in the birefringence and delta pH signals are consistent with the idea that, at the time of Ca2+ release, the potassium conductance of the SR membrane is large and not substantially increased by the addition of valinomycin to Ringer solution. (+info)