Enfermedad del ojo seco / Dry Eye Disease

El ojo seco es una condición frecuente que tiene un impacto importante sobre la calidad de vida, pues conlleva a una sensación de incomodidad y discapacidad visual. Adicionalmente, puede tener un efecto pernicioso sobre procedimientos quirúrgicos oculares, lo que compromete el resultado de las cirugías de córnea, catarata y refractiva. Este síndrome de disfunción lagrimal es un padecimiento multifactorial, derivado de una deficiencia o evaporación excesiva de la lágrima. Se realizó una búsqueda en la literatura científica, con el objetivo de describir de forma general la enfermedad del ojo seco, brindando información actualizada en relación a su concepto, epidemiología, clasificación, factores de riesgo, fisiopatología, síntomas y signos, retos diagnósticos atendiendo a la complejidad de la entidad y tratamiento. La identificación temprana de los subtipos y el control de la severidad es crucial para mejorar el bienestar del paciente. La carga económica en la sociedad, y el impacto de la enfermedad en el individuo, a través de su efecto sobre la visión, calidad de vida y productividad laboral, así como en su esfera psicológica y física son considerables. Por ello, es importante que los oftalmólogos con el apoyo de los tecnólogos en optometría y óptica diagnostiquen y traten la enfermedad en sus fases iniciales, en la que los signos y síntomas todavía no son graves, lo que permitirá ralentizar su evolución natural, y posiblemente disminuir las consecuencias perjudiciales que provoca(AU)

Dry eye is a common condition that has a significant impact on quality of life, leading to a feeling of discomfort and visual impairment. Additionally, it can have a pernicious effect on ocular surgical procedures, compromising the outcome of corneal, cataract and refractive surgeries. This lacrimal dysfunction syndrome is a multifactorial condition, derived from a deficiency or excessive tear evaporation. A search of the scientific literature was carried out with the aim of describing dry eye disease in a general way, providing updated information regarding its concept, epidemiology, classification, risk factors, pathophysiology, symptoms and signs, diagnostic challenges considering the complexity of the condition and its treatment. Early identification of subtypes and control of severity is crucial to improve patient welfare. The economic burden on society, and the impact of the disease on the individual, through its effect on vision, quality of life and work productivity, as well as on the psychological and physical aspects, are considerable. Therefore, it is important that ophthalmologists with the support of optometrists and ophthalmic technologists diagnose and treat the disease in its early stages, when signs and symptoms are not yet severe, which will slow down its natural progression, and possibly reduce the resulting harmful consequences(AU)

Study on effect and mechanism of Zhenzhu Mingmu Eye Drops protected HCEC against hypermeability-induced injury / 中草药

Objective: To investigate the effects and mechanism of Zhenzhu Mingmu Eye Drops (ZMED) on human corneal epithelial cells (HCEC) injury model induced by high permeability. Methods: The dye eyes disease model was established using 110 mmol/L NaCl to stimulate HCEC, and different concentration of ZMED was given to the treatment group. MTT assay and lactate dehydrogenase (LDH) leakage were used to evaluate the protection effects of ZMED on HCEC. The effects of ZMED on apoptosis of HCEC were analyzed by flow cytometry. AO/EB double staining and Hoechst 33258 analysis were used as sensitive assays for apoptosis. Moreover, HCEC treated with ZMED were subjected to Western blotting for protein levels of Caspase-9, Caspase-3 and PARP. Results: ZMED significantly increased cell viability of HCEC and decreased the LDH release in a dose-dependent manner. ZMED dramatically decreased the apoptosis rate. Furthermore, ZMED down-regulated the levels of cleaved Caspase-9, cleaved Caspase-3 and cleaved PARP. Conclusion: ZMED could protect HCEC against hypermeability, which may be related to the inhibition of Caspase-9/Casepase-3 signaling pathways.

A Case of Extrapontine Myelinolysis with both Frontal Lobe Dysfunction and Decreased Perfusion in SPECT

A thirty-nine year old woman was consulted because of personality change, agitation and memory disturbance. She received chemotherapy and oral steroids because of carcinoma within the bronchus. She had a high serum osmolarity caused by hyperglycemia and hypernatremia, and it was corrected rapidly. Her brain MRI showed EPM (extrapontine myelinolysis). Brain SPECT showed hypoperfusion in the bilateral orbitofrontal regions. We report a patient with EPM with typical frontal lobe dysfunction as an initial manifestation and bilateral orbitofrontal hypoperfusion.

Effects of Hyperosmolar Solution on the Twitch Force, Membrane Potential, and Intracellular Sodium Activity in Purkinje Fibers and Ventricular Muscles

BACKGROUND: Hypertonic solutions are using in emergency patients including refractory shock. The effects of the hyperosmotic solutions for the cardiac contractile effect has remained unclear. To study the mechanism of increase in twitch force by hypertonic solution, memberane potential, intracellular sodium activities(aNia), and twitch force were measured simultaneously in 1 Hz-driven canine Purkinje fibers and guinea pig papillary muscles. METHODS: To increase osmolarity, 20, 40, and 80 mOsm glucose, NaCl or mannitol was added to normal Tyrode solution. We used the conventional and Na(+)-selective microelectrodes, to study the membrane potential and intracellular sodium activity. Changes in twitch force were evaluated also by tension tranducer. RESULTS: 1) Hyperosmolar glucose or NaCl added to normal Tyrode solution produced membrane pontential hyperpolarization, increase in aNia, and increase in twitch force in dog Purkinje fibers. Increase in twitch force was related to decrease in the ratio of aNia to extracellular sodium activity(aNoa). NaCl-inducedd aNia increase was not blocked by 10(-5)M tetrodotoxin, a fast sodium channel blocker. 2) Hyperosmolar glucose or mannitol added to normal Tyrode solution produced membrane potential hyperpolarization, increase in aNia, and increase in twitch force in guinea pig papillary muscles. However, the addition of hyperosmolar NaCl did not affect on membrane potential, but produced increase in aNia, and decrease in twitch force. 3) Prolonging effect of hyperosmolar glucose on duration of action potential was smaller than that of NaCl or mannitol in Purkinje fibers and papillary muscles. 4) Increase in twich force produced by ECF Na+reduction or by hyperosmotic solution was reated to decrase in the aNia ratio. 5) Relationship curve between increase in twitch force and aNoa/aNia ratio in hyperosmolr solution was less steeper than that in ECF Na(+)-reduced solution. CONCLUSION: The above results suggested that hyperosmolar solution-induced twitch force change was related to aNoa/aNia ratio change which influenced intracellular calcium activity via Na(+)-Ca(2+)exchange.

P38 Signal Cascades in Hyperosmolarity-Induced Mucous Hypersecretion / 环境与健康杂志

0.05).Conclusion Hypertonic stress can induce the airway epithelial cells to develop a high mucus secretion with the concentration-dependent manner in the level of transcription,P38 signal pathway plays a major role.