Effect of A Multinutrient Complex on Retinal Microcirculation in Diabetic Patients Investigated Using an Adaptive Optics Retinal Camera.

CONTEXT: Alimentary supplements may have beneficial effects on retinal microvasculature in diabetic patients. OBJECTIVE AND DESIGN: State-of-the-art imaging techniques were used to assess retinal microcirculation in diabetic patients in an observational study before and after 3 months treatment with a multinutrient complex including resveratrol, vitamins D3, C, E, essential fatty acids, trace elements (zinc and copper) and macular pigments (lutein and zeaxanthin)-Resvega. SUBJECTS AND METHODS: Fifteen subjects were included in this study. Adaptive optics ophthalmoscopy was used to measure the parameters of temporal retinal arterioles. Optical coherence tomography angiography was employed to assess foveal avascular zone and vessel densities of the superficial capillary plexus, deep capillary plexus and choricapillary plexus. RESULTS: After 3 months of treatment, there was a statistically significant median decrease in wall-to-lumen ratio (p=0.0001). The same tendencies were noticed for wall thickness values (p=0.008) and wall cross sectional area values (p=0.001). On the other side, no significant changes were noticed concerning the OCTA parameters. CONCLUSIONS: Resvega seems to have a beneficial effect on the retinal arterioles in diabetic patients.

RETINAL MICROCIRCULATION INVESTIGATION IN TYPE I AND II DIABETIC PATIENTS WITHOUT RETINOPATHY USING AN ADAPTIVE OPTICS RETINAL CAMERA.

CONTEXT: State of art imaging techniques might be a useful tool to early detect the retinal vessels lesions in diabetes. OBJECTIVE AND DESIGN: This analytical observational study investigates the retinal microcirculation changes in type I and II diabetic patients without retinopathy using adaptive optics ophthalmoscopy (AOO) and optical coherence ophthalmoscopy angiography (OCTA). SUBJECTS AND METHODS: Fifty-five subjects were included in this study and were divided in three groups: type I diabetic group (n=16), type II diabetic group (n=19) and control group (n=20). An adaptive optics retinal camera was used to assess the parameters of the temporal superior retinal arterioles. Moreover, vessel density of the superficial capillary plexus across the parafoveal area was measured with OCT-A. All cases were investigated once, in a cross-sectional design. RESULTS: Diabetic patients from both groups had a higher wall-to-lumen-ratio compared to the controls (p=0.01 and 0.01, respectively). Interestingly, no significant differences were found between the two diabetic groups (p=0.69). Moreover, the vessel density was smaller in the type I diabetic group than in the control group (p=0.001). CONCLUSION: AOO might be a useful tool to detect early retinal vascular changes in diabetes before any clinical signs and together with OCTA it might bring important information on the prognostic and pathophysiology of the disease.

The remote effects of intravitreal anti-VEGF therapy.

Objective: To study the effects of intravitreal anti-Vascular Endothelial Growth Factor (VEGF) therapy with Avastin for wet Age-Related Macular Degeneration (AMD) on Benign Prostatic Hyperplasia (BPH)-related symptoms. Methods: An exploratory trial was conducted from August 1, 2013 to February 1, 2014, that included 14 male patients previously diagnosed with BPH, who were aged between 59 and 69 years. The trial was performed in Bucharest and involved two medical institutions: the Clinical Hospital of Eye Emergencies and the "Prof. Dr. Theodor Burghele" Hospital. This prospective study utilized both objective and subjective indicators to analyze the link between intravitreal anti-VEGF therapy for wet AMD and BPH. The evaluations consisted of uroflowmetry and International Prostate Symptom Score (I-PSS) assessments. Results: The maximum flow rate (Qmax) improved by an average of 5.05 ml/ sec in 9 patients, whereas the remaining 5 patients showed a slight decrease in Qmax (mean 1.6 ml/ sec). The I-PSS score improved, with an overall decrease of 1.18 points at follow-up compared to the initial score (mean initial score = 2.42; mean follow-up score = 1.24). Conclusion: The analysis revealed that anti-VEGF therapy for wet AMD had a significant positive effect on all BPH-related symptoms; patients reported improved urinary streams and decreased nocturia. Abbreviations: BPH = benign prostatic hyperplasia, AMD = age-related macular degeneration, VEGF = vascular endothelial growth factor, I-PSS = international prostate symptom score, Qmax = maximum flow rate, TSP-1 = thrombospondin-1, FGF-2 = fibroblast growth factor, mRNA = precursor messenger ribonucleic acid, PSA = prostate-specific antigen, DRE = digital rectal examination, AUR = acute urinary retention, COX2 = cyclooxygenase 2, QoL = quality of life.

Development and validation of glycoprotein-based native-subunit vaccine for fish against Aeromonas hydrophila.

Aeromonas hydrophila is known to be causative agent of an infection named as Bacterial haemorrhagic septicaemia or red pest in freshwater fish. The aim of this study was to develop and validate the glycoprotein-based fish vaccine against Aeromonas hydrophila. For this aim, after identification and characterization of A. hydrophila isolates from fish farms, one A. hydrophila isolate was selected as vaccine strain. Antigenic glycoproteins of this vaccine strain were determined by Western blotting and glycan detection kit. The connection types of these glycoproteins were examined by glycoprotein differentiation kit. Two glycoproteins, molecular weights of 19 and 38 kDa, with SNA connection type were selected for use in vaccination trials. After their purification by SNA-specific lectin and size-exclusion chromatography, protection studies with purified proteins were performed. For challenge trials, four experimental fish groups were designated: Group I (with montanide), Group II (with montanide and ginseng), Group III [with Al(OH)3 ] and Group IV [with Al(OH)3 and ginseng]. The survival ratings of fish were determined, and protection was calculated as 21.56%, 29.41%, 69.83% and 78.88% in groups I, II, III and IV, respectively. In conclusion, A. hydrophila glycoproteins with Al(OH)3 and ginseng could be used as a safe and effective vaccine for fish.

[Treatment for penetrating wound caused by metallic intraocular foreign body]. / REZOLVAREA UNEI PLAGI PENETRANTE CU CORP STRAIN INTRAOCULAR METALIC.

INTRODUCTION: Penetrating wounds with intraocular foreign body are ophthalmologic emergencies due to their severity and complexity and may require multiple surgeries for final resolution. CASE REPORT: 30-years-old patient with penetrating wound and metallic intraocular foreign body in the posterior vitreous requires successive operations for IOFB extraction, lensectomy, posterior vitrectomy for rhegmatogenous retinal detachment and then silicone oil extraction with final visual acuity 0, 4 PH.

Refractory secondary glaucoma-clinical case.

RATIONALE AND OBJECTIVE: The major objective of treatment in glaucomatous disease is the decrease of intraocular pressure while maintaining the patient's vision and quality of life. Despite therapeutic possibilities, some cases of glaucoma remain refractory to treatment with the maintenance of elevated intraocular pressure and further progression of the disease.Artificial drainage systems, Ahmed valve, is a treatment alternative for refractory glaucoma when medical therapy, laser or conventional surgery have shown no results. METHODS AND RESULTS: We present the case of a patient presenting with refractive to medical treatment secondary glaucoma, following cataract surgery and vitrectomy for retinal detachment. DISCUSSIONS: One of the complications of vitreoretinal surgery is secondary glaucoma. Some of the patients with this type of glaucoma are unresponsive to conventional medical therapy. In such situations, a DPS implantation is needed such as an Ahmed valve in our case. There are situations in which classical surgery-trabeculectomy--has no theoretical chance of success (in cases of neovascular glaucoma, secondary glaucoma, and inflammatory glaucoma post vitreoretinal surgery), [5,6]. Even though ASD are only used for refractory glaucoma, in this type of glaucoma, ADS can be used successfully as first line surgery.

Fatty acids, tocopherols, selenium and total carotene of pistachios (P. vera L.) from Diyarbakir (Southeastern Turkey) and walnuts (J. regia L.) from Erzincan (Eastern Turkey).

In this study, 14 well-adapted genotypes of pistachio (Pistachio vera L.) grown in Diyarbakir (Southeastern Turkey) and 15 walnut (Juglans regia L.) genotypes grown in Erzincan (Eastern Turkey) have been studied. Pistachio genotypes contained 8.16-9.33% palmitic acid, 0.54-0.68% palmitoleic acid, 2.35-4.21% stearic acid, 67.81-76.82% oleic acid, 9.42-18:32% linoleic acid, 0.27-0.38% linolenic acid and 0.19-0.33 % arachidic acid. The range of selenium, α-tocopherol, γ-tocopherol, δ-tocopherol, α-tocotrienoid, γ-tocotrienoid and total carotenoid of these promising genotypes were found to be between 11.44 and 190.71 ng/g, 1.36 and 26.93, 36.17 and 170, 0.45 and 2.61, 0.96 and 3.76, 2.33 and 37.72 and 1.01 and 4.93 mg/kg, respectively. Linoleic acid ranging from 43.19% to 53.16% was the most abundant fatty acid in 15 pomologically selected walnut genotypes, followed by oleic and linolenic acids (31.91% and 11.46%, respectively). Their selenium contents ranged between 7.25 and 57.67 ng/g. γ-Tocopherol was the predominant tocopherol in walnut genotypes. Pistachio and walnut genotypes with higher unsaturated fatty acids, tocopherols and selenium contents may be valuable for nutritional breeding efforts.

[Current therapeutic approach to diabetic macular edema refractory to laser coagulation]. / Abordarea terapeutica moderna a edemului macular diabetic rezistent la laserterapie.

The paper presents the evolution of a diabetic patient with CSME resistant to laser treatment. The intravitreal injection of Triamcinolone Acetonid represented a very efficient therapeutic solution the visual accuity improving for a period of 7-9 months.

The priming effect of human interferon-alpha is mediated by protein kinase C.

Human embryo fibroblasts (HEF) were primed when treated with a synthetic diacylglycerol, OAG, or the phorbol esters TPA or DBP. These primed HEF produce more interferon-beta (IFN-beta) in response to poly(rI).poly(rC), or poly(rA).poly(rU), added 1 h or 18 h later. These priming agents are activators of protein kinase C (PKC). A PKC inhibitor, H-7, blocked their priming effects and also those of human IFN-alpha. Two phorbol esters, 4PDD and 4P, that did not activate PKC did not prime HEF cells. Pretreatment of HEF cells for 1 h or 18 h with TPA or DBP reduced their susceptibility to infection with vesicular stomatitis virus (VSV); this effect was blocked by treatment with H-7. In contrast, the antiviral effects of IFN-alpha were not blocked by H-7, or by previous down-regulation of PKC by prolonged treatment of HEF cells with TPA. These results show that in HEF cells treated with IFN-alpha PKC plays a role in the processes that prime for IFN production, but not in those which establish the antiviral state.

Cell-membrane phospholipase C is involved in inducing the antiviral effect of interferon.

A monospecific inhibitory antibody directed to phospholipase C (phosphoinositidase C) blocked the antiviral effect of human interferons alpha and beta when tested on human quiescent fibroblasts challenged with the vesicular stomatitis virus. This action was due to specific inhibition of polyphosphoinositide hydrolysis because (a) the F(ab')2 fragment of the antibody molecule was also inhibitory; (b) excess antibodies directed to phospholipase A2 and to a phosphatidylcholine-preferring phospholipase C did not have any inhibitory effect, and (c) the combination of 12-O-tetradecanoyl-phorbol-acetate and calcium ionophore A23187 had an interferon-like antiviral effect which was not influenced by the inhibitory anti-phospholipase C antibodies. To avoid an interferon-like effect due to induction of interferon by second messengers, Vero cells, which lack interferon biosynthesis, were also used. Liposomes containing inositol 1,4,5-triphosphate and 1-oleoyl-2-acetyl-rac-glycerol protected Vero cells against the infection with the vesicular stomatitis virus. These results taken together show that phosphoinositide-derived second messengers are involved in triggering the antiviral effect of interferons alpha and beta.

Protein kinase C and the antiviral effect of human interferon.

Protein kinase C (PKC) inhibitors: Hidaka's compounds H-7 (10 microM) and H-8 (20 microM), palmitoyl-carnitine (10 microM) and phloretin (50 microM), did not modify the antiviral effect of human natural or recombinant interferon alpha and of natural interferon beta. The tumor promoter 12-o-tetradecanoyl-phorbol-13-acetate (TPA) (200 nM), known as activator of PKC induced an antiviral state when tested on human embryo fibroblasts challenged with the vesicular stomatitis virus. The battery of PKC inhibitors used inhibited the antiviral effect induced by TPA. Palmitoyl-carnitine (10 microM) exerted a toxic effect that was reversed by interferon treatment (2,000 IU/ml interferon alpha). These results suggest that PKC, possibly activated by interferon-receptor interaction, is not essential for inducing the antiviral effect of interferon, but, probably, mediates the antiviral effect of TPA.

Interferon: signal molecules involved in its antiviral effect.

A major problem concerning interferon (IFN)-cell interaction is the second messenger system that transduces the IFN signal. We discuss the evidences existing in literature and our arguments which suggest that the antiviral effect of IFNs alpha and beta are mediated by a membrane mechanism including a phospholipase C dependent hydrolysis of phosphoinositides. The resulting two second messengers: diacylglycerol and inositol triphosphate and subsequent, separate but interacting, signal pathways: activation of protein kinase C and ionic events are tested in respect with the antiviral effect of IFN.

Interferon-induced antiviral state is inhibited by neomycin and mimicked by diacylglycerols.

The antiviral effect of human interferons alpha and beta was inhibited in dose-dependent manner by submillimolar concentrations of neomycin, known to block phosphoinositide hydrolysis and therefore the diacylglycerol formation. On the contrary, the synthetic permeant diacylglycerols (1-oleoyl-2-acetyl-sn or rac-glycerol) were able to induce an interferon-like antiviral state when tested against the vesicular stomatitis virus and herpes simplex type I virus. Hidaka's compound H-8 (1.2 microM), expected to inhibit cAMP- and cGMP-dependent protein kinases, did not modify the antiviral effect of interferon. Our data suggest that the phosphoinositide pathway is involved in transducing the interferon antiviral signal, but, since the exogenous phospholipase C (0.1-1 U/ml) failed to induce an antiviral state, this pathway, although implicated, seems not the only one.

The antiviral effect of human interferon alpha is dependent on phosphoinositide-derived messengers.

Neomycin the putative blocker of membrane polyphosphoinositide hydrolysis, inhibited the antiviral activity of human interferon alpha, when tested on human quiescent fibroblasts challenged with vesicular stomatitis virus. The anti-interferon effect of neomycin could be correlated in terms of dose dependence for both neomycin (0.05-1 mM) and interferon (100-5,000 IU/ml). The results suggest that the antiviral activity of interferon alpha depends on diacylglycerol formation. Indeed, the synthetic diacylglycerol (50 microM) was as effective as 100 IU/ml interferon in inducing the antiviral state.