Natural antibodies and their relationship with total immunoglobulins and acquired antibody response in goat kid (Capra hircus, L. 1758) serum.

Natural antibodies (NAb) are antibodies that can bind to a particular antigen without any apparent antigenic stimulation. In this paper, a careful analysis has been carried out on NAb levels in goat kid serum; possible correlations with the total immunoglobulin (tot-Ig) levels and specific antibody (SpAb) response were considered. Twenty randomly chosen kids were submitted to a first blood sampling (day 0). After 60 and 100 days, new blood samplings were carried out in the same animals. On day 0, after blood collection, all animals were immunized with a commercial vaccine; the immunization was repeated 30 days apart. Some exogenous antigens were tested to verify their immunoreactivity to NAb. Among them, the synthetic hapten 2,4,6-trinitrophenyl (TNP) conjugated with bovine serum albumin, resulted as the antigen with the higher immunoreactivity to NAb. Tot-Ig levels increased over time (p < 0.001). On the contrary, NAb levels, both IgG- and IgM-isotypes, significantly decreased during the experimental period (p < 0.001 and <0.05, respectively). Linear regression analyses showed a high correlation between IgM-NAb and tot-IgM levels (p < 0.001) at all the evaluated sampling times. However, a significant correlation between IgG-NAb and IgM-NAb was found only at the 1st (p < 0.01) and at the 2nd sampling (p < 0.05). No significant correlations were found between SpAb response and the other assessed humoral immune parameters. The obtained results are discussed in the light of the possible use of NAb assessment for the evaluation of the immune system activity in goat.

The molecular characterization by SSRs reveals a new South Italian kinship and the origin of the cultivar Uva di Troia.

Vitis vinifera L. varieties were spread through cuttings following historic migrations of people, trades, or after biological crises due to pests outbreaks. Some today's varieties could be more than a 1000 years old and, although over the centuries these varieties generated most of the remaining cultivars, their origin could be impossible to track back. The Italian grapevine biodiversity is one of most important, most likely due to its strategic position in the middle of the Mediterranean sea. Unravelling of its structure is challenging because of its complexity and the lack of historical documentation. In this paper molecular data are compared with historical documentations. Simple Sequence Repeats fingerprinting are molecular markers best suited to investigate genetic relationships and identify pedigrees. South-Italian germplasm was studied with 54 nuclear microsatellites. A family was identified, consisting of two parents and three siblings and further genetically characterized with six nuclear and five chloroplast microsatellites and described with ampelographic and phylometric analysis. Although these latter were not informative for the kinship identification. The common Bombino bianco was the female parent and the previously unknown Uva rosa antica was the male parent. Bombino nero, Impigno and the popular Uva di Troia, all typical of the south-east Italy, were the offspring. Further research showed that the Uva rosa antica was a synonym of Quagliano and Bouteillan noir, both minor varieties. Quagliano was considered to be autochthonous of some alpine valleys in the north-west of Italy and Bouteillan noir is a neglected variety of Vancluse in France. This finding uncovers the intricate nature of Italian grape cultivars, considered peculiar of an area, but possibly being the remains of ancient latin founding varieties. Consequently, intriguing new hypotheses are discussed and some conclusions are drawn, based on the peculiar geographical origin of the parents, on the distribution of the offspring, on the chance of a single, and perhaps intentional, crossing event.

Combined paresis and restriction of the extraocular muscles after orbital fracture: a study of 16 patients.

Sixteen patients with combined paresis and restriction of extraocular muscle(s) orbital fracture repair were studied before and after in order to determine the clinical features and management of such patients. All 16 patients showed limited ductions of the involved eye in the field of action of the entrapped, paretic muscle and of the antagonist muscle after orbital fracture. Single extraocular muscles (13 patients) and two extraocular muscles (three patients) were demonstrated adjacent to the fracture site on orbital computed tomography (CT). In three patients prior to orbital surgery, a deviation in primary position was present. After fracture repair with release of the entrapped muscle in all patients, evidence of paresis of the muscle was demonstrated by underaction in its field of action and overaction in the field of its antagonist. There was a resultant manifest tropia or phoria in the primary position. In seven patients, the paresis gradually improved with no tropia and little diplopia in the functional fields of gaze. Three patients had minimal deviations and required no further treatment. Six patients with significant deviations required prisms (three patients) or strabismus surgery (three patients). The latter three patients had two muscles involved. Results of this study demonstrate that the ophthalmologist must appropriately diagnose patients with paresis and restriction of an extraocular muscle and counsel them that "new" diplopia may occur after orbital fracture repair and that this diplopia may require additional therapy.

Treatment of congenital forms of telecanthus with custom-designed titanium medial canthal tendon screws.

A custom-designed, titanium medial canthal tendon screw (MCTS) was used successfully to correct telecanthus in three patients--two with blepharophimosis syndrome and one with congenital telecanthus. This device avoids the need for complicated transnasal wiring. Precise placement of the screw into the bone at the anterior lacrimal crest may be accomplished through a small skin incision. A through-and-through transverse hole in the screw just below its head allows passage of sutures and wires for internal fixation of the medial canthal tissues as well as for external fixation by a silicone stent. Correction of telecanthus with the MCTS is simpler and apparently a safer procedure than traditional transnasal wiring and, furthermore, may be easily combined with any soft tissue repair.

Duane's retraction syndrome.

Duane's retraction syndrome (DRS) has been a recognized clinical entity for nearly a century. It is a clinically well described ocular disorder consisting of retraction of the globe with narrowing of the lid fissure in attempted adduction, frequent abduction deficiency with variable limitation to adduction, and upshoot and/or downshoot of the affected eye on adduction. Among strabismus patients the incidence of DRS is probably not more than 5%. Most cases are sporadic, but familial cases have been estimated at 10% by most authors. Numerous theories concerning the etiology and pathogenesis of DRS have been proposed, including agenesis of the abducens nucleus, but the majority of investigators concur that the characteristic findings are best explained by a paradoxical innervation of the lateral rectus muscle, which subsequently causes a cocontraction of the horizontal rectus muscles. The frequent association of DRS with other congenital anomalies suggests a teratogenic event occurring between the fourth to eighth week of gestation as an etiological factor. In this review historical aspects and theories of the syndrome are studied and statistical data are compiled and analyzed. Clinical features, differential diagnoses and variants of the syndrome are examined. Testing and treatment objectives are discussed.

The sit-up test: an alternate clinical test for evaluating pediatric torticollis.

The sit-up test, a new evaluation method for differentiating between ocular and orthopaedic torticollis, was evaluated against the monocular occlusion test, using results of three-step testing for standardization. The study group consisted of 31 patients with torticollis between the ages of 4 and 12.5 years. Subjects were selected based only on their ability to cooperate with three-step testing. Three-step testing identified 27 of the 31 patients as having ocular torticollis, with the remaining 4 having an orthopaedic etiology. Sit-up testing correctly identified all 27 ocular torticollis patients, with no false positives or false negatives. Monocular occlusion testing detected at best 22 (81.4%) of the ocular torticollis patients, with no false positives.

Simplified limbal incision for extraocular rectus muscle surgery.

We describe a limbal incision for extraocular muscle surgery which involves only one incision to the conjunctival-Tenon's layer instead of the three separate incisions required in the standard limbal approach. Based on the 316 extraocular muscle operations in which we have used this one-snip procedure, we conclude that it is simpler and faster than the standard limbal incision, and that it provides good surgical exposure and probably less tissue damage.

Nystagmus in Down's syndrome.

The incidence and characteristics of nystagmus in Down's syndrome are unclear. In 188 consecutive patients, 56 had nystagmus. Most had no clinically recognizable ocular pathology to account for the nystagmus. Twenty-nine had fine rapid horizontal nystagmus, 14 had a dissociated nystagmus which appeared pendular, whereas 9 had a form of latent or manifest latent nystagmus. Of the total patients with nystagmus, 41 had esotropia. Our findings suggest that fine rapid horizontal nystagmus, sometimes dissociated, occurs frequently in patients with Down's syndrome.

Keratoconjunctivitis sicca in male patients infected with human immunodeficiency virus type 1.

Keratoconjunctivitis sicca (KCS) has not been reported as occurring as a single entity in the acquired immune deficiency syndrome (AIDS) population. In a survey of human immunodeficiency virus type 1 (HIV-1) infected male patients, the authors found that 21% (9/42) had signs and symptoms compatible with KCS with positive Schirmer test results. Tear osmolarity determinations were obtained from this group and from an age- and sex-matched group of HIV-infected patients without symptoms of KCS and with negative Schirmer test results. Eighty-nine percent of the suspect group had increased tear osmolarity, whereas none of the control patients had a hyperosmolar tear film (P less than 0.0001). Results strongly suggest that KCS occurs at a significantly greater rate in male individuals infected with HIV-1 than in the general population.

Preferred postoperative alignment after congenital esotropia surgery.

A total of 117 patients with congenital esotropia who underwent muscle surgery were included in our study and were followed for a minimum of three years. Only those patients who were orthotropic or were within +/- 10 prism diopters (PD) of orthotropia six months postoperatively were included. Of the 117 patients, 101 patients (86%) remained orthotropic or within +/- 10 PD of orthotropia three years postoperatively, but 13 patients (11%) developed consecutive exotropia (greater than 10 PD). Five years after surgery, 17 of 68 patients (25%) had consecutive exotropia (greater than 10 PD). Our study demonstrates that despite satisfactory postoperative alignment, there is a steady progression towards exotropic drift over long-term follow-up. Our study also suggests that a preferred alignment shortly after congenital esotropia surgery is within 10 PD of esotropia since all of the patients who had consecutive exotropia (greater than 10 PD) were either orthotropic or exotropic (less than or equal to 10 PD) six months after surgery.

A modified extracapsular cataract extraction for pediatric cataracts.

We present a modified procedure of extracapsular cataract extraction (ECCE) with a small central posterior capsulectomy for pediatric cataracts that is designed to eliminate posterior capsule opacification and to keep open the option of later secondary implantation of a posterior chamber intraocular lens. Of 76 study eyes in which the procedure was performed only three developed posterior capsule opacification. All seven control eyes that had standard ECCE with the posterior capsule left intact developed secondary membranes shortly after surgery.

Down syndrome. Clinical review of ocular features.

A total of 187 medical records of Down syndrome individuals over a 10-year period were reviewed retrospectively for strabismus, myopia, hyperopia, astigmatism, nystagmus, cataract, glaucoma, and other significant eye findings. This study showed that a higher proportion of these individuals than reported in previous studies had strabismus (57%). Refractive errors of myopia (22.5%), hyperopia (20.9%) and astigmatism (22%) were common. The primary care physician needs to be aware of the specific eye problems of Down syndrome individuals so that he or she may initiate or refer the patient for appropriate ophthalmologic care, because most of the eye findings in Down syndrome are treatable. Significant visual loss, a usually avoidable event in Down syndrome, should occur rarely.

A survey of severe eye injuries in children.

We reviewed the medical records of 258 children from newborn to 20 years of age who had ocular injuries severe enough to warrant admission to United Hospitals Medical Center, Newark, NJ, over a 3 1/2-year period. In this time there were 1737 pediatric admissions for eye treatment and of these, 258 (14.85%) were directly related to trauma. Only strabismus, with 676 (38.9%) admissions, accounted for more pediatric hospitalizations for eye injuries. Balls, fists, and sticks were the most common causes of injury, and the most common diagnosis was hyphema. The majority of injuries occurred in children between 11 and 15 years of age (31%). Ocular injuries in children above 10 years of age were most commonly sports-related, whereas injuries in the home accounted for the majority of trauma in children younger than 10 years of age.

Trabeculectomy with cyclocryotherapy for infantile glaucoma in the Sturge-Weber syndrome.

Various mechanisms have been proposed to explain the pathogenesis of infantile glaucoma in the Sturge-Weber syndrome. We report the results of treating six patients with combined trabeculectomy and cyclocryotherapy. Successful control of the intraocular pressure occurred in all patients. Two patients required a second procedure at another site. We feel that the success of this procedure provides evidence that the glaucoma is secondary to elevated episcleral venous pressure in this condition.

Epibulbar choristomas containing lacrimal tissue. Clinical distinction from dermoids and histologic evidence of an origin from the palpebral lobe.

Three new cases of epibulbar choristomas, all containing lacrimal tissue, are presented and compared with those reported previously in the literature. The first and second cases were unilateral, complex choristomas, consisting of ectopic lacrimal tissue, smooth muscle, and cartilage; the first case was also remarkable for the presence of lesional tissue in the peripheral cornea and evidence of progressive growth during puberty. The third case was a bilateral, complex choristoma, manifesting epibulbar lacrimal tissue, cartilage, and smooth muscle; also associated were bilateral optic nervehead colobomas and a uniocular focus of posterior scleral cartilage demonstrated by computed tomography (CT) scanning. On clinical examination, all three lesions displayed highly vascularized thickenings of the conjunctiva with diagnostically useful gelatinous elevations, which corresponded microscopically to lobules of lacrimal tissue. In addition, all three cases had the interesting diagnostic feature of superficial corneal scarring or sclerosis, with a fine vascularity adjacent to the conjunctival lesional tissue. Electron microscopy of the third case demonstrated completely normal cytoarchitecture of the lacrimal tissue. Because of the frequent presence of Müller's smooth muscle in epibulbar lacrimal choristomas, the authors propose that these lesions represent embryologic ectopias or overly extensive field effects of the palpebral lobe of the lacrimal gland.

Congenital unilateral adduction deficit with simultaneous abduction. A variant of Duane's retraction syndrome.

Congenital adduction deficit not associated with other signs of oculomotor nerve weakness occurs infrequently. Type 2 Duane's retraction syndrome accounts for some of these cases. The authors identified three children with unilateral adduction deficits and simultaneous abduction of the eyes on attempted lateral gaze into the field of action of the apparently paretic medial rectus muscle. This is the first report of a series of patients with this condition previously termed simultaneous or synergistic divergence. All patients had a large exotropia, and two had a horizontal face turn away from the involved eye. A large (14 mm) lateral rectus muscle recession done on one of these children reduced the face turn but did not eliminate the simultaneous abduction. Clinical, intraoperative, and electromyographic data suggest that this condition is an unusual variant of type 2 Duane's syndrome.

Neodymium: YAG laser surgery: the treatment of pediatric cataract disease.

Cataract extraction in children has undergone dramatic changes during the past 20 years, largely as a result of technologic advances. The neodymium: yttrium aluminum garnet (Nd:YAG) laser has indirectly brought the surgical technique full circle. The posterior capsule may be preserved at surgery and treated successfully with the Nd:YAG when necessary. In 16 such cases reported here, 11 patients with congenital and five with acquired cataracts all had improved vision after treatment with the Nd:YAG laser. The youngest patient was aged four years. The safety of Nd:YAG laser therapy is supported by this study.