Effect of etanercept and lithium chloride on preventing secondary tissue damage in rats with experimental diffuse severe brain injury.

OBJECTIVE: Studies in animals have provided key evidence that antagonizing TNF-α is a viable therapeutic strategy for diffuse severe brain injury. This study is planned to prevent post-traumatic secondary tissue damages in rat diffuse severe brain injury model, which is induced by alone or combined administration of Etanercept and lithium chloride (LiCl). MATERIALS AND METHODS: Male Sprague-Dawley rats were used in the current study. Rats were divided into 5 groups. Trauma was not induced and treatment was not applied to rats of Sham group. For rats of Trauma+Saline group, saline 0.9% was administered via intraperitoneal (i.p.) route at dose of 1 mg/100 g body weight 1 hour after trauma. For rats of Trauma+Etanercept group, Etanercept was administered via i.p. route at dose of 5 mg/kg body weight 1 hour after trauma. For rats of Trauma+LiCl group, LiCl was administered via i.p. route at dose of 50 mg/kg body weight 1 hour after trauma. For rats of Etanercept+LiCl group, Etanercept and LiCl were administered via i.p. route at dose of 5 mg/kg body weight and 50 mg/kg body weight, respectively, 1 hour after trauma. Serum glial fibrillary acidic protein (GFAP) and Tau levels were analyzed with ELISA. For analyses H&E, TUNEL, GFAP and TNF-α staining methods were used. RESULTS: We demonstrate that Etanercept treatment reduced the TBI-induced brain tissues alteration, reduced the expression of TNF-α and improve edema and axonal swelling. We observed a significant decrease in TNF-α and GFAP positivity after LiCl was administered. CONCLUSIONS: The findings obtained in this study suggest that the combination therapy with Etanercept and LiCl decreased neuronal degeneration and alleviated secondary tissue damage in post-traumatic period.

Investigation of the course of GFAP in blood in the initial 24 hours in rats subjected to minor head trauma.

AIM: Aim of this study is to evaluate the diagnostic efficacy of Glial Fibrillar Acidic Protein (GFAP) particularly in minor head traumas. MATERIALS AND METHODS: 72 female and male, 3 month-old, Sprague Dawley rats were used in the study. The rats were divided into 9 groups. Following anesthesia, all rats were placed in prone position. A 10 mm long and 3 mm thick stainless steel metal disc was fixed onto the skull using dental paste in order to sustain a closed head trauma and evenly distribute the weight throughout the skull. After placing it under the metallic pipe arrangement over a height of 80 centimeters and fixing to make it constant, 50 g metallic discs were released by free fall, and the head trauma was sustained thanks to the gravity-generated force. Blood samples were collected from the rats under anesthesia for biochemical GFAP analysis 10 minutes after the trauma and in 1, 2, 3, 4, 5, 6 and 24 consecutive hours later. RESULTS: GFAP has a peak, and its peak level at hours 1 and 2 in rats subjected to a minor head trauma, with a slight decrease afterwards. CONCLUSIONS: GFAP is an important marker in determining the severity of traumatic brain injury.

NMDA receptor blockage with 2-amino-5-phosphonovaleric acid improves oxidative stress after spinal cord trauma in rats.

STUDY DESIGN: 2-amino-5-phosphonovaleric acid (APV) is an N-methyl-D-aspartate (NMDA) receptor blocker and has neuroprotective properties. This study is aimed at evaluating the effect of APV treatment on oxidative status after spinal cord injury (SCI). METHODS: The experiment was carried out on the following five groups: Group 1: sham operated, non-traumatized; Group 2: with injured spinal cord, no treatment; Group 3: with SCI, injected with 100 microg kg(-1) APV; Group 4: with SCI, injected with 200 microg kg(-1) APV; and Group 5: with SCI, injected with 400 microg kg(-1) APV. SCI was inflicted by epidural compression with a cerebral vascular clip after T9-11 laminectomy. The experiments were completed after 12 h of trauma. Spinal cords were excised for evaluation of superoxide dismutase (SOD), catalase, reduced glutathione (GSH) and malonyldialdehyde (MDA) levels. RESULTS: After SCI, SOD and GSH levels decreased and the MDA level increased significantly. APV treatment decreased the MDA level and increased SOD, catalase and GSH levels. The maximum decrease in MDA was detected in the group treated with 100 microg kg(-1) APV compared with the other groups. The GSH level was significantly increased in the group treated with 200 microg kg(-1) APV. The SOD level was significantly increased in the group treated with 200 microg kg(-1) APV. CONCLUSION: The results of this study have shown that APV treatment creates a dose-dependent antioxidant effect in rats with SCI and may be used for the treatment of SCIs.

Phacoemulsification and intraocular lens implantation in eyes with long axial length.

We evaluated the results of phacoemulsification and intraocular lens implantation in 414 eyes with long axial length and classified them according to axial length (AL): Group A: AL: 25-28 mm, Group B: AL >28 mm. Intraoperative maneuvers, pre- and postoperative photocoagulation for predisposing retinal lesions and retinal detachment rates were significantly higher in Group B than Group A. Eyes with an axial length over 28 mm are prone to more problems when compared to those with an axial length between 25 and 28 mm.

Staining of intraocular lenses with various dyes: a study of digital image analysis.

PURPOSE: To evaluate the interaction of various intraocular lens (IOL) materials with commonly used dyes. MATERIALS AND METHODS: One IOL of each of the five groups (polymethylmethacrylate, silicone, three-piece hydrophobic acrylic, single-piece hydrophobic acrylic and single-piece hydrophilic acrylic) was bathed in trypan blue 0.1%, fluorescein sodium 2% and indocyanine green (ICG) 0.5% for 15 min. Digital photographs of the IOLs were obtained prior to bathing and after the 15-min bath in each dye. The same IOLs were immersed in the same dye for another 15 min and digital images were reobtained to depict the 30-min dye uptake. New IOLs from the group that exhibited visible colour change after the 15-min bath were then bathed in twofold dilution and if there was still visible dye uptake, fourfold dilution was performed, repeating the 15-min bath and digital photography. The images were then processed using Adobe Photoshop 5.1 to get mean luminosity and red-green-blue values. These values were compared between the groups and the undyed control. Also, dye washout was observed in serum-containing vials. RESULTS: None of the polymethylmethacrylate, silicone and hydrophobic acrylic IOLs were stained with the dyes used. The only IOL material that changed colour was hydrophilic acrylic and did so with all dyes. The most marked colour change was with fluorescein sodium 2%, the least was with trypan blue 0.05%. Twofold dilution of trypan blue and fourfold dilutions of fluorescein sodium and ICG still stained the hydrophilic acrylic IOL; however, fourfold dilution of trypan blue did not cause a significant colour change. Trypan blue washed out within 6 h, while the IOL stained with ICG remained stained for longer than 24 h. COMMENT: Hydrophilic acrylic IOLs should be used with caution together with dyes since this material demonstrates marked dye uptake and washout may also take some time.

Colour Doppler assessment of blood flow in eyes with central retinal vein occlusion.

PURPOSE: To assess the blood flow changes in eyes with central retinal vein occlusion (CRVO) and compare these values with values of fellow eyes and eyes of normal subjects. METHODS: 25 eyes of 25 consecutive newly diagnosed patients with CRVO comprised the study group. Their fellow eyes and those of 25 healthy subjects were the control group. All patients underwent a complete ophthalmological examination. Eyes with CRVO were classified into two groups as non-ischaemic and ischaemic by fundus fluorescein angiography. Colour Doppler imaging was performed with a Toshiba Sonolayer SSH-140A and 7.5-MHz linear array probe. Maximum systolic velocity (V(max)), end-diastolic velocity (V(min)) and resistive index (R(i)) values were noted for each of the central retinal artery (CRA), central retinal vein (CRV) and ophthalmic artery (OA). These parameters were compared with those of the fellow eyes and both eyes of the control group. RESULTS: Mean ages were 63.55 and 61.45 years in the CRVO and control groups, respectively. Age and sex distributions were statistically identical in both groups. When we compared the eyes with CRVO to the control group, no statistically significant difference existed between the two groups with regard to the V(min) and R(i )values of the CRA and CRV. However, V(max ) values of the CRA and CRV were significantly lower in CRVO eyes when compared to the control group. The CRVO group and control group had similar V(max), V(min ) and R(i) values for the OA. Only the V(max) was significantly lower in the CRV in eyes with CRVO when compared to the unaffected fellow eyes. No statistically significant difference could be detected between any of the parameters of CRA, CRV and OA of the ischaemic and non-ischaemic CRVO groups. CONCLUSIONS: More data on broader series need to be obtained in order to decide on the practical use of colour Doppler imaging in the differentiation of ischaemic eyes from non-ischaemic eyes in CRVO.

Early postoperative capsular block syndrome.

PURPOSE: To report the results of early postoperative capsular block syndrome (CBS) after phacoemulsification and intraocular lens (IOL) implantation. SETTING: Department of Ophthalmology, Dokuz Eylül University School of Medicine, Izmir, Turkey. METHODS: Thirteen eyes of 13 patients with CBS who had uneventful phacoemulsification were included in the study. Twelve patients had in-the-bag implantation of a foldable IOL, and 1 had implantation of a poly(methyl methacrylate) IOL in the ciliary sulcus. Continuous curvilinear capsulorhexis was performed in all eyes, and sodium hyaluronate 1.4% (Healon GV(R)) was used during all steps of surgery. The patients were closely followed without intervention during the first month after surgery. If resolution did not occur during follow-up, a neodymium:YAG (Nd:YAG) laser peripheral anterior capsulotomy was performed first, followed by posterior capsulotomy if the anterior capsulotomy was not successful. RESULTS: The CBS resolved without intervention in 2 eyes by 1 month postoperatively. A small Nd:YAG laser peripheral anterior capsulotomy was attempted in 10 cases after 1 month but could not be performed in 2 eyes because of inadequate pupil dilation. Peripheral anterior capsulotomy was successful in 5 of 8 eyes, with resolution of CBS in a few days. The Nd:YAG laser posterior capsulotomy was successful in 5 cases after the failure of the anterior capsulotomy. One patient chose to postpone treatment for 11 months, at which time posterior capsulotomy was performed successfully and the CBS resolved. CONCLUSIONS: Resolution of CBS occurred spontaneously in only a small percentage of cases during the first month after phacoemulsification with IOL implantation. Neodymium:YAG laser peripheral anterior capsulotomy and posterior capsulotomy were successful in treating CBS.

An unusual central retinal dystrophy associated with ichthyosis vulgaris.

A number of ichthyosis syndromes may have retinal abnormalities such as the retinitis pigmentosa-like diffuse rod-cone dystrophy in Refsum's syndrome and the maculopathy in Sjögren-Larsson syndrome. We present two sisters who have an unusual, almost identical, bilaterally symmetric central retinal dystrophy associated with ichthyosis vulgaris in the absence of other systemic disorders. We believe that this dystrophy has not been previously described in patients with any of the known varieties of ichthyosis.

Retinal breaks and rhegmatogenous retinal detachment in association with branch retinal vein occlusion.

BACKGROUND AND OBJECTIVE: To report the incidence and clinical characteristics of retinal breaks and/or rhegmatogenous retinal detachment (RRD) in patients with branch retinal vein occlusion (BRVO). PATIENTS AND METHODS: We reviewed the clinical records of 230 eyes of 214 patients with BRVO and identified eyes with retinal breaks and/or RRD. Patients had at least 6 months of follow-up. RESULTS: Seven of 230 eyes (3%) had retinal breaks and 3 eyes (1.3%) had RRD. One of the eyes with RRD had subclinical retinal detachment. All 7 eyes had ischemic disease documented by fluorescein angiography. Two of 7 eyes had concurrent retinal neovascularization. Four eyes with breaks, but without RRD, and the eye with subclinical RRD were managed by argon green laser. Two eyes with RRD were managed successfully with scleral buckling surgery and postoperative supplemental argon green laser. The mean follow-up period was 14.8 +/- 8.3 months. CONCLUSIONS: Patients with BRVO should be monitored closely for possible retinal break formation and RRD development.

Combined central retinal artery and vein occlusion in a child with systemic non-Hodgkin's lymphoma.

PURPOSE: To report on a case of systemic non-Hodgkin's lymphoma and unilateral combined central retinal artery and vein occlusion. METHOD: We examined a 14-year-old boy who experienced a sudden unilateral visual loss five months after the initial diagnosis of systemic non-Hodgkin's lymphoma. RESULT: Visual loss was due to combined central retinal artery and vein occlusion in association with tumoral optic nerve involvement. CONCLUSION: Although very rare systemic non-Hodgkin's lymphoma may present with central retinal artery and vein occlusion prior to overt central nervous system involvement.