FIL-SSF Carlevale intraocular lens for sutureless scleral fixation: 7 recommendations from a serie of 72 cases. MICA study (Multicentric Study of the Carlevale IOL).

PURPOSE: Lacking a standard technique, the surgical management of aphakia without capsular support remains to be optimized. The goal of this study is to analyze results for the Carlevale FIL-SSF intraocular lens and propose surgical recommendations. PATIENTS AND METHODS: The P1.5 Collective performed a retrospective analysis, with a minimum follow-up of 6 months, of the records of 72 implantations of the Carlevale FIL-SSF intraocular lens, specifically designed for sutureless scleral fixation in the ciliary sulcus. RESULTS: The most common indication was exchange of a posterior chamber intraocular lens (70.8%). The surgery lasted a mean of 53.4minutes due to the creation of scleral flaps. The implant was damaged in 12.5% of cases. Visual acuity was improved in 83.3% of cases. The postoperative spherical equivalent was -0.3 diopters, with no change in corneal astigmatism. The implant was centered and stable in all cases. Two cases (2.8%) of cystoid macular edema were observed and resolved over six months. DISCUSSION: A number of advantages of the Carlevale FIL-SSF intraocular lens make it a safe and effective solution for correction of aphakia in the absence of capsular support. It requires a longer than usual surgical procedure, and the implant must be handled with care. From their experience, the authors propose 7 recommendations to accelerate the learning curve. CONCLUSION: In light of the results of this study, we propose the Carlevale FIL-SSF intraocular lens as the new standard for the correction of aphakia without capsular support, but other studies are necessary to determine its exact place within the heirarchy of other available techniques.

Combining thermophilic aerobic reactor (TAR) with mesophilic anaerobic digestion (MAD) improves the degradation of pharmaceutical compounds.

The removal efficiency of nine pharmaceutical compounds from primary sludge was evaluated in two different operating conditions: (i) in conventional Mesophilic Anaerobic Digestion (MAD) alone and (ii) in a co-treatment process combining Mesophilic Anaerobic Digestion and a Thermophilic Aerobic Reactor (MAD-TAR). The pilot scale reactors were fed with primary sludge obtained after decantation of urban wastewater. Concerning the biodegradation of organic matter, thermophilic aeration increased solubilization and hydrolysis yields of digestion, resulting in a further 26% supplementary removal of chemical oxygen demand (COD) in MAD-TAR process compared to the conventional mesophilic anaerobic digestion. The highest removal rate of target micropollutants were observed for caffeine (CAF) and sulfamethoxazole (SMX) (>89%) with no substantial differences between both processes. Furthermore, MAD-TAR process showed a significant increase of removal efficiency for oxazepam (OXA) (73%), propranolol (PRO) (61%) and ofloxacine (OFL) (41%) and a slight increase for diclofenac (DIC) (4%) and 2 hydroxy-ibuprofen (2OH-IBP) (5%). However, ibuprofen (IBP) and carbamazepine (CBZ) were not degraded during both processes. Anaerobic digestion affected the liquid-solid partition of most target compounds. Sorbed fraction of pharmaceutical compounds on the sludge tend to decrease after digestion, this tendency being more pronounced in the case of the MAD-TAR process due to much lower concentration of solids.

Hyperthermic intraperitoneal chemotherapy leads to an anticancer immune response via exposure of cell surface heat shock protein 90.

The occurrence of peritoneal carcinomatosis is a major cause of treatment failure in colorectal cancer and is considered incurable. However, new therapeutic approaches have been proposed, including cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC). Although HIPEC has been effective in selected patients, it is not known how HIPEC prolongs a patient's lifespan. Here, we have demonstrated that HIPEC-treated tumor cells induce the activation of tumor-specific T cells and lead to vaccination against tumor cells in mice. We have established that this effect results from the HIPEC-mediated exposure of heat shock protein (HSP) 90 at the plasma membrane. Inhibition or blocking of HSP90, but not HSP70, prevented the HIPEC-mediated antitumoral vaccination. Our work raises the possibility that the HIPEC procedure not only kills tumor cells but also induces an efficient anticancer immune response, therefore opening new opportunities for cancer treatment.

GAPDH enhances the aggressiveness and the vascularization of non-Hodgkin's B lymphomas via NF-κB-dependent induction of HIF-1α.

Deregulated expression of glycolytic enzymes contributes not only to the increased energy demands of transformed cells but also has non-glycolytic roles in tumors. However, the contribution of these non-glycolytic functions in tumor progression remains poorly defined. Here, we show that elevated expression of glyceraldehyde-3-phosphate dehydrogenase (GAPDH), but not of other glycolytic enzymes tested, increased aggressiveness and vascularization of non-Hodgkin's lymphoma. Elevated GAPDH expression was found to promote nuclear factor-κB (NF-κB) activation via binding to tumor necrosis factor receptor-associated factor-2 (TRAF2), enhancing the transcription and the activity of hypoxia-inducing factor-1α (HIF-1α). Consistent with this, inactive mutants of GAPDH failed to bind TRAF2, enhance HIF-1 activity or promote lymphomagenesis. Furthermore, elevated expression of gapdh mRNA in biopsies from diffuse large B-cell non-Hodgkin's lymphoma patients correlated with high levels of hif-1α, vegf-a, nfkbia mRNA and CD31 staining. Collectively, these data indicate that deregulated GAPDH expression promotes NF-κB-dependent induction of HIF-1α and has a key role in lymphoma vascularization and aggressiveness.

[Multicenter Ozurdex® assessment for diabetic macular edema: MOZART study]. / Étude rétrospective du traitement par Ozurdex® dans l'œdème maculaire diabétique: MOZART study.

PURPOSE: To evaluate the efficiency and safety of intravitreal implant of 0.7mg dexamathasone in visual impairment due to diabetic macular edema (DME). MATERIALS AND METHODS: This was a retrospective, multicenter, study. Seventy-four patients, with a mean age of 65 years, followed for at least 6 months (mean follow-up: 9.8 months) were included in 5 French eye clinics (P 1.5 collective). The mean systolic blood pressure was 138mmHg and the mean HbA1c was 7.2%. We monitored 2 systemic parameters: blood pressure and glycemic balance. Best-corrected visual acuity (BCVA), central retinal thickness (CRT, Spectralis OCT), intraocular pressure (IOP) and cataract progression are studied at baseline and then at 1, 2, 4 and 6 months. RESULTS: The average CRT decrease was: 239µm at month 2 (M2) and 135µm at month 6 (M6). The mean improvement from baseline of BCVA is 8.5 letters at M2 and 7.6 letters at M6. A gain greater than 15 letters is found in 27% of patients at M6. For naive patients the BCVA is 71 letters versus 60 letters (P<0.05). Patients with a baseline CRT <500mmHg have a BCVA of 66 letters versus 57 letters (P<0.05). The mean rate injections was 1.2 at 6 months with an average of 5.4 months for reinjection. Ocular hypertension greater than 25mmHg, managed by topical treatment, is observed in 13.4% of patients. No glaucoma surgery was necessary. CONCLUSION: Dexamethasone has an anatomical and functional effectiveness in the treatment of DME. Outcomes for naive patients and lower CRT suggest that the duration of diabetes mellitus and previous treatments are negative factors of recovery. Side effects are rare and manageable. Ozurdex(®) seems to be a treatment for visual impairment due to DME with a favorable safety profile. Patient follow-up must be adapted to half-life of the product with a control before M1 (intraocular pressure) and before M5 (DME recurrence, BCVA).

[Anatomical and functional prognosis of secondary retinal detachments after sutureless macular surgery]. / Pronostic anatomique et fonctionnel des décollements de rétine secondaires après chirurgie maculaire sans suture.

PURPOSE: To evaluate the incidence, characteristics and risk factors for rhegmatogenous complications of transconjunctival sutureless 23-gauge vitrectomy (TSV) in macular surgery. The results were correlated with those reported in the literature. METHODS: Multicentric retrospective study of a cohort of patients undergoing macular surgery by 23-gauge TSV between January 2009 and June 2010. RESULTS: Four hundred and seventy-four patients divided into: epiretinal membrane (MEM) (n=279), vitreomacular traction (n=65) and idiopathic macular hole n=130. Forty-three percent of patients were pseudophakic. Posterior vitreous detachment (PVD) was absent in 60% of cases and was therefore systematically performed intraoperatively. It was seen that 1.7% of patients developed retinal tears and 2.7% retinal detachment with a higher incidence in the vitreomacular traction (VMT) group and the group in which the PVD was performed intraoperatively. Rhegmatogenous lesions were localized mainly in the inferior retina in the macular hole group. DISCUSSION: Results are consistent with the TSV literature. Their location does not appear to be related to the sclerotomies or handedness as in 20-gauge surgery, probably due to sclerotomy trocars. Localization of rhegmatogenous lesions in the inferior retina in macular hole surgery suggests a role of gas in this subgroup. In addition to instrument-retinal touch, the performance of a surgical PVD represents a major independent risk factor for retinal detachment (RD). CONCLUSION: Even with limited macular surgery, it is essential to check the retinal periphery for 360 degrees, especially for VMT and intraoperative PVD, and especially inferiorly in the case of gas tamponnade.

[Tubercular fibrosing conjunctivitis associated with facial cutaneous tuberculosis]. / Conjonctivite fibrosante tuberculeuse au cours d'une tuberculose cutanée faciale.

BACKGROUND: Tuberculous conjunctivitis has been described only rarely during the course of lupus vulgaris. We report a case of hemifacial cutaneous tuberculosis, diagnosed as atypical lupus vulgaris, associated with homolateral fibrosing tuberculous conjunctivitis. PATIENTS AND METHODS: An 83-year-old woman presented inflammatory conjunctivitis without bullous involvement in the left eye leading to corneal neovascularisation, symblepharons and ptosis. Erythematous and atrophic papules were seen on the left side of the face. Biopsy of the skin and conjunctiva revealed a tuberculoid granulomatous infiltrate. Bacterial culture and PCR were both positive for Mycobacterium tuberculosis. DISCUSSION: This case illustrates the need to consider tuberculosis when faced with an atypical facial eruption and ocular involvement.

[Acute blepharoptosis caused by fibrous dysplasia]. / Ptôsis aigu unilatéral révélant une dysplasie fibreuse.

We report a case of fibrous dysplasia revealed by acute ptosis in a 38-year-old patient. Ophthalmologic examination disclosed a moderate right ptosis. The rest of the results were strictly normal except for a known facial asymmetry. Visual acuity was 20/20 in both eyes, there was no extrinsic or intrinsic oculomotor disorder, and funduscopy was normal. Given this acute presentation, emergency cerebral imagery was carried out, providing a diagnosis of fibrous dysplasia with orbital and cavernous repercussions, with no sign of cerebral disorder or obvious vascular lesion. Progression was marked by a regression of the ptosis. Fibrous dysplasia is a rare pathology but presents varied clinical presentations. The authors present the broad characteristics of this pathology and the management of an acquired ptosis. They discuss the possible mechanisms involved in the drop of the right upper eyelid of this patient and the therapeutic solutions.

[Deep sclerectomy in congenital glaucoma: results of a study lasting more than 3 years]. / Glaucome congénital et sclérectomie profonde: résultats d'une étude sur plus de 3 années.

PURPOSE: To assess the outcome of deep sclerectomy surgery with intraoperative antimitotic application in children with primary and secondary congenital glaucomas. PATIENTS AND METHODS: Thirty-seven eyes of 22 children aged from 1 day to 14 years were included in this study; 30 eyes had primary congenital glaucoma and were divided into two groups according to the management delay. Eighteen eyes were managed early (group 1) and 12 eyes were diagnosed late (group 2). Finally, seven eyes had a more complex dysgenic glaucoma (group 3). All the eyes had a deep sclerectomy with antimitotic intraoperative application (5 FU). Pre- and postoperative intraocular pressures, success rate, preoperative corneal transparency, corneal diameter, and surgical complications were assessed. Total success was defined by final postoperative intraocular pressure lower than 16 mmHG without combined medical treatment; partial success was defined by lower than 16 mmHG with a combined medical treatment. RESULTS: The mean follow-up was 38.2 months. Total success was 34% and partial was 82%: 56% and 89%, respectively, for group 1, 33% and 100% for group 2, and 14% and 57% for group 3. No severe complications occurred after surgery. CONCLUSION: The probability of success was significantly lower for secondary congenital glaucomas and for primary congenital glaucomas with late management. Management delay and the type of glaucoma seem to be capital in the prognosis of high intraocular pressure. Deep sclerectomy with antimitotic application (5 FU) is a good alternative to trabeculectomy in primary glaucomas.

Modelling of moisture-dependent aerobic degradation of solid waste.

In landfill, high temperature levels come from aerobic reactions inside the waste surface layer. They are known to make anaerobic processes more reliable, by partial removal of easily biodegradable substrates. Aerobic biodegradation of the main components of biodegradable matter (paper and cardboard waste, food and yard waste) is considered. In this paper, two models which take into account the effect of moisture on aerobic biodegradation kinetics are discussed. The first one (Model A) is a simple, first order, substrate-related model, which assumes that substrate hydrolysis is the limiting step of the process. The second one (Model B) is a biomass-dependant model, considering biological growth processes. Respirometric experiments were performed in order to evaluate the efficiency of each model. The biological oxygen demands of shredded paper and cardboard samples and of food and yard waste samples prepared at various initial water contents were measured. These experimental data were used to identify model parameters. Model A, which includes moisture dependency on the maximum amount of biodegraded matter, is relevant for paper and cardboard biodegradation. On the other hand, Model B, including moisture effect on the growth rate of biomass is suitable to describe food and yard waste biodegradation.

[Conjunctival melanoma at corneoscleral limbus on primary acquired melanosis. A case report]. / Mélanome conjonctival limbique développé sur mélanose acquise primitive.

A 51-year-old Caucasian man consulted for a visual loss in the left eye due to corneal extension of a conjunctival melanoma. This conjunctival melanoma arose from primary acquired melanosis with atypia at the temporal corneoscleral limbus. The patient was treated using a combination of surgical excision with physical treatment by ocular proton therapy. Progression remained under control 11 months after treatment: no local tumour recurrence or metastasis was observed. Primary acquired melanosis with atypia must be regarded as a premalignant melanocytic lesion. Based on this case report, the authors focus on primary acquired melanosis and its risk of transformation to a conjunctival malignant melanoma.

A logistic model for the prediction of the influence of water on the solid waste methanization in landfills.

This article deals with the impact of water content of solid waste on biogas production kinetics in landfills. This impact has been proved in the laboratory thanks to anaerobic biodegradation experiments on paper/cardboard waste samples. A strong dependence with the moisture level was observed for both kinetic rates and maximum methane production. In this article, a logistic model is proposed to simulate the biogas production rate. It is chosen as simple as possible in order to allow for a correct identification of the model parameters given the experimental data available. The moisture dependency is introduced through a linear weighing of the biomass specific growth rate and of the amount of accessible organic substrate. It is directly linked to physical properties of the waste: the holding capacity and the minimal moisture level allowing the presence of free water.

[Magnitude and strategies of cataract management in the world]. / Magnitude et strategies de prise en charge de la cataracte dans le monde.

Although cataracts cause 47% of global blindness, their epidemiologic impact in different countries is notoriously uneven and the world can be divided into two zones according to economic conditions. In advanced countries where care is good, cataracts account for only 5% of blindness while cataracts still account for 50% of blindness in developing countries. After a brief overview of historical, clinical and therapeutic aspects, this article updates epidemiological data on cataracts in the world. It also provides insight into political, socio-economic, and cultural factors adversely affecting care availability in developing countries thus making cataracts a major public health problem and an obstacle for development. Finally this article offers a few recommendations for reducing the backlog of cataracts in the world and for consolidating advances made over the last two decades thanks to experience gained in various National Blindness Prevention Programs (NBPP).

Modelling the growth dynamics of interacting mixed cultures: a case of amensalism.

In this work, a specific membrane bioreactor was used to perform co-cultures of two Saccharomyces cerevisiae yeast strains: a killer strain and a sensitive strain. Biomass could be segregated into four groups: viable killer yeasts, dead killer yeasts, viable sensitive yeasts and dead sensitive yeasts. An existing mathematical model describing the population dynamics in the mixed killer/sensitive cultures was confronted with the new experimental data. As it gave poor accuracy, some improvements were proposed and tested. In particular, a lag phase before the beginning of the lethal interaction between the two strains was introduced, in correspondence to the experimental observations.

In vitro maturation and fertilization techniques for assessment of semen quality and boar fertility.

The reliability of using different in vitro-derived measures of sperm quality to predict boar fertility was examined. On three occasions during a 20-wk period of breeding, special collections of the first sperm-rich fraction of the ejaculate from six boars were carried out. After in vitro capacitation procedures, three dilutions (5 x 10(5), 1.25 x 10(5), and 3.125 x 10(4) sperm/mL) of these semen samples were used in a standardized in vitro fertilization (IVF) test with oocytes recovered from prepubertal slaughterhouse ovaries and matured in vitro. Routine assessments of sperm motility, concentration, and morphology were also carried out for all collections used for AI during the 20-wk period. Semen from the same ejaculate, processed according to normal commercial practice using the AndroHEP extender, was used to inseminate equal numbers of recently weaned sows with either 3 x 10(9) or 2 x 10(9) total sperm, three times during the estrous period. Data from a total of 444 sows were used to determine boar fertility; between 12 and 54 sows were bred with each semen dose across the six boars. All measures of sperm fertilizing ability in vitro were different among boars (all P < .05) and use of different semen dilutions for IVF allowed further discrimination of apparent sperm quality among boars. The laboratory evaluation of semen collected during the period of breeding indicated effects of boar on ejaculate volume, total number of sperm per ejaculate, motility, and the percentage of sperm with normal morphology (all P < .01). Sperm dose used in AI had no effect on farrowing rate (80.7 vs 81.5%), but the lower AI dose resulted in a reduction (P < .05) in total numbers born (10.8 vs 10.0). For all three semen dilutions, estimated potential embryo production rate accounted for up to 70% of the variation in litter size obtained with 3 x 10(9) sperm per AI dose, and the number of sperm attached per oocyte was a major factor accounting for variation in litter size obtained with 2 x 10(9) sperm per AI dose. These IVF variables may, therefore, be effective indicators of boar sperm quality for use in AI. With 2 x 10(9) sperm per AI dose, the percentage of sperm with normal morphology also explained a large part of the variance in litter size born (R2 = .59), indicating that morphological characteristics are a useful measure of semen quality.

Effect of calf feeding regimes and diet EDTA on physico-chemical characteristics of veal stored under modified atmospheres.

Physico-chemical characteristics of veal from 30 calves allotted to five different rations with respect to iron bioavailability were evaluated at packaging and after 2 and 4 weeks of storage under both 100% CO(2) and 100% N(2). The five diets were 'Milk', 'Grain', 'Mix' (combination of Milk and Grain) and 'Mix + EDTA' and 'Grain + EDTA' where 15 mg EDTA were added per mg Fe in the feed concentrate. Diet EDTA was generally more influential on veal quality than storage treatments. The chelator caused an unexpected pH drop in veal stored four weeks irrespective of storage conditions (p ≤ 0.05). However, the colour, texture and flavour of meat from animals fed EDTA in the Grain- and Mix-ration was equivalent to that of Milk-fed veal (p ≤ 0.05). The EDTA treatments also improved the appearance of veal under anoxic atmospheres. Upon storage however, the chelator increased veal drip losses (p ≤ 0.05) and also cooking losses from Grain-fed calves (p ≤ 0.05). Packaging under CO(2) decreased pH (p ≤ 0.05) and increased drip losses (p ≤ 0.05) but did not alter other physico-chemical parameters. Dietary treatments had no effect on shear forces (p > 0.05) which decreased after two weeks in storage (p ≤ 0.05) independent of gas atmospheres. Overall, the quality characteristics of pale veal were obtained following addition of EDTA in Grain- and Mix-fed animals and were maintained in storage. This approach looks promising for the veal industry but warrants further research.

Rapid DNA purification for Hal gene PCR diagnosis in porcine tissues and extension to other meat species.

Two different halothane (Hal) gene polymerase chain reaction (PCR) tests were applied to genomic DNA extracted from porcine blood, semen, muscle and fat tissues by a rapid and simple Chelex-100 based method. One of the PCR procedure is designed from the ryanodine receptor coding sequence to produce a 81 base pair (bp) fragment, while the other is designed from pig intron sequences to produce a 659 bp fragment. Oligonucleotide primers derived from the coding sequence were also used for other meat species. Amplification products obtained from porcine, bovine, ovine, equine and deer genomic DNA were successfully digested with Hha I restriction enzyme to produce the same electrophoretic pattern as in the normal homozygous (NN) pig. No PCR products could be amplified from chicken and turkey DNA.

Detection of the ryanodine receptor mutation associated with malignant hyperthermia in purebred swine populations.

A restriction endonuclease assay (REA) that reveals a C/T transition in the ryanodine receptor gene (ryr-1 locus) was proposed to test swine for malignant hyperthermia. The REA was tested in a heterologous pig population of 1,227 individuals representing Hampshire, Duroc, Landrace, and Yorkshire breeds. Of this group, 713 pigs had been classified on the basis of the halothane challenge and progeny testing into the three possible Hal genotypes (685 negatives, 24 carriers, and 4 susceptibles). The REA confirmed the four susceptibles as T/T, 17/24 carriers as C/T, and 659/685 negatives as C/C. The rest of the sample was constituted of 514 pigs that had not been selected on the basis of the halothane gene. The proportions of C/T and T/T pigs within the breeds represented were 3.2 and 1.6% for Duroc, 27.3 and 1.4% for Landrace, and 17.9 and 1.9% for Yorkshire. No T/T allelic pairs were found in the Hampshire breed, although the sample was very small. Genotypic distribution and allelic frequencies at the ryr-1, Phi, and Pgd loci were reported among the breeds.

Validation of a culture system for porcine pituitary cells: effects of growth hormone-releasing factor and(or) somatostatin on growth hormone secretion.

The goal of the study was to establish the age-related responses of cultured porcine pituitary cells to growth hormone-releasing factor (GRF) and(or) somatostatin (SRIF). A culture system for dispersed porcine pituitary cells was validated. Pituitaries from female pigs of various ages (90 or 110 d of gestation, newborn, 3, 6, or 24 mo old) were enzymatically dispersed with collagenase and neuraminidase, plated (200,000 cells/well), and cultured for 3 d. Plated cells were then subjected to a 4-h challenge with increasing concentrations of GRF (10(-11) to 10(-8) M), SRIF (10(-9) to 10(-6) M), or 10(-8) M of each peptide with increasing concentrations of the other. Culture media were collected and assayed for growth hormone (GH). Pituitaries were pooled so that there were four replicates per age, and treatments were assigned to quadruplicate wells. Concentrations of GH in control wells (basal GH) were maximal at 110 d of gestation and decreased thereafter (P < .01) with increasing age of swine. All peptide combinations affected the GH response (P < .05) at all ages studied, yet GRF was more potent than SRIF in eliciting a response. Age had an effect (P < .05) on the GH response to any of the treatments; younger pigs (90, 110 d of gestation and newborns) had a greater response (P < .05) than older pigs (3, 6, and 24 mo), whereas 6- and 24-mo-old pigs responded similarly in all cases (P > .1).(ABSTRACT TRUNCATED AT 250 WORDS)