ABSTRACT
Intrinsically disordered regions (IDRs) are protein domains that participate in crucial cellular processes. During stress conditions, the physicochemical properties of the cellular environment change, directly impacting the conformational ensemble of IDRs. IDRs are inherently sensitive to environmental perturbations. Studying how the physicochemical properties of the cell regulate the conformational ensemble of IDRs is essential for understanding the environmental control of their function. Here, we describe a step-by-step method for measuring the structural sensitivity of IDRs in living Saccharomyces cerevisiae cells in response to hyperosmotic stress conditions. We present the use of ensemble fluorescence resonance energy transfer (FRET) to estimate how the global dimensions of IDRs change during a progressive increase of hyperosmotic stress imposed on cells with any osmolyte. In addition, we provide a script for processing fluorescence measurements and comparing structural sensitivity for different IDRs. By following this method, researchers can obtain valuable insights into the conformational changes that IDRs undergo in the complex intracellular milieu upon changing environments.
Subject(s)
Intrinsically Disordered Proteins , Intrinsically Disordered Proteins/chemistry , Fluorescence Resonance Energy Transfer , Protein Domains , Protein ConformationABSTRACT
A healthy 4-year-old male presented a fundus examination with a unilateral contractile peripapillary staphyloma surrounded by redundant retina and retinal pigment epithelium atrophy. Five years later, best-corrected visual acuity decreased to hand motion due to a retinal detachment with macular hole. One month after first vitrectomy, scleral buckle and intraocular gas, retina re-detached. Second surgery was performed with silicon oil tamponade and lensectomy without intraocular lens (IOL). Subretinal silicon oil was detected at the third month of follow-up when vitrectomy, inferior retinectomy, and laser photocoagulation of temporal border of staphyloma with silicon oil tamponade were performed. The retina remained attached and best-corrected visual acuity was 20/600 with intraocular silicon oil. A fourth surgery was performed for emulsified silicon oil extraction replaced with intraocular gas. At 6 months of follow-up, the retina re-detached again. This is a challenging vitreoretinal surgery in which re-detachments were due to retinal folds around the contractile staphyloma that raised macular hole. This is the first report of the combined presentation of contractile peripapillary staphyloma, retinal detachment and macular hole with a long-time follow-up period of years.
Subject(s)
Retinal Detachment , Retinal Perforations , Child, Preschool , Humans , Male , Retinal Detachment/etiology , Retinal Detachment/surgery , Retinal Perforations/surgery , Silicone Oils , Visual Acuity , VitrectomyABSTRACT
PURPOSE: To present a clinical case and surgical technique for management of optic disk pit (ODP) maculopathy. METHODS: Surgical technique video of lens sparring pars plana vitrectomy, autologous scleral flap insertion and gas tamponade. RESULTS: After 1 year follow-up visual acuity was restored to 20/25, retinal serous detachment and schisis were resolved and the autologous scleral flap remained in the (ODP). CONCLUSION: In this case, treatment with pars plana vitrectomy autologous scleral flap insertion and gas tamponade for optic pit maculopathy provided satisfactory anatomical and functional results.
Subject(s)
Eye Abnormalities , Macular Degeneration , Optic Disk , Retinal Detachment , Eye Abnormalities/surgery , Humans , Retinal Detachment/surgery , Tomography, Optical Coherence , VitrectomyABSTRACT
Introducción: el desprendimiento de retina regmatógeno (DRR) y agujero macular concomitante (AM) es una asociación poco frecuente, se reporta alrededor del 1-1,7%. Objetivo: presentar los resultados anatómicos y funcionales obtenidos en 11 casos intervenidos por DRR asociado a AM. Diseño del estudio: estudio observacional descriptivo retrospectivo. Método: estudio retrospectivo. Se registraron 11 pacientes con estas características entre 2010-2018. Se realizó vitrectomía con calibre 23 G, cerclaje escleral, remoción de membrana limitante interna (MLI), endofotocoagulación, lensectomía en los pacientes fáquicos y tamponaje con aceite de silicón o gas. Se evaluaron las siguientes variables: edad, sexo, agudeza visual (AV) al diagnóstico, tiempo de evolución del DRR, número de desgarros, grado de proliferación vitreoretiniana (PVR), si requirió retinectomía, tiempo de tamponaje con aceite de silicón, AV posterior a la extracción de aceite con colocación de lente intraocular y si se obtuvo el cierre del AM. El análisis estadístico descriptivo consistió en las variables cualitativas en frecuencias absolutas y relativas, mientras que en las cuantitativas medidas de tendencia central tipo promedio con rango mínimo y máximo. Resultados: los pacientes presentaban una edad promedio de 63 años (rango 53-74) con agudeza visual (AV) preoperatoria entre proyección luminosa y cuenta dedos. Diez pacientes presentaban mácula desprendida; el número de desgarros fueron de 1 a 2. El grado de PVR al diagnóstico: 2 grado B; 3 grado C2; 2 grado D1; 4 casos sin PVR. En 2 pacientes con PVR C3 y D1 se realizó retinectomía en 180°. En el 82% de los casos se logró la reaplicación de la retina en la primera cirugía, 100% en la segunda y en el 64% se constató el cierre completo del AM. La AV final fue entre 20/200 a 20/50, donde las mejores AV se asocian a casos con intervención precoz y sin PVR. Conclusión: Se encontró una tasa de reaplicación de la retina similar a O'Driscoll et al. donde alcanza el 78%, aunque solo 31% de su serie logra el cierre completo del AM utilizando gas SF6 como tamponaje sin pelaje de la MLI. En este estudio la tasa de cierre del AM es mayor alcanzando el 64% con pelaje de la MLI y una tasa de éxito anatómico con reaplicación de la retina en el 82% en la primera intervención.
Background: rhegmatogenous retinal detachment (RRD) and concomitant macular hole (MH) is a rare association, reported around 1-1,7%. Objective: to report anatomical and functional postoperative results in 11 patients with RD associated with MH. Study design: observational retrospective descriptive study. Method: this is a retrospective study. Eleven patients were registered with RRD and MH between 2010-2018. A 23G vitrectomy, scleral buckling, internal limiting membrane (ILM) peeling, laser photocoagulation, lensectomy in phakic patients and tamponade with silicone oil or gas were performed. The following variables were evaluated: age, sex, visual acuity (VA) at diagnosis, time of evolution of RRD, number of retinal tears, degree of vitreoretinal proliferation (VRP), if retinectomy is required, tamponade time with silicone oil, VA after extraction of silicon oil and scleral fixation of intraocular lens and if closure of the MH was obtained. The descriptive statistical analysis consisted of qualitative variables in absolute and relative frequencies; in the quantitative variables were applied measures of central tendency like average with minimum and maximum range. Results: the patients had an average age of 63 years (range 53-74) with preoperative visual acuity (VA) between luminous projection and counting fingers. Ten patients had detached macula; the number of retinal tears were 1 to 2. The degree VRP at diagnosis: 2 grade B; 3 grade C2; 2 grade D1; 4 cases without VRP. In 2 patients with VRP C3 and D1, a 180° retinectomy was performed. In 82% of the cases, the reapplication of the retina was achieved in the first surgery, 100% in the second and in 64% the complete closure of the MH was confi rmed. The final VA was from 20/200 to 20/50, where the best visual outcomes are associated with early intervention and without VPR. Conclusion: this study found a retinal reapplication rate similar to O'Driscoll et al. where it reaches 78%, although only 31% of this report achieves the complete closure of the MH using SF6 gas as tamponade without ILM peeling. In this study, the closure rate of the MH is greater reaching 64% with ILM peeling and an anatomical success rate with retinal reapplication in 82% in the first intervention.
Subject(s)
Retinal Detachment/surgery , Postoperative Period , Retinal Perforations/surgery , Vitrectomy , Retrospective StudiesABSTRACT
OBJECTIVES: This study aimed to evaluate physical function (PF), quality of life (QOL), and energy expenditure (EE) during activities of daily living (ADL) in late outcome post-bariatric surgery (BS) patients and to compare them to severe obese individuals and matched controls. METHODS: Sixty-three subjects were included: 21 patients in post-operative (PO) of BS (3-4 years post-Roux-en-Y gastric bypass) with a stable weight for at least 6 months (16 women, 41 ± 11 years old, BMI = 28 ± 4 kg m-2) (group PO); 21 obese individuals with BS indication (16 women, 44 ± 9 years old, BMI = 44 ± 6 kg m-2) (group OB); and 21 controls matched to PO by gender, age, and BMI (16 women, 42 ± 12 years old, BMI = 27 ± 6 kg m-2) (group MC). PF was objectively assessed by the Glittre and modified Glittre ADL-tests. QOL (SF-36), EE (activity monitoring during ADL), and body composition (bioelectrical impedance) were also assessed. RESULTS: OB had worse PF (Glittre ADL-test) compared to PO and MC (OB = 224 ± 76 s; PO = 143 ± 39 s; and MC = 118 ± 17 s; p < 0.0001). The same was observed for QOL (p < 0.05 for all SF-36 domains). OB also had higher total EE in the Glittre ADL-test. However, 63% of the activity time was in low-intensity EE. In the Glittre modified protocol, OB had poorer performance than PO and MC when walking up/downstairs, rising/sitting in a chair, and moving objects on a shelf. CONCLUSIONS: Post-BS patients have better PF and QOL and perform activities under lower total EE than obese subjects, very similar to matched controls.
Subject(s)
Activities of Daily Living , Energy Metabolism , Obesity, Morbid/physiopathology , Obesity, Morbid/surgery , Obesity/surgery , Quality of Life , Adult , Bariatric Surgery , Female , Healthy Volunteers , Humans , Male , Middle AgedABSTRACT
BACKGROUND: Obese and post-bariatric surgery (BS) subjects often present limitations in physical functioning (PF). The Glittre ADL-test is a simple and useful way to evaluate this outcome. It includes functional activities such as rising from a chair, lifting, carrying weights, and bending over and was never studied in the obese population. This study aimed to determine the validity and reproducibility of the Glittre ADL-test to evaluate PF in obese, post-BS, and healthy control subjects. METHODS: Twenty-one post-BS patients (3-4 years post-surgery) (16 women, 41 ± 11 years, BMI = 28 ± 4 kg m-2) (group PO); 21 obese individuals (16 women, 44 ± 9 years, BMI = 44 ± 6 kg.m-2) (group OB) and 21 control individuals matched to PO (16 women, 42 ± 12 years old, BMI = 27 ± 6 kg m-2) (group MC) were included. For the reproducibility analysis, the Glittre ADL-test was performed twice, with a 30-min interval. As criterion methods for the validation, subjects performed two walking tests and answered a health status questionnaire (SF-36). RESULTS: High intraclass correlation (OB: r = 0.91 and PO: r = 0.89; MC: r = 0.86; P < 0.0001 for all) and good Bland-Altman agreement between the two tests were found in all groups. However, learning effect ranged between 8.8 and 11.8 % and significant test-retest differences occurred. The test was valid for all groups (moderate-to-high significant correlations with the criterion methods). CONCLUSIONS: Glittre ADL-test is valid and reproducible to evaluate PF of obese, post-BS, and healthy control subjects. However, due to the large learning effect, two tests are required for accurate assessment.
Subject(s)
Activities of Daily Living , Bariatric Surgery/rehabilitation , Obesity, Morbid/rehabilitation , Obesity, Morbid/surgery , Surveys and Questionnaires , Adult , Case-Control Studies , Female , Humans , Male , Middle Aged , Mobility Limitation , Obesity, Morbid/diagnosis , Reproducibility of Results , Surveys and Questionnaires/standardsABSTRACT
Objetivo: Reportar el caso clínico de un paciente con diagnostico de retinopatía por anemia de células falciformes utilizando la angiografía por tomografía de coherencia óptica. Diseño: Reporte de caso. Método: Se reporta el caso de un paciente masculino asintomático con antecedente de anemia de células falciformes con hemoglobina tipo SS. Resultado: La angiografía por tomografía de coherencia óptica identificó cambios estructurales y zonas de isquemia en la macula de un paciente asintomático no identificados en la angiografía fluoresceinica asociado a adelgazamiento de las capas retinianas externas. Conclusión: El presente reporte de caso demuestra la ventaja que posee la angiografía por tomografía de coherencia óptica sobre la angiografía fluoresceinica para identificar cambios compatibles con vasculopatía isquémica a nivel del plexo vascular profundo en la macula de en un paciente con manifestaciones tempranas de retinopatía por anemia de células en la periferia. Evidencia que las alteraciones vasculares podrían causar adelgazamiento de las capas retinianas externas.
Objective: To report a case of sickle cell retinopathy using optical coherence tomography angiography. Design: Case Report. Methods: Case report of an asymptomatic male patient with type SS sickle cell anemia. Results: Optical coherence angiography identified structural changes and nonperfusion in the macula of an asymptomatic patient that were not identified with fluorescein angiography associated to outer layer retinal thinning. Conclusion: The present report demonstrates the advantage of optical coherence tomography angiography over fluorescein angiography to identify changes compatible with ischemic vasculopathy in the deep capillary plexus of the macula of patient with early signs of sickle cell retinopathy at the periphery. It provides evidence that the ischemic vascular alterations aff ect the deep capillary plexus and could cause outer retinal thinning.
Subject(s)
Humans , Anemia, Sickle Cell , Eye Diseases , Fluorescein Angiography , Macular DegenerationABSTRACT
Objetivo: Identificar a los microorganismos que conforman la flora normal del conducto auditivo externo. Material y Métodos: se analizaron 100 muestras tomadas del conducto auditivo externo de estudiantes de primer, segundo y tercer año de la Facultad de Medicina Humana de la Universidad de San Martín de Porres. Resultados: en el 97 % de las muestras obtenidas del conducto auditivo externo se observó crecimiento bacteriano, en el 92,8 % de las muestras se aisló una bacteria y en 7,2 % se aislaron dos bacterias. En 49 muestras se aisló Staphylococcus aureus, en 48 muestras Staphylococcus epidermidis, en cuatro muestras Klebsiella y en tres muestras Escherichia coli. Conclusiones: en las muestras obtenidas del conducto auditivo externo la bacteria Gram positiva más frecuente fue Staphylococcus aureus y la bacteria Gram negativa más frecuente fue Klebsiella.
Objective: to identify the organisms that conform the normal flora of the external auditory canal. Material and Methods: We have analyzed 100 samples of the ear canal of students from first, second and third year of the Faculty of Human Medicine at the University of San Martin de Porres. Results: In 97% of samples taken from the external auditory canal, bacterial growth was observed; in 92,8% of the samples a bacterium was isolated and in 7,2% two bacteria were isolated. In 49 samples Staphylococcus aureus was isolated; in 48 samples, Staphylococcus epidermidis; in four samples, Klebsiella and three samples, Escherichia coli. Conclusions: in the samples obtained from the external auditory canal the most common Gram-positive bacterium was Staphylococcus aureus and Gram negative bacteria was Klebsiella.
