Continuous production of succinic acid from glycerol: A complete experimental and computational study.

In this work, a bioprocess for the fermentation of A. succinogenes for the production of succinic acid from glycerol was developed, employing a continuous bioreactor with recycle. Moreover, a new bioprocess model was constructed, based on an existing double substrate limitation model, which was validated with experimental results for a range of operating parameters. The model was used to successfully predict the dynamics of the continuous fermentation process and was subsequently employed in optimisation studies to compute the optimal conditions, dilution rate, reflux rate and feed glycerol concentration, that maximise the productivity of bio-succinic acid. In addition, a Pareto front for optimal volumetric productivity and glycerol conversion combinations was computed. Maximum volumetric productivity of 0.518 g/L/h, was achieved at the optimal computed conditions, which were experimentally validated. This is the highest bio-succinic acid productivity reported so far, for such a continuous bioprocess.

Two-year results of cataract extraction with implantation of the hydrophilic acrylic B-lens.

PURPOSE: To evaluate the safety and efficacy of a hydrophilic acrylic intraocular lens (B-Lens((R)), Hanita, Israel) during a 2-year follow-up period. SETTING: Department of Ophthalmology, Meir Hospital, Sapir Medical Center, Kfar-Saba, Israel. PATIENTS & METHODS: Slit lamp biomicroscopy, refraction, visual function and patient satisfaction were recorded in 147 patients at 1 week, and at 1, 3, 12, and 24 months after surgery. RESULTS: Nine cases (6%) were associated with partial rupture of the superior haptic intraoperatively, which did not preclude in-the-bag centration of the IOL in all cases. Postoperative complications were mild or reversible and rarely observed. The posterior capsule opacification (PCO) rate increased considerably (from 0.35 to 0.80) from 1 to 2 years but was for the most clinically insignificant; 16 of the 90 cases (18%) with PCO at 2 years had clinically significant opacification of the posterior capsule. No IOL discoloration was observed. BCVA stabilized by the third month and refraction was at the predicted level at two years. Eighty-one of 91 cases (89%) had BCVA equal to or more than 20/40 and 43 of 91 (47%) gained a BCVA of 20/20 at two years. CONCLUSION: Hydrophilic acrylic B-Lens((R)) implantation is safe and effective for patients with cataract.

Traumatic neuroma of the infraorbital nerve subsequent to inferomedial orbital decompression for Graves' orbitopathy.

PURPOSE: To present and discuss the occurrence of a traumatic neuroma subsequent to inferomedial orbital decompression surgery in Graves' orbitopathy. METHODS: Case report. RESULTS: Approximately 1 month after surgery, a patient who underwent bilateral rehabilitative inferomedial orbital decompression developed a mass with clinical and radiologic characteristics compatible with a traumatic neuroma of the left infraorbital nerve. The lesion, which was thought to be the result of unnoticed nerve trauma at the time of surgical dissection of the infraorbital canal, remained stable in shape and other imaging characteristics during the 39-month follow-up period. Symptoms of trigeminal neuralgia could be only partially controlled with medical therapy (oral pregabalin 75 mg 3 times daily). CONCLUSIONS: The second branch of the trigeminal nerve may be damaged in the course of orbital floor removal decompression for Graves' orbitopathy. This may potentially induce the formation of traumatic or amputation neuromas. Such lesions should be included in the potential complications of decompressions when counseling patients about to undergo this type of surgery, as they are difficult to treat and may cause persistent and disabling pain.

Central retinal vein occlusion after uncomplicated glaucoma filtering procedure combined with phacoemulsification.

We present a case of central retinal vein occlusion after an combined phacotrabeculectomy in a patient with advanced open angle glaucoma. Possible pathogenetic mechanisms for this complication are discussed.

Treatment of idiopathic orbital inflammatory disease with cyclosporine-A: a case presentation.

We present a case of idiopathic orbital inflammatory disease that was responded favorably to low-dose cyclosporine-A.

Long-term results of Ahmed glaucoma valve implantation for uveitic glaucoma.

PURPOSE: To present long-term outcomes of Ahmed glaucoma valve implantation for uveitic glaucoma. DESIGN: Interventional case series. METHODS: Retrospective chart review of 60 patients (60 eyes) with uveitic glaucoma who underwent Ahmed valve implantation over a four-year period at a tertiary uveitis referral center. Success definition 1 included patients with an intraocular pressure (IOP) between 5 and 21 mm Hg, reduced by 25% from that before implantation. Success definition 2 (qualified success) excluded those patients in whom serious complications occurred. RESULTS: Mean follow-up time was 30 months (range, six to 87 months; four-year results relate to a cohort of 15 patients). Success rates were 77% and 50% and qualified success rates were 57% and 39% at one and four years, respectively. At four years, 74% of the patients required glaucoma medication to maintain IOP control. The overall complication rate was 12%/person-years. The rate of visual acuity loss was 4%/person-years; that was most commonly attributed to corneal complications that were more likely to occur in patients with preoperative corneal disease (P = .01, Fisher exact test). CONCLUSIONS: Ahmed glaucoma valve implantation is a safe yet moderately successful procedure for uveitic glaucoma. Long-term success rates are enhanced with the use of glaucoma medications, and corneal complications are the most common of all potential serious complications.

Human amniotic membrane transplantation for tube exposure after glaucoma drainage device implantation.

We present a case of conjunctival melting over the tube of a glaucoma shunt, which was successfully repaired with amniotic membrane transplantation.

Conjunctival non-caseating granulomas in a human immunodeficiency virus (HIV) positive patient attributed to sarcoidosis.

PURPOSE: To report a rare case of isolated ocular sarcoidosis in an HIV positive patient. DESIGN: Case report. METHODS: A 47-year-old HIV+ Caucasian male was referred for chronic bilateral follicular conjunctivitis. RESULTS: A conjunctival biopsy that was performed on the right eye showed sarcoidosis. General medical evaluation including a spiral thin cut chest CT scan revealed no systemic involvement. The ocular signs and symptoms resolved completely with topical corticosteroid treatment. CONCLUSIONS: HIV infection and sarcoidosis rarely coexist, presumably because their immunopathogenesis mechanisms diverge. In the absence of systemic involvement, a definite diagnosis can only be made by biopsy of the ocular tissues.

Somatostatin for Uveitic Cystoid Macular Edema (CME).

PURPOSE: To report the favorable response of bilateral recalcitrant uveitic cystoid macular edema (CME) to treatment with a somatostatin analog. METHODS: Medical ophthalmic history and the results of ophthalmic examinations were recorded. Fluorescein angiography (FA) studies were reviewed. RESULTS: A 52-year-old white female with intermediate uveitis developed bilateral recalcitrant CME. Treatment with subcutaneous injections of the somatostatin analog octreotide resulted in partial resolution of the CME and improvement of visual acuity. CONCLUSIONS: Somatostatin may play a role in the treatment of CME secondary to uveitis.

Digitizing stereoscopic optic nerve head photographs for storage and viewing using a personal computer.

Careful examination and monitoring of optic nerve head changes is essential in the treatment of patients with glaucoma. This often results in accumulation of numerous photographs and required appropriate storage space. A simple, inexpensive, and efficient means of storing and viewing stereoscopic optic nerve head photographs is described. Images were acquired with a fundus camera, on a color slide film. Slides were then scanned and digitized. A handheld stereoscope was used for stereoscopic viewing on a computer monitor. A scanning resolution of 300 dpi appeared optimal. At this resolution, the storage utilization was 16 kilobytes and the scanning time was 160 seconds per patient.

Actinomyces canaliculitis: diagnosis of a masquerading disease.

BACKGROUND: To review the diagnosis and management of seven cases of Actinomyces canaliculitis. METHODS: Culture of discharge was performed in six of seven patients with Actinomyces canaliculitis using a PD Plus/F blood culture bottle. All patients were treated by canaliculotomy with curettage of dacryoliths, followed by treatment with systemic penicillin and Sulphacetamide drops over a period of 3-6 months. Part of the curetted concretions was fixed on a glass slide and part was sent to the laboratory for culture. RESULTS: Four patients were women and three men with age ranging between 43 and 90 years. The average time lapse between onset of symptoms until diagnosis was 3 years. All cases presented with epiphora, chronic conjunctivitis, palpably thickened canaliculus, and yellow punctal discharge. Diagnosis was achieved by culture of discharge in three of six cases, culture of concretions in three of five cases, and staining of dacryoliths in all seven cases. Follow-up ranged between 12 and 48 months. The canaliculitis resolved completely and all patients have patent canalicula. CONCLUSIONS: Actinomyces canaliculitis presents with epiphora, chronic purulent conjunctivitis, a palpably thickened canaliculus, and yellow punctual discharge. In suspect cases canuliculotomy and curettage should be performed, although canalicular reconstruction is generally unnecessary. Culture of discharge and concretions using PD Plus/F blood culture medium gave improved results over accepted norms. Fixation of smeared concretions on a slide in alcohol is simple and is diagnostic of the disease. We recommend long-term systemic penicillin treatment in Actinomyces canaliculitis.

Epithelial ingrowth after laser in situ keratomileusis: a histopathologic study in human corneas.

OBJECTIVE: To report the histopathologic findings in 4 human corneas that developed epithelial ingrowth after laser in situ keratomileusis (LASIK), at various postoperative intervals. METHODS: One specimen was obtained intraoperatively during treatment of epithelial ingrowth 2 months after LASIK (case 1). The other 3 corneal specimens were obtained after penetrating keratoplasty performed at 7 months (case 2), 20 months (case 3), and 5 years (CASE 4) after LASIK. The specimens were examined with both light and transmission electron microscopy. RESULTS: In case 1, most of the epithelial cells under the flap looked viable. However, some had begun to lose their characteristic shape and intercellular contacts. In case 2, aggregations of nonactivated fibroblasts and degrading epithelial cells could be observed. The surrounding collagen matrix differed significantly from that of the intact corneal matrix. In case 3, only completely degraded epithelial cells could be found, surrounded by collagen fibrils approximately 2 to 2.5 times larger in diameter than typical corneal collagen. In case 4, epithelial cell remnants, surrounded by a continuous layer resembling the basal membrane, were observed. CONCLUSIONS: Corneal epithelial cells lose their characteristic morphologic features and eventually degrade in the metabolically "unusual" environment of the flap interface. Concurrently, a capsule of connective tissue similar to scar tissue forms, separating them from healthy cornea.

Primary deep sclerectomy versus primary deep sclerectomy with the use of mitomycin C in primary open-angle glaucoma.

PURPOSE: To prospectively study and compare the effectiveness and the safety of primary deep sclerectomy with and without the use of mitomycin C in eyes with open-angle glaucoma. PATIENTS AND METHODS: A total of 90 eyes of 90 patients with primary open-angle glaucoma or pseudoexfoliative glaucoma underwent deep sclerectomy. Patients were enrolled consecutively and assigned randomly to undergo deep sclerectomy without the use of mitomycin C (DS group) and deep sclerectomy with the application of mitomycin C (DSMMC group) in a concentration of 0.2 mg/mL for 2.5 minutes, before the superficial scleral flap formation. RESULTS: The intraocular pressure was significantly decreased by 7.13 mm Hg or 27.59% in the DS group and by 11.68 mm Hg or 42.25% in the DSMMC group at the end of the follow-up period. The intraocular pressure reduction in the DSMMC group was statistically significant when compared with that in the DS group (P <0.05). The complete (IOP <22 mm Hg without medication) and qualified (IOP < 22 mm Hg with or without medication) success rates at the end of the follow-up period were 42.5% and 72.5% in the DS group and 50% and 95% in the DSMMC group. The qualified success rate in the DSMMC group was statistically significant when compared with that in the DS group. Differences in complications (choroidal detachment, hyphema, leakage) seen between the two groups were statistically nonsignificant. A hemorrhagic detachment of the Descemet membrane was observed in one eye in the DSMMC group. CONCLUSIONS: The use of intraoperative mitomycin C during deep sclerectomy significantly reduced the postoperative IOP and increased the success rate of the procedure.