Evaluation of combined growth media for in vitro cultivation of oropharyngeal biofilms on prosthetic silicone.

In the upper aerodigestive tract, biofilm deposits by oropharyngeal microbes can cause failure of medical polymer devices like voice prostheses. Previous studies on testing of inhibitive strategies still lack of comparability due to varying study protocols concerning growth media, microbial species and growth conditions. Goal of the study was therefore to test cultivation of a mixed biofilm of isolated oropharyngeal microbes under in vitro growth conditions using mixtures of common growth media. Mixtures of yeast peptone dextrose medium (YPD), fetal bovine serum (FBS), RPMI 1640, Yeast nitrogen base medium (YNB) and brain heart infusion (BHI) were tested to grow mixed biofilm deposits of Candida albicans, Candida tropicalis, Staphylococcus aureus, Streptococcus epidermidis, Rothia dentocariosa and Lactobacillus gasseri on medical grade silicone. Periodic assessment of living biofilm was performed over 22 days by a digital microscope and the cultivated biofilm structures were analyzed by scanning electron microscopy after completion of the study. Mixtures of BHI, YPD and FBS improved microscopic growth of multispecies biofilm deposits over time, while addition of RPMI and YNB resulted in reduction of visible biofilm deposit sizes. A mixtures of FBS 30% + YPD 70% and BHI 30% + YPD 70% showed enhanced support of permanent surface growth on silicone. Growth kinetics of in vitro multispecies biofilms can be manipulated by using mixtures of common growth media. Using mixtures of growth media can improve growth of longterm multispecies oropharyngeal biofilm models used for in vitro testing of antibiofilm materials or coatings for voice prostheses.

[The long-term follow up after trabeculectomy]. / Dlugoterminowe wyniki operacyjnego leczenia jaskry metoda trabekulektomii.

THE AIM OF THE STUDY: To estimate the efficacy of trabeculectomy for primary open angle glaucoma. MATERIAL AND METHODS: Since 1990 to 2000 we observed 91 eyes of 79 patients (53 women and 26 men) aged 39-86. The results of performed surgery were valued directly after the trabeculectomy and in period of over 8 years. We carried out the examinations of visual acuity, intraocular pressure, visual field, state of optic nerve head, type of bleb following trabeculectomy and the necessity of applying additional topical treatment. The trabeculectomies were performed in a typical way. Some surgeons made a square or triangular superficial scleral flap based at the limbus, measuring from 2.5 x 3.0 to 4 x 4 mm or 3 x 3 mm. The deep block of scleral tissue with trabeculum (from 0.5 x 1.0 to 2.5 x 3.0 mm) was excised, the superficial cauterisation and the peripheral iridectomy were performed in every case. The scleral flap and conjunctiva were sutured with 10/0 Ethilon, 8/0 Vicryl or 6/0 Mersilk. RESULTS: The patients were divided into 3 groups depending on observation period: I--up to 4 years, II--from 5 to 8 years, III--over 8 years. We confirmed the normalisation of IOP in 80%, 73%, 90% and the successful control of visual field (no progress) in 82%, 77%, 70% of adequate groups. In the first and second group 45-50% of patients could resist from topical treatment, but after 8 years as many as 80% required additional pharmacological treatment. CONCLUSION: The trabeculectomy is the effective surgery in most patients with open angle glaucoma. The effectiveness of trabeculectomy can be controlled by the size of extracted deep scleral flap with trabeculum. For the stability of visual field it is necessary to keep the intraocular pressure at 13-18 mm Hg level.

[The seasonal course of recurrent uveitis in children and youth]. / Sezonowy przebieg nawrotowego zapalenia blony naczyniowej u dzieci i mlodziezy.

PURPOSE: To analyse the etiology, localisation of inflammation, frequency of recurrences and the visual function in the course of uveitis in children. MATERIAL AND METHODS: Sixteen children aged 4-18 years with uveitis were analysed for 2 to 15 years (mean 6.3 years) from the occurrence of the first symptoms. The ophthalmological examination, laboratory investigations, pediatric, stomatology and laryngology consultations were performed in all children. The medical topical and general treatment in all patients was applied. RESULTS: The certain etiological factors were found in 9 patients, the probable ones in 2 children and in 5 cases the cause of the illness was not established. Clinical inflammation was located in different parts of uvea, in 10 children it appeared in one eye and in 6 children in both. The course of illness showed a recurrent character (from 1 to 8 recurrences) in most children. We have established three seasonal occurrences of the disease, mainly in spring and autumn, less at the beginning of summer. After treatment the visual acuity improved in 17 eyes (77.3%), in 3 eyes (13.6%) it did not change and in 2 eyes (9.1%) got worse. CONCLUSIONS: The chronic, recurrent uveitis in children has a seasonal character (three times a year). The rheumatic disease is the main cause of multiple recurrences of uveitis in children. The early diagnosis of illness and careful medical supervision until the children are 16-18 years old may improve the final results of treatment.

[Visual system function in patients after surgery for intracranial tumors]. / Ocena stanu funkcjonalnego narzadu wzroku u pacjentów po przebytych operacjach guzów wewnatrzczaszkowych.

UNLABELLED: Visual function was studied in patients after operations for brain tumours. The study group comprised 7 cases. Visual acuity, field of vision by kinetic and static methods and visual evoked potentials were studied before and after operations. The follow up time was from 1 to 51 months, mean 20 months. In all patients decreased visual acuity, visual field defects and VEP abnormalities were found, before operation. The first control examination after operation showed improvement of visual acuity in 2 cases after removal of pituitary tumours, and worsening of vision in all the remaining ones. In two cases of tumours spreading to the basis of the frontal lobe blindness of one eye developed. Static and kinetic perimetry showed in all cases enlarged visual field defects. VEP confirmed that removal of pituitary tumours compressing visual tract can improve vision: P100 amplitudes increased and latencies become shorter. Further VEP improvement occurred even 6-20 months after achieving of good visual acuity. No improvement of vision developed if the visual pathway had been damaged during the operation. CONCLUSIONS: Pituitary tumours can be removed without damage to the surrounding structures and vision can improve after that. Meningiomas and gliomas lying in immediate vicinity of optic nerves and their chiasma or growing out from them are usually large and often their removal is associated with damage to the visual pathway leading to visual field defects to blindness. The assessment of vision should be based on static and kinetic perimetry and visual evoked potentials (VEP) since these methods are mutually complementary and only their comparison provides a full result.