Quantitative analysis of transforming growth factor beta isoforms mRNA in the human corneal epithelium.

TGF-beta is an important mediator of cell growth, differentiation, and proliferation and plays a significant role in both normal and pathological corneal tissue. However, the quantitative relations between TGF-beta1, -beta2 and -beta3 isoforms in human cornea still remain unclear. Therefore, the aim of this study was to determine the gene expression profile of TGF-betas in order to evaluate quantitative relations between the examined transcripts in human corneal epithelium. Transcriptional activity of TGF-beta1, 2, 3, GAPDH and beta-actin genes was estimated on the basis of mRNA copy number per 1 microg of total RNA using the real-time QRT-PCR technique with the SYBR Green I chemistry. Specificity of RT-PCR reaction was confirmed by determination of the characteristic melting temperature for each amplimer. Additionally, the RT-PCR products were separated on 6% polyacrylamide gels and visualized with silver salts. Expression of all TGF-beta genes for the corneal epithelium was determined. Comparable analysis of mRNA copies/1 mug of total RNA for each TGF-beta isoform showed that: TGF-beta1 > TGF-beta2; TGF-beta3 > TGF-beta2; TGF-beta1 = TGF-beta3 (ANOVA test P < 0.0001; post-hoc Tukey's test: TGF-beta1 and TGF-beta2, P = 0.0306; TGF-beta3 and TGF-beta2, P = 0.0045; TGF-beta1 and TGF-beta3 NS). We found different expression of the TGF-beta1, -2 and -3 isoforms in the human corneal epithelium. Such differential expression of TGF-betas suggests that each of them may play a specific role in corneal tissue.

[A grid pattern type of photocoagulation in treatment of diabetic maculopathy--personal experience]. / Fotokoagulacja typu grid pattern w leczeniu makulopatii cukrzycowej--doswiadczenia wlasne.

PURPOSE: The aim of the present study was the evaluation of visual outcome of 425 eyes in 283 patients treated by focal and grid pattern photocoagulation for clinically significant macular edema according to the recommendations of the Early Treatment Diabetic Retinopathy Study (ETDRS). MATERIAL AND METHODS: On the basis of baseline status of macula, eyes were classified into three groups: group I--eyes treated by focal photocoagulation (39 eyes), group II--eyes treated by focal photocoagulation and/or modified grid (84 eyes), group III--eyes treated by focal photocoagulation and/or grid pattern (302 eyes). Eligibility criteria for this retrospective study included a diagnosis of clinically significant macular edema according to the ETDRS scale. The baseline examination for all patients presented in this review included: the best corrected visual acuity (VA), slit lamp with contact lens indirect ophthalmoscopy, fundus color photography and fluorescein angiography. All patients were treated with argon green by grid with Nidek 2300 laser. Modified grid or focal photocoagulation according to the ETDRS recommendations were performed. Patients with proliferative diabetic retinopathy (PDR) were transferred to panretinal photocoagulation (PRP) after treatment of maculopathy. Development of VA from the baseline to last checkup in treated eyes was reported and compared. Follow-up ranged widely from 6 to 45 months. RESULTS: General stabilization was achieved in 51.3%, improvement in 10.1% and deterioration in 38.6% of eyes. The best results were achieved after selective and focal and/or modified grid treatment: in the Ist group stabilization of VA was achieved in 43.6% and improvement in 41% of eyes; in the IInd group: stabilization in 60.7% and improvement in 21.4% were stated; in the IIIrd group: stabilization in 49.7% and improvement only in 3.0%. In 164 (38.6%) cases supplemental treatment was administered. CONCLUSION: Photocoagulation has proved effective in the treatment of diabetic clinically significant macular edema.

[Surgical correction of astigmatism after wedge resection keratoplasty]. / Chirurgiczna korekcja wysokiej niezbornosci rogówki po keratoplastyce drazacej.

PURPOSE: To analyse the results of astigmatism correction after keratoplasty using wedge resection technique. MATERIAL AND METHODS: Eleven patients underwent a wedge resection for postkeratoplasty astigmatism. The average postoperative astigmatism was 13.9 diopters (range 11.0 to 17.0 D). Among the patients there were 5 women and 6 men, aged 25 to 70 years. All of the grafts were in static phase, after suture removal. The indications for keratoplasty were: keratoconus--8, pseudophakic and aphakic corneal edema--3. The follow-up period after wedge resection was 6 to 24 months. The astigmatism was evaluated by videokeratometer (ORC Masterviue Ultra). RESULTS: Postoperatively, the average astigmatism was 7.25 D by 6 months, 8.1 D by 12 months, 8.45 D by 24 months. The visual acuity corrected with spectacles was 0.2 to 1.0. 8 patients (72.7%) gained better visual acuity. Complications included: 1) growing vessels through the wound, 2) delay of epithelization. CONCLUSION: Wedge resection is an effective technique for managing postkeratoplasty high astigmatism.

[Polymorphism of the chymase gene and development of retinopathy in type 2 diabetic patients]. / Polimorfizm genu chymazy a rozwój retinopatii cukrzycowej u chorych na cukrzyce typu 2.

Diabetic retinopathy is one of the major causes of blindness in developed countries. Among the factors involved in development of retinopathy genetic factors related to the generation of angiotensin II are mentioned. Recently was described that tissue chymase enzyme is the alternative trait for angiotensin II formulation. The aim of the study was assessment of association of CMA/B hCC polymorphism of chymase gene with the development and progression of diabetic retinopathy. The study was conduced in 587 type 2 diabetic patients with diabetes duration longer than 10 years. Mean age 62.8 +/- 8.58, mean duration 16.7 +/- 5.66, HbA1c 8.23 +/- 1.71, BMI 29.1 +/- 4.91. Ophthalmological examination was performed to determine the presence of retinopathy. Next polymorphism CMA/B hCC chymase gene by PCR method was assessed. Gene distribution was estimated by chi-square test. In the whole examined group no significant changes of gene distribution was found. However, in female group without retinopathy the tendency to lower incidence of GG genotype was observed (p = 0.06). When assessed the female group without retinopathy despite 15 years duration of diabetes frequency decrease of GG genotype was significant (p = 0.04). According to the results we conclude that CMA/B hCC chymase gene polymorphism is associated with the presence of diabetic retinopathy. Association is expressed by decreased frequency of GG genotype in female group without retinopathy.

[Trans-sclerally fixated PC-IOLs: six year of investigations]. / Soczewki wewnatrzgalkowe tylnokomorowe mocowane do twardówki--szesc lat doswiadczen.

PURPOSE: To present the results of PC IOLs transscleral fixation to the ciliary sulcus in six years follow-up. MATERIAL AND METHODS: 152 eyes in 3 groups: 15 eyes with primary fixations of PC IOLs, 92 eyes with secondary fixations of PC IOLs and 45 eyes with secondary fixations of PC IOLs combined with penetrating keratoplasty. RESULTS: Postoperative corrected visual acuity was 0.5 or better in 32.2% of cases, the most common complications in our material was CME (9.9%), lens tilt (4.6%) and increase of IOP (3.95%). CONCLUSION: Transscleral fixation of PC IOLs offers good visual outcome with relatively low rate of complications and is recommended in cases with inadequate posterior capsule support.

[Glaucoma after penetrating keratoplasty in the material of the ocular department of the Mountain Hospital in Sosnowiec]. / Jaskra po keratoplastyce drazacej w materiale oddzialu okulistycznego szpitala górniczego w Sosnowcu.

PURPOSE: To evaluate the necessity of antiglaucoma therapy in patients after penetrating keratoplasty (PK). MATERIAL AND METHODS: An analysis of 537 penetrating keratoplasties performed in our department was undertaken. Incidence of glaucoma after penetrating keratoplasty procedure, necessity of pharmacological antiglaucoma treatment as well as the kind of surgical procedure and its influence on the graft transparency were estimated. RESULTS: The incidence of post keratoplasty glaucoma was 11.2% (60/537). 42 patients required pharmacological treatment (42/60) and the remaining 18 required surgery. 12 trabeculectomies, 6 drainage devices procedures and 1 cyclokrytherapy were performed and stabilization of intraocular pressure was obtained. 14 of the grafts treated surgically lost their transparency. CONCLUSIONS: Multiple surgical treatment of post-penetrating keratoplasty glaucoma, despite the stabilisation of the intraocular pressure, may lead to loss of graft transparency in most cases.

[Valve implants of glaucoma pressure regulator for refractory glaucoma: own experience]. / Wszczepy zastawkowe Glaucoma Pressure Regulator w jaskrze opornej na leczenie--doswiadczenia wlasne.

PURPOSE: To present our experiences in valve implantation for refractory glaucoma. MATERIAL AND METHODS: From October 1993 to December 1996 implantations of Glaucoma Pressure Regulator Optimed were performed in 7 eyes of 7 patients. There were 4 men and 3 women aged from 32 to 65 years. There were 3 eyes with neovascular glaucoma due to diabetes mellitus, 2 eyes with posttraumatic glaucoma, including 1 case after keratoplasty, 1 eye with postkeratoplasty glaucoma and 1 eye with aphakic glaucoma. Preoperative IOPs ranged from 33 to 61 mm Hg (mean 37.6 +/- 7.2 mm Hg). RESULTS: Success was considered an IOP of less than 22 mm Hg without medication (complete success) or with medication (qualified success) without additional filtering surgery. Postoperative success was obtained in 4 out of 7 eyes after follow-up period of 37.4 +/- 17.08 months (range 16-39 months). Early complications were hyphema (1 patient, 14.3%), blockage of intracameral portion of the tube (1 patient, 14.3%), hypertony (1 patient, 14.3%). Late complications were: external conjunctival bleb failure (2 patients, 28.6%), blockage of intracameral portion of tube by fibrovascular tissue (1 patient, 14.3%). CONCLUSION: Our experiences confirm that the valve implant is still today an alternative surgical procedure for controlling IOP in eyes with refractory glaucoma that have visual potential.

[The evaluation of the usefulness of phacotrabeculectomy as the only surgery for glaucoma and cataract patients]. / Ocena skutecznosci fakotrabekulektomii jako jednoczesnej operacji jaskry i zacmy.

PURPOSE: To evaluate IOP changes after phacotrabeculectomy. MATERIAL AND METHODS: 24 glaucoma patients (27 eyes) with coexistence of cataract. Age: 56-79 years. Mean IOP level before surgery: 23.2 +/- 2.4 mm Hg. In all cases phacotrabeculectomy was performed. Follow-up ranged from 3 to 12 months. RESULTS: IOP decrease after surgery was achieved: mean decrease 7.1 +/- 2.3 mm Hg after 3 months and 5.5 +/- 2.4 mm Hg, and 4.1 +/- 2.1 mm Hg after 6 and 12 months, respectively. CONCLUSION: Phacotrabeculectomy combines all advantages of phacoemulsification and creates perspective for IOP normalization.

[Keratectomy for a malignant melanoma of the cornea]. / Keratektomia jako metoda leczenia czerniaka zlosliwego rogówki.

PURPOSE: To present the possibility of malignant melanoma treatment of the cornea using keratectomy. MATERIAL AND METHODS: A 59-year old woman with a primary malignant melanoma of the cornea. Visual acuity before surgery 0.2. Malignant melanoma was removed using keratectomy. Follow-up 18 months. RESULTS: Satisfactory cosmetic result and visual acuity 1.0 was obtained. In 18 months follow-up no local or general symptoms of tumor recurrence are observed. CONCLUSION: Keratectomy should be considered as an alternative treatment for primary malignant melanoma of the cornea.

[Symptomatic eye changes during the course of sarcoidosis]. / Symptomatologia zmian ocznych w przebiegu sarkoidozy.

The authors present ocular changes observed in sarcoidosis. The most frequent features are: symptoms of dry eye and uveitis. Frequency of ocular manifestations leads to the conclusion that ophthalmic examinations ought to be routine procedure at sarcoid patients.

[Diagnostic-therapeutic procedures in ocular sarcoidosis]. / Postepowanie diagnostyczno-terapeutyczne w sarkoidozie narzadu wzroku.

The authors present diagnostic and therapeutic procedure in patients with ocular sarcoidosis.

[Evaluation of the usefulness of the laryngeal mask for general anesthesia in eye microsurgery--preliminary results]. / Ocena przydatnosci maski krtaniowej do znieczulenia ogólnego w mikrochirurgii oka--doniesienie wstepne.

PURPOSE: This prospective study was designed to compare intraocular pressure changes and haemodynamic response to insertion of either a laryngeal mask or an orotracheal tube during general anaesthesia for cataract surgery. MATERIAL AND METHODS: The effect of techniques (tracheal tube-TT, laryngeal mask airway-LMA) securing a clear upper airway on the heart rate changes (HR), arterial pressure (SAP, DAP), oxygen saturation (SpO2), end-tidal carbon-dioxide pressure (Et-CO2), intraocular pressure (IOP) and the incidence of coughing, stridor and sore throat was analysed in 60 patients undergoing cataract surgery during general anaesthesia. RESULTS: The mean values for HR, SAP, DAP and IOP measured before and after induction of anaesthesia were not different in both groups. After securing a clear airway, mean HR increased in TT group to 95.5/min and decreased to 75.7/min in LMA group. SAP increased in TT group to 131 mmHg, DAP to 82.6 mmHg, whilst in LMA group both values decreased to 98.6 mmHG and 66.3 mmHg, respectively. The significant difference in IOP values was observed after intubation or using laryngeal mask. In TT group, intraocular pressure increased to 15 mmHg in healthy eye and to 13.6 mmHg in ill eye whilst there was a decrease in LMA group to 5.5 and 7.43 mmHg, respectively. Furthermore, a greater incidence of such complications as coughing, stridor and sore throat in TT group was observed. CONCLUSION: The results show that using LMA in microsurgery during general anaesthesia is more advantageous and safer for patients in comparison with tracheal intubation.

[Treatment of idiopathic blepharospasm with botulinum toxin A]. / Leczenie samoistnego kurczu powiek wstrzykiwaniem toksyny botulinowej A.

The preparations of botulinum toxin A--Botox and Porton were injected into the orbicular muscle of eye in 18 patients with idiopathic blepharospasm or Meige's syndrome. Improvement was achieved in 17 patients; in 10 injections should be repeated after about 8 weeks. Minor side effects declined after several days. Injection of botulinum toxin could be effective in this disease, otherwise hard to cure.

[Keratoplasty with simultaneous cataract extraction and implantation of an intraocular lens]. / Keratoplastyka z równoczesnym usunieciem zacmy i wszczepieniem soczewki wewnqtrzgalkowej.

In the period of 1985-1992 we performed in our centres 34 operations of a double procedure and 12 operations of a triple procedure. During the observation--from 2 months to 7 years--we obtained favourable results encouraging to connect the corneal grafting with cataract extraction in high myopia and with extracapsular cataract extraction with implantation of an artificial lens in emmetropic eyes. Presented is the appropriate technique of operation and the results obtained.

[Retinal changes accompanying acute pancreatitis]. / Zmiany siatkówkowe towarzyszqce ostremu zapaleniu trzustki.

Observed were 12 patients with acute pancreatitis claiming to suffer various kinds of visual disturbances. All the examined patients exhibited changes in the eye fundus localized mainly in the area of the posterior pole. As the general condition was improving the fundus changes slowly receded.

[Inter-capsular technique of cataract extraction with implantation of intraocular disc lenses--own material]. / Miedzytorebkowa technika usuwania zacmy z implantacja soczewek wewnqtrzgalkowych dyskowych w materiale wlasnym.

The authors present personal results and complications of surgery with application of intraocular disc lenses. Evaluation of this model of intraocular lenses is positive. The authors are encouraging to their use.

[Significance of anterior and posterior lens capsule in inter-capsular cataract surgery]. / Znaczenie przedniej i tylnej torebki soczewki w miedzytorebkowej chirurgii zacmy.

Anterior as well as posterior lens capsule are nowadays the object of interest because of their importance. Discussing the cataract surgery the author presents the role of the lens capsule in the process of the inter-capsular technique of cataract extraction and in the postoperative course.

[Methods of preventing opacification in the posterior lens capsule after extracapsular cataract extraction]. / Sposoby zapobiegania zmetnieniom torebki tylnej soczewki po zewnqtrztorebkowym usunieciu zacmy.

The methods of extracapsular cataract extraction generated some problems connected with postoperative opacification of the posterior capsule. The authors present clinical and experimental methods applied nowadays, intended to prevent these opacifications from forming.

[Late results of stomatologic and ophthalmologic treatment of injuries involving the central part of the face]. / Odlegle wyniki leczenia stomatologicznego i okulistycznego urazów srodkowego odcinka twarzy.

The authors present an analysis of the results of treatment of patients with injury of the central fragment of the face, who have been hospitalized in the 2nd Department of the Maxillofacial surgery in Silesian Academy of Medicine. In the period 1980-1987 there were 447 patients with an injury of the central fragment of the face. Among this group 60 (13.4 p.c.) patients showed disturbances of the visual system. The most frequent causes of the injury were: assault (61.5 p.c.), traffic accidents (20.1 p.c.), occupational injuries (8.8 p.c.). Deformation of the face was the most frequent pathology observed in the course of a control stomatological check-up (32.0 p.c.). The most important ocular pathology were the posttraumatic atrophy of the eye (3.3 p.c.) and optic atrophy. Palpebral scars (33 p.c.) and diplopia (7.6 p.c.) were the most frequent ocular signs.

[Changes of the retinal pigmented layer in familial polyposis of the colon]. / Zmiany warstwy barwnikowej siatkówki w polipowatosci rodzinnej jelita grubego.

Ophthalmoscopic examinations were performed in 96 patients with polyps or another disturbances of the colon, among them 3 cases suffered a histopathologically confirmed familial polyposis of the colon. All 3 cases of the familial polyposis exhibited in the ophthalmological examination pathological changes of the retinal pigment epithelium of both eyes.