Setting spatial conservation priorities despite incomplete data for characterizing metapopulations.

Management of spatially structured species poses unique challenges. Despite a strong theoretical foundation, practitioners rarely have sufficient empirical data to evaluate how populations interact. Rather, assumptions about connectivity and source-sink dynamics are often based on incomplete, extrapolated, or modeled data, if such interactions are even considered at all. Therefore, it has been difficult to evaluate whether spatially structured species are meeting conservation goals. We evaluated how estimated metapopulation structure responded to estimates of population sizes and dispersal probabilities and to the set of populations included. We then compared outcomes of alternative management strategies that target conservation of metapopulation processes. We illustrated these concepts for Chinook salmon (Oncorhynchus tshawytscha) in the Snake River, USA. Our description of spatial structure for this metapopulation was consistent with previous characterizations. We found substantial differences in estimated metapopulation structure when we had incomplete information about all populations and when we used different sources of data (three empirical, two modeled) to estimate dispersal, whereas responses to population size estimates were more consistent. Together, these findings suggest that monitoring efforts should target all populations occasionally and populations that play key roles frequently and that multiple types of data should be collected when feasible. When empirical data are incomplete or of uneven quality, analyses using estimates produced from an ensemble of available datasets can help conservation planners and managers weigh near-term options. Doing so, we found trade-offs in connectivity and source dominance in metapopulation-level responses to alternative management strategies that suggest which types of approaches may be inherently less risky.

Gender differences in the effect of fish oil on appetite, inflammation and nutritional status in haemodialysis patients.

BACKGROUND: Haemodialysis patients show signs of chronic inflammation and reduced appetite, which is associated with a worse clinical status and an increased mortality risk. Fish oil has anti-inflammatory properties and may be useful as a therapeutic treatment. There is limited evidence to indicate the feasibility and efficacy of this intervention in dialysis patients. The present study aimed to compare the effect of 12 weeks of supplementation with fish oil on markers of appetite and inflammation in male and female haemodialysis patients. METHODS: The study was conducted in 28 haemodialysis patients. All patients were prescribed 3 g of fish oil per day for 12 weeks. Changes in appetite, plasma fatty acid profiles and inflammatory markers were measured at baseline and at 12 weeks. RESULTS: The mean (SD) increase in percent plasma eicosapentaenoic acid was statistically significant [1.1 (0.8) to 4.1 (2.2), P < 0.001], which was a strong indicator of good adherence. There were trends towards reductions in peptide YY (-9%; P = 0.078) and an increase in subjective sensations of hunger (+12%; P = 0.406), which reflects an increase in motivation to eat. Males (n = 13) experienced a more marked increase in hunger compared to females (+23% versus -6%), which was associated with maintenance in C-reactive protein and interleukin-6, and a reduction in soluble intercellular adhesion molecule-1. CONCLUSIONS: The results obtained demonstrate meaningful trends towards improvements in subjective appetite and certain inflammatory markers (although no change in dietary intake) and this effect was more pronounced in males. However, the levels of some inflammatory markers increased in females and this requires further study. The high level of adherence achieved indicates that an intervention requiring patients to consume four fish oil capsules per day is achievable. This was a short-term study and the effects need to be confirmed in a randomised controlled trial.

The relationship between subjective appetite sensations, markers of inflammation and appetite in dialysis patients.

BACKGROUND: Poor appetite is a marker of morbidity and mortality in haemodialysis patients, making it an important area for research. Visual analogue scales (VAS) can capture a range of subjective sensations related to appetite (such as hunger, desire to eat or fullness), but have not been commonly used to measure appetite in dialysis patients. The present study aimed to explore the association between retrospective ratings of appetite using VAS and a range of clinical variables, as well as biomarkers of appetite in haemodialysis patients. METHODS: Twenty-eight haemodialysis patients [mean age 61 +/- 17 years, 50% male, median dialysis vintage 19.5 (4-101) months] rated their appetite using VAS for hunger, fullness and desire to eat and a five-point categorical scale measuring general appetite. Blood levels of the appetite peptides leptin, ghrelin and peptide YY were also measured. RESULTS: Hunger ratings measured by VAS were significantly (P < 0.05) correlated with a range of clinical, nutritional and inflammatory markers: age (r = -0.376), co-morbidities, (r = -0.380) Patient-Generated Subjective Global Assessment score (r = -0.451), weight (r = -0.375), fat-free mass (r = -0.435), C-reactive protein (r = -0.383) and intercellular adhesion molecule (r = -0.387). There was a consistent relationship between VAS and appetite on a five-point categorical scale for questions of hunger, and a similar trend for desire to eat, but not for fullness. Neither method for measuring subjective appetite correlated with appetite peptides. CONCLUSIONS: Retrospective ratings of hunger on a VAS are associated with a range of clinical variables and further studies are warranted to support their use as a method for measuring appetite in dialysis patients.

The road to extinction is paved with good intentions: negative association of fish hatcheries with threatened salmon.

Hatchery programmes for supplementing depleted populations of fish are undergoing a worldwide expansion and have provoked concern about their ramifications for populations of wild fish. In particular, Pacific salmon are artificially propagated in enormous numbers in order to compensate for numerous human insults to their populations, yet the ecological impacts of this massive hatchery effort are poorly understood. Here we test the hypothesis that massive numbers of hatchery-raised chinook salmon reduce the marine survival of wild Snake River spring chinook, a threatened species in the USA. Based on a unique 25-year time-series, we demonstrated a strong, negative relationship between the survival of chinook salmon and the number of hatchery fish released, particularly during years of poor ocean conditions. Our results suggest that hatchery programmes that produce increasingly higher numbers of fish may hinder the recovery of depleted wild populations.

Malignant melanoma arising in a seborrheic keratosis.

We report a case of malignant melanoma associated with seborrheic keratosis. This has been reported rarely in the literature, with disagreement regarding whether it is coincidental or whether malignant transformation occurs. Because seborrheic keratoses are common and association with malignant melanoma is very rare, we conclude that the association is coincidental. However, because of the association of other malignancies, a biopsy of any suspect or changing seborrheic keratosis is essential.

X-ray diffraction and transmission electron microscopy of Morquio syndrome type A cornea: a structural analysis.

PURPOSE: This case report describes the structural characterization of the corneal stroma from a patient with Morquio syndrome type A. METHODS: A left penetrating keratoplasty was performed, and the cornea was examined using transmission electron microscopy and synchrotron x-ray diffraction. The interfibrillar proteoglycans were visualized in the electron microscope by using cuprolinic blue. RESULTS: Stromal collagen fibrils showed a bimodal distribution of diameters: 70% had a distribution comparable to that in normal tissue (20-30 nm) and 30% contained larger fibrils (30-42 nm) as seen by electron microscopy. Both electron microscopy and x-ray diffraction showed that the bulk numeric density of fibrils per unit area in cross-section (number density) was higher than normal in the Morquio syndrome cornea. The arrangement of proteoglycans throughout most of the Morquio syndrome cornea appeared normal, but many of the filaments were twice their normal length. In the anterior stroma, very large proteoglycan filaments (< or = 400 nm long) were found. Other ultrastructural differences also were noted, including abnormal keratocytes and long spacing collagen. CONCLUSION: The variation in fibril diameter and number density were modeled to account for only a 5% decrease in light scattering compared with the normal cornea. The extensive corneal clouding seen in the Morquio syndrome cornea cannot therefore be attributed to the variation in fibril diameters; collagen-free areas and expanded cells seem to be the most likely cause.

Scheie's syndrome: the architecture of corneal collagen and distribution of corneal proteoglycans.

Processes that modulate the regular architecture and, hence, transparency of the cornea are poorly understood, although proteoglycans are thought to be involved. Scheie's syndrome displays corneal opacification and systemic accumulation of glycosaminoglycans. The manifestations of these two occurrences were examined in relation to the corneal stroma. Collagen architecture was investigated by transmission electron microscopy and synchroton x-ray diffraction. Cuprolinic blue staining located sulfated glycosaminoglycan deposits that disrupted the extracellular matrix. Unlike normal cornea, which contained collagen fibrils of remarkably uniform diameter (26.0 +/- 2.4 nm), there was a large range of fibril sizes in the Scheie's syndrome stroma (19.9 to 52.0 nm). Moreover, the distribution of fibril diameters appeared bimodal. X-ray diffraction confirmed the discovery of abnormally large stromal collagen. The results suggest a link in Scheie's syndrome between proteoglycan content/distribution and stromal disruption, and between stromal disruption and corneal opacification.

Multifocal intraocular lenses and glare.

In a previous paper, we reported finding deficits in the contrast sensitivity functions of patients with diffractive multifocal intraocular lenses (IOL's). The results were consistent with optical measurements of the modulation transfer function (MTF) of the IOL. When this MTF is treated as a linear spatial frequency filter, it predicts the existence of a glare effect; contrast threshold for the recognition of target letters should be elevated by a bright, adjacent stimulus. We tested this prediction by measuring contrast thresholds for recognizing 0.2 degrees Sloan letters on a background luminance of 11.2 cd/m2. The letters were presented inside bright (300 cd/m2) annular rings with inner diameters ranging from 0.42 to 1.22 degrees. Thresholds were measured for seven multifocal subjects, age-matched groups of monofocal subjects and phakic-control subjects, and a young group. Multifocal subjects exhibited a greater glare effect than monofocal subjects, and they in turn exhibited a greater effect than phakic-control subjects. The observed glare effect for multifocal subjects was about twice that expected from the spatial filtering property of the multifocal IOL.

Contrast sensitivity and reading through multifocal intraocular lenses.

Multifocal intraocular lenses are intended to increase depth of focus for patients with cataracts, but optical considerations predict reduced retinal-image contrast. We evaluated visual performance through multifocal intraocular lenses by measuring contrast sensitivity functions and reading speed for age-matched groups with multifocal and monofocal intraocular lenses and two normal control groups. Contrast sensitivity functions of the patients with multifocal lenses did not differ significantly for optical distances differing by 2.5 diopters, indicating substantial depth of focus. Normal and monofocal contrast sensitivity functions were nearly identical, and both were about a factor of two higher than multifocal contrast sensitivity functions. Patients with multifocal lenses showed deficits in reading speed only for low-contrast text (less than 30%) and small letters (0.2 degree and 1.0 degree).

A morphological study of rabbit corneas after laser keratectomy.

We have examined the morphology of the collagen and proteoglycans in rabbit corneas that have undergone excimer laser photorefractive keratectomy using a clinical, 193 nm excimer laser. The photoablation was carried out to a stromal depth of 100 microns and a diameter of 6 mm. All ablated corneas developed a haze that was most intense between week 4 and week 8 and which showed no improvement after week 16. The corneas were stained with the cationic dye cuprolinic blue to visualise proteoglycans and were then processed for transmission electron microscopy. The ultrastructural location of proteoglycans (keratan sulphate and dermatan sulphate) was observed in the corneal wounds at different time intervals. Corneas that had undergone steroid treatment post-operatively were also examined. In the healing tissue proteoglycan filaments of abnormal size were observed, which became most prominent after 2 weeks. As healing progressed these abnormal filaments decreased but after 45 weeks some were still present, indicating that the proteoglycan content had not returned to normal.

Corneal endothelial decompensation after argon laser iridotomy.

Focal corneal edema overlying the site of argon laser iridotomy followed by generalized corneal decompensation developed in six eyes of five patients. The average interval between the iridotomy and the development of focal edema was 3 years, with generalized edema appearing an average of 3.5 months later. Light, scanning and transmission electron microscopy of tissue removed at the time of corneal transplantation showed abnormalities characteristic of Fuchs' dystrophy in two patients. Possible contributing factors include episodes of intraocular pressure elevation, cornea guttata and the use of high total amounts of energy during laser iridotomy.

Clinical use of the 193-nm excimer laser in the treatment of corneal scars.

Phototherapeutic keratectomy using a 193-nm excimer laser was performed at four centers on 33 sighted patients with corneal opacity and/or irregular astigmatism. Pathologic conditions included anterior stromal and superficial scarring from postinfectious and posttraumatic causes, including inactive herpes simplex virus, anterior corneal dystrophies, recurrent erosions, granular dystrophy, and band keratopathy. Most patients received peribulbar anesthesia and underwent removal of the epithelium prior to laser ablation. A majority of patients had a reduction in the amount of corneal scarring and approximately half had improved visual acuity. No intraocular reaction or changes in endothelial counts were seen, and some patients avoided the need for penetrating keratoplasty. Reepithelialization usually occurred within 4 or 5 days and we noted no significant scarring secondary to use of the laser. It was difficult to eliminate preexisting irregular astigmatism despite the use of surface modulators, such as methylcellulose. A hyperopic shift secondary to corneal flattening was encountered in approximately 50% of the patients. A combination of myopic ablation, followed immediately by a secondary hyperopic steepening, may minimize this refractive change. The 193-nm excimer laser is an effective new tool in the treatment of selected patients with superficial corneal opacity from a variety of conditions.

Topography and raytracing analysis of patients with excellent visual acuity 3 months after excimer laser photorefractive keratectomy for myopia.

We performed topography and raytracing analysis 3 months after surgery on five consecutive eyes of five patients, which had excimer laser photorefractive keratectomy for myopia. Three of the five eyes had uncorrected postoperative visual acuity of 20/20 or better. Two eyes had an uncorrected vision of 20/40. In three of five eyes, the area of excimer ablation was centered within 1.0 mm of the optical axis. Three other eyes showed decentration that ranged from 1.1 to 1.5 mm. The range of surface power seen within 2 mm of the central keratoscope ring was as follows: patient CK = 37.50 to 39.50 diopters; patient CA = 40.50 D to 44.80 D; patient CW = 37.90 D to 42.20 D; patient AC = 35.50 D to 39.00 D; patient DT = 34.50 D to 41.40 D. Topography patterns differed from eye to eye. A raytracing program modeled refraction of 20/80 and 20/20 "E" of 100%, 50%, 25%, 12.5% and 6.25% contrast through all measured points on the central 10 keratoscope rings of the five postoperative corneas. The five computer-derived images were ranked subjectively according to the observed degree of image degradation by three observers. Two eyes showed discernible 20/20 E's even at the 12.5% contrast level. Little to no ghost image was seen. Two eyes showed degraded but discernible 20/20 letters at higher levels of contrast only. These eyes showed moderate ghost images that were most apparent in the high-contrast 20/80 letters. One eye showed poor resolution of the 100% contrast 20/20 letter and moderately severe ghost images.(ABSTRACT TRUNCATED AT 250 WORDS)

Myopic excimer laser keratectomy: a preliminary report.

Six patients underwent excimer laser refractive keratectomy for the correction of myopia. All eyes, with the exception of patient 6, who underwent a previous failed epikeratophakia procedure and subsequent removal of the lenticule, had normal baseline ophthalmologic evaluations and best corrected visual acuities of 20/25 or better. Spherical equivalents ranged between -5.50 and -12.00 diopters. Under topical and peribulbar anesthesia, the central corneal epithelium was removed. The delivery system of the laser was programmed to ablate corrections onto the central 5.0 mm of the cornea that would result in approximate emetropia. Moderate fluctuation of refractive and topographic parameters was noted during the period of epithelial healing and remodeling. At the 12th postoperative week, five of the corneas were clear on biomicroscopic evaluation with best corrected acuities of 20/20. The final patient, who was noncompliant in the use of topical corticosteroid therapy, developed a central, 2-mm opacity and resulting best corrected acuity of 20/40. Overall, the group demonstrated that myopic excimer laser photorefractive keratectomy is consistent with good wound healing, insignificant corneal scarring, a stable refractive correction, and excellent visual acuity.

Multifocal intraocular lenses.

Current multifocal intraocular lens designs incorporate refractive or diffractive optical principles to achieve increased depth of focus. Information about four basic design concepts is presented. Early clinical results with two of these, the IOLAB Nuvue two-zone refractive multifocal and the 3M diffractive multifocal, are summarized.

Hyperplastic precorneal membranes. Extending the spectrum of neurotrophic keratitis.

Neurotrophic keratitis is a recognized complication of the neurosurgical treatment of trigeminal neuralgia. Following a retrogasserian rhizotomy, our patient developed, in addition to the anterior segment abnormalities anticipated with neurotrophic keratitis, an actively growing hyperplastic precorneal membrane originating from the limbal area and overlying intact corneal epithelium. Growth of the membrane continued towards the visual axis until all but the central 3 mm of the corneal epithelium was covered. This previously undescribed observation may indicate that the epithelium of the conjunctival and limbal areas are maintained and regulated by a different physiologic mechanism than that of the central corneal epithelium following sensory deafferentation. The significance of the membrane is discussed in context with the X, Y, Z hypothesis of corneal epithelial maintenance.