Biomedical subjects

C Wirbelauer

Publications and source records attributed to C Wirbelauer.

49 records · Page 3Linked to original sources

PubMed1998

Corneal shape changes after pars plana vitrectomy.

BACKGROUND: The purpose of this prospective, controlled, clinical study was to investigate corneal shape changes due to pars plana vitrectomy (PPV) in patients with potential visual improvement postoperatively. METHODS: A total of 36 consecutive patients undergoing conventional PPV combined with or without macular surgery were studied. Sequential determinations of the corneal curvature by manual keratometry and corneal topography were performed preoperatively, during the first postoperative week, at 4 weeks and after 2-8 months (mean 4 months). RESULTS: The mean surgically induced keratometric astigmatism was 2.92 +/- 1.98 diopters (D) (P < 0.0001) during the first postoperative week. After 4 weeks and 4 months the values decreased to 1.01 +/- 0.97 D and 0.67 +/- 0.43 D, respectively. Videokeratographic analysis confirmed significant curvature changes, with corneal steepening (P < 0.008) which corresponded to the superonasal and temporal semimeridian, and flattening (P < 0.008) along the inferior and inferonasal semimeridians. Corneal changes persisted in some cases for several weeks, partly in an asymmetric and irregular configuration. Shifts in axis to against-the-rule and oblique meridians were noted postoperatively with redistribution within preoperative values in 53% of the cases at 4 weeks after surgery. Subgroup analysis revealed that suture diameter, as well as the use of gas endotamponade, influenced the induced astigmatism. CONCLUSION: A substantial increase of the corneal astigmatism and distinct shape changes can occur after PPV in the immediate postoperative period. Consecutive stabilization at preoperative values was observed after several weeks. The time course of the corneal curvature alterations should be considered in the postoperative management to detect refractive causes of inadequate visual acuity.

Adult↗

PubMed1998

Intraocular pressure in nonglaucomatous eyes with pseudoexfoliation syndrome after cataract surgery.

BACKGROUND AND OBJECTIVE: To investigate the course of the intraocular pressure (IOP) in nonglaucomatous patients with pseudoexfoliation (PSX) syndrome after cataract surgery. PATIENTS AND METHODS: In a prospective age-matched controlled clinical study, 23 consecutive patients with PSX were studied and compared with a control group of 23 patients. The IOP was measured by applanation tonometry preoperatively, and postoperatively on day 1, after 4 weeks, and after 6 months. All patients were operated on with a self-sealing 7-mm scleral tunnel incision, phacoemulsification, and posterior chamber intraocular lens (IOL) implantation. RESULTS: Preoperatively the IOP was similar between both groups (P = .962). At the first postoperative day the IOP was below 22 mm Hg in all cases. After 4 weeks and 6 months a mean decrease of 3.88 mm Hg (P = .001) in the control group and of 3.15 mm Hg (P = .002) in the PSX group was observed; this difference was not statistically significant (P = .543). CONCLUSIONS: At 1 day postoperatively no pressure increase was observed in the eyes with PSX after scleral tunnel incision and phacoemulsification. Six months after cataract extraction with IOL implantation, the tension level decreased in the presence of PSX similarly as in normal eyes.

Aged↗

PubMed1997

[Early postoperative endothelial cell loss after corneoscleral tunnel incision and phacoemulsification in pseudoexfoliation syndrome].

INTRODUCTION: Corneal endothelial involvement can be found in pseudoexfoliation syndrome (PEX). Evaluation of possible differences in endothelial cell loss following cataract extraction was compared to normal eyes. PATIENTS AND METHODS: In a controlled clinical study we prospectively studied 20 patients with PEX and compared them with an age-matched control group with senile cataract. All patients were treated with a standardized self-sealing 7-mm corneoscleral tunnel incision, phacoemulsification and posterior intraocular lens implantation using sodium hyaluronate. In addition to a complete ophthalmological examination, quantitative and qualitative endothelial cell analysis of the central and peripheral cornea was performed preoperatively, at the first postoperative day and after 4 weeks using non-contact specular microscopy (Konan Noncon Robo-ca SP 8000, Konan, Japan). RESULTS: In eyes with PEX (2394 +/- 271 cells/mm2) endothelial cell counts were 10.5% (P < 0.05) lower than in the control group (2674 + 341 cells/mm2). Intraoperatively, ultrasound time (90 +/- 51 s) and power (38 +/- 17%) did not differ between the two groups. After 4 weeks the mean endothelial cell loss in the two groups was 10.4% and 9.8%, respectively (P < 0.001). The mean cell area increased by 55 and 48 microns2 (P < 0.001), respectively. Polymegethism increased postoperatively in both groups and stabilized at 4 weeks at preoperative values. Pleomorphism increased significantly only in the PEX group. CONCLUSIONS: In eyes with PEX no increased cell loss was found in the early postoperative period compared to normal eyes following corneoscleral tunnel incision and phacoemulsification. Due to preoperative reduced endothelial cell densities, endothelium-protecting measures are recommended in eyes with PEX.

Aged↗

PubMed1997

Effect of incision location on preoperative oblique astigmatism after scleral tunnel incision.

PURPOSE: To evaluate the effect of incision location or clinically relevant preoperative oblique astigmatism. SETTING: Department of Ophthalmology, Virchow Medical Center, Humboldt-University, Berlin, Germany. METHODS: This prospective study included 68 patients who had phacoemulsification and posterior chamber lens implantation using a standardized 7.0 mm self-sealing trapezoidal scleral tunnel incision. Each patient was randomly assigned to one of three incision locations: Group A, conventional superior incision; Group B, temporal incision; Group C, oblique incision centered on the steeper meridian (modified BENT incision). Astigmatism analysis was performed by manual keratometry and corneal topography. RESULTS: A significant mean reduction in astigmatism of 0.58 diopter (D) (P < .01) was achieved in only the modified BENT incision group. Postoperatively, significant flattening of 0.27 D (P < .01) in the steeper meridian as well as steepening of 0.29 D (P < .01) in the flatter meridian occurred. No decrease in astigmatism was noted in the superior or temporal incision groups. Five months postoperatively, vector analysis showed that surgically induced astigmatism was significantly higher in the superior incision group (1.16 D +/- 0.44 [SD]) than in the temporal incision group (0.66 +/- 0.32 D) or modified BENT incision group (0.82 +/- 0.50 D). Corneal topographic analysis confirmed these results within +/- 0.3 D. CONCLUSIONS: Only the oblique incision centered on the steeper meridian (modified BENT incision) effectively and predictably reduced preoperative oblique astigmatism. In eyes with clinically relevant oblique astigmatism, we recommend using a modified BENT incision.

Aged↗

PubMed1997

Photovaporization rate and profile of an erbium-chromium:YAG laser in the fundamental mode.

PURPOSE: To evaluate the ablation characteristics of an experimental erbium:YAG (Er:YAG) laser and assess whether it delivers sufficient output for performing photorefractive keratectomy. SETTING: Department of Ophthalmology, Virchow-Clinics, Humboldt University, Berlin, Germany. METHODS: An experimental Er:YAG laser, the erbium-chromium:YAG, running in fundamental mode was used to evaluate the energy profile. Measurements obtained using a joulemeter were compared to the ablation profiles of cadaver pig eyes. The pig eyes were treated with different fluences (mean 0.8 to 2.9 J/cm2) and, after histological preparation, were examined using light and scanning electron microscopy. RESULTS: Measurements with the joulemeter and in the cadaver pig eyes showed a Gaussian-curved profile of energy (ablation). In the current setting, the diameter of ablation was 3.5 mm. Histological examination showed a homogeneous profile of ablation with minor thermal damage. CONCLUSION: The Er:YAG laser running in the fundamental mode allows homogeneous ablation of corneal tissue. The Er:YAG laser is easier to handle technically than the excimer laser and has none of the potential risks of ultraviolet light.

Animals↗

PubMed1993

Cloning and sequencing of a cDNA fragment from Plasmodium chabaudi chabaudi that contains repetitive sequences coding for a potentially lysine-rich aspartic acid-rich protein.

Screening of a cDNA library (prepared in lambda gt11) of the blood stages of Plasmodium chabaudi chabaudi (AS) with immune serum has revealed an antigen the elicits a strong antibody response in infected mice. The clone (clone 6) expressing that antigen contains a 0.7 kb insert and produces a beta-galactosidase fusion protein of about 150 kDa. In Western blot analysis performed on parasite extracts, monoclonal antibodies and polyclonal sera prepared against the fusion protein revealed that the fusion protein contains part of a malarial protein of 93 kDa. Northern hybridization with clone 6 insert as probe detected a plasmodial RNA of about 3.2 kb, which could well code for a protein of this size. The insert hybridized to a single EcoRI fragment and a single HindIII fragment in genomic Southern blotting, suggesting that the gene is present in one copy in the P. chabaudi genome. The DNA sequence of clone 6 insert predicts a hydrophilic, acidic polypeptide consisting of seven repeats of 23-34 amino acids rich in lysine (24%) and aspartic acid (17.5%).

Amino Acid Sequence↗

PubMed1993

Baculovirus-mediated expression of human 65 kDa and 67 kDa glutamic acid decarboxylases in SF9 insect cells and their relevance in diagnosis of insulin-dependent diabetes mellitus.

cDNAs coding for the full-length human 65 and 67 kDa glutamic acid decarboxylases (GAD65 and GAD67) were amplified from pancreas and hippocampus cDNA libraries by polymerase chain reaction, respectively. Both cDNAs were inserted into a baculovirus vector which mediated highly efficient expression of the human GAD65 and GAD67 with histidine-hexapeptides as affinity ligands at their C-termini in Spodoptera frugiperda (Sf9) cells. The recombinant GAD proteins were purified to homogeneity by affinity chromatography using a metal-chelating matrix. The infected Sf9 insect cells expressed the recombinant human GAD65 and GAD67 with natural-like conformations, as confirmed by measurement of their enzyme activities as well as their fully restored autoantigenicities. Immunoprecipitation of metabolically labeled infected Sf9 cells demonstrated the autoantigenic potential of the recombinant GAD proteins. The practicability of using recombinant GAD65 and GAD67 derived from the baculovirus expression system for the development of an immunoassay for the diagnosis of insulin-dependent diabetes mellitus is discussed.

Animals↗

PubMed1993

Expression of recombinant human thyroid peroxidase by the baculovirus system and its use in ELISA screening for diagnosis of autoimmune thyroid disease.

The cDNAs coding for human full-length and soluble thyroid peroxidase (TPO) were constructed, cloned into a baculovirus transfer vector and used for infection of Spodoptera frugiperda (Sf9) cells. The soluble TPO lacking 87 amino acids of the C-terminal transmembrane and intracisternal domains was designed as a fusion protein with a histidine-hexapeptide as an affinity ligand at its C-terminus. Whereas the recombinant full-length TPO was expressed mainly in an insoluble form in Sf9 cells, the recombinant soluble TPO was almost completely secreted into the culture medium. Both the full-length and the soluble TPO were purified by conventional methods and by a specific affinity chromatography using metal chelating matrix respectively, and tested for their autoantigenicity towards anti-TPO autoantibodies. The ELISA established with the purified recombinant soluble TPO as antigen demonstrated its specificity, practicability and reproducibility in screening of anti-TPO autoantibodies in sera of autoimmune thyroid patients. High correlation (r = 0.89, n = 175) was obtained between the soluble TPO and natural TPO prepared from human thyroid glands. Pathological sera (n = 200) were positively assayed with a significance of 91%.

Animals↗

PubMed1991

Screening cDNA expression libraries in lambda gt11 with a T cell hybridoma.

A T cell hybridoma specific for a protein of Plasmodium chabaudi chabaudi has been used to test a system for direct T cell screening of a cDNA library of P. chabaudi in the phage lambda gt11. The technique is based upon the rapid separation of the recombinant beta-galactosidase fusion protein from the bacterial mixtures using polystyrene beads coated with anti-beta-galactosidase antibodies. These coated beads are cultured with antigen-presenting cells and the T cell hybridoma. The technique is sufficiently sensitive to pick up the products of one recombinant phage in a pool of 1000-10,000 other phages. Individual plaques or clones of recombinant phage can be selected after testing of sequential dilutions of pools containing positive recombinant phages. This technique will be generally applicable and should be useful for the identification of important T cell peptides in infectious diseases.

Animals↗

PubMed1990

Analysis of T lymphocyte reactivity to complex antigen mixtures by the use of proteins coupled to latex beads.

This report describes a suitable model for analysing heterogeneous T cell responses to complex foreign antigens using coated polystyrene beads. The advantage of this technique is that it allows the simple removal of detergents from bound antigen so that biochemically separated antigens or crude antigen mixtures can be used. Furthermore, due to the enhanced uptake of latex-bound antigens by phagocytic antigen-presenting cells (APC), very small amounts of antigen will suffice for activation of T cells in vitro. The potential use of this technique to analyse relevant T cell responses to antigens which are difficult to obtain purified in bulk quantities, is discussed.

Animals↗

PubMedDate not supplied

Relative mydriasis after photorefractive keratectomy.

PURPOSE: To report the incidence of anisocoria after unilateral excimer laser photorefractive keratectomy (PRK) for myopia and subsequent corticosteroid therapy in a retrospective and prospective study and to explore possible etiologies. METHODS: The horizontal pupil diameter was determined in 6 patients (6 eyes) at 21.8 +/- 12.6 months after unilateral wide-field excimer laser PRK (retrospective group) as well as in 8 consecutive patients (8 eyes) before and 3.4 +/- 2.9 months after unilateral PRK (prospective group). The Schwind-Keratom wide-field excimer laser was used. Measurements were done in an examination room using Rosenbaum card comparison pupillometry and with a Goldmann perimeter at 31.5 asb. In the prospective group, the effect of fitting a hard contact lens of zero diopter power and the application of 0.1% pilocarpine were evaluated. RESULTS: Relative mydriasis was present in all treated eyes and the difference in pupil diameter between the two eyes measured 0.25 to 1.75 mm (retrospective group: +0.56 +/- 0.82 mm; prospective group: +0.72 +/- 0.29 mm). At the time of pupil measurement, the retrospective group had a significantly longer mean postoperative follow-up (21 mo) than the prospective group (3.4 mo) and significantly more eyes still received topical corticosteroid treatment (retrospective group, 1 of 6 eyes; prospective group, 7 of 8 eyes). The amount of anisocoria did not correlate with the applied laser energy, ablation depth, or refractive change, but showed a negative correlation with increasing time after PRK. Neither hard contact lens fitting nor pilocarpine 0.1% reduced the amount of anisocoria significantly. CONCLUSION: Unilateral PRK with wide-field excimer laser ablation and subsequent application of topical corticosteroids regularly resulted in a relative pupillary mydriasis. Neither an altered corneal profile nor parasympathetic denervation is responsible for this. Weakening of the pupillary sphincter of the treated eye may cause this phenomenon.

Administration, Topical↗

PubMedDate not supplied

Corneal endothelial cell damage after experimental diode laser thermal keratoplasty.

PURPOSE: To evaluate the safety of diode laser thermal keratoplasty (LTK) with respect to corneal endothelial cell damage. METHODS: In an in vitro animal model system, porcine eyes were irradiated with a continuously emitting laser diode at wavelengths (lambda) of 1.85 or 1.87 microm, corresponding to an absorption coefficient (micro(a)) of 1.1 or 2.0 mm(-1). Different irradiation and application parameters were tested serially. To determine the temperature threshold for endothelial damage, corneal buttons were analyzed separately in a waterbath experiment. The endothelial damage was assessed after trypan blue and alizarin red supravital staining under light microscopy. RESULTS: The thresholds for the 50% probability of thermal damage (ED50) were determined at corneal temperatures of 65 degrees C for a 10-second water-bath immersion, and 59 degrees C for 60 seconds. Coagulations that reached the deeper stromal layers revealed severe endothelial cellular alterations and areas of exposed Descemet's membrane. The thermally induced changes were dependent on laser power and the absorption coefficient (wavelength). Mean diameter of total endothelial cell damage was 245 +/- 154 microm (range, 0 to 594 microm) for an absorption coefficient of 1.1 mm(-1). The maximal lateral extent of endothelial cell damage induced by the laser exposure was 594 microm in diameter. Increasing the absorption coefficient decreased the penetration depth of the laser irradiation, creating a greater temperature rise within the corneal stroma and significantly less endothelial damage (P < .01), when the same laser power was applied. The calculated total area of damage for the paracentral human corneal endothelium ranged from 1.8% to 13.6%. CONCLUSION: Data obtained in this in vitro study were transferred to an endothelial cell damage nomogram, demonstrating that appropriate parameter improvements can minimize the adverse effects to the corneal endothelium. However, model adjustment to the human cornea indicates the potential for endothelial cell damage after diode laser thermal keratoplasty, and should be considered when performing this elective procedure.

Animals↗

PubMedDate not supplied

First experimental and clinical results with transscleral optical coherence tomography.

BACKGROUND AND OBJECTIVE: To evaluate the potentials of optical coherence tomagraphy (OCT) using long wavelength to penetrate highly scattering tissues of the eye and visualize the anterior chamber angle and the ciliary body. METHODS: OCT images were generated by an experimental prototype in enucleated porcine eyes using as light source a superluminiscent diode with a wavelength of 1310 nm and a scan frequency of 60 Hz. The number of lateral scans was variable in a range from 100 to 400. RESULTS: Infrared OCT was able to penetrate the sclera. The anterior chamber angle could be visualized completely and the ciliary body could be identified. However, it was not possible to penetrate the highly reflective iris pigment epithelium. CONCLUSION: The use of infrared OCT allows penetration of the sclera, thus, providing complete visualization of the anterior chamber angle and limited demonstration of the ciliary body. Because of its higher resolution, it may represent an interesting noninvasive alternative to ultrasound biomicroscopy.

Animals↗