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Biomedical subjects

J Murube

Publications and source records attributed to J Murube.

32 records · Page 2Linked to original sources
PubMed1994

Amylase in mare lacrimale in patients with submandibular salivary gland transplantation to the lacrimal basin.

Six patients with dry eyes of different etiologies underwent transplants of 1.0 to 1.6 ml of submandibular salivary gland tissue, five of them to one eye and one to both eyes. In the four cases in which the transplants survived, the amylase activity in tear fluid sampled from the cisterna lacrimalis (temporal canthal meniscus) had a mean value of 5,147 U/l in contrast with the mean value 943 U/l of the fellow control eyes. In the two eyes in which the transplants failed to survive, the average value was 635 U/l. The small sample size does not enable calculation of statistical significance to the results but suggests that salivary amylase determinations in tear fluid would facilitate assessment of the functional status of the transplanted salivary tissue.

Aged↗
PubMed1994

Previous ocular compression increases intraocular penetration of systemic drugs.

Intraocular drug penetration is dependent upon the physical and chemical characteristics of the drug, the manner of drug administration and the drug's ability to pass through the blood/aqueous barrier. Most systemically administered drugs do not achieve intraocular therapeutic levels. The authors present a new method to increase the intraocular concentration of intravenously administered drugs based on the premise that ocular hypotony by ocular compression produces a temporary break in the blood/aqueous barrier during the period of hypersecretion that follows to regain normal intraocular pressure levels. Vancomycin introduced parenterally was used as the drug model. The right eye of 22 rabbits served as experimental eye, while the left eye served as control. The concentrations of vancomycin in the aqueous humor half an hour after intravenous injection of 40 mg/kg vancomycin in 50 ml of lactated Ringer's solution were as follows: 30.17 +/- 20.68 micrograms/ml in the right (hypotonized) eyes and 4.92 +/- 3.33 micrograms/ml in the left (control) eyes. The difference in drug levels between the two sets of eyes had a high statistical significance at p = 0.001.

Animals↗
PubMedDate not supplied

Treatment of dry eye by blocking the lacrimal canaliculi.

Occlusion of the lacrimal canaliculi improves the objective signs and subjective symptoms of dry eye. In this review, methods of occlusion are classified as surgical, thermal and tamponade. Surgical methods include dacryocystectomy, canalicular ligature, canalicular offset, canalicular excision, transfer of the punctum to dry dock, punctal tarsorrhaphy and punctal patch. Thermal methods include cautery, diathermy and laser burn. Tamponade methods use absorbable inserts of hydroxypropyl cellulose, gelatin, collagen and catgut, and nonabsorbable inserts of silicone (punctum plugs, canalicular plugs), polyethylene, cyanoacrylate, and others. The characteristics of all these methods are analyzed.

Electrocoagulation↗
PubMedDate not supplied

Measuring the lacunar sulci as a new indicator of shrinkage of the ocular surface.

PURPOSE: To present a new indicator that measures the sulci of the lacrimal lake of the eye according to the degrees of ocular abduction at which they vanish. This new approach will help determine the severity and progression of mucosal retraction in ocular surface diseases. METHODS: A total of 181 eyes of 94 healthy persons, 130 eyes of 65 patients with Sjogren's syndrome, and 30 eyes of 15 patients with ocular pemphigoid were examined using the slit lamp. We recorded the vanishing point of the three main lacunar sulci (plico-bulbar, plicocaruncular and dermo-caruncular) while abducting. RESULTS: In healthy persons, the average vanishing points for the first and second lacunar sulci were respectively, 53.20 +/- 12.3 and 54.50 +/- 9.8. In patients with Sjogren's syndrome, 49.53 degrees +/- 10.81 and 53.17 degrees +/- 7.28 and in patients with incipient ocular cicatricial pemphigoid, 42.69 degrees +/- 14.33 and 44.46 degrees +/- 16.85. Statistical significance was p < 0.005. CONCLUSIONS: The lacunar sulci are shallower and vanish sooner in ocular cicatricial pemphigoid and Sjogren syndrome than in normals. Investigating the vanishing point of the lacunar sulci while abducting is useful for grading the shrinkage of the conjunctiva, caruncle and medial canthus.

Adult↗
PubMedDate not supplied

Soft tissue conjunctivo-rhinostomy.

PURPOSE: To evaluate the results of implantation of a tubular prosthesis between the medial palpebral canthus and the nasal fossa, through the soft tissues of the face, in cases of irrecuperable damage of the lacrimal canaliculi. MATERIAL AND METHODS: Fifty eyes with canalicular destruction were operated, placing a silicone and Pyrex tubular prosthesis between the lacrimal caruncle and the nasal vestibulum, running almost vertically through the soft tissues of the face, without osteal perforation. RESULTS: Lacrimal flow was restored in 47 cases. There were three cases of dislocation of the prosthesis, three infections and five papillomata. CONCLUSIONS: Vertical conjunctivo-rhinostomy without osteal perforation is an easy and efficient solution for irrecuperable occluded canaliculi.

Conjunctiva↗
PubMedDate not supplied

The triple classification of dry eye for practical clinical use.

PURPOSE: "Dry Eye is a condition produced by the inadequate interrelation between lacrimal film and ocular surface epithelium, and is caused by quantitative and qualitative deficits in one or both of them. It can be produced by one or combined etiologic causes, affecting one or several of the secretions of the glands serving the ocular surface, and producing secondary manifestations of different grades of severity". Clinicians need a practical classification to face diagnosis, prognosis and treatment. Dry eyes have many etiologies and pathogenesis, different affectation of the various dacryoglands and ocular surface epithelium, and diverse grades of severity. The specialists in xero-dacryology must know these three parameters to evaluate any case of dry eye, and to establish an adequate treatment. METHODS: To facilitate this, an open session in the 8th congress of the International Society of Dacryology and Dry Eye (Madrid, April, 2005) proposed modifying the Triple Classification of dry eye approved in the XIV congress of the European Society of Ophthalmology (Madrid, June, 2003). There was consensus of all conclusions. CONCLUSIONS: The following classification has been established: First, a classification of the etio-pathogenesis, distributed in ten groups: age-related, hormonal, pharmacologic, immunopathic, hyponutritional, dysgenic, infectious/inflammatory, traumatic, neurologic and tantalic. Second, a classification of the affected glands and tissues, which under the acronym of ALMEN includes the Aqueo-serousdeficient, Lipodeficient, Mucindeficient and Epitheliopatic dry eyes, and the Non dacryological affected exocrine glands (saliva, nasal secretion, tracheo-pharyngeal secretion, etc). And thirdly, a classification of severity, in three grades: Grade 1 or mild (symptoms without slitlamp signs), grade 2 or moderate (symptoms with reversible signs), and grade 3 or severe (symptoms with permanent signs).

Aging↗
PubMedDate not supplied

Phacoemulsification in previously vitrectomized patients: an analysis of the surgical results in 100 eyes as well as the factors contributing to the cataract formation.

PURPOSE: To evaluate the safety and effectiveness of phacoemulsification with clear corneal incision in previously vitrectomized patients as well as factors affecting the development time and type of cataract occurring after pars plana vitrectomy (PPV). METHODS: The authors conducted a prospective study of 100 consecutive eyes of patients who developed a cataract after PPV. Three groups were established based on the underlying vitreoretinal pathology. The main outcome measurements were intraoperative and postoperative complications and changes in best-corrected visual acuity (BCVA). RESULTS: The median interval between PPV and phacoemulsification was 11.5 months. Patients with proliferative diabetic retinopathy required phacoemulsification earlier (p=0.018). Posterior subcapsular cataracts developed more frequently in patients <50 years (73.7%, p=0.000) and affected those who underwent vitrectomy primarily for complicated retinal detachment (48.8%, p=0.046). Intraoperative complications included posterior capsular tears (4%), luxated nucleus into vitreous (2%), and zonular dialysis (5%). Postoperative complications were vitreous hemorrhage (6%), retinal redetachment (4%), pupillary synechiae (6%), ocular hypertension (4%), and Seidel phenomenon (3%). Posterior Nd:YAG laser capsulotomy was required in 44% of eyes. BCVA was improved in 85% of cases at the end of follow-up (median, 15.5 months). Twenty-one patients with one functioning eye (61.9%) demonstrated visual improvement compared with 79 patients with bilateral vision (91.1%; p=0.003). CONCLUSIONS: The technique allows stable improvement in BCVA through long follow-ups. It is more risky than in nonvitrectomized eyes. The visual results after phacoemulsification in vitrectomized eyes seem to be limited by retinal comorbidity and surgical complications.

Adult↗
PubMedDate not supplied

Ultrastructural study of the conjunctiva in patients with keratoconjunctivitis sicca not associated with systemic disorders.

PURPOSE: The aim of this work was to evaluate ultrastructural alterations of the conjunctiva during the clinical course of keratoconjunctivitis sicca (KCS), and to detect its earliest and most characteristic morphological changes. METHODS: The conjunctiva was studied in biopsies from 75 patients and 10 controls. Patients were classified according to the results of the Schirmer I test, break-up time, rose Bengal staining, osmolarity and impression cytology. RESULTS: The conjunctiva in these KCS patients showed progressive hyperplasia, hypertrophy and cellular flattening, with diminution of goblet cell density and microvilli. In the severe cases, the epithelial cells lost their organelles, and fibrous material increased. From the early phases of KCS, clear nuclear alterations (indentation, binucleation) were found, but pyknotic nuclei or anucleated cells were only observed in the most severe cases. From the earliest stages to the most severe cases of KCS, decreases in cell membrane interdigitations were observed parallel to increases in the number and size of desmosomes. There were also increases in the number of inflammatory cells. Alterations in blood vessels were only observed in the most severe cases. CONCLUSIONS: Morphological studies alone were able even in the earliest phases of KCS, to detect the squamous metaplasia that progresses from the surface of the epithelium to the connective tissue. This degenerative or adaptative cellular process was characterized mainly by marked proliferation of the cytoskeleton and a general loss of organelles, mitochondria being the least affected.

Biopsy↗
PubMedDate not supplied

The association of conjunctival snake-like chromatin with keratoconjunctivitis SICCA.

PURPOSE: This work describes the snake-like chromatin cells in the conjunctiva of patients with keratoconjunctivitis sicca (KCS), assessing the relationship between tear function parameters and the severity of the disease, and searching for any differential pattern that could lead to early and diagnosis help clarify the etiology of KCS. METHODS: The conjunctiva of 366 eyes from 187 patients with KCS, and 30 eyes from 15 controls, were classified according to the results of the Schirmer I test, break-up time, rose Bengal staining, osmolarity, ferning tests and electrophoresis; they were then studied by impression cytology and electron microscopy. RESULTS: Snake-like chromatin cells, other nuclear changes, and a decreased number of goblet cells were found by impression cytology in different areas of the KCS conjunctiva. The presence of snake-like chromatin was significantly correlated with the severity of the disease. No nuclear changes were found in the control group. CONCLUSIONS: We assume these findings can be attributed to a natural regeneration of conjunctival cells and to resistance to a pathological reaction to KCS.

Adult↗
PubMedDate not supplied

Origin and types of emotional tearing.

OBJECTIVE: To understand why a wide range of states of mind are expressed by spilling tears. METHODS: 465 different episodes of crying with tears were analyzed and their motivation interpreted in the search for a common factor. RESULTS: The only common factor in all tear-spilling episodes was a relationship with help: either requesting help or offering help. This leads us to speculate on the biological origins of emotional tearing. CONCLUSIONS: 1) The classical division of emotional tearing as either negative or positive is based on accidental characteristics and does not answer most of the questions. All kinds of emotional tearing are related to help, and can be classified as requiring-help and offering-help. 2) Why do we spill tears when we are asking for help? When children need help because of hunger, fear or pain, they add tearing to sound and body language to symbolise their suffering. Accordingly, tearing was chosen as a symbol of suffering because the reaction was already present as a reflex response to physical pain when ocular trauma and inflammation occurred, as they did very frequently in mankind's past. Moreover, this sign is seen on the face, the most conspicuous part of the body. 3) Why do we spill tears when we are offering help? As humanity evolved and needed to express empathy and sympathy, i.e. an emotion diametrically opposed to requesting help, the same core symbol was used, though the facial and body language are different.

Adult↗