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Biomedical subjects

R B Mandell

Publications and source records attributed to R B Mandell.

At least 37 records · Page 2Linked to original sources

Initial in vivo tear protein deposition on individual hydrogel contact lenses.

We investigated and compared the initial composition, morphology, and time course of deposits on individual soft contact lenses of different water contents and surface charges in order to evaluate the potential for antigenic reactions and to predict the optimal frequency of lens replacement. Newly manufactured lenses were worn for graduated periods of time from 1 min to 8 h by subjects who were first adapted to daily wear soft lenses. The morphology and composition of the deposits were analyzed by histological staining, light microscopy, scanning electron microscopy (SEM), sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) with silver nitrate staining, and immunofluorescence microscopy. The protein bands of the acrylamide gels were divided according to their molecular weights into six groups which have been defined in the literature from tear analyses by electrophoretic techniques and include lysozyme, proteins migrating faster than albumin (PMFA), protein G, albumin, lactoferrin, and other proteins heavier than albumin such as Ig-G and secretory Ig-A. Specific proteins (lysozyme, PMFA, and protein G) were detected on individual lenses after as little as 1 min of wear. There was an increasing amount of protein deposited as the wearing time increased. Differences in the rates and amounts of deposition were more dependent on lens water content and ionic characteristics than on intersubject differences. Such early significant protein deposition may occur in wearers of disposable lenses as well as in those subject to complications due to accumulation of protein.

Adolescent↗

Humidity effects on corneal hydration.

Overall corneal hydration control expressed as the percent recovery per hour (PRPH) can be assessed with an exponential model that uses data derived from two kinds of corneal thickness measurements; one from monitoring recovery after inducing corneal swelling, and the other from measurements made after the eye has been open long enough to reach its open-eye steady-state (OESS) corneal thickness. Up to now these thickness measurements have been made without controlling the ambient humidity. It is possible that changes in relative humidity may effect tear film osmolarity sufficiently to change the state of corneal hydration. To evaluate the effects of humidity on hydration control, the OESS and PRPH were determined under several humidity levels. For both the OESS and the PRPH, two substudies were conducted. For the OESS, substudy 1 consisted of measuring corneal thickness when humidity was changed from 30% (ambient) to 52 or 97% controlled humidity. This resulted in mean +/- standard deviation (SD) changes in OESS thickness amounting to -0.33 +/- 3.5 microns and 2.6 +/- 3.4 microns, respectively, with a differential change of 2.94 +/- 3.04 microns (95% confidence interval [CI] from 0.77 to 5.11 microns). Corresponding results for substudy 2 connected with changes from 43% (ambient) to 12 or 97% controlled humidity were -2.4 +/- 2.7 microns and -0.3 +/- 1.9 microns, respectively, with a differential change of 2.1 +/- 1.8 microns (95% CI from 0.9 to 3.4 microns).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

The spore coat of a fucosylation mutant in Dictyostelium discoideum.

Strain HL250 of Dictyostelium discoideum cannot convert GDP-mannose to GDP-fucose, resulting in an inability to fucosylate protein. This affects a group of proteins which are normally fucosylated intracellularly and then secreted via prespore vesicles to become part of the outer lamina of the spore coat. We have found that strain HL250 nevertheless accumulates typical amounts of these proteins, stores them normally in prespore vesicles, and secretes them normally to become a part of the spore coat. However, affected proteins are proteolyzed after germination, the spore coat is more accessible to penetration by a macromolecular probe, and germination is inefficient in older spores. These findings can be explained by a dependence of the integrity of the outer layer of the spore coat on protein-linked fucose.

Antibodies, Monoclonal↗

The effect of time, patching, and lens flexibility on RGP lens adherence.

The effects of time, eye patching, and lens flexibility on rigid lens adherence was evaluated in five overnight, in-laboratory test sessions. Patching was investigated with a group of 11 subjects in two overnight test sessions. Sleep time and lens flexibility were investigated in three separate overnight test sessions with two groups of subjects wearing two lens types of fluorosilicone materials (Dk 92 and 60). Adherence occurred in a significant portion of eyes within a 2-hour time period, and the incidence increased throughout the night. There was no significant difference between the incidence of adherence for lenses of a flexible material compared to lenses of a more rigid material (p greater than 0.6, X2 test), nor did patching have a significant influence on the incidence of adherence. The mechanism of lens adherence may be related to several factors including arbitrary lens movement to a peripheral corneal position, the creation of a geometric spacing between the lens and the eye, lid forces producing a negative pressure, and an increase in tear viscosity throughout the night.

Adhesiveness↗

Corneal hydration control in Fuchs' dystrophy.

Corneal hydration control was tested in 22 patients with Fuchs' dystrophy, and eight subjects of similar age without the disease, by measuring the corneal thickness recovery from swelling induced by hypoxia or following overnight sleep. Measurement precision was enhanced by using a modified optical pachometer and conducting two test procedures which were analyzed by a coupled exponential model. We have identified three parameters of the recovery from corneal swelling which may be used to describe hydration control: percent recovery per hour (PRPH) (mean 25.4% for Fuchs' and 34.2% for normals), time for 95% of corneal thickness recovery (mean 10.2 hr for Fuchs' and 7.1 hr for normals), and the open-eye steady-state thickness (mean 562 microns for Fuchs' and 537 microns for normals.) A PRPH of 17.1%/hr was identified as the minimum below which the cornea could not regain its open-eye steady state during the entire day and approaches decompensation. Our test procedure quantifies the corneal hydration control mechanism and may provide a test of endothelial function which can be used to monitor the progression of Fuchs' disease and guide decisions related to corneal surgery.

Aged↗

Rigid contact lens area and corneal oxygenation.

The corneal area covered by a rigid contact lens under static conditions was calculated for various combinations of lens and corneal diameters. The lens was then assumed to move to various positions on the cornea to find the lens overlap of the corneal area originally covered by the lens. For most clinically practical dimensions, when the contact lens moves to the corneal limbus, a small area of lens overlap remains. This corneal area receives no direct exposure to the external atmosphere and must derive its oxygen via a tear-pumping action by the lens. A method for the calculation of this area is presented. The model is used to explain the appearance of central corneal clouding (CCC), the function of the contact lens peripheral curve, and a possible mechanism for corneal oxygenation during extended wear.

Contact Lenses↗

Rigid contact lens adherence: incidence, severity and recovery.

The incidence of rigid lens adherence in one eye of 25 subjects was compared to the results for the fellow eye wearing a soft lens of nearly equal permeability in an in-laboratory overnight study. A 48% incidence of adherence was found for both extended wear modalities, which demonstrates the high frequency of this problem. Adherence of both rigid and soft lenses caused epithelial breakdown and corneal distortion, but these sequelae were generally more severe with rigid lenses. Recovery data on nine subjects whose rigid lenses adhered show that positive signs of adherence often disappear within 1 hour, demonstrating the need for early morning examinations. Practical considerations for the detection of rigid lens adherence and the possible consequences of failure to diagnose this condition are discussed.

Adhesiveness↗

Differential antigen presentation by heat-treated peripheral blood mononuclear cells and Epstein-Barr virus-transformed lymphoblastoid cell lines (EBV-LCL): heated EBV-LCL present alloantigen and soluble antigen but are deficient in the stimulation of autologous EBV-LCL primed T cells.

Heat-treated PBM (1 hr at 45 degrees C) cannot present soluble Candida albicans antigens (CAN) or stimulate in the mixed lymphocyte culture (MLC) reaction. This is despite their continued expression of serologically defined class II MHC antigens. In contrast, heat-treated EBV-LCL present soluble CAN and stimulate allogeneic T cells in the MLC. Heated EBV-LCL stimulate strong secondary responses from allogeneic alloprimed T-cell lines in the primed lymphocyte test (PLT), while heated PBM stimulate only weak secondary allogeneic responses. To test whether this difference was due to a subtle difference in the thermal stability of the functional expression of class II MHC antigens on PBM and EBV-LCL cells, the EBV-LCL cells were heated for 1 hr at temperatures from 45 degrees C to 60 degrees C. Even after treatment at 60 degrees C, the heated EBV-LCL strongly stimulated alloreactive T cells in MLC and PLT reactions. Heated EBV-LCL are not nonspecifically mitogenic, as they do not stimulate autologous T-cell lines primed to alloantigens. However, the weak response of alloprimed T-cell lines to heated allogeneic PBM can be augmented by coculturing with autologous heated EBV-LCL, suggesting heated EBV-LCL maintain a metabolic activity necessary for allogeneic stimulation that is deficient in heated PBM. While heated EBV-LCL stimulate allogeneic alloprimed T-cell lines, they no longer stimulate autologous EBV-LCL primed T-cell lines; irradiated EBV-LCL stimulate both strongly. This suggests the involvement of a heat labile antigenic or metabolic factor in the T-cell recognition of autologous but not allogenic EBV-LCL.

Antigen-Presenting Cells↗

Slit lamp classification system.

A slit lamp classification system is presented which follows the same divisions as the FDA Slit Lamp Classification System but expands the number of categories. It also differs in that there is an orderly progression of the various findings and a numbering system which allows for easy statistical analysis. In this way, the incidence of findings may be grouped according to degree of severity, and may be easily compared across different categories.

Conjunctival Diseases↗

Corneal oxygen need and gas permeable contact lenses.

The minimum corneal oxygen need varies between 2 and 5% depending on individual characteristics. The tear pump alone is not sufficient to provide the corneal oxygen needs of many PMMA wearers. Hard permeable contact lenses may provide oxygen to the cornea by the tear pump and/or direct transmission through the lens. The relationship between the various oxygen permeable hard materials and the oxygen provided at the corneal surface is shown in this paper.

Contact Lenses↗

Centration and coverage of hydrogel contact lenses.

Decentration of the AOsoft lenses and Bausch & Lomb Soflens occurs during wear. The extent of the decentration of 14 lenses on 36 eyes of 18 subjects was studied by means of a biomicroscope with a reticle mounted in the ocular. Unexpectedly, for the AOsoft vault IV lens greater decentration occurred than for flatter lenses. Corneal toricity showed no correlation with lens decentration.

Adult↗

Ascorbate induction of collagen synthesis as a means for elucidating a mechanism of quantitative control of tissue-specific function.

Ascorbic acid displays the characteristics of an ideal inducer of tissue-specific function in primary avian tendon cells in culture. It is a highly specific, potent stimulator of collagen synthesis, it demonstrates slow reversible kinetics, and it has no effect on growth rate of the cultured cells. Kinetic analysis of ascorbate induction of collagen synthesis was used to determine the critical steps in this complex biosynthetic pathway. Full hydroxylation of the proline residues in collagen, although probably a necessary step for collagen induction, was in itself not sufficient for achieving either increased secretion or increased synthesis. On the other hand, an increase in secretion rate, which required both the presence of ascorbate and a high cell density, did correlate with the later stimulation in procollagen production. The process of procollagen secretion, therefore, meets the minimal requirements for the rate-limiting step. The fact that the cells maintained a large pool of intracellular procollagen despite changes in the rates of translation or secretion led us to postulate a possible feedback between the level of the internal procollagen pool and the rate of procollagen synthesis.

Animals↗

Optical power calculation for contact lens wet cells.

Calculations show that there can be a significant error in the estimated power of a hydrogel lens when standard techniques are used to arrive at the lens power by means of a lensometer and a wet cell. Ray-tracing procedures were used to produce graphs which provide more accurate correction factors so that the lens power can be determined with improved precision.

Contact Lenses, Hydrophilic↗

Acute systemic toxicological tests of soft contact lens extractives.

The toxic potential of three major components of soft contact lenses was assessed in white mice. Accepted procedures for toxicological studies were used to evaluate the effects of 2-hydroxyethyl methacrylate, ethylene glycol, and methacrylic acid. No observable signs of gross toxicity were detected in any of the mice injected with the original doses. Larger doses of methacrylic acid produced ataxia, irregular breathing, convulsions, and death. From the concentrations of these chemicals normally occurring in contact lenses, no systemic toxic effects would be expected.

Animals↗

Corneal swelling at low atmospheric oxygen pressures.

Corneas of 28 human subjects were exposed to oxygen partial pressures, in a gas goggle, of either 6.9, 17.1, or 22.2 mm Hg, and the corneal swelling was measured by pachometry for 4 hr. Following an initial rise, the swelling stabilized after about 3 hr; in many subjects it was reversed, indicating an adaptation process. The average corneal swelling after 4 hr for the three oxygen partial pressures was 5.07%, 2.13%, and 1.66%, respectively. The average minimum oxygen requirement to prevent corneal swelling was at least 23 mm Hg and varied significantly among individuals. The variations in swelling responses were large enough to explain clinical differences in edema of patients wearing oxygen-permeable contact lenses, in the absence of adequate tear pumping.

Adaptation, Physiological↗

Etiology of corneal striae accompanying hydrogel lens wear.

Vertical striae in the posterior cornea were produced experimentally in ten human subjects by depriving the anterior corneal surface of its normal oxygen supply and inducing corneal edema. These striae were similar in appearance and time of occurrence to those observed in gel lens wearers. Three subjects also wore gel lenses and developed vertical striae while wearing their lenses. These striae were eliminated by increasing the oxygen concentration at the anterior lens surface. The data confirm many clinical observations which have suggested that verical striae are caused by corneal edema accompanying gel lens wear.

Adult↗

Corneal thickness changes from bathing solutions.

Corneal thickness changes were measured after bathing the outer corneal surface with sodium chloride solutions of various concentrations. Bathing was accomplished by total immersion in the solution in a goggle or by the application of drops for a period of 20 minutes. A nearly linear relationship was found between hypotonicity and the degree of corneal swelling.

Cornea↗