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T P O'Brien

Publications and source records attributed to T P O'Brien.

At least 37 records · Page 2Linked to original sources

Cytokine-induced calgranulin C expression in keratocytes.

The authors have identified a corneal stromal protein (CO-Ag) that may be involved in the pathogenesis of Mooren's ulcer. The CO-Ag cDNA sequence is identical to that of human neutrophil calgranulin C (CaGC). This study sought to demonstrate expression of the CaGC gene in the human cornea and in corneal keratocytes after cytokine stimulation. In situ hybridization and immunohistochemistry were used to localize CaGC mRNA and protein in normal and diseased human corneas, including a specimen with Mooren's ulcer. Cultured bovine keratocytes were stimulated with IL-1 alpha or TNF-alpha, and reverse transcription polymerase chain reaction (RT-PCR) was performed to amplify CaGC cDNA from cytokine-stimulated keratocytes and unstimulated controls. Southern blotting verified the specificity of the RT-PCR amplification products. In situ hybridization detected human CaGC mRNA in the stroma of corneas with Fuchs' dystrophy, postinfection corneas, and a cornea with Mooren's ulcer. In cultured bovine keratocytes, peak levels of CaGC mRNA were reached 6 h after cytokine stimulation. Southern blots with an oligonucleotide probe specific for CaGC detected the RT-PCR products of expected sizes (273 bp) and confirmed that the amplified CO-Ag sequence was identical to that of CaGC. These studies are the first to demonstrate the presence of CaGC in the human cornea and the ability of stromal keratocytes to produce CaGC (CO-Ag). The up-regulation of CaGC gene expression by corneal keratocytes due to proinflammatory cytokines from trauma or inflammation may induce autoimmunity that ultimately results in Mooren's ulceration.

Animals↗

Determination of bis(tributyltin) oxide by GC--MS with on-line hydride derivatization: application to drug substance analysis.

We report the determination of residual bis(tributyltin) oxide in a drug substance by GC-MS after extraction and on-line conversion to tributyltin hydride. Gas chromatography was performed using a 15 m x 0.25 mm i.d. DB-5 HT column with a temperature program from 100 to 160 degrees C at 15 degrees C min(-1). A mass range of 165-185 amu was monitored with the MS detector. Hydride generation is performed by placing a small amount of solid sodium borohydride in the injection port of a gas chromatograph and injecting samples and standards through this material. Conversion to tributyltin hydride is shown to be quantitative and linear for levels of bis(tributyltin) oxide between 1 and 100 ppm in the drug substance. The use of GC-MS provides sensitive and selective detection of tin containing species and the tin isotope pattern allows for confirmation of the presence of tin in chromatographic peaks. Recovery at 6 ppm was 89% with an injection precision of 6%. The limit of detection for bis(tributyltin) oxide in drug substance is 1 ppm.

Borohydrides↗

Provision of anesthesia with single application of lidocaine 2% gel.

PURPOSE: To compare the efficacy of a single application of lidocaine 2% gel with tetracaine 0.5% drops for topical anesthesia in clear corneal cataract surgery. SETTING: The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. METHODS: A preliminary toxicity study applied lidocaine 2% gel in the conjunctival fornices of rabbit eyes (n = 9). Biomicroscopic examination was performed and then enucleation at sequential intervals after the application. Intentional intracameral injection of lidocaine gel was performed (n = 3), followed by enucleation. Histopathological analysis was performed on all eyes. A randomized clinical trial comparing topical anesthesia in clear corneal cataract surgery was performed in 25 eyes of 25 patients (12 eyes randomly assigned to lidocaine gel, 13 eyes to tetracaine drops). Corneal sensation was measured with the Cochet-Bonnet aesthesiometer before application of the topical anesthesia, 5 minutes after application, and at the conclusion of surgery. Additional intraoperative local anesthesia and systemic sedation were recorded. Patients' subjective level of comfort was reported 20 minutes after surgery, and the surgeon's perception of patients' comfort was also noted. RESULTS: In rabbits, lidocaine gel did not cause clinical or histopathological alteration of the ocular tissues. In the clinical study, median corneal sensitivity before application, after 5 minutes, and postoperatively was 6, 0, 0 (maximum sensitivity = 6), respectively, in the lidocaine gel group and 5, 0, 0, respectively, in the tetracaine drops group. Additional local anesthesia was administered in 17% and 31% of patients, respectively. Satisfactory comfort was reported by 58% in the lidocaine gel group and 62% in the tetracaine drops group. CONCLUSIONS: A single application of lidocaine 2% gel was a safe and effective alternative to multiple topical anesthetic drops for clear corneal cataract surgery. Lidocaine 2% gel was similar to tetracaine drops in provision of corneal anesthesia and patient comfort, while causing no significant toxicity to the ocular surface.

Aged↗

Propranolol blocks cocaine-induced cerebral vasodilation in newborn sheep.

OBJECTIVE: The objective of this study was to test the hypothesis that cocaine-induced cerebral vasodilation in newborn sheep is mediated via beta-adrenergic receptor activation. DESIGN: The cerebral effects of a single intravenous injection of cocaine (4 mg/kg) given 30 mins after pretreatment with propranolol (1 mg/kg) were studied and compared with the results from a previous study using an identical cocaine protocol without propranolol pretreatment. SUBJECTS: Seven chronically catheterized, unanesthetized newborn sheep (6 +/- 1 days old). MEASUREMENTS: Cerebral blood flow using radiolabeled microspheres, mean arterial blood pressure (MAP), heart rate, and cerebral arterial and venous oxygen content were measured at baseline, after administration of propranolol, and 0.5, 5, 15, and 60 mins after cocaine injection. Cerebrovascular resistance was calculated as the MAP divided by the cerebral blood flow. MAIN RESULTS: Propranolol injection alone caused no systemic or cerebral physiologic changes other than an 11 +/- 2% (mean +/- SEM) decrease in heart rate, which was sustained after cocaine injection. In contrast to previous studies showing cerebral vasodilation (25% decrease in cerebrovascular resistance) and acute hypertension (57% increase in MAP) 30 secs after cocaine injection, there were no changes in cerebrovascular resistance after cocaine injection and after propranolol pretreatment and there was only a 23 +/- 7% increase in MAP 30 secs after injection, with a return to baseline by 15 mins. Cocaine and norepinephrine levels were similar to those previously reported in the newborn sheep after an injection of 4 mg/kg cocaine. CONCLUSION: Propranolol blocks cocaine-induced cerebral vasodilation and blunts the acute hypertension in newborn sheep, suggesting that cocaine's cerebrovascular effects in the developing brain are mediated, at least in part, by beta-adrenergic receptor activation.

Adrenergic beta-Antagonists↗

Cytokines and apoptotic molecules in experimental melanin-protein induced uveitis (EMIU) and experimental autoimmune uveoretinitis (EAU).

The cytokine profile and occurrence of apoptosis during experimental melanin-protein induced uveitis (EMIU) were investigated and compared with that of experimental autoimmune uveoretinitis (EAU). EMIU or EAU was induced in Lewis rats. Eyes were collected at different time points after immunization. Cytokine mRNA expression was identified in the inflammatory cells in the uvea of EMIU rats; IL-2, IFN-gamma and IL-12 increased at the peak of the inflammation, and then tapered off as inflammation subsided. IL-4 and IL-10 increased at the peak of ocular inflammation, and persisted with inflammation resolved. Fas and FasL were expressed consistently in ocular resident cells of EMIU, but were elevated in EAU. In EAU, Bcl-2 expression showed a sharp peak in inflammatory cells but not in the resident cells. In EMIU, high levels of Bcl-2 were present and persisted in both ocular resident and inflammatory cells. Expression of Bax was relatively stable in both EAU and EMIU. Cellular DNA fragmentation was detected in the retinal glial cells of EAU and some inflammatory cells of EMIU. In EMIU, the dynamics of Th1 cytokines were consistent with the ocular inflammation, whereas persistent expression of Th2 cytokines was consistent with their known regulatory role. The continuous high expression of Bcl-2 and the high ratio of Bcl-2 to Bax in the eyes of EMIU may possibly contribute to prevention of ocular tissue damage, and of inflammatory cells from undergoing apoptosis, thus resulting in chronic recurrent inflammation.

Animals↗

Inflammatory response in the early stages of wound healing after excimer laser keratectomy.

OBJECTIVE: To evaluate the inflammatory response and its potential role in the early stages of corneal wound healing after excimer laser keratectomy. MATERIALS AND METHODS: Lewis rats underwent excimer keratectomy using a 193-nm excimer laser. The central corneas were ablated in 3 depths: group A, epithelium; group B, superficial stroma; or group C, deep stroma. Eyes were harvested 1, 12, 24, and 36 hours, and 1 week after the rats were killed. Immunohistochemistry was used to test frozen sections with monoclonal antibodies of various inflammatory cellular markers. RESULTS: Reepithelialization was observed at 12 hours in group A, and at 24 hours in groups B and C. Regenerated epithelium covered the denuded corneal surface in groups B and C after 1 week. The expression of major histocompatibility complex II antigen was detected in infiltrating cells, corneal epithelial cells, and endothelial cells 1 hour after surgery. Only a few macrophages and Langerhans cells were in the limbus at baseline. Macrophages migrated from the limbus to the corneal ablation zone and increased 2-fold after 36 hours in all 3 groups compared with baseline. Occasional lymphocytic infiltration was identified after 25 to 36 hours. CONCLUSION: Macrophages play an active role in the wound healing after laser keratectomy and may contribute to transient corneal haze.

Animals↗

Defensin gene expression in the cornea.

PURPOSE: To determine whether defensin genes are expressed in human corneas and bovine corneal keratocytes. METHODS: In situ hybridization and immunohistochemistry were used to localize defensin mRNA and protein in normal and diseased human corneas. Cultured bovine keratocytes were stimulated with IL-1alpha or TNFalpha to determine whether defensin mRNA production occurred. Reverse transcription polymerase chain reaction (RT-PCR) was performed to amplify defensin cDNA from cytokine-induced keratocytes, and Southern blots were used to verify the specificity of RT-PCR amplification products. RESULTS: Defensin mRNA and protein were not detected in normal human corneal stroma, but were readily detectable in the corneal stroma in cases of rejected transplants and postinfectious keratitis. IL-1alpha was a potent inducer of defensin gene expression in keratocytes, which began 12 h after challenge and peaked at 18 to 24 h. TNFalpha weakly induced defensin mRNA in keratocytes at about 18 h. Southern blots of the RT-PCR products probed with an oligonucleotide complementary to internal sequences of defensin demonstrated the appropriately sized products (198 bp) specific for defensin. CONCLUSIONS: This report demonstrates the presence of defensin in the human cornea and the capacity of corneal keratocytes to produce defensin mRNA in response to IL-1alpha and TNFalpha. Release of defensins by keratocytes in response to cytokines elaborated in corneal inflammation may contribute to the host defense response in microbial keratitis.

Animals↗

Biochemical and functional antigenic mimicry by a polyclonal anti-idiotypic antibody for chlamydial exoglycolipid antigen.

A vaccine developed by using a genus-specific antigen (Ag) of Chlamydia trachomatis would elicit a wide range of protection against various chlamydial infections. We have produced an anti-idiotypic antibody (Ab2) in guinea pigs which, in rabbits, mimics the immunogenicity of a genus-specific exoglycolipid Ag (GLXA) of C trachomatis. Furthermore, the Ab2 fulfills the functional criteria of an 'internal image' of the nominal Ag: it inhibits the binding of the idiotypic (Id) monoclonal Ab (mAb1) to GLXA, and it induces in rabbits anti-anti-Id antibody (Ab3) which recognizes both the affinity-purified nominal Ag GLXA and whole organisms. Moreover, Ab3 induced by immunization of rabbits with guinea pig Ab2 neutralizes infectious heterologous chlamydiae and prevents in vitro and in vivo infection. Taken together, these results demonstrate functional and biochemical mimicry of the Ab2 for the chlamydial GLXA and suggest that anti-idiotypic Ab to GLXA is a potential candidate vaccine against chlamydia-related diseases.

Animals↗

Comparative intravitreal antibiotic therapy for experimental Enterococcus faecalis endophthalmitis.

OBJECTIVE: To evaluate the most effective intravitreal antibiotic treatment of vancomycin-sensitive and -resistant Enterococcus faecalis endophthalmitis. DESIGN: Animal experiment. SETTING: Seventy-eight New Zealand white rabbits received an intravitreal injection of 10(5) vancomycin-sensitive or -resistant E faecalis organisms in one eye. Infections were allowed to proceed 3 hours before dividing animals randomly into the following treatment groups (n = 6, each): the vancomycin-sensitive E faecalis model--(1) vancomycin (1 mg/0.1 mL), (2) combined vancomycin (1 mg/0.1 mL) and amikacin (0.4 mg/0.1 mL), (3) combined vancomycin (1 mg/0.1 mL) and gentamicin (0.1 mg/0.1 mL), (4) combined vancomycin (1 mg/0.1 mL) and ceftazidime (2 mg/0.1 mL), (5) combined ampicillin (5 mg/0.1 mL) and gentamicin (0.1 mg/0.1 mL), and (6) pristinamycin (1 mg/0.1 mL); and the vancomycin-resistant E faecalis model--(1)same as above, excluding group 4. Control groups received sterile balanced salt solution. Twenty-four hours following intravitreal treatment, vitreous humor was collected for quantitative bacteriological studies. RESULTS: Intravitreal therapy with combined vancomycin and amikacin provided the most effective reduction of vancomycin-sensitive E faecalis organisms compared with combined vancomycin and gentamicin therapy (P =.10, Wilcoxon's rank sum test) or any other treatment group (P < .01, Wilcoxon's rank sum test). For vancomycin-resistant E faecalis endophthalmitis model, the combined ampicillin and gentamicin therapy was the most effective, followed by the combined vancomycin and amikacin therapy (P < .01, Wilcoxon's rank sum test). CONCLUSIONS: Treatment with intravitreal vancomycin plus amikacin and with intravitreal ampicillin plus gentamicin provide an effective bactericidal therapy for severe experimental vancomycin-sensitive and -resistant E faecalis endophthalmitis, respectively.

Animals↗

Complementation mapping of skeletal and central nervous system abnormalities in mice of the piebald deletion complex.

The s15DttMb, s36Pub, s1Acrg and s24Pub piebald deletion alleles belong to a set of overlapping deficiencies on the distal portion of chromosome 14. Molecular analysis was used to define the extent of the deletions. Mice homozygous for the smallest deletion, s15DttMb, die shortly after delivery and display alterations in the central nervous system, including hydrocephalus and a dorsally restricted malformation of the spinal cord. These mice also display homeotic transformations of vertebrae in the midthoracic and lumbar regions. Homozygous s27Pub mice contain a point mutation in the piebald gene, survive to weaning, and display no central nervous system or skeletal defects, arguing that the s15DttMb phenotype results from the loss of genes in addition to piebald. A larger deletion, s36Pub, exhibits additional cartilage malformations and defects in the anterior axial and cranial skeleton. The skeletal defects in both s15DttMb and s36Pub mice resemble transformations associated with the targeted disruption of Hox genes and genes encoding the retinoic acid receptors, which play a role in the specification of segmental identity along the anteroposterior axis. Complementation analysis of the s15DttMb and s36Pub phenotypes, using two additional deletions, localized the gene(s) associated with each phenotype to a defined chromosomal region.

Abnormalities, Multiple↗

The microbiologic effect of gas filtration.

BACKGROUND: Air and expansile gases commonly are injected into the eye in both vitreoretinal surgery and anterior segment surgery. Although the halogenated gases are filtered routinely before injection, air often is not prepared in this manner. This study was designed to investigate the effect of filtration on the microbiology of gas mixtures. METHODS: Two separate studies were conducted, one examining medical grade perfluoropropane gas (C3F8), and the other evaluating air collected from an ophthalmic operating room or emergency room. Aliquots of air or gas were collected through a 0.22-micron filter before and after filtration. The filter discs were cultured for bacterial and fungal organisms. RESULTS: Of 514 samples collected, none grew either bacterial or fungal organisms. There was no difference with regard to recovered microbes between filtered and unfiltered air or C3F8, nor was there a difference between operating room air and emergency room air. Positive controls using aerosolized microorganisms yielded heavy growth. CONCLUSION: Based on results obtained in this study and available information on the concentration of airborne microbes, the microbiologic effect of gas filtration is of little significance for volumes routinely injected in ophthalmic surgery.

Air↗

Effect of a non-steroidal anti-inflammatory drug on tissue levels of immunoreactive prostaglandin E2, immunoreactive leukotriene, and pain after periodontal surgery.

The aim of this study was to measure tissue levels of immunoreactive prostaglandin E2 (iPGE2), immunoreactive leukotriene B4 (iLTB4), and pain after periodontal surgery and to evaluate the effect of the non-steroidal anti-inflammatory drug (NSAID), ibuprofen, on these levels. Two contralateral quadrants in each of nine patients were selected to undergo separate surgical procedures, one with ibuprofen (800 mg 1 hour presurgery and 400 mg postsurgery) and one with a placebo. Intra-operatively, a custom-made microdialysis probe, with a 3,000 dalton molecular weight cut-off, was inserted beneath the soft tissue flap and a dialysate collected every 20 minutes for 4 hours after surgery. Pain perception was measured at the same time intervals using two pain scales. Dialysate samples were assayed using two enzyme immunoassays. Mean tissue levels of iPGE2 in the placebo group increased from 74 nM at 40 minutes to a peak of 261 nM at 200 minutes. Mean tissue levels of iLTB4 in the placebo group fluctuated between 0.2 and 0.6 nM. Pain levels in this group increased continuously with time, peaking at 4 hours. Mean tissue levels of iPGE2 in the ibuprofen group were significantly suppressed, exhibiting more than a 95% reduction. This was accompanied by a significant reduction in pain. Ibuprofen had no detectable effect on tissue levels of iLTB4. These data indicate that iPGE2 and iLTB4 are present at relatively high concentrations in the periodontal tissues after surgery. Since these concentrations exceed the Kd values for binding to their respective receptors, PGE2 and LTB4 may be associated with the development of postsurgical pain and inflammation. These data also indicate that ibuprofen can successfully inhibit iPGE2 production in the periodontal tissues and in this way may help reduce postoperative pain and inflammation.

Adult↗

Efficacy of ofloxacin vs cefazolin and tobramycin in the therapy for bacterial keratitis. Report from the Bacterial Keratitis Study Research Group.

PURPOSE: To compare ofloxacin solution with a combination of fortified antibiotic cefazolin sodium and tobramycin sulfate solutions in the treatment of bacterial keratitis. METHODS: Patients under care at any one of 28 participating clinical centers who had an eye with suspected bacterial keratitis were randomly allocated in a double-masked manner to treatment with 0.3% ofloxacin solution or a combination of the fortified antibiotics (1.5% tobramycin and 10.0% cefazolin solutions). MAIN OUTCOME MEASURES: Time to healing defined as complete re-epithelization, accompanied by a nonprogressive stromal infiltrate for two consecutive visits. Secondary outcome measures included patient symptoms and signs of infection and adverse reactions to study medications. Only patients with a positive bacterial corneal culture were included in most analyses. RESULTS: A positive bacterial corneal culture was obtained in 140 (56%) of the 248 enrolled patients. The time to healing was similar among the 73 patients receiving ofloxacin and the 67 patients receiving fortified antibiotics (P = .70). By 7 days after study entry, the keratitis in 37% of the ofloxacin group and 38% of the fortified antibiotics group had healed. By 28 days, keratitis in 89% of the ofloxacin group and 86% of the fortified antibiotics group had healed. Two patients receiving ofloxacin and one receiving fortified antibiotics discontinued study medication because of lack of efficacy. Patients receiving ofloxacin reported substantially less burning and stinging on instillation than the patients receiving fortified antibiotics (P < .001). Five of six patients among the 140 with positive bacterial cultures who had study medications discontinued because of ocular side effects were in the fortified antibiotics group; an additional three patients, all in the fortified antibiotics group, among the remaining 108 receiving study medications had ocular side effects. CONCLUSIONS: The efficacy of ofloxacin solution in treating bacterial keratitis is equivalent to that of the fortified cefazolin and tobramycin solutions. The reduced frequency of ocular toxic effects and the relative ease of preparation of ofloxacin are additional considerations.

Adult↗

A chlamydial major outer membrane protein extract as a trachoma vaccine candidate.

PURPOSE: As shown in infected humans and in animal models of chlamydial infection, the major outer membrane protein (MOMP) of Chlamydia trachomatis is immunogenically potent. The purpose of this investigation was to test in the cynomolgus monkey model of trachoma a new extract of MOMP as a candidate vaccine against ocular chlamydial infection. METHOD: The nonionic detergent octyl-beta-D glucopyranoside (OGP) was used to extract MOMP from purified C. trachomatis (serovar C) elementary bodies. Protective immunization with OGP-MOMP by mucosal and systemic routes was compared in the cynomolgus monkey model of trachoma. All control and immunized monkeys were challenged by topical application of infectious C. trachomatis to the conjunctivae 35 days after the initiation of immunization. RESULTS: Immunization with OGP-extracted MOMP successfully induced chlamydia-specific local and systemic immunity to MOMP and to whole organism before challenge and early clearance of infection by systemically immunized monkeys. Although ocular disease was not significantly reduced in either immunized group compared to control animals, the lowest clinical and microbiologic disease scores developed in two animals in the mucosal group with the highest immunoglobulin A tear antibody titers at day 0 to 14, whereas higher tear and serum immunoglobulin G correlated with reduced disease in the systemically immunized group. CONCLUSIONS: These data demonstrate that despite evidence of vigorous MOMP-specific and other chlamydia-specific serologic and cell-mediated immunity, as well as anamnestic serologic responses to chlamydia, vaccination with OGP-MOMP was only partially protective against chlamydial ocular disease. The partial protection correlated best with tear immunoglobulin A responses after mucosal immunization and with local and systemic immunoglobulin G responses after peripheral immunization, suggesting that alternative chlamydial antigens may have to be considered in future vaccine development to induce more effective protective immunity and that evaluation of efficacy must be appropriate to route of immunization.

Administration, Oral↗