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Biomedical subjects

W Sekundo

Publications and source records attributed to W Sekundo.

26 records · Page 2Linked to original sources

Immuno-electron labelling of matrix components in congenital hereditary endothelial dystrophy.

Two corneal buttons were obtained from a patient with congenital hereditary endothelial dystrophy (CHED) at the ages of 2.5 years (right eye) and 14 years (left eye) and were studied by light and electron microscopy including immunogold labelling for collagen types I-V and laminin. The posterior collagenous layer (PCL) of Descemet's membrane contained collagen types I, III-V, and laminin: the latter was also localised to fine-banded and granular material in the posterior non-banded zone (PNBZ). Comparison of the endothelium 2.5 years and 14 years revealed occasional dystrophic changes in the former and extensive dystrophic changes in the latter. The distribution of collagen types I, III and V within the PCL supports previous morphological observations of fibroblast-like change of the endothelium in CHED. Persisting endothelial properties were manifest as positive labelling of type IV collagen and laminin. An excessive amount of laminin found in PNBZ and PCL is another stress-related endothelial reaction.

Adolescent↗

An ultrastructural investigation of an early manifestation of the posterior polymorphous dystrophy of the cornea.

BACKGROUND: Posterior polymorphous dystrophy of the cornea is an uncommon, but well-recognized, congenital disease affecting Descemet's membrane and endothelium. Visual impairment usually is minimal and slowly progressive. Edema develops in a small number of patients, necessitating a corneal graft in middle age. An early manifestation of posterior polymorphous dystrophy with corneal edema present at birth or soon thereafter is extremely rare; only a few ultrastructural reports are available. METHODS: The corneal button of a 5-month-old baby with posterior polymorphous dystrophy was examined by conventional light and electron microscopy. FINDINGS: The anterior banded zone of Descemet's membrane was thinned (2 microns) in the axial part of the cornea, contained defects in the paraxial part, and was absent at the periphery. Where present, the anterior banded zone was lined posteriorly by a fibrocellular layer (containing fibroblast-like spindle cells and striated collagen fibrils) and a fibrillar layer forming an abnormal posterior collagenous layer. This layer was lined posteriorly by degenerate overlapping endothelial cells, which also were in apposition to the stroma in regions with an absent anterior banded zone. The defects in Descemet's membrane were used by the abnormal keratocytes to migrate between the anterior banded zone and the posterior collagenous layer. At the periphery, a multilayer of spindle cells was present behind the stroma. CONCLUSIONS: Failure to produce a continuous anterior banded zone indicates an onset of the disease before the twelfth week of gestation. It appears that, in posterior polymorphous dystrophy, there is a mosaic of better preserved and dystrophic endothelial cells and that the presence or absence of the normal components of Descemet's membrane is determined by the proportion of dystrophic cells in the endothelial cell population.

Consanguinity↗

Bilateral uveal melanoma presenting simultaneously.

A case of bilateral uveal melanoma in a 54-year-old man is described. On admission of the patient for a choroidal melanoma of the left eye, an asymptomatic ciliary-body tumour was detected in his right eye. A thorough general examination did not reveal any metastases. The left eye was enucleated and local excision of the tumour in the right eye was performed 2 months later. Histology confirmed the presence of malignant melanomas in both eyes. The tumours were of similar A/B spindle-cell type. The patient remained healthy, showing no sign of metastasis or local recurrence of melanoma 9 months after the date of diagnosis. The visual acuity in his remaining eye remained 6/6. Immunological assessment of the blood serum revealed abnormally high interleukin 1 beta (IL-1 beta) and IL-2 levels. Possible implications of these findings are discussed.

Choroid Neoplasms↗

Multirecurrence of corneal posterior polymorphous dystrophy. An ultrastructural study.

Posterior polymorphous corneal dystrophy (PPD) is a rare bilateral, autosomal-dominant disease. The presence of the epitheliumlike endothelium and the thickening of Descemet's membrane by the posterior collagenous layer (PCL) has been reported in the majority of published cases. Reepithelialization of the posterior cornea in donor tissue has been reported only once. Therefore, to examine this process we examined, by light and electron microscopy, three corneal buttons (an original and two subsequent keratoplasties after 3 and 4 years, respectively) from the left eye of a patient with bilateral disease. Our study showed a repopulation of the posterior surface of the donor corneas by the host epitheliumlike endothelium, which was of identical morphology in each case. In contrast to the previously published work, a posterior collagenous layer in the failed grafts was absent from the axial cornea, where the epitheliumlike endothelium was in direct contact with donor Descemet's membrane. A PCL at the periphery in the failed transplants was of the fibrocellular type and differed from the fibrillar PCL in the first keratoplasty specimen. The fibroblastlike cells within the fibrocellular PCL were distinct from the underlying epithelial-like cells and contained numerous tertiary phagolysosomes. We suggest that the major contributor to the fibrocellular PCL in the repeat keratoplasties was a fibrous ingrowth from the host/graft junction and not the epitheliumlike endothelium. It appears that the synthetic capacity of the epitheliumlike endothelium was similar to that of the normal epithelium and was much lower than that of normal native endothelium.

Corneal Dystrophies, Hereditary↗

Differences in the composition of inflammatory cell infiltrate in lens-induced uveitis under therapy with allopurinol or steroids.

PURPOSE: The aim of this study was to compare the qualitative changes in the composition of inflammatory cell infiltrate in lens-induced uveitis (LIU) under treatment with allopurinol (Allo), methylprednisolone (Pred) or the two drugs combined (Allo/Pred). METHODS: Twenty male Wistar rats were sensitized with lens proteins for eight weeks. Intravenous (IV) therapy was started after anterior capsule disruption in one eye of each animal. Five rats were randomly assigned to each of the four groups: controls, Allo (50 mg/kg bw), Pred (7.5 mg/kg bw) and Allo/Pred (50 mg/7.5 mg per kg bw). Eyes were enucleated 24 hours later and fixed in paraformaldehyde/glutaraldehyde. Sections at three levels were stained with Giemsa and examined using a 0 to 4+ score for each type of inflammatory cell. Granulocytes were seen as neutrophils and eosinophils. Neutrophils were divided into polymorphs and "others", and graded with lymphocytes. RESULTS: In all therapy groups there was a significant reduction of polymorphs (p<0.05) in comparison to the control group. There was also a significant reduction in lymphocytes (p<0.05) in the Pred and Allo/Pred groups as compared to the control group and the Allo group. CONCLUSIONS: Single-dose IV allopurinol significantly reduced the overall number of polymorphonuclear leucocytes in LIU. Unlike methylprednisolone, allopurinol did not have any significant impact on lymphocytes.

Allopurinol↗

Topical allopurinol or corticosteroids and acetylcysteine in the early treatment of experimental corneal alkali burns: a pilot study.

PURPOSE: To investigate the effect of topical allopurinol on experimental corneal burns and to compare this to established treatment modalities such as topical prednisolone and acetylcysteine. METHODS: Twenty Wistar rats were randomly assigned to four groups (n=5 each). The groups were controls (normal saline), allopurinol 0.4% eye drops, prednisolone acetate 1% eye drops and acetylcysteine 8% eyedrops. Corneal burn was induced using a 3 mm paper disc soaked in 1N NaOH for 60 seconds. Drops were instilled 6 times per day. In addition, one drop/day ofloxacine was given to prevent secondary infections. Eyes were enucleated 50 hours later and fixed in 4.5% formaldehyde. Three histological levels of each globe were stained with hematoxylin-eosin and examined by two independent masked investigators using a 0 to 4+ inflammatory score. All pair-wise multiple comparison procedures (Student-Newman-Keuls method) were applied for statistical work-up. RESULTS: All three substances significantly reduced the number of histologically visible inflammatory cells compared to the control group (p<0.05). CONCLUSIONS: In the present study, topical allopurinol was as effective as established drugs, namely steroids and acetylcysteine, in the early treatment of experimental alkali corneal burns.

Acetylcysteine↗

Surgical treatment of keratoconus at the turn of the 20th century.

PURPOSE: This paper reviews surgical modalities for treatment of keratoconus at the threshold of the 20th century. METHODS: All ophthalmic literature from 1895 until 1925 in English and German, available at the library of the Institute of Ophthalmology, London, United Kingdom, was studied with respect to this topic. RESULTS: Three thermal procedures were described; galvanocauterization with perforation, without perforation, and a non-contact application of heat to the corneal apex. Radial extension of a thermal burn to correct the minus cylinder represented a further modification. Excision of the conical area was suggested either as a lamellar dissection or as a full thickness trephination. Incision of the cone appeared to be less popular. In staged procedures, a combination of galvanocauterization, splitting of the cornea, conjunctival flap, and a subsequent optical iridectomy were applied. CONCLUSION: The treatment of keratoconus 100 years ago used refractive surgery to improve visual function by modifying corneal shape.

Cornea↗