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Biomedical subjects

Y Pouliquen

Publications and source records attributed to Y Pouliquen.

At least 19 recordsLinked to original sources
PubMed2000

The intrastromal corneal ring in clinical refractive surgery: reference to results in rabbit eyes.

BACKGROUND: The intrastromal corneal ring (ISR) is a refractive device recently introduced for clinical application that is implanted in the mid-peripheral corneal stroma in order to correct myopia without invasion of the central optical zone. First clinical results of intracorneal ring segment implantation were published recently. These results reveal striking similarities to our own experimental data, only briefly published up to now. The aim of this study is to present the refractive and histopathological data of ISR implants in rabbits and to compare these results with the clinical data actually available. METHODS: Expansion/constriction effects were evaluated with a ring of constant size (7.5 x 0.5 x 0.2 mm) in channels of 7.0, 7.5, or 8.0 mm in diameter, volume effects by implantation of 7.5-mm rings with varying thickness (0.2, 0.3, 0.4 mm) into a channel of 7.5 mm, respectively. Refractive power was measured preoperatively and at day (D) 7, D14, D30 for the first and the second experiment, plus D60, D90 for the second experiment. Histological evaluations of the induced morphological changes were additionally performed at all time intervals. RESULTS: Significant (P<0.05) flattening of the cornea was obtained in all but the first (constant ring, 7.0-mm channel) implants postoperatively at D7 and/or D14, with mean dioptric changes up to -5.03+/-2.92 compared with controls. However, from D30 on, there was no statistically significant difference between operated and control eyes. Biomicroscopy and histology of the implanted eyes revealed good biocompatibility, with only rare major complications such as stromal abscess or massive neovascularization. CONCLUSIONS: Although our implantation technique differs slightly from that employed in the recent FDA studies, our results tend to confirm the maximal achievable refractive change of about -5 dpt with this procedure. Furthermore, this study is the first to demonstrate that in rabbits, ISR implantation has only a shortterm effect on refractive power. Our results indicate that long-term refractive follow-up may be necessary in human eyes prior to the introduction of ISRs as a routine procedure in refractive surgery.

Animals↗
PubMed2000

Clinical, histologic, and ultrastructural features of the corneal dystrophy caused by the R124L mutation of the BIGH3 gene.

OBJECTIVE: This study was designed to describe the clinical, histologic, and ultrastructural features of the corneal dystrophy associated with the R124L mutation of the BIGH3 gene. DESIGN: Retrospective clinical and histologic review of a new genetic mutation. PARTICIPANTS: Thirty-four patients from five unrelated French families with corneal dystrophy caused by the R124L mutation of the BIGH3 gene were studied at the clinical, histologic, and ultrastructural levels. Records of patients carrying this mutation were compared with those from three unrelated patients with corneal dystrophy of Bowman's layer (CDB) type 2 (R555Q mutation) and from three unrelated patients with classic corneal granular dystrophy (R555W mutation). INTERVENTION: The mutational genetic status of the BIGH3 gene was determined for each patient, and the histologic and ultrastructural data available after corneal graft were analyzed. MAIN OUTCOMES MEASURES: Genomic DNA was extracted from peripheral blood leukocytes. Exons 4 and 12 of the BIGH3 gene were amplified by the polymerase chain reaction (PCR), and the PCR products were directly sequenced. RESULTS: All 34 patients with the R124L mutation displayed the clinical, histologic, and electron microscopic features of the dystrophy previously described as a superficial variant of corneal granular dystrophy. Combining molecular genetics with clinical and histologic findings established a clear distinction between the R555Q and R555W dystrophies. CONCLUSIONS: The R124L mutation of the BIGH3 gene is associated with specific clinical and morphologic criteria. This indicates that molecular studies are needed for an adequate classification of corneal dystrophies. All criteria are presently available to segregate the dystrophy caused by the R124L mutation (known as CDB1) from the dystrophy caused by the R555Q mutation (known as CDB2).

Adult↗
PubMed2000

[Avellino dystrophy. Current diagnostic criteria].

We report a French family suffering from an Avellino corneal dystrophy diagnosed by using clinical, histological, ultrastructural and genetics findings. Our results indicate that direct corneal examination and routine histological examinations must always be associated with an assay for BIGH3 gene mutations to establish a modern and unambiguous diagnosis of a corneal dystrophy.

Adult↗
PubMed1999

Parameters influencing human mu opioid receptor over-expression in baculovirus-infected insect cells.

The cDNA encoding the human mu opioid receptor (hMOR) was cloned in the baculovirus Autographa californica (AcMNPV) under the control of the polyhedrin promoter. We investigated the influence of different molecular constructions on receptor expression levels: the receptor was fused either to an amino- or a carboxy-terminal histidine tag (hMOR-N-His and hMOR-C-His respectively), or to the cleavable sequence signal of the baculovirus gp64 glycoprotein (gp-hMOR and gp-hMOR-C-His). Two cell lines, Spodoptera frugiperda (Sf9) and Trichoplusia ni (BTI-TN-5B1-4), in combination with three different culture media were also tested for their ability to produce maximal protein expression. Molecular constructions and culture conditions were both shown to influence substantially protein production. The best results were obtained using cells adapted to serum-free medium combined with constructions in fusion with the endogenous signal sequence of the baculovirus gp64 protein. Those conditions led to maximal expression and shortened the time required for receptor production. We also showed that an amino-terminal location of a hexahistidine tag was more detrimental to the expression level than a carboxy-terminal position.

Animals↗
PubMed1999

Novel synthetic meshwork for glaucoma treatment. I. Design and preliminary in vitro and in vivo evaluation of various expanded poly(tetrafluoroethylene) materials.

A novel drainage implant for glaucoma filtering surgery (MESH) is proposed. After various expanded poly(tetrafluoroethylene) (e-PFTE) materials were evaluated, the feasibility and the short-term safety of the technique were assessed in this first pilot study in the rabbit. The porous structure and the in vitro resistance to aqueous flow of seven different e-PTFE membranes (5-80 microm average pore size) were compared. Eight Dutch pigmented rabbits were implanted with the T-shaped MESH implants made from either 20- or 50-microm average pore size e-PTFE membranes. Clinical examination, intraocular pressure (IOP) measurements, and histology analyses were performed over a period of 3 months. The contralateral nonoperated eyes served as controls. MESH implantation took less than 7 min. No postoperative hypotony, migration, or extrusion of the implant and no intraocular inflammation or infection occurred. A significant IOP reduction in the implanted eyes was obtained past postoperative day 21 with the 20-microm material implant. The drainage efficacy was correlated with the degree of colonization of the porous materials and the inner spacing of the implant as observed by histology. With a filtering patency 3 times longer than conventional trabeculectomy and laser sclerectomy, MESH surgery is a promising technique for glaucoma treatment. Further studies are underway to enhance the device efficacy and understand the mechanism of filtration.

Animals↗
PubMed1999

Classical LCAT deficiency resulting from a novel homozygous dinucleotide deletion in exon 4 of the human lecithin: cholesterol acyltransferase gene causing a frameshift and stop codon at residue 144.

Lecithin: cholesterolacyltransferase (LCAT) transacylates the fatty acid at the sn-2 position of lecithin to the 3beta-OH group of cholesterol forming lysolecithin and the majority of cholesteryl ester found in plasma. LCAT participates in the reverse cholesterol transport pathway in man where it esterifies tissue-derived cholesterol following efflux from peripheral cells into HDL. Only 38 unique mutations in the human LCAT gene have been reported worldwide. Our French female proband presented with corneal opacity and no detectable plasma LCAT activity using either endogenous or exogenous assays. Her total plasma cholesterol and HDL cholesterol were low (2.34 mmol/l and 0.184 mmol/l, respectively) with a very high cholesterol/cholesteryl ester molar ratio (10.9:1). Plasma triglycerides were 0.470 mmol/l with low apo B (40.5 mg/dl), apo A-I (14.7 mg/dl), apo A-II (6.8 mg/dl) and apo E (2.1 mg/dl) levels. Plasma lipoprotein analysis by ultracentrifugation showed very low HDL concentrations and a characteristic shift of the lipoprotein profile towards larger, less dense particles. No proteinuria, renal dysfunction or signs of atherosclerosis were noted at age 45. Sequence analysis of her LCAT gene showed a novel homozygous TG-deletion at residues 138-139 that resulted in a frameshift causing the generation of a stop codon and premature termination of the LCAT protein at amino acid residue 144. Western blotting of the patient's plasma using a polyclonal IgY primary antibody against human LCAT failed to demonstrate the presence of a truncated LCAT protein. A 53 bp mismatched PCR primer was designed to generate an Fsp 1 restriction site in the wild type sequence of exon 4 where the mutation occurred. The 155 bp PCR product from the wild type allele produced a 103 bp and 52 bp fragment with Fsp 1 and no cleavage products with the mutant allele thus permitting rapid screening for this novel mutation.

Adolescent↗
PubMed1999

Scleral and episcleral histological changes related to encircling explants in 20 eyes.

PURPOSE: To investigate scleral and episcleral histological alterations induced by encircling explants used in scleral buckling procedures. METHODS: We performed a histopathological study of 20 enucleated eyes after failure of retinal detachment surgery including encircling scleral buckle. RESULTS: Nonabsorbable materials were encapsulated and often gave rise to a limited scleral invagination. The inner capsular surface was regular in 10 silicone explants, it was partially covered with hydrogel fragments and a granulomatous foreign body giant cell reaction in 8 hydrogel explants. One Arruga thread was encased in fibrosis and a catgut circle showed no encapsulation. Other changes were mostly related to the long-standing retinal detachment: peripheral anterior synechiae, anterior uveal effusion, persistent retinal detachment, retinal gliosis, retinal atrophy, retinal breaks, and silicone oil droplets. CONCLUSION: All nonabsorbable explants underwent encapsulation and prompted scleral invagination. A granulomatous reaction accompanied hydrogel fragmentation. The long term fragmentation impact on implanted eyes remains unknown.

Adult↗
PubMed1999

Experimental encircling scleral buckle with silicone and hydrogel: histopathologic and comparative study of 26 rabbit eyes.

PURPOSE: To analyze histologic changes induced by encircling elements, rabbit eyes were implanted with two different biomaterials. MATERIALS AND METHODS: Thirty-seven rabbit eyes (37 rabbits) were implanted with encircling oval episcleral elements. Two materials were used: silicone sponge and hydrogel. The animals were killed and their eyes collected for histopathology. Of 37 eyes, 26 that were implanted for 111 to 455 days were selected for the study. RESULTS: In 26 eyes, scleral buckling was visible. Scleral examination showed a regular erosion under the buckle, mainly with silicone. All explants were surrounded by a fibrous capsule, which was smooth and regular with silicone. With hydrogel, fragmentation was observed with a giant cell reaction. Capsule thickness increased, mainly with hydrogel. CONCLUSION: Fragmentation affected segmental or circumferential hydrogel explants. As in silicone explants, the capsule surface was normal when the hydrogel surface was respected. The fragmentation mechanism remains unclear.

Animals↗
PubMed1999

Exophiala (Wangiella) dermatitidis keratitis after keratoplasty.

We report the first French case of an intraocular infection due to Exophiala (Wangiella) dermatitidis. Two months after a second corneal transplant for congenital hereditary endothelial dystrophy, the patient presented with ocular pain and corneal infiltrates leading to the graft rejection. Diagnosis was established by positive direct examination and cultures of the same fungus from corneal buttons, iris biopsies and ablated sutures.

Adult↗
PubMed1999

[Association of nevus and herpetic keratitis sequela. Apropos of an anatomo-clinical case].

Most conjunctival nevi are found during the two first decades of life. Beyond this period, the diagnosis must be assessed by histopathology. We report the case of a conjunctival nevus recently discovered in a 33-year-old patient who, additionally, was previously treated for herpetic disciform keratitis. The corneal scar decreased vision. A corneal graft and nevus excision were performed simultaneously. Histopathologic study confirmed the diagnosis of nevus and disclosed the corneal scar changes induced by herpes.

Adult↗
PubMed1999

[Phototherapeutic keratectomy in the treatment of Groenouw's type I corneal dystrophy].

PURPOSE: This study was designed to investigate the therapeutic potential of phototherapeutic keratectomy (PTK) for the treatment of corneal granular dystrophy. PATIENTS AND METHODS: PTK was performed with the Excimed UV 200, (Summit Technology, Inc) on a series of 27 eyes of 22 patients with corneal granular dystrophy. Mean patients' age was 34.6 years. The mean follow-up period was 31 months (ranged from 6 to 52 months). The changes in best corrected visual acuity and spherical equivalent were evaluated at 6, 12, 18 and 24 months. RESULTS: All of patients achieved visual improvement. Mean preoperative best corrected visual acuity (BCVA) was 20/100 and mean postoperative BCVA was 20/30 at one year. The mean hyperopic shift caused by tissue ablation was +/- 2.8 D after one year. CONCLUSION: Corneal grafting was the standard treatment for visually disabling granular dystrophy, but PTK has significant advantages over this procedure and must now be the standard method of managing corneal granular dystrophy when intervention is required.

Adult↗
PubMed1998

Free radical depolymerization of hyaluronan by Maillard reaction products: role in liquefaction of aging vitreous.

The degradation of hyaluronan was followed by viscosimetry and by HPLC in order to study the possible role of Maillard products (lysine-glucose) on the alteration of the vitreous gel in aging and diabetes. Lysine-glucose generated Maillard products produced a decrease of viscosity and of the number average molecular weight (Mn) of hyaluronan during a 1 h incubation at 37 degrees C. This effect was comparable to that produced by 1 U/ml of testicular hyaluronidase but was weaker than the effect of a Fenton-type reagent (Udenfriend's reagent). The polydispersity of hyaluronan incubated with Maillard products appeared higher than with hyaluronidase suggesting a more random reaction. Antioxydant enzymes (SOD, catalase), the iron chelators (desferrioxamine, transferrin) and the free radical scavengers (uric acid, carnosine) inhibited the degradation by Maillard products confirming its free radical nature and the intervention of trace metals. Maillard products have been detected in diabetic vitreous and may play a role in its accelerated modifications (liquefaction) in diabetes as compared to normal aging.

Aging↗
PubMed1998

Encapsulation of scleral buckling materials. A study of sixty specimens.

OBJECTIVE: The purpose of the study was to obtain information on the encapsulation of two nonabsorbable biomaterials (silicone and hydrogel) used as explants in scleral buckling in retinal detachment surgery. DESIGN: The study design was a histopathologic study on a cohort of capsule fractions and complete eyes. PARTICIPANTS: Fifty-nine patients participated in this study, in which 60 specimens, including 37 hydrogel and 21 silicone capsule specimens as well as 2 whole eyes, were gathered. There were no control subjects. INTERVENTION: The capsule specimens were obtained from eyes operated on previously for scleral buckling for retinal detachment. The two whole eyes were enucleated. All specimens were studied with routine optic microscopy. MAIN OUTCOME MEASURES: Patient characteristics, type of scleral buckling, and number of operations performed were analyzed. Histologically, the capsular structure, its interface with the explant, and its different components also were studied. Remnants of the buckling material also were investigated. RESULTS: There were 45 male and 14 female patients, with a mean age of 49 years. Histologically, capsule specimens had a fibrous matrix with fibroblasts and few inflammatory cells. Eighteen (48.6%) of 37 hydrogel capsule specimens displayed hydrogel fragments surrounded by a foreign body giant cell granuloma in 16 cases. CONCLUSION: Nonabsorbable materials undergo encapsulation after implantation on the eye surface. Giant cell granuloma was observed in some hydrogel capsule specimens in relation to hydrogel fragmentation. The exact origin of this fragmentation remains unknown.

Adolescent↗
PubMed1998

Reduction of corneal edema in endotoxin-induced uveitis after application of L-NAME as nitric oxide synthase inhibitor in rats by iontophoresis.

PURPOSE: To investigate the involvement of the cornea during endotoxin-induced uveitis (EIU) in the rat and the effect of Ngamma-nitro-L-arginine methyl ester (L-NAME) as nitric oxide synthase (NOS) inhibitor, administered by iontophoresis. METHODS: EIU was induced in Lewis rats that were killed at 8 and 16 hours after lipopolysaccharide (LPS) injection. The severity of uveitis was evaluated clinically at 16 hours, and nitrite levels were evaluated in the aqueous humor at 8 hours. Corneal thickness was measured, 16 hours after LPS injection, on histologic sections using an image analyzer. Transmission electron microscopy (TEM) was used for fine analysis of the cornea. Transcorneoscleral iontophoresis of L-NAME (100 mM) was performed either at LPS injection or at 1 and 2 hours after LPS injection. RESULTS: At 16 hours after LPS injection, mean corneal thickness was 153.7+/-5.58 microm in the group of rats injected with LPS (n=8) compared with 126.89+/-11.11 microm in the saline-injected rats (n=8) (P < 0.01). TEM showed stromal edema and signs of damage in the endothelial and epithelial layers. In the group of rats treated by three successive iontophoreses of L-NAME (n=8), corneal thickness was 125.24+/-10.36 microm compared with 146.76+/-7.52 microm in the group of rats treated with iontophoresis of saline (n=8), (P=0.015). TEM observation showed a reduction of stromal edema and a normal endothelium. Nitrite levels in the aqueous humor were significantly reduced at 8 hours by L-NAME treatment (P=0.03). No effect on corneal edema was observed after a single iontophoresis of L-NAME at LPS injection (P=0.19). Iontophoresis of saline by itself induced no change in corneal thickness nor in TEM structure analysis compared with normal rats. CONCLUSIONS: Corneal edema is observed during EIU. This edema is significantly reduced by three successive iontophoreses of L-NAME, which partially inhibited the inflammation. A role of nitric oxide in the corneal endothelium functions may explain the antiedematous effect of L-NAME.

Animals↗