Biomedical subjects

Z Zagórski

Publications and source records attributed to Z Zagórski.

At least 19 recordsLinked to original sources

PubMed2001

Presence of kynurenic acid and kynurenine aminotransferases in the inner retina.

Kynurenine aminotransferases (KATs I and II) are pivotal to the synthesis of kynurenic acid (KYNA), the only known endogenous glutamate receptor antagonist and neuroprotectant. This study is the first to identify KYNA in the rat retina and to examine immunohistochemically the distribution of KAT isoforms. As determined by HPLC, KYNA concentration in the retina was 99.9 +/- 24.6 pmol/g wet wt. Immunohisto- chemical experiments showed that both KATs were present in the retina. KAT I was preferentially localised on Müller cell endfeet while KAT II was expressed in cells within the ganglion cell layer. In conclusion, KYNA is present and synthesised in the inner retina. This may suggest a modulatory role in glutamate-mediated retinal neurotransmission.

Animals↗

PubMed2001

[Zinsser-Engman-Cole syndrome (dyskeratosis congenita) with severe sicca syndrome, panuveitis and corneal perforation--a case report].

BACKGROUND: Zinsser-Engman-Cole syndrome (Z.E.C.) is a very rare type of ectodermal dysplasia, inherited in X-linked recessive manner and characterised by poikiloderma, nail dystrophy, lingual leucoplakia, bone marrow hypoplasia, hyperkeratosis and hyperhidrosis of planta and palms, dental anomalies and caries, premature grey hair. PATIENT AND METHODS: We report on a 46-year-old man who presented with occlusion of lacrimal puncta, trichiasis, severe dry eye, recurrent corneal ulceration and perforation, uveitis. HLA typing, flow cytometry of peripheral lymphocytes, bone marrow biopsy, conjunctival biopsy and extensive laboratory evaluation towards autoimmune and infectious diseases were performed. RESULTS: CD4+ T cells fraction was decreased, CD8+ and CD3+ HLA DR+ elevated. The patient was HLA-B27 positive. Laboratory studies revealed increased erythrocyte sedimentation rate and C-reactive protein level, hypochromic and hypoplastic anaemia, negative serum titers of antibodies to Epstein-Barr virus, HIV, HTLV-I, toxoplasma gondii and treponema pallidum, repeated titers to cytomegalovirus, herpes simplex and herpes zoster viruses--IgM negative, IgG positive. Corneal perforation was treated with amniotic membrane transplantation and corneal transplantation. CONCLUSION: The defect in cell-mediated immune mechanisms in Z.E.C. syndrome explains the corneal perforation, sicca syndrome and uveitis, first reported in this syndrome.

Autoimmune Diseases↗

PubMed2001

[Clinical evaluation of isopropyl unoprostone (Rescula), in the adjunctive treatment of primary open angle glaucoma].

AIM: To investigate the clinical characteristics of docosanoid derivative, isopropyl unoprostone in the treatment of primary open angle glaucoma (POAG). MATERIAL AND METHODS: In 17 patients (22 eyes) with POAG we analysed prospectively the effect of Rescula upon intraocular pressure, aqueous flare, pupil size, ocular signs and symptoms. Patients were followed up every 2 weeks for at least 8 weeks with complete ocular examination. Concomitant topical therapeutics were used in the study: 0.5% Timolol--group I (16 eyes), and 0.5% Timolol + 2% Dorzolamide--group II (6 eyes). RESULTS: Mean (+/- SD) pretreatment pressure was 24.7 +/- 4.3 mm Hg in group I and it was reduced by 3.7 mm Hg (13.5%) (p < 0.05) at the end of the follow up. In group I Rescula was very effective (delta T% > 25%) in 6/16 eyes (37.5%) and it was ineffective (delta T% < 10%) in the same number of eyes. In group II pretreatment pressure was 24.8 +/- 2.6 mm Hg and it was reduced by 2.6 mm Hg (10.6%) (p = 0.1). Rescula induced no elevation of the aqueous flare during the treatment. No effect on pupil size was observed, either. Eye stinging/conjunctival hyperaemia was noted in 2/17 patients and punctate epitheliopathy in 1 patient (5.9%) that caused discontinuation of drops. CONCLUSIONS: Unoprostone produced significant additive effect to Timolol. Thus, it may be a valuable option for adjunctive therapy. However, interindividual differences need to be considered, as in some patients the response was insignificant.

Administration, Topical↗

PubMed2001

[Vitrectomy in the treatment of endophthalmitis].

PURPOSE: To present our experience with the surgical management of endophthalmitis. MATERIAL AND METHODS: The results of 27 pars plana vitrectomies in 19 patients with clinical evidence of endophthalmitis were analysed. The endophthalmitis was considered as endogenous in 4 cases and exogenous in 15 cases. RESULTS: With the use of vitrectomy good anatomical and functional results were obtained. Pre-operative visual acuity was worse than 1/50 in 16 patients and ranged from 1/50 to 4/50 in 3 patients. Postoperative visual acuity was worse than 1/50 in 7 patients, ranged from 1/50 to 4/50 in 3 patients and was better than 5/50 in 9 patients. CONCLUSIONS: Pars plana vitrectomy in the management of endophthalmitis makes it possible to collect material for culture, removal of viable organisms and inflammatory products. In cases of posttraumatic endophthalmitis vitrectomy allows to prevent future complications.

Adolescent↗

PubMed2001

[Localization of intraocular foreign bodies using computed tomography].

PURPOSE: To present the evaluation of computed tomography (CT) application for detecting the intraocular foreign bodies. MATERIAL AND METHODS: Sixteen computed tomographies of orbit to localise a foreign body were performed in the 2nd Radiology Department at Lublin University School of Medicine from May 1995 to October 1998. During examination 2 mm computed tomography cuts were taken. In almost all cases fundus examination was not possible because of hazy media (cataract, vitreous haemorrhage, endophthalmitis). Pars plana vitrectomy was applied to remove foreign body in all cases. RESULTS: In 14 cases a foreign body was localised inside the eye (3 of them were embedded in the wall of the eye) and in 2 cases a double perforation was noticed. With pars plana vitrectomy 12 of 14 intraocular foreign bodies were removed. Two foreign bodies deeply embedded in the wall of the eye were left. One of the two foreign bodies after double perforation was removed from the orbit and the second, which was localized deeply in the orbit, was left. CONCLUSION: The localisation of the foreign bodies using the computed tomography is a very accurate and sensitive method, facilitating further surgery.

Eye Foreign Bodies↗

PubMed2001

[Change of self-concept in patients after radial keratotomy].

PURPOSE: The study is focused on the problem of self-concept change following radial keratotomy. MATERIAL AND METHODS: 25 patients (17 F, 8 M) were investigated 0.5-1.5 year after the surgery by means of the Adjective Check List by Gough and Heilbrun with double instruction concerning actual self-concept (after the surgery) and retrospective self-concept (before the surgery). RESULTS: In the actual self-concept the patients obtained significantly higher results in the following measures: 1) number of positive words used for self description (Fav, p < 0.05; Iss, p < 0.05); 2) some need scales like affiliation (Aff, p < 0.005), heterosexuality (Het, p < 0.01), and interception (Int, p < 0.05); 3) self-confidence (S-cfd, p < 0.01), military leadership (Mls, p < 0.05), and Adult (A, p < 0.05); 3) two Welsh's scales (A-3, p < 0.05; A-4, p < 0.05). CONCLUSIONS: Patients after radial keratotomy perceive themselves in a more positive way, as more self confident in interpersonal functioning than before. The result suggests that the main reason of the differences resolve in higher well being stemming from the surgical correction of vision.

Adult↗

PubMed2001

Etiology of uveitis in rural and urban areas of mid-eastern Poland.

The aim of this study was to assess and compare the frequencies of uveitis etiology in inhabitants of rural and urban areas of mid-eastern Poland. We reviewed the cases of 563 patients (263 males, 300 females; aged 2-87) with uveitis, treated at the 1st Department of Ophthalmology at the Medical Academy in Lublin and at the District Ophthalmic Hospital in Kielce, Poland, from January 1996-December 2000. Anatomical classification of uveitis was used according to the International Uveitis Study Group and etiological classification including uveitis associated with trauma, infection, systemic disease, non-associated with a systemic disease and masquerade syndromes. Data regarding age, gender, place of residence, anatomical location and etiology of uveitis were obtained. Statistical analyses were performed using Pearson's chi-square test, Spearman's rank correlation test and logistic regression. Etiology of uveitis was established in 70.0% of cases. The most common cause of uveitis was infection. Patients from rural areas were significantly more likely to have uveitis of infectious origin whereas patients from urban areas significantly more likely to have uveitis associated with a systemic disease. In conclusion, the pattern of uveitis in mid-eastern Poland confirms the influence of environmental factors on the etiology of this heterogenous disease.

Adolescent↗

PubMed2000

[Postoperative ptosis after cataract extraction: own material].

PURPOSE: To determine the incidence of postoperative ptosis in patients after cataract extraction and whether the type of local anaesthesia has any influence on the occurrence of this complication. MATERIAL AND METHODS: This study comprised 72 patients who had phakoemulsification of cataract. In group I 36 patients received 2-point peribulbar anaesthesia and in group II 36 patients received retrobulbar anaesthesia and the lid block. No bridle suture was used in both groups. To evaluate the ptosis the distance between the upper lid margin and central corneal reflex was measured before and 3 days after the operation. RESULTS: The ptosis of 2 mm occurred in one patient. There was no statistical difference between two groups referring to the incidence of ptosis. CONCLUSION: This relatively low incidence may be due to not using bridle suture. The technique of anaesthesia seemed to have no influence on the incidence of postoperative ptosis in our study.

Adult↗

PubMed2000

[Evaluation and monitoring of selected inflammation patterns in uveitis using laser tyndallometry].

AIM: The purpose of the present study was to evaluate the degree of inflammation and to monitor the dynamics of the blood-aqueous barrier disruption in selected cases of uveitis using laser tyndalometry. MATERIAL AND METHOD: Measurements with the use of laser tyndalometer (Kowa FM-500) were performed in 72 patients (90 eyes) with various types of uveitis. They were divided into four groups: anterior uveitis (28 eyes), intermediate uveitis (pars planitis) (28 eyes), posterior uveitis (26 eyes) and panuveitis (8 eyes). Aqueous flare values were expressed as photon counts per millisecond. RESULTS: Tyndalometric mean values in control eyes were 4.8 +/- 1.0 ph/msec. Mean initial flare was pronounced in multifocal choroiditis and panuveitis--196.0 ph/msec, HLA-B27 positive acute anterior uveitis--145.4 ph/msec, and in acute herpes zoster anterior uveitis--52.4 ph/msec. It was mild to moderate in Fuchs uveitis syndrome--7.8 ph/msec, pars planitis--15.7 ph/msec, posterior uveitis in toxoplasmosis--6.8 ph/msec and toxocariasis--17.5 ph/msec. The potential of laser flare-meter for precise follow-up and adjustment of therapy was demonstrated in selected cases. CONCLUSIONS: Laser tyndalometry has been proved to be a useful tool for the objective and quantitative evaluation of anterior chamber flare in uveitis and for monitoring the effectiveness of the treatment, thus improving therapeutic efficacy of uveitis.

Adolescent↗

PubMed1999

Corneal stromal calcification after topical steroid-phosphate therapy.

Secondary corneal calcification involving the full thickness of the stroma is a rare potential complication of severe dry eye conditions, recurrent corneal ulcerations, chronic ocular inflammation, or multiple surgical procedures. We describe on a patient with unusual, hitherto unreported calcareous degeneration of the corneal stroma after topical steroid-phosphate therapy for chronic keratoconjunctivitis after Stevens-Johnson syndrome. The patient's serum levels of calcium and phosphorus were normal. Histopathologic and electron microscopic examination of the corneal button revealed mainly intracellularly located crystalline calcium deposits throughout all layers of the corneal stroma but sparing the Bowman layer. Energy-dispersive x-ray analysis confirmed the presence of calcium phosphate. The calcium deposits were closely associated with intracellular and pericellular accumulations of glycosaminoglycans. Our findings indicate that corneal stromal calcification may develop after topical steroid-phosphate medication, and suggest a possible role of alterations in the glycosaminoglycan metabolism of stromal keratocytes in the calcification process.

Adult↗

PubMed1999

[Diode laser trans-scleral cyclo-photo-coagulation].

The purpose of this study is to present the results of treatment of refractory glaucoma with diode laser transscleral cyclophotocoagulation (DLCT). 88 patients (from 10 to 91 years old) were treated with diode laser. The follow up was 6 months. Mean intraocular pressure (IOP) before treatment was 38.2 mm Hg, 1 week after treatment--23.8 mm Hg, 1 month after treatment--21.3 mm Hg, after 6 months--19.0 mm Hg. We repeated treatment in 5 patients (5.6%). In 2 patients we observed hypotony--about 2 mm Hg. Diode laser cycloablation is a relatively safe and effective method in treatment of advanced refractory glaucoma.

Adolescent↗

PubMed1999

[Secondary glaucoma in the course of arterio-cavernous fistula: a case report].

PURPOSE: To present a case of 59-year-old woman with the symptoms of redness, proptosis of her left eye and temporary bruit in her head. METHODS: Basic ophthalmological examination, measurement of proptosis, tonometry, visual field examination (Humphrey 30-2 threshold) CT, MRI and carotid angiography were performed. CLINICAL SIGNS: Proptosis of the left eye, dilatation of the episcleral vessels, fundus examination--optic disc normal, enlarged and engorged venous vessels, intraretinal haemorrhages in posterior pole. Tonometry--13 mm Hg--right eye, 24 mm Hg--left eye. Perimetry--general reduction of sensitivity. CT scan--abnormal structure (0.9 x 0.4 cm) in the medial part of the left orbit, without enhancement after applying contrast. MRI examination--enlargement of extraocular muscles of the left eye. Carotid artery angiography revealed indirect carotid--cavernous fistula. CONCLUSION: Special investigations like CT and MRI showed different picture, final diagnosis could be based upon the clinical picture and confirmed by angiography.

Carotid Artery, Internal↗

PubMed1999

[Capsule contraction syndrome].

AIM: To analyse the occurrence of the anterior capsule contraction following cataract surgery. Capsule contraction syndrome (CCS) is defined as an extreme reduction in diameter of anterior capsulectomy, capsular bag diameter and, occasionally, displacement of the IOL after extracapsular cataract extraction. It is relatively frequent in pseudoexfoliation, advanced age, in association with uveitis, pars planitis and myotonic muscular dystrophy. MATERIALS AND METHODS: 5965 eyes of patients were operated on cataract between 1.01.1994 and 31.12.1997 in Tadeusz Krwawicz Chair of Ophthalmology and 1st Eye Hospital, Medical School in Lublin. Two types of surgical procedures were performed: "divide and conquer" phacoemulsification with 4.5-8 mm continuous curvilinear capsulorhexis (3385 eyes) and extracapsular cataract extraction with "can opener" capsulotomy (2580 eyes). RESULTS: 20 cases of clinically apparent CCS were referred to the Department: in the course of intensive postoperative inflammation--5, in patients over 80--4, in pseudoexfoliation syndrome--2, myotonic dystrophy--1, ectopia lentis--2, other causes--6. In order to improve visual acuity in 4 cases surgical removal of the distorted and opaque anterior capsule was performed, in 3 cases relaxing radial tears were done, in 3 cases secondary anterior capsulotomy was performed using Q-switched Nd:YAG laser. CONCLUSIONS: In cases where the occurrence of CCS is especially high large diameter capsulorhexis should be performed and IOL designed to provide maximal peripheral capsular bag expansion should be implanted.

Adult↗

PubMed1999

[Application of amniotic membrane transplantation in severe corneal diseases].

PURPOSE: To present our experience with the amniotic membrane transplantation in severe corneal diseases. MATERIAL AND METHODS: In 1998 amniotic membrane transplantation was applied in 18 eyes (17 patients) with severe and persistent corneal diseases. The indications were as follows: perforated corneal ulcer--9 eyes, persistent non-perforated corneal ulcer--4 cases, recurrent transplant disease--2 eyes, 1 patient with Sjögren syndrome and 1 with keratolysis in the course of ulcerative colitis. Amniotic membrane was prepared in the International Eye Bank of Lublin from human placenta after elective caesarean section according to the standard protocol. RESULTS: In 7 eyes with perforated ulcers and 4 eyes with non-perforated ulcers prompt healing was observed. In 4 cases markedly improved visual acuity resulted from corneal clarification. In 1 eye perforation persisted in spite of amniotic membrane transplantation and keratoplasty was performed afterwards. In the case of keratolysis, amniotic membrane transplantation did not prevent corneal perforation which was closed successfully with autologous conjunctival flap. In 2 eyes with recurrent transplant disease amniotic membrane dissolved quickly after transplantation. In one case the state of the cornea improved. The second eye required retransplantation of the membrane. We observed that amniotic membrane dissolved more quickly in a vascularized bed. CONCLUSION: Amniotic membrane transplantation may be considered a good alternative method for treating severe corneal disorders that are refractory to conventional treatment.

Adult↗

PubMed1998

[Histopathologic studies of the rabbit retina after use of perfluorodecalin].

PURPOSE: To investigate the retinal toxicity of a vitreous substitute perfluorodecalin (PFD) in the rabbit eye up to 2 weeks after injection. MATERIAL AND METHODS: A space was created in the vitreous cavity by injecting 0.4 cc of perfluoropropane gas. After 3 days gas-fluid exchange was performed. Experimental eyes were injected with 1 cc of PFD and control eyes with 1 cc of Ringer solution. The eyes were enucleated 1, 3, 6 and 14 days after the procedure and histological studies were conducted. RESULTS: Control samples showed almost normal histology. One day after PFD injection photoreceptor nuclei dropout and migration below the outer limiting membrane, pyknosis and occasional densification of cell bodies were observed. After 3 days glial cell hypertrophy and accumulation of macrophages above the inner limiting membrane was also noted. After 6 days necrosis was observed in the outer and inner retinal layers. Foci of cell death in the retina were also observed 14 days after PFD injection. CONCLUSION: PFD induced degenerative changes in the rabbit retina within the first 24 hours after administration. Structural alterations in the inner and outer retina persisted within the two weeks of observation. Our results support the removal of PFD at the end of the primary surgical procedure.

Animals↗

PubMed1998

[Evaluation of astigmatism and blood-aqueous barrier breakdown following procedures in the anterior eye segment].

PURPOSE: The aim of this study was to evaluate the disruption of the blood-aqueous barrier (BAB) and the induced astigmatism following phacoemulsification, trabeculectomy and phacotrabeculectomy. MATERIAL AND METHODS: 141 eyes of patients who underwent different surgical procedures of the anterior segment were examined with the use of computer-assisted videokeratography. All maps were recorded preoperatively, and one and five days after surgery. We also applied a laser flare-meter in 41 eyes in order to quantify aqueous flare following these procedures. RESULTS: The mean surgically-induced astigmatism following conventional trabeculectomy was 2.1 D and 1.4 D one and five days postoperatively, phacoemulsification with sutures 2.7 D and 1.9 D and phacotrabeculectomy 3.0 D and 2.4 D, respectively. Lower values of astigmatism obtained after sutureless phacoemulsification were 0.6 D and 0.3 D one and five days postoperatively, respectively (p < 0.05 vs Phaco+IOL+Trab. group, p < 0.01 vs other groups). It was found that aqueous flare values following phacotrabeculectomy were 58.0 photon counts/milisec.--one day, 39.3--3 days, 24.4--7 days, 20.4--10 days postoperatively. Significantly reduced values were observed after phacoemulsification--27.6 one day after surgery and 17.6--3 days later (p < 0.01 vs Phaco+IOL+Trab.group). CONCLUSIONS: It could be concluded that induced astigmatism and the amount of inflammation were the highest after triple procedure and the lowest after phacoemulsification.

Anterior Chamber↗

PubMed1998

[Solar retinopathy].

The purpose of this study is the present clinical evaluation of 21 patients (number of affected eyes--33), who watched eclipse of the sun on 12 October 1996. All patients had general ophthalmic examination with emphasis on visual acuity, visual field, Amsler test, fluorescein angiography and fundus appearance. Eleven out of 21 patients had at least one follow up examination (number of affected eyes--17). None of the patient received any treatment. All patients revealed tiny, central scotomata--positive Amsler test and decreased visual acuity on the first visit; reading Snellen chart could be improved in all patients by adequate head tilt or eye movement (improvement up to 3 Snellen chart lines). No signs of retinopathy were observed in two eyes with uncorrected refractive error and one amblyopic eye. After 7-8 weeks the visual acuity was decreased to 5/30 in two eyes and to 5/10 in ten eyes. In all those eyes persisted a tiny, central scotoma. Looking at the eclipse of the sun in spite of using primitive eye protection may cause irreversible retinal damage. Return of visual acuity to 5/5 does not always imply complete recovery because of persistent central scotoma.

Adolescent↗

PubMed1997

[Corneal topography of keratoconus].

PURPOSE: The present study was designed to evaluate the topography of a series of keratoconus patients. SUBJECTS AND METHODS: Using a computer-assisted videokeratography (Eye Sys) we determined the topographic findings of 85 eyes of 46 consecutive patients with keratoconus. We analysed some quantitative topographic parameters like: power at the apex, central corneal power, the amount of irregular astigmatism, distance between the apex and the visual axis, difference in central corneal power between the two eyes of the same individual and steepening of the inferior cornea compared with the superior cornea. RESULTS: Keratoconic topographic alterations were classified into two groups. Fifty seven of the cones (71%) could be described as peripheral with steepening of the cornea extending to the limbus. The remaining twenty three eyes (29%) had steepening confined to the central cornea. In many instances corneal topography was characterized by a high degree of nonsuperimposable mirror image symmetry (enantiomorphism) in the location of the topographic alterations between the two eyes of an individual patient. In all patients, irrespective of the topographic pattern, the inferior midperipheral cornea was steeper than superior cornea as quantified by an l-S value. CONCLUSION: Study of the topography in keratoconus using this technique may prove useful for documenting the pattern of involvement of the anterior corneal surface and providing insight into the pathogenesis of this condition.

Adult↗