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Comparative effects of pilocarpine in different vehicles on pupil diameter in albino rabbits and squirrel monkeys.

Several commercial pilocarpine preparations have been compared for their efficacy of drug delivery as evaluated by changes in pupil diameter, and return to base-line pupil size, in rabbits and squirrel monkeys. Adsorbocarpine, Isoptocarpine, Pilocar, all at 2%, and Pilopine HS gel, 4%, were used. In albino rabbits the order of efficacy, as judged by area under the curve, or maximal pupil diameter change, was Pilopine greater than Isoptocarpine = Adsorbocarpine greater than Pilocar = saline (prepared in this laboratory). In general, greater areas under the curve were associated with greater changes in pupil diameter. Pupil diameter had returned to normal by a maximum of 5 hours after drop instillation. In squirrel monkeys, the maximum pupillary change was statistically (P greater than 0.05) the same for all preparations, as was the percentage change in pupil diameter at 6 hours since pupils were still somewhat constricted at this time after drop instillation. The differences in area under the curve were minor. The greater response in primates compared to rabbits may be due to differences in pigment, intraocular kinetics and a far more active ciliary muscle in primates. Also studied were newly developed, non-surfactant containing, preservative-free polymer- and microparticle-based vehicles. Some of the vehicles, based on cyanoacrylate, modified hyaluronate, anionic copolymers, polyvinyl-pyrrolidone, cross-linked gelatin and microparticles showed greater pupillary changes and areas under the curve in rabbits compared to saline vehicle. When compared to commercial preparations in the monkey eye cyanoacrylate block copolymer and modified hyaluronate showed an increase in efficacy. Polyvinylpyrrolidone, anionic copolymer and cross-linked gelatin were equal to the commercial preparations.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[Hypersensitivity in the pupil dilation response to a cholinergic antagonist in patients with Alzheimer's disease and Down's syndrome].

In 1994, Scinto et al. reported hypersensitivity in the pupil-dilation response to topical application of a cholinergic antagonist, tropicamide, in patients with Alzheimer-type dementia. Similar tests on Japanese subjects showed significant differences in pupil response between subjects with Alzheimer-type dementia (under age 70 years) and age-matched controls. The present study included 24 patients with early-onset Alzheimer-type dementia, 29 patients with late-onset Alzheimer-type dementia, 15 healthy controls (all spouse of patients with Alzheimer-type dementia), 9 patients with vascular dementia and 5 patients with Down's syndrome. After adapting to semi-darkness (10 lux), a solution of tropicamide (Midrin-P, Santen Co, Ltd) was instilled into the right eye. Pupil diameters were measured every 5 to 10 min, and the maximum pupil diameter for each eye was used in the data analysis. The solution was diluted until the tropicamide concentration reached 0.01%. Pupil diameters were measured, and differences between baseline and maximum pupil diameter were computed. Among 18 patients with early-onset Alzheimer-type dementia (mean age 63.9 years) the pupils dilated by 1.12 +/- 0.52 mm (mean +/- SD) as compared with 0.20 +/- 0.75 mm in 7 age-matched controls (mean age 57.8 years); this difference was significant (T-test, p < 0.05). Correlations between the degrees of pupillary dilation and the scores on the revised version of Hasegawa's Dementia Scale were not significant. These data suggest that in subjects under 70 years of age, the diagnostic methods described by Scinto et al. can be used to distinguish those with Alzheimer-type dementia from those without dementia, but those methods may not be effective in subjects over 70 years of age.

Adult↗

Pupil size in refractive surgery candidates.

PURPOSE: To assess pupil size measurements obtained under scotopic and mesopic conditions with the Procyon pupillometer and under photopic conditions with the Humphrey videokeratographer. METHODS: The pupil sizes of 96 candidates for refractive surgery (192 eyes) were measured with the Procyon pupillometer PS2000 SA and the Humphrey Atlas 992 corneal topographer. Anisocoria and pupillary unrest were analyzed according to gender (two groups: 51 females and 45 males), age (five groups: 20 to 30 yr, 31 to 40 yr, 41 to 50 yr, 51 to 60 yr, older than 60 yr) and level of refraction (five groups: >-6.00 D SE, -6.00 to -3.00 D SE, -3.00 to 0 D SE, 0 to +2.50 D SE, +2.50 to +5.00 D SE). RESULTS: The median value of pupil diameter measured with the Procyon pupillometer at the scotopic (0.04 lux), mesopic-low (0.4 lux), and mesopic-high (4 lux) levels of illumination were 6.54+/-0.88 mm; 5.62+/-0.95 mm, and 4.09+/-0.76 mm, respectively. The median pupil size with the Humphrey topographer was 3.65+/-0.62 mm. Pupillary unrest was highest at the mesopic-high level of illumination, with a median value of 0.31+/-0.34 mm. Median pupil size measured with both instruments at all light levels dropped significantly after the fifth decade of life (P<.05, ANOVA). CONCLUSIONS: The Procyon pupillometer and Humphrey videokeratographer revealed an inverse correlation between the pupil size and the age, but no relationship with gender or level of refraction. The Procyon pupillometer provides an objective method for measuring pupil size at controlled light levels with a permanent printed record.

Adult↗

Responses of intraocular pressure and the pupil of feline eyes to prostaglandin EP1 and FP receptor agonists.

PURPOSE: Previous studies suggested that FP receptors do not mediate the relaxation of the ciliary muscle and reduction of intraocular pressure in cats by prostaglandin (PG) F2alpha. The present study was undertaken to determine whether the reduction of intraocular pressure in cats induced by PGF2alpha is mediated by FP or other prostaglandin receptors. METHODS: One eye of each cat was treated topically with prostaglandin F2alpha, fluprostenol (FP receptor agonist), or 17-phenyl trinor PGE2 (EP1 receptor agonist) in a dose range of 12.5 to 50 microg. The effects of SC19220 and SC51089 (EP1 receptor antagonists), BWA868c, and SQ29548 (DP and TP receptor antagonists, respectively) on the intraocular response to PGF2alpha were also examined. At intervals up to 6 hours after treatment, intraocular pressure was measured with a pneumotonometer, and pupil diameters were measured with a millimeter ruler. RESULTS: In the dose ranges used, PGF2alpha and 17-phenyl trinor PGE2 decreased intraocular pressure and pupil diameter. The greatest reduction of intraocular pressure by 50.0 microg PGF2alpha was 5.0+/-1.4 mm Hg, whereas that by 50 microg 17-phenyl trinor PGE2 was 6.2+/-1.5 mm Hg. The isopropyl ester of PGF 2alpha at a dose of 1.25 microg reduced intraocular pressure by 3.75+/-0.25 mm Hg at 2 hours. At doses up to 100 microg, fluprostenol did not decrease intraocular pressure but did reduce pupil diameter. SC19220, a weak but selective EP1 receptor antagonist, inhibited the intraocular pressure response to both PGF2alpha and 17-phenyl trinor PGE2. The more potent EP1 receptor antagonist SC51089 had a greater inhibitory effect than SC19220 on the intraocular pressure response to PGF2alpha. Both of these antagonists had a small but non-dose dependent and statistically insignificant effect on the pupil response to PGF2alpha. These observations suggest that in cats, intraocular pressure and pupil responses to PGF2alpha, are mediated by EP1 and FP receptors, respectively. However, SC19220 significantly and dose-dependently inhibited the pupil response to 17-phenyl trinor PGE2alpha suggesting that EP1 receptors mediate pupil response to this agonist. DP and TP receptor antagonists at doses 5- to 20-fold greater than the IC50 values had no effect on the ocular hypotensive response to PGF2alpha. The concurrent administration of 12.5 microg of each of PGF2alpha and 17-phenyl trinor PGE2 did not produce an additive effect on intraocular pressure, indicating that in cats PGF2alpha and 17-phenyl trinor PGE2 act on the same receptor type. CONCLUSIONS: These results suggest that a significant proportion of the ocular hypotensive action of PGF2alpha in cats is mediated by EP1 but not by FP receptor. Evidence was also provided to show that 17-phenyl trinor PGE2 is an ocular hypotensive agent in cats.

Animals↗

[Tonic pupil caused by ischemia].

Tonic pupil is usually an idiopathic condition. In some cases, the cause of the ciliary ganglion lesion leading to tonic pupils is obvious. Rarely ischemia causes a lesion of the ciliary ganglion or the short ciliary nerves due to the good blood supply of the ciliary ganglion. Only two cases of tonic pupils in the course of giant cell arteritis are mentioned in the literature, but tonic pupils are probably much more common with this disease. Five cases are demonstrated here. All had associated ischemic optic neuropathy, and stagnation of the blood flow in the supratrochlear artery could be demonstrated in two cases by Doppler sonography. Tonic pupils may also occur when an oclusion of the internal carotid artery resolves, probably because of transient stasis of the orbital blood flow. In another case, tonic pupils were associated with choroidal ischemia (proved by video fluorescent angiography) of unknown origin. The diagnosis of tonic pupils was made by pharmacological testing for cholinergic hypersensitivity with 0.1% pilocarpine.

Adult↗

Detection of narcotic use. Comparison of the nalorphine (pupil) test with chemical tests.

The nalorphine (pupil) test for narcotic abuse is widely used in California. It is based on the ability of nalorphine to produce mydriasis in subjects who have recently taken morphine-like drugs and to produce miosis in others. The test will usually detect as little as 15 mg of morphine or comparable doses of other narcotics for several hours except in special circumstances. It is even more reliable for detection of chronic use of narcotics. A simple card pupillometer is adequate for measuring changes in pupil size resulting from nalorphine. Analysis for narcotics in urine by thin layer chromatography is also used, either alone or in conjunction with the pupil test, to detect drug abuse. In one study which included many urine speciments from subjects who had negative pupil tests the correlation between the pupil test and urinalysis was good (85 percent). When urinalysis was used to confirm suspicion of drug use resulting from a positive or equivocal pupil test, inter-method agreement dropped to about 50 percent for various reasons. Even so, use of the pupil test for screening and urinalysis for confirmation provides a satisfactory program for detection of narcotic abuse.

Chromatography, Thin Layer↗

Edge-light pupil cycle time and optic nerve disease.

Edge-light pupil cycle time is a quantitative measure of pupil reaction to light, dependent on the functioning of the afferent arm of the pupillary reflex arc. It has been used as an objective assessment of optic nerve function in various neuroophthalmic diseases. In this study, pupil cycle times were determined on 60 eyes of 30 normal subjects, and a mean value of 814 ms with an upper limit of normal at 935 ms was established. The average difference between the two eyes was 34 ms, and the upper limit of normal was 79 ms. Pupil cycle times were then performed on ten eyes with optic atrophy, and all ten (100%) had abnormal values. Nine patients with multiple sclerosis were tested and abnormal cycle times were found in 15 of 18 eyes (83%). Five additional patients with questionable diagnoses were tested, and all but one had abnormal pupil cycle times. A discussion of pupil reactions in optic nerve disease is presented, and the value of edge-light pupil cycle time as a quantitative measure of nerve function is assessed.

Adult↗

Fixed dilated pupil after penetrating keratoplasty for macular corneal dystrophy and keratoconus.

PURPOSE: To identify predisposed eyes, risk factors, and protective measures and to evaluate methods of treatment for fixed dilated pupil after penetrating keratoplasty (PKP) for macular corneal dystrophy (MCD) and keratoconus. DESIGN: Retrospective observational case series. METHODS: A retrospective review was conducted of the charts of 195 patients who had PKP for MCD and of 1800 patients who had PKP for keratoconus at the King Khaled Eye Specialist Hospital in Riyadh, Saudi Arabia. The review included an evaluation of the preoperative and intraoperative data and the postoperative course. In addition, clinical examinations at the last visit and photographs of the cornea, pupil, iris, and lens were analyzed. RESULTS: Twenty-one eyes of 18 patients had fixed dilated pupil after PKP; 15 eyes of 12 patients had MCD, and six eyes of six patients had keratoconus. A rise in intraocular pressure (IOP) during the procedure was seen in five patients (23.8%). Fixed dilated pupil was documented on the first and second postoperative days and the second postoperative week in 17 (80.9%), one (4.8%), and three (14.3%) eyes, respectively. Six eyes (28.6%) of six patients had severe eye inflammation. Only one eye (4.8%) regained partial reactivity of the pupil on follow-up visits. Seven eyes (33.3%) experienced lens changes; nine eyes (42.8%) had elevated IOP on the first postoperative day, and none of the eyes had chronic glaucoma. CONCLUSION: Inflammatory and multifactorial pathologic condition can cause fixed pupil after PKP. Atropine use, keratoconus, and high IOP are not constant findings in this syndrome. Awareness of the risk factors of fixed dilated pupil will help prevent against its occurrence.

Adolescent↗

Could the peer group explain school differences in pupil smoking rates? An exploratory study.

Schools differ in the proportion of their pupils who smoke. Such differences transcend pupil intake characteristics and relate to the internal life of the school. Although adolescents' smoking behaviour has been associated with that of their peers, little consideration has been given to whether peer structures and processes contribute to school differences in pupil smoking rates. In two relatively deprived Scottish schools, one with a higher and one with a lower rate of pupil smoking, 13 and 15 year-olds were surveyed. Sociometric data and information on pupils' smoking behaviour and views were gathered. Twenty-five single-sex discussion groups were then held with a sub-sample of the 13 year-olds in order to explore in detail their views on smoking, smokers and fellow pupils. Findings showed that in the higher smoking school, pupils were more often in groups, smokers were identified as popular, and attitudes (especially among non-smoking females) were more pro-smoking. In the lower smoking school, by contrast, there were more isolates and dyads, there were no popular smokers and attitudes (especially among non-smoking females) were much less pro-smoking. Thus, evidence suggests peer group structures and related influences could be one explanation for school differences in smoking, and that the popularity of smokers together with the views of non-smoking females may be particularly important in creating such differences.

Adolescent↗

Cutaneous afferents producing a reflex pupil dilation in anesthetized rats.

Cutaneous afferents producing a reflex pupil dilation were examined using natural mechanical stimulation of the hindlimb skin and electrical stimulation of a sural nerve in anesthetized, artificially ventilated rats. Pupil diameter was continuously recorded after magnification using a microscope connected to a charge coupled device camera. Innocuous brushing, or weak pressing of the skin, did not have any effect on pupil diameter, while pressing the skin more than 720 g/cm2 produced a pressure-dependent pupil dilation. Pinching rather than pressing the skin induced the larger pupil dilation. Electrical stimulation of a sural afferent nerve with weak intensity, which was supra-threshold for Abeta-afferents and sub-threshold for Asigma-afferents, induced a reflex pupil dilation. This dilation continued to increase with further increases in stimulus intensity which involved excitation of Asigma afferents and C afferents. It is concluded that Abeta, Asigma and C afferents in the skin can work as afferents in eliciting reflex pupil dilation in anesthetized rats.

Afferent Pathways↗

Knowledge and attitudes of high school pupils towards peers' attention deficit and learning disabilities.

The purpose of this study was to investigate pupils' knowledge and attitudes in the areas of attention deficit and hyperactivity (ADHD) and learning disabilities (LD). One hundred and four high school pupils in Holon (Israel) were interviewed and anonymously completed a questionnaire on these conditions. Pupils' knowledge on the topic of ADHD was low (62%); they showed a better knowledge about LD (75%). They showed a partially tolerant attitude (62.7%) towards pupils suffering from ADHD; on the other hand, they had a somewhat more positive and perceptive attitude (74.1%) towards peers diagnosed as learning disabled. Pupils' attitudes became more perceptive with increasing age. There was no correlation between pupils' knowledge and attitude. Pupils had learned about these two handicapped conditions from various sources; TV (66.3%), newspapers (63.5%) and school (53.8%), while physicians and nurses occupied the 5th and last place. Information about these two disabilities (ADHD and LD) should be added to the curriculum and be taught by qualified specialists, as there is an obvious statistically deficient knowledge in these areas.

Adolescent↗

Knowledge of and attitudes to HIV/AIDS of senior secondary school pupils and trainee teachers in Udupi District, Karnataka, India.

A cross-sectional descriptive study using a questionnaire with mostly closed-ended questions was carried out on 990 pupils and 46 trainee teachers to investigate their knowledge of and attitudes to HIV/AIDS. Pupils in one school were reassessed after a health talk and distribution of a handout. Despite having had no formal sex education, most respondents were reasonably well informed about the transmission of HIV. However, there were many misconceptions about transmission and prevention and 16.9% of pupils were found to possess very little knowledge of HIV/AIDS. Mass media, teachers and health workers were quoted as the main sources of knowledge. It was found that 24.3% pupils and 6.3% of trainee teachers thought there was a cure, and 27.4% of pupils and 14% of trainee teachers thought there was a vaccine to prevent HIV infection. Schools that were rural, private and English-speaking scored better, as did male students and schools teaching science. The necessity of formal sex education was expressed by 98.5% of pupils and all the trainee teachers. The pupils who were reassessed after receiving a talk and handout showed significant improvement in their knowledge and a change in attitude (p < 0.01). The mass media are important in disseminating knowledge on HIV/AIDS in India but due to the lack of inter-personal approaches to the education system, knowledge is inadequate and misconceptions exist.

Adolescent↗

Butt in, butt out: pupils' views on the extent to which staff could and should enforce smoking restrictions.

Schools which enforce a no-smoking policy may experience lower rates of pupil smoking. Little is known, however, about how young people view such restrictions and it has been argued that smoking bans might actually encourage adolescent smoking. This paper presents pupils' views on the extent to which staff could, and should, enforce smoking restrictions. Twenty-five single-sex discussion groups were held with 13-year-old pupils who had been purposively selected from two Scottish secondary schools. Both schools served relatively deprived communities and ostensibly had no-smoking policies, but varied in their pupil smoking rates. The pupils' accounts suggested that staff enforcement could interrupt pupil smoking and discourage smoking on school premises, but did not affect whether or not they actually smoked. Pupils viewed staff efforts as ineffective and felt staff did not always have the authority or status needed to enforce a ban. Differences were found between the schools, but these did not explain the variation in their smoking profiles.

Adolescent↗

Phase-retrieved pupil functions in wide-field fluorescence microscopy.

Pupil functions are compact and modifiable descriptions of the three-dimensional (3D) imaging properties of wide-field optical systems. The pupil function of a microscope can be computationally estimated from the measured point spread function (PSF) using phase retrieval algorithms. The compaction of a 3D PSF into a 2D pupil function suppresses artefacts and measurement noise without resorting to rotational averaging. We show here that such 'phase-retrieved' pupil functions can reproduce features in the optical path, both near the sample and in the microscope. Unlike the PSF, the pupil function can be easily modified to include known aberrations, such as those induced by index-mismatched mounting media, simply by multiplying the pupil function by a calculated aberration function. PSFs calculated from such a modified pupil function closely match the corresponding measured PSFs collected under the aberrated imaging conditions. When used for image deconvolution of simulated objects, these phase-retrieved, calculated PSFs perform similarly to directly measured PSFs.

Algorithms↗

Is there a "school effect" on pupil outcomes? A review of multilevel studies.

STUDY OBJECTIVE: The school environment is of importance for child outcomes. Multilevel analyses can separate determinants operating at an individual level from those operating at a contextual level. This paper aims to systematically review multilevel studies of school contextual effects on pupil outcomes. DESIGN: Key word searching of five databases yielded 17 cross sectional or longitudinal studies meeting the inclusion criteria. Results are summarised with reference to type of school contextual determinant. MAIN RESULTS: Four main school effects on pupil outcomes were identified. Having a health policy or antismoking policy, a good school climate, high average socioeconomic status, and urban location had a positive effect on pupil outcomes. Outcomes under study were smoking habits, wellbeing, problem behaviour, and school achievement. CONCLUSIONS: Despite the different pupil outcomes and the variety of determinants used in the included papers, a school effect was evident. However, to improve our understanding of school effects, presentations of results from multilevel studies need to be standardised. Intraclass correlation and explained between school variance give relevant information on factors in the school environment influencing pupil outcomes, and should be included in all multilevel studies. Inclusion of pupil level predictors in the multilevel models should be based on theoretical considerations of how schools and communities are interconnected and how pupils and their families are influenced by school contextual factors.

Achievement↗

Pupil cycle induction test: a way of evaluating the pupillary light reflex.

The Pupil Cycle Induction Test (PCIT) described here is a simple and sensitive clinical method for the evaluation of afferent pupillary defect. It assesses the difficulty in setting up regular and sustained light-induced pupil oscillations, in contrast to methods assessing the light reflex by timing the oscillations. PCIT was applied to 186 presumably normal eyes (with normal visual acuity and normal fundi). In ten eyes, sustained oscillations could not be induced; further investigation showed that four of these eyes had altered visual-evoked response. The test was also carried out in 34 patients suffering from anterior visual pathway disorders. Sustained pupil oscillations could not be set up in 44 out of the 57 affected eyes. In the present series, significant alteration of light-induced pupil oscillations has been observed in several patterns: (1) immediate alteration; (2) delayed interruption of oscillations without spontaneous recovery, and (3) intermittent periods with oscillations of relatively small amplitude lasting more than three pupil cycles. PCIT assesses changes in light threshold for pupil response. It is suggested that delayed and transient alterations of oscillations are related to time-dependent afferent pupil defects similar to intermittent abnormalities of visual function reported in patients with diseases of the optic nerve or the chiasm.

Adolescent↗

I used to like it but now I don't: the effect of the transfer test in Northern Ireland on pupils' intrinsic motivation.

BACKGROUND: Research has suggested that the pressure of exams could undermine pupils' interest in their subjects, but almost all of this research has been conducted in laboratory settings. The Transfer Test in Northern Ireland provides an unusual opportunity to assess the effects of exam pressure in real life because some 10- and 11-year-olds sit a Transfer Test to be admitted to grammar school while others are not tested until they are 14. AIM: To assess the effect of exams on pupils' interest in their subjects both during the period before the exam and after the results are known. SAMPLE: The sample comprised 66 pupils preparing to sit the Transfer Test and 55 not preparing for the test. METHOD: Pupils' interest in their school subjects was assessed by questionnaires administered 2 weeks before the Transfer Test and then again 2 weeks after the results were announced. RESULTS: Surprisingly, prior to sitting the test, there was no significant difference in motivation between the test and no-test pupils. However, after sitting the test, the motivation of the test pupils decreased significantly relative to their no-test counterparts, despite the fact that most achieved the grades they needed for admission to grammar school. CONCLUSIONS: Exams provide a valuable tool for assessing academic progress, but under some circumstances they can reduce pupils' interest in the subjects they are studying.

Child↗

Self-selection of standards by children: The relative effectiveness of pupil-selected and teacher-selected standards of performance.

This study examines the effects of contingent reinforcement under conditions of pupil-selected and teacher-selected performance standards upon pupils' academic response rates. The academic response rate was measured by the number of correct responses emitted per session. Thirty pupils (15 second-graders and 15 third-graders) were randomly assigned to one of three experimental groups, based on matched triplets. One group worked under pupil-selected standards; the second group worked under standards selected by the experimenter with each pupil yoked to a member of the pupil-selected standards groups. Both groups participated in the calculation of their daily earnings. The third group served as a no-contingency control group. Baseline academic response rates on writing and math tasks were determined. During the experimental sessions reinforcement was provided in the form of points which were later traded for tangible rewards. The pupil-selected standards group showed a significantly greater number of correct responses in the writing and math tasks than the externally selected standards group.

Journal Article↗