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PubMed2002

Substance P and its metabolites in normal human tears.

PURPOSE: To determine amounts and biochemical characteristics of substance P-like immunoreactivity (SPLI) in tears of normal human subjects. METHODS: Forty-three healthy subjects (16 males and 27 females; age range, 17-80 years) participated. Ten microliters of unstimulated tears were collected with a micropipette from one eye of all subjects. Tear samples were partially purified by C-18 cartridges. SPLI concentrations in purified samples were measured by enzyme immunoassay (EIA). For biochemical characterization of SPLI, tear extracts were fractionated by high-performance liquid chromatography (HPLC). Each fraction then was subjected to EIA. To determine the metabolism of substance P in tears, synthetic substance P was incubated in medium containing pooled tears and then analyzed by HPLC with the detector set at a 210-nm wavelength. RESULTS: The SPLI concentration in normal human tears was 306.0 +/- 96.5 pg/mL (mean +/- SD; range, 148-555 pg/mL). SPLI did not significantly vary by age or gender. HPLC analysis indicated that SPLI in tears consisted of five different substances and that substance P was converted to several fragments, including SP(8-11) by enzymes present in tears. CONCLUSIONS: Substance P, a normal component of human tears, presumably is released from the nerve endings in the ocular surface and converted to fragments by degradative enzymes in tears.

Adolescent↗
PubMed2004

Elevated free tear lactoferrin levels in leprosy are associated with Type 2 reactions.

PURPOSE: To determine the association of demographics, leprosy and ocular characteristics with altered levels of lactoferrin in the tears of normal subjects and leprosy patients, and to detect the presence of antibodies to lactoferrin in these tear samples. METHOD: We collected light-stimulated tears from 298 leprosy patients and an equal number of normal subjects using the glass capillary method. Free lactoferrin levels were estimated using ELISA and the presence of antibodies to lactoferrin was detected using the immuno-blotting method. Significant associations were looked for between tear lactoferrin levels and demographic characteristics, leprosy characteristics such as type of disease, duration of disease, reactions, deformity and bacterial load, and ocular complications, using chi-square and regression analysis. RESULTS: Tear lactoferrin levels with a mean (SD) of 2.55 (2.83)mg/ml in the control group were significantly different (P<0.000) from leprosy patients with a smean (SD) of 5.66 (7.21)mg/ml. Age showed an inverse correlation with tear lactoferrin levels in controls. Increased bacterial load, grade 2 leg deformity and Type 2 reactions were significantly associated (P<0.05) with increased tear lactoferrin levels. Type 2 reactions remained significantly associated (P=0.01) on multiple regression analysis. Tear lactoferrin levels were not associated with gender, serum lactoferrin levels, Type 1 reactions, face patches, treatment status, orbicularis oculi weakness, lagophthalmos, ectropion, entropion, corneal opacity, cataract and iridocyclitis. CONCLUSION: Age is inversely related to tear lactoferrin levels in normal subjects. Free lactoferrin levels in tears are significantly higher in leprosy patients compared with normal controls. Type 2 reactions in leprosy are significantly associated with elevated tear lactoferrin levels.

Adolescent↗
PubMed1990

Stimulation of tear secretion by topical agents that increase cyclic nucleotide levels.

The authors examined the effect of topical application of agents known to increase cyclic nucleotide levels on tear secretion by accessory lacrimal gland tissue in their rabbit model for keratoconjunctivitis sicca (KCS). Tear secretion was studied by changes in tear film osmolarity and tear volume caused by application of the agents relative to application of isotonic buffer solution alone. A decrease in tear film osmolarity or increase in tear volume was interpreted as an increase in tear secretion. Irritative stimulation was distinguished from pharmacologic stimulation by the prior use of topical proparacaine. The following agents significantly decreased tear film osmolarity and increased tear volume: vasoactive intestinal peptide (2 X 10(-8) to 2 X 10(-6) M); three pro-opiomelanocortin fragments alpha-, beta-, and gamma-melanocyte stimulating hormone at 10(-4), 10(-3), and 10(-3) M, respectively; the permeable cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) analogs 8-Br cAMP (0.3-3.0 X 10(-3) M) and 8-Br cGMP (1.0-10.0 X 10(-3) M); and the cyclic nucleotide phosphodiesterase inhibitor 1-isobutyl-3-methyl xanthine (0.3-3.0 X 10(-3) M). Forskolin (2 X 10(-4) M), which activates the catalytic subunits of adenyl cyclase, increased tear volume significantly. Secretin, adrenocorticotropic hormone, and pilocarpine were ineffective. The authors conclude that agents that increase either cAMP or cGMP levels pharmacologically stimulated tear secretion when applied topically to rabbit eyes with surgically induced KCS.

Administration, Topical↗
PubMed1986

Use of tears for diagnosis of feline leukemia virus infection.

A comparison was made of the use of serum, tears, and saliva for the detection of feline leukemia virus (FeLV) infection in cats. Cotton swabs were used to collect saliva, and tear-test strips were used to collect tears. Specimens were analyzed by a commercially available ELISA. Using a 10- to 15-minute specimen incubation period, FeLV was detected in 70% of the saliva specimens and in 73% of the tear specimens from viremic (serum-positive) cats. Feline leukemia virus antigen was not detected in saliva and tear specimens from serum-negative cats. The sensitivity of the tear assay was improved by increasing the incubation time to 24 hours. Tear strips could be air-dried and stored at room temperature for up to 7 days without any appreciable loss of activity. Client-owned and experimentally infected laboratory cats were tested for FeLV, using air-dried tear-test strips and a 24-hour incubation period. Tears were positive (contained FeLV antigen) in 65 of 72 (90%) serum-positive cats and did not contain antigen in 46 of 46 (100%) serum-negative cats. Results of ELISA obtained from serum and tears also were compared with results obtained from indirect fluorescent antibody testing of blood smears. Results of indirect fluorescent antibody and ELISA compared favorably with each other and with the results of tear testing.

Animals↗
PubMed1988

Viral antibodies in normal tears.

Viruses are a common cause of eye infection. The local mucosal response, with production of antibodies released into tears, is believed to provide an important immune defense against these agents. However very little information exists on the viral specificity of normal tear immunoglobulins. In this study we obtained tears, parotid saliva and serum from 40 normal subjects without eye disease. Samples were examined by enzyme linked immunosorbent assay (ELISA) for antibodies to seven common viruses which invade mucosa: cytomegalovirus (CMV), Epstein Barr (EBV), herpes simplex type I (HSVI), measles, mumps, rubella and varicella zoster virus (VZV). The majority of normal tears contained antibodies to HSVI (73%) and EBV (65%), occasionally to mumps (30%), rubella (30%), and VZV (20%), and rarely to CMV (5%). Tear viral antibodies were mainly IgA class, but it was not unusual to find IgG antibodies to HSVI, VZV, rubella and measles. Tear and parotid saliva immunoglobulins from the same individual had entirely different viral reactivity. In most cases tear viral antibodies were reflected in serum viral antibodies, although the immunoglobulin class might differ. However, 15% of normal tears had antibodies to HSVI without detectable serum antibodies. From this study we conclude that normal tear immunoglobulins contain antibodies to common viruses, in particular to HSVI and EBV. These tear antibodies are mainly IgA, but can consist of IgG. Viral antibodies in tears are independent of the antibodies present in parotid saliva, suggesting that there is preferential homing of committed B lymphocytes to different mucosal surfaces.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1997

The effects of age, gender, and fluid dynamics on the concentration of tear film epidermal growth factor.

PURPOSE: To identify the relationship between epidermal growth factor (EGF) concentration in human tears and clinical tear-flow parameters and how these vary with age and gender. METHODS: Tear samples were collected with minimal stimulation from 68 healthy and asymptomatic adults (33 men, 35 women), aged 21-88 years. EGF concentrations were determined by sandwich enzyme-linked immunosorbent assay (ELISA) in 65 cases. Schirmer tests were performed without anesthesia, and the clearance of fluorescein from the tear film assessed. The Tear Function Index (TFI) was calculated from these values. RESULTS: There were approximately equal numbers of male and female subjects with a similar age distribution for each gender (48 +/- 3 and 51 +/- 3 years, mean +/- SEM, respectively). Ninety percent of tear EGF concentrations were between 0.75 and 7.1 ng/ml. Tear EGF level correlated significantly with Schirmer I value, but not with age. Schirmer I value correlated with tear clearance [LN(TCR)] but not with age. Tear EGF concentrations were significantly higher for men (3.4 +/- 0.3 ng/ml) than for women (2.4 +/- 0.3 ng/ml; p = 0.043). CONCLUSIONS: EGF concentrations is tear samples from normal humans were found to correlate with gender and Schirmer I value but not with tear clearance.

Adult↗
PubMedDate not supplied

Infectious bronchitis virus antibodies in tears and their relationship to immunity.

Antibodies to infectious bronchitis virus (IBV) in chicken tears were investigated to determine if they could be used as an indicator of protective immunity. Antibody production in tears and serum was measured by enzyme-linked immunosorbent assay (ELISA) in specific-pathogen-free (SPF) white leghorn and broiler chickens vaccinated with a live attenuated vaccine containing the Massachusetts (Mass) Connaught strain of IBV. The effect of virulent infectious bursal disease virus (IBDV) infection on antibody production in tears was also evaluated. Immunity was assessed by challenging the chickens with Mass 41 and performing tracheal swabbings 5 days later. In addition, tears were also evaluated for virus-neutralizing (VN) antibodies to IBV. Following eyedrop vaccination, anti-IBV antibodies were consistently detected by ELISA in tears prior to and in higher concentrations than in the sera of SPF white leghorn and broiler chickens. Maternal IBV antibodies were present in the tear secretions of broiler chickens but in lower concentrations than in sera. Infection of SPF chicks with a virulent and immunosuppressive strain of IBDV at 1 day of age greatly reduced IBV ELISA antibody production in tears as well as serum compared with infection of chickens with IBDV at 14 days of age. IBV ELISA and VN antibody levels in tears were not accurate indicators of IBV immunity as determined by challenge with Mass 41. High tear IBV antibody titers were observed in some chickens determined to be susceptible to IBV challenge and low tear titers were detected in some protected chickens. This finding suggests that mechanisms other than antibody-mediated immunity in tears are important in viral clearance following challenge.

Animals↗
PubMed1976

Calcium in tears, lacrimal gland fluid, and fluid from the other orbital glands.

Abnormal tear calcium concentrations, which might be expected in ocular and systemic disorders,may be obscured if tear calcium concentration varies with flow rate. The results of the present study indicated that tear calcium concentration is independent of flow rate with rates faster than those which occur with stimulated overflow tearing (i.e., 2 mu1 per minute), but with slower flow rates such as would be encountered with basal, nonstimulated tear flow, tear calcium concentration increases as flow rate decreases. In addition, at given flow rates, tear calcium concentration is the same as that in at least two components of tears, i.e., lacrimal gland fluid, uncontaminated by fluid from the other orbital glands, and fluid from the other orbital glands, uncontaminated by lcarimal gland fluid. It is apparent that only if calcium concentration is correlated with fluid flow rate will determination of calcium in tears and in the components of tears produce valid information not only about tear calcium levels in the presence of ocular and systemic diseases but also about the mechanism of secretion of calcium by the orbital glands.

Animals↗
PubMed2003

Results of endosonographic imaging of the anal sphincter 2-7 days after primary repair of third- or fourth-degree obstetric sphincter tears.

OBJECTIVES: To describe the endosonographic image of the anal sphincter 2-7 days after delivery in women who had undergone a primary repair of an obstetric sphincter tear. METHODS: Forty-eight women who had suffered a third- or fourth-degree sphincter tear at delivery and had undergone primary sphincter repair were examined with endoanal sonography 2-7 days after delivery. A score from 0 to 16 was used to describe the extent of the endosonographic defects, a score of 0 indicating no defect and a score of 16 a defect > 180 degrees involving the whole length and depth of the sphincter. Clinical information was retrieved from the delivery and operation records after the analysis of the ultrasound images and the classification of the sonographic defects had been completed. RESULTS: Clinically, 34 (71%) women had a partial third-degree tear, 11 (23%) had a total third-degree tear, and three (6%) had a fourth-degree tear. Forty-three (90%; 95% CI, 77-97%) women had sonographic defects, all hypoechoic. Twenty-three (54%) sonographic defects were confined to the proximal part of the anal canal and involved less than half of the length of the anal canal. Thirty (63%) defects were confined to the external sphincter. Five of nine women (56%) with an endosonographic sphincter defect score >/= 8 had undergone primary sphincter repair by a doctor in training vs. 9 of 39 women (23%) with an endosonographic sphincter score < 8 (P = 0.05), despite the fact that 86% (12/14) of the tears sutured by doctors in training were clinically partial third-degree tears vs. 65% (22/34) of those sutured by specialists (P = 0.15). Five (15%) of 34 women with a clinical partial third-degree tear had an endosonographic sphincter score >/= 8 vs. four (29%) of 14 with a clinical total third- or fourth-degree sphincter tear (P = 0.26). CONCLUSIONS: Most women (90%) with a clinical third- or fourth-degree obstetric sphincter tear have endosonographic sphincter defects if they are examined 2-7 days after primary repair. The extent of the endosonographic defects seems to be determined mainly by the surgical experience of the doctor performing the repair, and not by the clinical degree of the tear.

Anal Canal↗
PubMed1992

Prognostic value of new retinal tears associated with the development of postoperative proliferative vitreoretinopathy.

We prospectively evaluated for the presence of new retinal tears 60 eyes of 60 patients who developed recurrent retinal detachment complicated by proliferative vitreoretinopathy (PVR) after surgery for primary rhegmatogenous retinal detachment. New retinal tears associated with the development or recurrence of postoperative PVR were disclosed in 27 eyes (45%). New tears were categorized into two distinct groups: (1) peripheral new tears and (2) posterior new tears. Peripheral new tears were disclosed in 11 eyes. They were invariably located at the posterior edge of the vitreous base and showed a prevalence in the inferior quadrants. The prognosis for permanent retinal reattachment after reoperation was not influenced by the presence of peripheral new tears. Posterior new tears were disclosed in 19 eyes. They were located in the mid-periphery or close to the posterior pole. They were more frequent in grade D PVR (57.7%) compared with grade C PVR (11.7%) (P less than 0.01). Posterior new tears were associated with a poor prognosis. In grade D PVR the anatomic success rate following repeated surgery was only 13.3% (2/15 eyes), whereas all eyes with grade D PVR and no posterior new tears were successfully reattached (P less than 0.001). Failures to reattach the retina were related to recurrent PVR. It is concluded that the development of posterior new tears in postoperative PVR reflects a severe and active PVR process.

Adolescent↗
PubMed2006

Comparison of the MR findings on indirect MR arthrography in patients with rotator cuff tears with and without symptoms.

PURPOSE: To compare indirect magnetic resonance (MR) arthrography findings in patients with rotator cuff tears with and without symptoms. MATERIALS AND METHODS: Indirect MR arthrography results of 15 asymptomatic and 23 symptomatic rotator cuff tears were retrospectively reviewed, comparing the type and size of tears and amount of subacrominal-subdeltoid bursal fluid. RESULTS: There were 14 partial-thickness tears and one full-thickness tear in the asymptomatic group, with 4 small and 11 medium tears. In the symptomatic group, there were 16 partial-thickness and 7 full-thickness tears, with 14 small, 5 medium, and 4 large tears. In the asymptomatic group, the amount of subacrominal-subdeltoid bursal fluid was grade 0, 6 patients; grade 1, 6 patients; grade 2, 2 patients; and grade 3, 1 patient. In the symptomatic group, the amount of subacrominal-subdeltoid bursal fluid was grade 0, 4 patients; grade 1, 3 patients; grade 2, 8 patients; and grade 3, 8 patients. We found no statistically significant difference between symptomatic and asymptomatic tears in the kind and size of tears, and in the amount of subacrominal-subdeltoid bursal fluid. CONCLUSION: We found no difference in the MR findings between symptomatic and asymptomatic rotator cuff tears.

Aged↗
PubMed2006

Bucket handle tears of the medial meniscus: meniscal intrusion rather than meniscal extrusion.

OBJECTIVE: To determine the frequency of medial meniscal extrusion (MME) versus "medial meniscal intrusion" in the setting of bucket handle tears. Images were evaluated for previously reported risk factors for MME, including: medial meniscal root tear, radial tear, degenerative joint disease and joint effusion. METHODS: Forty-one consecutive cases of bucket handle tear of the medial meniscus were reviewed by consensus by two musculoskeletal radiologists. Imaging was performed using a 1.5 GE Signa MR unit. Patient age, gender, medial meniscal root integrity, MME, medial meniscal intrusion, degenerative joint disease, effusion and anterior cruciate ligament (ACL) tear were recorded. RESULTS: Thirteen females and 27 males (age 12-62 years, median=30 years) were affected; one had bucket handle tear of each knee. Effusion was small in 13, moderate in 9 and large in 18. Degenerative joint disease was mild in three, moderate in two and severe in one. 26 ACL tears included three partial and three chronic. Medial meniscal root tear was complete in one case and partial thickness in two. None of the 40 cases with an intact or partially torn medial meniscal root demonstrated MME. MME of 3.1 mm was seen in the only full-thickness medial meniscal root tear, along with chronic ACL tear, moderate degenerative joint disease and large effusion. Medial meniscal intrusion of the central bucket handle fragment into the intercondylar notch was present in all 41 cases. CONCLUSION: Given an intact medial meniscal root in the setting of a "pure" bucket handle tear, there is no MME.

Adolescent↗
PubMed2001

Biochemical markers in the synovial fluid of glenohumeral joints from patients with rotator cuff tear.

It is known that rotator cuff tears are sometimes accompanied by joint destruction. Our purpose was to elucidate the pathology with this condition. Thirty-two synovial fluid (SF) samples aspirated from the glenohumeral joints of patients with rotator cuff tears, including 7 with partial-thickness and 25 with full-thickness tears of the rotator cuff (10 massive and 15 isolated supraspinatus tendon (SSp) tears), were examined. Collagenase (MMP-1), stromelysin 1 (MMP-3), tissue inhibitor of metalloproteinases-1 (TIMP-1) and carboxy-terminal type II procollagen peptide (pCOL Il-C) were measured in the SF using the respective sandwich enzyme immunoassays. Glycosaminoglycan (GAG) was also quantified with a cationic dye binding method using 1,9-dimethylmethylene blue. Levels of any molecules except pCOL II-C in the SF appeared to be higher in full-thickness tears than those in partial-thickness tears. Moreover, levels of MMP-1, MMP-3 and GAG in the SF were significantly higher in massive tears of the rotator cuff in comparison with those in isolated SSp tears. Such significance was not observed in the levels of TIMP-1 or pCOL II C in the SF. We examined the relation of those levels with operative findings or clinical parameters from full-thickness tears, and observed significant correlations of the tear size with the levels of MMP-1, MMP-3 and GAG in the SF. Although these marker molecules in SF do not always originate from cartilage, our results may indicate the potential for accelerated cartilage-degrading activity in the glenohumeral joint in massive tears of the rotator cuff.

Adult↗
PubMed2002

The effect of rotator cuff tears on reaction forces at the glenohumeral joint.

The rotator cuff muscles maintain glenohumeral stability by compressing the humeral head into the glenoid. Disruption of the rotator cuff compromises concavity compression and can directly affect the loads on the glenohumeral joint. The purpose of this study was to quantify the effect of rotator cuff tears on the magnitude and direction of glenohumeral joint reaction forces during active shoulder abduction in the scapular plane using nine cadaveric upper extremities. Motion of the full upper extremity was simulated using a dynamic shoulder testing apparatus. Glenohumeral joint reaction forces were measured by a universal force-moment sensor. Five conditions of rotator cuff tears were tested: Intact, Incomplete Supraspinatus Tear, Complete Supraspinatus Tear, Supraspinatus/Infraspinatus Tear, and Global Tear. Reaction forces at the glenohumeral joint were found to steadily increase throughout abduction and peaked at maximum abduction for all conditions tested. There were no significant differences in reaction force magnitude for the intact condition (337 +/- 88 N) or those involving an isolated incomplete tear (296 +/- 83 N) or complete tear (300 +/- 85 N) of the supraspinatus tendon. Extension of tears beyond the supraspinatus tendon into the anterior and posterior aspect of the rotator cuff led to a significant decrease in the magnitude of joint reaction force (126 +/- 31 N). Similarly, such tears resulted in a significant change in the direction of the reaction force at the glenohumeral joint. These results suggest that joint reaction forces are significantly affected by the integrity of the rotator cuff, specifically, by the transverse force couple formed by the anterior and posterior aspects of the cuff. The quantitative data obtained in this study on the effect of rotator cuff tears on magnitude and direction of the reaction force at the glenohumeral joint helps clarify the relationship between joint motion, joint compression and stability.

Aged↗
PubMed1999

Denervation of rabbit lacrimal gland increases levels of transferrin and unidentified tear proteins of 44 and 36 kDa.

PURPOSE: The main lacrimal gland secretes proteins and fluid that make up the aqueous component of the tears. Previous reports indicate that the parasympathetic innervation of the gland influences the secretion of protein from the lacrimal gland. We investigated the effect of lacrimal nerve transection on the levels of individual proteins and overall protein concentration in the tear fluid. METHODS: The main lacrimal gland was unilaterally denervated in adult rabbits at the site of nerve entry to the gland. The contralateral gland (sham-operated) had identical surgical manipulations, excluding nerve transection. Tears were collected daily from both eyes for up to 9 days, after which lacrimal glands were collected. SDS-PAGE, densitometric and image analysis, and Western blot were performed. RESULTS: Consistently measurable tear protein bands ranged from 6 kDa to 85 kDa, using densitometric analysis. Lacrimal gland denervation produced a sustained increase in proteins of 85, 44, and 36 kDa in tears and lacrimal gland tissue from the denervated side, compared with the sham-operated side (0.025 > p > 0.001). The band at 85 kDa was identified as transferrin by Western blot. Tears from the denervated glands also showed transient decreases in low molecular weight tear proteins (18, 12/10, and 6 kDa), as well as a decrease in overall protein concentration, compared with tears from sham-operated glands and non-operated glands (p < 0.001). CONCLUSIONS: These results demonstrate that, in rabbit tears, the quantities of transferrin and two unidentified tear proteins, as well as overall protein concentration, are influenced by the sensory and/or autonomic innervation to the lacrimal gland. The decrease in overall tear protein concentration after lacrimal gland denervation may be related to a loss of nerve-regulated secretagogue-induced protein secretion.

Animals↗
PubMed2004

Long-term MRI findings in operated rotator cuff tear.

PURPOSE: To describe magnetic resonance imaging (MRI) findings at long-term follow-up after rotator cuff (RC) tear using standard MRI sequences without fat saturation. MATERIAL AND METHODS: Twenty-eight patients aged 55.8+/-7.6 underwent MRI examination 4.6+/-2.1 years after surgery for RC tear. Standard sequences in oblique coronal, oblique sagittal, and axial planes were obtained. The RC, including re-tears and tendon degeneration, was independently evaluated by two observers. Thickness of the supraspinatus tendon and narrowing of the subacromial space were measured. The clinical outcome was evaluated with the Constant score and compared with the MRI findings. RESULTS: The RC tear was traumatic in 18 (64%) patients and degenerative in 10 (36%). At follow-up, 11 (39%) had normal RC tendons with good clinical outcome. Four (14%) patients had painful tendinosis without RC tear. A full-thickness RC tear was found in 7 (25%) patients and a partial tear in 6 (21%). In one patient with a full-thickness tear, and in two with partial tear, tendinosis was found in another of the RC tendons. The subacromial space was narrowed in 13 (46%) of the patients. A narrowing of the subacromial space correlated with re-tear (P<0.05). CONCLUSIONS: The RC may be evaluated with standard MRI sequences without fat saturation at long-term follow-up. A normal appearance of the RC is correlated with good clinical outcome, while re-tear and tendinosis are associated with pain.

Adult↗
PubMedDate not supplied

Partial interosseous ligament tears of the wrist: difficulty in utilizing either primary or secondary MRI signs.

PURPOSE: Prior reports on scapholunate ligament (SLL) and lunotriquetral ligament (LTL) tears have evaluated complete tears. As these complete tears have markedly different biomechanical manifestations and surgical considerations than do partial tears, we evaluated the accuracy of MR and the usefulness of secondary MR signs to diagnose partial interosseous ligament tears. METHOD: Fifty wrists in 50 patients underwent arthroscopy following 1.5 T MR. Images were evaluated by two independent blinded observers for normal or partially torn SLL and LTL and for three secondary signs potentially seen as mechanical sequelae of tears: osseous offset, arc disruption, or focal osteoarthritis. RESULTS: Arthroscopically, there were 16 SLL and 14 LTL partial tears. Accuracy of primary MR signs of partial tears was lower than that described in the literature for complete tears [sensitivity/specificity (kappa) = 0.56/0.56 (0.12)-SLL, 0.31/0.76 (0.13)-LTL]. Secondary signs showed low sensitivity but high specificity, particularly for LTL tears: arc disruption [0.17/0.83 (0.43)-SLL, 0.0/1.00 (1.0)- LTL], focal osteoarthritis [0.32/0.78 (0.18)-SLL, 0.11/0.91 (0.12)-LTL], and focal osseous offset [0.39/0.75 (0.10)-SLL, 0.26/0.93 (0.39)-LTL]. Additionally, there was poor interobserver consistency for both primary and secondary signs. CONCLUSION: The sensitivity of morphologic evaluation for diagnosing partial intercarpal ligament tears, particularly those of the LTL, is limited. Secondary signs increase specificity but have low sensitivity, and with the exception of arc disruption, all signs had poor interobserver agreement.

Adult↗
PubMed2005

Effect of preservative-free artificial tears on the antimicrobial activity of human beta-defensin-2 and cathelicidin LL-37 in vitro.

PURPOSE: Human beta-defensin-2 (hBD-2) and cathelicidin LL-37 are salt-sensitive cationic antimicrobial peptides expressed by ocular surface epithelia. The goal of this study was to investigate the effect of preservative-free artificial tears on hBD-2 and LL-37 antimicrobial activity against Pseudomonas aeruginosa. METHODS: P. aeruginosa was incubated with hBD-2 or LL-37 in the absence or presence (70% vol/vol) of different preservative-free artificial tears--Visine Tears (300 mOsm/kg), Tears Naturale Free (261 mOsm/kg), TheraTears (185 mOsm/kg), and Refresh Plus (325 mOsm/kg)--for 2 hours at 37 degrees C. In some experiments, P. aeruginosa was incubated with hBD-2 or LL-37 and Visine Tears or Tears Naturale Free with or without carboxymethylcellulose (0.5% vol/vol final concentration). Plates were inoculated with samples of each reaction mixture and then incubated for 24 hours at 37 degrees C. RESULTS: Visine Tears and Tears Naturale Free had little or no effect on the antimicrobial activity of 100 microg/mL hBD-2 or LL-37. In the presence of Refresh Plus and TheraTears, the activity of 100 microg/mL hBD-2 or LL-37 was reduced by 90% to 100%. Carboxymethylcellulose, at a concentration comparable to that present in Refresh Plus, reduced the effectiveness of hBD-2 or LL-37 by 40% to 90% in the presence of Tears Naturale Free and Visine Tears. CONCLUSION: Human beta-defensin-2 and cathelicidin LL-37 inhibit the growth of P. aeruginosa in vitro, but this activity is markedly reduced in the presence of Refresh Plus and TheraTears. These results suggest that carboxymethylcellulose-containing artificial tears may reduce the activity of the endogenously produced antimicrobial peptides.

Anti-Infective Agents↗