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PubMed2002

Effect of artificial tears on corneal surface regularity, contrast sensitivity, and glare disability in dry eyes.

OBJECTIVE: To investigate the effects of artificial tears on corneal surface regularity and visual function in dry eyes. DESIGN: Nonrandomized, comparative trial. PARTICIPANTS: Forty patients (40 eyes) with dry eyes with (group 1, n = 15 eyes) or without (group 2, n = 25 eyes) punctate epithelial keratopathy and a normal control group of 20 individuals (20 eyes) with no ocular abnormalities (group 3). METHODS: In both dry and normal eyes, the surface regularity index (SRI), surface asymmetry index (SAI), and potential visual acuity (PVA) were measured by computer-assisted videokeratography (TMS-1; Computed Anatomy, New York, NY). Spatial-contrast sensitivity and glare disability were also measured before and 1 minute after instillation of artificial tears. MAIN OUTCOME MEASURES: Differences in SRI, SAI, PVA, spatial-contrast sensitivity, and glare disability between groups, before instillation of tears, and within groups, after instillation of tears. RESULTS: Compared with group 3, eyes in group 1 had significantly worse SRI, SAI, PVA, and contrast sensitivity (incomplete glare disability data precluded analysis) before instillation of artificial tears. Differences in corneal surface regularity and visual function between groups 2 and 3 were not significant except for a significantly increased glare disability at low spatial frequency (1.5 cycles per degree [cpd]) in group 2. Significant improvement in SRI, SAI, PVA, and contrast sensitivity were observed after instillation of artificial tears in group 1. In groups 2 and 3, the only significant changes were improvement in glare disability at 1.5 cpd and worsening of the SRI, respectively. CONCLUSIONS: Tear film changes in dry eye patients may lead to irregularities on the corneal surfaces, causing glare disability. However, these changes may be too subtle in the early stages of dry eyes to be detected by corneal topography or contrast sensitivity measurements. Significant improvement in SRI, SAI, PVA, and contrast sensitivity were found after instillation of artificial tears in dry eyes with punctate epithelial keratopathy.

Adult↗
PubMed2003

The educational needs of non-specialist breast care nurses.

AIMS: To provide an indicative occupational profile and identify the educational needs of non-specialist nurses working with breast cancer patients. DESIGN: A postal questionnaire survey, using a modified, but psychometrically validated, training needs analysis instrument. SETTING: The acute and community sectors of three large trusts. PARTICIPANTS: 119 general nurses working with breast cancer patients. FINDINGS: Significant educational needs were identified for all 30 items of the questionnaire, thereby indicating that participants had both general and cancer-specific training needs. However, 13 of the 14 cancer-related items were among the top 19 training needs, suggesting that these should be a priority focus for targeted educational programmes. No differences were found between acute and community nurses, although D grade (newly qualified) nurses had significantly greater educational needs than E grade nurses (with around 2 years' experience post-qualifying). The indicative occupational profile suggested that the most important tasks were perceived to be communication/team-work, self-management, awareness of special psycho-social problems, knowledge of specific clinical issues, and management of the care package; the least relevant tasks were seen to be specific health promotion activities, supervision, using technical equipment and research/audit. CONCLUSION: This sample of general nurses working with breast cancer patients reported both general and specific educational needs. The information yielded by the current survey could be used to inform continuing educational development for this group, and in this way, could inform the content and mode of delivery of its provision. Continuing professional development (CPD) courses which are based on empirical studies of workforce educational needs could rationalise resources and ultimately enhance patient care. The indicative occupational profile could be used as a competency indicator and might also inform CPD provision.

Analysis of Variance↗
PubMed1990

Peritoneal dialysis in the geriatric patient.

Elderly patients on chronic peritoneal dialysis (CPD) from two large chronic peritoneal dialysis programs were compared with younger patients in regard to peritonitis rates, catheter problems, hospital days, transfers to other forms of therapy, and mortality. Peritonitis rates and organisms were similar in younger and older patients. Catheter replacements were less common in the elderly. Differences in hospital days were attributable to hospitalization for vascular disease. The elderly were more likely to have the first episode of peritonitis, to die and to change dialysis modalities at all times after the first year of continuous ambulatory peritoneal dialysis (CAPD) treatment, although other than increased mortality, differences between the two groups were small. CPD appears to be an acceptable form of renal replacement therapy in the elderly.

Aged↗
PubMed1993

Determinants of oxalate balance in patients on chronic peritoneal dialysis.

We assessed plasma levels and removal rates of oxalate in 24 patients on chronic peritoneal dialysis (CPD) for oxalosis-unrelated renal failure. The ion-chromatographic (IC) measurements of oxalate in plasma, dialysate, and urine (in seven patients with residual renal function) were used to calculate peritoneal and renal clearances of oxalate. The serum state of saturation with calcium oxalate was calculated by means of a computer-based model system. Patient data were compared with those from 19 healthy individuals. Peritoneal clearance of oxalate was 6.3 +/- 4.7 mL/min, ie, 8% of the normal renal clearance. As a result, both plasma oxalate and calcium oxalate saturation were higher than in controls and did not overlap. Plasma was supersaturated with calcium oxalate in only two of 24 patients (8%). Removal of oxalate by dialysis was related to the amount of fluid infused. Overall removal of oxalate (dialysate plus urine) was similar to 24-hour excretion of normal subjects and was taken as a measure of its generation. Oxalate generation rate was dependent on protein (whole and animal) intake, but not on caloric intake or pyridoxine status. Pyridoxine supplementation, 75 and 300 mg daily for 1 months, was not effective in reducing plasma levels or generation rates of oxalate. Residual renal function had a minor influence on oxalate patterns. We conclude that current programs are adequate to maintain oxalate balance in patients on CPD under basic conditions.

Adult↗
PubMed2001

Changes of tumor vascularity during gene therapy monitored with color Doppler US.

Using contrast-enhanced color Doppler (CD) sonography, we assessed alterations of tumor blood flow induced in 25 murine Morris hepatomas transfected with a gancyclovir- (GCV-)sensitizing Herpes simplex virus thymidine kinase (HSVtk) suicide gene in combination with systemic GCV treatment and compared findings with a control tumor. CD measurements were quantified by the color pixel density (CPD) and the mean encoded flow velocity (mean color value, MCV), using computer-assisted image analysis, and compared with histologic arteriole counts. During 5 days, the tumor volume remained constant. In HSVtk-expressing tumors, the median CPD dropped from 16% at baseline to 5% on day 5 (p = 0.001), remaining constant in controls. The MCV decreased from 1.9 cm/s to 1.6 cm/s in the HSVtk-expressing tumors (p = 0.001) and rose from 1.8 cm/s to 2.0 cm/s in the controls (p = 0.002). In an accompanying histologic arteriole assay, we found no alterations attributable to treatment.

Animals↗
PubMed2001

Fast and slow neurons in the nucleus of the basal optic root in pigeons.

The nucleus of the basal optic root (nBOR) is involved in the generation of the optokinetic response. Previous studies showed that most nBOR neurons exhibit direction-selectivity in response to largefield motion. We investigated the responses of pigeon nBOR neurons to drifting sine wave gratings of varying spatial and temporal frequency (SF,TF). Two groups of neurons were revealed. The first group preferred gratings of low SF (mean, 0.07 cycles per degree (cpd)) and high TF (mean, 0.76 Hz) ('fast' stimuli). The second group preferred gratings of high SF (mean, 0.56 cpd) and lower TF (mean, 0.33 Hz) ('slow' stimuli). Previous studies have demonstrated fast and slow neurons in pretectal nucleus lentiformis mesencephali, which is also involved in the generation of the optokinetic response.

Animals↗
PubMed1983

[Changes in the rheologic properties of various samples of blood preserved at +4 degrees C].

Apparent stationary viscosity, viscoelasticity and thixotropy measured with a Couette viscosimeter have been determined on blood samples stored in eight anticoagulant and/or preservative solutions. All the results as well as those obtained in a previous morphological study show clearly the advantages of the SAG or PAGGS storage processes. It is observed that the rheological parameters of RBC stored in protein poor media are, between the 30 th and 35 th days, identical on CPD at the first week and with that measured in CPD concentrates between second and third week (for a same hematocrit value). We want to emphasize that the erythrocytes stored in these new media retain for a long time their ability to circulate in the capillary system.

Adenine↗
PubMed1984

[Adaptation of a freezing technic with a low concentration of glycerol for preserving red blood cells resuspended in saline-adenine-glucose].

We describe here a freezing method with a final low concentration of 20% glycerol and storage in a aluminium flask at - 150 degrees C. This technique allows the freezing of red blood cells concentrates collected on CPD and resuspended in SAG, without having to eliminate the SAG solution. For this we used an initial solution of 60% glycerol, which we added to the red blood cell concentrate in two steps separated by a resting time. Accordingly to the final concentration of glycerol, this freezing process is similar to the method currently used in our laboratory. This consists in one step addition V/V of 40% glycerol solution to the CPD red blood cells. The two techniques have been compared after thawing, and washing in a IBM Blood Processor 2991. The following parameters have been studied mainly: --haemoglobin level --residual glycerol --leucocytes and platelets --amount of 2-3 DPG and of intra-erythrocyte ATP. The results of the two freezing techniques are similar. They show that the SAG solution does not impair the intracellular penetration of glycerol. The in vitro qualities of the erythrocytes are well preserved.

Adenine↗
PubMed2001

[Pharmaceutical traceability integrated with the patient file. Development of a computerized hospital application].

The Clinical Pharmacy Department (CPD) of the Gustave Roussy Institute, has developed a traceability software package that is integrated with the patient file. The Traceability & Medical Devices Functional Unit manages the Blood Derivative Medicinal Product traceability circuits, the circuits of over 400 Sterile Medical Devices and, generally speaking, those for all pharmaceutical goods for which traceability is imperative. The SIMBAD-TRACE software package has been developed in situ and was first open for access in March 1999. It enables pharmaceutical traceability data to be accessed from 500 networked workstations. The references tracked generated about 10,000 movements per year. In terms of performance, the system achieves three complementary objectives: 1) reporting traceability scores which reflect the ability of CPD and the establishment to pertinently respond to a complex regulatory requirement on a daily basis; 2) the contribution of the tool to cost containment with respect to allocating rare goods; the contribution of the software package to the implementation of medical device vigilance inquiries, particularly descending inquiries. Finally, SIMBAD-TRACE is one of the pillars of our Quality Assurance Program (QAP).

Equipment and Supplies↗
PubMed2003

Quality of vision after laser in situ keratomileusis: influence of dioptric correction and pupil size on visual function.

PURPOSE: To determine the influence of pupil size and the amount of ablation on visual performance and on the patient's perception of glare or halo after laser in situ keratomileusis (LASIK). SETTING: Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan. METHODS: This study included a random cross-section of 50 eyes of 32 patients with "uniform" topography at least 6 months after LASIK and 51 eyes of 28 patients who had normal corneas. Each LASIK patient completed a survey rating adverse effects such as symptoms of night glare and halo. Pupil diameter and best spectacle-corrected visual acuity (BSCVA) were measured under photopic and scotopic conditions. Contrast sensitivity was measured with an MCT 8000 (Vistech Consultants, Inc.) under daytime and nighttime and with night glare conditions. A Technomed C-scan (Technomed Technology) was performed, and the potential corneal visual acuity (PCVA) was calculated after the settings for the pupil size were changed to the values measured under bright-light or dim-light conditions. RESULTS: No significant difference was found between the post-LASIK and normal cornea groups in photopic or scotopic BSCVA (P>.05). In cases of moderate myopia, the post-LASIK group had decreased PCVA and contrast sensitivity (P<.05). In cases of high myopia, the post-LASIK group had decreased contrast sensitivity at spatial frequencies of 1.5 cycles per degree (cpd) under daytime conditions and 3 cpd under nighttime conditions (P<.05). Glare or halo symptoms did not correlate with scotopic BSCVA, PCVA, or nighttime contrast sensitivity with or without glare (P>.05). Pupil size was not significantly correlated with glare or halo symptoms, BSCVA, or contrast sensitivity under scotopic or photopic conditions (P>.05). In moderate myopia, the amount of attempted correction of the spherical equivalent (SE) was correlated with halo symptoms (P<.05; adjusted r(2) = 0.17). In high myopia, the amount of attempted astigmatism correction was correlated with the development of glare symptoms (P<.05; adjusted r(2) = 0.16). CONCLUSIONS: There was a decrease in contrast sensitivity in post-LASIK eyes. The amount of attempted correction of the SE or astigmatism was correlated with the development of glare and halo symptoms. Pupil size was not significantly correlated with glare or halo symptoms, BSCVA, or contrast sensitivity in post-LASIK patients with "uniform" topography who had scotopic pupils not larger than 7.0 mm.

Adult↗
PubMed2003

Reproducibility of morphoscopic contrast sensitivity testing with the Visual Capacity Analyzer.

PURPOSE: To determine the reproducibility of morphoscopic contrast sensitivity test values in healthy subjects using the Visual Capacity Analyzer (VCA) (L2 Informatique). SETTING: Institute of Vision Research, Department of Ophthalmology, Yong-Dong Severance Hospital, Yonsei University, Seoul, South Korea. METHODS: Five healthy volunteers were recruited for this study. With the VCA, 1 eye of each person was tested with different sized letters displayed on a computer screen at 11 spatial frequencies ranging from low (3.0 cycles/deg [cpd]) to high (30.0 cpd). The measurement was repeated 5 times under 2 screen luminance levels (maximum and 3 cd/m2). RESULTS: Under maximum luminance background, the coefficient of variation (CV) and reliability coefficient (RC) at the spatial frequencies examined ranged from 4.3% to 35.0% and 89.1% to 99.8%, respectively. Under a screen luminance of 3 cd/m2, the CV ranged from 0.5% to 15.9% and the RC, from 97.5% to 100.0%. CONCLUSION: At the spatial frequencies examined, morphoscopic contrast sensitivity testing using the VCA had a high level of reproducibility and may be useful in measuring a patient's visual function in the actual environment.

Adult↗
PubMed1998

Contrast sensitivity after laser in situ keratomileusis.

PURPOSE: To evaluate the effect on contrast sensitivity function of laser in situ keratomileusis (LASIK) for the correction of myopia. SETTING: Alicante Institute of Ophthalmology, University of Alicante, Spain. METHODS: Fourteen eyes of 10 patients had LASIK to correct myopia ranging from 6.00 to 19.50 diopters (D). Mean preoperative myopia was 10.39 D +/- 3.69 (SD). Contrast sensitivity was tested preoperatively and 1, 3, and 6 months postoperatively using the CVS-1000E contrast sensitivity unit (VectorVision). RESULTS: Contrast sensitivity decreased 1 month postoperatively; the decrease was significant only at the low and intermediate spatial frequencies of 3 and 6 cycles per degree (cpd) (P = .034 and .030, respectively). Starting from the first month, there was rapid recovery of contrast sensitivity and at the third month, no statistically significant decrease at all spatial frequencies. Six months after surgery, there was an increase in contrast sensitivity values at 3, 12, and 18 cpd, although the changes were not significant. CONCLUSION: Although LASIK decreased contrast sensitivity values at low and intermediate spatial frequencies for 1 month after surgery, these values rapidly returned to the preoperative values at 3 months. The improvement at certain frequencies at 6 months suggests that LASIK can improve the quality of vision in eyes with moderate and high myopia.

Adult↗
PubMed1999

Role of clearance and treatment zones in contrast sensitivity: significance in refractive surgery.

PURPOSE: To evaluate the relationship between contrast sensitivity, surgical treatment zone, and clearance (ablation or clear zone-pupil diameter) in photorefractive keratectomy (PRK) and radial keratotomy (RK). SETTING: Saint Louis University Eye Institute, St. Louis, Missouri, and Hunkeler Eye Center, Kansas City, Missouri, USA. METHODS: Thirteen patients had PRK and 20, RK. Contrast sensitivity was measured with the Stereo Optical F.A.C.T. (F.A.C.T.) and VectorVision CSV-1000 (VV) charts. Pupils were measured with the Rosenbaum card. RESULTS: In the PRK group, VV contrast sensitivity at 6 and 12 cycles per degree (cpd) correlated with the ablation zone (r2 = 0.18 and 0.22, respectively), while visual acuity and F.A.C.T. contrast sensitivity did not correlate. In the RK group, both VV and F.A.C.T. contrast sensitivity at 6 cpd correlated with clearance (r2 = 0.29 and 0.12, respectively). Pupils were larger with the VV test than with the F.A.C.T. chart because ambient chart luminance was less in the former. CONCLUSION: Contrast sensitivity is likely a more sensitive indicator of visual function than acuity in refractive surgery. The VV system unmasks aberrations from the transition zone of ablated and unablated cornea in PRK. Larger samples are needed to determine the critical ablation clearance of the pupil to avoid loss of visual function.

Adult↗
PubMed2001

The SOS-dependent upregulation of uvrD is not required for efficient nucleotide excision repair of ultraviolet light induced DNA photoproducts in Escherichia coli.

We have shown previously that induction of the SOS response is required for efficient nucleotide excision repair (NER) of the major ultraviolet light (UV) induced DNA lesion, the cyclobutane pyrimidine dimer (CPD), but not for repair of 6-4 photoproducts (6-4PP) or for transcription-coupled repair of CPDs [1]. We have proposed that the upregulation of cellular NER capacity occurs in the early stages of the SOS response and enhances the rate of repair of the abundant yet poorly recognized genomic CPDs. The expression of three NER genes, uvrA, uvrB, and uvrD, is upregulated as part of the SOS response. UvrD differs from the others in that it is not involved in lesion recognition but rather in promoting the post-incision steps of NER, including turnover of the UvrBC incision complex. Since uvrC is not induced during the SOS response, its turnover would seem to be of great importance in promoting efficient NER. Here we show that the constitutive level of UvrD is adequate for carrying out efficient NER of both CPDs and 6-4PPs. Thus, the upregulation of uvrA and uvrB genes during the SOS response is sufficient for inducible NER of CPDs. We also show that cells with a limited NER capacity, in this case due to deletion of the uvrD gene, repair 6-4PPs but cannot perform transcription-coupled repair of CPDs, indicating that the 6-4PP is a better substrate for NER than is a CPD targeted for transcription-coupled repair.

Adenosine Triphosphatases↗
PubMed1998

Evaluation of CAPTURE CMV solid phase testing over the allowable shelf-life of red blood cells (adenine-saline added).

BACKGROUND: CAPTURE CMV (IMMUCOR Inc., Norcross, GA) is a solid-phase screening test used to detect IgM and IgG antibodies to cytomegalovirus (CMV). CAPTURE CMV is licensed for testing whole blood (WB) in citrate phosphate dextrose (CPD) preserved segments of units of red blood cells (RBC) only up to 7 days of storage. We determined if CAPTURE CMV could produce consistent results in CPD preserved WB segments from RBC adenine-saline added (ASA) for their 42 day shelf-life. METHODS: Ten CMV-seropositive and 10 CMV-seronegative RBC (ASA) tested by CAPTURE CMV during the first week of storage were studied. Segments were tested weekly for 6 weeks. RESULTS: All 10 units that initially tested as CMV-seropositive remained strongly seropositive. All 10 units initially CMV-seronegative, remained seronegative. CONCLUSION: CAPTURE CMV testing provides consistent results over the entire shelf-life of RBC (ASA).

Adenine↗
PubMed1999

Increased anticoagulant osmolality improves separation of leukocytes from red blood cells (RBC).

BACKGROUND: The bottom-and-top (BAT) procedure separates the buffy coat (BC) from plasma and red blood cells (RBC). The contents of mononuclear cells (MNC) remaining in the RBC are about 1 x 10(6) cells/unit, whereas the granulocytes are removed less effectively, 500-800 x 10(6) or more remaining in the RBC unit. The aim was to improve the separation efficacy by collecting the blood in an hyperosmolar anticoagulant, followed by BAT separation. It was expected that the red cells would shrink, thereby increasing their density, while the granulocytes would not change volume and density. STUDY DESIGN AND METHODS: 18 donors were included in the study, 12 in the test group and 6 in the control group. CPD-SAGM bags were used, with a modification of the anticoagulant by removal of 20-ml CPD from all units and addition of 20-ml mannitol (test group) or 20 ml of isotonic saline (control group). The collected blood units were cooled on butanediol plates for 2-4 h, then centrifuged and separated into components. The levels of leukocytes in the whole blood, the BC and the RBC were determined by flow cytometry gated for intact CD45+ cells. A number of other tests were performed during 42-day storage. RESULTS: The plasma yield was slightly higher in the test group than in the control group (ns). The contents of leukocytes (CD 45+ intact cells) in the RBC units were 32 +/- 20 x 10(6) in the test group and 573 +/- 241 x 10(6) in the control group. The numbers of MNC were 1.2 +/- 0.6 x 10(6) and 2.6 +/- 1.8 x 10(6), respectively. The RBC 2,3-DPG concentration was slightly better maintained in the test group at day 7 of refrigerated storage (p = 0.0027), but most other tested parameters showed no difference during 42-day storage. It was possible to prepare platelet concentrates with good yield using the pooled-BC method. CONCLUSION: This study indicates that considerable improvement in the BAT procedure can be obtained if the anticoagulant is made hypertonic by the addition of mannitol. This is achieved without altering the already low levels of MNC and keeping the same quality.

Anticoagulants↗
PubMed2001

Biological consequences of cyclobutane pyrimidine dimers.

In the skin many molecules may absorb ultraviolet (UV) radiation upon exposure. In particular, cellular DNA strongly absorbs shorter wavelength solar UV radiation, resulting in various types of DNA damage. Among the DNA photoproducts produced the cyclobutane pyrimidine dimers (CPDs) are predominant. Although these lesions are efficiently repaired in the skin, this CPD formation results in various acute effects (erythema, inflammatory responses), transient effects (suppression of immune function), and chronic effects (mutation induction and skin cancer). The relationships between the presence of CPD in skin cells and the subsequent biological consequences are the subject of the present review.

Animals↗
PubMed2001

Effect of xenogenic repair enzymes on photoimmunology and photocarcinogenesis.

Exposure to ultraviolet B (UVB) radiation leads to an increased generation of UVB-induced skin damage in humans. The most important UVB-induced side effects are UVB-induced immunosuppression and photocarcinogenesis and there is a large body of evidence that cyclobutane pyrimidine dimers (CPD) induced by UVB radiation play a pivotal role in both processes. The topical application of DNA repair enzymes is a new innovative strategy to reduce the amount of CPDs in human skin. Two different methods have recently been established. The use of T4 endonuclease V was of clinical efficacy in protecting patients with a nucleotide excision repair defect from premalignant and malignant skin lesions. Application of photolyase, a xenogenic enzyme which has been found in different organisms is also capable of removing UVB-induced CPD from normal human skin cells in vivo and appears to be more effective than T4 endonuclease V in damage removal. Photolyase encapsulated in liposomes may have in the near future a broad use as an active ingredient in modern skin care products.

Animals↗