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PubMed1993

Decentralization of the superior cervical ganglia inhibits mast cell mediated TNF alpha-dependent cytotoxicity. 1. Potential role of salivary glands.

Decentralization or ganglionectomy of the superior cervical ganglia (SCG) reduces pulmonary inflammation, as well as chemotaxis and activation of circulating neutrophils. However, the protective effect of decentralization was abolished when combined with removal of the submandibular glands (sialadenectomy) in the same animals. Thus, it has been postulated that the submandibular glands (SMG) release an anti-inflammatory factor(s) that is controlled by cervical sympathetic nerves. Decentralization of SCG did not modify in vitro histamine release or in vivo levels of rat mast cell protease II, but it reduced mast cell (MC)-mediated tumor necrosis factor alpha (TNF alpha)-dependent cytotoxicity. Combined decentralization/sialadenectomy abrogated the inhibition of MC cytotoxic activity, as we have shown previously for pulmonary inflammation and neutrophil functions. However, sialadenectomy alone inhibited MC-mediated TNF alpha-dependent cytotoxicity, an observation which suggests that SMG produce a factor(s) that can potentiate MC cytotoxic activity. Studies of the effects of SMG-derived factors, such as epidermal growth factor, nerve growth factor, and transforming growth factor beta (TGF beta), showed that only pretreatment of MCs with TGF beta 10(-8) g/ml inhibited MC-mediated TNF alpha-dependent cytotoxicity. Thus, the modulation of MC-mediated TNF alpha-dependent cytotoxicity by cervical sympathetic innervation and SMG is complex and distinct from the modulation of pulmonary inflammation and neutrophil functions identified previously.

Animals↗
PubMedDate not supplied

Influence of selective autonomic decentralization on myocardial deoxyglucose uptake initiated by cardio-cardiac reflexes.

UNLABELLED: The aim of this study was to evaluate the effect of autonomic reflexes as initiated by stimulation of the right recurrent cardiopulmonary nerve afferent axons on myocardial deoxyglucose uptake and to determine how such uptake can be modified by selective neural ablation. The afferent axon in the right recurrent cardiopulmonary nerve was stimulated 30 s/min for 1 h in five anesthetized open-chest dogs in which 14-C labeled deoxyglucose was i.v. injected at the beginning of the stimulation period. Three additional sham-operated dogs served as neurally intact controls. Concentrations of label and glucose were measured in plasma. Regional myocardial deoxyglucose concentration was measured by quantitative autoradiography, following the calibration of plasma samples autoradiographic density by beta counting. Stimulation of right recurrent cardiopulmonary nerve afferent axons in the intact nervous system preparation did not significantly enhance deoxyglucose uptake as compared to neurally intact controls. When the right cervical vagosympathetic complex was cut a similar uptake was observed. Following decentralization of the right stellate ganglion, uptake was markedly reduced, as well as when the right cervical vagosympathetic was cut and the right stellate ganglion decentralized. CONCLUSIONS: Activation of afferent axons from cardiopulmonary receptors does not alter myocardial deoxyglucose uptake. Reduction in uptake occurs following unilateral stellate ganglion decentralization.

Animals↗
PubMed1994

Tilt and decentration of bag-fixated intraocular lenses: a comparative study between capsulorhexis and envelope techniques.

Malposition of an intraocular lens (IOL) may cause symptoms such as glare, halos, and other visual aberrations. The purpose of this study is to determine the effect of two different anterior capsulotomy techniques on IOL tilt and decentration. Bag-fixated IOL implantation after uncomplicated extracapsular cataract extraction was performed using both envelope (65 eyes) and continuous circular capsulorhexis (CCC) technique (42 eyes). Eyes were followed-up at least 6 months postoperatively. While the mean IOL decentration after envelope technique was found to be 0.65 mm, this was 0.15 mm after CCC technique. On the other hand, the mean actual tilting angle of IOL after envelope technique was 5.66 degrees, whereas this was 1.13 degrees after CCC technique. The aforementioned differences were statistically significant (p < 0.01, and p < 0.01). Furthermore, in 17 eyes (26.1%) where envelope technique and in 29 (69.0%) eyes where CCC technique was used demonstrated no IOL tilt and decentration. This study shows that the CCC technique may result in less optical problems due to IOL malposition compared to the envelope technique.

Adult↗
PubMed1993

Co-localization of the beta-subtype of protein kinase C and phosphorylation-dependent immunoreactivity of neurofilaments in intact, decentralized and axotomized rat peripheral neurons.

The localizations of protein kinase C-beta-immunoreactivity and phosphorylation-dependent immunoreactivity of neurofilaments were compared in rat dorsal root, hypogastric, and superior cervical ganglia. In all the ganglia studied, protein kinase C-beta and phosphorylation-dependent immunoreactivity of neurofilaments were co-localized in nerve fibres, and no fibres with only protein kinase C-beta-immunoreactivity or phosphorylation-dependent immunoreactivity of neurofilaments were observed. Most intense perikaryal protein kinase c-beta and phosphorylation-dependent neurofilament-staining were seen in large dorsal root ganglion neurons, whereas in the superior cervical ganglion only very faint protein-kinase C-beta and no phosphorylation-dependent staining was seen in the neuronal cell bodies. Both decentralization and axotomy of the superior cervical ganglion induced an accumulation of protein-kinase C-beta-immunoreactivity and phosphorylation-dependent immunoreactivity of neurofilaments in the majority of neuronal perikarya. The accumulation was first observed at 1-2 days postoperation and it persisted up to 6-10 days postoperation. In strongly labelled decentralized neuronal perikarya, precipitation of immunoreactivity was seen near the cell and nuclear membranes, whereas in axotomized neurons, immunoreactivity was often concentrated as a unipolar clump in the cytoplasm. The results show that protein kinase C-beta-immunoreactivity and phosphorylation-dependent immunoreactivity of neurofilaments are colocalized in intact rat peripheral ganglia and that both accumulate transiently in cell bodies of the superior cervical ganglion after decentralization and axotomy.

Animals↗
PubMed1983

Absence of decremental response in decentralized muscles of a myasthenic patient.

Decentralized muscles of patients with upper motoneurone lesions may show anomalous responses to drugs acting on acetylcholine receptors. We compared the effects produced by repetitive nerve stimulation on normal and decentralized muscles of a patient with myasthenia gravis admitted to our Institute for a right hemiparesis. A myasthenic response was observed on the left (unaffected) deltoid muscle and a normal response on the opposite (paretic) side. It is suggested that decentralization might alter the functional properties of junctional receptors.

Aged↗
PubMed2001

[Refraction, anterior chamber depth, decentration and tilt after implantation of monofocal and multifocal silicone lenses].

BACKGROUND: We prospectively investigated changes in refraction, anterior chamber depth, decentration and tilt after implantation of multifocal (MIOL) and monofocal (MONO) intraocular lenses (IOL). PATIENTS AND METHODS: We examined 103 cataractous eyes from 103 patients receiving either a three-piece monofocal or multifocal silicone IOL. Anterior chamber depth (ACD), amount of IOL decentration, and degree of IOL tilt were quantified using retroillumination and Scheimpflug photographs. Examinations, including subjective refraction, were performed preoperatively, one week and 6 months postoperatively. RESULTS: All eyes were within 2 dpt (spherical equivalent) from the target refraction, and 93% of eyes with a MIOL were within 1 dpt. No significant refractive shift or ACD change occurred during the postoperative course. Median tilt in the MIOL group at 6 months was 1.1 degrees (0-2.6) and that in the MONO group 1.0 degree (0-2.5). There was no statistically significant change in intraindividual IOL decentration or tilt. CONCLUSION: Three-piece silicone MIOLs and MONOs with polymethylmethacrylate haptics implanted in the capsular bag after circular capsulorhexis provide good centration and very little tilt without statistically significant change up to 6 months after surgery. Postoperative refractive shift is of minor concern for 6 months after surgery.

Adult↗
PubMed1987

Effect of total sympathectomy and of decentralization on migrating complexes in dogs.

The effect of total sympathectomy and of decentralization on interdigestive myoelectric activity of the stomach and small intestine and on cycling levels of plasma motilin were studied in conscious dogs. In controls, 98.3% +/- 7.9% of the migrating myoelectric complexes (mean +/- SD) originated in the stomach. In sympathectomized dogs, 38.17% +/- 16.7% originated in the stomach, 35.8% +/- 12.3% in the duodenum, and 26.3% +/- 4.3% in the jejunum. In decentralized dogs, 5.3% +/- 1.4% of the migrating myoelectric complexes originated in the stomach, 71.0% +/- 16.5% in the duodenum, and 23.9% +/- 17.4% in the jejunum. Cycling of plasma motilin was not affected by long-term sympathectomy but coordination of peak levels of plasma motilin and initiation of gastric migrating myoelectric complexes was disrupted in decentralized dogs. These data suggest that central nervous input is required for initiation of migrating myoelectric complexes in the stomach and that central vagal but not central sympathectic input is essential for cycling of plasma motilin.

Animals↗
PubMed1995

Decentralization of health services in Western Highlands Province, Papua New Guinea: an attempt to administer health service at the subdistrict level.

In 1990, Western Highlands Province in Papua New Guinea, decentralized the administration of health services from the province (population 264,000) to 14 districts (equivalent to subdistricts elsewhere). Two years later interviews were conducted with health workers and district and provincial heads. Productivity data were obtained from the provincial health information system and financial data from the provincial and national budgetary report. Health workers had a predominately negative opinion of the results of the decentralization. The most common complaints listed were lack of qualifications of District Assistant Secretaries, a diversion of funds to other programs, unavailability of transportation, a lack of equity in personnel between districts and a lack of adequate professional supervision. The problems which developed in this attempt at further decentralization related to a lack of professional support and oversight of health professionals, a lack of role definition for provincial and district administrators, lack of management training for district officials, inadequate oversight by local elected officials and inadequate budgets.

Adolescent↗
PubMed2004

Influence of intraocular lens tilt and decentration on wavefront aberrations.

PURPOSE: To investigate the influence of intraocular lens (IOL) tilt and decentration on higher-order aberrations (HOAs) using wavefront analysis. SETTING: Department of Ophthalmology, Nara Medical University, Nara, Japan. METHODS: Forty eyes of 40 patients with a 5.5 mm optic, foldable acrylic IOL were examined 4 to 48 months postoperatively. Ocular wavefront aberrations of the central 4.0 mm aperture diameter were measured using a Hartmann-Shack aberrometer. Higher-order aberrations from the 3rd to 4th order were calculated using Zernike polynomials. The relationship between IOL tilt and decentration, measured with a Scheimpflug camera, and ocular HOAs were investigated. RESULTS: The correlation between IOL tilt and coma-like aberrations was significant (r=0.431, Spearman rank correlation coefficient; P=.007). However, the correlation between IOL tilt and the spherical-like and total aberrations was not significant (P>.05), nor was the correlation between IOL decentration and coma-like, spherical-like, and total aberrations (P>.05). CONCLUSIONS: Intraocular lens tilt influenced ocular coma-like aberrations. The quality of the retinal image may improve by reducing IOL tilt.

Aged↗
PubMed2006

Decentred comparative research: Context sensitive analysis of maternal health care.

Cross-national comparison is an important tool for health care research, but too often those who use this method fail to consider important inter-national differences in the social organisation of health care and in the relationship between health care practices and social experience. In this article we make the case for a context-sensitive and reflexive analysis of health care that allows researchers to understand the important ways that health care systems and practices are situated in time and place. Our approach--decentred comparative research--addresses the often unacknowledged ethnocentrism of traditional comparative research. Decentred cross-national research is a method that draws on the socially situated and distributed expertise of an international research team to develop key concepts and research questions. We used the decentred method to fashion a multilevel framework that used the meso level of organisation (i.e., health care organisations, professional groups and other concrete organisations) as an analytical starting point in our international study of maternity care in eight countries. Our method departs from traditional comparative health systems research that is most often conducted at the macro level. Our approach will help researchers develop new and socially robust knowledge about health care.

Delivery of Health Care↗
PubMed1997

Corneal topographic evaluation of decentration in photorefractive keratectomy: treatment displacement vs intraoperative drift.

PURPOSE: To evaluate treatment displacement and movement during treatment (drift) after excimer laser photorefractive keratectomy using tangential topographic maps. METHODS: Forty-eight eyes of 48 patients showing axial decentration of 0.30 mm or more at 1 month posttreatment were reevaluated retrospectively to determine treatment displacement of the center of the photorefractive keratectomy ablation from the center of the pupil. A drift index was calculated to determine the relative degree of movement (drift) during treatment. We subdivided patients into four groups based on the degree of treatment displacement and drift and compared the mean axial decentration and the mean best-corrected logMAR visual acuity among the subgroups. RESULTS: Mean treatment displacement +/- SD from the center of the entrance pupil was 0.34 +/- 0.21 mm. Thirty-eight eyes (79.2%) had ablations within 0.50 mm from the center of the entrance pupil. We observed downward displacement in 27 eyes (56.2%) and upward displacement in 21 eyes (43.8%). The drift index showed a positive, statistically significant correlation with best-corrected visual acuity (r = .58, P < .0001). Patients with low displacement and low drift had mean logMAR best-corrected visual acuity of 0.91, which was statistically significantly better than patients with high displacement and high drift (r = 0.64; P = .009). CONCLUSIONS: In patients with gross decentration by axial topography after photorefractive keratectomy, tangential corneal topography is valuable in evaluating and differentiating photorefractive keratectomy treatment displacement from movement during treatment (drift). Patients with high drift index have worse visual outcomes after photorefractive keratectomy than those exhibiting high treatment displacement.

Cornea↗
PubMed1985

The effect of parasympathetic decentralization on the feline urinary bladder.

To examine the pharmacologic nature of parasympathetic decentralization on feline vesical smooth muscle, male cats were subjected to bilateral ventral rhizotomy from levels lumbar 7 to coccygeal 1 and studied at 1 and 3 months. By employing manual bladder decompression twice daily, compensatory bladder hypertrophy was absent or minimal in all specimens. In vitro muscle bath studies of bladder body demonstrated no significant end organ pharmacologic supersensitivity to cholinergic or alpha and beta adrenergic stimulation. Membrane receptor assays displayed a rise in muscarinic cholinergic and beta adrenergic receptors at 1 month which decreased at 3 months. The cholinergic receptor data parallels ultrastructural studies which demonstrate early cholinergic nerve terminal degeneration after motor decentralization followed by subsequent regrowth of cholinergic axons. Alpha 1 and alpha 2 adrenergic receptor densities remained constant in control, 1 month, and 3 month preparations. This lack of classic end organ denervation supersensitivity in the decentralized urinary bladder suggests that other mechanisms may be responsible for eliciting a positive response with the clinical denervation supersensitivity test.

Animals↗
PubMed1988

Decentration of flexible loop posterior chamber intraocular lenses in a series of 222 postmortem eyes.

Two hundred twenty-two postmortem eyes containing posterior chamber intraocular lenses (IOLs) were analyzed for optic decentration in relationship to lens style, implant duration, and loop fixation site. Decentration values were not affected significantly by either lens style or implant duration. In 33.3% of specimens, both loops were situated within the lens capsular sac, 18.0% had both loops fixated in the ciliary sulcus, and in 48.7% one loop was fixated in the lens capsular sac and the opposite loop in the ciliary sulcus or zonular region. There was a statistically significant difference in the amount of decentration in the three fixation groups studied. Capsular fixation provides the best and most consistent centration compared with fixation of both loops in the ciliary sulcus or asymmetrical fixation with only one loop in the capsular sac.

Ciliary Body↗
PubMed2000

Sympathetic decentralization abolishes increased secretion of immunoglobulin A evoked by parasympathetic stimulation of rat submandibular glands.

Salivary secretion of immunoglobulin A (IgA) in response to electrical stimulation of the parasympathetic nerve supply was assessed bilaterally in the submandibular glands of anaesthetized rats 1 week following unilateral pre-ganglionic sympathectomy (decentralization). Nerve-mediated stimulation on the non-denervated side increased IgA secretion several fold above an unstimulated rate of secretion whereas sympathetic decentralization reduced the parasympathetically stimulated secretion of IgA without affecting the basal rate. Glandular levels of IgA were increased following decentralization compared to the control glands. Salivary levels of free secretory component (FSC), the cleaved polymeric immunoglobulin receptor (plgR), were increased by parasympathetic stimulation and reduced by sympathectomy, though not as much as IgA. The decreased secretion of FSC suggests a reduced production of plgR and may account in part, for reduced IgA secretion following long-term removal of sympathetic nerve impulses.

Animals↗
PubMed2001

Early decentration of plate-haptic silicone intraocular lenses.

We report 4 eyes of a consecutive series of 1299 that developed early decentration of a 10.5 mm diameter plate-haptic silicone intraocular lens (IOL) after uneventful phacoemulsification. All eyes had an intact continuous curvilinear capsulorhexis (CCC) with the IOL placed in the capsular bag. After an initial period of good vision, patients noted the onset of glare or monocular diplopia between 1 and 5 weeks after surgery. On examination, there was no significant anterior capsule contraction; however, the edge of the IOL optic was visible in the undilated pupil. There was adhesion between the anterior and posterior capsules at the margin of the CCC that maintained the IOL decentration. Decentration recurred in 1 eye after the IOL was rotated 90 degrees and recentered. Symptoms resolved in 3 eyes after the IOL was removed and replaced with a rigid IOL with a larger diameter optic.

Device Removal↗
PubMed2001

Increased higher-order optical aberrations after laser refractive surgery: a problem of subclinical decentration.

PURPOSE: To study the clinical and theoretical effects of subclinical decentrations on the optical performance of the eye after photorefractive laser surgery. SETTING: Department of Ophthalmology, University of Dresden, Dresden, Germany. METHODS: Ocular aberrations were determined before and 1 month after uneventful photorefractive keratectomy (PRK) with the Multiscan laser (Schwind) in 10 eyes of 8 patients. The corrections ranged from -2.5 to -6.0 diopters, and ablation zones of 6.0 mm and larger were used. The measured wavefront errors were compared to numerical simulations using the individually determined decentrations and currently used ablation profiles. RESULTS: The PRK-induced aberrations were significantly greater than the preoperative aberrations. The numerically calculated increase in the higher-order optical aberrations correlated with the clinical results, demonstrating a major increase in coma- and spherical-like aberrations. Subclinical decentration (less than 1.0 mm) was found to be a major factor in increased coma-like and spherical-like aberrations after corneal laser surgery. CONCLUSION: To minimize higher-order optical errors, special efforts to center the ablation zone are necessary; for example, by eye-tracking systems that consider the visual axis.

Astigmatism↗
PubMed2004

Phakic toric intraocular lens implantation after flap decentration in laser in situ keratomileusis.

We describe a patient with flap decentration after laser in situ keratomileusis (LASIK) and subsequent phakic toric intraocular lens (IOL) implantation. A 19-year-old man with mixed astigmatism had LASIK in the left eye complicated by flap decentration. Laser ablation was abandoned and implantation of a phakic toric IOL was done. Ten months after IOL implantation, the uncorrected visual acuity in the left eye was 20/25 and best corrected visual acuity was 20/20 with +0.25 -0.50 x 90. Simulated keratometry values were 44.30@150 and 42.00@60 before LASIK and 45.00@150 and 41.90@60 after IOL implantation. Phakic toric IOL implantation may be adequate treatment for flap decentration after LASIK in cases of mixed astigmatism.

Adult↗
PubMed1988

Measurement of intraocular lens decentration and tilt in vivo.

A method for measuring the tilt and decentration of intraocular lenses (IOLs) in the static eye using the Purkinje image locations is presented. The patient fixates on a target that is coaxial with the camera or is at a predetermined angle with the camera axis. A telecentric stop is introduced in the camera so the positions of the Purkinje images on the film are independent of their distance from the camera. Measurements of the image locations on the film are used with anterior chamber depth and corneal curvature measurement to calculate the tilt and decentration of the IOL. In a group of 14 randomly selected patients with posterior chamber IOLs, 13 gave Purkinje images that could be measured. The average tilt was 7.8 degrees and the average decentration was 0.7 mm.

Humans↗