Phacoemulsification in anterior megalophthalmos

This case outlines the phacoemulsification technique used to overcome the challenge of the hyperdeep anterior chamber, weak zonules, abnormal anterior capsule, and large capsular bag. Key steps included trypan blue staining of the anterior capsule, a large capsulorhexis, prolapse of the nucleus into the anterior chamber with phacoemulsification anterior to the capsulorhexis, and a posterior chamber-placed iris-clip intraocular lens. Successful visual rehabilitation is achievable in these anatomically challenging eyes. © 2006 ASCRS and ESCRS.

Primary cilia in vertebrate corneal endothelial cells

The presence of primary cilia in corneal endothelial cells of a range of species from six non-mammalian vertebrate classes (Agnatha, Elasmobranchii, Amphibia, Teleostei, Reptilia, and Aves) is examined by scanning and transmission electron microscopy. Our aim is to assess whether these non-motile cilia protruding into the anterior chamber of the eye are a consistent phylogenetic feature of the corneal endothelium and if a quantitative comparison of their morphology is able to shed any new light on their function. The length (0.42-3.80 mum) and width (0.12-0.44 mum) of the primary cilia varied but were closely allied with previous studies in mammals. However, interspecific differences such as the presence of a terminal swelling in the Teleostei and Amphibia suggest there are functional differences. Approximately one-third of the endothelial cells possess cilia but the extent of protrusion above the cell surface varies greatly, supporting a dynamic process of retraction and elongation. The absence of primary cilia in primitive vertebrates (Agnatha and Elasmobranchii) that possess other mechanisms to control corneal hydration suggests an osmoregulatory and/or chemosensory function. (C) 2003 Elsevier Ltd. All rights reserved.

Perforated corneal hydrops treated with sulfur hexafluoride (SF6) gas and tissue adhesive

Purpose: To report a case of a perforated acute hydrops in a mentally retarded patient that was successfully managed with intracameral sulfur hexafluoride gas and cyanoacrylate tissue adhesive. Methods: Interventional case report. Results: A 14-year-old mentally retarded male patient with keratoconus presented with a perforated acute hydrops. A bandage contact lens was applied. However, following a large emesis 2 days later, the aqueous leak worsened with shallowing of the anterior chamber. Under general anesthesia, sulfur hexafluoride was injected to reform the anterior chamber and cyanoacrylate tissue adhesive was applied to the perforated site and covered by a bandage contact lens and temporary tarsorrhaphy. A follow-up examination at 1 month showed a formed anterior chamber with tissue adhesive in situ and no aqueous leak. Conclusions: The successful use of intracameral sulfur hexafluoride and tissue adhesive in the management of perforated acute hydrops may avoid emergency tectonic penetrating keratoplasty and reduce potential complications in the poorly cooperative patient.

Anterior adhesive areas and adjacent secretions in the parasitic flatworms Decacotyle lymmae and D. tetrakordyle (Monogenea: Monocotylidae) from the gills of stingrays

The monogeneans Decacotyle lymmae and D. tetrakordyle (Monocotylidae: Decacotylinae), from gills of the dasyatid stingrays Taeniura lymma and Pastinachus sephen, respectively, have a single aperture for adhesive secretion on each side of the anterior ventrolateral region. Rod-shaped bodies (S1) and electron-dense spherical secretion (S2) exit through specialised ducts opening adjacent to one another within these apertures. The S1 bodies are 230 +/- 11 nm wide and greater than or equal to4 mum long in D. lymmae and 240 +/- 9 nm wide and greater than or equal to3.3 mum long in D. tetrakordyle. The S2 bodies have a diameter of 88 +/- 7 nm in D. lymmae and 65 +/- 6 nm in D. tetrakordyle. The apertures are unusual in being extremely small (internal diameter, 3-5 mum). Each aperture has a slit-like surface opening as small as 160 nm wide, surrounded by muscle fibres indicating that they may be opened and closed. The aperture is also surrounded and underlain by muscle fibres that may aid in secretion from, or even eversion of, the tissue within the aperture. Sensilla/cilia are also found within the apertures. Additional secretions from anteromedian and anterolateral glands (body glands), each containing granular secretions, occur in profusion and exit anteriorly and posteriorly to the position of the apertures, through duct openings in the general body tegument. These granular secretions do not appear to be associated with anterior adhesion. Both species show similarities in aperture, underlying tissue, sense organ, and secretion detail, in accordance with findings from other monogenean genera, and which supports the importance of such data for phylogenetic studies.

Neuromuscular efficiency of the sternocleidomastoid and anterior scalene muscles in patients with chronic neck pain

Purpose: This study compared the neuromuscular efficiency (NME) of the sternocleidomastoid (SCM) and anterior scalene (AS) muscles between 20 chronic neck pain patients and 20 asymptomatic controls. Method: Myoelectric signals were recorded from the sternal head of SCM and the AS muscles as subjects performed sub-maximal isometric cervical flexion contractions at 25 and 50% of the maximum voluntary contraction (MVC). The NME was calculated as the ratio between MVC and the corresponding average rectified value of the EMG signal. Ultrasonography was used to measure subcutaneous tissue thickness over the SCM and AS to ensure that differences did not exist between groups. Results: For both the SCM and AS muscles, NME was shown to be significantly reduced in patients with neck pain at 25% MVC (p < 0.05). Subcutaneous tissue thickness over the SCM and AS muscles was not different between groups. Conclusions: Reduced NME in the superficial cervical flexor muscles in patients with neck pain may be a measurable altered muscle strategy for dysfunction in other muscles. This aberrant pattern of muscle activation appears to be most evident under conditions of low load. NME, when measured at 25% MVC, may be a useful objective measure for future investigation of muscle dysfunction in patients with neck pain.

Traumatic tear of tibialis anterior during a Gaelic football game: A case report

Reports of traumatic injury to the anterior lower leg muscles are scarce, with only a handful of reports of traumatic injury to the tibialis anterior. A database search of Medline, Cinhal, and Sports Discus only revealed three such cases, and they did not result from a direct sporting injury. This report documents the case of a traumatic rupture of tibialis anterior muscle in a young female Gaelic football player. It details the surgical repair and management of tibialis anterior muscle and the physiotherapy rehabilitation to full function.

Mechanism of adhesion and detachment at the anterior end of Merizocotyle icopae (Monogenea : Monocotylidae) including ultrastructure of the anterior adhesive matrix

The anterior adhesive mechanism was studied for Merizocotyle icopae (Monogenea: Monocotylidae). Adult anterior apertures can open and close. In addition, duct endings terminating within the apertures are everted or retracted depending on the stage of attachment. Adhesive in adults is synthesized from all 3 secretory types (rod-shaped, small and large spheroidal bodies) found within anterior apertures. All exit together and undergo mixing to produce the adhesive matrix, a process that depletes duct contents. A greater number of ducts carrying rod-shaped bodies is depleted than ducts containing spheroidal bodies which changes the ratio of secretory types present on detachment. Detachment involves elongation of duct endings and secretion of additional matrix as the worm pulls away from the substrate. The change in secretory type ratio putatively modifies the properties of the secreted matrix enabling detachment. Only after detachment do ducts refill. During attachment, individual secretory bodies undergo morphological changes. The larval and adult adhesive matrix differs. Anterior adhesive in oncomiracidia does not show fibres with banding whereas banded fibres comprise a large part of adult adhesive. The data Suggest that this is the result of adult spheroidal secretions modifying the way in which the adult adhesive matrix forms.

Mechanism of adhesion and detachment at the anterior end of Neoheterocotyle rhinobatidis and Troglocephalus rhinobatidis (Monogenea : Monopisthocotylea : Monocotylidae)

The anterior adhesion and detachment mechanisms observed for Neoheterocotyle rhinobatidis and Troglocephalus rhinobatidis (Monogenea: Monocotylidae) appear similar to those observed for the two other monopisthocotylean monogenean species with anterior apertures for which published data are available. This supports the theory that monogeneans with apertures may utilise a common mechanism. Adult anterior apertures can open and close and duct endings can evert during the adhesion phase and retract during detachment and searching behaviour. The adhesive is comprised of two secretory types, rod-shaped and spheroidal bodies, found within anterior apertures. These exit together and undergo mixing to produce the adhesive matrix in which elongate membranes from rod-shaped bodies are seen intermixed with a granular electron-dense matrix. The morphology of the adhesive matrix differs from that found for some other monogenean taxa. Anterior detachment by these monocotylids appears to involve a depletion of rod-shaped bodies in ducts and mechanical withdrawal of the anterior end.

A comparison of the anterior adhesive system in the oncomiracidium and adult of the monogenean parasite Merizocotyle icopae (Monocotylidae)

The anterior adhesive system of the oncomiracidium and adult of Merizocotyle icopae (Monogenea: Monocotylidae) were compared. The oncomiracidium has one ventrally placed aperture on either side of the head near the anterior extremity. In the adult, there are three ventrally placed apertures on either side of the head region. Both systems have three types of electron-dense secretory bodies opening into each aperture. A rod-shaped secretion (S1) and a small electron dense ovoid secretion (S2) are common to larvae and adults. The third secretion type differs: in adults, it is a large, spherical (S3) type but in larvae, it is an ovoid (S4) body. S4 bodies do occur in adults, but appear to be secreted as a general body secretion. An additional anteromedian secretion (S5) is also present in the oncomiracidium, but is not secreted into the anterior apertures. Homology and function of secretions are discussed.

Effects of experimentally-induced anterior knee pain on knee joint position sense in healthy individuals

Purpose. The ability to sense the position of limb segments is a highly specialised proprioceptive function important for control of movement. Abnormal knee proprioception has been found in association with several musculoskeletal pathologies but whether nociceptive Stimulation can produce these proprioceptive changes is unclear. This study evaluated the effect of experimentally induced knee pain on knee joint position sense (JPS) in healthy individuals. Study design. Repeated measures, within-subject design. Methods. Knee JPS was tested in 16 individuals with no history of knee pathology under three experimental conditions: baseline control, a distraction task and knee pain induced by injection of hypertonic saline into the infrapatellar fat pad. Knee JPS was measured using active ipsilateral limb matching responses at 20degrees and 60degrees flexion whilst non-weightbearing (NWB) and 20degrees flexion single leg stance. During the tasks, the subjective perception of distraction and severity of pain were measured using 11-point numerical rating scales. Results. Knee JPS was not altered by acute knee pain in any of the positions tested. The distraction task resulted in poorer concentration, greater JPS absolute errors at 20degrees NWB, and greater variability in errors during the WB tests. There were no significant correlations between levels of pain and changes in JPS errors. Changes in JPS with pain and distraction were inversely related to baseline knee JPS variable error in all test positions (r = -0.56 to -0.91) but less related to baseline absolute error. Conclusion. Knee JPS is reduced by an attention-demanding task but not by experimentally induced pain. (C) 2004 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved.

The nature of anterior knee pain following injection of hypertonic saline into the infrapatellar fat pad

The infrapatellar fat pad has been implicated as a possible source of anterior knee pain. This study examined the nature, distribution and time-course of experimentally induced pain in the infrapatellar fat pad. Hypertonic saline (5%) was injected into the medial fat pad of 11 healthy individuals with no history of knee pain. Severity of pain was assessed at rest and during activity using an 11 point numerical rating scale (NRS) at regular intervals over 15-30 min following injection. Participants described the size of the pain region from a series of different sized circles while the area and type of pain was established from a body chart and the McGill pain questionnaire. The effect of pain on temperature-pain threshold and sensory thresholds of the anterior knee was assessed. Participants generally reported a deep aching pain that peaked in severity around 3 min and gradually declined over 15 min. Pain levels were not altered by clinical manoeuvres designed to impinge the fat pad. The size of the pain region was related to pain intensity. Pain was most commonly felt in the region of the fat pad medial to the patella, although some individuals reported proximal referred pain as far as the groin region. Thermal and sensory thresholds were not altered at a region close to the injection site during the experimental pain. These results suggest that nociceptive stimulation of the infrapatellar fat pad may cause anterior knee pain that is not necessarily confined locally particularly if pain is severe. This has implications for the investigation of pathological structures in patients presenting clinically with anterior knee pain and provides an experimental model of anterior knee pain. (C) 2003 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved.

Specialization in pyramidal cell structure in the cingulate cortex of the Chacma baboon (Papio ursinus): An intracellular injection study of the posterior and anterior cingulate gyrus with comparative notes on the macaque and vervet monkeys

This study forms part of an ongoing investigation of pyramidal cell structure in the cingulate cortex of primates. Recently we have demonstrated that layer III pyramidal cells in the anterior cingulate gyrus are considerably larger, more branched and more spinous than those in the posterior cingulate gyrus (areas 24 and 23, respectively) in the macaque and vervet monkeys. Moreover, the extent of the interareal difference in specialization in pyramidal cell structure differed between the two species. These data suggest that pyramidal cell circuitry may have evolved differently in these closely related species. Presently there are too few data to speculate on what is selecting for this specialization in structure. Here we extend the basis for comparison by studying pyramidal cell structure in cingulate gyrus of the Chacma baboon (Papio ursinus). Methodology used here is the same as that for our previous studies: intracellular injection of Lucifer Yellow in flat-mounted cortical slices. We found that pyramidal cells in anterior cingulate gyrus (area 24) were more branched and more spinous than those in posterior cingulate gyrus (area 23). Moreover, the complexity in pyramidal cell structure in both the anterior and posterior cingulate gyrus of the baboon differed to that in the corresponding regions in either the macaque or vervet monkeys. (C) 2005 Elsevier Ireland Ltd. All rights reserved.

Motor unit synchronization is reduced in anterior knee pain

Anterior knee pain (AKP) is common and has been argued to be related to poor patellofemoral joint control due to impaired coordination of the vasti muscles. However, there are conflicting data. Changes in motor unit firing may provide more definitive evidence. Synchronization of motor unit action potentials (MUAPs) in vastus medialis obliquus (VMO) and vastus lateralis (VL) may contribute to coordination in patellofemoral joint control. We hypothesized that synchronization may be reduced in AKP. Recordings of single MUAPs were made from VMO and multiunit electromyograph (EMG) recordings were made from VL. Averages of VL EMG recordings were triggered from the single MUAPs in VMO. Motor units in VL firing in association with the VMO motor units would appear as a peak in the VL EMG average. Data were compared to previous normative data. The proportion of trials in which a peak was identified in the triggered averages of VL EMG was reduced in people with AKP (38%) compared to controls (90%). Notably, although 80% of subjects had values less than controls, 20% were within normal limits. These results provide new evidence that motor unit synchronization is modified in the presence of pain and provide evidence for motor control dysfunction in AKP. Perspective: This study shows that coordination of motor units between the medial and lateral vasti muscles in people with anterior knee pain is reduced compared to people without knee pain. It confirms that motor control dysfunction is a factor in this condition and has implications for selection of rehabilitation strategies. (c) 2005 by the American Pain Society.

Chaulioleptos haywardi n. gen., n. sp (Digenea : Sanguinicolidae) from Filimanus heptadactyla (Perciformes : Polynemidae) of Moreton Bay, Australia

Here we describe the first Species of sanguinicolid blood fluke (Trematoda: Digenea) from a polynemid fish. Chaulioleptos haywardi n. gen., n. sp. is described from Filimanus heptadacryla Cuvier, 1829 (Perciformes: Polynemidae), the sevenfinger threadfin from Sandgate, Moreton Bay (southeast Queensland, Australia). Chaidioleptos haywardi differs from existing sanguinicolid genera in the combined possession of the following 7 characters: 2 testes, an entirely postovarian uterus, a uterine chamber, separate genital pores, an H-shaped intestine with abbreviated anterior caeca, tegumental spines in incomplete ventromarginal transverse rows that are continuous along the length of the body, and vitelline follicles that are tightly compacted and subsequently appear to form a solid branching mass occupying the area anterior to intestinal bifurcation and extending posteriorly to the level of the posterior margin of the anterior testis. Chaulioleptos haywardi is most closely related to Paracardicola Martin, 1960 and Adelomyllos Nolan and Cribb, 2004.

Expression of human neuronal protein 22, a novel cytoskeleton-associated protein, was decreased in the anterior cingulate cortex of schizophrenia

Human neuronal protein 22 (hNP22) is a novel neuron-specific protein featuring numerous motifs previously described in cytoskeleton-associating and signaling proteins. Because previous studies have supported abnormalities in neuronal cytoarchitecture and/or development in the schizophrenia brain, we examined the expression of hNP22 in the anterior cingulate cortex, the hippocampus and the prefrontal cortex of schizophrenic and normal control postmortem brains using high-sensitive immunohistochemistry. Seven schizophrenic and seven age- and sex-matched control brains were examined. The ratio of hNP22-immunopositive cells/total cells was significantly reduced in layer V (p = .020) and layer VI (p = .022) of the anterior cingulate cortex of schizophrenic brain compared with controls. In contrast, there were no significant changes observed in the hippocampus and the prefrontal cortex. These results suggest that altered expression of hNP22 may be associated with modifications in neuronal cytoarchitecture leading to dysregulation of neural signal transduction in the anterior cingulate cortex of the schizophrenia brain.