Relationship between ocular perfusion pressure and retrobulbar blood flow in patients with glaucoma with progressive damage

PURPOSE: To evaluate the relationship between ocular perfusion pressure and color Doppler measurements in patients with glaucoma. MATERIALS AND METHODS: Twenty patients with primary open-angle glaucoma with visual field deterioration in spite of an intraocular pressure lowered below 21 mm Hg, 20 age-matched patients with glaucoma with stable visual fields, and 20 age-matched healthy controls were recruited. After a 20-minute rest in a supine position, intraocular pressure and color Doppler measurements parameters of the ophthalmic artery and the central retinal artery were obtained. Correlations between mean ocular perfusion pressure and color Doppler measurements parameters were determined. RESULTS: Patients with glaucoma showed a higher intraocular pressure (P <.0008) and a lower mean ocular perfusion pressure (P <.0045) compared with healthy subjects. Patients with deteriorating glaucoma showed a lower mean blood pressure (P =.033) and a lower end diastolic velocity in the central retinal artery (P =.0093) compared with normals. Mean ocular perfusion pressure correlated positively with end diastolic velocity in the ophthalmic artery (R = 0.66, P =.002) and central retinal artery (R = 0.74, P <.0001) and negatively with resistivity index in the ophthalmic artery (R = -0.70, P =.001) and central retinal artery (R = -0.62, P =.003) in patients with deteriorating glaucoma. Such correlations did not occur in patients with glaucoma with stable visual fields or in normal subjects. The correlations were statistically significantly different between the study groups (parallelism of regression lines in an analysis of covariance model) for end diastolic velocity (P =.001) and resistivity index (P =.0001) in the ophthalmic artery, as well as for end diastolic velocity (P =.0009) and resistivity index (P =. 001) in the central retinal artery. CONCLUSIONS: The present findings suggest that alterations in ocular blood flow regulation may contribute to the progression in glaucomatous damage.

Mean field methods for classification with Gaussian processes

We discuss the Application of TAP mean field methods known from Statistical Mechanics of disordered systems to Bayesian classification with Gaussian processes. In contrast to previous applications, no knowledge about the distribution of inputs is needed. Simulation results for the Sonar data set are given.

Study of thermal spin crossover in [Fe(II)(isoxazole)6](BF4)2 with Mössbauer spectroscopy

57Fe Mössbauer spectroscopy of the mononuclear [Fe(II)(isoxazole)6](BF4) 2compound has been studied to reveal the thermal spin crossover of Fe(II) between low-spin (S = 0) and high-spin (S = 2) states. A temperature-dependent spin transition curve has been constructed with the least-square fitted data obtained from the Mössbauer spectra measured at various temperatures in the 240-60K range during the cooling and heating cycle. The compound exhibits a temperature-dependent two-step spin transition phenomenon with Tsco (step 1) = 92 and Tsco (step2) = 191K. The compound has three high-spin Fe(II) sites at the highest temperature of study; among them, two have slightly different coordination environments. These two Fe(II) sites are found to undergo a spin transition, while the third Fe(II) site retains the high-spin state over the whole temperature range. Possible reasons for the formation of the two steps in the spin transition curve are discussed. The observations made from the present study are in complete agreement with those envisaged from earlier magnetic and structural studies made on [Fe(II)(isoxazole)6](BF4)2, but highlights the nature of the spin crossover mechanism.

Do lutein, zeaxanthin, and macular pigment optical density differ with age or age-related maculopathy?

Background and aims Current age-related macular disease (ARMD) treatment includes antioxidant supplementation. Lutein (L) and zeaxanthin (Z) are antioxidants that make up macularpigment within the retina and may reduce the risk of developing ARMD. Ageing and smoking are leading risk factors for developing ARMD. We investigated differences in dietary, supplemental and retinal L and Z, and smoking habits in healthy younger eyes (HY), healthy older eyes (HO) and eyes with an early form of ARMD called age-related maculopathy (ARM). Methods HO, HY and ARM groups were assessed for dietary intakes of L and Z using food diaries. Smoking habits and self-administered quantities of L and Z were obtained via questionnaire. Retinal L and Z levels (macularpigmentopticaldensity, or MPOD) were determined using heterochromatic flicker photometry. Results No significant difference was demonstrated for dietary L and Z intake (?2 = 4.983, p = 0.083) or for MPOD between groups (F = 0.40, p = 0.67). There was a significant difference between the HY (mean ± sd: 1.20 ± 2.99), HO (4.51 ± 7.05) ARM groups (9.15 ± 12.28) for pack years smoked (?2 = 11.61, p = 0.03). Conclusions Our results do not support the theory that ARM develops as a result of L and Z deficiency. Higher pack years smoked may be a factor in disease development. Dietary and supplementary L and Z levels must be obtained when assessing MPOD between groups or over time.

Mutations of beta-arrestin 2 that limit self-association also interfere with interactions with the beta2-adrenoceptor and the ERK1/2 MAPKs:implications for beta2-adrenoceptor signalling via the ERK1/2 MAPKs

FRET (fluorescence resonance energy transfer) and co-immunoprecipitation studies confirmed the capacity of beta-arrestin 2 to self-associate. Amino acids potentially involved in direct protein-protein interaction were identified via combinations of spot-immobilized peptide arrays and mapping of surface exposure. Among potential key amino acids, Lys(285), Arg(286) and Lys(295) are part of a continuous surface epitope located in the polar core between the N- and C-terminal domains. Introduction of K285A/R286A mutations into beta-arrestin 2-eCFP (where eCFP is enhanced cyan fluorescent protein) and beta-arrestin 2-eYFP (where eYFP is enhanced yellow fluorescent protein) constructs substantially reduced FRET, whereas introduction of a K295A mutation had a more limited effect. Neither of these mutants was able to promote beta2-adrenoceptor-mediated phosphorylation of the ERK1/2 (extracellular-signal-regulated kinase 1/2) MAPKs (mitogen-activated protein kinases). Both beta-arrestin 2 mutants displayed limited capacity to co-immunoprecipitate ERK1/2 and further spot-immobilized peptide arrays indicated each of Lys(285), Arg(286) and particularly Lys(295) to be important for this interaction. Direct interactions between beta-arrestin 2 and the beta2-adrenoceptor were also compromised by both K285A/R286A and K295A mutations of beta-arrestin 2. These were not non-specific effects linked to improper folding of beta-arrestin 2 as limited proteolysis was unable to distinguish the K285A/R286A or K295A mutants from wild-type beta-arrestin 2, and the interaction of beta-arrestin 2 with JNK3 (c-Jun N-terminal kinase 3) was unaffected by the K285A/R286A or L295A mutations. These results suggest that amino acids important for self-association of beta-arrestin 2 also play an important role in the interaction with both the beta2-adrenoceptor and the ERK1/2 MAPKs. Regulation of beta-arrestin 2 self-association may therefore control beta-arrestin 2-mediated beta2-adrenoceptor-ERK1/2 MAPK signalling.

Subthalamic nucleus neurones in slices from 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-lesioned mice show irregular, dopamine-reversible firing pattern changes, but without synchronous activity

The loss of dopamine in idiopathic or animal models of Parkinson's disease induces synchronized low-frequency oscillatory burst-firing in subthalamic nucleus neurones. We sought to establish whether these firing patterns observed in vivo were preserved in slices taken from dopamine-depleted animals, thus establishing a role for the isolated subthalamic-globus pallidus complex in generating the pathological activity. Mice treated with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) showed significant reductions of over 90% in levels of dopamine as measured in striatum by high pressure liquid chromatography. Likewise, significant reductions in tyrosine hydroxylase immunostaining within the striatum (>90%) and tyrosine hydroxylase positive cell numbers (65%) in substantia nigra were observed. Compared with slices from intact mice, neurones in slices from MPTP-lesioned mice fired significantly more slowly (mean rate of 4.2 Hz, cf. 7.2 Hz in control) and more irregularly (mean coefficient of variation of inter-spike interval of 94.4%, cf. 37.9% in control). Application of ionotropic glutamate receptor antagonists 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX) and 2-amino-5-phosphonopentanoic acid (AP5) and the GABAA receptor antagonist picrotoxin caused no change in firing pattern. Bath application of dopamine significantly increased cell firing rate and regularized the pattern of activity in cells from slices from both MPTP-treated and control animals. Although the absolute change was more modest in control slices, the maximum dopamine effect in the two groups was comparable. Indeed, when taking into account the basal firing rate, no differences in the sensitivity to dopamine were observed between these two cohorts. Furthermore, pairs of subthalamic nucleus cells showed no correlated activity in slices from either control (21 pairs) or MPTP-treated animals (20 pairs). These results indicate that the isolated but interconnected subthalamic-globus pallidus network is not itself sufficient to generate the aberrant firing patterns in dopamine-depleted animals. More likely, inputs from other regions, such as the cortex, are needed to generate pathological oscillatory activity. © 2006 IBRO.

The interrogation and multiplexing of long period grating curvature sensors using a Bragg grating based, derivative spectroscopy technique

A long period grating is interrogated with a fibre Bragg grating using a derivative spectroscopy technique. A quasi-linear relationship between the output of the sensing scheme and the curvature experienced by the long period grating is demonstrated, with a sensitivity of 5.05 m and with an average curvature resolution of 2.9 × 10-2 m-1. In addition, the feasibility of multiplexing an in-line series of long period gratings with this interrogation scheme is demonstrated with two pairs of fibre Bragg gratings and long period gratings. With this arrangement the cross-talk error between channels was less than ± 2.4 × 10-3 m-1.

Flow patterns on distillation trays

Studies into the two-phase flow patterns produced on a sieve tray were carried out using an air-water simulator of 2.44 m in diameter. The flow patterns were investigated by a number of methods, direct observation using directional flow pointers; by water-cooling to simulate mass transfer; and by measurement of the height of clear liquid across the tray with manometers. The flow rates used were designed to show how the flow pattern changed with the change in the gas and liquid rates. The results from water-only studies on an un-perforated tray were compared with those produced on a sieve tray with holes of 12.7 mm diameter. The presence of regions on the sides of the tray where the liquid was circulating was noted from the water-only experiments. The presence and magnitude of the circulations was reduced when the air was passed through the liquid. These were similar to the findings of Hine (1990) and Chambers (1993). When circulation occurred, the flow separated at the ends of the inlet downcomer and circulations of up to 30% of the tray area were observed. Water-cooling and the manometer measurements were used to show the effect of the flow pattern on the tray efficiency and the height of clear liquid respectively. The efficiency was severely reduced by the presence of circulations. The height of clear liquid tended to rise in these areas. A comparison of data collected on trays with different hole diameters showed that the larger hole diameter inhibited the on-set of separation to a greater extent than small hole diameters. The tray efficiency was affected by a combination of the better mixing on smaller hole trays and detrimental effect of greater circulation on these trays. Work on a rectangular tray geometry was carried out to assess the effect of hole size on the height of clear liquid. It was found that the gradient on the outlet half of the tray was very small and that the highest clear liquid height was given by the highest hole size. Overall, the experiments helped to clarify the effect that the flow pattern had on the operation of the tray. It is hoped that the work can be of use in the development of models to predict the flow pattern and hence the tray efficiency.

Further studies on flow distribution on distillation sieve trays

The thesis describes experimental work on the possibility of using deflection baffles in conventional distillation trays as flow straightening devices, with the view of enhancing tray efficiency. The mode of operation is based on deflecting part of the liquid momentum from the centre of the tray to the segment regions in order to drive stagnating liquid at the edges forward. The first part of the work was a detailed investigation into the two-phase flow patterns produced on a conventional sieve tray having 1 mm hole size perforations. The data provide a check on some earlier work and extend the range of the existing databank, particularly to conditions more typical of industrial operation. A critical survey of data collected on trays with different hole sizes (Hine, 1990; Chambers, 1993; Fenwick, 1996; this work) showed that the hole diameter has a significant influence on the flow regime, the size of the stagnant regions and the hydraulic and mass transfer performance. Five modified tray topologies were created with different configurations of baffles and tested extensively in the 2.44 m diameter air-water pilot distillation simulator for their efficacy in achieving uniform flow across the tray and for their impact on tray loading capacity and mass transfer efficiency. Special attention was given to the calibration of the over 100 temperature probes used in measuring the water temperature across the tray on which the heat and mass transfer analogy is based. In addition to normal tray capacity experiments, higher weir load experiments were conducted using a 'half-tray' mode in order to extend the range of data to conditions more typical of industrial operation. The modified trays show superior flow characteristics compared to the conventional tray in terms of the ability to replenish the zones of exceptionally low temperatures and high residence times at the edges of the tray, to lower the bulk liquid gradient and to achieve a more uniform flow across the tray. These superior flow abilities, however, tend to diminish with increasing weir load because of the increasing tendency for the liquid to jump over the barriers instead of flowing over them. The modified tray topologies showed no tendency to cause undue limitation to tray loading capacity. Although the improvement in the efficiency of a single tray over that of the conventional tray was moderate and in some cases marginal, the multiplier effect in a multiple tray column situation would be significant (Porter et al., 1972). These results are in good agreement with an associated CFD studies (Fischer, 1999) carried out by partners in the Advanced Studies in Distillation consortium. It is concluded that deflection baffles can be used in a conventional distillation sieve tray to achieve better liquid flow distribution and obtain enhanced mass transfer efficiency, without undermining the tray loading capacity. Unlike any other controlled-flow tray whose mechanical complexity impose stringent manufacturing and installation tolerances, the baffled-tray models are simple to design, manufacture and install and thus provide an economic method of retrofitting badly performing sieve trays both in terms of downtime and fabrication. NOTE APPENDICES 2-5 ARE ON A SEPARATE FLOPPY DISK ONLY AVAILABLE FOR CONSULTATION AT ASTON UNIVERSITY LIBRARY WITH PRIOR ARRANGEMENT

Retinal thickness in pregnant women with diabetes

Poster section Design. Retrospective study. Purpose. To assess whether there are changes in foveal thickness (FT) and total macular volume (TMV) in pregnancy in diabetic subjects. Methods. The audit consisted of pregnant women with diabetes, with no maculopathy, who completed their antenatal care at Birmingham Heartlands Hospital. The Zeiss Stratus Optical coherence tomography (OCT) was performed on patients attending diabetic retinopathy (DR) screening at intervals throughout their pregnancy. To be included in the audit patients had to have at least one OCT scan during their pregnancy. Results. Altogether there were 8 type 1 and 22 type 2 patients with mean diabetes duration of 6 years (range 1-20). Mean gestation at DR screening with OCT during the first trimester was 9.7 weeks (6-13) (n=22). The mean and standard deviation for FT for the right was 179.1 µm ± 21.49 and for the left eye was 187.3 µm ± 23.55. The mean TMV was right 6.43 µm ± 0.35 and left 6.50 µm ± 0.39. The mean gestation at DR screening with OCT during the second trimester was 23.4 weeks (18-26) (n=25). The mean FT for the right was 191.4 µm ± 22.70 and the left 195.6 µm ± 24.77. The mean TMV was right 6.74 µm ± 0.45 and left 6.91 µm ± 0.35. The gestation of DR screening with OCT during the third trimester was 31.1 weeks (27-36) (n=15). The mean FT for the right was 181.5 µm ± 24.84 and for the left 193.1 µm ± 28.55. The mean TMV was right 6.80 µm ± 0.40 and left 6.84 µm ± 0.31. There were no significant differences in FT over the 3 trimesters. The TMV showed a significant difference when comparing the first and second trimesters (p<0.05). However, there was no significant statistical difference in TMV in the second and third trimesters. None of the patients showed any macula edema on the OCT. Conclusions. The results suggest there is no significant change in foveal thickness in pregnancy in diabetic subjects. There was a significant statistical difference in total macular volume in the second trimester; however, this would not be clinically significant. This is an important observation proven by the OCT which has not been previously studied.

The interrogation and multiplexing of long period grating curvature sensors using a Bragg grating based, derivative spectroscopy technique

A long period grating is interrogated with a fibre Bragg grating using a derivative spectroscopy technique. A quasi-linear relationship between the output of the sensing scheme and the curvature experienced by the long period grating is demonstrated, with a sensitivity of 5.05 m and with an average curvature resolution of 2.9 × 10-2 m-1. In addition, the feasibility of multiplexing an in-line series of long period gratings with this interrogation scheme is demonstrated with two pairs of fibre Bragg gratings and long period gratings. With this arrangement the cross-talk error between channels was less than ± 2.4 × 10-3 m-1.

Potential risk factors for medication non-adherence in patients with chronic obstructive pulmonary disease (COPD)

Aims - To investigate the effect of a range of demographic and psychosocial variables on medication adherence in chronic obstructive pulmonary disease (COPD) patients managed in a secondary care setting. Methods - A total of 173 patients with a confirmed diagnosis of COPD, recruited from an outpatient clinic in Northern Ireland, participated in the study. Data collection was carried out via face-to-face interviews and through review of patients’ medical charts. Social and demographic variables, co-morbidity, self-reported drug adherence (Morisky scale), Hospital Anxiety and Depression (HAD) scale, COPD knowledge, Health Belief Model (HBM) and self-efficacy scales were determined for each patient. Results - Participants were aged 67 ± 9.7 (mean ± SD) years, 56 % female and took a mean (SD) of 8.2 ± 3.4 drugs. Low adherence with medications was present in 29.5 % of the patients. Demographic variables (gender, age, marital status, living arrangements and occupation) were not associated with adherence. A range of clinical and psychosocial variables, on the other hand, were found to be associated with medication adherence, i.e. beliefs regarding medication effectiveness, severity of COPD, smoking status, presence of co-morbid illness, depressed mood, self-efficacy, perceived susceptibility and perceived barriers within the HBM (p < 0.05). Logistic regression analysis showed that perceived ineffectiveness of medication, presence of co-morbid illness, depressed mood and perceived barriers were independently associated with medication non-adherence in the study (P < 0.05). Conclusions - Adherence in COPD patients is influenced more by patients’ perception of their health and medication effectiveness, the presence of depressed mood and co-morbid illness than by demographic factors or disease severity.

Gas-liquid-solid flow modelling in a bubble column

An alternative approach to the modelling of solid-liquid and gas-liquid-solid flows for a 5:1 height to width aspect ratio bubble column is presented here. A modified transport equation for the volume fraction of a dispersed phase has been developed for the investigation of turbulent buoyancy driven flows (Chem. Eng. Proc., in press). In this study, a modified transport equation has been employed for discrete phase motion considering both solid-liquid and gas-liquid-solid flows. The modelling of the three-phase flow in a bubble column was achieved in the following case: injecting a slug of solid particles into the column for 10 s at a velocity of 0.1 m s-1 and then the gas phase flow was initiated with a superficial gas velocity of 0.02 cm s-1. © 2003 Elsevier B.V. All rights reserved.

Synthesis and magnetic properties of Fe-Mn-Cr multinuclear complexes with 4-amino-1,2,4-triazole and oxalate ligands

A multinuclear Fe-Mn-Cr complex with 4-amino-1,2,4-triazole (NH2trz) and oxalate (ox) ligands has been synthesized successfully. The formula of the [Fe(NH2trz)3][ClO4][MnCr(ox)3].4H2O complex has been obtained based on the metal and C, H, N contents. The presence of water molecules, metal-ligand bonding and bridge ligand in the multinuclear complex has been confirmed by its infrared spectrum. The compound crystallizes in the hexagonal system with cell parameters of a = b = 18.695 Å and c = 57.351 Å. The compound shows a gradual spin crossover for iron(II) in the [Fe(NH2trz)3]2+ with transition temperature (T1/2) of 205 K. The antiferromagnetic interaction between Cr(III) and Mn(II) ions in the [MnCr(ox)3]n n- network is observed from the Weiss constant (θ) of –2.3 K.

Photodynamic therapy with verteporfin for juxtafoveal choroidal neovascularisation secondary to pathological myopia

The treatment of choroidal neovascularisation (CNV) secondary to pathological myopia has presented a number of problems to ophthalmologists over the years, but the advent of photodynamic therapy (PDT) with verteporfin has changed how we manage these patients. Until PDT became available, the use of laser photocoagulation for extra and juxtafoveal lesions had been shown to be effective in the short term in preventing loss of vision, although the risk of regrowth of CNV and undertreatment were well recognised. However, even in apparent successful cases of photocoagulation, laser scar enlargement and creepage into the fovea in the mid-to-long term often occurred with resulting loss of central vision.1 Other options for treatment were very limited with little evidence that other modalities such as transpupillary thermotherapy or submacular surgery and macular transplantation surgery would be successful in highly myopic eyes. The evidence for the role of PDT and verteporfin CNV secondary to pathological myopia comes from the verteporfin in photodynamic therapy (VIP) study that has shown how effective this treatment is in eyes with subfoveal CNV.2, 3 Now in this publication, Lam et al4 from Hong Kong have shown that PDT is also effective in juxtafoveal CNV, with high myopia. They performed a small prospective study of 11 patients of mean age 44.8 years, with 12 months of follow-up. They found that there was a mean improvement of 1.8 lines of LogMAR best-corrected visual acuity (BCVA) at 12 months, with a mean number of 2.3 PDT treatments. The most rapid improvement occurred within the first 3 months of treatment and by 12 months none of the patients had suffered a deterioration in BCVA from baseline. There were no cases of adverse effects from the infusion or laser treatment. For ophthalmologists dealing with patients with CNV secondary to causes other than AMD, this is further evidence of the effectiveness of PDT with verteporfin in maintaining vision. These patients are likely to be younger than those with AMD and are likely to be in active employment and supporting families, and clearly the preservation of best vision possible is imperative in this group. It is therefore encouraging for ophthalmologists in the United Kingdom that the verteporfin in PDT Cohort Study (VPDT Study) includes the ability to treat patients with subfoveal CNV secondary to high myopia if they fulfill National Institute of Clinical Excellence guidelines, and will allow representations to be made on an individual basis for treatment of juxtafoveal lesions.5 For those ophthalmologists used to juggling increased patient expectations with scarce NHS resources, this is promising news and will allow us to offer a better standard of care to our patients.