Scleritis after proton therapy in uveal melanoma [Skleritis nach Protonentherapie bei Aderhautmelanom]

BACKGROUND: Sclera is a very radioresistant tissue and scleritis after proton therapy has not been described so far. HISTORY AND SIGNS: Four female patients, aged between 31 and 74 years, were treated with proton therapy for uveal melanoma (height range: 2.2 - 3.5 mm), located in the macula, the superior equator and 2 in the ciliary body. All patients had a history of a previous or active inflammatory disease and developed scleritis after radiotherapy. THERAPY AND OUTCOME: Two patients had infectious scleritis and were treated with adequate antibiotic therapy. After systemic corticotherapy, 3 patients recovered completely; the remaining patient was managed with additional immunosuppressive treatment as well as a conjunctival and scleral graft, but has not become pain free yet. CONCLUSION: Scleritis is a possible complication after proton therapy, probably on an ischemic basis, where there is a predisposing factor such as inflammatory systemic disease.

In vivo distribution and ex vivo permeation of cyclosporine A prodrug aqueous formulations for ocular application.

Cyclosporine A is a poorly water-soluble, immunosuppressive drug used to treat a variety of ocular diseases. Its limited solubility makes challenging the development of a cyclosporine A-based eye drop for ocular topical application. Based on the prodrug strategy, the practically insoluble cyclosporine A was converted into a freely soluble prodrug. Such a water-soluble prodrug made it possible to develop water-based concentrated eye drops. The prodrug formulations were tested for their ex vivo permeation and in vivo distribution at three concentrations (equivalent to 0.05%, 0.50% and 2.00% w/v cyclosporine A). The ex vivo permeation experiments were performed on corneal and conjunctival epithelia. The in vivo distribution evaluated the total cyclosporine A present in the ocular structures as well as in serum, spleen and cervical lymphatic ganglions. Each prodrug formulation was compared to conventionally used cyclosporine A eye drops at an equivalent concentration. The experimental results showed that the tested eye drops behaved differently. The prodrug formulation was characterized by the following: i) preferential conjunctival penetration, ii) an interesting capacity to create large tissue deposits and iii) a lower risk of systemic complications and immunosuppression. The prodrug aqueous eye drop was demonstrated to be a patient-friendly option for the treatment of ocular diseases requiring high ocular levels of cyclosporine A, pushing the boundaries of the current therapeutic arsenal.

Association naevus et papillome de la caroncule. A propos d'un cas observation anatomo-clinique [Papillomatous and nevus of the caruncle].

A 63-year-old male patient was operated of a single conjunctival papillomatous lesion located on the left caruncle. The curative tumoral excision was followed by its histological analysis. Histologically, the tumor associated an epithelial squamous papilloma with a subepithelial nevus, confirming a combination of two different lesions.

Controlled delivery of 5-chlorouracil using poly(ortho esters) in filtering surgery for glaucoma.

PURPOSE: To evaluate the antimitotic and toxic effects of 5-chlorouracil (5-CU) and 5-fluorouracil (5-FU) and study their potential to delay filtering bleb closure in the rabbit eye when released by poly(ortho esters) (POE). METHODS: Rabbit Tenon fibroblasts and human conjunctival cells were incubated with various 5-CU and 5-FU concentrations. Antiproliferative effects and toxicity were evaluated at 24 and 72 hours by monotetrazolium, neutral red, and Hoechst tests and cell counting. Mechanisms of cell death were evaluated using TUNEL assay, annexin V binding, immunohistochemistry for anti-apoptosis-inducing factor (AIF) and LEI/L-DNase II. Trabeculectomy was performed in pigmented rabbits. Two hundred microliters of POE loaded with 1% wt/wt 5-FU or 5-CU was injected into the subconjunctival space after surgery. Intraocular pressure (IOP) and bleb persistence were monitored for 150 days. RESULTS: In vitro, 5-FU showed a higher antiproliferative effect and a more toxic effect than 5-CU. 5-FU induced cell necrosis, whereas 5-CU induced mostly apoptosis. The apoptosis induced by 5-CU was driven through a non-caspase-dependent pathway involving AIF and LEI/L-DNase II. In vivo, at 34 days after surgery, the mean IOP in the POE/5-CU-treated group was 83% of the baseline level and only 40% in the POE/5-FU-treated group. At 100 days after surgery, IOP was still decreased in the POE/5-CU group when compared with the controls and still inferior to the preoperative value. The mean long-term IOP, with all time points considered, was significantly (P < 0.0001) decreased in the POE/5-CU-treated group (6.0 +/- 2.4 mm Hg) when compared with both control groups, the trabeculectomy alone group (7.6 +/- 2.9 mm Hg), and the POE alone group (7.5 +/- 2.6 mm Hg). Histologic analysis showed evidence of functioning blebs in the POE-5-CU-treated eyes along with a preserved structure of the conjunctiva epithelium. CONCLUSIONS: The slow release of 5-CU from POE has a longstanding effect on the decrease of IOP after glaucoma-filtering surgery in the rabbit eye. Thus, the slow release of POE/5-CU may be beneficial for the prevention of bleb closure in patients who undergo complicated trabeculectomy.

Tannin-tolerant bacteria from crossbred Holstein x Zebu cows

The objective of this work was to isolate and characterize tannin-tolerant ruminal bacteria from crossbred Holstein x Zebu cows fed a chopped mixture of elephant grass (Pennisetum purpureum), young stems of "angico-vermelho" (Parapiptadenia rigida), and banana tree (Musa sp.) leaves. A total of 117 bacteria strains were isolated from enrichment cultures of rumen microflora in medium containing tannin extracts. Of these, 11 isolates were able to tolerate up to 3 g L-1 of tannins. Classical characterization procedures indicated that different morphological and physiological groups were represented. Restriction fragments profiles using Alu1 and Taq1 of 1,450 bp PCR products from the 16S rRNA gene grouped the 11 isolates into types I to VI. Sequencing of 16S rRNA PCR products was used for identification. From the 11 strains studied, seven were not identifiable by the methods used in this work, two were strains of Butyrivibrio fibrisolvens, and two of Streptococcus bovis.

Le xeroderma pigmentosum et ses manifestations oculaires. A propos du premier cas camerounais [Xeroderma pigmentosum and its ocular manifestations. The first case in Cameroon].

We report a case of xeroderma pigmentosum in a 9-year-old back Cameroonian boy. The diagnosis was based on typical clinical presentation of the disease: cutaneous atrophy, hypepigmented macules, and areas of depigmentation on sun exposed regions of the skin. Multiple tumoral lesions were localized on the head. Ocular findings were also present: conjunctival hyperemia, peripheral corneal opacification. Excision of the tumors and potoprotection was proposed for this patient. The role of tribal black African marriage traditions in disease transmission is discussed.

Topical azithromycin or ofloxacin for endophthalmitis prophylaxis after intravitreal injection.

Background: The number of patients who have undergone intravitreal injections has increased enormously in recent years, but a consensus is still lacking on prophylaxis for endophthalmitis. The aim of this prospective, observational study was to evaluate the prophylactic effect of azithromycin eye drops versus ofloxacin eye drops. Methods: The study was conducted in five hospitals in Spain and included all patients under going intravitreal injections of triamcinolone, bevacizumab, ranibizumab, or pegaptanib over one year. Patients received azithromycin 15 mg/g eye drops (twice daily on the day prior to injection and for another 2 days) or ofloxacin 3 mg/g eye drops (every 6 hours on the day prior to injection and for another 7 days). Results: In the azithromycin group, there were 4045 injections in 972 eyes of 701 patients. In the ofloxacin group, there were 4151 injections in 944 eyes of 682 patients. There were two cases of endophthalmitis (0.049%) in the azithromycin group and five (0.12%) in the ofloxacin group. The odds ratio of presenting with endophthalmitis in the ofloxacin group compared with the azithromycin group was 2.37 (95% confidence interval [CI] 1.32-3.72, P ,0.001). There were two cases of noninfectious uveitis after triamcinolone injection in the azithromycin group (0.049%) and two (0.048%) in the ofloxacin group; no significant differences were observed (odds ratio 0.902, 95% CI 0.622-1.407, P= 0.407). Conjunctival hyperemia was observed in 12 cases in the azithromycin group and none in the ofloxacin group. Conclusion: The risk of endophthalmitis was significantly greater with ofloxacin than with azithromycin. These findings provide a valuable addition to the ever-increasing pool of infor - mation on endophthalmitis prophylaxis after intravitreal injection, although further large-scale studies are required to provide definitive conclusions.

El consumo de probiótico Lactobacillus plantarum CECT 7315/7316 mejora el estado de salud general en personas de edad avanzada

Fundamentos: Con la edad avanzada se producen cambios en la microflora intestinal que pueden afectar al estado de salud general. En este trabajo analizamos el efecto de Lactobacillus plantarum CECT 7315/7316 sobre la regulación del tránsito intestinal y el estado nutricional. Métodos: Hemos realizado un estudio clínico dobleciego, controlado por placebo y aleatorizado. Hemos evaluado la evolución de la frecuencia de defecación semanal y los niveles en sangre de proteínas totales, albúmina,colesterol y proteína C-reactiva. Resultados: Lactobacillus plantarum CECT 7315/7316 ayuda a regular el tránsito intestinal y mejora el estado nutricional en personas mayores. Conclusiones: El consumo de productos funcionales que contengan L. plantarum CECT 7315/7316 mejora la calidad de vida de personas de la tercera edad.

Precisiones cronoestratigráficas sobre la Fm. Escucha en el sector noroeste de la cuenca del Maestrazgo. Cordillera Ibérica oriental

Uno de los problemas clásicos en el estudio del registro sedimentario cretácico de la Cordillera Ibérica es la datación cronoestratigráfica de los materiales detriticos que subyacen al cretácico superior calcáreo, debido a su carácter continental y de transición. En el presente trabajo se muestrean dos series de la Fm. Escucha situadas en los depocentros de las cubetas de Calanda y de Castellote, para realizar un análisis palinológico de las mismas y compararlo con otros análisis realizados en la cubeta de Traiguera, en donde la edad está contrastada con el contenido en ammonites. Los resultados de este análisis, muestran un contenido en microflora equivalente para las dos series, asi como con las de Benassal, Benifassa, Traiguera y Salom. Este hecho nos lleva a datar a la Fm. Escucha en este sector como Albiense inferior terminal- Albiense medio, con 10 cual se contribuye a aclarar las relaciones estratigráficas entre las formaciones de Escucha, Val de la Piedra y Calizas de Benassal.

Produção de isomaltulose, um substituto da sacarose, utilizando glicosiltransferase microbiana

Isomaltulose, a functional isomer of sucrose, is a non-cariogenic reducing disaccharide; has a low glycemic index; selectively promotes growth of beneficial bifidobacteria in the human intestinal microflora; and has greater stability than sucrose in some foods and beverages. Isomaltulose is a nutritional sugar that is digested more slowly than sucrose, and has health advantages for diabetics and nondiabetics. Immobilization techniques, especially entrapment of the cells, are widely used for conversion of sucrose into isomaltulose. Immobilization offers advantages such as minimum downstream processing, continuous operation and reusability of cells. Isomaltulose is currently considered to be a promising sugar substitute.

Resistência natural de nove madeiras do semi-árido brasileiro a fungos causadores da podridão-mole

O objetivo desta pesquisa foi avaliar a resistência de nove madeiras de ocorrência no semi-árido brasileiro a fungos de podridão-mole, em condições de laboratório. As madeiras estudadas foram algaroba (Prosopis juliflora), angico (Anadenanthera colubrina var. cebil), aroeira (Myracrodruon urundeuva), braúna (Schinopsis brasiliensis), cássia (Senna siamea), craibeira (Tabebuia aurea), cumaru (Amburana cearensis), pau-d'arco (Tabebuia impetiginosa) e pereiro (Aspidosperma pyrifolium). De cada espécie foram retirados corpos-de-prova de 3,0 x 1,5 x 0,5 cm, com a maior dimensão no sentido das fibras, em quatro posições na direção medula-casca do tronco. As amostras permaneceram por 120 dias sob a ação da microflora natural existente em solo orgânico. A resistência ao apodrecimento da aroeira, braúna e cássia não foi afetada pela posição na direção medula-casca, não esteve relacionada à densidade das madeiras ensaiadas. As madeiras de aroeira e braúna (cerne), pereiro e pau-d'arco apresentaram melhor desempenho. A resistência natural não esteve associada à concentração de extrativos solúveis em água quente.

Resistência natural de nove madeiras do semiárido brasileiro a fungos xilófagos em simulares de campo

Os objetivos desta pesquisa foram avaliar a resistência de nove madeiras de ocorrência no semiárido brasileiro a fungos xilófagos em simuladores de campo e relacionar a resistência natural com a densidade e teor de substâncias extraídas em água quente. As madeiras estudadas foram algaroba (Prosopis juliflora), angico-vermelho (Anadenanthera colubrina var. cebil), aroeira (Myracrodruon urundeuva), braúna (Schinopsis brasiliensis), cássia (Senna siamea), craibeira (Tabebuia aurea), cumaru (Amburana cearensis), pau-d'arco (Tabebuia impetiginosa) e pereiro (Aspidosperma pyrifolium). De cada espécie foram retirados corpos-de-prova de 0,5 x 1,5 x 15,0 cm, com a maior dimensão na direção das fibras, em quatro posições na direção medula-casca do tronco. As amostras permaneceram por 180 dias sob ação da microflora natural existente em três tipos de solos: de floresta, de uso agrícola e com gramíneas. Em todas as madeiras ensaiadas, a resistência ao apodrecimento foi afetada pela posição na direção medula-casca. Apenas na aroeira a resistência da madeira esteve associada à sua densidade e à quantidade de extrativos solúveis em água quente. A resistência das madeiras de algaroba, angico, craibeira e pau-d'arco não esteve associada à densidade nem ao teor de extrativos. O alburno foi a posição mais atacada em todos os solos analisados. Entre os solos testados, o de uso agrícola apresentou menos atividade biológica, deteriorando menos as madeiras testadas.

"Cara inchada" of cattle, an infectious, apparently soil antibiotics-dependant periodontitis in Brazil

The objective of this review on the investigation of "cara inchada" in cattle (CI), pursued over the last 30 years, was to elucidate the pathogenicity of the disease and come to proper conclusions on its etiology. CI has been widely considered to be of nutritional origin, caused primarily by mineral deficiency or imbalance. However, the disease consists of a rapidly progressive periodontitis, affecting the periodontal tissues at the level of the premolars and molars during the period of tooth eruption generally starting in young calves. The disease led to great economic losses for farmers in central-western Brazil, after the occupation of new land for cattle raising in the 1960s and 1970s. The lateral enlargement of the maxillary bones of affected calves gave the disease the popular name of "cara inchada", i.e., swollen or enlarged face. The enlargement was found to be due to a chronic ossifying periostitis resulting from the purulent alveolitis of CI. Black-pigmented non-saccharolytic Bacteroides melaninogenicus, always together with Actinomyces (Corynebacterium) pyogenes, were isolated in large numbers from the periodontal lesions. B. melaninogenicus could be isolated in small numbers also from the marginal gingiva of a few healthy calves maintained on CI-free farms. "In vitro"-assays showed that streptomycin and actinomycin, as well as the supernatants of cultivates of actinomycetes from soils of CI-prone farms, applied in subinhibitory concentrations to the bacteria tested, enhanced significantly (up to 10 times) the adherence of the black-pigmented B.melaninogenicus to epithelial cells of the bovine gingiva. The antibiotics are apparently produced in large quantities by the increased number of soil actinomycetes, including the genus Streptomyces, that develop when soil microflora are modified by cultivating virgin forest or "Cerrado" (tree-savanna) for the first time for cattle grazing. The epidemiology of CI now provides strong evidence that the ingestion with the forage of such antibiotics could possibly be an important determinant factor for the onset and development of this infectious periodontitis. The antibiotic enhanced adherence of B.melaninogenicus to the sulcus-epithelium of the marginal gingiva, is thought to allow it to colonize, form a plaque and become pathogenic. There is experimental evidence that this determinant factor for the development of the periodontitis is present also in the milk of the mothers of CI-diseased calves. It has been shown that the bacteria isolated from the periodontal CI-lesions produce enzymes and endotoxins capable of destroying the periodontal tissues. The epidemiology of CI, with its decline in incidence and its disappearance after several years, could be explained by the fact that the former equilibrium of the microflora of the once undisturbed virgin soil has been reached again and that the number of antibiotic producing actinomycetes has been anew reduced. By this reasoning and all the data available, CI should be considered as a multifactorial infectious disease, caused primarily by the anaerobic black-pigmented non-saccharolytic Bacteroides melaninogenicus, always together with the micro-anaerobic Actinomyces pyogenes. Accordingly, the onset and development of the infectious periodontitis is apparently determined by ingestion with the forage of subinhibitory concentrations of antibiotics produced in recently cultivated virgin soils. This hypothesis is supported by the recent observation of renewed outbreaks of CI-periodontitis in former CI-prone areas, following fresh cultivation after many years. The infectious nature of CI is confirmed by trials in which virginiamycin was used efficiently for the oral treatment of CI-diseased cattle. Previously it has been shown, that spiramycin and virginiamycin, used as additives in mineral supplements, prevented CI-periodontitis.

Allelopathic Influence of Residues from Sphagneticola trilobata on Weeds and Crops

The allelopathic effect studied in many cultures has currently generated great expectations that displayed a natural and environmentally friendly tool for weed management using bioherbicides. The objective of this work was to assess allelopathic influence of residues of S. trilobata on the germination and growth of weeds, as well as their relation with some crops and effects on soil properties. Results show that residues from S. trilobata have inhibited the germination of weeds (31.6 - 72%), increasingly with the applied dose. All residue doses of this specie have inhibited dicotyledonous germination, but only maximum concentration has affected monocotyledons. The residues did not affect onion germination, but stimulated it in radish and tomato, while the dose applied at 50% produced tomato stimulation and inhibition of cabbage. The effects of residues on hypocotyl growth in different crops showed changes in species response. For onion, the three doses had negative effects on the growth of hypocotyl, while tomato was stimulated. For radish, the growth was hindered by any dose applied, and were only different (50 and 100%) compared to control. For cabbage, only hypocotyl length was stimulated, when maximum dose (100%) was applied. For the radicle growth, in onion and radish no differences were found compared to control. While the tomato radicle growth was inhibited, in cabbage, all doses encouraged the elongation of the radicle. The dry mass of weed was affected by increased dose of residue (0.49 - 8.8 g m-2), however the soil microflora was stimulated, while the population of Azotobacter spp. was not affect. Some soil properties were affected, the level of organic material, Na+ and electrical conductivity were increased, while pH (H2O) decreased a bit, however it remained basic.

Studies of the small bowel surface by scanning electron microscopy in infants with persistent diarrhea

We describe the ultrastructural abnormalities of the small bowel surface in 16 infants with persistent diarrhea. The age range of the patients was 2 to 10 months, mean 4.8 months. All patients had diarrhea lasting 14 or more days. Bacterial overgrowth of the colonic microflora in the jejunal secretion, at concentrations above 10(4) colonies/ml, was present in 11 (68.7%) patients. The stool culture was positive for an enteropathogenic agent in 8 (50.0%) patients: for EPEC O111 in 2, EPEC O119 in 1, EAEC in 1, and Shigella flexneri in 1; mixed infections due to EPEC O111 and EAEC in 1 patient, EPEC O119 and EAEC in 1 and EPEC O55, EPEC O111, EAEC and Shigella sonnei in 1. Morphological abnormalities in the small bowel mucosa were observed in all 16 patients, varying in intensity from moderate 9 (56.3%) to severe 7 (43.7%). The scanning electron microscopic study of small bowel biopsies from these subjects showed several surface abnormalities. At low magnification (100X) most of the villi showed mild to moderate stunting, but on several occasions there was subtotal villus atrophy. At higher magnification (7,500X) photomicrographs showed derangement of the enterocytes; on several occasions the cell borders were not clearly defined and very often microvilli were decreased in number and height; in some areas there was a total disappearance of the microvilli. In half of the patients a mucus-fibrinoid pseudomembrane was seen partially coating the enterocytes, a finding that provides additional information on the pathophysiology of persistent diarrhea.