New Technique of Exposed Glaucoma Drainage Tube Repair: Report of a Case.

We present the case of successful repair of an exposed glaucoma drainage tube by cornea graft fixation with tissue adhesive, and without subsequent coverage by adjacent conjunctiva or donor tissues. Patient with history of keratoglobus with thin cornea and sclera, and phthisical contralateral eye, underwent three unsuccessful corneal grafts followed by Boston type 1 keratoprosthesis in the right eye. Ahmed drainage device with sclera patch graft was implanted to control the intraocular pressure.

Effect of age and disc size on rim order rules by Heidelberg Retina Tomograph.

Purpose: The ISNT rule for nonglaucomatous eyes suggests that the neuroretinal rim is thickest at the inferior quadrant (I), followed by the superior (S), nasal (N), and temporal (T) quadrants. This study aimed to use Heidelberg Retina Tomograph (HRT III) measurements to assess (a) fulfillment of the ISNT rule and its derivatives in a large normative database and (b) effect of disc size and age on rule fulfillment.

Patients And Methods: A multicenter, prospective, cross-sectional study of a Caucasian normative database consisting of 280 subjects with normal comprehensive biomicroscopic examination, intraocular pressure <21 mm Hg, and normal automated visual field testing was conducted.

Topical glaucoma therapy and ocular surface disease: a prospective, controlled cohort study.

Objective: To evaluate the association between the intensity and duration of glaucoma topical therapy and severity of signs and symptoms of ocular surface disease (OSD).

Design: Single-site, prospective, controlled, cross-sectional study.

Participants: Sixty-one patients with no diagnosis of or previous treatment for OSD were identified.

Long term efficacy of repeat selective laser trabeculoplasty.

Purpose: To evaluate long term intraocular pressure (IOP) control after repeat selective laser trabeculoplasty (SLT).

Methods: This single center study retrospectively reviews the electronic medical records of patients with open angle glaucoma undergoing repeat SLT. Eyes with prior argon laser trabeculoplasty, or incisional surgery before or during the study period were excluded.

Repeat selective laser trabeculoplasty can be effective in eyes with initial modest response.

Purpose: To evaluate the effectiveness of repeat selective laser trabeculoplasty (SLT) in eyes exhibiting only a modest response upon initial treatment.

Materials And Methods: Retrospective chart review was conducted of 51 eyes that received initial 360 degree SLT (SLT1) and subsequent SLT (SLT2) from 2003-2011 at a large academic ophthalmology practice. Successful response (S) was a post-treatment 12 month mean IOP reduction ≥ 20% from baseline, while modest response (M) was <20% reduction over the same time.

Does recombinant factor XIII eliminate early manifestations of multiple-organ injury after experimental burn similarly to gut ischemia-reperfusion injury or trauma-hemorrhagic shock?

The authors have previously shown that recombinant factor XIII (rFXIII) eliminates early manifestations of multiple-organ injury caused by experimental superior mesenteric artery occlusion or trauma-hemorrhagic shock. The aim of the present study was to test the hypothesis that rFXIII provides similar protective effect in experimental burn injury. Rats were randomly divided into five groups (eight animals per group): group 1: burn + placebo treatment; group 2: burn + rFXIII pretreatment; group 3: burn + rFXIII treatment; group 4: sham burn + placebo treatment, and group 5: sham burn + rFXIII treatment.

Visual field and ocular safety during short-term vigabatrin treatment in cocaine abusers.

Purpose: To evaluate the ocular safety of short-term vigabatrin treatment of cocaine abuse.

Design: Multicenter, prospective, randomized, placebo-controlled, double-masked, parallel assignment study.

Methods: Cocaine addicts were randomized to receive vigabatrin 3000 mg/day, cumulative dose 218 g (n = 92), or placebo (n = 94) for 12 weeks.

Peripheral visual field thresholds using Humphrey Field Analyzer program 60-4 in normal eyes.

Purpose: Various methods have been used for testing peripheral visual field disturbances such as defects caused by drug toxicity. Static threshold perimetry with Humphrey Field Analyzer (HFA) is widely available. The aim of this study was to better define the normal thresholds for peripheral visual field (PVF) sensitivity and to refine analysis strategies.

Recombinant factor XIII mitigates hemorrhagic shock-induced organ dysfunction.

Background: Plasma factor XIII (FXIII) is responsible for stabilization of fibrin clot at the final stage of blood coagulation. Since FXIII has also been shown to modulate inflammation, endothelial permeability, as well as diminish multiple organ dysfunction (MOD) after gut ischemia-reperfusion injury, we hypothesized that FXIII would reduce MOD caused by trauma-hemorrhagic shock (THS).

Materials And Methods: Rats were subjected to a 90 min THS or trauma sham shock (TSS) and treated with either recombinant human FXIII A(2) subunit (rFXIII) or placebo immediately after resuscitation with shed blood or at the end of the TSS period.

Augmenting regional cerebral blood flow using external-to-internal carotid artery flow diversion method.

The objective of this study was to assess the effect of flow diversion by external carotid artery (ECA) occlusion on ipsilateral regional cerebral blood flow (rCBF). Local cerebral hyperperfusion in rats (n = 12) was induced by ligating the right ECA. Ipsilateral rCBF was determined pre- and post-ligation for 120 min using a laser Doppler flow meter.

Trauma-hemorrhagic shock-induced red blood cell damage leads to decreased microcirculatory blood flow.

Objective: To test the hypothesis that trauma-hemorrhagic shock (T/HS)-induced changes in red blood cells (RBC) contribute to the reduction of blood flow in distant organs.

Design: Laboratory study.

Setting: Academic medical center laboratory.

Recombinant factor XIII diminishes multiple organ dysfunction in rats caused by gut ischemia-reperfusion injury.

Plasma factor XIII (FXIII) is responsible for stabilization of fibrin clot at the final stage of blood coagulation. Because FXIII has also been shown to modulate inflammation and endothelial permeability, we hypothesized that FXIII diminishes multiple organ dysfunction caused by gut I/R injury. A model of superior mesenteric artery occlusion (SMAO) was used to induce gut I/R injury.

The influence of the type of resuscitation fluid on gut injury and distant organ injury in a rat model of trauma/hemorrhagic shock.

Background: Recognition that resuscitation with Ringers lactate (RL) potentiates trauma-hemorrhagic shock (T/HS)-induced organ injury and systemic inflammation has led to a search for improved initial fluid resuscitation regimens. However, one relatively neglected component in the search for new and novel resuscitation strategies is a determination of what fluid resuscitation therapy (i.e.

Microscopic and macroscopic evaluation of emboli captured during angioplasty and stent procedures in extracranial vertebral and internal carotid arteries.

Purpose: To compare the quantities of emboli dislodged during percutaneous transluminal angioplasty/stenting in the vertebral artery (VA) with those released during stent placement in the internal carotid artery (ICA).

Methods: Macroscopic images of distal protection devices (DPD) used during 30 stent procedures in 16 ICAs (11 men; mean age 64.6+/-10.

Resistance of the female, as opposed to the male, intestine to I/R-mediated injury is associated with increased resistance to gut-induced distant organ injury.

We tested the hypothesis that the female intestine is more resistant to gut I/R injury than the male intestine by comparing the effects of the isolated pure gut I/R superior mesenteric artery occlusion (SMAO) model on gut morphology and whether SMAO-induced distant organ injury (lung, bone marrow [BM], neutrophils, and red blood cells [RBCs]) would differ between male and proestrus female rats. At 6 or 24 h after SMAO or sham SMAO, gut injury, lung permeability, pulmonary neutrophil sequestration, RBC deformability, and BM RBC and white blood cell progenitor growth were measured, as was the ability of the plasma from these rats to activate naive rat neutrophils. At both 6 and 24 h after SMAO, the female rats had significantly less intestinal injury and reduced gut-induced lung injury, BM suppression, RBC dysfunction, and neutrophil activation than male rats subjected to SMAO.

Adenosine A2A receptor activation reduces lung injury in trauma/hemorrhagic shock.

Objective: Hemorrhagic shock and resuscitation trigger a global ischemia/reperfusion phenomenon, in which various inflammatory processes critically contribute to the ensuing tissue damage. Adenosine is an endogenous nucleoside that is released during shock. Activation of adenosine A(2A) receptors can broadly inactivate inflammatory cascades.

Small volume resuscitation with hypertonic saline is more effective in ameliorating trauma-hemorrhagic shock-induced lung injury, neutrophil activation and red blood cell dysfunction than pancreatitic protease inhibition.

Background: Recognition of the limitations of standard crystalloid resuscitation has led to the search for alternative resuscitation strategies that might better limit the development of trauma-hemorrhage-induced organ dysfunction and systemic inflammation. Thus, the goal of this study was to compare the effects of two resuscitation strategies alone, and in combination, with those of standard resuscitation with Ringers lactate (RL). The two strategies were small volume resuscitation with hypertonic saline (HTS) and intraluminal inhibition of pancreatic proteases with the serine protease inhibitor nafamostat.

Amiloride combined with small-volume resuscitation with hypertonic saline is superior in ameliorating trauma-hemorrhagic shock-induced lung injury in rats to the administration of either agent alone.

Objective: Recognition of the limitations of standard crystalloid resuscitation has led to exploration for alternative resuscitation strategies that might better prevent the development of trauma-hemorrhage-induced organ dysfunction and systemic inflammation. Thus, the goal of this study was to compare the effects of two resuscitation strategies alone and in combination with that of standard resuscitation with Ringer's lactate. These two strategies were intravenous injection of amiloride, an inhibitor of Na/H exchange and epithelial Na channels, and resuscitation with hypertonic saline.

Mesenteric lymph duct ligation decreases red blood cell alterations caused by acute pancreatitis.

Background: Both experimental and clinical studies have shown that acute pancreatitis (AP) causes a significant decrease in red blood cell (RBC) deformability. The mechanisms by which AP induces RBC injury are unknown. The purpose of this study was to test the hypothesis that factors carried in the mesenteric lymph after an attack of AP significantly contribute to the RBC injury observed in AP.

Pancreatic duct ligation reduces lung injury following trauma and hemorrhagic shock.

Objective: To determine whether pancreatic digestive enzymes released into the ischemic gut during an episode of T/HS are involved in the generation of distant organ injury. This hypothesis was tested by examining the effect of PDL on T/HS-induced intestinal injury, lung injury, and RBC deformability.

Summary Background Data: The effect of pancreatic duct ligation (PDL) on distant organ injury following trauma/hemorrhagic shock (T/HS) was examined.

Alterations of red blood cell shape in patients with severe trauma.

Background: Trauma is accompanied by a decrease in red blood cell (RBC) deformability, which may manifest itself earlier than secondary septic complications. The mechanisms of this phenomenon are not clear. The aim of this study is to determine when the alterations of RBC shape appear in trauma patients.

Female sex hormones protect red blood cells from damage after trauma-hemorrhagic shock.

Background: Trauma/hemorrhagic shock (T/HS) is known to cause changes in red blood cell (RBC) deformability and resting shape. Our previous studies have shown that proestrus female rats are more protected from shock-induced RBC damage than diestrus females or males. However, it is unclear whether female or male sex hormones can influence the severity of these alterations.

Burn-induced red blood cell deformability and shape changes are modulated by sex hormones.

Background: Burns are known to cause changes in red blood cell (RBC) deformability and resting shape. However, it is unclear whether sex and sex hormones can influence the severity of these alterations.

Methods: Red blood cell deformability and shape were examined in proestrus and diestrus female rats, ovariectomized female rats, as well as castrated and non-castrated male rats (6 animals per group) subjected to scald burn.

Effect of trauma-hemorrhagic shock on red blood cell deformability and shape.

Previous work in our laboratory has demonstrated a decrease in red blood cell (RBC) deformability in sepsis. This has not been studied following hemorrhagic shock. We tested the hypotheses that hemorrhagic shock, associated with soft tissue trauma, leads to decreased RBC deformability and that this is related to alterations in the resting shape of the RBC.

Mesenteric lymph duct ligation prevents shock-induced RBC deformability and shape changes.

Objectives: The exact mechanisms that lead to RBC deformability and shape changes after trauma/hemorrhagic shock remain unknown. We hypothesize that RBC injury is caused in part by gut injury and is mediated by gut-derived factors carried in the intestinal lymph.

Materials And Methods: RBC deformability was measured by a laser-assisted ektacytometer before and after trauma/hemorrhagic shock (T/HS) in 6 rats whose mesenteric lymph duct had been ligated and in 10 rats subjected to T/HS without duct ligation.