Success rates, quality of life, and feasibility of sacral nerve stimulation in elderly patients: 1-year follow-up.

Introduction And Hypothesis: Urgency urinary incontinence (UUI) frequently occurs in elderly. International guidelines recommend pharmacological therapy as first-line treatment, but elderly do not respond in many cases. The purpose of this study was to report cure rates, quality of life, and feasibility of sacral neurostimulation (SNS) as an alternative option in the elderly.

Novel mutation of the sex-determining region on the Y chromosome in a 46,XY female patient with monolateral dysgerminoma: a case report.

Patients with 46,XY complete gonadal dysgenesis (Swyer syndrome) are characterized by the presence of female internal genital tract and bilateral streak gonads in a phenotypic female. These women have a high risk of developing rare type II malignant germ cell tumors. We report a rare case of a 33-year-old 46,XY female patient, who presented with an adnexal mass suspected for dysgerminoma, with a novel mutation of the sex-determining region on the Y chromosome consisting in the variant c.

Nerve growth factor therapy for corneal disease.

Purpose Of Review: To review the experimental and clinical data on the effects of nerve growth factor (NGF) in corneal physiopathology and to discuss the future development of NGF therapy for corneal diseases.

Recent Findings: NGF plays a key role in the modulation of immune reaction, trophic support, healing of ocular surface, corneal sensitivity and tear film function. These properties of NGF make this neurotrophin a potential therapeutic agent for several corneal diseases.

Comparison and critical analysis of robotized technology for monoclonal antibody high-throughput production.

We have previously demonstrated how to transform the conventional method of hybridoma production and screening into a fast, high-throughput technology. Nevertheless, there were still open questions related to automated procedures and immunization protocols that we address now by comparing the hybridoma production work-flow in automated and manually executed processes. In addition, since the animals' antibody responses to single or multiple antigen challenge affect monoclonal antibody throughput, different immunization and fusion strategies were tested.

Toll-like receptors in ocular surface diseases: overview and new findings.

The ocular surface is the first line of defence in the eye against environmental microbes. The ocular innate immune system consists of a combination of anatomical, mechanical and immunological defence mechanisms. TLRs (Toll-like receptors), widely expressed by the ocular surface, are able to recognize microbial pathogens and to trigger the earliest immune response leading to inflammation.

Production, novel assay development and clinical applications of monoclonal antibodies.

Since the advent of hybridoma technology 35 years ago, research on monoclonal antibodies has developed enormously. Monoclonal antibodies of mouse origin were the first to be produced and continue to be the most popular affinity reagents for investigating the proteome of all organisms. For their adaptability to a variety of biological assays monoclonal antibodies are key tools for basic research as well as for diagnosis and therapy of human diseases.

Tear levels of neuropeptides increase after specific allergen challenge in allergic conjunctivitis.

Purpose: Growing evidence is showing a role of neurogenic inflammation in allergic reactions, with sensory and autonomic nerve fibers releasing neuromediators, which may actively participate in the allergic inflammatory cascade. Although the cornea is the most densely innervated tissue of the human body, little is known on the role of neuromediators at the ocular surface. In this study, we aimed at evaluating the role of substance P (SP), calcitonine gene related peptide (CGRP), neuropeptide Y (NPY) and vasoactive intestinal peptide (VIP) in allergic reactions of the ocular surface.

Sacral neuromodulation after stabilization of L2-S1 vertebrae with metallic fixation devices: is it feasible?

Sacral neuromodulation is a surgical treatment for voiding difficulties. We report the case of a patient affected by overflow urinary incontinence and reduced bladder sensation subsequent to decompression and stabilization of L2-S1, showing that sacral nerve stimulation can be used in patients with sacral anatomy distortion and metallic fixation system. In these cases, implant is feasible with fluoroscopic guidance and little changes of standard implantation procedure.

Nerve growth factor eye drops to treat glaucoma.

Since the discovery of nerve growth factor (NGF) in the 1950s, scientists have had great expectations for NGF in the treatment of neurodegenerative diseases. The main obstacle to overcome was the blood-brain barrier, which NGF does not cross when administered systemically. Our research group has recently demonstrated that topically instilled NGF eye drops are effective in treating several ocular diseases such as neurotrophic and autoimmune corneal ulcers.

Antigenic features of protein carriers commonly used in immunisation trials.

An aluminium hydroxide adjuvant induced a more elevated and rapid immune responses against short peptides conjugated to the Keyhole Lympet Hemocyanin carrier than immuneasy adjuvant. Furthermore, since carrier proteins may compete with the fused or chemically linked polypeptides in eliciting antigen-specific immune response, we classified the immunogenicity of the most common carrier proteins used in molecular biology for antigen expression and mouse immunisation. The disulfide isomerase protein A gave a carrier with the lowest immunogenicity whilst disulfide isomerase protein C gave the highest immunogenicity and therefore should be avoided as a fusion partner.

An ultra-miniinvasive treatment for stress urinary incontinence in complicated older patients.

Objective: To evaluate use of bulking agents (polydimethylsiloxane) as an alternative treatment of female stress urinary incontinence (SUI) in older patients.

Study Design: Prospective cohort study.

Main Outcome Measures: Women with age >75 years old, affected by stress urinary incontinence, presenting to our institution between January 2005 and January 2008 were considered for eligibility in this prospective study.

Toxic corneal ulcer: a frequent and sight-threatening disease.

Purpose: Overtreatment with topical ophthalmic preparations can lead to toxic corneal ulcer development. This study aimed to investigate the clinical and visual impact of toxic corneal ulcers and the management and risk factors for their development and outcomes.

Methods: Clinical records of 226 consecutive patients with corneal ulcers referred to our tertiary care center were retrospectively evaluated.

Experimental and clinical evidence of neuroprotection by nerve growth factor eye drops: Implications for glaucoma.

Elevated intraocular pressure (IOP) in glaucoma causes loss of retinal ganglion cells (RGCs) and damage to the optic nerve. Although IOP is controlled pharmacologically, no treatment is available to restore retinal and optic nerve function. We evaluated the effects of NGF eye drops in a rat model of glaucoma.

Preliminary evidence of the efficacy of probiotic eye-drop treatment in patients with vernal keratoconjunctivitis.

Background: Probiotics have been shown to improve allergic inflammation. The aim of this study was to evaluate the efficacy of Lactobacillus Acidophilus eye-drops in controlling signs and symptoms of vernal keratoconjunctivitis (VKC).

Methods: Seven patients (mean age 11.

Clinical grading of vernal keratoconjunctivitis.

Purpose Of Review: The purpose of the present review is to provide an overview on the clinical features of vernal keratoconjunctivitis on the basis of cases series presented in the literature. Furthermore, a new grading system of vernal keratoconjunctivitis based on the severity of the disease is proposed. Different treatment options are discussed based on the clinical grade of vernal keratoconjunctivitis.

Development and testing of the quality of life in children with vernal keratoconjunctivitis questionnaire.

Purpose: To develop and validate a questionnaire that measures health-related quality of life (HRQoL) in children with vernal keratoconjunctivitis (VKC).

Design: Prospective, observational case series.

Methods: An initial list of 42 items was developed and administered to 30 children with active VKC (six girls and 24 boys; mean age, nine +/- two years).

Systematic review and meta-analysis of randomised clinical trials on topical treatments for vernal keratoconjunctivitis.

Aims: The aim of this study was to assess the efficacy of currently available topical drugs for vernal keratoconjunctivitis (VKC) through a meta-analysis of randomised clinical trials (RCTs).

Methods: Twenty-seven RCTs (n = 2184 eyes) that had evaluated the efficacy of topical drugs for the treatment of VKC were selected according to the set criteria; 10 of these trials were suitable for statistical analysis and were enrolled in the meta-analysis. Articles published up to December 2005 were identified from the following

Data Sources: Medline, Embase, Lilacs, the Cochrane Controlled Trials Register, and references from relevant articles.

One-year follow-up of tension-free vaginal tape (TVT) and trans-obturator suburethral tape from inside to outside (TVT-O) for surgical treatment of female stress urinary incontinence: a prospective randomised trial.

Objectives: To compare tension-free vaginal tape (TVT) and trans-obturator suburethral tape from inside to outside (TVT-O) for surgical treatment of stress urinary incontinence (SUI) for complications (primary end point) and success rate (secondary end point).

Methods: Seventy-two consecutive patients, with a mean age of 53.2 yr (range: 38-69 yr) and affected by SUI, were included in this randomised controlled trial.

Pharmacokinetics of conjunctivally applied nerve growth factor in the retina and optic nerve of adult rats.

Purpose: Nerve growth factor (NGF) has been shown to inhibit retinal ganglion cell (RGC) degeneration when injected intraocularly in animal models of ocular hypertension, optic nerve transaction, and ischemia. The present study sought to establish the bioavailability of topical NGF to the retina and optic nerve in rats.

Methods: Autoradiography was performed to evaluate whether exogenous (125)I-labeled NGF reaches the retina and optic nerve when applied topically to the rat conjunctiva.

Nerve growth factor modulates in vitro the expression and release of TGF-beta1 by amniotic membrane.

Purpose: To determinate the basal production of NGF and TGF-beta1 by amniotic membrane (AM) and to verify the presence of NGF receptors (trkA(NGFR) and p75(NTR)) in AM. Thereafter, to evaluate in an in vitro model if increasing concentrations of NGF are able to stimulate AM to produce and release TGF-beta1.

Methods: Immunohistochemistry, ELISA, in situ hybridization and PCR analysis for NGF, TGF-beta1, trkA(NGFR) and p75(NTR) were performed to study their presence in AM.

Toll-like receptors and the eye.

Purpose Of Review: This review will describe the structure, expression/distribution and functional activity of Toll-like receptors, in particular in the ocular structures. It will also discuss innate and adaptive immune responses, by exploring the possible modulation/regulation of innate and adaptive immunity by Toll-like receptors, in view of recent findings observed in the ocular surface.

Recent Findings: Current knowledge indicates that Toll-like receptors represent essential elements in host defence against pathogens, a prerequisite to the induction of adaptive immune responses.

Clinical and cytological findings in limbal stem cell deficiency.

Purpose: To evaluate and relate the clinical (including corneal sensitivity and tear function) and cytological (presence of goblet cells and cytokeratin 3- and 19-positive cells) features of limbal stem cell deficiency (LSCD).

Methods: Twenty-nine patients (44 eyes) with a clinical diagnosis of LSCD participated in this study. Corneal signs (epithelial alterations, superficial neovascularisation and stromal scarring) and cytological findings (presence of goblet cells and cytokeratins 3 and 19) were evaluated and scored (from 0 to 3) from each of the five corneal sectors.

Allergic chronic inflammation of the ocular surface in vernal keratoconjunctivitis.

Purpose Of Review: The purpose of this review is to describe the new immunopathologic features of vernal keratoconjunctivitis: the involvement of cytokines, growth factors, cells, mediators and neurotransmitters, as well as the mechanism leading to tissue remodelling.

Recent Findings: Vernal keratoconjunctivitis is an allergic eye disease affecting young boys living in a warm climate. It is characterized by conjunctival giant papillae, hyperemia and frequent involvement of the cornea.