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Biomedical subjects

E Håskjold

Publications and source records attributed to E Håskjold.

18 recordsLinked to original sources

[Quality indicators in cataract surgery].

Outcome-based registration is an important aspect of quality assurance in clinical medicine. Cataract surgery has become a more advanced and difficult procedure than in the past. To assess the overall quality of cataract surgery in Norway, it is necessary to establish nationwide registration of relevant clinical data. We suggest a number of parameters identifying the quality of medical performance in cataract surgery. These parameters may be used in a central cataract register.

Age Factors↗

[EDP based medical records].

In our department we have begun to write our patients' medical history files in a computer data base. Each file is organized as a series of questions where it is possible to choose among several alternative answers instead of writing out each patient's history. We use a commercial software package modified to our specific needs. Statistical analysis of patients' files is included in the programme, to enable continuous quality control analysis of our performance.

Hospital Departments↗

Circadian variation in cell proliferation and maturation. A hypothesis for the growth regulation of the rat corneal epithelium.

The rat corneal epithelium has been chosen as a model for studying growth regulation. In this epithelium a large single cohort of cells enters the S phase during a fairly short time period once a day. The factor responsible for this wave of cell proliferation is unknown, but it may be a chemical signal from the central nervous system (the suprachiasmatic nucleus or the corpus pineale). The mature cell compartment of the corneal epithelium is assumed to produce a negative feedback factor (chalone), counteracting the effect of the circadian proliferative factor on the local cell proliferation. When no circadian factor is being produced, during most of the 24 h, the chalone seems to enhance the maturation process. During diminished chalone production (e.g. after cell injury and subsequent regeneration), we will get a more or less unrestricted cell proliferation in the tissue with a delayed maturation process prolonging the chalone depletion. This interaction between the circadian proliferative factor and the negative feedback factor for regulation of proliferation with its accompanying stimulatory effect on maturation, may represent a general mechanism in the regulation of cell proliferation in any tissue. Since in at least some organs virtually all cells entering the S phase do this as a single wave once a day, this mechanism may be enough to explain the regulation of cell proliferation during both normal and regenerative conditions.

Animals↗

[Cataract extraction with bifocal lens implantation].

Extracapsular cataract extraction with implantation of an intraocular lens (IOL) is a routine operation in Norway today. With the conventional monofocal IOL, most people require spectacles post-operatively to attain optimal vision. A new principle is the bifocal IOL, which is designed to minimize the patient's need for additional post-operative near vision correction. In this article we present the first results using this bifocal lens. Ten out of 17 patients (18 eyes) had no need of post-operative spectacles. We believe that this lens represents a promising new optical principle, and is an advance in IOL implant technology.

Aged↗

Circadian variations in the DNA synthesis of the rat corneal epithelium. A study using double labelling with tritiated thymidine.

A prominent circadian rhythm was found in the labelling indices (LI) of the peripheral rat corneal epithelium and of the adjacent conjunctival epithelium, while almost no diurnal variation was found in the central area. Application of a double labelling technique indicated that there are rhythmic pulses of high and low influx of cells into the S phase and similar pulses of efflux of cells from the S phase. Results of the study indicate that there are different cohorts of cycling cells all over the rat corneal epithelium. Cells belonging to a rapidly proliferating cohort are observed in the peripheral cornea. There is a gradual reduction in the fraction of labelled DNA-synthesizing cells towards the centre. The considerably lower fraction of cells taking up tritiated thymidine (3H)TdR in the central cornea may be due to a higher fraction of basal cells having reached higher levels of differentiation. This may result in a shift from the salvage to the de novo pathway. The slowly proliferating cohort seems to have a prolonged S phase duration and displays practically no diurnal variation in the LI. The DNA-synthesizing cells belonging to this latter cohort probably use the salvage pathway for DNA synthesis resulting in uptake of (3H)TdR all over the cornea. The LI is thus not a reliable indicator of cell proliferation in the corneal epithelium, due both to the heterogeneity of the cell proliferation, and in particular due to the lack of labelling of the centrally located DNA-synthesizing cells. To what extent these properties may also be present in other proliferating tissues with different levels of differentiations, may be questioned.

Animals↗

Two cell kinetic methods studied on the rat corneal epithelium.

A stathmokinetic method (using Colcemid) and the [3H]thymidine technique (pulse labelling with tritiated thymidine, [3H]TdR) have been evaluated in the rat corneal epithelium. The dose is not of critical importance for the Colcemid method, thus indicating an all or nothing effect within the dose range studied. A one point estimate is sufficient to calculate the mitotic rate (MR), and in the rat corneal epithelium a 4 h accumulation period is recommended. After administration of [3H]TdR there is an increasing response with increasing dose, followed by a levelling off at higher doses. It seems reasonable to use the lowest maximal effective dose. The labelling index (LI) can be reliably registered 1 h after administration of the drug. For each of the drugs we found corresponding results after topical application and intraperitoneal injection. Hence, topical application of small doses of both Colcemid and [3H]TdR makes interesting in vivo experiments on larger animals and even on human beings possible. Due to the extreme regularity of the corneal epithelium this part of the eye is an interesting organ for cell kinetic studies and provides an excellent tool for evaluating cell kinetic methods.

Administration, Topical↗

Circadian variation in the mitotic rate of the rat corneal epithelium. Cell divisions and migration are analyzed by a mathematical model.

A stathmokinetic method was used to study the diurnal variation in the mitotic rate (MR) of the rat corneal epithelium, and in the adjacent conjunctival epithelium. A prominent circadian variation in cell proliferation was observed in both epithelia, both showing almost the same pattern, which may indicate that both tissues are submitted to the same regulatory mechanisms. The average rate of cell renewal during a 24 h period indicated a mean cell renewal time of 12.3 days. This is longer than previously assumed. The MR declined toward the central cornea. Based on the above observations and the known centripetal migration of cells in the corneal epithelium, we have developed a mathematical model showing isomorphism with the renewal of the corneal epithelium.

Animals↗

The morphology of the denuded epidermal basal cell layer of the hairless mouse after different preparation methods. A scanning and transmission electron microscopical study.

The denuded basal cell layer of the hairless mouse epidermis is described in the present scanning (SEM) and transmission electron microscopical (TEM) study. The suprabasal layers were removed mechanically after trypsinization or by extracellular calcium depletion. Trypsinization before removal of the suprabasal cells caused the basal cells to shrink. Characteristic surface plication and hemi-desmosomal attachment to the basement membrane were generally preserved. SEM revealed partly maintained intercellular bridging, whereas by TEM such contacts were absent because half desmosomes were internalized. Total calcium depletion induced more serious damage to the basal cell surface, which was smooth with apparent perforations. However, cell bridges, and occasional desmosomes were present. The cell interior demonstrated important cellular injury. If the calcium deprived explants were allowed to recover in calcium-containing medium, the cells acquired an activated "regenerative" morphology, without junctions, similar to that observed in wound healing. Epidermal non-keratinocytes were seen only after trypsinization. Control experiments revealed that they adapted poorly to organ culture conditions. By TEM, we observed several interesting aspects of the differences, between dark and clear basal keratinocytes. This was unexpected because fixation studies had shown, that with the present fixation method, typical dark and clear cells do not occur in untreated epidermis. We believe that membrane injury through mechanical stripping of partly adhering epidermal layers induced "clear cells", whereby the neighboring cells appeared darker. This provides additional evidence as to the origin of the two sub-populations, dark and clear basal cells. The clear cells may be injured cells, caused by cell damage, and not by processes of cellular differentiation. The results of the present investigation supports the view that basal keratinocytes have a polygonal shape with numerous free surface extensions and they are anchored to the basement membrane with "foot pads". Our study also shows that SEM of the epidermal basal layer might be feasible. Various artifacts, however, must be considered, depending on the denudation method used. We prefer trypsinization to calcium depletion because it is less time-consuming and results in a cell morphology which in TEM is comparable to that of basal cells in untreated whole epidermis. Extra-cellular calcium depletion, however, might be useful as a method to prepare single cell suspensions for flow cytometry. Restoration of a normal calcium concentration after stripping, provides an opportunity to mimic wound healing in situ, as an alternative t

Animals↗

Migration of cells in the rat corneal epithelium.

The migration of cells in the rat corneal epithelium was studied using continuous labelling with tritiated thymidine [3H]TdR, during a 24 h period. Most mitoses resulted in 2 new basal cells. Cells leaving the basal cell layer moved vertically to the surface in all areas of the corneal epithelium. The first labelled cells reached the surface 3 days after the first injection of [3H]TdR. No stream of cells from the conjunctiva to the cornea in the limbal areas was observed, and no centripetal migration of epithelial cells in the cornea could be observed. After a cell has lost its attachment to the basement membrane, it is committed to be exfoliated in a few days without undergoing mitosis. Thus the slow centripetal migration of epithelial cells and the exchange of centrally located cells, as indicated by clinical findings and experimental studies, can only be explained by migration of basal cells.

Animals↗

Cell kinetics during healing of corneal epithelial wounds.

After removing a circular area of the central corneal epithelium of the rat eye, the labelling indices and the mitotic rates were measured at various times after wounding, both in the cornea and in the adjacent conjunctival epithelium. The proliferative response was most marked in the corneal epithelium adjacent to the wound, but there was also a definite response in the epithelium covering the denuded areas, and in the conjunctival epithelium. The study demonstrated that the conjunctival epithelium. The study demonstrated that the conjunctiva itself plays a role in the healing of a central corneal epithelial wound. The similarities in the cellular response may indicate that both epithelia are under the influence of the same growth-suppressing factors (chalones), and must be looked upon as a unit. However, no support was found for the theory that the limbal area serves as a generative organ for the corneal epithelium.

Animals↗

Isolation and culture of basal cells of the human corneal epithelium.

The present study introduces a method that permits the isolation of a pure population of viable basal cells of the human corneal epithelium. We demonstrate that this population can be maintained in culture with a maintained epithelial phenotype, DNA-synthesis, migratory and mitotic activity. The isolation procedure permits evaluation of the adhesion between cells in the epithelium and of the surface morphology and histological organisation of the basal cells. This organization is demonstrated to be far more complex than previously recognized. The culture system permits evaluation of the in vitro behaviour of a basal cell population without contaminating superficial cells or stromal cells.

Cell Adhesion↗

Cell renewal of the rat corneal epithelium. A method to compare corresponding corneal areas from individual animals.

A stathmokinetic method to study the mitotic rate in the corneal epithelium of the rat is described and applied. Horizontal and vertical diameter sections were used. In order to analyze the mitotic rate in the various parts of the corneal epithelium, each vision field (objective 100, eye piece 12.5), comprising 182 microns basement membrane, was regarded as a separate unit. Since the number of vision fields across the cornea varies from specimen to specimen, we constructed a mathematical method to correlate corresponding corneal areas from different eyes. Using this method it is shown that the mitotic rate is almost equal all over the cornea, with no definite reduction in the central areas. There is no area of significantly high proliferation rate, either in the limbal area or in the adjacent conjunctiva.

Animals↗

The influence of technical procedures on cell countings in the rat corneal epithelium: a statistical analysis.

We have performed a statistical analysis on cell counts from different areas of the rat corneal epithelium by using the number of cells per high power microscopical vision field (1250 x) as a unit. Each vision field consisted of 182 micron basal membrane. The number of vision fields varied from 29 to 39 in the horizontal and vertical diameter sections used. Only small variations were found in the number of cells from the different vision fields inside one single section. This confirm the extreme regularity of this epithelium. However, when comparing different sections, even from the same eye, the variations were much greater. Further, sections prepared for autoradiography showed a 10% reduction of the number of cells compared with the sections only stained with hematoxylin. A large proportion of the variation in the cell counts must be a result of the technical procedures, and is thus not an intrinsic property of the corneal epithelium. This conclusion may also be valid in cell counts from other epithelial structures.

Animals↗

Endogenous candida endophthalmitis. Report of two cases.

Two cases of endogenous endophthalmitis as a complication to spontaneous abortion, truly caused by candida albicans are presented. One patient received no antimycotic treatment. Endophthalmitis resulted in amaurosis in the affected eye, which had to be enucleated. The second patient was treated with intravenously administered amphotericin B and flucytocine, and was cured. The importance of early diagnosis and treatment is stressed.

Abortion, Spontaneous↗

Ocular polyarteritis nodosa. Report of a case.

A patient with bilateral amaurosis as a complication to polyarteritis nodosa is presented. He developed affection of the central retinal arteries and the arteries supplying the optic discs followed by retinal and optic atrophy. After one month no vessels could be observed neither in the retinae nor at the optic discs. The importance of early diagnosis and aggressive immunosuppressive treatment is stressed.

Aged↗