PURPOSE: Recent studies have found nocturnal reductions in systemic arterial blood pressure associated with progressive visual field loss in glaucoma. Although ocular ischemia has been hypothesized to link these two phenomena, it remains unknown if perfusion of the eye is reduced during the night in patients with glaucoma. PATIENTS AND METHODS: Nine patients with primary open-angle glaucoma (POAG) and stable visual fields who were free from systemic hypertension, as well as nine age- and gender-matched controls, were studied at 9:00 P.M., and then during sleep at 12:00, 3:00, and 6:00 A.M. Systemic blood pressure, intraocular pressure (IOP), and color Doppler imaging (CDI) of the ophthalmic artery were measured at each time. RESULTS: Arterial blood pressure and ophthalmic artery peak systolic and end-diastolic velocities were similar and were unchanged over time, in both groups. In contrast, the ophthalmic arterial resistance index decreased as the night progressed (p < 0.05), identically in controls and patients. In patients with glaucoma, CDI indices were independent of changes in arterial pressure, IOP, or calculated ocular perfusion pressure. CONCLUSION: Patients with POAG characterized by stable visual fields who were free from systemic hypertension exhibited normal ophthalmic arterial hemodynamics at night; there was no evidence of ocular ischemia or vasoconstriction.

Blood Pressure↗

PubMed1995

Fibre is an essential ingredient of enteral diets to limit bacterial translocation in rats.

OBJECTIVE: To assess the effect of six different enteral diets on the gut barrier. DESIGN: Laboratory study. SETTING: University hospital, Germany. MATERIAL: 70 Specific pathogen free female Crl:CDR BR rats. INTERVENTIONS: For 7 days, 6 groups of rats were fed orally with standard chow (n = 15); total parenteral nutrition solution (oral TPN, n = 15); elemental diet (ED, n = 10); nutrient-defined diet (NDD, n = 10); or the NDD supplemented with uracil (NDD+uracil, n = 10), or fibre (NDD+fibre, n = 10). MAIN OUTCOME MEASURES: Bacterial translocation to mesenteric lymph nodes, numbers of Gram negative enterobacteria and total aerobic bacteria in the caecum, and intestinal concentrations of secretory IgA. RESULTS: The incidence of bacterial translocation was significantly increased in the groups given oral TPN, ED, NDD, and NDD+uracil compared with the group given chow. Only NDD+fibre resulted in a similar degree of translocation to that in the chow group. All groups in which there was increased translocation had a highly significant overgrowth of aerobic bacteria in the caecum, mainly by Gram negative enteric organisms. The secretory IgA concentration was reduced in the group that had been given oral TPN, and that in the ED and NDD+uracil groups was similar to that in the chow group. NDD and NDD+fibre were associated with higher intestinal concentrations of secretory IgA than chow. CONCLUSION: Fibre-free enteral diets do not protect the gut antimicrobial barrier whatever else is in them. The superiority of early enteral as opposed to parenteral nutrition after injury may, therefore, not be the result of a specific protective effect on the gut barrier. The supplementation of commercial enteral diets with bulk fibre should be tested in clinical trials.

Analysis of Variance↗

PubMed1994

Secretory immunoglobulin A, intestinal mucin, and mucosal permeability in nutritionally induced bacterial translocation in rats.

OBJECTIVE: The authors investigated the role of mucin and secretory immunoglobulin A (slgA) in a model of nutritionally induced bacterial translocation. BACKGROUND: Parenteral and certain elemental diets have been shown to impair intestinal barrier function, whereas fiber has been shown to protect against nutritionally induced bacterial translocation. However, the factors responsible for these phenomenon have not been fully determined. METHODS: Intestinal mucin levels, mucosal protein content, slgA, intestinal morphology, and permeability to horseradish peroxidase, bacterial translocation, and intestinal bacterial population levels were measured in rats 7 days after receiving total parenteral nutrition (TPN) solution (28% glucose, 4.25% amino acids; 307 kcal/kg/day) enterally (ORAL-TPN) or parenterally (IV-TPN) with or without enteral bulk fiber supplementation. Chow-fed rats served as control subjects. RESULTS: The incidence of bacterial translocation in the ORAL-TPN and IV-TPN groups was reduced significantly by the provision of fiber (p < 0.05). Mucosal protein, slgA, and insoluble mucin levels were decreased in the jejunum of the ORAL-TPN and IV-TPN groups, with mucosal protein levels being decreased to a greater extent than slgA or mucin. Although similar decreases in these parameters were observed in the fiber-fed groups, fiber appeared to improve intestinal barrier function as measured by horseradish peroxidase permeability. CONCLUSIONS: The provision of bulk-forming fiber improves intestinal barrier function as measured by peroxidase permeability and bacterial translocation, but does not restore mucosal protein content, intestinal mucin, or slgA levels to normal.

Animals↗

PubMed1991

The effect of a glaucoma medication reminder cap on patient compliance and intraocular pressure.

A multi-site, open-labeled clinical trial was conducted to evaluate the ease of use and acceptance of a newly developed medication cap with a memory aid (C Cap Compliance Cap, Allergan, Inc.) and its effect on patient compliance and intraocular pressure. One-hundred-twenty-two patients with glaucoma or ocular hypertension received their prescribed eye drops in bottles with the compliance cap. Overall, 83% of the patients found the compliance cap very easy to use. By the end of the study, significantly more patients (67%) claimed 100% compliance than prior to using the compliance cap (41%). An overall drop in intraocular pressure of 0.8 mm Hg was seen. However, in a subset of patients who reported an increase in compliance, mean intraocular pressure decreased from baseline by 1.7 mm Hg. The results of this study suggest that the compliance cap helps patients with glaucoma or ocular hypertension remember to take their medication as prescribed.

Adolescent↗

PubMed1990

Splenectomy influences endotoxin-induced bacterial translocation.

To determine whether splenectomy affects the antibacterial defenses of the gut, experiments were performed using bacterial translocation (BT) as a marker of intestinal barrier failure. The incidence of BT was measured 8 days after splenectomy or sham-splenectomy in mice receiving or not receiving endotoxin (0.1 mg IP). Splenectomy does not appear to promote BT from the gut, since the incidence of bacterial translocation after splenectomy or sham-splenectomy (5%) were not different. A second experiment was performed to determine whether the resistance to endotoxin-induced BT was modified after splenectomy. The incidence of endotoxin-induced BT was 73% in the unoperated control group, 59% in the sham-splenectomy group, but 23% in the splenectomy group (p less than 0.002). Thus, splenectomy but not sham-splenectomy increased the resistance of otherwise healthy mice to endotoxin-induced BT.

Animals↗

PubMed1990

Food without fiber promotes bacterial translocation from the gut.

To determine whether the route and/or composition of nutritional support alters intestinal barrier function (measured as bacterial translocation), rats were divided into three groups: food (controls), intravenous total parenteral nutrition (IV-TPN) fed, and oral total parenteral nutrition (ORAL-TPN) fed. Bacterial translocation did not occur in the rats that were fed normally, but did occur in 60% of the rats fed the IV-TPN or the ORAL-TPN diets for 7 days (p less than 0.05). Since both the IV-TPN and ORAL-TPN diets induced bacterial translocation and the TPN solution (28% glucose and 4.5% amino acids) lacks fiber, two additional groups of rats were fed orally 2.5 gm cellulose powder/day plus TPN solution by either the intravenous or the oral route. The addition of cellulose powder decreased the incidence of bacterial translocation to 8% in the group fed the ORAL-TPN diet and to 0% in the group fed the IV-TPN diet. Cellulose improved intestinal barrier function, even though it did not prevent bacterial overgrowth or the loss of mucosal mass in the rats fed the IV-TPN or ORAL-TPN diets. Cellulose powder appears to have prevented bacterial translocation primarily by preventing IV-TPN- or ORAL-TPN-induced alterations in mucosal structure. Thus the oral administration of this fiber maintains intestinal barrier function and prevents bacterial translocation even in the absence of oral nutrients.

Administration, Oral↗

PubMed1989

A comparison of the ocular hypotensive efficacy of once-daily and twice-daily levobunolol treatment.

The authors compared the ocular hypotensive efficacy of two different treatment regimens of levobunolol 0.5% in a double-masked, randomized, controlled clinical trial. Seventy-one patients with open-angle glaucoma or ocular hypertension received levobunolol 0.5% as their sole glaucoma medication either on a once-daily or twice-daily treatment regimen for 3 months. Approximately 81% of the patients in the once-daily treatment group and 88% of subjects in the twice-daily treatment group successfully completed the 3-month study period. The overall mean decrease in intraocular pressure (IOP) was 4.5 mmHg in the once-daily group and 5.6 mmHg in the twice-daily group. These differences were not statistically different. For both treatment groups, effects on mean heart rate and blood pressure were minimal. The authors' data from this population suggest that once-daily treatment with levobunolol is an effective glaucoma regimen.

Blood Pressure↗

PubMed1988

A new handheld air impulse tonometer.

A new type of non-contact tonometer is described. The instrument is handheld and incorporates a system which automatically generates the measuring pulse of air when the alignment is correct. A brief description of the design and the results of clinical trials are presented. These establish a good correlation with paired Goldmann readings (correlation coefficient, r = 0.88 to 0.95, standard deviation, S.D. 1.56 to 2.66 mm Hg).

Air↗

PubMed1985

Minimum concentration of levobunolol required to control intraocular pressure in patients with primary open-angle glaucoma or ocular hypertension.

In a double-masked, randomized, comparison titration study to determine the effective dose of topically applied levobunolol, three concentrations of levobunolol (0.25%, 0.5%, and 1%) and of timolol (0.125%, 0.25%, and 0.5%) were evaluated in patients with mild open-angle glaucoma or ocular hypertension. Following a washout of ocular hypotensive medication, twice-daily treatment in both eyes was initiated with the lowest of the three doses of either drug. The concentration was increased if intraocular pressure remained uncontrolled. Intraocular pressure was controlled in 63% (15 of 24) of the patients tested with the lowest concentration of levobunolol and 69% (18 of 26) with the lowest concentration of timolol. Overall, 75% (18 of 24) of the patients in the levobunolol group and 73% (19 of 26) of the patients in the timolol group had adequately controlled intraocular pressure. At the lowest concentrations tested, mean decreases from baseline in intraocular pressure ranged from 6 to 8 mm Hg in both treatment groups.

Clinical Trials as Topic↗

PubMed1982

Osteoinduction. Part I: Test model and comparative long term observation of allogenic and xenogenic matrix implants.

In order to demonstrate osteoinductive activity of transplants and implants an experimental approach is presented in this study. Matrix induced osteogenesis following allogenic and xenogenic implantation is demonstrated morphologically, by induction of alkaline phosphatase, and by mineralisation of the newly formed matrix. Beginning on day 20 new bone formation can be found lasting up to 6 months in allogenic implants, whereas in xenogenic implants only inflammatory infiltrations are detectable. Osteoinduction is a matrix conducted phenomenon, as was confirmed by control experiments. Orthotopic allogenic implantation in diaphyseal defects of dogs demonstrates the ability of such implants to bridge a great defect by induced new bone formation and the property of the newly formed bone to adapt to physiologic stress.

Alkaline Phosphatase↗

PubMed1969

Oguchi's disease in Negroes.

Explore the source record for details and available documents.

Adaptation, Ocular↗

PubMedDate not supplied

Bulk prevents bacterial translocation induced by the oral administration of total parenteral nutrition solution.

The effects of a fat and glutamine-free orally administered total parenteral nutrition (TPN) solution on intestinal mucosal mass, morphology, barrier function, and cecal bacterial population levels were measured in CD-1 mice. Ileal mucosal protein content decreased by 63% (p less than 0.01) in the oral TPN-fed mice, although they gained weight on this diet. These TPN-fed mice also exhibited changes in mucosal structure and the normal ecology of their cecal microflora was disrupted leading to overgrowth with Gram-negative enteric bacilli. These changes in intestinal mucosal mass, morphology, and gut bacterial ecology were associated with an increased incidence of bacterial translocation (BT) (TPN group 70% BT vs control group 15% BT: p less than 0.01). The administration of cellulose fiber or kaolin (bulk-forming agents), but not of citrus-pectin (a fully-fermentable, nonresidue fiber) reduced the incidence of BT in the TPN-fed mice to control levels. The beneficial effects of these bulk-forming agents appeared to be due to their ability to prevent TPN-induced disruption of the intestinal microflora and alterations in intestinal morphology, even though they did not prevent ileal mucosal protein levels from decreasing. These results suggest that the administration of bulk forming agents will prevent the loss of intestinal barrier function against luminal bacteria that occurs in mice fed an oral TPN solution.

Administration, Oral↗

PubMedDate not supplied

Glutamine peptide does not improve gut barrier function and mucosal immunity in total parenteral nutrition.

In two separate experiments, three groups of 10 (first experiment) and 12 (second experiment) rats each were catheterized for the long term via the right jugular vein and fed one of the following dietary regimens for 7 days while in individual metabolism cages. The rat food control groups were fed powdered rat food. The total parenteral nutrition (TPN) formula for one group was enriched with the stable dipeptide L-alanyl-L-glutamine (ALA-GLN) equivalent to a 1% or 2% glutamine concentration. For the control TPN groups, the dipeptide was replaced by isonitrogenous amounts of alanine (ALA). In both experiments, bacterial translocation was promoted to a similar extent by the ALA-GLN and ALA TPN formulas compared with the rat food groups. Bacterial overgrowth in the cecum and intestinal atrophy, quantitated by the mucosal protein content, did not differ between ALA-GLN and ALA groups. The nitrogen balances of the three groups showed similar values in the second experiment. The secretory immunoglobulin A was measured in washings of the jejunum and ileum (soluble fraction) and in the homogenates of the gut mucosa (insoluble fraction). The secretory immunoglobulin A values of both fractions showed no difference between the ALA and ALA-GLN groups, irrespective of whether they were normalized for gut segment length or corrected for mucosal protein content. In conclusion from these results, the supplementation of TPN with glutamine does not seem to improve gut barrier function or mucosal immunity in unstressed rats.

Alanine↗