Biomedical subjects

K Engelmann

Publications and source records attributed to K Engelmann.

At least 55 records · Page 3Linked to original sources

PubMed1999

Interventional MR: interstitial therapy.

The rationale and results for interstitial therapies via interventional MRI in the treatment of tumors in various regions are presented. Different interstitial treatment techniques are presented based on varying technologies both for tumor ablation and treatment monitoring. Data are presented based on 335 patients, 29-84 years of age (mean age 59 years, 196 men and 139 women) with a total of 932 liver tumors, 16 head and neck tumors and 14 abdominal recurrent pelvic and lymphatic tumors. All lesions had been treated with MR-guided laser-induced interstitial thermotherapy (LITT) via 2516 laser applications and 1856 cannulations. Data in the literature are extremely varying depending on author experience, treatment technique, and the included patient material. In our patient material we were able to achieve a local tumor control of 96.7% depending on the size of the tumorous lesion, the topographical relationship, and the applied laser parameters. The overall cumulative survival rate of patients with liver metastases was 45.74 months (median 40.97 months, 95 % confidence interval 31.42-50.52). The cumulative survival rate of the patient group with hepatic metastases of colorectal carcinoma was 42.71 months (median 39.33 months, 95% confidence interval 33.26-45.37). In patients with head and neck tumors a relevant reduction in clinically relevant symptoms such as pain, swallowing disorders, or nervous compression was achieved in 11 of 15 patients treated with LITT. In 14 soft tissue tumors, such as pelvic tumor recurrence and lymph node metastases, a local tumor control was obtained in 68% of lesions. Interstitial therapies under interventional MRI guidance, such as LITT, results in a high local tumor control with an improved survival rate.

Abdominal Neoplasms↗

PubMed1999

[Endothelial cell transplantation and growth behavior of the human corneal endothelium].

BACKGROUND: The human corneal endothelium has a limited proliferative capacity in vivo. Until now it has only been possible to replace damaged endothelium by transplantation of a donor cornea. After establishing methods for the isolation and in vitro cultivation of human corneal endothelial cells, transplantation of these cells my be an alternative therapeutic option. MATERIALS AND METHODS: In this review methods for the in vitro cultivation of human corneal endothelial cells and their transplantation on the Descemet membrane of donor corneas are described. RESULTS: In vitro proliferation of human adult corneal endothelial cells was achieved by the development of defined cell culture conditions, including supplementation of culture medium with specified growth factors and substances. Dependent on the culture conditions, as well as independent of them, in vitro cultured endothelial cells showed phenotypic changes and different proliferative behavior. Thus, molecular biological examinations revealed a different expression pattern of growth factor receptors in fibroblast-like endothelial cells (dedifferentiated) compared to typical endothelial cells (differentiated). Moreover, the proliferative capacity of the cells differed, dependent on their corneal location. Cells isolated from the peripheral part of donor corneas have a higher proliferative capacity than cells obtained from the central part. The propagation of corneal endothelial cells in vitro offered the possibility of their transplantation on donor corneas in an in vitro model. After transplantation, these cells formed a monolayer whose morphology and cell density depended on the differentiation of the cells. DNA synthesis was predominantly detectable in cells of the corneal periphery. CONCLUSIONS: Our findings are the basis of the following hypothesis: the periphery of the cornea represents a regenerative zone of the corneal endothelium. The fact that early after transplantation corneal endothelial cells form a monolayer on the natural extracellular matrix (ECM), which shows contact inhibition, suggests that inhibitory factors are released by the Descemet membrane that influence the proliferation of the cells. Further studies on the regulation of the proliferation and differentiation of human corneal endothelial cells in vitro and after transplantation might offer the possibility to establish a selective procedure for the treatment of corneal endothelial cell loss in the near future.

Adult↗

PubMed1999

[Structure of a cell bank for transplantation of HLA-typed, cryopreserved human adult retinal pigment epithelial cells].

BACKGROUND: The transplantation of retinal pigment epithelial cells (RPE) in patients with age-related macular degeneration is discussed as a future therapy. A cornea bank can serve as a source for cells that can be isolated, cultivated, HLA-typed and cryopreserved for subsequent tissue-compatible transplantation. METHODS: RPE cells are isolated enzymatically from donor eyes and are cultured in a specially designed growth medium. After multiplication, one part of the culture is cryopreserved; the other part is subcultured for HLA-typing. Completely typed and morphologically sufficiently well-differentiated cell cultures are registered on a donor list (RPE cell bank) and can be provided for cell transplantations with matching HLA type in patients suffering from RPE degenerative diseases. RESULTS: A total of 461 cell cultures have been prepared since 1996; 116 fully typed and well-differentiated cell cultures are stored in our cell bank. Since January 1998 patients who agreed to have an RPE transplantation have been registered on a waiting list. Seven transplantations have already been performed. CONCLUSION: RPE cells can be stored cryopreserved in a cell bank and can be kept available for transplantation for a prolonged period of time.

Adolescent↗

PubMed1999

Physiological features of primary cultures and subcultures of human retinal pigment epithelial cells before and after cryopreservation for cell transplantation.

BACKGROUND: One striking disadvantage of in vitro culturing of human retinal pigment epithelial (RPE) cells is the loss of epithelial differentiation and specific cell function during culture. This may be one of the main reasons for the failure of RPE cell transplantation. The aim of this study was to evaluate cell culture conditions ensuring the maintenance of differentiation and function of RPE cells after subcultivation and storage in liquid nitrogen. METHODS: Enzymatically isolated cells were seeded onto coated culture dishes, cultured with a specially formulated improved growth medium until confluence and then cryopreserved in liquid nitrogen for 16-66 months. HLA class I and II typing was performed before cryopreservation and after thawing. Expression of Ca2+ channels in primary, first-passage and cryopreserved RPE cells was studied using the patch-clamp technique. RESULTS: After cryopreservation no loss of any HLA antigen was detectable in 12 of 14 cell strains studied. Patch-clamp experiments demonstrated that high-threshold L-type Ca2+ channels, which are typical for freshly isolated cells, could be detected in first-passage and cryopreserved RPE cells only when improved culture conditions were employed, not in conventionally cultured cells. The characteristics of these channels showed little change in subcultured cells compared to primary cultures. CONCLUSION: This is the first study showing the maintenance of adult human RPE-specific cell differentiation and characteristics in vitro after primary culture and after cryopreservation using improved cell culture methods. The optimization and quality control of cell culture is an important prerequisite for successful cell transplantation.

Adolescent↗

PubMed1999

Transplantation of adult human or porcine corneal endothelial cells onto human recipients in vitro. Part I: Cell culturing and transplantation procedure.

PURPOSE: To develop a method for grafting endothelial cells isolated from organ-cultured adult human corneas onto the denuded Descemet's membrane of human recipients. METHODS: Adult human or porcine corneal endothelial cells were isolated and maintained in monolayer cultures before seeding. Recipient corneas were stripped of their own endothelium by one of three different methods (mechanical, chemical, or physical) and the completeness of removal assessed after vital staining. The utility of each method was evaluated by monitoring the quality of attachment of the seeded-cell population. The seeding density of transplanted cells required for optimal results also was determined and the final numeric cell density achieved on recipient corneas after culturing for 7-20 days ascertained. The influence of incubating source cells with fibroblast growth factor (FGF), both on this latter parameter and on cell morphology, also was evaluated. The functional integrity of regrafted endothelium was assessed in 24-h perfusion experiments. RESULTS: The seeding of between 150,000 and 700,000 cells onto recipient corneas, followed by gentle centrifugation to improve attachment, yielded maximal final numeric cell densities of 3,450/mm2 and 1,850/mm2 in porcine and human lines, respectively. Recipient corneas were most effectively denuded of their own endothelium by freezing-and-thawing. The newly established endothelial monolayer remained stable for up to 20 days in organ culture (longest period monitored). FGF treatment did not enhance the final numeric density of cells attained on recipient corneas, but it did have a beneficial effect on their morphology. Only those recipient corneas that exhibited a well-differentiated monolayer of seeded endothelial cells underwent stromal deswelling near to physiologic levels. CONCLUSION: A practical working model has been developed, whereby recipient corneas stripped of their own endothelium can be furnished with a "new," near-normal endothelium by appropriate manipulations of the seeded-cell population. This now paves the way for a realistic tackling of the problem of endothelial cell paucity in donor corneas destined for transplantation.

Adult↗

PubMed1999

Transplantation of cultured adult human or porcine corneal endothelial cells onto human recipients in vitro. Part II: Evaluation in the scanning electron microscope.

PURPOSE: To evaluate the morphology of endothelial monolayers, which have been regrafted onto the denuded Descemet's membrane, with scanning electron microscopy (SEM). METHODS: Material derived from each of the experimental groups described in part I of this investigation was evaluated in the current study. Recipient corneas, denuded of their native endothelium by mechanical, chemical, or physical debridement, were examined to assess the effectiveness of each technique in killing and removing cells. Porcine or human donor corneal endothelial cells maintained in monolayer culture for up to 10 passages then were seeded onto the denuded Descemet's membranes of recipients in the absence or presence of fibroblast growth factor (FGF). The monolayers thereby established were examined in the SEM, and the morphologic status of individual cells compared with that manifested in normal human donor corneas maintained for 4 weeks in organ culture (reference control). Isolated and cultured human keratocytes regrafted onto the denuded Descemet's membranes of recipient corneas served as nonendothelial control specimens. Tissue was processed for examination in the SEM according to standard techniques. RESULTS: Each of the three methods used to strip recipient corneas of their native endothelium was effective and elicited no gross structural damage to Descemet's membrane. Some small focal defects within this latter layer were, however, observed, these being encountered at higher frequency after mechanical debridement than after chemical or physical stripping. Porcine or human endothelial cells seeded onto the denuded Descemet's membranes of recipient corneas formed stable monolayers. The morphologic status of regrafted cells corresponded to that manifested in monolayer cultures before seeding, porcine ones always being more differentiated than their human counterparts. Poorly differentiated human endothelial cells had a slender, elongated, fibroblast-like appearance, whereas more highly differentiated ones manifested broad, flat, polygonal profiles. Monolayers covered the entire corneal surface and impinged to a variable degree onto the trabecular meshwork, at which juncture cells always assumed a less well-differentiated morphology. FGF consistently effected an increase in differentiation status, and as this became augmented, the capacity of monolayers to violate the corneal-trabecular meshwork border was correspondingly repressed. Seeded keratocytes formed dense, multilayered sheaths, resembling retrocorneal membranes, across the entire corneal surface, trabecular meshwork, and iris root. The surface characteristics of the constituent cells were quite distinct from those manifested by endothelial cells, even the least well-differentiated ones. CONCLUSION: Regrafting of human corneal endothelial cells onto the denuded Descemet's membranes of recipients resulted in the formation of stable monolayers. Because the morphologic status of seeded cells closely mimicked that manifested in monolayer cultures before transplantation, it may be anticipated that efforts to refine and optimize culturing conditions would yield improvements in this parameter after regrafting. If these expectations can be realized, then the possibility of successfully establishing a "new" and functional endothelium on recipient corneas destined for clinical grafting may well be brought to fruition in the not-too-distant future.

Adult↗

PubMed1999

Fetal calf serum protects cultured porcine corneal endothelial cells from endotoxin-mediated cell damage.

In corneal organ culture, a contamination of sterile culture media with endotoxin is frequently found. Thus, we investigated if the presence of endotoxin affects the viability of cultured porcine corneal endothelial cells. Endotoxin in high concentrations caused morphological cell changes in porcine corneal endothelial monolayer cultures, delayed proliferation and decreased cellular esterase activity of porcine corneal endothelial cells in vitro. The toxic effect of endotoxin was modulated by the fetal calf serum content of the medium, the concentration of endotoxin and the incubation time.

Animals↗

PubMed1998

[Necrotizing keratitis in chronic polyarthritis. Combined immunosuppressive and surgical therapy].

INTRODUCTION: Areactive forms of keratitis in patients with seropositive rheumatoid arthritis are inflammations threatening the visual acuity and integrity of the eye. They commonly occur in a rheumatologically inactive interval and have a poor prognosis. A retrospective evaluation of medicamentous and surgical strategies for a curative therapy with optical rehabilitation is necessary to optimise the treatment of patients with necrotic sclerokeratitis. PATIENTS AND METHODS: A total of 27 eyes of 22 patients (14 women and 8 men, ranging in age at the time of operation from 40 to 88 years; mean 68.7 years) with seropositive rheumatoid arthritis and secondary Sjögren's syndrome were reviewed retrospectively. There were 17 eyes with necrotic keratitis and 9 eyes with necrotic sclerokeratitis. In one eye, necrotic sclerokeratitis with bacterial transmigrating keratitis and hypopyon occurred. OPERATIONS: In 8 cases we performed a perforating mini-keratoplasty, in 16 cases a tectonic and optical perforating keratoplasty, in 3 cases a tectonic sclerokeratoplasty, in 9 patients a combined keratoplasty and cataract extraction with posterior chamber lens implantation and in 1 case a partial conjunctival plasty. Follow-up ranged from 7 months to 4 years (average 2.8 years). RESULTS: In all eyes, a sufficient tectonic and primary curative effect was achieved only under cyclophosphamide immunosuppression. In 3 cases, a rekeratoplasty had to be performed because of recurrent keratitis after changing the systemic cyclophosphamide therapy to methotrexate, glucocorticosteroids or non-steroid antiphlogistic agents. Visual acuity outcome was depending on the eccentricity of the keratoplasty and earlier affections of the eye. Postoperatively, the visual acuity improved in 23 eyes. In 3 cases, no change of visual acuity was achieved. Visual acuity deteriorated in one case from counting fingers to hand motions. Peri- and postoperative complications during the follow-up period were corneal infiltration around sutures in 4 eyes, graft rejecting reactions in 3 cases, and sicca syndrome in 6 cases. CONCLUSIONS: The intensive cooperation of ophthalmologists and rheumatologists enables the successful treatment of apparently hopeless situations in necrotic sclerokeratitis in patients with seropositive rheumatoid arthritis. The rate of complications under an immunosuppressive therapy with cyclophosphamide was found at average 2.8 years follow-up to be low. The indication for the combined therapy depends on the ophthalmological findings; rheumatologists and ophthalmologists should decide on the appropriate dosage for the systemic cyclophosphamide therapy. Topical glucocorticosteroid therapy alone is contra-indicated.

Adult↗

PubMed1998

[Effect of E. coli endotoxin on auto-/paracrine function and endothelial cell loss of donor corneas in organ culture].

Corneal cells are known to participate in the regulation of local inflammatory processes by secretion of cytokines. As the corneal endothelium may be exposed to endotoxin in organ culture and endotoxin is known to trigger inflammatory reactions, we investigated the effect of endotoxin from E. coli on organ cultured donor corneae with respect to autocrine and paracrine functions and the endothelial viability and density. 6 pairs of donor corneae were transferred to organ culture. Medium samples were taken prospectively from day 0 to day 20. On day 10 the medium was changed and one of each pair was incubated with 50 micrograms/ml of endotoxin while the other was immersed in standard organ culture medium. The samples were screened for IL-1, -2, -4, -5, -6, -8, -10, TNF alpha and GM-CSF by ELISA. In addition endothelial cell counts were performed at day 0, after 10 and after 20 days of organ culture, using the fixed frame technique. All endotoxin-incubated organ culture media showed significantly increased IL-6 and -8 levels compared to the fellow cornea and to pre-exposure levels (P < or = 0.004). In the endotoxin-treated corneae a significantly higher endothelial cell loss occurred (P = 0.007) and signs of degeneration were observed. None of the other cytokines (IL-1 alpha, IL-2, IL-4, IL-5, IL-10, GM-CSF and TNF alpha) were detected during either the first (1 to 10-day) or the second (11 to 20-day) phase of incubation. A correlation seems to exist between an increase in IL-6 and -8 induced by endotoxin, and endothelial cell loss in organ culture.

Adult↗

PubMed1998

A sensitive method for testing the quality of organ culture media and of individual medium components in a cornea bank.

BACKGROUND: It has been suggested that variations in the quality of organ culture preservation media are responsible for variations in early postoperative graft morphology. Spates of such variations have been observed repeatedly for short periods. This paper reports the results of a series of grafts with low postoperative clearing observed during a period of 6 weeks. Simultaneously, preoperative phase-contrast microscopy evaluation of the corneal endothelium revealed that an unusually large proportion of donor corneae were unsuitable for transplantation. METHODS: The corneal storage media were therefore rigorously screened, paying particular attention to specific components and properties of the medium, including L-glutamine, amphotericin B, water quality, pH, and the glassware used. Possible toxic effects were identified by means of a sensitive growth assay performed using isolated human corneal endothelial cells. RESULTS: The evaluation demonstrated that both the water quality and the L-glutamine which had been used for preparation of the medium were substandard during the period in which poor clinical results were obtained. CONCLUSION: It is recommended that cornea banks undertaking long-term organ culture use standardized protocols and carefully monitored equipment. The quality of the basal media and supplements should be routinely checked.

Amphotericin B↗

PubMed1998

Detection of neurone-specific enolase in long-term cultures of human corneal endothelium.

BACKGROUND: Human corneal endothelial cells cultivated in monolayer culture for protracted periods undergo morphological dedifferentiation, whereby they assume a more fibroblast-like appearance. These cultures may also become overgrown with contaminating stromal fibroblasts and/or with keratocytes, when non-selective media are employed, thus rendering identification of actual endothelial cells difficult on a strictly morphological basis. METHODS: The endothelium of the human cornea stains for neurone-specific enolase (NSE) in situ, and we therefore wished to study the expression of this marker in primary and long-term monolayer cultures of these cells. Ten such cultures were established, six being stained for NSE at the primary and first-passage stage, the other four for 6, 8, 10 and 12 months. The NSE-staining pattern manifested in co-cultures of corneal endothelium and fibroblasts or keratocytes (first to fifth passage cultures) was also investigated, and co-cultures established from each of the latter two cell types served as controls. RESULTS: In monolayers of corneal endothelium which had retained their cobblestone-like morphology, NSE could be demonstrated even after more than 20 passages, which amounted to 1 year in culture. Dedifferentiated or degenerating endothelial cells stained poorly and inhomogeneously. Control cultures of fibroblasts or keratocytes were consistently NSE-negative, and when each of these cell types was co-cultured separately with corneal endothelium, only the latter expressed the marker protein. CONCLUSION: Since antibodies against NSE are commercially available, practical use may be made of this marker protein for confirming corneal endothelial status in long-term cultures.

Biomarkers↗

PubMed1998

Different characteristics of endothelial cells from central and peripheral human cornea in primary culture and after subculture.

Several methods for isolation and cultivation of human corneal endothelial cells have been described during the last few decades. In contrast to the situation in vivo, the cultured cells show mitogenic activity but often lose their typical morphological appearance. In this paper, we describe a technique to isolate and cultivate morphologically unchanged endothelium from the human cornea. This method revealed different characteristics of endothelial cells according to their position within the human cornea. Endothelial cells isolated from the central part have a morphology similar to that of cells in vivo (i.e., they are densely packed and show no mitogenic activity). In contrast, endothelial cells derived from the peripheral part of the cornea are characterized by mitogenic activity but their cell-to-cell attachment seems to be less tight than in vivo. The significance of these two different endothelial cell types for wound healing in the human cornea is discussed.

Cells, Cultured↗

PubMed1997

Endothelial cell death in organ-cultured donor corneae: the influence of traumatic versus nontraumatic cause of death.

BACKGROUND: Donors who have suffered a traumatic death are, on average, younger than those who have died from other causes, and the time from death to enucleation (DET) also tends to be shorter. Corneae obtained from such donors are therefore considered particularly suitable for grafting. One of the reasons for excluding a donor cornea from transplantation is the occurrence of endothelial cell necrosis during organ culture, and we investigated whether the incidence of this phenomenon bears a relationship to death by traumatic or nontraumatic means. METHODS: Data from 2125 donor corneae were collected using standardized evaluation protocols between January 1991 and December 1995 and included information on cause of death, age and DET, as well as endothelial cell loss and necrosis. Traumatic deaths were recorded in 346 cases, nontraumatic deaths in the other 1779 cases. Since differences in age (P = 0.006) but not in DET occurred within each of these groups, a more refined comparison, with matched data (< 35 years), was also undertaken. RESULTS: Forty (11.6%) of the 346 corneae derived from traumatic death donors manifested total or partial endothelial cell death in organ culture. The corresponding figure in the nontraumatic death group was only 105/1779 (5.8%; P = 0.0002). After matching for age, endothelial cell death during culturing was revealed in 18 (13.5%) of the 133 of the traumatic death corneae and in 3 (2.6%) of the 115 nontraumatic death ones (P = 0.004); the overall incidence of endothelial cell death (total or partial) during organ culture was 6.8% (145/2125). Endothelial cell loss during culturing of the 227 age-matched donor corneae which still had an intact endothelial monolayer at the end of the incubation period was 340 +/- 388 cells/mm2 in traumatic death corneae (n = 115) and 255 +/- 318 cells/mm2 in nontraumatic death ones (n = 112; P = 0.051). CONCLUSION: Corneae obtained from traumatic death donors were more liable to undergo total or partial endothelial cell death during organ culture than were those procured from nontraumatic death ones. However, in corneae which survived the period of culture, there was no significant difference in endothelial cell loss between the two groups. Whilst the mechanism underlying this increased susceptibility of traumatic death corneae to cell death remains elusive, the data gleaned from this investigation nonetheless emphasize the potential importance of being able to perform meaningful in vitro viability tests on donor corneae; this is possible only under organ culture conditions.

Adult↗

PubMed1997

Corneoscleral discs excised from enucleated and non-enucleated eyes are equally suitable for transplantation.

PURPOSE: To assess whether the biological quality of corneoscleral tissue dissected in situ is, after organ culture, comparable to that harvested after enucleation. METHODS: Corneoscleral discs were prepared from 23 donor eyes, either after enucleation, under laminar flow conditions (right eyes; group 1) or by direct excision in situ (left eyes; group 2). Endothelial cell counts were made and the degree of tissue contamination assessed both prior to and upon termination of organ culture. RESULTS: Microbial growth was found in 12/22 conjunctival swabs collected from group 1 eyes and in 14/22 of those obtained from group 2 globes (p = 0.76). Bacterial growth was detected in four primary culture media, two from each group, at low colony densities. No significant difference in endothelial cell counts were encountered between the two groups, either immediately after dissection [group 1: 2940 +/- 308 (2100-3500) c/mm2; group 2: 2947 +/- 345 (2200-3700) c/mm2; p = 0.945] or upon termination of organ culture [group 1: 2646 +/- 321 (1895-3200); group 2: 2723 +/- 312 (2100-3650); p = 0.413]. CONCLUSION: Dissection of corneoscleral discs in situ may serve as an alternative to the conventional technique if consent is obtained to remove only the cornea. The risk of contamination is no higher and endothelial cell viability no lower than in tissue derived from enucleated globes, provided that the excision is performed by a skilled surgeon and a rigorous disinfection protocol is instigated.

Adolescent↗

PubMed1997

Comparative study on the effects of different growth factors on migration of bovine corneal endothelial cells during wound healing.

PURPOSE: In a comparative study we investigated the effects of epidermal growth factor, acidic and basic fibroblast growth factor, transforming growth factor-beta1, and vascular endothelial growth factor on proliferation and migration of cultured bovine corneal endothelial cells during wound healing. METHODS: Cell proliferation was determined by incorporation of 5-bromo-2'-deoxy-uridine and by cell counting. To investigate cell migration, we established a method to produce identically shaped cell-free areas in monolayers of cultured cells and documented the wound-healing process. RESULTS: Concerning the five tested growth factors, only epidermal growth factor as well as basic and acidic fibroblast growth factor stimulated DNA synthesis, cell proliferation, and migration during wound healing. Vascular endothelial growth factor stimulated migration during wound healing without influencing DNA synthesis or cell proliferation. CONCLUSION: Whereas epidermal growth factor and the basic and acidic forms of fibroblast growth factor enhance proliferation as well as migration during wound healing, vascular endothelial growth factor seems to be a stimulatory agent specific for corneal endothelial cell migration.

Animals↗

PubMed1997

Endotoxins modulate the autocrine function of organ cultured donor corneas and increase the incidence of endothelial cell death.

BACKGROUND/AIMS: Bacterial endotoxin is a potent inflammatory stimulator, the local and systemic responses thereby elicited being mediated via the release of cytokines from diverse cell types. Under physiological conditions, the corneal endothelium is protected from these toxins by the epithelial and vascular barriers, but in organ culture these safeguards are no longer operative, and such substances will therefore have ready access to this cell layer. The consequences of such exposure may take the form of overt damage to the endothelium and/or a more discreet influence on the cornea's immunological status, the effects of which may be realised only after transplantation, by its poor performance. The media bathing organ cultured donor corneas were monitored for the presence of various cytokine mediators of the inflammatory response before and after incubation with endotoxin, and these data compared with those pertaining to endothelial cell morphology and numerical density. METHODS: Six pairs of fellow donor corneas were cultured for an initial equilibration period of 10 days and then transferred to fresh medium; thereafter, one of each pair was incubated in the absence, and the other in the presence, of endotoxin (50 micrograms/ml = 25,000 units/ml), and culturing continued for a further 10 days. Samples of medium were withdrawn at regular intervals throughout the 20 days and screened for the cytokines IL-1, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, GM-CSF, AND TNF by ELISA; endothelial cell morphology and area density were assessed on days 0, 10, and 20. RESULTS: Spiking of organ culture media with endotoxin led to a substantial increase in the level of IL-8, and a smaller one in that of IL-6, but none of the other cytokines were detected. In five of the six stimulated corneas, these changes coincided with an increased incidence of endothelial cell loss, compared with that incurred by the fellow control, and the surviving population also evinced signs of degeneration not seen in the latter. CONCLUSION: Endotoxin induced increases in the levels of IL-6 and IL-8 appear to be correlated with endothelial cell loss. Since no adverse effects of this toxin on long term cultured monolayers of human corneal endothelial cells have been previously observed, the damage incurred in corneal organ culture may well be attributable to the influence of cytokines produced by other corneal cells or a non-intrinsic (passenger) cell population, such as macrophages, Langerhans cells or lymphocytes present under these latter conditions.

Autocrine Communication↗

PubMed1996

[Rhegmatogenous retinal detachment in atrophia gyrata: pars plana vitrectomy with silicone oil instillation].

BACKGROUND: Gyrate atrophy is a form of choroidal dystrophia characterized by a genetic defect of the mitochondrial matrix enzyme ornithine ketoacidoaminotransferase on chromosome 10. Apart from rare myopathic problems, cases of choroidal, iridal atrophy, complicated subcapsular cataract, optic atrophy, macular edema, reticular retinoschisis, vasculitis and perivasculitis could be observed so far. To our knowledge, rheumatogenous retinal detachment has been described before. We present a 34-year-old female subject with a retinal detachment of the right eye over 3 quadrants with 3 small round foramina in the area 10 to 11 o'clock. PATIENTS: Concentric defects of the visual field had been known since the age of 4; the patient was slightly myopic. At the age of 31, the patient had undergone cataract extraction with implantation of posterior chamber lenses in both eyes. The ophthalmological examination revealed large areas of choroidal atrophia in both eyes. A determination of visual acuity resulted in hand movements in the right eye and 0.1 in the left eye. The ERG was extinguished. RESULTS: The retina could be fully reattached by pars plana vitrectomy and instillation of silicone oil. At the same time, we performed an excision of secondary cataract. On demission, the visual acuity of the right eye was finger counting. Because a brother of the patient had also suffering from a progressive choroidal atrophy since his childhood, an autosomal recessive disease was suspected. The only abnormality detected was strongly elevated plasma levels of ornithin (7.5 to 14 mg/dl, compared to levels of 0.6 to 2.0 in controls). Urinary excretion of ornithin was also strongly increased. DISCUSSION: To our knowledge there was no previous description of a case of atrophia gyrata in association with rhegmatogenous retinal detachment after intraocular surgery. As the pigment epithelium is missing, intraoperative endolaser-coagulation would be useless. For this reason, and since a tendency for reattachment is lacking consistent with one of the characteristics of this disease, the only approach to this case is intraocular tamponade with silicone oil.

Adult↗

PubMed1996

[HLA typing of donor corneas with extended post mortem time].

In case of high-risk patients cornea transplantation should be carried out using HLA-matched donor corneas to minimize the risk of rejection. HLA typing using blood lymphocytes of the donor is impossible because of the long post-mortem times. Alternatively, HLA typing can be performed using retinal pigment epithelium (RPE). Nevertheless, this method is limited by increasing post-mortem times. The aim of the present study was the optimization of culture conditions for RPE cells isolated from donor eyes with long post-mortem times. The HLA type should be evaluated during an acceptable period of organ preservation of the corresponding cornea. In different steps the method for isolation of the cells was optimized and a growth medium for RPE cells was established. Various supplements, including uvea-conditioned medium, were assessed using growth assays. The optimization of culture conditions led to an increase in the estimation of the complete HLA I and HLA II antigens from 36% to 74%. The time needed for the typing-procedure could be reduced from 38 to 17 days (average). At present 30% of the donor tissue with long post-mortem times can be typed in less than 14 days.

Cell Division↗