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Biomedical subjects

M B Goren

Publications and source records attributed to M B Goren.

At least 19 recordsLinked to original sources
PubMed1997

Corneal topography after selective suture removal for astigmatism following keratoplasty.

BACKGROUND AND OBJECTIVE: The authors sought to determine whether the immediate corneal topographic changes induced by selective suture removal for astigmatism after keratoplasty were stable over time. PATIENTS AND METHODS: Computerized videokeratoscopic images were obtained prior to and immediately following suture removal in 14 patients, and then again at the next postoperative visit 4 to 6 weeks later. These images were analyzed and statistically compared for central corneal power and vector of the central 3-mm corneal astigmatism. RESULTS: Most of the topographic changes induced by suture removal occurred immediately. However, continued shifting in corneal curvature did take place over the subsequent 4 to 6 weeks. Unpredictable shifts were more pronounced in patients whose surgery had been performed more than 20 months prior to suture removal. CONCLUSION: Computerized videokeratoscopy graphically elucidates continued shifts in corneal topography following the removal of sutures for the control of astigmatism after keratoplasty.

Aged↗
PubMed1995

Suture erosion after penetrating keratoplasty.

Because suture erosion after keratoplasty is an important risk factor for inflammation, infection, vascularization, and graft rejection, we aimed to delineate patient characteristics associated with these erosions. One hundred eyes of 97 consecutive patients who presented to our service with 10-0 nylon suture erosion after keratoplasty were selected for study. Patient age, preoperative diagnosis, duration from surgery, location and type of eroded suture, vascularity of recipient bed, contact lens or topical steroid use, and presence of infiltrate at the erosion site and subsequent culture results were tabulated. The average duration from keratoplasty to presentation was 33 (range 1-144) months. The locations of the eroded sutures were superior in 53%, nasal in 17%, temporal in 16%, and inferior in 14% of eyes (p < 0.005). Seventy-one percent of the eyes presented with broken sutures (an average 36 months postoperatively) and 29% with intact but loosened eroded sutures (an average 25 months postoperatively, p < 0.05). Sixty-nine percent of the eyes were being treated with topical steroids and presented 11 months earlier (29 months postoperatively) than did those not being treated with topical steroids (40 months postoperatively, p < 0.05). Eyes that had been subjected to keratoplasty for inflammatory conditions presented with suture erosion 10 months earlier than did those that had been subjected to keratoplasty for noninflammatory conditions (p = 0.09). Of the 10 eyes with a suture-related stromal infiltrate, one was culture-positive. Increased elapsed time from surgery, superior position of the suture, topical steroid use, and inflammatory ocular disorders are associated with suture erosions after penetrating keratoplasty.

Adolescent↗
PubMed1995

Positive donor rim culture in penetrating keratoplasty.

A 3-year retrospective study on the risk factors of positive donor rim cultures in penetrating keratoplasty was performed. One thousand and ninety-seven consecutive donor rim cultures were reviewed from the period between June 1990 and October 1993 to determine the rate of culture positivity. The sex, age, diabetes status, use of respirator at time of death, cause of death, harvesting technique, storage time, and corneal storage medium utilized for the donors with positive donor rim culture were compared to those for 100 randomly selected culture negative donor controls. Logistic analysis was performed to eliminate confounding effects. Forty-six of the 1,097 (4.19%) donor rim cultures were positive. We found an association between the in situ technique for donor harvesting and culture negativity (p = 0.03). None of the other donor characteristics was associated with culture positivity. None of the 46 recipients who received the positive culture corneas developed endophthalmitis. In situ cornea harvesting promotes less contamination than enucleation and enriched gentamicin and streptomycin storage medium may further decrease donor rim culture positivity.

Anti-Bacterial Agents↗
PubMed1995

Corneal neovascularization after penetrating keratoplasty.

The purpose of this study was to delineate the patient and surgical factors that contribute to the development of corneal neovascularization (CNV) after penetrating keratoplasty (PK). Thirty-six eyes of 36 patients with no antecedent CNV were enrolled in the study. Grafts were sutured to the host with 16 10-0 nylon sutures with the knots buried alternately in either the host or donor corneal stroma. Multiple perioperative factors were recorded for each patient, and at each postoperative visit systematic corneal drawings were used to follow the development of neovascularization. The stroma adjacent to each suture of each graft was given a neovascularization score based on the extent of vessel growth toward the wound interface. Univariate and multivariate analyses were performed, including generalized estimating equations logistic regression where each eye is considered a cluster of observations. Thirty-four patients without preoperative CNV or inflammation were followed prospectively for 6-9 (mean, 7) months after PK. Fourteen eyes (41%) developed some degree of CNV. Indication for keratoplasty, age, gender, phakic status, and size of donor button were not risk factors for CNV development. The most significant risk factor identified for any degree of CNV was placement of the suture knot in the host stroma (p = 0.00007), with the overall relative risk of CNV associated with these knots over 2 (95% confidence interval, 1.1-4.2). Furthermore, the mean recipient size in eyes with postoperative CNV was larger than eyes that did not develop neovascularization (p = 0.015), and active blepharitis was associated with a fivefold increase in the risk of developing CNV to the wound edge (p = 0.008). Embedding suture knots in the host stroma, active blepharitis, and a large recipient bed are significantly associated with postkeratoplasty CNV.

Adult↗
PubMed1994

Screening of synthetic trehalose 6,6'-diesters and trehalose 6-monoesters as potential immunoreactants for the serodiagnosis of tuberculosis.

The absence of serological cross-reactivity between trehalose 2,3-diester (DAT, formerly SL-IV) and synthetic trehalose 6,6'-diesters and trehalose 6-monoesters was established by ELISA testing using polyclonal immune sera raised in rabbits sensitized with "DAT". From the screening of fifteen synthetic trehalose 6,6'- and 6-esters, "mirror" pseudo cord factor no. 1, "mirror" amides no. 5 and 6, cord factor analogues 7 and 8 and trehalose 6-monoesters 10 and 11 were selected for future, more extensive serological analysis. Paired comparisons of analogues among these fifteen substances showed that serodiagnostic discrimination power was more a function of the carbon chain length of their substituent groups--as well as of their position--than of the "mirror" constitution of the molecules. More exhaustive testing of these seven compounds is needed to select the synthetic product most efficient in the ELISA serodiagnosis of tuberculosis.

Animals↗
PubMed1992

Evaluation of synthetic pseudo cord-factor-like glycolipids for the serodiagnosis of tuberculosis.

A number of glycolipids were evaluated in an ELISA test for their serodiagnostic usefulness in tuberculosis. One hundred and twelve (112) sera belonging to bacteriologically confirmed TB patients, patients with pathologies other than tuberculosis and healthy individuals were examined against several synthetic "mirror" pseudo cord factors (analogues of trehalose-6,6'-dimycolate or TDM) using natural cord factor and another recently described natural glycolipid (SL-IV) of Mycobacterium tuberculosis as control antigens. Analysis of the results shows that all synthetic "mirror" pseudo cord factors, except one with a short 8-carbon chain, were better recognized by the sera of tuberculosis patients than natural cord factor, with sensitivity and specificity values in the ELISA test similar to those reported for M. tuberculosis species-specific SL-IV. Of all antigens tested in this study, BDA. TDA, a bis(N,N-dioctadecylamide) of "trehalose dicarboxylic acid", [(alpha-D-glucopyranosyluronic acid) (alpha-D-glucopyranosiduranic acid)], showed the highest serodiagnostic discriminating power (93% sensitivity and specificity). We postulate that either these artificial molecules are cross-reactants of similarly structured native glycolipids of M. tuberculosis or that they bear closer resemblance to actual phagosome-lysosome-modified antigens than to native mycobacterial ones.

Cord Factors↗
PubMed1992

Comparison of bis-di-octadecylamide of trehalose dicarboxylic acid (BDA.TDA) with glycolipid SL-IV as ELISA antigens for the serodiagnosis of leprosy.

Two glycolipids--one synthetic and non-natural (BDA.TDA), the other natural and Mycobacterium tuberculosis species-specific (SL-IV)--were tested to determine their serological activity in sera obtained from leprosy patients, and to determine their discriminating ability in the detection of disease. The ELISA results obtained in the IgG antibody class show that both were useful substances capable of detecting multibacillary and paucibacillary disease in about 2 out of 3 leprosy patients. When these antigens were tested in parallel, the sensitivity of the ELISA test was increased by 10% without a decrease in specificity.

Antibodies, Bacterial↗
PubMed1991

The effect of corneal hypesthesia on the duration of proparacaine anesthetic eyedrops.

The duration of action of proparacaine is known in the normal cornea but not in the hypesthetic cornea. To determine this, we examined both eyes in seven patients with documented unilateral corneal hypesthesia associated with inactive herpetic disease. Cochet-Bonnet measurements were made in both eyes before and at two- to five-minute intervals after the instillation of one drop of 0.5% proparacaine until baseline corneal sensitivity levels were again achieved. Mean recovery time was 34.86 minutes in eyes with normal corneal sensitivity, compared to 45.43 minutes in hypesthetic corneas. In all patients, the recovery time was remarkably longer in the hypesthetic eye than it was in the normal fellow eye. These data demonstrate the need to wait up to one hour after the instillation of proparacaine in eyes suspected of having corneal hypesthesia if corneal sensitivity is to be determined accurately. Additionally, the duration of action of topically instilled anesthetic may be a useful method of discovering subtle differences in corneal sensitivity.

Adult↗
PubMed1991

Acute intermittent porphyria with atypical neuropathy.

The patient we have described had lower extremity numbness, paresthesias, constipation, urinary retention, and sexual dysfunction. Laboratory evaluation confirmed a diagnosis of acute intermittent porphyria (AIP). Vitamin B6 and glucose therapy initiated resolution of symptoms. The sensory neuropathy described here is unusual, and we believe sexual dysfunction is a previously unreported manifestation of AIP.

Adult↗
PubMed1991

Ophthalmologic screening of adults with mental retardation.

Ophthalmological screening was conducted on 113 clients in a work activity center for adults with mental retardation. Thirty-two percent had abnormalities that were neither refractive nor strabismic. We encountered no instance of neglect of current organic ocular disease. However, 37% of clients had at least one eye that either was not within one diopter of emmetropia or that was not corrected to within one diopter of their retinoscopic findings. Ophthalmologists should consider providing screenings in settings familiar to such clients, where they are more likely to be cooperative.

Adult↗
PubMed1990

Influence of phagosomal contents on the apparent inhibition of phagosome-lysosome fusion mediated by polyanionic substances in mouse peritoneal macrophages.

The study of fusion of phagosomes with secondary lysosomes in macrophages is facilitated by assessing transfer of fluorescent or electron-opaque markers (or both) from the lysosomes to the phagosomes. When certain virulent viable pathogens are phagocytosed by mouse peritoneal macrophages, phagosome-lysosome fusion (P-LF) is inhibited. Nonviable counterparts ordinarily cannot impose this block. A similar, but spurious, block to P-LF seems to be mediated from the lysosomal domain following sequestration of certain polyanionic substances. This block has been judged to be relieved by, for example, heat-killed yeasts and various viable bacteria designated as fusion-inducing microorganisms, acting from the phagosome. In this study we tested this concept and believed it to be unfounded. Macrophages labeled with Thorotrast and incubated with dextran sulfate were offered a variety of viable and heat-killed microorganisms for phagocytosis: Saccharomyces cerevisiae, Mycobacterium lepraemurium, Streptococcus faecalis, and Escherichia coli. By electron microscopy, a transfer of Thorotrast to phagosomes up to 18 h was seen to be highly suppressed as compared with controls, but was not notably different for any of the targets, whether viable or not. Instead, inert 0.45-micron carboxylated polystyrene beads (the smallest target) showed the most delivery of marker. If polyanionic agents truly inhibited fusion, then "fusiogenic" microorganisms should free the marker for delivery. If polyanions do not inhibit P-LF and only trap the marker, the behavior of the various targets would correspond to what we found.

Animals↗
PubMed1989

Uptake and utilization of human polymorphonuclear leukocyte granule myeloperoxidase by mouse peritoneal macrophages.

Functional myeloperoxidase contained in granules of polymorphonuclear neutrophil leukocytes or in fixed whole cells can be endocytosed by mouse peritoneal macrophages. Acquired myeloperoxidase was distributed in what we considered to be the secondary lysosomal system and, following a phagocytic stimulation, was delivered to newly formed phagosomes containing the targets.

Animals↗
PubMed1989

Synthesis of 6,6'-di-O-mycoloyl- and corynomycoloyl-(alpha-D-galactopyranosyl alpha-D-galactopyranoside) via triflates.

Tritylation of 2,3,2',3'-tetra-O-benzyl-(alpha-D-galactopyranosyl alpha-D-galactopyranoside) (4) (A. Liav, H.M. Flowers and M.B. Goren (1984) Carbohydr. Res. 133, 53-58) followed by benzylation and acid hydrolysis gave 2,3,4,2',3',4'-hexa-O-benzyl-(alpha-D-galactopyranosyl alpha-D-galactopyranoside) (6). Triflation of 6 with triflic anhydride gave the ditriflate 7. Treatment of 7 with potassium mycolate or potassium corynomycolate in toluene, followed by catalytic hydrogenolysis afforded the respective cord-factor analogs 6,6'-di-O-mycoloyl-(alpha-D-galactopyranosyl alpha-D-galactopyranoside) (10) and 6,6'-di-O-corynomycoloyl (alpha-D galactopyranosyl alpha-D-galactopyranoside) (11). An alternative approach, based on the debenzylation of 2,3,2',3'-tetra-O-benzyl-6,6'-di-O-p-tolylsulfonyl- (alpha-D-galactopyranosyl alpha-D-galactopyranoside) (1) and conversion of the latter into the corresponding 3,4,3',4'-diisopropylidene derivative 3 failed to yield satisfactory results.

Cord Factors↗
PubMed1989

Phenotypes of infiltrating cells in trehalose dimycolate-induced interstitial pneumonitis.

Trehalose dimycolate is a glycolipid component of the cell walls of mycobacteria, nocardia, and corynebacteria. When trehalose dimycolate is injected into certain strains of mice, they develop interstitial pneumonitis that is characterized by mononuclear cell infiltration of the alveolar walls, intra-alveolar hemorrhages, and in some animals, granuloma formation. The disorder is seldom fatal, and in approximately 4 weeks, the lungs are normal. There is strong evidence that T lymphocytes are essential for production of interstitial pneumonitis by trehalose dimycolate, but little is known about the mechanisms of lung injury in this model. The experiments described in this report were conducted to identify the roles of the various cells that accumulate in the lungs of mice with this form of interstitial pneumonitis. We found that Mac3+ macrophages were the first cells to appear in the alveolar walls. Increases in the number of L3T4+ T lymphocytes, Lyt2+ T lymphocytes, and surface-immunoglobulin-positive lymphocytes followed, but significant increases in the number of lymphoid cells were not observed until day 7, when the pulmonary lesions were well developed. Treatment of the mice with cyclophosphamide or anti-T-cell sera significantly reduced the number of lymphoid cells in the alveolar walls but did not affect the number of Mac3+ cells and did not affect development of intra-alveolar hemorrhages. Treatment with poly(I.C) significantly decreased the number of Mac3+ cells in the lungs, and these mice did not develop pulmonary hemorrhages. We conclude that although development of pulmonary lesions in trehalose dimycolate-treated mice is a T-cell-dependent process, macrophages are also essential and are more directly involved in production of the lung injury. We postulate that the lung lesions are the direct effect of macrophage-produced cytokines, such as tumor necrosis factor.

Animals↗
PubMed1989

Enhancement of growth of Mycobacterium lepraemurium in macrophages by gamma interferon.

Gamma interferon, an immune lymphokine that protects mouse macrophages against infection by several parasites, was ineffective against Mycobacterium lepraemurium. On the contrary, it significantly stimulated multiplication of M. lepraemurium in the macrophages. Simultaneous treatment of macrophages with gamma interferon and interleukin-4 or interleukin-2 or a combination of all three did not enhance the macrophage resistance to infection with M. lepraemurium, but instead stimulated growth of M. lepraemurium.

Adjuvants, Immunologic↗