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Biomedical subjects

M Charest

Publications and source records attributed to M Charest.

9 recordsLinked to original sources

Dorzolamide and corneal recovery from edema in patients with glaucoma or ocular hypertension.

PURPOSE: To investigate whether dorzolamide alters corneal hydration control in patients with glaucoma or ocular hypertension. METHODS: Pachymetry, tonometry, and endothelial cell density were measured by a masked observer in 19 subjects with bilateral glaucoma or ocular hypertension. They were treated with 2% dorzolamide in one eye, and with saline in the other, before wearing contact lenses under patched eyes. Corneal thickness, measured each 30 minutes up to 4.5 hours after contact lens removal, enabled estimation of percentage recovery per hour and time for 95% of corneal thickness recovery for both eyes. Seven patients repeated this test after 1 year of dorzolamide use, and their results were compared with those of the preceding year. RESULTS: After induction of hypoxic corneal edema, there was no significant difference between paired corneas in swelling levels (60.0+/-11.8 and 59.8+/-12.9 microm) (P = .94), time to 95% recovery (440.6+/-255.8 and 445.4+/-186.7 minutes) (P = .93), and percentage recovery per hour (38.1%+/-10.9% and 36.1%+/-9.6%) (P = .40). Subjects followed up after 1 year of dorzolamide use did not differ significantly in values of endothelial cell density, percentage recovery per hour, or time to 95% recovery from those obtained a year before. One subject developed persistent corneal edema after his stress test in the eye treated with dorzolamide. CONCLUSION: There is no significant difference in the recovery from induced corneal edema after either a short-term or 1-year use of dorzolamide in patients with glaucoma or ocular hypertension with a normal corneal endothelium. One patient had persistent corneal edema after the stress test was performed on the dorzolamide-treated eye.

Aged↗

Contrast and glare testing in the assessment of visual performance of candidate eyes for penetrating keratoplasty.

PURPOSE: To determine whether visual acuity (VA) measurements performed at low levels of contrast and glare are a better diagnostic tool for determining whether corneal clouding warrants surgery. METHODS: Fifty-nine subjects were recruited from among the candidates for corneal graft. Monocular VA was measured with three Regan contrast VA charts: 96, 25, and 11%, with and without glare provided by the Brightness Acuity Tester (BAT). The discriminative ability of the tests was estimated using the area (AR) under receiver operating characteristic (ROC) curves. Associations between the different VA tests and the Visual Function Index (VF-14) score were studied, using Spearman coefficients. RESULTS: When comparing candidate eyes with contralateral eyes with corneal disease, lower contrasts VA tests provided greater discriminative power. VA measurements made with glare also tended to provide greater discrimination. In fact, discrimination was best with 11% contrast VA with glare, but "testability" was poor. The most practical test in a clinical setting, which retained high discriminative ability (0.798), was the 25% contrast VA with glare. The eye with the best VA correlated strongly with the VF-14, especially at 25% contrast without glare, resulting in an Rs of -0.729. CONCLUSION: Twenty-five percent contrast VA with BAT could help the practitioner to decide whether a corneal transplant is warranted when symptoms of reduced vision are more important than what high-contrast VA might indicate.

Adult↗

The VF-14 index of functional visual impairment in candidates for a corneal graft.

PURPOSE: To validate the Visual Function-14 (VF-14) index of functional visual impairment in candidates for a corneal graft. METHODS: One hundred thirty-four patients who were candidates for a corneal graft participated in this study between August 1996 and February 1997. Demographic, ocular history, best-corrected visual acuity, and detailed ocular examination data were collected. Functional visual impairment information was obtained by telephone interviews using the following: VF-14, SF-36 (Short Form-36, a more generic measure of general health function), and Visual Symptom Score, and four questions measuring the overall amount of trouble with vision, dissatisfaction with vision, ocular pain, and discomfort. RESULTS: The average age of corneal graft candidates was 64 +/- 18 years (range, 18 to 90 years) and 60% were women. The most frequent corneal disease was pseudophakic bullous keratopathy (41%). Ocular comorbidities included glaucoma or ocular hypertension (30%) and cataract (19%). The mean best-corrected visual acuity of the eye scheduled for surgery was 1.33 +/- 0.56 logMAR whereas the best eye best-corrected visual acuity was 0.36 +/- 0.44 logMAR. The mean VF-14 score was 73% +/- 26%, and the internal consistency was high, with a Cronbach alpha value of 0.94. The VF-14 correlated strongly with the best eye best-corrected visual acuity. It also correlated strongly with the Visual Symptom Score, the global measures of trouble and dissatisfaction with vision. Candidates for a corneal graft had low scores for all eight general health concepts evaluated with the SF-36, and the VF-14 correlated with seven of the eight SF-36 subscales. CONCLUSION: The VF-14 is a valid measure of functional visual impairment in candidates for a corneal graft. The Visual Symptom Score and the SF-36 are also useful indices in such patients.

Adolescent↗

Validation of French-language versions of the Visual Functioning Index (VF-14) and the Cataract Symptom Score.

OBJECTIVE: To produce and validate French-language versions of the Visual Functioning Index (VF-14), the Cataract Symptom Score (CSS) and two global measures of trouble and satisfaction with vision. DESIGN: Survey by means of telephone interviews conducted 2 weeks apart. SETTING: Ophthalmology clinic of a teaching hospital in Montreal. SUBJECTS: Subjects were recruited among patients with ocular media opacities, such as cataracts and corneal opacities. Of the 71 subjects recruited, 66 (41 French-speaking and 25 French- and English-speaking) completed the study. OUTCOME MEASURES: Visual acuity, scores on vision-related questionnaires and on the 36-Item Short-Form Health Survey (SF-36), a measure of perceived health status. RESULTS: The integral consistency of the French-language versions of the VF-14 and the CSS was high, with Cronbach alpha values of 0.96 and 0.82 respectively. The fidelity with regard to the English-language version, the test-retest reproducibility and the interrater agreement were high (intraclass correlation coefficients > or = 0.80). The correlation between the visual acuity of the better eye and the mean score on all four vision-related measures was statistically significant (p < or = 0.05). The VF-14 scores were also correlated with the score on five of the eight SF-36 subscales (p < or = 0.05). CONCLUSIONS: Our results show that French-language versions of the VF-14, CSS and global measures of trouble and satisfaction with vision are reliable and valid.

Adult↗

Corneal endothelial cell density in glaucoma.

PURPOSE: We studied corneal endothelial cell density in patients with glaucoma. METHODS: One hundred two patients with glaucoma were compared with 52 patients without glaucoma of the same age group. Exclusion criteria included history of either corneal disease, ocular inflammation, trauma, or surgery other than peripheral iridectomy. The following data were extracted from the patient files: glaucoma type and duration, laser treatments, glaucoma medications, and documented intraocular pressure (IOP) measurements. Specular microscopies were performed on central corneas, endothelial images were analyzed by computerized planimetry, and cell counts were calculated. RESULTS: Corneal endothelial cell counts were significantly lower in patients with glaucoma (2,154 +/- 419 cells/mm2) than in controls (2,560 +/- 360 cells/mm2; t test, p < 0.0001). In the glaucoma group, cell counts were inversely proportional to the means of IOPs. Patients receiving three or four glaucoma medications had lower cell counts than those receiving one or two medications. Cell counts were significantly lower both in primary angle-closure glaucoma and in primary open-angle glaucoma. CONCLUSION: This study suggests that patients with glaucoma may have lower corneal endothelial cell density than those without glaucoma of the same age group. The proposed mechanisms are direct damage from IOP, congenital alteration of the corneal endothelium in patients with glaucoma, glaucoma medication toxicity, or a combination of these.

Aged↗

Metabolism of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone by hamster respiratory tissues cultured with ellagic acid.

Previous studies have shown that the nicotine-derived N-nitrosamine-4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) induces tracheal papillomas and lung carcinomas in Syrian golden hamsters. In this study, we showed that hamster tracheal and lung explants metabolize NNK by alpha-carbon hydroxylation, pyridine N-oxidation and carbonyl reduction. alpha-Methylene hydroxylation and methyl hydroxylation yield methylating and pyridyloxobutylating intermediates, respectively. Levels of binding of the pyridyloxobutyl moiety to explant proteins was 200 times lower than the total amount of metabolites formed by alpha-carbon hydroxylation and released in the culture medium. Viable and heat-treated lung explants were cultured with [CH3-3H]NNK or [5-3H]NNK. In viable explants, the rate of binding of the methyl group was 2-fold higher than the rate of binding of the pyridyloxobutyl moiety of NNK. Heat treatment reduced 54-fold the binding of [CH3-3H] NNK but only 5-fold the binding [5-3H]NNK. Tracheal explants were cultured with [5-3H]NNK (5.6 microM) and ellagic acid (EA, 10 microM), a naturally-occurring plant phenol. EA did not inhibit any of the three metabolic pathways nor the binding of the pyridyloxobutyl moiety to explant proteins. Lung explants were cultured with NNK (3.7 microM) and with or without EA (100 microM). EA inhibits alpha-carbon hydroxylation by 19% and the overall metabolism of NNK by 6%. Formation of 7-methylguanine and O6-methylguanine was observed in lung explants and the levels of both adducts were reduced by EA (100 microM). These results suggest that high concentrations of EA modulate the metabolism of NNK and that NNK does not necessarily require enzymatic activation to bind to protein.

Alkylation↗

In vitro and in vivo modulation of the bioactivation of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone in hamster lung tissues.

The metabolism of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) by hamster lung explants was studied. The three major metabolic pathways were alpha-C-hydroxylation (activation), pyridine N-oxidation (deactivation) and carbonyl reduction. alpha-C-Hydroxylation and pyridine N-oxidation were linear with time (0.5-5 h) and number of explants per dish (3-10). Addition of [2-(diethylamino)ethyl 2,2-diphenylpentenoate] hydrochloride (SKF-525A) to the culture medium reduced alpha-C-hydroxylation and pyridine N-oxidation. alpha-C-Hydroxylation was enhanced by treatment of the hamsters with the two cytochrome P-450 inducers, phenobarbital and 3-methylcholanthrene. These results suggest that cytochrome P-450 monooxygenases are involved in the activation of NNK by alpha-C-hydroxylation. Three groups of hamsters were fed a control diet or diet supplemented with 2% 2(3)-tert-butyl 4-hydroxyanisole (2(3)-BHA) or given a 0.002% solution of (S)-nicotine to drink for two weeks. Lung explants were then cultured with NNK in vitro. Treatment with 2(3)-BHA and (S)-nicotine induced the alpha-C-hydroxylation pathways. Pyridine N-oxidation was increased by (S)-nicotine treatment. These results indicate that dietary factors and tobacco smoke components can modulate the metabolism of NNK.

Animals↗

Production of mutacin-like substances by Streptococcus mutans.

Production of inhibitory substances by strains of the Streptococcus mutans group is well documented, but the nature of the substances implied is often unknown. Of nine laboratory strains known to produce inhibitory substances, the optimal conditions for producing inhibition zones on solid media were found to vary between strains but good production was generally obtained on all-purpose media with Tween 80 at 37 degrees C after 2-4 days of aerobic incubation. Streptococcus sanguis Ny101 was found to be more sensitive than Streptococcus rattus LG-1 to all inhibitory substances produced by the S. mutans strains tested. While all strains showed some inhibition, only six showed inhibition after neutralization; arginine incorporated in agar at 0.75% completely eliminated all inhibition zones. However 1% arginine in the overlays did not affect the production of inhibition zones by strains of S. mutans C67-1, Ny257, Ny266, and T8. These strains were shown to elaborate (in a reproducible fashion) inhibitory substances which were not organic acids. Inhibitory activity was never obtained in liquid preparations, except for strains Ny257 and T8 where it was found to be very unstable.

Aerobiosis↗

Estimation of the misclassification rate of self-reported visual disability.

PURPOSE: To estimate the misclassification rate of self-reported visual disabilities in a hospital-based population with known visual impairment. METHODS: Subjects (N=570) were recruited among patients aged 50 years and more and classified to three categories of visual impairment level. The questionnaire was administered to consenting patients through a telephone interview. Data collected from questionnaires and medical records were compared regarding severity of visual impairment. Sensitivity and specificity were determined for each question. Predictive ability and misclassification rates were computed for various prevalences. RESULTS: Questions related to near and far distance visual acuity with glasses have both a good sensitivity (82.6% and 81.8%) and a good specificity (85.6% and 88.9%) for the presence of severe visual impairment. CONCLUSION: The findings allow the determination of the misclassification rate and predictive ability. This could be useful to estimate the prevalence of visual impairment from health surveys.

Aged↗