Lacrimal gland growth factors and receptors: lacrimal fibroblastic cells are a source of tear HGF.
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Animals↗
Biomedical subjects
S Hargrave
Publications and source records attributed to S Hargrave.
Hepatocyte growth factor and hepatocyte growth factor receptor in the lacrimal gland, tears, and cornea.
PURPOSE: The purpose of this study was to characterize the expression of hepatocyte growth factor (HGF) and HGF receptor proteins in lacrimal gland, tears, and cornea. METHODS: The reverse transcription-polymerase chain reaction method was used to detect HGF and HGF receptor messenger RNA in human lacrimal gland tissue. HGF and HGF (c-met) receptor monoclonal antibody specificity was demonstrated with fluorescent antibody sorting of cells engineered to express HGF or HGF receptor compared with control cell lines, enzyme-linked immunoadsorbent assay (ELISA), immunoprecipitation, and immunohistology with preabsorption. Immunohistochemistry was applied to study the distribution of HGF and HGF receptor expression in rabbit lacrimal gland tissue and in wounded and unwounded rabbit cornea. An ELISA was used to detect HGF in pooled samples of human tears and individual aliquots of tears collected from patients 1 day after anterior segment surgery. RESULTS: Amplification products of the expected size for HGF and HGF receptor mRNAs were detected in lacrimal tissue and were confirmed to be specific by hot blotting and nucleic acid sequencing. Hepatocyte growth factor protein was detected in interalveolar and interlobular connective tissue cells adjacent to glandular alveolar (acinar) cells and associated with the cells lining the interlobular ducts. Hepatocyte growth factor receptor protein was expressed in the glandular alveolar and interlobular ductal cells in the lacrimal gland and all three cell types of the cornea. It was detected in keratocyte and endothelial cells, and expression was increased in keratocytes after epithelial wounding. Hepatocyte growth factor was not present in corneal epithelial cells, but in the unwounded cornea a strong signal was associated with the epithelial cell surface. It was detected by ELISA in pooled normal tears at levels 186 to 290 pg/ml and in individual postoperative tear samples at 453 to 619 pg/ml. In some tear samples, HGF levels were below the sensitivity of the assay (97.5 pg/ml). CONCLUSIONS: The distribution of HGF receptor protein expression in the lacrimal gland suggests that HGF secreted by interalveolar connective tissue cells traverses the acinar cells and modulates functions in acinar and ductal epithelial cells. Hepatocyte growth factor likely collects within the interlobular ducts and becomes a component in normal tears. Thus, lacrimal gland HGF probably modulates corneal epithelial cell proliferation, motility, and differentiation. Its expression in keratocytes is upregulated after corneal epithelial wounding and probably contributes to the epithelial wound healing process.
Animals↗
Automated topographic screening for keratoconus in refractive surgery candidates.
PURPOSE: We evaluated an automated corneal topography classification system developed as an adjuvant for screening patients prior to keratorefractive surgery. We screened for patterns suspicious for keratoconus by applying the system to the analysis of a series of patients who presented for evaluation for surgical correction of myopia. METHODS: Both eyes of 53 consecutive patients who were included in a previously reported prospective study were evaluated using the Expert System classification algorithm. This quantitative classification system incorporating eight indices was applied to the videokeratoscopic data from each patient to divide the topographic patterns into keratoconus and non-keratoconus groups. The group assignment of the Expert System classifier was compared with the clinical diagnosis of keratoconus versus non-keratoconus based on the topographic pattern and objective biomicroscopy signs. RESULTS: The Expert System classified eight of the videokeratographs as keratoconus. All five corneas that had clinical evidence of keratoconus were classified as such by the Expert System (sensitivity 100%). The other three corneas that were classified as keratoconus were of patients who wore rigid contact lenses and had pseudo-keratoconus topographic patterns, without other clinical signs of keratoconus. The specificity with which the Expert System detected normal corneas was 97% (98/101). CONCLUSIONS: Evaluation of the videokeratographic data with computerized algorithms designed to detect keratoconus may aid preoperative evaluation and facilitate distinction between keratoconus and some keratoconus-like topographic patterns.
Algorithms↗
Infection after insertion of alloplastic orbital floor implants.
Ten patients developed infections after alloplastic implantation (nine silicone, one gelatin film [Gelfilm] implant) for orbital floor fracture repair. Infection resulted from the following: (1) dental surgery, (2) upper respiratory infection, (3) inferior extrusion of a retained implant into the maxillary sinus with a fistulous tract into the inferior conjunctival fornix, (4) rhinoplasty, (5) snorting cocaine and other drugs, (6) postoperative infection after orbital floor repair, and (7) medial implant migration resulting in chronic dacryocystitis. In all ten patients, implants were removed because of orbital abscess, recurrent infection, or chronic low-grade infections. Microbiologic culture of removed implants disclosed Staphylococcus aureus, S. epidermidis, Serratia marcescens, and Pseudomonas aeruginosa as the offending organisms. The main complication of infection included severe cicatricial ectropion of the lower eyelid in three patients. The final globe position was not adversely affected by implant removal performed from five months to 20 years after insertion. Guidelines for prevention and management of orbital implant infections based on these ten patients are presented.
Adolescent↗
Effect of frequency-altered feedback on stuttering frequency at normal and fast speech rates.
The purpose of this study was to determine the effect of the magnitude and direction of the frequency shift of frequency-altered auditory feedback (FAF) on stuttering frequency at both normal and fast speech rates. Twelve adult male and 2 adult female subjects who stutter read 10 different passages at either a normal or fast speech rate under nonaltered auditory feedback (NAF) and each of four FAF conditions in which the feedback signal was shifted: up one-half octave; up one octave; down one-half octave; and down one octave. Mean stuttering frequency for NAF was significantly higher than mean stuttering frequencies for all FAF conditions (p < 0.05). There were no statistically significant differences between the FAF conditions (p > 0.05). Subjects exhibited significantly more disfluencies under the fast speech rate condition relative to the normal speech rate condition. Future research should examine the relationship between frequency shifts of less than one-half octave and stuttering amelioration.
Adolescent↗
A comparative study of combination chemotherapy versus marrow transplant in first remission in adult acute lymphoblastic leukaemia.
The results of conventional chemotherapy in adult acute lymphoblastic leukaemia (ALL) have not improved substantially in recent years. The present study is based on a flexible policy of marrow transplantation (allograft and autograft without marrow purging) in first remission compared with a group treated with standard maintenance therapy after a common induction sequence. The actuarial disease free survival (DFS) and actuarial overall survival (OS) at 3 years for autologous marrow grafted patients was 30% and 65% respectively. The allogeneic transplant group had DFS of 30% and OS at 3 years of 38% compared with DFS (12%) and OS (12%) for patients on 6-mercaptopurine and methotrexate maintenance. The actuarial disease free survival calculations include patients on protocol not entering remission, therefore, giving the worst possible result. We conclude that high dose chemo/radiotherapy with autologous marrow rescue in first remission followed by no maintenance provides better results in terms of overall survival and quality of life than standard ALL maintenance in adult patients. Results for allogeneic transplant in ALL are less good in terms of duration and quality of survival and the majority of deaths are related to causes other than leukaemic relapse.
Adolescent↗
Use of therapeutic ultrasound to restore failed trabeculectomies.
We treated 20 recently postoperative eyes with nonfunctioning trabeculectomies at the site of the failed bleb with two to four ultrasound applications, each of five seconds duration, at an intensity level of 10 kW/cm2. Fifteen of the eyes demonstrated a long-term decrease in intraocular pressure to 21 mm Hg or below. The mean intraocular pressure of all patients fell from a preultrasound mean (+/- S.D.) of 32 +/- 8 mm Hg to 20 +/- 10 mm Hg at a mean time of 236 +/- 204 days postultrasound. Complications included an immediate postultrasound rise in pressure over 10 mm Hg in 13 eyes, and the immediate development of a cataract in one patient.
Combined Modality Therapy↗
LATCH -- it works!
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Libraries, Hospital↗
Complications of ocular paintball injuries in children.
PURPOSE: To evaluate the ocular complications of paintball injuries in children. METHODS: The clinical course of four children with traumatic ocular paintball injuries was evaluated. All patients underwent a complete ocular examination. Their age, injuries sustained, surgical procedure(s) performed, presence of protective eyewear at the time of injury, and final visual outcome was assessed. The presence of directly related anterior and posterior segment abnormalities were also evaluated. RESULTS: Four boys sustained traumatic paintball injuries. Average patient age was 11.25 years (range: 10-12 years). None of the children were wearing ocular or facial protection at the time of the initial injury. All patients had hyphema and traumatic cataract, and some form of retinal pathology (vitreous hemorrhage, epiretinal membrane, retinal hemorrhage, and choroidal rupture). One child had a partial-thickness corneal laceration that did not require surgical intervention. All other patients underwent ophthalmic surgery. Final visual acuity was 20/30 or better in two patients, and 20/100 or worse in the others. The cause of decreased visual acuity in these children was directly related to macular pathology. CONCLUSION: Ocular injuries resulting from paintball impact are often severe and usually occur when the participants are not wearing eye protection or this protection becomes dislodged. Treatment of these injuries is sometimes limited to an attempt to salvage what remains of useful vision. Unfortunately, most of these sports-related injuries could have been prevented if patients wore adequate eye protection when involved in this sport.
Anterior Eye Segment↗