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PubMed2006

Far forward gynecologic care of the female soldier.

OBJECTIVE: To evaluate the value, unit cost and medical effectiveness of providing specialized obstetric and gynecologic care far forward, at echelon III, the combat support hospital (CSH), in the operating theater of Afghanistan during Operation Enduring Freedom (OEF), rotation 5. STUDY DESIGN: Between April 2004 and September 2004, records were reviewed from the outpatient gynecology clinic at Bagram Air Field (BAF), in Afghanistan, through an approved protocol request. Cohort analysis was performed on all gynecologic patients. Significant differences in distribution of clinical factors were determined by Student's t test. RESULTS: A total of 62 cases were extracted for analysis over the 6-month period. Fifty-seven total patients were seen at echelon III, the CSH at BAF, while 5 were sent to level IV or V echelon care in Landstuhl, Germany. The average distance traveled for the patients coming to BAF was 158 km, while those sent to Germany averaged 5,204 km. The mean travel time in days was significantly lower among patients seen at BAF, 0.5 versus 7 days for patients sent to Germany. The time to appointment was also significantly lower among those patients seen at BAF: 0.04 versus 13 days for patients sent to Germany. CONCLUSION: We devised and implemented the concept of far forward specialized gynecologic care for women participating in OEF. This substantially decreased the woman-hours lost by their individual units. The far forward availability of gynecologic care and the supplies to evaluate and treat abnormal Pap smears should be considered by all military services in their plans for providing health care for the modern female soldier.

Afghanistan↗

PubMed1991

[Bronchiectasis: a method of obtaining bronchoalveolar lavage fluid and studying its cytological characteristics].

The bronchoalveolar fluid (BAF) cytology of 63 patients with bronchiectasis has been studied. BAF from 8 subjects without pulmonary pathology served as control. BAF samples were obtained after preliminary cleaning of the bronchial tree from the purulent contents. BAF cytosis was found significantly increased in bronchiectasis as compared to the control being observed even at minimal inflammatory activity in the lungs and due to elevated neutrophil count. Alveolar macrophage numbers reduced only in advanced inflammation. Lymphocyte count remained unchanged. BAF cytologic evidence objectively reflects the degree of the bronchoalveolar inflammation.

Adult↗

PubMed1995

Secretin, cholecystokinin and the biliary canalicular secretion in the rat.

An attempt has been made to further assess which fraction of bile can be stimulated by the main gastrointestinal hormones in rats. In the cannulated conscious animals the i.v. infusions of glucagon, impure Boots secretin, impure Boots cholecystokinin (CCK) and OP-CCK resulted in 8.9% (N.S.), 68.5% (P < 0.001), 88.7% (P < 0.001) and 19.0% (P < 0.05) increase in the estimated bile acid-dependent bile flow (BAF) and in 25.4% (P < 0.01), 49.2% (P < 0.001), 44.5% (P < 0.001) and 1.6% (N.S.) increase in the estimated bile acid-independent bile flow (BAIF), respectively as compared to the control values. When the calculated BAF values corresponding to the bile acid impurities in Boots secretin and Boots CCK were subtracted from BAF and BAIF values obtained during hormone infusions (the corrected values), the increase in both BAF and BAIF was equal to 38.9% (P < 0.02) and 29.4% (P < 0.02) during Boots secretin infusion and to 61.1% (P < 0.01) and 29.4% (P < 0.02) during Boots CCK infusion, respectively as compared to the control values. It can be suggested that the hormonal impurities in the Boots preparations interacting with the principal hormonal component are able to stimulate BAF in the rat. Further extensive study embracing the interactions of the purified gut hormones may confirm their role in the control of canalicular bile secretion in the rat.

Animals↗

PubMed1993

Differential effects of bone associated factors on newly synthesized anionic glycoconjugates by articular chondrocyte cultures from adult and immature bovines.

OBJECTIVE: To determine if bone associated peptide factors (BAF) differentially affect proteoglycan and hyaluronic acid (HA) synthesis as a result of the maturity of the animal and of the location of chondrocytes within cartilage zones. METHODS: Calf and adult bovine articular chondrocytes were isolated and cultured, as high density monolayers, with 3H-glucosamine and 35S-sulfate. The effects of commercial transforming growth factor beta (TGF-beta) and a preparation from bovine bone that contained the total extractable stimulatory activity for glycosaminoglycan (GAG) synthesis (matrigenin activity) were studied. RESULTS: Calf chondrocytes spontaneously synthesized a higher proportion of proteoglycans of larger hydrodynamic size, but the addition of the BAF resulted in a proportionally greater shift in the adult chondrocytes towards the synthesis of larger proteoglycans, appearing in the medium. Subpopulations of adult chondrocytes from the deep zone synthesized spontaneously more chondroitin sulfate (CS) and less HA than chondrocytes from the superficial zone, but the calf chondrocytes from the 3 zones showed similar patterns of GAG synthesis. Adult chondrocytes from the deep zone had large responses to the BAF for HA but not CS synthesis, resembling the subpopulations of the calf chondrocytes. CONCLUSION: BAF differentially modulate HA and CS synthesis of articular chondrocytes as a result of maturation and topography. We speculate as to how this differential response to BAF may help set the stage for the progression of osteoarthritis in weight bearing joints.

Aging↗

PubMed1996

[Influence of stellate ganglion block and electrical stimulation of the stellate ganglion on bilateral brachial arterial blood flow--is stellate ganglion block effective either unilaterally or bilaterally?].

The purpose of this study was to investigate the influence of the stellate ganglion block (SGB), stellate ganglion electrical stimulation (SGES) and stellate ganglionectomy on bilateral arterial blood flows (BAF). Sixteen mongrel dogs were divided into two groups; a SGB group (n = 8) and a SGES group (n = 8). Anesthesia was induced with pentobarbital 25 mg.kg-1 and the animals were mechanically ventilated to maintain proper PaO2 (90-100 mmHg) and PaCO2 (35-40 mmHg). After a thoracotomy, the SGB with 0.5% mepivacaine 1.0 ml was performed in the SGB group. SGES was performed at a strength of 12 volts, and at a frequency of 50 Hz, applied for 15 minutes and then 15 minutes after the SGES, stellate ganglionectomy was performed in SGES group. In the SGB group, BAF in the blocked side increased significantly but BAF in the contralateral side decreased significantly after SGB. In the SGES group, bilateral BAF decreased significantly (Lt > Rt) and after the stellate ganglionectomy, bilateral BAF increased more than after SGES. These results suggest that the SGB may not be effective on the contralateral side under normal conditions, but under the conditions of sympathetic stimulation, the SGB may be effective on the contralateral side.

Animals↗

PubMed1997

IFN-gamma upregulates anti-apoptotic gene expression and inhibits apoptosis in IL-3-dependent hematopoietic cells.

IFN-gamma is a cytokine which functions in a wide range of biological activities by inducing a number of early and delayed genes. In murine IL-3-dependent cell lines BAF-B03 and 32D, IFN-gamma upregulated bag-1 and bcl-xL gene expression. These cells revealed prolonged cell survival against IL-3-deprivation by IFN-gamma stimulation. In contrast, human myeloma cell line RPMI8226, despite expression of IFN-gamma receptor, showed neither induction of their expressions nor prolonged cell survival against serum starvation-induced apoptosis by IFN-gamma stimulation. Gene-transfer-mediated overexpression of BAG-1 protein in BAF-B03 cells led to prolonged cell survival against IL-3-deprived apoptosis compared with control BAF-B03 transfectants, indicating that levels of BAG-1 expression are crucial for cell survival in BAF-B03 cells. Taken together, these studies suggest that induction of anti-apoptotic gene expression is a crucial factor for the anti-apoptotic function of IFN-gamma in IL-3-dependent immature hematopoietic cells.

Animals↗

PubMed1996

A probabilistic model for deriving soil quality criteria based on secondary poisoning of top predators. I. Model description and uncertainty analysis.

In previous studies, the risk of toxicant accumulation in food chains was used to calculate quality criteria for surface water and soil. A simple algorithm was used to calculate maximum permissable concentrations [MPC = no-observed-effect concentration/bioconcentration factor(NOEC/BCF)]. These studies were limited to simple food chains. This study presents a method to calculate MPCs for more complex food webs of predators. The previous method is expanded. First, toxicity data (NOECs) for several compounds were corrected for differences between laboratory animals and animals in the wild. Second, for each compound, it was assumed these NOECs were a sample of a log-logistic distribution of mammalian and avian NOECs. Third, bioaccumulation factors (BAFs) for major food items of predators were collected and were assumed to derive from different log-logistic distributions of BAFs. Fourth, MPCs for each compound were calculated using Monte Carlo sampling from NOEC and BAF distributions. An uncertainty analysis for cadmium was performed to identify the most uncertain parameters of the model. Model analysis indicated that most of the prediction uncertainty of the model can be ascribed to uncertainty of species sensitivity as expressed by NOECs. A very small proportion of model uncertainty is contributed by BAFs from food webs. Correction factors for the conversion of NOECs from laboratory conditions to the field have some influence on the final value of MPC5, but the total prediction uncertainty of the MPC is quite large. It is concluded that the uncertainty in species sensitivity is quite large. To avoid unethical toxicity testing with mammalian or avian predators, it cannot be avoided to use this uncertainty in the method proposed to calculate MPC distributions. The fifth percentile of the MPC is suggested as a safe value for top predators.

Algorithms↗

PubMed2000

Reversible physiological alterations in sympathetic neurons deprived of NGF but protected from apoptosis by caspase inhibition or Bax deletion.

Cell death in nervous system development and in many neurodegenerative diseases appears to be apoptotic or programmed. Withdrawal of nerve growth factor (NGF) from cultures of superior cervical ganglia neurons (SCG) is an excellent model of programmed cell death (PCD), producing apoptosis within 24-48 h. This death can be prevented by treatment with caspase inhibitors or deletion of the proapoptotic Bax gene. Since inhibition of apoptosis is an attractive strategy for the therapy of many neurological diseases and little is known about the function of neurons when apoptosis has been aborted, we examined the electrophysiological properties of NGF-deprived SCG neurons from rats and mice, saved by the caspase inhibitor boc-aspartyl(OMe)fluoromethyl ketone (BAF) or by Bax deletion. Compared to NGF-maintained controls, the resting membrane potentials of BAF-saved neurons were depolarized by 9 mV and the action potentials were prolonged by over 50%. Nicotinic cholinergic current density was depressed by about 50%. Electrophysiological parameters returned to normal within 4 days after NGF restoration. Neurons from Bax-deficient mice were altered differently by NGF withdrawal. There were no detectable changes in resting or action potentials. However, nicotinic current density was reduced just as in BAF-saved rat neurons. There were no observable changes in the processes of individual neurons after 6 days of NGF deprivation in the presence of BAF. Our results indicate that neurons are physiologically altered during pharmacological inhibition of PCD, but fully recover after trophic support is returned.

Amino Acid Chloromethyl Ketones↗

PubMed1985

Histamine in late asthmatic reactions following house-dust mite inhalation.

In order to investigate the role of histamine in the late asthmatic reaction (LAR) following house-dust mite (HDM) inhalation, we studied, with hourly intervals, urinary N tau-methylhistamine (an important metabolite of histamine) in 14 allergic asthmatic patients before and after broncho provocation with HDM. Four patients showed an early asthmatic reaction (EAR), while 10 patients developed a LAR as well. In the hour following the EAR a significant increase in urinary N tau-methylhistamine was observed as compared to the control day (0.01 less than p less than 0.05). During the LAR no increase of this metabolite was detected in the urine of the patients. Additionally, histamine was measured in broncho alveolar lavage fluid (BAF) obtained from 6 patients during the HDM-provoked LAR and compared to histamine levels in BAF from patients without a LAR, following broncho provocation. In the LAR group higher histamine levels were found than in the other patient and control groups. For the whole patient group no correlation was found between the degree of bronchial obstruction during the LAR and the BAF histamine values. No difference was found in N tau-methylhistamine in BAF between patients with LAR and controls. Thus histamine metabolite studies in the urine failed to provide evidence of involvement of histamine in the LAR, while further data are needed to interpret the results of local sampling in the lung.

Adolescent↗

PubMed2006

Modeling the bioconcentration factors and bioaccumulation factors of polychlorinated biphenyls with posetic quantitative super-structure/activity relationships (QSSAR).

During bioconcentration, chemical pollutants from water are absorbed by aquatic animals via the skin or a respiratory surface, while the entry routes of chemicals during bioaccumulation are both directly from the environment (skin or a respiratory surface) and indirectly from food. The bioconcentration factor (BCF) and the bioaccumulation factor (BAF) for a particular chemical compound are defined as the ratio of the concentration of a chemical inside an organism to the concentration in the surrounding environment. Because the experimental determination of BAF and BCF is time-consuming and expensive, it is efficacious to develop models to provide reliable activity predictions for a large number of chemical compounds. Polychlorinated biphenyls (PCBs) released from industrial activities are persistent pollutants of the environment that produce widespread contamination of water and soil. PCBs can bioaccumulate in the food chain, constituting a potential source of exposure for the general population. To predict the bioconcentration and bioaccumulation factors for PCBs we make use of the biphenyl substitution-reaction network for the sequential substitution of H-atoms by Cl-atoms. Each PCB structure then occurs as a node of this reaction network, which is some sort of super-structure, turning out mathematically to be a partially ordered set (poset). Rather than dealing with the molecular structure via ordinary QSAR we use only this poset, making different quantitative super-structure/activity relationships (QSSAR). Thence we developed cluster expansion and splinoid QSSARs for PCB bioconcentration and bioaccumulation factors. The predictive ability of the BAF and BCF models generated for 20 data sets (representing different conditions and fish species) was evaluated with the leave-one-out cross-validation, which shows that the splinoid QSSAR (r between 0.903 and 0.935) are better than models computed with the cluster expansion (r between 0.745 and 0.887). The splinoid QSSAR models for BAF and BCF yield predictions for the missing PCBs in the investigated data sets.

Animals↗

PubMed1990

Relative tumor initiating activity of benzo[a]fluoranthene, benzo[b]fluoranthene, naphtho[1,2-b]fluoranthene and naphtho[2,1-a]fluoranthene on mouse skin.

The tumor-initiating activities of benzo[a]fluoranthene (BaF), benzo[b]fluoranthene (BbF), naphtho[1,2-b]fluoranthene (NbF) and naphtho[2,1-a]fluoranthene (NaF) were evaluated on the skin of female CD-1 mice. Each of these polycyclic aromatic hydrocarbons was assayed at total initiation doses of 1.0 and 4.0 mumol/mouse. These hydrocarbons were applied in 10 subdoses administered every other day. Promotion commenced 10 days after the last initiator dose and consisted of thrice weekly application of 2.5 micrograms of tetradecanoylphorbol acetate for 20 weeks. BbF was the most potent tumor initiator inducing a 100% incidence of tumor-bearing mice with an average of 8.5 tumors per mouse at a total initiator dose of 1.0 mumol. NaF was slightly more active as a tumor initiator than either NbF or BaF. NaF induced a 90% incidence of tumor-bearing mice with an average of 5.9 tumors per mouse at a total initiator dose of 1.0 mumol. BaF and NbF at a total initiator dose of 4.0 mumol exhibited similar tumor-initiating activity with both inducing a 90% incidence of tumor-bearing mice with an average of 4.3 and 6.6 tumors per mouse, respectively. However, at a total initiator dose of 1.0 mumol, BaF and NbF induced a 95% and 65% incidence of tumor-bearing mice with an average of 3.3 and 2.5 tumors per mouse, respectively.

Animals↗

PubMed1994

Interactions between oncostatin M and the IL-6 signal transducer, gp130.

Recently, gp130, the signal transducer for interleukin 6 (IL-6), leukemia inhibitory factor (LIF), and ciliary neurotrophice factor (CNTF), was identified as the low-affinity receptor for oncostatin M (OM). However, it is not yet clear if OM binding to gp130 requires accessory factor(s) and if gp130 alone can mediate OM signalling. Here we report that: (a) expressing murine gp130 in BAF-B03 cells (BAF-m130) resulted in the appearance of a single class of low-affinity OM binding sites; (b) chemical cross-linking studies with 125I-OM identified a 180 kDa labelled complex on BAF-m130 cells; (c) OM cross-linking to the H2981 cell line which expresses both low- and high-affinity OM receptor, identified a 180 kDa and an additional 280 kDa species; (d) 125I-OM was specifically cross-linked to soluble recombinant gp130 (sgp130-Rg) in solution; and (e) the cellular proliferation of BAF-m130 was unaffected by OM treatment. These data indicate that gp130 can act as the low-affinity receptor for OM, however, gp130-OM interactions alone are unable to elicit cellular proliferation. This suggests that an additional factor(s) are required to interact with the OM/gp130 complex to form the high-affinity functional receptor. We propose that the 280 kDa species detected on H2981 cells is likely a complex of OM, gp130, and the putative beta chain of the functional OM high-affinity receptor. Recently, OM has been shown to be the major growth factor for Kaposi's sarcoma derived cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed2005

Structural basis for DNA bridging by barrier-to-autointegration factor.

The ability of barrier-to-autointegration factor (BAF) to bind and bridge DNA in a sequence-independent manner is crucial for its role in retroviral integration and a variety of cellular processes. To better understand this behavior, we solved the crystal structure of BAF bound to DNA. The structure reveals that BAF bridges DNA using two pairs of helix-hairpin-helix motifs located on opposite surfaces of the BAF dimer without changing its conformation.

Amino Acid Sequence↗

PubMed1994

Effect of increasing intravesicular pH on nitrite production and leishmanicidal activity of activated macrophages.

We examined the effect of bafilomycin A1 (BAF), an inhibitor of vacuolar-type H(+)-ATPases, on macrophages activation (measured as increased nitrite production and leishmanicidal activity) induced by interferon gamma alone or together with lipopolysaccharide or tumour necrosis factor alpha. BAF increased intravesicular pH and enhanced nitrite release by activated macrophages; however, the NO concentration necessary to kill parasites was higher in BAF-exposed than control macrophages, suggesting that microbicidal nitrogen derivatives were less active at alkaline pH. Antibody to tumour necrosis factor alpha inhibited BAF-induced nitrite production in interferon-activated cultures. To determine if enhanced NO synthesis was related to vesicular alkalinization, macrophages were incubated with the lysosomotropic bases NH4Cl and methylamine. These agents also increased intravesicular pH and nitrite production. Nitrite production was correlated with enhanced NO synthase activity in cytosolic extracts of the activated cells.

Amino Acid Oxidoreductases↗

PubMed2003

Regulation of procollagen I (alpha1) by interleukin-4 in human bronchial fibroblasts: a possible role in airway remodelling in asthma.

BACKGROUND: In bronchial mucosa, T cells are in close association with fibroblasts. This cell contact raises the possibility of cross-talk between the two cell types through cytokines, such as interleukin-4 (IL-4). OBJECTIVE: We postulated that IL-4 may modulate collagen synthesis and degradation in the fibroblasts of asthmatics. METHODS: Bronchial fibroblasts from asthmatics (BAF) and normal controls (BNF) were stimulated with IL-4. Procollagen I gene expression and protein production were measured by real-time PCR, RT-PCR, and radioimmunoassay. The effect of IL-4 on the regulation of procollagen I (alpha1) promoter was studied through transient cell transfections. The implication of Sp1 and AP-1 in regulating IL-4-induced procollagen I (alpha1) production was determined. The effect of IL-4 on metalloproteinase-2 (MMP-2) and tissue inhibitor of metalloproteinase-2 (TIMP-2) production and gene expression was evaluated. RESULTS: Following IL-4 stimulation, there was a significant increase in the expression of mRNA of procollagen I (alpha1) by human bronchial fibroblasts of asthmatics and controls. IL-4 has a dose-response effect on mRNA, with a maximal effect at 5 ng/mL, as determined by real-time PCR. The maximal increase in procollagen I (alpha1) was observed at 6 h after IL-4 stimulation in both BNF and BAF. BAFs have a greater increase in the procollagen I (alpha1)/beta2 microglobulin ratio after 6 h of IL-4 stimulation (4.1 x 10-2+/-0.03 to 20.8 x 10-2+/-0.1) compared with BNF (2.9 x 10-2+/-0.006 to 9.2 x 10-2+/-0.08) (P=0.001). In transient transfection experiments, IL-4 increased promoter activity by threefold in BAF and BNF. Sp1 was up-regulated after IL-4 stimulation and AP-1 was down-regulated as shown by electrophoretic mobility shift assay. IL-4 decreased MMP-2 protein and mRNA levels, and did not alter TIMP-2 production. CONCLUSIONS: IL-4 positively regulates procollagen I (alpha1) transcription by direct promoter activation and increases the TIMP-2/MMP-2 ratio, thereby supporting the profibrotic effect of this cytokine. Thus, this study emphasizes that IL-4 may be considered as a link between inflammation and collagen deposition observed in asthmatic airways.

Asthma↗

PubMed2002

Cyclosporin A inhibits caspase-independent death of NGF-deprived sympathetic neurons: a potential role for mitochondrial permeability transition.

Opening of the permeability transition pore (PTP) has been implicated as an important mitochondrial event that occurs during apoptosis. We examined the role of the PTP in the well-characterized cell death of rat sympathetic neurons deprived of nerve growth factor (NGF) in vitro. Removal of NGF causes these neurons to undergo either a classic apoptotic cell death or, when treated with a broad-spectrum caspase inhibitor such as boc-aspartyl(OMe)-fluoromethylketone (BAF), a delayed, nonapoptotic cell death. The PTP inhibitor, cyclosporin A (CsA), blocked commitment-to-die in the presence of BAF, as defined by the ability of NGF readdition to rescue cells, but had little effect on commitment-to-die in the absence of BAF. CsA did not have trophic effects on BAF-saved cells, but did block the decrease in mitochondrial membrane potential. These data suggest that PTP opening is a critical event in caspase-independent, nonapoptotic (but not caspase-dependent, apoptotic) death of NGF-deprived rat sympathetic neurons.

Animals↗

PubMed1998

Retrograde transport from the pre-Golgi intermediate compartment and the Golgi complex is affected by the vacuolar H+-ATPase inhibitor bafilomycin A1.

The effect of the vacuolar H+-ATPase inhibitor bafilomycin A1 (Baf A1) on the localization of pre-Golgi intermediate compartment (IC) and Golgi marker proteins was used to study the role of acidification in the function of early secretory compartments. Baf A1 inhibited both brefeldin A- and nocodazole-induced retrograde transport of Golgi proteins to the endoplasmic reticulum (ER), whereas anterograde ER-to-Golgi transport remained largely unaffected. Furthermore, p58/ERGIC-53, which normally cycles between the ER, IC, and cis-Golgi, was arrested in pre-Golgi tubules and vacuoles, and the number of p58-positive approximately 80-nm Golgi (coatomer protein I) vesicles was reduced, suggesting that the drug inhibits the retrieval of the protein from post-ER compartments. In parallel, redistribution of beta-coatomer protein from the Golgi to peripheral pre-Golgi structures took place. The small GTPase rab1p was detected in short pre-Golgi tubules in control cells and was efficiently recruited to the tubules accumulating in the presence of Baf A1. In contrast, these tubules showed no enrichment of newly synthesized, anterogradely transported proteins, indicating that they participate in retrograde transport. These results suggest that the pre-Golgi structures contain an active H+-ATPase that regulates retrograde transport at the ER-Golgi boundary. Interestingly, although Baf A1 had distinct effects on peripheral pre-Golgi structures, only more central, p58-containing elements accumulated detectable amounts of 3-(2, 4-dinitroanilino)-3'-amino-N-methyldipropylamine (DAMP), a marker for acidic compartments, raising the possibility that the lumenal pH of the pre-Golgi structures gradually changes in parallel with their translocation to the Golgi region.

Animals↗

PubMed2002

Diagnostic signs of accommodative insufficiency.

PURPOSE: To determine which are the most sensitive tests, together with accommodative amplitude, to classify accommodative insufficiency (Al), we analyzed the relation between monocular estimated method (MEM) dynamic retinoscopy, monocular and binocular accommodative facility (MAF, BAF), and positive relative accommodation (PRA) with or without the presence of reduced amplitude of accommodation. METHODS: We studied 328 symptomatic patients who presented consecutively to an optometric clinic. From this sample, we selected the 41 patients who presented amplitude of accommodation at least 2 D below the minimum age-appropriate amplitude according to Hofstetter's formula: 15 - 0.25 x age. We also selected data from 40 consecutive subjects (control group) with no general binocular disorders and normal accommodative amplitudes. We studied the specificity and sensitivity of the four signs related with the accommodative insufficiency: high MEM dynamic retinoscopy, failing MAF and BAF with minus lenses of +/- 2 D flipper lenses, and low PRA. RESULTS: Using the standard deviation as the cutoff, the specificity values were MEM = 0.88, MAF = 1, BAF = 0.93, and PRA = 1. When using the mean value as the cutoff, the specificity diminished, fundamentally for MEM. The sensitivity for the 41 patients using standard deviation as the cutoff was MEM = 0.44, MAF = 0.34, BAF = 0.27, and PRA = 0.27, and when using the mean value as the cutoff the four, sensitivity values increased. CONCLUSIONS: According to the sensitivity results, with both cutoffs used, failing the +/- 2 D MAF test seems to be the sign that is most associated with the accommodative insufficiency.

Accommodation, Ocular↗