OBJECTIVE

Non-penetrating deep sclerectomy (NPDS) can enhance drainage of aqueous humour without disrupting the trabecular endothelial layer, reducing risks of postoperative hypotony and hyphema. This study explores associations of angle morphology with surgical efficacy in eyes with open and obstructed angles.

METHODS

Eighty-nine consecutive eyes undergoing successful NPDS (non-implant, with 0.4 mg/ml mitomycin C and limbus-based two-layer closure) were studied in this institutional review board-approved retrospective quality assurance study. Postoperative complication frequency, intraocular pressure (IOP), glaucoma medications required and acuity were monitored (baseline vs 3, 6, 9, 12 and 18-month postoperative levels), along with 30-2 Humphrey MD and corrected pattern standard deviation (CPSD) (baseline vs 6, 12 and 18-month postoperative values). Preoperative gonioscopy was compared with the subsequent requirement for specific postoperative interventions.

RESULTS

IOP at all five postoperative intervals was reduced (22 ± 0.9 to 12 ± 0.5 mm Hg; p<0.0001). No hyphema were observed. Postoperative hypotony (IOP < 4 mm Hg) occurred rarely (8/445; 1.8%). Mean glaucoma medication use dropped from 3.1 ± 0.1 to 0.23 ± 0.1 at 18 months (p<0.0001). Mean 30-2 MD improved by approximately 1.4 dB at 6, 12 and 18 months (p<0.002); CPSD remained stable.

CONCLUSIONS

Following NPDS, a sustained IOP decrease of 10 mm Hg (45%) was attained, with stable acuity, increased perimetric generalised light sensitivity and 90% reduction in medical therapy requirement. Morbidity risk was associated with narrow gonioscopic angle insertion and synechia, but not with shallow approach or trabecular pigmentation.

Chromosome segregation in bacteria is poorly understood outside some prominent model strains^1-5 and even less is known about how it is coordinated with other cellular processes. This is the case for the opportunistic human pathogen Streptococcus pneumoniae (the pneumococcus)⁶, which lacks the Min and the nucleoid occlusion systems⁷, and possesses only an incomplete chromosome partitioning Par(A)BS system, in which ParA is absent⁸. The bacterial tyrosine kinase⁹ CpsD, which is required for capsule production, was previously found to interfere with chromosome segregation¹⁰. Here, we identify a protein of unknown function that interacts with CpsD and drives chromosome segregation. RocS (Regulator of Chromosome Segregation) is a membrane-bound protein that interacts with both DNA and the chromosome partitioning protein ParB to properly segregate the origin of replication region to new daughter cells. In addition, we show that RocS interacts with the cell division protein FtsZ and hinders cell division. Altogether, this work reveals that RocS is the cornerstone of a nucleoid protection system ensuring proper chromosome segregation and cell division in coordination with the biogenesis of the protective capsular layer.

Streptococcus iniae is an invasive pathogen causing meningitis and other lesions in various fish species. Furthermore, S. iniae is an emerging zoonotic agent that causes cellulitis in man. The aims of this study were to establish an intraperitoneal infection model for S. iniae in Nile tilapia (Oreochromis niloticus) and to develop a new histopathological scoring system to reflect the degree and extent of inflammation as well as the presence of necrosis in the brain and eye. Intraperitoneal administration of 10(6) colony-forming units (CFU) led to 80% mortality and numerous fish developing clinical signs of central nervous system dysfunction. Microscopical examination of four regions of the brain (olfactory bulb, cerebellum, cerebrum and optical lobe) and the eye revealed the presence of lymphohistiocytic leptomeningitis, meningoencephalitis and endophthalmitis. Lesions were dominated by macrophages that often contained intracellular bacteria. Necrosis was recorded in some cases. Bacteriological screening revealed that multiple organs, including brain and eye, were infected with S. iniae and S. iniae colonized the scales and gills in high number. S. iniae was detected in tank water during the first week post infection, suggesting that infected tilapia might shed up to 3 × 10(7) CFU of S. iniae within 24 h. A multiplex polymerase chain reaction allowed confirmation of the challenge strain by detection of the virulence factors simA, scpI, cpsD, pgi, pgm and sagA.

Fourteen different insertion sequences belonging to seven families were identified in the genome of Streptococcus agalactiae. Among them, IS1548, a mobile element of the ISAs1 family, was linked to clonal complex (CC) 19 strains associated with neonatal meningitis and endocarditis. IS1548 impacts S. agalactiae in two reported ways: i) inactivation of virulence genes by insertion in an open reading frame (e.g. hylB or cpsD), ii) positive modulation of the expression of a downstream gene by insertion in an intergenic region (e.g. lmb). We previously identified an unknown integration site of IS1548 in the intergenic region between the folK and the murB genes involved in folate and peptidoglycan biosynthesis, respectively. In this work, we analyzed the prevalence of IS1548 in a large collection of nine hundred and eleven S. agalactiae strains. IS1548 positive strains belong to twenty-nine different sequence types and to ten CCs. The majority of them were, however, clustered within sequence type 19 and sequence type 22, belonging to CC19 and CC22, respectively. In contrast, IS1548 targets the folK-murB intergenic region exclusively in CC19 strains. We evaluated the impact of the insertion of IS1548 on the expression of murB by locating transcriptional promoters influencing its expression in the presence or absence of IS1548 and by comparative β-galactosidase transcriptional fusion assays. We found that in the absence of IS1548, genes involved in folate biosynthesis are co-transcribed with murB. As it was postulated that a folic acid mediated reaction may be involved in cell wall synthesis, this co-transcription could be necessary to synchronize these two processes. The insertion of IS1548 in the folK-murB intergenic region disrupt this co-transcription. Interestingly, we located a promoter at the right end of IS1548 that is able to initiate additional transcripts of murB. The insertion of IS1548 in this region has thus a dual and divergent impact on the expression of murB. By comparative β-galactosidase transcriptional fusion assays, we showed that, consequently, the overall impact of the insertion of IS1548 results in a minor decrease of murB gene transcription. This study provides new insights into gene expression effects mediated by IS1548 in S. agalactiae.

UNASSIGNED

Sleep disturbance is a major health concern for heroin users receiving methadone maintenance treatment (MMT). The present study was aimed to investigate the predictors for new-onset clinically predominant sleep disturbance (CPSD) among heroin users receiving MMT.

UNASSIGNED

This 2-year retrospective study included 152 individuals (127 males and 25 females) with heroin use disorder who visited our MMT clinics for the first time. A univariate Cox proportional hazards regression model (Cox model) was used to estimate the potential factors of subsequent CPSD, followed by a multivariate Cox model to identify significant predictors of CPSD after adjusting for other covariates.

UNASSIGNED

Twenty-nine (19.1%) participants developed CPSD during the 2-year period. After forward selection in the Cox model, earlier age at onset of heroin exposure (OR=0.95; P=0.044), lower attendance rate (OR =0.04; P=0.03), greater maximum dose of methadone (OR =1.01; P=0.022), and shorter time to maximum methadone dose (OR =0.98; P=0.007) were significantly associated with new-onset CPSD.

UNASSIGNED

We identified predictors that were significantly associated with new-onset CPSD, and clinicians should be aware of sleep disturbance in heroin users receiving MMT with these risk factors. Future studies are necessary to verify our findings and extend the applicability.

In Gram-positive bacteria, tyrosine kinases are split into two proteins, the cytoplasmic tyrosine kinase and a transmembrane adaptor protein. In Streptococcus pneumoniae, this transmembrane adaptor is CpsC, with the C terminus of CpsC critical for interaction and subsequent tyrosine kinase activity of CpsD. Topology predictions suggest that CpsC has two transmembrane domains, with the N and C termini present in the cytoplasm. In order to investigate CpsC topology, we used a chromosomal hemagglutinin (HA)-tagged Cps2C protein in S. pneumoniae strain D39. Incubation of both protoplasts and membranes with carboxypeptidase B (CP-B) resulted in complete degradation of HA-Cps2C in all cases, indicating that the C terminus of Cps2C was likely extracytoplasmic and hence that the protein's topology was not as predicted. Similar results were seen with membranes from S. pneumoniae strain TIGR4, indicating that Cps4C also showed similar topology. A chromosomally encoded fusion of HA-Cps2C and Cps2D was not degraded by CP-B, suggesting that the fusion fixed the C terminus within the cytoplasm. However, capsule synthesis was unaltered by this fusion. Detection of the CpsC C terminus by flow cytometry indicated that it was extracytoplasmic in approximately 30% of cells. Interestingly, a mutant in the protein tyrosine phosphatase CpsB had a significantly greater proportion of positive cells, although this effect was independent of its phosphatase activity. Our data indicate that CpsC possesses a varied topology, with the C terminus flipping across the cytoplasmic membrane, where it interacts with CpsD in order to regulate tyrosine kinase activity.

14 patients (14 eyes) who sustained hyphema after blunt ocular trauma underwent visual field testing on a Humphrey field analyzer. The severity of field defects based on mean deviation (MD) and corrected-pattern standard deviation (CPSD) p values was correlated with age, presence of hyphema and the extent of angle recession. Over 60% of eyes with blunt ocular trauma suffer from a significant visual field loss (MD < 5%). There was no correlation between severity of field defects and the extent of hyphema or the angle recession. MD p values were found to be associated with older group, but not CPSD p values.

Psychosis commonly occurs as a direct result of complex partial seizure disorder (CPSD). This organic mental disorder is indeed "complex" and is easily and frequently misdiagnosed as a variety of functional disorders, including schizophrenia, schizoaffective disorder, bipolar illness, psychotic depression, and, at best, "atypical psychosis." However, this important clinical syndrome has several clinical features that suggest its presence and which often permit it to be distinguished from other forms of psychosis. Furthermore, this disorder can be successfully treated with limbic anticonvulsants, with or without neuroleptics and/or lithium, but it is generally refractory to neuroleptic medications alone. In this paper, the author reviews the available literature relevant to the clinical phenomenology and treatment of this topic and illustrates the clinical profiles of 10 treatment-refractory patients admitted to a state hospital with previously undiagnosed psychoses secondary to CPSD. This illness needs to be seriously considered in the differential diagnosis of severely ill patients with atypical psychoses refractory to traditional treatments.

Identification of the genes responsible for the recovery of virulence in brain-passaged Acanthamoeba culbertsoni was attempted via mRNA differential display-polymerase chain reaction (mRNA DD-PCR) analysis. In order to identify the regulatory changes in transcription of the virulence related genes by the brain passages, mRNA DD-PCR was performed which enabled the display of differentially transcribed mRNAs after the brain passages. Through mRNA DD-PCR analysis. 96 brain-passaged amoeba specific amplicons were observed and were screened to identify the amplicons that failed to amplify in the non-brain-passaged amoeba mRNAs. Out of the 96 brain-passaged amoeba specific amplicons, 12 turned out to be amplified only from the brain-passaged amoeba mRNAs by DNA slot blot hybridization. The clone, A289C, amplified with an arbitrary primer of UBC #289 and the oligo dT11-C primer, revealed the highest homology (49.8%) to the amino acid sequences of UPD-galactose lipid transferase of Erwinia amylovora, which is known to act as an important virulence factor. The deduced amino acid sequences of an insert DNA in clone A289C were also revealed to be similar to cpsD, which is the essential gene for the expression of type III capsule in group B streptococcus. Upregulated expression of clone A289C was verified by RNA slot blot hybridization. Similar hydrophobicity values were also observed between A289C (at residues 47-66) and the AmsG gene of E. amylovora (at residues 286-305: transmembrane domains). This result suggested that the insert of clone A289C might play the same function as galactosyl transferase controlled by the AmsG gene in E. amylovora.

BACKGROUND

The amino acid l-citrulline is used as a therapeutic agent for urea cycle disorders (UCD) including ornithine transcarbamylase deficiency (OTCD), carbamoyl phosphate synthetase I deficiency (CPSD), and N-acetylglutamate synthase deficiency. There are few reports, however, on the use of l-citrulline in Japan and little consensus regarding the effects of l-citrulline.

METHODS

We conducted a questionnaire survey of patients undergoing l-citrulline treatment for a UCD to evaluate the current status of this therapy. The survey included patient background, details of l-citrulline treatment, clinical examination data, treatment, frequency of vomiting, and liver transplantation.

RESULTS

We retrospectively investigated 43 questionnaire respondents (OTCD, n = 33; CPSD, n = 10). The weight of male OTCD patients improved by +0.79 SD, and the ammonia level decreased by a mean of 44.3 μmol/L in all patients. The protein intake of all patients and of male OTCD patients increased by 0.14 g/kg/day and 0.17 g/kg/day, respectively.

CONCLUSIONS

l-Citrulline effectively reduced ammonia level, increased protein intake, and improved weight gain in UCD patients. l-Citrulline should be considered a standard therapy in OTCD and CPSD patients.

We investigated the ability of the GDx-Nerve Fiber Analyzer (NFA) to discriminate between normal and early glaucomatous eyes among Korean individuals by reviewing the medical records of 217 consecutive subjects: 61 early glaucoma patients, 68 ocular hypertensive patients, and 88 normal subjects. GDx parameters were compared using ANOVA. The Receiver Operating Characteristics (ROC) curve for each GDx-NFA variable was used to diagnose each parameter, and Pearson correlation coefficients were calculated to assess the association between GDx-NFA parameters and visual field indices in early glaucoma. The best GDx parameters to discriminate between early glaucomatous and normal subjects were the number, maximum modulation, ellipse modulation and inferior ratio (i.e. area under the ROC curve>> 0.8). A value for the Number of equal to or greater than 27 was optimal for detecting early glaucoma, with a sensitivity of 80.3% and specificity of 80.7%. In addition, symmetry was positively correlated with the corrected pattern standard deviation (CPSD) among visual field indices in early glaucoma.

The authors evaluated, by means of colour Doppler imaging, the blood flow in ophthalmic artery and posterior ciliary arteries in subjects with chronic open angle glaucoma. On the basis of the visual field indices (MD, SF, CPSD) the patients' eyes were divided in two groups: group A with better indices and group B with great damage. At the posterior ciliary arteries they found these values: PSV 10.264 +/- 2.363 cm/s (group A) vs. 7.882 +/- 1.251 cm/s (group B) (p < 0.008); RI 0.615 +/- 0.065 (group A) vs. 0.695 +/- 0.064 (group B) (p < 0.009). These data highlight a correlation between the visual field damage and the reduced supply of optic nerve head.

OBJECTIVE

To describe a new method of quantifying retinal nerve fiber layer defects (NFLD) in glaucomatous eyes using the Heidelberg Retina Tomograph (HRT).

METHODS

Mean tomographic images including the optic disc and peripapillary area were constructed using HRT. An image field of 15 degrees x 15 degrees or 20 degrees x 20 degrees was used for the NFLD analysis. Data on the nerve fiber layer thickness was collected and further analyzed circumferentially across the NFLD at a position 500 microm away from the optic disc margin. We studied 31 patients with early to moderate open-angle glaucoma, ie, with visual field defects appearing earlier than stage 3 of the modified Aulhorn-Greve classification. We determined the width (W), maximum depth (D), and cross-sectional area of the NFLD (A), and we identified correlations between these parameters and the visual field indices from Humphrey Visual Field tests, mean deviation (MD) and corrected pattern standard deviation (CPSD).

RESULTS

NFLD parameters could be obtained from 20 of 31 eyes (65%). There was a statistically significant correlation between the D and A parameters, and between these parameters and the maximum depression threshold in the corresponding visual field. No significant correlation was found between the NFLD parameters, the global visual field indices (MD, CPSD) and the mean value of the total deviation (TD) in the corresponding hemifield visual field.

CONCLUSIONS

A cross-sectional NFLD image can be obtained using HRT. Among the three NFLD parameters, maximum depth (D), and area under the surface (A) correlated well with the visual field threshold.

OBJECTIVE

To evaluate the relationship between peripapillary focal arteriolar narrowing and visual field defects.

METHODS

From our institutional practice, we identified 31 patients with glaucoma who had peripapillary focal arteriolar narrowing in only one eye and compared visual field data between the two eyes. Mean deviation (MD) and corrected pattern standard deviation (CPSD) were recorded using Humphrey visual field testing at the time proximal narrowing was apparent on the fundus photograph. Visual field data from subsets of patients with mild and severe narrowing were also compared.

RESULTS

The MD and CPSD were significantly worse in eyes with peripapillary focal arteriolar narrowing. The eyes with narrowing exhibited a mean MD of -8.77 +/- 8.27 dB and a mean CPSD of 5.01 +/- 3.42 dB. Eyes without narrowing displayed a mean MD of -4.52 +/- 6.64 dB and a mean CPSD of 3.01 +/- 2.68 dB (P =.003 for both). There was no significant difference in severity of the visual field defect between eyes with mild and severe arteriolar narrowing.

CONCLUSIONS

To our knowledge, this is the first study to show that the presence of peripapillary focal arteriolar narrowing is related to the severity of visual field loss in patients with glaucoma.

OBJECTIVE

To evaluate the correlation between High-Pass Resolution Perimetry (HRP) and standard threshold perimetry in patients with glaucoma or ocular hypertension.

METHODS

31 glaucomatous patients and 37 ocular hypertension subjects with previous perimetric examination experience were consecutively recruited and only one eye for each patient was selected at random. Glaucomatous patients were classified as having primary open angle glaucoma when they had an abnormal visual field and/or an abnormal optic nerve head (ONH)/retinal nerve fiber layer (RNFL) typical of glaucoma, open angle at gonioscopy and no clinically apparent secondary cause for their glaucoma. Ocular hypertension subjects were defined as having intraocular pressure >21 mm Hg on no treatment, normal visual field, normal ONH and RNFL, elevated intraocular pressure without any treatment. All the subjects were examined with Humphrey Field Analyzer (HFA) 640, 'program central 30-2' (Humphrey Systems, San Leandro, CA, USA) and with High-Pass Resolution Perimeter (HRP), Ophthimus version 2.4,'ring program' (Nikon-HighTech Vision, Goteborg, Sweden). Visual field indices were obtained with both systems: for HFA mean deviation (MD), corrected pattern standard deviation (CPSD) and short term fluctuation (SF), while for HRP global deviation (GD), local deviation (LD), form index (FI) and neural capacity (NC). The data were analyzed by descriptive analysis, Student's t test with Bonferroni's correction or Mann-Whitney non-parametric test and Pearson or Spearman's correlation coefficient.

RESULTS

A significant correlation was found between MD and GD (r = -0.81), CPSD and LD (r = 0.87), PSD and LD (r = 0.72). NC was significantly correlated with MD (r = 0.76), GD (r = -0.94). FI was significantly correlated with PSD (r = -0.58), CPSD (r = -0.72), LD (r = -0.56). When the same data were analyzed for the glaucomatous group only, similar results were found; in the ocular hypertensive group no significant correlation was found except between NC and MD (r = 0.52).

CONCLUSIONS

HRP indices vary comparably with HFA indices. Parameters as NC and FI were significantly correlated with standard visual field indices of both HFA and HRP. Although the clinical applications for FI are not clear yet, NC could detect both early glaucomatous damage and age related changes.

OBJECTIVE

A prospective controlled cohort study examined the effects of obstructive sleep apnea syndrome (OSAS) on the visual field, including morphological and physiological aspects.

METHODS

Thirty-two patients with newly discovered and previously untreated moderate to severe OSAS (apnea-hypopnea index >20) were compared with a control group of 32 healthy individuals. Global visual field indices [mean deviation (MD), corrected pattern standard deviation (CPSD)] were compared, and optic disc changes, intraocular pressure, correlations between MD and polysomnography, and the frequency of local defects (using the Humphrey Field Analyzer) were examined.

RESULTS

The MD was significantly reduced (R -1.66/L -1.62 dB; p<0.001) in OSAS patients, whereas there was no difference in CPSD. Diffuse local defects in the middle periphery of the 30° visual field were increased in OSAS patients (p<0.003). Normal intraocular tension values were found in all persons, with no correlation to MD. The incidence of pathological optic disc changes was increased in the apnea group (6.25%).

CONCLUSIONS

OSAS seems to lead to reduced sensitivity in the visual field by diffuse rarefaction of nerve tissue in the retina, optic nerve, or both. An increased incidence of development of a low-tension glaucoma is assumed.

BACKGROUND

We study the estimation of breathing frequency (BF) derived from wearable single-channel ECG signal in the context of mobile daily life activities. Although respiration effects on heart rate variability and ECG morphology have been well established, studies on ECG-derived respiration in daily living settings are scarce; possibly due to considerable amount of disturbances in such data. Yet, unobtrusive BF estimation during everyday activities can provide vital information for both disease management and athletic performance optimization.

UNASSIGNED

For robust ECG-derived BF estimation, we combine the respiratory information derived from R-R interval (RRI) variability and morphological scale variation of QRS complexes (MSV), acquired from ECG signals. Two different fusion techniques are applied on MSV and RRI signals: cross-power spectral density (CPSD) estimation and power spectrum multiplication (PSM). The algorithms were tested on large sets of data collected from 67 participants during office, household and sport activities, simulating daily living activities. We use spirometer reference BF to evaluate and compare our estimations made by different models.

CONCLUSIONS

PSM acquires the least average error of BF estimation, [Formula: see text] and [Formula: see text], compared to the reference spirometer values. PSM offers approximately 25 and 75% less error in comparison with the CPSD fusion estimation and the estimation by those two exclusive sources, respectively. Our results demonstrate the superiority of both of the fusion approaches, compared to the estimation derived from either of RRI or MSV signals exclusively.

OBJECTIVE

To develop a machine learning (ML) methodology based on features extracted from odd-ball auditory evoked potentials to identify neurophysiologic changes induced by Clozapine (CLZ) treatment in responding schizophrenic (SCZ) subjects. This objective is of particular interest because CLZ, though a potentially dangerous drug, can be uniquely effective for otherwise medication-resistant SCZ subjects. We wish to determine whether ML methods can be used to identify a set of EEG-based discriminating features that can simultaneously (1) distinguish all the SCZ subjects before treatment (BT) from healthy volunteer (HV) subjects, (2) distinguish EEGs collected before CLZ treatment (BT) vs. those collected after treatment (AT) for those subjects most responsive to CLZ, (3) discriminate least responsive subjects from HV AT, and (4) no longer discriminate most responsive subjects from HVs AT. If a set of EEG-derived features satisfy these four conditions, then it may be concluded that these features normalize in responsive subjects as a result of CLZ treatment, and therefore potentially provide insight into the functioning of the drug on the SCZ brain.

METHODS

Odd-ball auditory evoked potentials of 66 HVs and 47 SCZ adults both BT and AT with CLZ were derived from EEG recordings. Treatment outcome, after at least one year follow-up, was assessed through clinical rating scores assigned by an experienced clinician, blind to EEG results. Using a criterion of at least 35% improvement after CLZ treatment, subjects were divided into "most-responsive" (MR) and "least-responsive" (LR) groups. As a first step, a brain source localization (BSL) procedure was employed on the EEG signals to extract source waveforms from specified brain regions. ML methods were then applied to these source waveform signals to determine whether a set of features satisfying the four conditions outlined above could be discovered.

RESULTS

A set of cross-power spectral density (CPSD) features meeting these criteria was identified. These CPSD features, consisting of a combination of brain regional source activity and connectivity measures, significantly overlap with the default mode network (DMN). All decrease with CLZ treatment in responding SCZs.

CONCLUSIONS

A set of EEG-derived discriminating features which normalize as a result of CLZ treatment was identified. These discriminating features define a network that shares significant commonality with the DMN. Our findings are consistent with those of previous literature, which suggest that regions of the DMN are hyperactive and hyperconnected in SCZ subjects. Our study shows that these discriminating features decrease after treatment, consistent with portions of the DMN normalizing with CLZ therapy in responsive subjects.

CONCLUSIONS

Machine learning is proposed as a potentially powerful tool for analysis of the effect of medication on psychiatric illness. If replicated, the proposed approach could be used to gain some improved understanding of the effect of neuroleptic medications in treating psychotic illness. These results may also be useful in the development of new pharmaceuticals, since a new drug which induces changes in brain electrophysiology similar to those seen after CLZ could also have powerful antipsychotic properties.

BACKGROUND

Brusini developed a new interpretation system for Octopus and Humphrey automated perimeters that is based on mean defect (MD) and corrected loss variance (CLV) or corrected pattern standard deviation (CPSD). This study tested the performance of Brusini's glaucoma staging system (GSS) in staging and follow-up.

METHODS

Retrospectively, 610 visual fields of 64 eyes of open-angle glaucoma patients were analyzed with Brusini GSS and compared with Aulhorn-Karmeyer stages and by PeriData 7.0 trend analysis.

RESULTS

Follow-up was comparable to PeriData 7.0 trend analysis in 97%. Change was observed in 41% of eyes, i.e., initial improvement (19% eyes), deterioration (16%), and after an initial improvement, either deterioration (11%) or a stable period (5%). No change was seen in 59% of the eyes, of which 30% showed small and 19% high long-term fluctuation (LF) due to fatigue effect, poor cooperation of patient, impaired reliability, or short-term fluctuation (SF) greater than 1.7 dB. However, for 8% of the eyes there was no apparent reason for high LF.

CONCLUSIONS

Brusini GSS is useful for staging and recommended for follow-up evaluation of visual fields in glaucoma.

Acid stress can affect the viability of probiotics, especially Bifidobacterium. This study aimed to improve the acid tolerance of Bifidobacterium longum BBMN68 using adaptive evolution. The stress response, and genomic differences of the parental strain and the variant strain were compared by acid stress. The highest acid-resistant mutant strain (BBMN68m) was isolated from more than 100 asexual lines, which were adaptive to the acid stress for 10(th), 20(th), 30(th), 40(th), and 50(th) repeats, respectively. The variant strain showed a significant increase in acid tolerance under conditions of pH 2.5 for 2 h (from 7.92 to 4.44 log CFU/ml) compared with the wildtype strain (WT, from 7.87 to 0 log CFU/ml). The surface of the variant strain was also smoother. Comparative whole-genome analysis showed that the galactosyl transferase D gene (cpsD, bbmn68_1012), a key gene involved in exopolysaccharide (EPS) synthesis, was altered by two nucleotides in the mutant, causing alteration in amino acids, pI (from 8.94 to 9.19), and predicted protein structure. Meanwhile, cpsD expression and EPS production were also reduced in the variant strain (p < 0.05) compared with WT, and the exogenous WT-EPS in the variant strain reduced its acid-resistant ability. These results suggested EPS was related to acid responses of BBMN68.

A new PCR-based method to detect putative exopolysaccharide (EPS) producers from the genus Bifidobacterium was developed based on the detection of two priming glycosyltransferase genes: rfbP (undecaprenyl-phosphate sugar phospho-transferase) and cpsD (galactosyl-transferase). An in silico analysis of the genomes of 28 bifidobacterial strains, belonging to 8 different species, allowed us to detect rfbP, cpsD, or both, in the large majority of the genomes. Based on DNA sequence homology studies, 24 degenerated primers were synthesised in order to select the primer pairs with the broadest capacity to detect the presence of these genes. Four primer pairs targeting internal regions of rfbP and cpsD were selected, allowing the detection of at least one of the two genes in 63 out of 99 bifidobacterial strains analysed, whereas control strains from other genera yielded negative results, suggesting that these genes are widely spread in this genus. The use of these primers is recommended to screen for the potential of Bifidobacterium strains to produce EPS.

Anion exchange materials were prepared from pine sawdust (Pinus sylvestris, PSD) through cationizing treatment with N-(3-chloro-2-hydroxypropyl) trimethyl ammonium chloride (CHMAC) in the presence of NaOH. Response surface methodology (RSM) was used to find the optimal reaction conditions. Three factors were chosen: reaction temperature (26-94 °C), reaction time (0.32-3.7 h) and NaOH/CHMAC molar ratio (0.19-2.2). Product yield (%) was used as a response. A quadratic model was fitted to the experimental data. The optimal conditions were: a reaction temperature of 57 °C, a reaction time of 1.8 h and a NaOH/CHMAC molar ratio of 1.32. A maximum nitrogen content of 2.6% was obtained at 60 °C, 3.7 h and a molar ratio of 1.2. The molar ratio had the greatest impact on the response. Regression analysis revealed that over 95% of the variance can be explained by the model. A maximum nitrate sorption capacity of 15.3 ± 1.4 mg N/g was achieved. The effect of CHMAC dose was also studied (a NaOH/CHMAC molar ratio of 1.2): 0.064 mol/g PSD was found to be near the optimum. Nitrate-contaminated groundwater (27.5 mg/l NO3) was treated with CPSD. Doses of 3-6 g/l resulted in 59-71% nitrate reduction.

Urea cycle disorders (UCDs) are inherited metabolic diseases causing hyperammonemia by defects in urea cycle enzymes or transporters. Liver transplantation (LT) currently is the only curative treatment option until novel therapies become available. We performed a nationwide questionnaire-based study between January 2000 and March 2018 to investigate the effect of LT in patients with UCDs in Japan. A total of 231 patients with UCDs were enrolled in this study. Of them, a total of 78 patients with UCDs (30 male and 16 female ornithine transcarbamylase deficiency (OTCD), 21 carbamoyl phosphate synthetase 1 deficiency (CPSD), 10 argininosuccinate synthetase deficiency (ASSD) and 1 arginase 1 deficiency (ARGD)) had undergone LT. Concerning the maximum blood ammonia levels at the onset time in the transplanted male OTCD (N = 28), female OTCD (N = 15), CPSD (N = 21) and ASSD (N = 10), those were median 634 (IQR: 277-1172), 268 (211-352), 806 (535-1382), and 628 (425-957) μmol/L, respectively. The maximum blood ammonia levels in female OTCD were thus significantly lower than in the other UCDs (all P < 0.01). LT was effective for long-term survival, prevented recurrent hyperammonemia attack, and lowered baseline blood ammonia levels in patients with UCDs. LT had limited effect for ameliorating neurodevelopmental outcome in patients with severe disease because hyperammonemia at the onset time already had a significant impact on the brain. Patients with ASSD may be more likely to survive without cognitive impairment by receiving early LT despite severe neonatal hyperammonemia ≥360 μmol/L. In patients with neonatal onset OTCD or CPSD, there may be additional factors with adverse effects on the brain that are not improved by LT. This article is protected by copyright. All rights reserved.

Keywords: Amino acids; hyperammonemia; liver transplantation; long-term survival; neurodevelopmental outcome; urea cycle disorders.

OBJECTIVE

The purpose of the following study is to compare short wave automated perimetry (SWAP) versus standard automated perimetry (SAP) for early detection of diabetic retinopathy (DR).

METHODS

A total of 40 diabetic patients, divided into group I without DR (20 patients = 40 eyes) and group II with mild non-proliferative DR (20 patients = 40 eyes) were included. They were tested with central 24-2 threshold test with both shortwave and SAP to compare sensitivity values and local visual field indices in both of them. A total of 20 healthy age and gender matched subjects were assessed as a control group.

RESULTS

Control group showed no differences between SWAP and SAP regarding mean deviation (MD), corrected pattern standard deviation (CPSD) or short fluctuations (SF). In group I, MD showed significant more deflection in SWAP (-4.44 ± 2.02 dB) compared to SAP (-0.96 ± 1.81 dB) (P = 0.000002). However, CPSD and SF were not different between SWAP and SAP. In group II, MD and SF showed significantly different values in SWAP (-5.75 ± 3.11 dB and 2.0 ± 0.95) compared to SAP (-3.91 ± 2.87 dB and 2.86 ± 1.23) (P = 0.01 and 0.006 respectively). There are no differences regarding CPSD between SWAP and SAP. The SWAP technique was significantly more sensitive than SAP in patients without retinopathy (p), but no difference exists between the two techniques in patients with non-proliferative DR.

CONCLUSIONS

The SWAP technique has a higher yield and efficacy to pick up abnormal findings in diabetic patients without overt retinopathy rather than patients with clinical retinopathy.