Cataract extraction with erisophake

Today the erisophake offers the most successful means for the intracapsular extraction of cataracts. The advantages of this method are that no counterpressure is required so that the incidence of vitreous loss is reduced; the vacuum cup provides a firmer grasp of the lens with less danger of rupture of the lens capsule; and the vacuum cup can be used for the delivery of practically all types of cataract in the adult, including intumescent and Morgagnian cataracts as well as lenses with exfoliating and friable capsules. While the forceps method of intracapsular extraction is generally successful in not more than 70 to 75 per cent of cases, the erisophake may offer success in 90 per cent of cases.     

THE PROGNOSIS IN CATARACT OPERATIONS—A Correlation of Preoperative Appraisal with Results

The preoperative and postoperative data on 500 cases in which cataracts were removed from the eyes were reviewed to correlate the results with the preoperative prognosis as determined by light identification and macular function tests. Another purpose was to consider the adequacy of various methods of preoperative appraisal.The vision was improved to better than 20/200 in 89.4 per cent of the cases. In 5.6 per cent (28 cases) vision was improved but was 20/200 or less. In 5 per cent (25 cases) the operation was a failure, for various causes.There was wide variation in methods used to determine the condition of the retina preoperatively by means of light identification and macular function tests, and there was no uniformity of terms used to describe degree of function.A standardized method of estimating retinal function in the presence of cataract was used in 60 cases. The equipment used is simple and inexpensive. From analysis of preoperative determination of prognosis and the operative results, it would appear that this simple inexpensive procedure is more reliable in arriving at a preoperative prognosis than some of the methods frequently employed.     

The prognosis in cataract operations; a correlation of preoperative appraisal with results

The preoperative and postoperative data on 500 cases in which cataracts were removed from the eyes were reviewed to correlate the results with the preoperative prognosis as determined by light identification and macular function tests. Another purpose was to consider the adequacy of various methods of preoperative appraisal. The vision was improved to better than 20/200 in 89.4 per cent of the cases. In 5.6 per cent (28 cases) vision was improved but was 20/200 or less. In 5 per cent (25 cases) the operation was a failure, for various causes. There was wide variation in methods used to determine the condition of the retina preoperatively by means of light identification and macular function tests, and there was no uniformity of terms used to describe degree of function.A standardized method of estimating retinal function in the presence of cataract was used in 60 cases. The equipment used is simple and inexpensive. From analysis of preoperative determination of prognosis and the operative results, it would appear that this simple inexpensive procedure is more reliable in arriving at a preoperative prognosis than some of the methods frequently employed.     

Elevated Frequency of Cataracts in Birds from Chernobyl

Background

Radiation cataracts develop as a consequence of the effects of ionizing radiation on the development of the lens of the eye with an opaque lens reducing or eliminating the ability to see. Therefore, we would expect cataracts to be associated with reduced fitness in free-living animals.

Methodology/Principal Findings

We investigated the incidence of lens opacities typical of cataracts in more than 1100 free-living birds in the Chernobyl region in relation to background radiation. The incidence of cataracts increased with level of background radiation both in analyses based on a dichotomous score and in analyses of continuous scores of intensity of cataracts. The odds ratio per unit change in the regressor was 0.722 (95% CI 0.648, 0.804), which was less than odds ratios from investigations of radiation cataracts in humans. The relatively small odds ratio may be due to increased mortality in birds with cataracts. We found a stronger negative relationship between bird abundance and background radiation when the frequency of cataracts was higher, but also a direct effect of radiation on abundance, suggesting that radiation indirectly affects abundance negatively through an increase in the frequency of cataracts in bird populations, but also through direct effects of radiation on other diseases, food abundance and interactions with other species. There was no increase in incidence of cataracts with increasing age, suggesting that yearlings and older individuals were similarly affected as is typical of radiation cataract.

Conclusions/Significance

These findings suggest that cataracts are an under-estimated cause of morbidity in free-living birds and, by inference, other vertebrates in areas contaminated with radioactive materials.     

Developmental and physiological pattern of aldose reductase mRNA expression in lens and retina

Aldose reductase (AR), an enzyme which converts glucose to sorbitol, has been implicated in the pathogenesis of diabetic cataracts and retinopathy. The normal physiological role of this enzyme in ocular tissue, however, remains unclear. In a developmental study in the rat using in situ and Northern hybridization analyses, we have found that there is a high level of AR mRNA expression in optic cup and lens as early as embryonic day 13. Serial sections through whole embryos at this stage showed that the eye was the only site of AR mRNA hybridization. Levels of AR mRNA declined in the retina as differentiation proceeded and were very sparse there postnatally. As lens development progressed, epithelial AR mRNA levels remained high, especially in the germinative zone, which is the source of the cells that will become lens fibers, and in the bow region, where these cells undergo a dramatic morphogenetic differentiation into lens fibers. AR mRNA was undetectable in terminally differentiated lens fibers. Since it has been suggested that AR-catalyzed sorbitol production could be an osmoprotective device of lens epithelium during systemic hyperosmolar stress, AR mRNA levels from dehydrated hyperosmolar rats were compared with euvolemic control values, and no difference was found. In summary, AR appears to be of particular importance in the development of the eye, with its retinal role receding relative to lens as differentiation is completed. A continued high level of expression in lens epithelium in adulthood may be explained by the fact that lens tissue, unlike retina, normally continues to proliferate and differentiate after birth. The temporal and spatial pattern of distribution of AR mRNA is strongly suggestive of a role for this enzyme in lens fiber morphogenesis.     

High prevalence of cataracts in birds with pheomelanin-based colouration

The crystalline lens of the eyes of vertebrates focuses light on the retina. Therefore, maintaining the lens clear is necessary for proper visual function. However, oxidative damage to proteins of the lens leads to opacification and lens dysfunction, termed cataract. Antioxidants thus have a role in avoiding the development of cataracts through their reduction of oxidative stress, and glutathione (GSH), a key intracellular antioxidant, belongs to the primary antioxidant defence mechanism of the lens. Other physiological mechanisms that require GSH may compete with the antioxidant mechanism of the eye. Pheomelanin is a main type of melanin, the most common pigment in vertebrates, and its synthesis consumes GSH. Here, we use data on 81 bird species to test the hypothesis that species producing large amounts of pheomelanin should have diminished capacity to use GSH to protect their eyes and, as a consequence, higher prevalence of cataracts. As predicted, the proportion of pheomelanic plumage was positively associated with the proportion of individuals with cataracts across species, suggesting that production of pheomelanin may have profound fitness consequences, as birds with cataracts have limited ability to perform vital activities. This constitutes the first comparative study of cataracts in wild animals.     

A juvenile-onset, progressive cataract locus on chromosome 3q21-q22 is associated with a missense mutation in the beaded filament structural protein-2

Juvenile-onset cataracts are distinguished from congenital cataracts by the initial clarity of the lens at birth and the gradual development of lens opacity in the second and third decades of life. Genomewide linkage analysis in a multigenerational pedigree, segregating for autosomal dominant juvenile-onset cataracts, identified a locus in chromosome region 3q21.2-q22.3. Because of the proximity of the gene coding for lens beaded filament structural protein-2 (BFSP2) to this locus, we screened for mutations in the coding sequence of BFSP2. We observed a unique C-->T transition, one that was not observed in 200 normal chromosomes. We predicted that this led to a nonconservative R287W substitution in exon 4 that cosegregated with cataracts. This mutation alters an evolutionarily conserved arginine residue in the central rod domain of the intermediate filament. On consideration of the proposed function of BFSP2 in the lens cytoskeleton, it is likely that this alteration is the cause of cataracts in the members of the family we studied. This is the first example of a mutation in a noncrystallin structural gene that leads to a juvenile-onset, progressive cataract.     

Moderate caloric restriction delays cataract formation in the Emory mouse

Eye lens senile cataract is a major cause of blindness, affecting the elderly in particular. The etiology of the disorder has been elusive, and attempts to delay the onset of senile cataracts have been unsuccessful. The need for more information is underscored by epidemiologists who estimate that the ability to delay cataract formation in humans by only 10 years would eliminate the need for 50% of the cataract extractions performed annually in the United States. The Emory mouse provides the best model for human senile cataracts. Feeding Emory mice a diet that was restricted in calories by approximately 21% delayed the onset of cataracts. This is the first study that demonstrates in vivo the delay of senile-type cataracts. In these animals, aging and cataracts are associated with diverse changes in the proportion of various proteins (particularly 21, 22, 31-34 kDa) and with transformation of proteins from a soluble to an insoluble state. In advanced cataracts, there is a loss of total protein. Within a cataract grade, there is no difference between restricted and nonrestricted animals in relative proportion of specific lens proteins or in amounts of total or soluble proteins. The transition from a clear to cataractous lens appears when the soluble-to-total protein ratio falls below about 0.58. The exclusive use of gamma-crystallin as an indicator of lens viability is questioned. To the extent that cataract formation is due to lens protein oxidation and/or an inability to proteolytically remove damaged protein, it would appear that caloric restriction results in enhanced protection against lens oxidative stress or in prolonged proteolytic function.     

Congenital cataracts and their molecular genetics

Cataract can be defined as any opacity of the crystalline lens. Congenital cataract is particularly serious because it has the potential for inhibiting visual development, resulting in permanent blindness. Inherited cataracts represent a major contribution to congenital cataracts, especially in developed countries. While cataract represents a common end stage of mutations in a potentially large number of genes acting through varied mechanisms in practice most inherited cataracts have been associated with a subgroup of genes encoding proteins of particular importance for the maintenance of lens transparency and homeostasis. The increasing availability of more detailed information about these proteins and their functions and is making it possible to understand the pathophysiology of cataracts and the biology of the lens in general.     

The Lens Effect and Phototropism of Phycomyces

Normally, the dioptrics in air of the cylindrical sporangiophore of Phycomyces blakesleeanus confer on the distal side a focusing advantage of about 30 per cent for unilateral stimuli of parallel light. This advantage can be nullified or reversed to produce negative curvatures by means of diverging light stimuli. A thin cylindrical glass lens was positioned 0.15 mm from the light-adapted growing zone with its long axis parallel to the long axis of the sporangiophore. A 3 minute blue stimulus was given and the lens removed. Reproducible negative curvatures were observed with a maximum of 13 degrees occurring within 8 minutes after the beginning of the stimulus. Experiments in air were done in a water-saturated atmosphere to minimize avoidance responses due to the proximity of the lens. The data support Buder's conclusion that the focusing advantage is the principal mechanism which produces the response differential necessary for phototropism. When the lens advantage is small, the attenuation becomes important in determining the direction of the response. Data obtained from sporangiophores immersed in inert liquids indicate that the attenuation is about 14 per cent. Therefore, whenever the focusing advantage is less than 14 per cent, negative curvatures are produced by unilateral stimuli.     

Vacuum extraction: use in a small rural hospital.

The effectiveness of vacuum extraction with the Silastic Obstetrical Vacuum Cup (SOVC), which has a soft, maleable cup, was assessed by two family physicians in a small rural hospital. Vacuum extraction was attempted in 35 of 231 deliveries over an 18-month period, with an overall success rate of 66%. The main indications for vacuum extraction were fetal distress, followed by a prolonged second stage of labour and malrotation of the occiput. The efficiency of the technique improved with experience. The effects of vacuum extraction on the fetus and mother compared favourably with those reported in the literature. After introduction of the SOVC, the rate of primary cesarean section for cephalopelvic disproportion declined, as did the rate of forceps delivery. Despite careful antenatal screening and referral, and the availability of alternatives, delivery by vacuum extraction with the SOVC was found to be a useful and effective adjunct to obstetric practice.     

Stapes mobilization for otosclerotic deafness; the monitored peribasal technique

Direct surgical operation on the stapes footplate region in the treatment of hearing loss due to otosclerosis has been revived. In the last 100 cases of a total series of 600, the peribasal stapes mobilization (stapedolysis) technique was completely successful in 62 per cent, partially successful in 29 per cent and a failure in 9 per cent. Stapes mobilization requires precise microsurgical technique monitored by audiometry during the surgical procedure. It appears that mobilization is the preferred approach to the surgical treatment of otosclerosis, but fenestration of the vestibular labyrinth is an important secondary procedure in some cases. Successful restoration of hearing requires adequate mobility of the footplate coupled with physiological continuity of the drum ossicular chain mechanism.     

Mice transgenic for Alzheimer disease beta-amyloid develop lens cataracts that are rescued by antioxidant treatment

Alzheimer disease is characterized by cerebral Abeta deposition, which we have recently discovered occurs also in the lens as cataracts in Alzheimer disease patients. Here we report the presence of significantly increased cataracts in the lenses of an Abeta-transgenic mouse model for Alzheimer disease and their amelioration upon treatment with EUK-189, a synthetic SOD/catalase mimetic. These data support an oxidative etiology for AD-associated lens cataracts and their potential to be treated preventatively with antioxidants.     

Optic cup morphogenesis requires pre-lens ectoderm but not lens differentiation

The formation of the vertebrate optic cup is a morphogenetic event initiated after the optic vesicle contacts the overlying surface/pre-lens ectoderm. Placodes form in both the optic neuroepithelium and lens ectoderm. Subsequently, both placodes invaginate to form the definitive optic cup and lens, respectively. We examined the role of the lens tissue in inducing and/or maintaining optic cup invagination in ovo. Lens tissue was surgically removed at various stages of development, from pre-lens ectoderm stages to invaginating lens placode. Removal of the pre-lens ectoderm resulted in persistent optic vesicles that initiated neural retinal differentiation but failed to invaginate. In striking contrast, ablation of the lens placode gave rise to optic vesicles that underwent invagination and formed the optic cup. The results suggest that: (1) the optic vesicle neuroepithelium requires a temporally specific association with pre-lens ectoderm in order to undergo optic cup morphogenesis; and (2) the optic cup can form in the absence of lens formation. If ectopic BMP is added, a neural retina does not develop and optic cup morphogenesis fails, although lens formation appears normal. FGF-induced neural retina differentiation in the absence of the pre-lens ectoderm is not sufficient to create an optic cup. We hypothesize the presence of a signal coming from the pre-lens ectoderm that induces the optic vesicle to form an optic cup.     

Cataract induction by products of lipid peroxidation

Liposome suspension prepared from the unsaturated phospholipids exposed to lipid peroxidation (LPO) induced posterior subcapsular cataracts after injection into the posterior vitreous of rabbit eyes. In the background of this model lies a type of lens opacity formed during retinal degeneration when toxic peroxide substances diffuse anteriorly through the vitreous body resulting in vitreous opacities and complicated cataracts. Saturated liposomes (prepared from beta-oleoyl-gamma-palmitoyl) L-alpha-lecithin) did not induce lens opacities, which is the evidence that a lipid peroxidation mechanism may be responsible for the posterior cataracts. Along with cataract formation accumulation of LPO fluorescent products in vitreous, aqueous humor and lens was observed. It was followed by a decreased level of reduced glutathione in the lens. The obtained results strongly support the hypothesis of LPO initial role in cataracts.     

Gap junctions or hemichannel-dependent and independent roles of connexins in cataractogenesis and lens development

In the last decade or so, increasing evidences suggest that the mutations of two connexin genes, GJA3 and GJA8, are directly linked to human congenital cataracts in North and Central America, Europe and Asia. GIA3 and GIA8 genes encode gap junction-forming proteins, connexin (Cx) 46 and Cx50, respectively. These two connexins are predominantly expressed in lens fiber cells. Majority of identified mutations are missense, and the mutated sites are scattered across various domains of connexin molecules. Genetic deletion of either of these two genes leads to the development of cataracts; however, the types of cataracts developed are distinctive. More interestingly, microphthalmia is only developed in Cx50, but not Cx46 deficient mice, suggesting the unique role of Cx50 in lens cell growth and development. Knockin studies with the replacement of Cx46 or Cx50 at their respective gene locus further demonstrate the unique properties of these two connexins. Furthermore, the function of Cx50 in epithelial-fiber differentiation appears to be independent of its conventional role in forming gap junction junction channels. Due to their specific functions in maintaining lens clarity and development, and their malfunctions resulting in lens cataractogenesis and developmental impairment, connexin molecules could be developed as potential drug targets for therapeutic intervention for treatment of cataracts and other eye disorders. Recent advances in basic research of lens connexins and the discoveries of clinical disorders as a result of lens connexin dysfunctions are summarized and discussed here.     

Ethanol extraction of free amino acids from soil

Summary A technique was developed for extracting and analyzing the free amino acid fraction of soil. Ethanol was used as an extracting agent. Ethanolextraction curves showed 20 per cent ethanol was the optimum percentage for extraction. Extraction-time curves indicated 18 to 20 hours of extraction with 20 per cent ethanol produced satisfactory results.The free amino acid fraction of soil was characterized and the limitations of the technique were determined. The naturally occurring amino acids extracted with 20 per cent ethanol were limited to acidic and neutral amino acids; basic amino acids were not extracted in sufficient quantities to permit detection. Based on the percent recovery of amino acids incorporated into soil and extracted with 20 per cent ethanol 90 to 95 per cent of the acidic, 80 to 85 per cent of the neutral and 1 to 5 per cent of the basic amino acids used were recovered with the technique.     

A Large-scale Isolation Procedure for Cereal Mesophyll Protoplasts

A method suitable for the large-scale isolation of cereal protoplastsfrom up to 50 g of leaf material is described. Surface-sterilizedleaves from cultivars of wheat, barley, maize, sorghum, andTriticale were diced and vacuum infiltrated with enzyme mixturecomposed of cellulysin (1 per cent w/v), hemicellulase (1 percent w/v), and macerozyme (0.5 per cent w/v). With this procedure,yields of between 10⁶ to 10⁷ protoplasts per gram of leavescan be reproducibly obtained after only 1.5–3 h of enzymatictreatment. These protoplasts were almost 100 per cent viable(as determined by fluorescein diacetate staining) and incorporationof ³H-uridine and ¹⁴C-leucine into an acid-insoluble fractionwas demonstrated. Almost one-third of the ribosomes of theseisolated protoplasts were present as polysomes. cereals, leaf mesophyll, protoplast isolation