Alcohol-assisted versus Mechanical Epithelium Removal in Photorefractive Keratectomy

Purpose: To compare the outcomes and complications of alcohol-assisted versus mechanical corneal epithelial debridement for photorefractive keratectomy (PRK). Methods: This randomized controlled trial included 1,250 eyes of 625 patients undergoing PRK for correction of myopia and myopic astigmatism. Each patient was randomly assigned to alcohol-assisted or mechanical epithelial removal. Results: A total of 658 eyes underwent alcohol-assisted epithelial removal while the epithelium was removed mechanically in 592 eyes. Mean spherical equivalent was ‑4.37}2.3 D in the alcohol group and ‑3.8}1.3 D in the mechanical group (P = 0.78). There was no significant difference in postoperative pain between the study groups (P = 0.22). Uncorrected visual acuity ≥ 20/20 and ≥ 20/40 was achieved in 90.9% versus 93.4% (P = 0.08), and 98.9% versus 99.5% (P = 0.36) of eyes in the alcohol and mechanical groups, respectively. Final refractive error within 1D of emmetropia was achieved in 90% versus 92.2% of eyes in the alcohol and mechanical groups, respectively (P = 0.23). Alcohol-assisted debridement required less time than mechanical debridement (96±18 vs. 118±26 seconds, P=0.035). There was no significant difference between the two groups in terms of early and late postoperative complications. Conclusion: Alcohol-assisted and mechanical epithelium removal are comparable in terms of efficacy and side effects. The method of epithelial debridement in PRK may be left to the surgeon′s choice

Effective Parameters on the Phase Morphology and Mechanical Properties of PP/PET/SEBS Ternary Polymer Blends

In this work, ternary polymer blends based on polypropylene (PP)/ polyethylene terephthalate (PET) /poly(styrene-b (ethylene-co-butylene)-b-styrene) (SEBS) triblock copolymer and a reactive maleic anhydride grafted SEBS (SEBS-g-MAH) at various compositions were prepared by co-rotating twin screw extruder. The effects of PET, SEBS and SEBS-g-MAH compatibilizer on morphology of the blends were examined by scanning electron microscopy (SEM). The blends morphology was also estimated by some predicting methods, however, SEM results revealed some contrasts between results of predicting methods and the real morphology. Population of individual and core-shell particles as well as average diameter of the rubber-based cavities is extremely dependent on SEBS, SEBS-g-MA and PET content. Mechanical inspection tests showed that in comparison with the pure PP, addition of SEBS/SEBS-MA causes an increase in the impact strength of the system. Keeping other parameters constant, with increase in SEBS rubbery phase, the core-shell morphology was affected and the impact strength increased consequently. On the other hand, increase in PET content results in modulus increase and the impact strength decrease. Finally, the optimum processing conditions for compounding ternary PP/PET/SEBS blends were achieved

Gene Expression Analysis of VEGF and Its Receptors and Assessment of Its Serum Level in Unexplained Recurrent Spontaneous Abortion

Objective: Unexplained recurrent spontaneous abortion (URSA) is one of the main complications of pregnancy which is usually defined as three or more consecutive pregnancy losses before the 20th week of gestation without a known cause. Vascular endothelial growth factor (VEGF) is a potent angiogenic factor and shown, along with its receptors (VEGFR1, 2), to play important roles in several physiologic processes including reproduction. The aim of the present study was to analyze gene expression of VEGF and VEGF receptors in endometrium of patients with a history of URSA compared with normal fertile women. In addition, serum VEGF concentration was assessed and compared between the two groups at the same time. Materials and Methods: In this case control study, endometrial and blood samples were obtained between day 19th and 24th of menstrual cycle (window of implantation) from 10 women with a history of URSA (case group) and 6 fertile women who had at least one successful pregnancy (control group). Expression of VEGF and VEGFRs was studied by reverse transcription- polymerase chain reaction (RT-PCR) and then quantified by real time PCR. Normalization of expression levels was done by comparison with beta-actin expression level as an internal control. Relative VEGF, VEGFR1 and VEGFR2 expression quantities were compared between the two groups. Enzyme linked immunosorbent assay (ELISA) was used for serum VEGF assay. Results: VEGF, VEGFR1 and VEGFR2 gene expression was detected in endometrial samples of both groups. The mean relative expression of VEGF gene was lower in the case group compared with control women, however, both VEGF receptors were expressed higher in endometrium of the case group. In addition, the serum level of VEGF was significantly higher in the case group compared with the controls. Conclusion: Alteration in gene expression of VEGF and its receptors in endometrium and changes of serum VEGF might play important roles in pathogenesis of unexplained RS

Downregulation Of Extracellular Matrix And Cell Adhesion Molecules In Cumulus Cells Of Infertile Polycystic Ovary Syndrome Women With And Without Insulin Resistance

Objective The extracellular matrix (ECM) of the cumulus oocyte complex (COC) is composed of several molecules that have different roles during follicle development. This study aims to explore gene expression profiles for ECM and cell adhesion molecules in the cumulus cells of polycystic ovary syndrome (PCOS) patients based on their insulin sensitivity following controlled ovarian stimulation (COS). Materials And Methods In this prospective case-control study enrolled 23 women less than 36 years of age who participated in an intracytoplasmic sperm injection (ICSI) program. Patients were subdivided into 3 groups: control (n=8, fertile women with male infertility history), insulin resistant (IR) PCOS (n=7), and insulin sensitive (IS) PCOS (n=8). We compared 84 ECM component and adhesion molecule gene expressions by quantitative real-time polymerase chain reaction array (qPCR-array) among the groups. Results We noted that 21 of the 84 studied genes differentially expressed among the groups, from which 18 of these genes downregulated. Overall, comparison of PCOS cases with controls showed downregulation of extracellular matrix protein 1 (ECM1); catenin (cadherin-associated protein), alpha 1 (CTNNA1); integrin, alpha 5 (ITGA5); laminin, alpha 3 (LAMA3); laminin, beta 1 (LAMB1); fibronectin 1 (FN1); and integrin, alpha 7 (ITGA7). In the IS group, there was upregulation of ADAM metallopeptidase with thrombospondin type 1 motif, 8 (ADAMTS8) and neural cell adhesion molecule 1 (NCAM1) compared with the controls (P<0.05). Conclusion Downregulation of ECM and cell adhesion molecules seem to be related to PCOS. Gene expression profile alterations in cumulus cells from both the IS and IR groups of PCOS patients seems to be involved in the composition and regulation of ECM during the ovulation process. This study highlights the association of ECM gene alteration as a viewpoint for additional understanding of the etiology of PCOS

Investigation of Serum Levels and Activity of Matrix Metalloproteinases 2 and 9 (MMP2, 9) in Opioid and Methamphetamine-Dependent Patients

Matrix metalloproteinases (MMPs) are a group of zinc-dependent proteolytic enzymes that play a role in extracellular matrix (mainly collagen) degradation and remodeling. MMPs are not only causes of the increase rewarding effects of drugs, but also act as pro-addictive agents. In this research, 22 morphine and 20 methamphetamine-dependent patients included and their serum levels and activity of MMP2 and 9 were assessed by ELISA and gelatin zymography and compared with those of 23 healthy individuals as a control group. Our findings showed a significant increase in serum levels and activity of MMP-2 in opium and methamphetamine groups in comparison with the control group. Moreover, unlike MMP-2, serum levels and activity of MMP-9 in both case groups found to be decreased. This study showed that long-term abuse of opium and methamphetamine changes the activity and serum levels of MMP9 and MMP2. The effects of methamphetamines and opium are associated with an increase in extracellular dopamine levels in the brain, achieved by facilitating the release of dopamine from pre-synaptic nerves. Our findings showed that serum levels and activities of MMP-9 and MMP-2 could be considered as alternative valuable biomarkers from those investigated of pro-addictive or anti-addictive factors in dependent patients

Postnatal quality of life in women after normal vaginal delivery and caesarean section

<p>Abstract</p> <p>Background</p> <p>Caesarean section might increase the incidence of surgical interventions and problems resulting from hospitalization and thus affecting quality of life in women after delivery. This study aimed to compare quality of life in women after normal delivery and caesarean section.</p> <p>Methods</p> <p>This was a prospective study. A sample of women with normal delivery and caesarean section from 5 health care centers in Isfahan, Iran were entered into the study. Quality of life was measured using the SF-36 at two points in time (time 1: 6 to 8 weeks after delivery; time 2: 12 to 14 weeks after delivery). Data were analyzed to compare quality of life in the two study groups.</p> <p>Results</p> <p>In all 100 women were interviewed (50 with normal delivery and 50 with caesarean section). Postnatal quality of life in both groups was improved from time1 to time 2. However, comparing the mean scores between the normal and caesarean delivery groups the results showed that in general the normal vaginal delivery group had a better quality of life for almost all subscales in both assessment times. The differences were significant for vitality (mean score 62.9 vs. 54.4 P = 0.03) and mental health (mean score 75.1 vs. 66.7, P = 0.03) at first assessment and for physical functioning (mean score 88.4 vs. 81.5, P = 0.03) at second evaluation. However, comparing the findings within each group the analysis showed that the normal vaginal delivery group improved more on physical health related quality of life while the caesarean section group improved more on mental health related quality of life.</p> <p>Conclusion</p> <p>Although the study did not show a clear cut benefit in favor of either methods of delivery that are normal vaginal delivery or caesarean section, the findings suggest that normal vaginal delivery might lead to a better quality of life especially resulting in a superior physical health. Indeed in the absence of medical indications normal vaginal delivery might be better to be considered as the first priority in term pregnancy.</p