Long-term outcomes of allogeneic ocular surface reconstruction : keratolimbal allograft (KLAL) followed by penetrating keratoplasty (PK)

Purpose. Long-term results of the patients with total LSCD, who had undergone keratolimbal allograft (KLAL) for limbal reconstruction followed by penetrating keratoplasty (PK). Methods. +e study analyzes surgical treatment of 43 eyes with severe ocular surface disorders. All subjects underwent KLAL to achieve suitable conditions for consecutive PK. Due to failures of primary treatment in 17 eyes (39%), the KLAL was repeated. PK was performed in all the patients at 9-12 months after KLAL. As a retrospective study we analyzed data from the medical records including the preoperative and postoperative best corrected visual acuity, corneal clarity, surgical outcomes and complications, postoperative intraocular pressure, graft rejection, and other comorbidities and complications. Results. +e preoperative visual acuity ranged from light perception to 0.01. +e final improvement of visual acuity within a gain of one or more lines with the Snellen chart, including the results of successive surgical treatments after PK, was achieved in 23 operated eyes (53%). Early graft rejection was observed in 4 eyes (9%). In 3 eyes, it was manifested as endothelial rejection, and in 1 eye, as combined endothelial and epithelial rejection. PK failure requiring repetitive PK was present in 14 eyes (32%). Phthisis bulbi developed in 6 eyes (14%). Glaucoma or ocular hypertension was reported in 25 eyes (58%). A majority were treated with up to 3 topical agents or referred for trabeculectomy in 3 cases, transscleral cyclophotocoagulation in 2 eyes, and EX-PRESS glaucoma shunt implantation in 3 cases. Conclusions. Successful KLAL carries a high risk of subsequent PK failure. Visual function remains the second aim of treatment; the primary one is to stabilize the surface

Lessons from chlorophylls : modifications of porphyrinoids towards optimized solar energy conversion

Practical applications of photosynthesis-inspired processes depend on a thorough understanding of the structures and physiochemical features of pigment molecules such as chlorophylls and bacteriochlorophylls. Consequently, the major structural features of these pigments have been systematically examined as to how they influence the S_{1} state energy, lifetimes, quantum yields, and pigment photostability. In particular, the effects of the macrocyclic π-electron system, central metal ion (CMI), peripheral substituents, and pigment aggregation, on these critical parameters are discussed. The results obtained confirm that the π-electron system of the chromophore has the greatest influence on the light energy conversion capacity of porphyrinoids. Its modifications lead to changes in molecular symmetry, which determine the energy levels of frontier orbitals and hence affect the S_{1} state properties. In the case of bacteriochlorophylls aggregation can also strongly decrease the S_{1} energy. The CMI may be considered as another influential structural feature which only moderately influences the ground-state properties of bacteriochlorophylls but strongly affects the singlet excited-state. An introduction of CMIs heavier than Mg^{2+} significantly improves pigments' photostabilities, however, at the expense of S_{1} state lifetime. Modifications of the peripheral substituents may also influence the S1 energy, and pigments’ redox potentials, which in turn influence their photostability

Comparative study of anterior eye segment measurements with spectral swept-source and time-domain optical coherence tomography in eyes with corneal dystrophies

Purpose. To compare anterior eye segment measurements and morphology obtained with two optical coherence tomography systems (TD OCT, SS OCT) in eyes with corneal dystrophies (CDs). Methods. Fifty healthy volunteers (50 eyes) and 54 patients (96 eyes) diagnosed with CD (epithelial basement membrane dystrophy, EBMD = 12 eyes; Thiel-Behnke CD = 6 eyes; lattice CD TGFBI type = 15 eyes; granular CD type 1 = 7 eyes, granular CD type 2 = 2 eyes; macular CD = 23 eyes; and Fuchs endothelial CD = 31 eyes) were recruited for the study. Automated and manual central corneal thickness (aCCT, mCCT), anterior chamber depth (ACD), and nasal and temporal trabecular iris angle (nTIA, tTIA) were measured and compared with Bland-Altman plots. Results. Good agreement between the TD and SS OCT measurements was demonstrated for mCCT and aCCT in normal individuals and for mCCT in the CDs group. The ACD, nTIA, and tTIA measurements differed significantly in both groups. TBCD, LCD, and FECD caused increased CCT. MCD caused significant corneal thinning. FECD affected all analyzed parameters. Conclusions. Better agreement between SS OCT and TD OCT measurements was demonstrated in normal individuals compared to the CDs group. OCT provides comprehensive corneal deposits analysis and demonstrates the association of CD with CCT, ACD, and TIA measurements

Endocrine disorders and fertility and pregnancy: An update

It is estimated that more and more couples suffer from fertility and pregnancy maintenance disorders. It is associated with impaired androgen secretion, which is influenced by many factors, ranging from genetic to environmental. It is also important to remember that fertility disorders can also result from abnormal anatomy of the reproductive male and female organ (congenital uterine anomalies – septate, unicornuate, bicornuate uterus; acquired defects of the uterus structure – fibroids, polyps, hypertrophy), disturbed hormonal cycle and obstruction of the fallopian tubes resulting from the presence of adhesions due to inflammation, endometriosis, and surgery, abnormal rhythm of menstrual bleeding, the abnormal concentration of hormones. There are many relationships between the endocrine organs, leading to a chain reaction when one of them fails to function properly. Conditions in which the immune system is involved, including infections and autoimmune diseases, also affect fertility. The form of treatment depends on infertility duration and the patient’s age. It includes ovulation stimulation with clomiphene citrate or gonadotropins, metformin use, and weight loss interventions. Since so many different factors affect fertility, it is important to correctly diagnose what is causing the problem and to modify the treatment regimen if necessary. This review describes disturbances in the hormone secretion of individual endocrine organs in the context of fertility and the maintenance of pregnancy

Does the position of the body impact the return of spontaneous circulation and hospital survival in sudden cardiac arrest patients?

Introduction: Out-of-hospital cardiac arrest (OHCA) is a big medical problem.Material and methods: The aim of this study was to assess the occurrence of sitting position in victims of OHCA at the arrival of Emergency Medical Services (EMS) and examine whether maintaining a supine position until ambulance arrival impacts the return of spontaneous circulation (ROSC) and survival until hospital admission and discharge. The documentation of patients in the OHCA registry of part of Silesian Voivodeship 1–06.2018 was accessed and yielded 634 cases for analysis.Results: The sitting position was found in 41 (6.5%) patients. These patients were more frequently female: 46.3% vs 30.6%, and older: 74.0 (57.9–82.0) vs 67.7 (54.9–75.8) and less frequently received cardiopulmonary resuscitation (CPR) from bystanders: 7.3% vs 63.6%, while ROSC was found with similar frequency: 34.2% vs 34.1%, survival until hospital admission in ROSC subgroups was lower in those in a sitting position than in a lying position: 50% vs 75.5%. None patients who were found in the sitting position survived until hospital discharge, while 33 (6.1%) patients out of those found in the lying positions survived. The univariable analysis showed that the sitting position was associated with female sex, older age, previously implanted implantable cardioverter-defibrillator (ICD) before OHCA. The multivariable logistic revealed that the sitting position was independently associated with chest pain and the presence of ICD.Conclusions: Patients found in a sitting position at the arrival of EMS constituted 6.5% of patients with OHCA in whom resuscitation attempts were undertaken and were at higher risk of unfavorable outcomes

Recent Multiomics Approaches in Endometrial Cancer

Endometrial cancer is the most common gynecological cancers in developed countries. Many of the mechanisms involved in its initiation and progression remain unclear. Analysis providing comprehensive data on the genome, transcriptome, proteome, and epigenome could help in selecting molecular markers and targets in endometrial cancer. Multiomics approaches can reveal disturbances in multiple biological systems, giving a broader picture of the problem. However, they provide a large amount of data that require processing and further integration prior to analysis. There are several repositories of multiomics datasets, including endometrial cancer data, as well as portals allowing multiomics data analysis and visualization, including Oncomine, UALCAN, LinkedOmics, and miRDB. Multiomics approaches have also been applied in endometrial cancer research in order to identify novel molecular markers and therapeutic targets. This review describes in detail the latest findings on multiomics approaches in endometrial cancer

-643C/T polymorphism of RANKL gene and its association with osteoporosis in postmenopausal women

INTRODUCTION RANKL is a key cytokine involved in osteoclast differentiation from its precursors, activation and survival of osteoclasts themselves. Because RANKL binds with RANK, the presence of RANK on target cells is a necessary condition of target cell control mediated by RANKL. AIM OF STUDY The aim of the study was to examine the incidence of RANKL gene polymorphism and evaluate its association with the clinical parameters concerning bone turnover and the degree of postmenopausal osteoporosis development. MATERIAL AND METHODS The study was conducted among a group of 570 women at postmenopausal age (404) and reproductive age (166). The group at postmenopausal age included women with osteoporosis, osteopenia as well as healthy individuals. The women at reproductive age were healthy. The polymorphism incidence of the examined gene in a group of patients with determined bone mineral density (BMD) and in the control group was studied. The study was performed by means of the RFLP-PCR method. RESULTS The obtained results did not show a correlation of RANKL gene C-643T polymorphism with decreased bone density or increased risk of osteoporotic changes after menopause. CONCLUSIONS The homozygote of the TT polymorphism of the RANKL receptor gene seems to be an increased risk factor of osteoporosis development and is associated with growth and birth mass.WSTĘP RANKL jest kluczową cytokiną uczestniczącą w różnicowaniu osteoklastu ze swoich prekursorów oraz aktywacji i przeżyciu samych osteoklastów. Ponieważ wiąże się z RANK, obecność RANK na komórkach docelowych jest nieodzownym warunkiem kontroli komórek docelowych za pośrednictwem RANKL. CEL PRACY Celem pracy było zbadanie częstości występowania polimorfizmu genu RANKL oraz ocena jego związku z parametrami klinicznymi dotyczącymi obrotu kostnego i stopnia zaawansowania osteoporozy pomenopauzalnej. MATERIAŁY I METODY Badania przeprowadzono w grupie 570 kobiet w wieku postmenopauzalnym (404 kobiety) i rozrodczym (166 kobiet). Grupa w wieku postmenopauzalnym obejmowała kobiety z osteoporozą, osteopenią i zdrowe. Kobiety w wieku rozrodczym były zdrowe. Zbadano częstość występowania polimorfizmu badanego genu w grupie pacjentek z oznaczoną gęstością mineralną kości (bone mineral density – BMD) oraz w grupie kontrolnej. Badanie przeprowadzono metodą RFLP-PCR. WYNIKI Uzyskane wyniki badań nie wykazały korelacji polimorfizmu C-643T genu RANKL ze zmniejszoną gęstością kości oraz zwiększonym ryzykiem występowania zmian osteoporotycznych po menopauzie. WNIOSKI Wydaje się, że homozygota TT polimorfizmu genu receptora RANKL może być czynnikiem zwiększonego ryzyka wystąpienia osteoporozy i jest powiązana ze wzrostem i masą urodzeniową

575C/T polymorphism of RANK gene and its association with osteoporosis in postmenopausal women

INTRODUCTION Osteoporosis is a skeletal disturbance in which bone strength is at increased risk of fracture. It was demonstrated that genetic variations in RANK are associated with skeletal diseases. AIM OF STUDY The aim of the study is to examine the frequency of RANK gene polymorphism and evaluate its relation with clinical parameters concerning bone turnover and the degree of postmenopausal osteoporosis progress. MATERIAL AND METHODS The study was conducted among a group of 570 women at postmenopausal age (404) and reproductive age (166). The group at postmenopausal age included women with osteoporosis, osteopenia and healthy individuals. The women at reproductive age were healthy. The polymorphism incidence of the examined gene in a group of patients with a determined bone mineral density (BMD) and in the control group was studied. The study was performed by means of the RFLP-PCR method. RESULTS The obtained results did not show a correlation of RANK C575T polymorphism with decreased bone density or increased risk of postemopausal osteoporosis incidence. CONCLUSIONS The TT polymorphism homozygote of the RANK receptor gene is not an increased risk factor of osteoporosis development and is associated with lower values describing bone density in women with osteoporosis and osteopenia.W S T Ę P Osteoporoza jest szkieletowym zaburzeniem charakteryzującym się obniżeniem wytrzymałości kości, zwiększającym ryzyko złamania. Wykazano, że genetyczne wariacje w RANK mają związek z chorobami szkieletu kostnego. Celem pracy było zbadanie częstości występowania polimorfizmu genu RANK oraz ocena jego związku z parametrami klinicznymi dotyczącymi obrotu kostnego i stopnia zaawansowania osteoporozy pomenopauzalnej. M A T E R I A Ł Y I M E T O D Y Badania przeprowadzono w grupie 570 kobiet w wieku postmenopauzalnym (404) i rozrodczym (166). Grupa w wieku postmenopauzalnym obejmowała kobiety z osteoporozą, osteopenią i zdrowe. Kobiety w wieku rozrodczym były zdrowe. Zbadano częstość występowania polimorfizmu badanego genu w grupie pacjentek z oznaczoną gęstością mineralną kości (bone mineral density – BMD) oraz w grupie kontrolnej. Badanie przeprowadzono metodą RFLP-PCR. WYNIKI Uzyskane wyniki badań nie wykazały korelacji polimorfizmu RANK C575T ze zmniejszoną gęstością kości oraz zwiększonym ryzykiem występowania osteoporozy pomenopauzalnej. WNIOSKI Homozygota TT polimorfizmu genu receptora RANK nie jest czynnikiem zwiększonego ryzyka wystąpienia osteoporozy i jest powiązana z niższymi wartościami opisującymi BMD u kobiet z osteoporozą i osteopenią

1181G/C polymorphism of OPG gene and its association with osteoporosis in postmenopausal women

INTRODUCTION Osteoporosis is a systemic disease of the bone system, characterized by low bone mass and bone microarchitecture disturbances, increased bone brittleness and susceptibility to fracture. There is an essential genetic contribution to bone density, as well as its transformation. It is suggested that the OPG polymorphism may affect bone density and its transformation. AIM OF STUDY The aim of the study was to examine the incidence of OPG gene polymorphism and evaluate its association with the clinical parameters concerning bone turnover and the degree of postmenopausal osteoporosis development. M ATERIAL AND METHODS The study was conducted among a group of 570 women at postmenopausal age (404) and reproductive age (166). The group at postmenopausal age included women with osteoporosis, osteopenia as well as healthy individuals. The women at reproductive age were healthy. The polymorphism incidence of the examined gene in a group of patients with determined bone mineral density (BMD) and in the control group was studied. The study was performed by means of the RFLP-PCR method. RESULTS The correlation of the G1181 polymorphism of the OPG gene with body mass and birth mass was demonstrated as well as the association of decreased bone density and increased risk of postmenopausal osteoporosis development. CONCLUSIONS Homozygotic genotypes of the G1181C polymorphism of the OPG gene may affect women’s birth mass and an increased risk of osteoporosis development.WSTĘP Osteoporoza jest układową chorobą układu kostnego, charakteryzującą się niską masą kostną i zaburzeniami mikroarchitektury kości, ze zwiększoną kruchością kości oraz podatnością na złamania. Istnieje istotny wkład genetyczny tak w gęstość kości, jak i jej przemianę. Sugeruje się, że polimorfizm OPG może wpływać na gęstość kości oraz jej przemianę. CEL PRACY Celem pracy było zbadanie częstości występowania polimorfizmu genu OPG oraz ocena jego związku z parametrami klinicznymi dotyczącymi obrotu kostnego i stopnia zaawansowania osteoporozy pomenopauzalnej. MATERIAŁY I METODY Badania przeprowadzono na grupie 570 kobiet w wieku postmenopauzalnym (404 kobiety) i rozrodczym (166 kobiet). Grupa w wieku postmenopauzalnym obejmowała kobiety z osteoporozą, osteopenią i zdrowe. Kobiety w wieku rozrodczym były zdrowe. Zbadano częstość występowania polimorfizmu badanego genu w grupie pacjentek z oznaczoną gęstością mineralną kości (bone mineral density – BMD) oraz w grupie kontrolnej. Badanie przeprowadzono metodą RFLP-PCR. WYNIKI Wykazano korelację polimorfizmu G1181C genu OPG z masą ciała i masą urodzeniową oraz związek ze zmniejszoną BMD, a także zwiększonym ryzykiem powstawania osteoporozy pomenopauzalnej. WNIOSKI Genotypy homozygotyczne polimorfizmu G1181C genu OPG mogą mieć wpływ na masę urodzeniową kobiet i wzrost ryzyka wystąpienia osteoporozy