Fibrin membrane pupillary-block glaucoma after uneventful cataract surgery treated with intracameral tissue plasminogen activator: a case report

<p>Abstract</p> <p>Background</p> <p>Fibrin pupillary-block glaucoma is a rare complication after cataract surgery. The treatment for this condition is still controversial, since Nd:YAG laser fibrin membranotomy tends to reocclude and laser peripheral iridotomy entails the risk of damaging the corneal endothelium in the presence of corneal edema associated with elevated intraocular pressure.</p> <p>Case presentation</p> <p>A 62-year-old man with diabetes mellitus developed acute elevation of intraocular pressure with a shallow anterior chamber five days after uneventful cataract surgery. Initially, slit lamp examination provided only limited information due to severe corneal edema. After resolution of corneal edema with systemic glaucoma therapy, a complete fibrin membrane was observed across the pupil by slit lamp examination. Anterior segment optic coherence tomography clearly revealed a thin fibrin membrane covering the entire pupillary space, a shallow anterior chamber, and a deep posterior chamber. The intraocular lens was not observed by anterior segment optic coherence tomography. In contrast, ultrasound biomicroscopy, which has superior penetration depth, was able to visualize the intraocular lens deep in the posterior chamber. Injection of tissue plasminogen activator into the anterior chamber resulted in complete fibrinolysis and released the pupillary block.</p> <p>Conclusion</p> <p>This case suggests that ocular anterior segment imaging modalities, especially ultrasound biomicroscopy, serve as powerful diagnostic tools to identify mechanisms of acute angle closure glaucoma, which is often accompanied by poor intraocular visibility. This is the first reported case of fibrin pupillary-block glaucoma after cataract surgery successfully treated with intracameral tissue plasminogen activator.</p

Removal of epididymal visceral adipose tissue prevents obesity-induced multi-organ insulin resistance in male mice

Obesity is associated with insulin resistance, an important risk factor of type 2 diabetes, atherogenic dyslipidemia, and nonalcoholic fatty liver disease. The major purpose of this study was to test hypothesize that prophylactic removal of epididymal visceral adipose tissue (VAT) prevents obesity-induced multi-organ (liver, skeletal muscle, adipose tissue) insulin resistance. Accordingly, we surgically removed epididymal VAT pads from adult C57BL/6J mice and evaluated in vivo and cellular metabolic pathways involved in glucose and lipid metabolism following chronic high-fat diet (HFD) feeding. We found that VAT removal decreases HFD-induced body weight gain while increasing subcutaneous adipose tissue (SAT) mass. Strikingly, VAT removal prevents obesity-induced insulin resistance and hyperinsulinemia and markedly enhances insulin-stimulated AKT-phosphorylation at serine-473 (Ser473) and threonine-308 (Thr308) sites in SAT, liver, and skeletal muscle. VAT removal leads to decreases in plasma lipid concentrations and hepatic triglyceride (TG) content. In addition, VAT removal increases circulating adiponectin, a key insulin-sensitizing adipokine, whereas it decreases circulating interleukin 6, a pro-inflammatory adipokine. Consistent with these findings, VAT removal increases adenosine monophosphate-activated protein kinase C phosphorylation, a major downstream target of adiponectin signaling. Data obtained from RNA sequencing suggest that VAT removal prevents obesity-induced oxidative stress and inflammation in liver and SAT, respectively. Taken together, these findings highlight the metabolic benefits and possible action mechanisms of prophylactic VAT removal on obesity-induced insulin resistance and hepatosteatosis. Our results also provide important insight into understanding the extraordinary capability of adipose tissue to influence whole-body glucose and lipid metabolism as an active endocrine organ

Extremely Large Magnetoresistance in the Nonmagnetic Metal PdCoO2

Extremely large magnetoresistance is realized in the nonmagnetic layered metal PdCoO2. In spite of a highly conducting metallic behavior with a simple quasi-two-dimensional hexagonal Fermi surface, the interlayer resistance reaches up to 35000% for the field along the [1-10] direction. Furthermore, the temperature dependence of the resistance becomes nonmetallic for this field direction, while it remains metallic for fields along the [110] direction. Such severe and anisotropic destruction of the interlayer coherence by a magnetic field on a simple Fermi surface is ascribable to orbital motion of carriers on the Fermi surface driven by the Lorentz force, but seems to have been largely overlooked until now.Comment: Phys. Rev. Lett. 111, 056601 (2013

Effect of Progressive Weight Loss on Lactate Metabolism: A Randomized Controlled Trial.

OBJECTIVE:Lactate is an intermediate of glucose metabolism that has been implicated in the pathogenesis of insulin resistance. This study evaluated the relationship between glucose kinetics and plasma lactate concentration ([LAC]) before and after manipulating insulin sensitivity by progressive weight loss. METHODS:Forty people with obesity (BMI = 37.9 ± 4.3 kg/m2 ) were randomized to weight maintenance (n = 14) or weight loss (n = 19). Subjects were studied before and after 6 months of weight maintenance and before and after 5%, 11%, and 16% weight loss. A hyperinsulinemic-euglycemic clamp procedure in conjunction with [6,6-2 H2 ]glucose tracer infusion was used to assess glucose kinetics. RESULTS:At baseline, fasting [LAC] correlated positively with endogenous glucose production rate (r = 0.532; P = 0.001) and negatively with insulin sensitivity, assessed as the insulin-stimulated glucose disposal (r = -0.361; P = 0.04). Progressive (5% through 16%) weight loss caused a progressive decrease in fasting [LAC], and the decrease in fasting [LAC] after 5% weight loss was correlated with the decrease in endogenous glucose production (r = 0.654; P = 0.002) and the increase in insulin sensitivity (r = -0.595; P = 0.007). CONCLUSIONS:This study demonstrates the interrelationships among weight loss, hepatic and muscle glucose kinetics, insulin sensitivity, and [LAC], and it suggests that [LAC] can serve as an additional biomarker of glucose-related insulin resistance

An autoencoder-classified cluster of SARS-CoV-2 strain with two mutations in helicase

Using an autoencoder-based analysis to classify genomes of SARS-CoV-2 coronaviruses, we found a cluster consisting only of a specific genotype with two mutations in the helicase. This virus genotype, called C-type SARS-CoV-2, was almost exclusively prevalent in the United States from March to July 2020. This type of virus, characterized by a pair of the C17747T (P504L) and A17858G (Y541C) mutations on the nsp13 gene, had never been highly prevalent at any other time or in any other part of the world. In the U.S., Washington State was the center of the epidemic, and the C-type viruses, along with the viruses with wild-type helicase, seemed to have aroused the pandemic. In Washington State, USA, the CoViD-19 epidemic during the first two months of the year, starting at the end of February 2020, was mainly caused by the type-C virus. During this period, the infection spread rapidly; from May onwards, the number of viruses with wild-type helicases became higher than that of type-C viruses, and no type-C viruses have been collected since early July. The involvement of the helicase in this COVID-19 disease was discussed