Optical Coherence Tomography: An Adjunctive Tool for Differentiating between Choroidal Melanoma and Metastasis

Purpose. To investigate the value of optical coherence tomography (OCT) for differentiation between choroidal melanoma and metastasis based on characteristics of the anterior choroidal surface and the chorioretinal interface. Methods. This retrospective observational case series included 29 patients with untreated choroidal melanomas and 21 patients with untreated choroidal metastases. Regularity and lobularity characteristics of the anterior choroidal surface were evaluated in a masked manner. Retinal and retinal pigment epithelium (RPE) findings were documented as well. Results. OCT demonstrated a regular and smooth anterior choroidal surface in 89.7% of the eyes with melanoma and in 47.6% of the eyes with metastasis (p=0.002; sensitivity = 89.7%; specificity = 52.4%). The anterior choroidal contour was lobulated in 81.0% of the eyes with metastasis versus 17.2% of the eyes with melanoma (p<0.001; sensitivity = 82.8%; specificity = 81.0%). RPE thickness and neuroretinal characteristics (e.g., retinal thickness, the presence of cysts, and the presence of subretinal fluid) were similar in both choroidal tumors. Conclusion. OCT may serve as a noninvasive adjunctive tool for the differential diagnosis of choroidal tumors. Choroidal melanomas usually demonstrate regular surfaces on OCT, while choroidal metastases usually have an irregular and lobulated surface

Potential Savings of Harmonising Hospital and Community Formularies for Chronic Disease Medications Initiated in Hospital

Hospitals in Canada manage their formularies independently, yet many inpatients are discharged on medications which will be purchased through publicly-funded programs. We sought to determine how much public money could be saved on chronic medications if hospitals promoted the initiation of agents with the lowest outpatient formulary prices.We used administrative databases for the province of Ontario to identify patients initiated on a proton pump inhibitor (PPI), angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) following hospital admission from April 1(st) 2008-March 31(st) 2009. We assessed the cost to the Ontario Drug Benefit Program (ODB) over the year following initiation and determined the cost savings if prescriptions were substituted with the least expensive agent in each class.The cost for filling all PPI, ACE inhibitor and ARB prescriptions was $2.48 million,$968 thousand and $325 thousand respectively. Substituting the least expensive agent could have saved$1.16 million (47%) for PPIs, $162 thousand (17$14 thousand (4%) for ARBs over the year following discharge.In a setting where outpatient prescriptions are publicly funded, harmonising outpatient formularies with inpatient therapeutic substitution resulted in modest cost savings and may be one way to control rising pharmaceutical costs

Towards Commercial Production of Sponge Medicines

Sponges can provide potential drugs against many major world-wide occurring diseases. Despite the high potential of sponge derived drugs no sustainable production method has been developed. Thus far it is not fully understood why, when, where and how these metabolites are produced in sponges. For the near future sea-based sponge culture seems to be the best production method. However, for controlled production in a defined system it is better to develop in vitro production methods, like in vitro sponge culture or even better sponge cell culture, culture methods for symbionts or the transfer of production routes into another host. We still have insufficient information about the background of metabolite production in sponges. Before production methods are developed we should first focus on factors that can induce metabolite production. This could be done in the natural habitat by studying the relation between stress factors (such as predation) and the production of bioactive metabolites. The location of production within the sponge should be identified in order to choose between sponge cell culture and symbiont culture. Alternatively the biosynthetic pathways could be introduced into hosts that can be cultured. For this the biosynthetic pathway of metabolite production should be unraveled, as well as the genes involved. This review discusses the current state of sponge metabolite production and the steps that need to be taken to develop commercial production techniques. The different possible production techniques are also discussed

Environmental risk assessments for transgenic crops producing output trait enzymes

The environmental risks from cultivating crops producing output trait enzymes can be rigorously assessed by testing conservative risk hypotheses of no harm to endpoints such as the abundance of wildlife, crop yield and the rate of degradation of crop residues in soil. These hypotheses can be tested with data from many sources, including evaluations of the agronomic performance and nutritional quality of the crop made during product development, and information from the scientific literature on the mode-of-action, taxonomic distribution and environmental fate of the enzyme. Few, if any, specific ecotoxicology or environmental fate studies are needed. The effective use of existing data means that regulatory decision-making, to which an environmental risk assessment provides essential information, is not unnecessarily complicated by evaluation of large amounts of new data that provide negligible improvement in the characterization of risk, and that may delay environmental benefits offered by transgenic crops containing output trait enzymes

Visually Evoked Potentials in a Patient with a Fyodorov-Zuev Keratoprosthesis

Purpose: To describe a visually evoked potential (VEP) examination performed on a patient with a keratoprosthesis. Methods: We report the case of a 60-year-old patient with a Fyodorov-Zuev keratoprosthesis in the right eye complained of gradual visual deterioration in that eye. His past medical history consisted of failed corneal graft procedures due to corneal dystrophy and an Ahmed valve implantation due to secondary glaucoma. A clinical examination and an ultrasound demonstrated vitreal opacities. In order to assess the visual status, a flash VEP test was conducted. Results: VEP recorded from the right eye consisted of a broadened and poorly formed positive P1 wave, with a subnormal amplitude, but a normal latency. Consequently, the patient underwent a pars plana vitrectomy. Conclusion: This case demonstrates the viability of VEP exams in patients with keratoprostheses

Structural Characterization of Full-Length Human Dehydrodolichyl Diphosphate Synthase Using an Integrative Computational and Experimental Approach

Dehydrodolichyl diphosphate synthase (DHDDS) is the catalytic subunit of the heteromeric human cis-prenyltransferase complex, synthesizing the glycosyl carrier precursor for N-linked protein glycosylation. Consistent with the important role of N-glycosylation in protein biogenesis, DHDDS mutations result in human diseases. Importantly, DHDDS encompasses a C-terminal region, which does not converge with any known conserved domains. Therefore, despite the clinical importance of DHDDS, our understating of its structure&ndash;function relations remains poor. Here, we provide a structural model for the full-length human DHDDS using a multidisciplinary experimental and computational approach. Size-exclusion chromatography multi-angle light scattering revealed that DHDDS forms a monodisperse homodimer in solution. Enzyme kinetics assays revealed that it exhibits catalytic activity, although reduced compared to that reported for the intact heteromeric complex. Our model suggests that the DHDDS C-terminus forms a helix&ndash;turn&ndash;helix motif, tightly packed against the core catalytic domain. This model is consistent with small-angle X-ray scattering data, indicating that the full-length DHDDS maintains a similar conformation in solution. Moreover, hydrogen&ndash;deuterium exchange mass-spectrometry experiments show time-dependent deuterium uptake in the C-terminal domain, consistent with its overall folded state. Finally, we provide a model for the DHDDS&ndash;NgBR heterodimer, offering a structural framework for future structural and functional studies of the complex

Addition of a fine-textured soil to compost to reduce nutrient leaching in a sandy soil

Compost addition to soil can increase nutrient availability, but if added to sandy soils, nutrients can be rapidly leached. Clay added to compost could increase nutrient retention and reduce nutrient leaching due to binding to the clay. An incubation experiment was conducted to assess the effect of addition of a fine-textured soil (34% clay) to garden waste compost on nutrient availability and leaching in a sandy soil. The sandy soil was non-amended or amended with compost only, at a rate 27.3 g kg–1, or with a mixture of compost and 5% or 20% (w/w) of fine-textured soil. Two additional treatments included sandy soil amended with only the fine-textured soil at rates similar to those added with compost. Soil, compost, and fine-textured soil were mixed and packed to a bulk density of 1.22 g cm–3. Soil respiration was measured over 23 days. On days 1, 5, and 23, the soils were leached with 50 mL reverse-osmosis water, and the following parameters were measured in the leachate: water-soluble organic carbon (OC), inorganic nitrogen (N), and phosphorus (P); water-soluble OC and available N and P were measured in the soil after leaching. Compost increased nutrient availability and leaching compared with the non-amended control. Addition of the fine-textured soil to compost reduced cumulative respiration and N and P leaching, with the effect more pronounced at 20% (w/w). Addition of the fine-textured soil alone had no effect on nutrient availability and leaching because of the low nutrient concentration in this soil. This study showed that addition of fine-textured soil to compost can reduce N and P leaching, which could enhance and prolong the positive effects of compost on soil fertilityTrung-Ta Nguyen and Petra Marschne