Evaluation of multiple sclerosis severity using a new OCT tool

Purpose: To assess the ability of a new posterior pole protocol to detect areas with significant differences in retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thickness in patients with multiple sclerosis versus healthy control subjects; in addition, to assess the correlation between RNFL and GCL thickness, disease duration, and the Expanded Disability Status Scale (EDSS). Methods: We analyzed 66 eyes of healthy control subjects and 100 eyes of remitting-relapsing multiple sclerosis (RR-MS) patients. Double analysis based on first clinical symptom onset (CSO) and conversion to clinically definite MS (CDMS) was performed. The RR-MS group was divided into subgroups by CSO and CDMS year: CSO-1 (≤ 5 years) and CSO-2 (≥ 6 years), and CDMS-1 (≤ 5 years) and CDMS-2 (≥ 6 years). Results: Significant differences in RNFL and GCL thickness were found between the RR-MS group and the healthy controls and between the CSO and CDMS subgroups and in both layers. Moderate to strong correlations were found between RNFL and GCL thickness and CSO and CDMS. Furthermore, we observed a strong correlation with EDSS 1 year after the OCT examination. Conclusions: The posterior pole protocol is a useful tool for assessing MS and can reveal differences even in early stages of the disease. RNFL thickness shows a strong correlation with disability status, while GCL thickness correlates better with disease duration

Diagnostic Ability of Macular Nerve Fiber Layer Thickness Using New Segmentation Software in Glaucoma Suspects

Purpose. To assess the capacity of internal retinal layer thickness measurements made at the macula using new spectral-domain optical coherence tomography (OCT) software to distinguish between healthy subjects and those with suspected glaucoma. The diagnostic performance of such measurements also was compared with that of conventional peripapillary retinal nerve fiber layer (RNFL) thickness measurements. Methods. The study included 38 subjects with suspected glaucoma and 38 age-matched healthy subjects. In one randomly selected eye of each participant, thickness measurements at the level of the macula were made of the nerve fiber layer (mRNFL), the ganglion cell layer (GCL), and the ganglion cell complex (GCC; GCL + internal plexiform layer) through automated OCT segmentation. Peripapillary RNFL thickness (pRNFL) also was determined using the conventional scan. Results. As the only variable showing intergroup variation, mRNFL in the glaucoma suspects was significantly thinner in the quadrants inner inferior (P = 0.003), inner temporal (P = 0.010), and outer inferior (P = 0.017). The variable best able to discriminate between the two groups was inner inferior mRNFL thickness, as indicated by an area below the receiver operating characteristic (ROC) curve of 0.742. Conclusions. Macular RNFL thickness measurements showed an improved diagnostic capacity over the other variables examined to distinguish between healthy subjects and glaucoma suspects

Visual outcomes after bilateral trifocal diffractive intraocular lens implantation

Background In recent years new models of intraocular lenses are appearing on the market to reduce requirements for additional optical correction. The purpose of this study is to assess visual outcomes following bilateral cataract surgery and the implant of a FineVision® trifocal intraocular lens (IOL). Methods Prospective, nonrandomized, observational study. Vision was assessed in 44 eyes of 22 patients (mean age 68.4 ± 5.5 years) before and 3 months after surgery. Aberrations were determined using the Topcon KR-1 W wave-front analyzer. LogMAR visual acuity was measured at distance (corrected distance visual acuity, CDVA 4 m), intermediate (distance corrected intermediate visual acuity, DCIVA 60 cm) and near (distance corrected near visual acuity, DCNVA 40 cm). The Pelli-Robson letter chart and the CSV-1000 test were used to estimate contrast sensitivity (CS). Defocus curve testing was performed in photopic and mesopic conditions. Adverse photic phenomena were assessed using the Halo v1.0 program. Results Mean aberration values for a mesopic pupil diameter were: total HOA RMS: 0.41 ± 0.30 μm, coma: 0.32 ± 0.22 μm and spherical aberration: 0.21 ± 0.20 μm. Binocular logMAR measurements were: CDVA −0.05 ± 0.05, DCIVA 0.15 ± 0.10, and DCNVA 0.06 ± 0.10. Mean Pelli-Robson CS was 1.40 ± 0.14 log units. Mean CSV100 CS for the 4 frequencies examined (A: 3 cycles/degree (cpd), B: 6 cpd, C: 12 cpd, D: 18 cpd) were 1.64 ± 0.14, 1.77 ± 0.18, 1.44 ± 0.24 and 0.98 ± 0.24 log units, respectively. Significant differences were observed in defocus curves for photopic and mesopic conditions (p < 0.0001). A mean disturbance index of 0.28 ± 0.22 was obtained. Conclusions Bilateral FineVision IOL implant achieved a full range of adequate vision, satisfactory contrast sensitivity, and a lack of significant adverse photic phenomena. Trial registration Eudract Clinical Trials Registry Number: 2014-003266-2

A Diagnostic Calculator for Detecting Glaucoma on the Basis of Retinal Nerve Fiber Layer, Optic Disc, and Retinal Ganglion Cell Analysis by Optical Coherence Tomography

Purpose: The purpose of this study was to develop and validate a multivariate predictive model to detect glaucoma by using a combination of retinal nerve fiber layer (RNFL), retinal ganglion cell-inner plexiform (GCIPL), and optic disc parameters measured using spectral-domain optical coherence tomography (OCT). Methods: Five hundred eyes from 500 participants and 187 eyes of another 187 participants were included in the study and validation groups, respectively. Patients with glaucoma were classified in five groups based on visual field damage. Sensitivity and specificity of all glaucoma OCT parameters were analyzed. Receiver operating characteristic curves (ROC) and areas under the ROC (AUC) were compared. Three predictive multivariate models (quantitative, qualitative, and combined) that used a combination of the best OCT parameters were constructed. A diagnostic calculator was created using the combined multivariate model. Results: The best AUC parameters were: inferior RNFL, average RNFL, vertical cup/disc ratio, minimal GCIPL, and inferior-temporal GCIPL. Comparisons among the parameters did not show that the GCIPL parameters were better than those of the RNFL in early and advanced glaucoma. The highest AUC was in the combined predictive model (0.937; 95% confidence interval, 0.911–0.957) and was significantly (P = 0.0001) higher than the other isolated parameters considered in early and advanced glaucoma. The validation group displayed similar results to those of the study group. Conclusions: Best GCIPL, RNFL, and optic disc parameters showed a similar ability to detect glaucoma. The combined predictive formula improved the glaucoma detection compared to the best isolated parameters evaluated. The diagnostic calculator obtained good classification from participants in both the study and validation groups

〈初期軍記〉における戦闘被害の表現-女の描かれ方をめぐって-

軍記・語り物研究会第374回例会(平成19年7月22日・於:法政大学)共同討議「初期軍記」研究の検証と展開-新たな「状況」と「変容」を探る-における基調報

Impaired antigen-specific B-cell responses after Influenza vaccination in kidney transplant recipients receiving co-stimulation blockade with Belatacept

Emerging data suggest that costimulation blockade with belatacept effectively controls humoral alloimmune responses. However, whether this effect may be deleterious for protective anti-infectious immunity remains poorly understood. We performed a mechanistic exploratory study in 23 kidney transplant recipients receiving either the calcineurin-inhibitor tacrolimus (Tac, n=14) or belatacept (n=9) evaluating different cellular immune responses after influenza vaccination such as activated T follicular Helper (Tfh), plasmablasts and H1N1 hemagglutinin (HA)-specific memory B cells (HA(+)mBC) by flow-cytometry, and anti-influenza antibodies by hemagglutination inhibition test (HI), at baseline and days 10, 30 and 90 post-vaccination. The proportion of CD4+CD54RA-CXCR5+ Tfh was lower in belatacept than Tac patients at baseline (1.86%[1.25-3.03] vs 4.88%[2.40-8.27], p=0.01) and remained stable post-vaccination. At M3, HA(+)mBc were significantly higher in Tac-treated patients (0.56%[0.32-1.49] vs 0.27%[0.13-0.44], p=0.04) and correlated with activated Tfh numbers. When stratifying patients according to baseline HA(+)mBc frequencies, belatacept patients with low HA(+)mBC displayed significantly lower HA(+)mBc increases after vaccination than Tac patients (1.28[0.94-2.4] vs 2.54[1.73-5.70], p=0.04). Also, belatacept patients displayed significantly lower seroprotection rates against H1N1 at baseline than Tac-treated patients (44.4% vs 84.6%) as well as lower seroconversion rates at days 10, 30 and 90 after vaccination (50% vs 0%, 63.6% vs 0%, and 63.6% vs 0%, respectively). We show the efficacy of belatacept inhibiting T-dependent antigen-specific humoral immune responses, active immunization should be highly encouraged before starting belatacept therapy

Potential New Diagnostic Tool for Alzheimer&apos;s Disease Using a Linear Discriminant Function for Fourier Domain Optical Coherence Tomography

PURPOSE. We calculated and validated a linear discriminant function (LDF) for Fourier domain optical coherence tomography (OCT) to improve the diagnostic ability of retinal and retinal nerve fiber layer (RNFL) thickness parameters in the detection of Alzheimer&apos;s disease (AD). METHODS. We enrolled AD patients (n ¼ 151) and age-matched, healthy subjects (n ¼ 61). The Cirrus and Spectralis OCT systems were used to obtain retinal measurements and circumpapillary RNFL thickness for each participant. An LDF was calculated using all retinal and RNFL OCT measurements. Receiver operating characteristic (ROC) curves were plotted and compared among the LDF and the standard parameters provided by OCT devices. Sensitivity and specificity were used to evaluate diagnostic performance. A validating set was used in an independent population to test the performance of the LDF. RESULTS. The optimal function was calculated using the RNFL thickness provided by Spectralis OCT, using the 768 points registered during peripapillary scan acquisition (grouped to obtain 24 uniformly divided locations): 18.325 þ 0.056 3 (3158-3308) À 0.122 3 (3008-3158) À 0.041 3 (2858-3008) þ 0.091 3 (2558-2708) þ 0.041 3 (2258-2408) þ 0.183 3 (1958-2108) À 0.108 3 (1508-1658) À 0.092 3 (758-908) þ 0.051 3 (308-458). The largest area under the ROC curve was 0.967 for the LDF. At 95% fixed specificity, the LDF yielded the highest sensitivity values. CONCLUSIONS. Measurements of RNFL thickness obtained with the Spectralis OCT device differentiated between healthy and AD individuals. Based on the area under the ROC curve, the LDF was a better predictor than any single parameter

MENINOS E MENINAS: A CONSTRUÇÃO DOS PAPÉIS DE GÊNERO NO COLÉGIO AGRÍCOLA ESTADUAL AUGUSTO RIBAS ENTRE 1967 E 2002 (Boys and girls: the construction of gender roles in Colégio Agrícola Estadual Augusto Ribas between 1967 and 2002)

O Presente trabalho analisa a relação entre a espacialidade do Colégio Agrícola Estadual Augusto Ribas (CAAR) e a construção dos papéis de gênero, através dos cursos de Economia Doméstica Rural e Técnico em Agropecuária. As análises realizadas sobre os resultados do levantamento de campo evidenciam que a espacialidade do CAAR coloca-se enquanto uma possibilidade de experimentação de técnicas e ferramentas que remetem as espacialidades do privado/público, relacionadas a esperas de comportamentos sociais referentes a meninos e meninas, segundo a construção cotidiana dos papéis de gênero. Palavras-chave: Ponta Grossa; Colégio Agrícola Estadual Augusto Ribas; gênero; Geografia. ABSTRACT This paper examines the relationship between the spatiality of the Colégio Agrícola Estadual Augusto Ribas (CAAR) and the construction of gender roles through the courses rural home economics and technician in farming. The analyzes performed about the results of the field survey evidenced that the spatiality of the CAAR arises as a possibility of experimentation of techniques and tools that refer the spatialities of private / public, expect from social behaviors related for boys and girls, according the daily construction of gender roles. Keywords: Ponta Grossa; Colégio Agrícola Estadual Augusto Ribas; gender, Geography. RESUMEN El presente trabajo examina la relación entre la espacialidad de Colegio Agrícola Estadual Augusto Ribas (CAAR), y la construcción de los roles de género a través de los cursos de economía doméstica rural y un técnico en la agricultura. Los análisis realizados sobre los resultados de la encuesta muestran que el campo de la espacialidad del CAAR surge como una oportunidad para experimentar con técnicas y herramientas que se refieren las espacialidades de privado / público, espera de comportamientos sociales relacionados para niños y niñas, de acuerdo la construcción cotidiana de los roles de género. Palabras clave: Ponta Grossa; Colegio Agrícola Estadual Augusto Ribas, género, Geografía. DOI: 10.5654/actageo2013.0714.001

Cell Type of Origin Influences the Molecular and Functional Properties of Mouse Induced Pluripotent Stem Cells

Induced pluripotent stem cells (iPSCs) have been derived from various somatic cell populations through ectopic expression of defined factors. It remains unclear whether iPSCs generated from different cell types are molecularly and functionally similar. Here we show that iPSCs obtained from mouse fibroblasts, hematopoietic and myogenic cells exhibit distinct transcriptional and epigenetic patterns. Moreover, we demonstrate that cellular origin influences the in vitro differentiation potentials of iPSCs into embryoid bodies and different hematopoietic cell types. Notably, continuous passaging of iPSCs largely attenuates these differences. Our results suggest that early-passage iPSCs retain a transient epigenetic memory of their somatic cells of origin, which manifests as differential gene expression and altered differentiation capacity. These observations may influence ongoing attempts to use iPSCs for disease modeling and could also be exploited in potential therapeutic applications to enhance differentiation into desired cell lineages.Stem Cell and Regenerative Biolog

Current Perspectives on the Use of Anti-VEGF Drugs as Adjuvant Therapy in Glaucoma

The approval of one of the first anti-vascular endothelial growth factor (VEGF) agents for the treatment of neovascular age-related macular degeneration one decade ago marked the beginning of a new era in the management of several sight-threatening retinal diseases. Since then, emerging evidence has demonstrated the utility of these therapies for the treatment of other ocular conditions characterized by elevated VEGF levels. In this article we review current perspectives on the use of anti-VEGF drugs as adjuvant therapy in the management of neovascular glaucoma (NVG). The use of anti-VEGFs for modifying wound healing in glaucoma filtration surgery (GFS) is also reviewed. Selected studies investigating the use of anti-VEGF agents or antimetabolites in GFS or the management of NVG have demonstrated that these agents can improve surgical outcomes. However, anti-VEGF agents have yet to demonstrate specific advantages over the more established agents commonly used today. Further studies are needed to evaluate the duration of action, dosing intervals, and toxicity profile of these treatments