23 research outputs found

    Wound healing after paranasal sinus surgery: neutrophilic inflammation influences the outcome.

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    After failure of medical treatment, functional endoscopic sinus surgery (FESS) remains the best treatment for chronic sinusitis (CS) and nasal polyposis (NP). The precise mechanisms involved in wound healing after sinus surgery remain unclear. The aim of this study was to explore systematically the different histomorphological processes and cell populations involved in the wound repair of the paranasal mucosa.Journal ArticleResearch Support, Non-U.S. Gov'tFLWINinfo:eu-repo/semantics/publishe

    Diagnostic Test Efficacy of Meibomian Gland Morphology and Function

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    Meibomian gland dysfunction (MGD) is the leading cause of dry eye and proposed treatments are based on disease severity. Our purpose was to establish reliable morphologic measurements of meibomian glands for evaluating MGD severity. This retrospective, cross-sectional study included 100 MGD patients and 20 controls. The patients were classified into dry eye severity level (DESL) 1-4 based on symptoms and clinical parameters including tear-film breakup time, ocular staining and Schirmer I. The gland loss, length, thickness, density and distortion were analyzed. We compared the morphology between patients and controls; examined their correlations to meibum expressibility, quality, and DESL. Relative to controls, the gland thickness, density and distortion were elevated in patients (p amp;lt; 0.001 for all tests). The area under the receiver operating characteristic curve was 0.98 (95% confidence interval [CI], 0.96-1.0) for gland loss, and 0.96 (CI 0.91-1.0) for gland distortion, with a cutoff value of six distorted glands yielding a sensitivity of 93% and specificity of 97% for MGD diagnosis. The gland distortion was negatively correlated to the meibum expressibility (r = -0.53; p amp;lt; 0.001) and DESL (r = -0.22, p = 0.018). In conclusion, evaluation of meibomian gland loss and distortion are valuable complementary clinical parameters to assess MGD status

    Functional and Morphological Evaluation of Meibomian Glands in the Assessment of Meibomian Gland Dysfunction Subtype and Severity

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    PURPOSE: To classify subtypes of meibomian gland dysfunction (MGD) and evaluate the dependency of dry eye signs, symptoms, and parameters on MGD subtype. DESIGN: Cross-sectional study. Study Population: the right eyes of 447 patients with MGD of various subtypes and 20 healthy volunteers. METHODS: Patients were divided into 4 subtypes of MGD based on meibum expression, meibum quality, and MG loss on meibography images (meibograde of 0-6). Subtypes were patients with high meibum delivery (hypersecretory and nonobvious MGD) and those with low meibum delivery (hyposecretory and obstructive MGD). Additional clinical tests included tear film break-up time (TFBUT), ocular staining, osmolarity, Schirmer I, blink interval timing and the Ocular Surface Disease Index (OSDI) questionnaire. RESULTS: A total of 78 eyes had hypersecretory MGD; 49 eyes had nonobvious MGD; 66 eyes had hyposecretory MGD; and 254 eyes had obstructive MGD. Increased tear film osmolarity and lower TFBUT were found in the low-delivery groups; hyposecretory (P = 0.006, P = 0.016) and obstructive MGD (P = 0.008, P = 0.006) relative to high-delivery MGD (hypersecretory and nonobvious groups, respectively). Worse ocular symptoms and ocular staining were also found in low-delivery MGD groups than the high delivery MGD groups (P amp;lt; 0.01 and P amp;lt; 0.006, respectively). " CONCLUSIONS: Patients with low-delivery MGD had worse dry eye parameters and ocular symptoms than those with high meibum delivery, indicating the pivotal role of meibum secretion in ocular surface health that should be targeted in MGD therapy. Furthermore, nonobvious MGD cannot be diagnosed using conventional dry eye tests and requires morphologic assessment of meibography images to confirm MG loss. ((C) 2019 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

    TheraPearl Eye Mask and Blephasteam for the treatment of meibomian gland dysfunction : a randomized, comparative clinical trial

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    Meibomian gland dysfunction (MGD) is the most common cause of dry eye disease (DED). In this study, we aimed to compare the effects of eyelid warming treatment using either TheraPearl Eye Mask (Bausch &amp; Lomb Inc., New York, USA) or Blephasteam (Spectrum Thea Pharmaceuticals LTD, Macclesfield, UK) in a Norwegian population with mild to moderate MGD-related DED. An open label, randomized comparative trial with seventy patients (49 females, 21 males; mean age 53.6 years). Patients were randomly assigned to treatment with Blephasteam (n = 37) or TheraPearl (n = 33). All received a hyaluronic acid based artificial tear substitute (Hylo-Comod, Ursapharm, Saarbrucken, Germany). Patients were examined at baseline, and at three and six months initiation of treatment. Treatment efficacy was primarily evaluated by fluorescein breakup time (FBUT) and Ocular Surface Disease Index (OSDI) scores. Other outcome measures included ocular surface staining (OSS), Schirmers test, and meibomian quality and expressibility. Baseline parameter values did not differ between the groups. After six months of treatment, Blephasteam improved FBUT by 3.9 s (p &amp;lt; 0.01) and OSDI by 13.7 (p &amp;lt; 0.01), TheraPearl improved FBUT by 2.6 s (p &amp;lt; 0.01) and OSDI by 12.6 (p &amp;lt; 0.01). No difference between treatments was detected at 6 months (p = 0.11 for FBUT and p = 0.71 for OSDI), nor were there differences in the other tested parameters between the treatment groups. Blephasteam and TheraPearl are equally effective in treating mild to moderate MGD in a Norwegian population after 6-months of treatment. Clinicaltrials.gov ID: NCT03318874; Protocol ID: 2014/1983; First registration: 24/10/2017.Funding Agencies|Faculty of Medicine, University of Oslo; ABIGO; AlconNovartis; AllerganAbbVieAllergan; AMWO; BauschLomb; European school for advanced studies in ophthalmology; InnZ Medical; Medilens Nordic; Medistim; NovartisNovartis; Santen; Specsavers; Shire; Thea Laboratoires</p

    Supplementary Data File

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    The file presents data underlying the analyses for an article called "Serum-free and Xenobiotic-free Preservation of Cultured Human Limbal Epithelial Cells" in preparation for publication in PlosOne. The file includes data on cell viability, epithelial and amniotic membrane thickness and expression of 11 different immunohistochemical markers (deltaNP63alpha, P63, Bmi1, C/ebpdelta, ABCG2, Connexin-43, Keratin-19, Keratin-3, PCNA, Caspase-3)

    Data from: Serum-free and xenobiotic-free preservation of cultured human limbal epithelial cells

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    Aim/Purpose of the Study: To develop a one-week storage method, without serum and xenobiotics, that would maintain cell viability, morphology, and phenotype of cultured human limbal epithelial sheets. Materials and Methods: Human limbal explants were cultured on intact human amniotic membranes for two weeks. The sheets were stored in a hermetically sealed container at 23°C in either a serum-free medium with selected animal serum-derived compounds (Quantum 286) or a xenobiotic-free medium (Minimal Essential Medium) for 4 and 7 days. Stored and non-stored cultures were analyzed for cell viability, amniotic membrane and epithelial sheet thickness, and a panel of immunohistochemical markers for immature cells (ΔNp63α, p63, Bmi-1, C/EBP∂, ABCG2 and K19), differentiated cells (K3 and Cx43), proliferation (PCNA), and apoptosis (Caspase-3). Results: The cell viability of the cultures was 98 ± 1% and remained high after storage. Mean central thickness of non-stored limbal epithelial sheets was 23 ± 3 μm, and no substantial loss of cells was observed after storage. The non-stored epithelial sheets expressed a predominantly immature phenotype with ΔNp63α positivity of more than 3% in 9 of 13 cultures. After storage, the expression of ABCG2 and C/EBP∂ was reduced for the 7 day Quantum 286-storage group; (P = 0.04), and Bmi-1 was reduced after 4 day Quantum 286-storage; (P = 0.02). No other markers varied significantly. The expression of differentiation markers was unrelated to the thickness of the epithelia and amniotic membrane, apart from ABCG2, which correlated negatively with thickness of limbal epithelia (R = -0.69, P = 0.01) and ΔNp63α, which correlated negatively with amniotic membrane thickness (R = -0.59, P = 0.03). Conclusion: Limbal epithelial cells cultured from explants on amniotic membrane can be stored at 23°C in both serum-free and xenobiotic-free media, with sustained cell viability, ultrastructure, and ΔNp63α-positivity after both 4 and 7 days

    Preparation of Human Limbal Epithelial Cell Sheets.

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    <p>Photo showing preparation of a Human Limbal Epithelial Cell Sheet after 14- day culture prior to the transfer into storage containers. The polyester membrane insert is about to be cut out with a surgical blade, before being transferred to a storage container. In the center of the insert, a triangular shaped human limbal explant can be seen. The leading edge of the continuous epithelial sheet growing out from the explant is seen as a gray line outside the black suture in the picture.</p

    Mean Cell Viability of Non-Stored and Stored Cultured Limbal Epithelial Cells.

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    <p>A) Laser confocal micrographs following viability staining of cultured HLEC a) not subjected to storage, b) stored for 4 days in Quantum 286, c) stored for 4 days in MEM, d) stored for 7 days in Quantum 286 and e) stored for 7 days in MEM. Live cells are CAM+ (green), whereas dead cells are EH-1+ (red). Original magnification x250. B) Bar chart illustrating the percentage of viable cells in non-stored and stored cultured HLEC sheets for 4 and 7 days at 23°C in Quantum 286 or MEM. Error bars: Standard error of the mean.</p
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