Capsular Adhesion Research Articles

Dynamic Changes of Capsular-Intraocular Lens Adhesion in Plate-Haptic Hydrophilic and Loop-Haptic Hydrophobic Eyes.

The aim of this work is to investigate the dynamic changes of capsular-intraocular lens (IOL) adhesion in plate-haptic hydrophilic and loop-haptic hydrophobic eyes. Cataract eyes that met the inclusion criteria were randomly assigned to receive implantation of a plate-haptic hydrophilic or loop-haptic IOL. The anterior capsular adhesion, posterior capsular adhesion, and the configurations of the capsular bend were evaluated using swept-source optical coherence tomography at 1day, 1week, 1month, and 3months postoperatively. In total, 66 eyes of 66 patients were eligible for the analysis: 33 in the plate-haptic group and 33 in the loop-haptic group. The contact between the anterior capsule and IOL in the plate-haptic group was earlier than that in the loop-haptic group upon comparing the measurements taken at 1day and 1week (p = 0.001, p = 0.003, respectively). The complete attachment of the posterior capsule and IOL in the plate-haptic group was significantly greater at 1week, 1month, and 3months (p = 0.001, p = 0.000, p = 0.001, respectively). The capsular bend index of the plate-haptic group was significantly greater than that of the loop-haptic group at each time points except at 1day (p = 0.007, p = 0.049, p = 0.005, respectively). Furthermore, a new type of capsular bend, "cocked adhesion," was observed in the plate-haptic eyes. The plate-haptic IOL demonstrated excellent capsular adhesion compared to the loop-haptic IOL, which was probably attributed to haptic compressibility. A special cocked configuration of the capsular bend in plate-haptic IOL was observed for the first time. Further studies are warranted to confirm the effect of the new type of capsular bend.

Evidence from the large VALIGA cohort validates the subclassification of focal segmental glomerulosclerosis in IgA nephropathy

Evidence from the Oxford IgA nephropathy (IgAN) cohort supports the clinical value of subclassifying focal segmental glomerulosclerosis lesions (S1). Using the larger Validation in IgA (VALIGA) study cohort, we investigated the association between podocytopathic changes and higher proteinuria, kidney outcome and response to immunosuppressive therapy. All biopsies were evaluated for glomeruli with segmental capillary occlusion by matrix ("not otherwise specified", NOS lesion), simple capsular adhesion without capillary occlusion (Adh), tip lesions, and podocyte hypertrophy (PH). S1 required a NOS lesion and/or Adh. A Chi-Squared Automatic Interaction Detection method was used to identify subgroups of FSGS lesions associated with distinctive proteinuria at biopsy. We assessed survival from a combined event (kidney failure or 50% decline in estimated glomerular filtration rate). Finally, we evaluated within each subgroup if immunosuppression was associated with a favorable outcome using propensity analysis. In 1147 patients, S1 was found in 70% of biopsies. Subclassification found NOS lesions in 44%, Adh in 59%, PH in 13%, and tip lesions in 3%, with much overlap. Four subgroups were identified with progressively higher proteinuria: from lowest, S1 without NOS, S1 with NOS but without Adh/PH, to highest, S1 with NOS and Adh but without PH, and S1 with NOS and PH. These four subgroups showed progressively worse kidney survival. Immunosuppression was associated with a better outcome only in the two highest proteinuria subgroups. Propensity analysis in these two groups, adjusted for clinical and pathological findings, found a significantly reduced time-dependent hazard of combined outcome with corticosteroids. Podocyte hypertrophy and glomeruli with simple adhesions appeared to reflect active lesions associated with a response to corticosteroids, while other S1 lesions defined chronicity. Thus, our findings support subclassifying S1 lesions in IgAN.

PS-B06-6: LOSS OF SKELETAL MUSCLE MASS INFLUENCES IMMUNE HOMEOSTASIS AND ACCELERATES THE RENAL-RELATED RISK OF HYPERTENSION

Objective: Patients with systemic lupus erythematosus (SLE) are predisposed to developing sarcopenia associated with their underlying proinflammatory condition and a decrease in motility. Also, SLE related autoimmune renal diseases are in part imputed to classical vascular risk factors such as hypertension. The relationship between circulating autoantibodies and hypertension has been recognized. How sarcopenia hastens immune dysfunction in SLE and autoimmunity per se is an underlying cause of hypertension remains uncertain. The present study elucidated the relationship between skeletal muscle loss and systemic immune status with regards to how sarcopenia-mediated immune dysfunction contributes as a critical risk factor in hypertension. Design and Methods: A denervation-induced skeletal muscle loss model was established, and the function of the immune system was evaluated. Systemic immune cell proportions and serum cytokine levels were profiled. Calcium influx and mitochondrial function were also assessed in the T cells. Finally, MRL/lpr mice were used to assess the influence of denervation-induced sarcopenia on SLE-related lupus nephritis progression and circulating autoantibodies, along with the cytokines that contributes to the development of hypertension, such as TNF-α and MCP-1, were evaluated. Results: The results of immune status profiling and functional assessment demonstrated that the loss of skeletal muscle shifts the immune balance in favor of the Th1/Th17 axis. Along with the peak Ca2+ influx, denervation-induced amyotrophy also impaired the spare respiratory capacity in mitochondrial of T cells, as well as the basal respiration and adenosine triphosphate production. The results of proteinuria tracing, serum blood urea nitrogen level, and C3 and IgE deposition in mesangium and capsular adhesion suggests that the sarcopenia promoted nephritis progression. A significant increase of the level in TNF-α, which promotes renal vasoconstriction, a pro-hypertensive effect, was also observed in sarcopenic mice. Conclusion: Consequently, sarcopenia might promote the progression of lupus nephritis because of the enhancement of systemic Th1/Th17 functions and accelerate the deposition of the vascular damage factors. The data herein suggested that the protection from developing hypertension in SLE patient may afforded by preventing skeletal muscle losing. A multidisciplinary approach is required to minimize the overall adverse impact of sarcopenia in the management of SLE-related hypertension.

Abstract 11052: Implanting Cardiovascular Electronic Devices With a Biologic Tissue Envelope Improves Healing and Facilitates Reoperative Procedures

Introduction: Fibrous encapsulation of implanted cardiovascular implantable electronic devices (CIED) may create a hostile environment during device reoperation. An acellular biologic extracellular tissue CIED envelope (CanGaroo®, Aziyo Biologics) may attenuate host foreign body response to the implant, decrease fibrosis and enable adaptive vascularized healing to facilitate reoperation & decrease complications. Hypothesis: CIED implant site findings at reoperation differ in patients who previously received a biologic envelope (BIO) vs no envelope (NO-BIO) at time of device implant. Methods: Patients undergoing reoperative CIED procedures (9 BIO, 12 NO-BIO) were assessed (medical profiles, procedural notes, scaled scoring of intra-operative assessments & tissue biopsy histology of the implant pocket). Results: There were no significant cohort differences in mean age, gender or implant location. Median capsular lead adhesion classification (semi-qualitative scale) was significantly lower (less severe) for BIO implants (p=0.02) [Fig. 1, double arrows]. Physicians scored BIO reoperations (10-pt scale) as 39% less difficult in generator mobilization (p=0.04), 43% less difficult in lead mobilization (p=0.04) and 45% less overall procedural difficulty (p=0.01). BIO pockets required 63% fewer capsulectomies (p=0.18). Multipoint histologic assessment of fibrotic capsule thickness (16 matrixed measurements, 5 BIO vs 11 NO-BIO with complete datasets) revealed a 39% reduction in BIO implant pockets (p=0.05), with no significant differences between groups in capsule mature collagen density [Fig. 1, single arrows]. Conclusions: When a BIO envelope was used at initial CIED implantation (vs no envelope), we observed significantly less fibrous lead entrapment, easier generator & lead mobilization, and thinner mature fibrotic capsules at reoperation. Biologic tissue envelopes may prevent operative complications and enhance clinical outcomes.

Aspergillus oryzae attenuates quorum sensing -associated virulence factors and biofilm formation in Klebsiella pneumoniae extended-spectrum beta-lactamases

Background: Klebsiella pneumoniae communicate between and among species using quorum sensing (QS). Biofilm formation and virulence factors are regulated by QS. This QS is indirectly responsible for K. pneumoniae pathogenicity. Inhibiting QS is a novel and highly effective method for controlling K. pneumoniae extended-spectrum beta-lactamases (KP-ESBL) infections. This study aimed to investigate how Aspergillus oryzae extracellular protein (AOEP) affected QS and KP-ESBL virulence factors. Methods: Methods used included minimal inhibitory concentration (MIC) through the microdilution method, biofilms with crystal violet staining, extracellular polysaccharides using the Congo Red assay, quantifying the expression of genes coding for capsular polysaccharide (wzI gene) and adhesion (mrkA gene) through quantitative reverse-transcription polymerase chain reaction (RT-qPCR), siderophore level measurement using Chrome Azurol sulphonate assay (CAS assay), biofilm morphology using a scanning electron microscope (SEM), and confirmation using the life span killing assay method on Caenorhabditis elegans (C. elegans). Results: In vitro studies revealed that AOEP inhibited biofilms and exopolysaccharides (EPS) in KP-ESBL at the sub-MIC level. In addition, AOEP inhibited the expression of the mrkA gene, which is involved in the adhesion process. Furthermore, an in vivo study revealed that AOEP levels of 75 and 150 µg/mL respectively increased C. elegans survival rates by 72.67% and 80.76% against K. pneumoniae infection. Conclusions: Our findings suggest that the extracellular protein of A. oryzae may be an effective QS inhibitor and a novel anti-virulence agent to control bacterial pathogens.

Hypertriglyceridemia Is Associated with More Severe Histological Glomerulosclerosis in IgA Nephropathy

IgA nephropathy (IgAN) is a globally well-known primary glomerular nephropathy. Hypertriglyceridemia (HTG) is one factor contributing to atherosclerosis and is a common complication of renal failure. HTG is a significant risk factor for decreased renal function in patients with IgAN. We evaluated the association of HTG with the histopathological features of IgAN patients. A total of 480 patients diagnosed with IgAN via kidney biopsy from eight university hospitals affiliated with the College of Medicine of the Catholic University of Korea were included in the final cohort. Pathological features were evaluated by eight expert pathologists with hospital consensus. HTG was defined as a serum triglyceride (TG) level of ≥150 mg/dL. In the study population analysis, the HTG group was older, with more males; higher body mass index (BMI), low-density lipoprotein cholesterol (LDL-C) and spot urine protein ratio; and lower estimated glomerular filtration rate (eGFR). In the lipid profile analysis, eGFR was negatively correlated with TGs/ high-density lipoprotein cholesterol (HDL) and triglyceride-glucose index (TyG). Proteinuria positively correlated with TGs/HDL, non-HDL/HDL, LDL/HDL, TyG, TGs and LDL. The percentages of global sclerosis (GS), segmental sclerosis (SS) and capsular adhesion (CA), and the scores for mesangial matrix expansion (MME) and mesangial cell proliferation (MCP), were more elevated in the HTG group compared to the normal TG group. Multivariable linear regression analysis showed that the percentages of global sclerosis, segmental sclerosis and capsular adhesion, as well as the scores for mesangial matrix expansion and mesangial cell proliferation, were positively associated with TG level. In binary logistic regression, the HTG group showed a higher risk for global sclerosis and segmental sclerosis. In conclusion, HTG is a significant risk factor for glomerulosclerosis in IgAN.

Molecular epidemiology of infections caused by group B Streptococcus in pregnant women and newborns, and development of preventive vaccines

Hypothesis/aims of study. The present analysis was undertaken to summarize current knowledge about molecular properties of group B streptococci (GBS), emphasizing potential targets of vaccines against neonatal GBS infection.
 Study design, materials, and methods. This review is based on articles published mainly in the last ten years.
 Results. Epidemiological data on serotypes, multilocus sequence types, clonal complexes of GBS and their relationship are presented. Genetic events in GBS populations indicate significant obstacles to vaccine development. We described key properties of major GBS virulence factors, such as capsular polysaccharide, pili, and cell adhesion molecules, as well as results of experimental immunization on their basis.
 Conclusion. The population of invasive GBS strains is molecularly and genetically heterogeneous, which complicates selection of vaccine targets. Capsular switching, a low level of immunogenicity and variability of population composition are the most important factors that necessitate the accumulation and monitoring of molecular epidemiological data.

Identification of virulence factors in contact lens associated bacteria: A physiological approach.

Wearing contact lens requires awareness about possible contaminants, the causative agents of multiple complications. The present study focused on identification of potential pathogens and presence of virulence associated markers in contact lens associated bacteria. Bacterial contaminants were isolated from contact lenses or cleaning solutions collected from University students. Isolates were identified using conventional methods followed by 16S rRNA gene sequencing and screened for the presence of virulence factors which included capsular presence, adhesion, serum resistance, iron chelation, haemagglutination and hemolysis. Moreover, antibiotic resistance profile was also monitored. Contamination was observed in 79% (45 of 57) of lenses. Based on 16S rRNA sequencing Bacillus sp. was found to be most abundant (26%). The presence of at least three pathogenic characteristics was recorded in 75.8% isolates. Among the pathogenic characteristics, capsule presence was found to be the most prevalent character (73%) followed by hemolysin production (65%), serum resistance (61%), haemagglutination (56%), iron chelation (50%) and polystyrene adherence (42%). Multiple antibiotic resistance was recorded in 66.13% isolates. Cluster analysis on the basis of virulence markers separated all isolates in two groups. Potential pathogens and non-pathogens were found to be equally frequent among contaminants of contact lens cases. The present work provides evidence that pathogenic bacteria can adhere and survive in contact lens or lens solution. It highlights the need for the development of new methods to protect contact lenses and lens care accessories. Drugs targeting capsule formation may offer a good option for treatment or use in cleaning solution.

The Review of Certain In Vivo Antioxidant Effects on Essential Oils of Origanum Minutiflorum O Schwarz-Ph Davis, Juniperus Excelsa Bieb.subsp. Excelsa and Histopathologic Changes

ABSTRACT Essential oil of plants called Juniperus excelsa Bieb. (JE), Origanum minutiflorum O. Schwarz and P.H. Davis (OM) were used in this study. In order to determine experimental doses, LD50 values of essential oils were determined on mice. Taking into consideration the LD30 range, the experimental toxic doses were calculated for each rat (rat/kg). The toxic dosages thus determined were adapted to rats for active substances (rat/kg). Using commercially available pure virgin olive oil (VOO) as the solvent and diluting agent, OM oil (n=10), JE fruitoil (n=10), carvacrol (CRV) (n=10), VOO (n=10) and normal saline SF (n=8) were administered on the basis of 12 days into intraperitoneal (IP). Enzyme activities of Glucose-6-Phosphate dehydrogenase (G6PDH), malate dehydrogenase (MDH), Superoxide Dismutase (SOD), Glutathione-S-transferase (GST), Adenosine-deaminase (ADA) and Catalase were studied in isolates of kidney, brain and liver tissues. The data was statistically analyzed through Kruskal Wallis variance analysis. Elevated levels of GST and catalase have been found statistically important, as have both essential oil activities of OM and JE in the kidney tissue (p<0.005). All of the enzymes except the levels of ADA and SOD led to a statistically significant change in the brain and liver. There was sinusoidal hyperemia and capsular adhesion in the liver as histopathological were found to be statistically significant (p<0.005). It did not observe any important changes in the other organs. Findings were scored and analyzed by using x2(chi-square) test and Fisher’s definite variance analysis.

Histopathology of renal asphyxia in newborn piglets: Individual susceptibility to tubular changes.

To analyze the effects on the kidney of hypoxia-reoxygenation in an experimental model of normocapnic asphyxia. To this end, 40 newborn Landrace/Large-White piglets aged 1-4 d were studied in this work. Hypoxia was induced by decreasing the inspired fiO2 to 0.06-0.08. Animals were resuscitated with different fiO2 and subdivided into 4 groups: group 1, 2, 3 and 4 received 18%, 21%, 40% and 100% O2 respectively. Macroscopic examination was carried out to evidence possible pathological features. Tissue sample were obtained from both kidneys. Four or five micron paraffin sections were stained with H-E and PAS stain and examined under an optical microscope. Pathological changes, mainly affecting tubular cells, were observed in the vast majority of kidneys of asphyxiated piglets. The most frequent tubular changes were: tubular casts (95%), tubular dilatation (87.5%), tubular vacuolization (70%), tubular eosinophilia (52.5%), sloughing (50%), fragmentation of the brush border (50%), oedema (32.5%), apoptosis (15%) and glomerular changes (meningeal cell proliferation, capsular adhesion between the flocculus and Bowman's capsule, glomerulosclerosis and fibrous or cellular crescents associated with collapse of the glomerular tuft). Statistical analysis was carried out on changes observed when the animals were allocated in the 4 groups (χ(2)-test 0.05). The statistical analysis showed no evidence of differences regarding kidney lesions among the animals groups. Our data show that renal pathology in newborn piglets is characterized by interindividual variability to hypoxia and is not associated with oxygen concentration.

Autologous Chondrocyte Implantation for Treatment of Osteochondral Lesions of the Talus

Autologous chondrocyte implantation (ACI) technology and techniques are a rapidly evolving field. There are currently 3 generations of chondrocyte implantation techniques for osteochondral defects. First-generation and some second-generation ACI techniques are in use in the United States, whereas third-generation chondrocyte implantation methods are in the early phases of human clinical trials. ACI is reserved for patients who have failed marrow stimulation. Caveats to this may be the larger osteochondral lesion of the talus (>1.5 cm2) or the presence of significant subchondral cyst (>8 mm), where ACI with “sandwich” bone grafting is more likely to restore the congruity of the articular surface and underlying bone. Complications specific to ACI in osteochondral lesion of the talus include periosteal hypertrophy, capsular adhesion or arthrofibrosis, painful hardware from osteotomy fixation, and lack of graft incorporation. Newer 1-stage techniques that eliminate the need for a second procedure are also promising and less invasive than first-generation procedures. Furthermore, new-generation cell-based therapies eliminate the need for a periosteal patch, and although third-generation techniques are only investigational, it may eliminate complications associated with scaffolds, such as integration, rate of degradation, and biocompatibility. Prospective randomized studies with long-term follow-up are needed to assess the efficacy of ACI in comparison with marrow stimulation.

Joint haemorrhage partly accelerated immobilization-induced synovial adhesions and capsular shortening in rats

To elucidate the effects of intra-articular haemorrhage on the joint capsule of immobilized knees in rats. The unilateral knee joints were immobilized using a plastic plate and screws. Sham operated rats had only screws inserted. A single injection of fresh autologous blood was given postoperatively into the knee joints of the immobilized blood injection (Im-B) and the Sham blood injection (Sm-B) groups. Normal saline was administered for the immobilized-saline injection (Im-S) group. Sagittal sections were prepared from the medial midcondylar region of the knee and assessed with histological, histomorphometric, and immunohistochemical methods. The range of motion (ROM) was measured, and the mechanical property of the capsule was assessed by scanning acoustic microscope. Absorption of the injected blood was delayed and made severe adhesions in the Im-B group. The length of the synovial membrane in the Im-B group was significantly shorter than that of the other groups. The ROM was significantly restricted in the Im-B group compared with the other groups. The elasticity of the posterior capsule in the Im-B group was significantly lower than that in the Sm-B group. Iron deposition was observed in the Im-B and Sm-B groups. Strong immunoreactivities of CD68, TGF-β1, and α-SMA were observed in the adhesion area of the Im-B group. Joint immobilization with blood injection caused severe capsular adhesion and limited range of motion. Immunostaining related to fibrosis increased with joint haemorrhage. Intra-articular haemorrhage with joint immobilization might be an accelerated risk factor for joint contracture. It is likely that leaving a haematoma inside an immobilized joint should be avoided.

Capsular Adhesion to Intraocular Lens in Highly Myopic Eyes Evaluated In Vivo Using Ultralong-scan-depth Optical Coherence Tomography

To evaluate the in vivo capsular apposition to the intraocular lens (IOL) in subjects with high myopia by ultralong-scan-depth optical coherence tomography (OCT). Prospective observational case series. Forty eyes from 40 cataract patients scheduled for phacoemulsification surgery at the Affiliated Eye Hospital, Wenzhou Medical College were studied, of which 20 eyes were highly myopic (axial length >26 mm) and 20 eyes were emmetropic (22 mm < axial length <24.5 mm). All eyes were examined with a custom-built ultralong-scan-depth OCT at 4 hours, 1 day, 7 days, 14 days, and 28 days after surgery. Anterior capsule contact with the IOL was significantly delayed in highly myopic eyes. Complete apposition of the posterior capsule with the IOL was significantly less common among highly myopic eyes than in emmetropic eyes (4 vs 16 eyes; P = .001). Posterior capsule adhesion to the IOL was inversely correlated with axial length (r = -0.494, P < .001, nonparametric Spearman test). The 3 types of complete adhesive capsular bend configurations observed were classified as anterior adhesion, middle adhesion, and posterior adhesion. Incomplete adhesion patterns were classified as funnel adhesion, parallel adhesion, and furcate adhesion. Five highly myopic eyes had slight posterior capsule opacification (PCO) at the last follow-up, as did 1 emmetropic eye. Ultralong-scan-depth OCT revealed weak capsular adhesion and incompletely adhesive types of capsular bend in highly myopic eyes. These features presumably increase the likelihood of PCO during the early postoperative period.

Histomorphological classification of focal segmental glomerulosclerosis: A critical evaluation of clinical, histologic and morphometric features

Primary focal segmental glomerulosclerosis (FSGS) has recently been divided into five subtypes by the Columbia classification. However, little is known about the incidence of these subtypes in the Indian population. In addition, there are very few studies evaluating the clinico-pathologic features with morphometric parameters in these subtypes. This study was aimed at evaluating the clinical, histopathological and morphometric parameters in various subtypes of FSGS at our referral center. Sixty-five (65) cases of idiopathic FSGS, diagnosed over two years (2006-2007), were included in the study. Detailed clinical and biochemical investigations were noted. Histological sections were reviewed and cases classified according to the Columbia classification and various glomerular and tubulo-interstitial features were noted. Glomerular morphometry on digitized images was performed using image analysis software. Renal biopsies with minimal change disease were used as controls for morphometric evaluation. In this study, FSGS not otherwise specified (NOS) was the most common subtype (44.6%), followed by perihilar FSGS (24.6%), collapsing (13.8%), tip (12.3%) and cellular FSGS (4.6%). Collapsing subtype showed significantly shorter duration of symptoms and higher degree of proteinuria, mean serum urea and creatinine compared with the other subtypes. On histologic analysis, features like glomerular hyalinosis, capsular adhesion, mesangial proliferation and visceral epithelial cell prominence (VEP) were frequently seen. The cases with VEP had a shorter duration of symptoms and a higher mean serum creatinine and 24-h urine protein excretion compared with those without VEP. The morphometric study revealed a significant higher mean glomerular area in the NOS, perihilar and collapsing variants as compared with the control biopsies. The present study highlights the differences in the prevalence in the FSGS subtypes in our population compared with the western data. Also, the significant differences in the clinical, biochemical and histological parameters reaffirm the utility of the Columbia classification of FSGS in routine reporting of renal biopsies. We found VEP (without causing collapse of the tuft) to be associated with higher serum creatinine at presentation. This feature needs to be evaluated in further studies for its potential significance.

Clinically aggressive primary solid pseudopapillary tumor of the ovary in a 45-year-old woman

We report the first case of primary solid pseudopapillary tumor of the ovary with aggressive behavior and fatal outcome in a 45-year-old woman. The patient presented with weight loss, decrease of appetite, and abdominal bloating for the last several weeks. Computed tomography scan revealed an ovarian mass, omental caking, complex ascites, and 2 hepatic lesions. The pancreas was unremarkable. Grossly, the ovarian mass showed severe capsular adhesion, and the cut surface was cystic and solid. On histologic examination, the tumor was composed of diffuse solid pseudopapillary and pseudocystic patterns. The neoplastic cells were uniform and round with very dispersed chromatin. The cytoplasm was faintly pink. There was mild atypia, but the mitotic rate was as high as 62 per 50 high-power field, and the Ki-67 was elevated at 20%. The tumor exhibited severe necrosis. Numerous foci of lymphovascular invasion were also seen. The tumor cells were positive for cytokeratin (focal) and for β-catenin (cytoplasmic and nuclear patterns). They were negative for chromogranin, synaptophysin, thyroglobulin, calcitonin, hepatocyte-paraffin 1, epithelial membrane antigen, calretinin, and α-inhibin. Electron microscopic study revealed nests of tumor cells with oval nuclei. The cytoplasm contained numerous pleomorphic mitochondria interspersed among short strands of rough endoplasmic reticulum. The tumor involved the fallopian tube, omentum, cul-de-sac, and abdominal wall. The pelvic washing was also positive for tumor cells. Despite chemotherapy, the patient's condition had worsened, and she died of her disease 8 months after the initial diagnosis. We discuss the differential diagnosis of this tumor and the hypothesis of its origin.

A PVA/PVP hydrogel for human lens substitution: Synthesis, rheological characterization, and in vitro biocompatibility

To overcome opacification and absence of accommodation of human lens substitutes a new poly(vinyl alcohol) (PVA)/poly(N-vinyl-2- pyrrolidinone) (PVP) based hydrogel (PPS31075) was realised. The Infrared Spectroscopy and the mechanical spectra confirmed the successful occurrence of crosslinking reaction. The rheological analysis pointed out a behavior comparable with that of young human lens in terms of complex shear modulus and accommodation capability. Further analysis in terms of optical properties, water content measurements, diffusion coefficient, cytotoxicity, and human capsular cell adhesion confirmed the applicability of such a hydrogel as potential human lens substitute.

Transgenic mice expressing nitroreductase gene under the control of the podocin promoter: a new murine model of inductible glomerular injury

The present work identifies a new mouse model of inductible acute glomerular injury leading to focal segmental glomerulonephritis. We take advantage of the suicide gene/prodrug nitroreductase/CB1954 combination, in which nitroreductase converts CB1954, a monofunctional alkylating agent, into its toxic form. We generate two lines of transgenic mice in which the nitroreductase gene was placed under the control of the podocyte-specific gene podocin. The functional analysis of transgenic mice lines showed that CB1954 treatment induced a severe but transitory proteinuria. Sequential histopathological analysis was performed on serial kidney biopsies. Injured glomeruli showed acute lesions with early podocyte vacuolization and detachment, podocyte apoptosis, and cellular proliferation leading to a marked hypercellularity of the urinary space that was associated with collapsing of the glomerular tuft. After 1 month, progressive scarring lead to focal segmental glomerulosclerosis with fibrous capsular adhesion, hyalinosis, and podocytosis associated with interstitial fibrosis. The phenotype of podocytes was changed exhibiting dedifferentiation characterized by the loss of podocyte specific proteins/transcription factor and the expression of injury markers. Bowman's capsule cells were also involved in the cellular changes in a manner suggesting epithelial to mesenchymal transition. This model of podocyte injury in transgenic mice provides new insights into the cellular mechanisms of podocytopathies and their progression to scarring.

Inhibition of Posterior Capsule Opacification by a Capsular Adhesion–Preventing Ring

To assess the inhibitory effect of a capsular adhesion-preventing ring (CAPR) that facilitates aqueous humor circulation into the capsular bag on posterior capsule opacification (PCO) formation after cataract surgery. After phacoemulsification, a polymethyl methacrylate intraocular lens with (n=5) or without (n=5) a CAPR was implanted in rabbit eyes. The inhibitory effect of the CAPR on PCO formation was assessed by stereoscopic microscopy and histologic examination 8 weeks after surgery. All eyes in which a CAPR was implanted demonstrated remarkably less PCO than the control eyes. Neither anteroposterior capsular adhesion nor regeneration of lens fiber occurred in 2 eyes in the CAPR group. The remaining 3 eyes with a CAPR showed partial capsular adhesion and limited lens fiber regeneration in the resultant closed capsular space. The CAPR appears to prevent PCO formation by separating the anterior and posterior capsules and allowing circulation of aqueous humor, including growth inhibitory factors, into the equatorial space of the capsule through the holes and grooves in the ring. A CAPR may be useful for preventing PCO in the clinical setting.

IgA Nephropathy: Correlation of WHO Classification and Morphologic Semi-quantitative Scoring System

Background : IgA nephropathy (IgAN) is the most common glomerulonephritis worldwide, and the clinical course of IgAN shows marked variability. Many efforts have made to histologically predict the clinical outcome. There are two methods to classify IgAN. One is mainly based on the glomerular changes, such as the WHO and the Lee and Haas classification systems. The other is a morphologic semi-quantitative scoring system, which counts the changes of the glomerular, tubulointerstitial and vascular structures, respectively. The purpose of this study is to determine whether the WHO classification properly reflects the various morphologic findings of IgAN. Methods : We analyzed 354 cases of IgAN by both the WHO classification system and the semiquantitative scoring system and evaluated the correlations of these two methods. Results : The severity of the glomerular lesions (glomerulosclerosis, capsular adhesion and mesangial matrix expansion) and the tubulointerstitial lesions (interstitial fibrosis, tubular atrophy and interstitial lymphocytic infiltration) are strongly correlated with the increase of the WHO classes of IgAN (Spearman’s rho [R] ≥0.5, p<0.05). There is a weak correlation between crescent formation and the increase of the WHO classes (R=0.3, p<0.05). Conclusions : This study shows that the WHO classification well reflects the severity of various morphologic findings and this suggests a complementary role for the semi-quantitative scoring system in classifying IgAN.

Intraocular lens–capsular bag imaging with ultrahigh-resolution optical coherence tomography

To compare in vitro ultrahigh-resolution optical coherence tomography (UHR OCT) cross-sectional images of the pseudophakic human autopsy eye with histology to evaluate the potential of this imaging technique for enhanced visualization of the anterior segment, especially the capsular bag, intraocular lens (IOL), and posterior capsule opacification (PCO) formation after cataract surgery.Department of Medical Physics and Department of Ophthalmology, University of Vienna, Vienna, Austria, and Department of Oral and Maxillofacial Surgery Institute of Dentistry, University of Turku, Turku, Finland.Ultrahigh-resolution OCT images were acquired from 7 pseudophakic human autopsy eyes using 1.4 microm axial x 3.0 microm transverse resolution. The axial resolution with UHR OCT is 1.4 microm compared to 10.0 microm with the commercially available OCT. Plastic-embedded histologic sections were obtained in precise alignment with the OCT tomograms.Ultrahigh-resolution OCT cross-sectional tomograms corresponded to the histologic sections. With the wavelength used (800 nm), the anterior and posterior capsules, area of lens epithelial cell growth and extracellular matrix proliferation, and IOL could be clearly visualized. The extent of capsular bag adhesion to the IOL could be detected, as well as the amount of PCO formation.The improved resolution makes UHR OCT a powerful tool in anterior segment imaging and evaluation of the capacity of IOL materials and models to induce capsular bag adhesion. Ultrahigh-resolution OCT may also help in determining the area of origin of PCO after cataract surgery.