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PURPOSE: We examined the accuracy of intraocular lens power calculation formulas, with special emphasis on the prediction of refraction in different axial lengths. MATERIAL AND METHODS: 786 cases were subdivided into four groups based on the axial length (short axial length < 22.0 mm, normal axial length = 22-24.4 mm, mid-range axial length = 24.5-26.9 mm and long axial length > 27 mm). Seven different formulas (Holladay, SRK, SRK II, SRK/T, S-SRK, M-SRK, L-SRK) were tested for their accuracy in predicting post-operative refraction. RESULT: The best results were obtained using the S-SRK formula in the short axial length group (n = 114), The SRK and Holladay formulas in the normal axial length group (n = 278). The Holladay and SRK/T formulas in the mid-range axial length group (n = 135), and the SRK/T and L-SRK in the long axial length group (n = 259). CONCLUSION: Our results emphasize the importance of using an intraocular lens formula specific for each range of axial length when calculating the predicted refraction.

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We determined the levels of vascular endothelial growth factor/vascular permeability factor (VEGF/VPF) in the aqueous and serum in non-insulin dependent diabetic patients with proliferative retinopathy (n = 12) and neovascular glaucoma (n = 11). The aqueous levels of PEGF/VPF were significantly higher in both groups than in 10 diabetics without such complications. The levels were very high in patients with neovascular glaucoma, suggesting that VEGF/VPF is involved in the pathogenesis and progression of diabetic neovascular glaucoma. The serum levels were not significantly related to the presence or the stage of retinopathy. The findings suggest the possibility of treatment of neovascular glaucoma using anti- VRGF/VFP preparations.

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BACKGROUND: Studies in corneal transplant rejection remain important because acute immunologic rejection continues to be the leading cause of human corneal transplant failure. As the permeability of vessels and the neovascularization induce cells infiltration into the graft, we considered the possibility that vascular endothelial growth factor (VEGF), a potent permeability-increasing factor and angiogenesis-mediating factor, could participate in the immune response. METHODS: As the established corneal transplant model for rejection, the corneal transplant between Lewis and Fisher rats has been reported. First, we evaluated VEGF production in the graft by immunohistochemical method in the animal model. Next, we tried to neutralize the effect of VEGF by topical administration of anti-VEGF antibody. We administered anti-VEGF antibody as eye drops for 10 days just after the transplantation of the established animal corneal transplant model. RESULTS: VEGF was strongly produced from the infiltrative cells into the graft. Anti-VEGF antibody significantly suppressed the acute rejection compared with saline or rabbit IgG. CONCLUSIONS: The inhibition of VEGF by topically applied neutralizing antibody is a new potential therapeutic strategy for the treatment of corneal transplantation.

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The persistence of protective immunity after postexposure prophylaxis against varicella using oral aciclovir was evaluated in the family setting. Sixty one of 78 recipients of oral aciclovir were assessed by questionnaire, and 13 of 61 were evaluated for serum antibody to varicella zoster virus (VZV) using the fluorescent antibody to membrane antigen method. The observation period ranged from 33 to 50 months. None of those (n = 44) who had initially seroconverted to VZV after aciclovir prophylaxis developed breakthrough varicella. All 13 who had serology repeated still had titres > or = 4. Antibody titres in those who had histories of re-exposure to the virus were significantly higher than in those who had not (p < 0.01).

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Activation of Ras leads to the constitutive activation of a downstream phosphorylation cascade comprised of Raf-1, mitogen-activated protein kinase (MAPK) kinase, and MAPK. We have developed a yeast-based assay in which the Saccharomyces cerevisiae mating pheromone-induced MAPK pathway relied on co-expression of K-Ras and Raf-1. Radicicol, an antifungal antibiotic, was found to inhibit the K-ras signaling pathway reconstituted in yeast. In K-ras-transformed, rat epithelial, and K-ras-activated, human pancreatic carcinoma cell lines, radicicol inhibited K-Ras-induced hyperphosphorylation of Erk2. In addition, the level of Raf kinase was significantly decreased in radicicol-treated cells, whereas the levels of K-Ras and MAPK remained unchanged. These results suggest that radicicol disrupts the K-Ras-activated signaling pathway by selectively depleting Raf kinase and raises the possibility that pharmacological destabilization of Raf kinase could be a new and powerful approach for the treatment of K-ras-activated human cancers.

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Retinal images produced by two types of multifocal intraocular lenses (IOLs) were studied using an eye model. One of them was a refractive IOL with five zones, and the other was a diffractive lens. The IOLs were inserted into an eye model with a pupil diameter of 3 mm. The retinal plane of the eye model was observed microscopically. When the section of the IOL used for far vision was in focus, the retinal image of the refractive IOL was almost the same as that of the monofocal IOL, which was better than that of the diffractive IOL. When the near vision section of the IOL was in focus, the retinal image of the diffractive IOL had almost the same quality as the far section. The light rings produced when the multifocal IOLs were illuminated by a glare source were also examined. They showed that the diffractive IOL was stronger than the refractive IOL, but the monofocal was the smallest of the three.

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Safely suturing a posterior chamber intraocular lens (PC-IOL) to the ciliary sulcus requires a means of visualizing the ciliary sulcus, since it cannot be viewed directly with the operating microscope. We, therefore, created several trial instruments consisting of a mirror with a built-in light source, which we call an endo-mirror, designed for observing the area behind the iris. Using these instruments, we were able satisfactorily to view the ciliary sulcus and suture a PC-IOL to it, first in a number of animal eyes, and then, using an endo-mirror incorporating the best features of the trial versions, in actual clinical cases.

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Contrast and glare tests were performed on small intraocular lenses (IOLs) using a new eye model, which was based on and about the same size as the Gullstrand eye model. Lenses with a small optic diameter were inserted and retinal images were observed under the operating microscope. Contrast and glare disability tests were done using the MCT-8000 contrast tester and the Miller-Nadler glare tester. No effect on contrast sensitivity attributable to glare was observed, but under severe glare light conditions a faint reflection around the circumference of the optic was found. Questionnaires from patients implanted with small optic IOLs confirmed that this phenomenon was similar to their symptoms.

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Twenty-one infants who had virologically confirmed exanthem subitum and central nervous system (CNS) complications were studied to elucidate the clinical features, laboratory and virological findings, and outcome. The primary infection with human herpesvirus 6 was confirmed by isolation of the virus from blood, a significant rise in the antibody titers to the virus, or both. All convulsive seizures (15 generalized and 6 focal) occurred during the pre-eruptive stage of exanthem subitum. Four infants with encephalitis/encephalopathy had more severe clinical features with abnormalities demonstrated on electroencephalograms and cerebral computed tomograms. All infants except those with encephalitis/encephalopathy recovered without any sequelae. One infant with encephalitis/encephalopathy developed epilepsy and another one died. Human herpesvirus 6 DNA amplified by the nested polymerase chain reaction method was detected in the cerebrospinal fluid of 6 infants, including 3 with encephalitis/encephalopathy, of 11 patients examined by the fifth day of the illness. These findings suggest that CNS complications including encephalitis/encephalopathy occur at the pre-eruptive stage of exanthem subitum, that human herpesvirus 6 invades the CNS in some patients, and that the outcome is not always benign.

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IgE-mediated mechanisms are important in immediate hypersensitive reactions (IHR) to buckwheat. However, a part of subjects with high IgE for buckwheat show no IHR to buckwheat ingestion. Inspite of cross-allergenicity between buckwheat and rice, rice ingestion rarely induces IHR even in subjects with high IgE for rice unlike buckwheat-induced IHR. We speculated that there were some relationships between the presence of IHR to buckwheat and recognition of cross-allergenic determinants on buckwheat components with rice components. We examined IgE-RAST for rice in 58 subjects with positive IgE-RAST for buckwheat. IgE-RAST for Dermatophagoides pteronyssinus (Dp), egg white and cow's milk as unrelated antigens with rice were also assessed for a comparison. Subjects (n = 33) without IHR to buckwheat showed higher IgE-RAST values for rice than those (n = 25) with IHR, whereas there were no differences in IgE-RAST values for Dp, egg white and cow's milk between two groups with and without IHR. IgE-RAST values for buckwheat showed significant close correlations to those for rice in subjects without IHR to buckwheat but not in those with IHR. There were no significant correlations between IgE-RAST values for buckwheat and for Dp, egg white or cow's milk in both groups with and without IHR. These results suggested that the IgE from subjects without IHR to buckwheat recognized cross-allergenic determinants with rice on the buckwheat components.

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The authors investigated the influence of facial tonsillar hypertrophy to physical growth, and diseases of the nose and the ear for 7190 pupils of elementary schools in nine different areas in Japan. Tonsillar hypertrophy seemed to prevent physical growth of pupils of lower grades. In pupils without tonsillar hypertrophy, the number of pupils suffering from rhinitis gradually decreased from 16.9% in the first grade to 8% in the sixth degree. On the other hand, the number of pupils suffering from rhinitis remained to be large, ranging between 20.5% and 29.7% in the group of tonsillar hypertrophy. The number of pupils with hearing loss were much more in the group of tonsillar hypertrophy. Since an only available diagnostic mean of ear disease was an otoscopic examination, a significant number of pupils with serous otitis media may be labeled as hearing loss. For this reason, tonsillar hypertrophy possibly affected the number of pupils with hearing loss. There were no apparent relations between tonsillar hypertrophy and allergic rhinitis, chronic paranasal sinusitis and chronic otitis media.

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The authors examined degree of facial tonsillar hypertrophy for 7190 pupils of elementary schools in nine different areas in Japan. The frequency of the third degree of tonsillar hypertrophy, based on Mackenzie's criteria, decreased gradually from 6.9% of the first-year pupils to 2.9% of the sixth-year pupils with a mean of 4.8%. We also studied the relation between the degree of tonsillar hypertrophy of each pupil and the reply to the questionnaire from his or her teacher regarding various aspects of his or her school-life. The third degree of tonsillar hypertrophy of each pupil and the reply to the questionnaire from his or her teacher regarding various aspects of his or her school-life. The third degree of tonsillar hypertrophy seemed to affect school-life of pupils. For example, the frequency of pupils whose speech can be clearly recognized, was less in pupils with the third degree of tonsillar hypertrophy than in pupils without any tonsillar hypertrophy. Pupils of higher grades with the third degree of tonsillar hypertrophy were classified into two groups. One was the pupils whose school-life was not altered by tonsillar hypertrophy. The other was the pupils who were often absent from school due to chronic or acute tonsillar inflammation.

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Mice showed a marked suppression of motility when placed in the same environment where they had been given electric shocks (ES) 24 h before. This conditioned suppression of motility (CS) was attenuated by the administration of cycloheximide (CXM, 25-150 mg/kg) immediately after ES treatment in a dose-dependent manner. CXM (50 mg/kg) administered 1 h after ES failed to attenuate the CS. These effects seem to be caused by retrograde amnesia. Furthermore, the amnesic action of CXM was antagonized by naloxone (10 mg/kg), which did not affect CS. Physostigmine (0.2 mg/kg), propranolol (1 mg/kg) and cyproheptadine (2 mg/kg) did not antagonize CXM-induced amnesia significantly. In the same way, the amnesia-inducing actions of phencyclidine and scopolamine were detected. The CS method seems to be useful to examine learning and memory performances in animals and has the advantage that evaluation is extremely easy.

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