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Aim: To evaluate cornea and corneal biomechanical properties of patients with Fuchs heterochromic iridocylitis. Materials and Methods: Fourteen FHI positive eyes (Group 1) and the contralateral healthy eyes (Group 2) were included. All patients underwent a detailed ophthalmic examination was performed. Also, Ocular Response Analyzer was used to detect corneal biomechanical properties, and specular microscopic evaluation for corneal endothelial cells count was performed. Results: The mean best corrected visual acuity and intraocular pressure were statistically similar. (p values were 0.077 and 0.557, respectively). Corneal biomechanical properties including corneal hysteresis, corneal resistance factor, IOPcc and IOPg were not statistically significant. (p values were 0.521, 0.817, 0.980 and 0.980, respectively). Mean central corneal thickness in Group 1 and 2 were 555.57±42.95 (467-626), 556.5±37.04 (480-623) micrometer, respectively. The difference was not statistically significant (p=0.959). Mean corneal endothelial cell density of Group 1 and Group 2 were 2313±420.22 (1271-2717) and 2404.42±326.75 (1566-2834) cells/mm2, respectively. The difference was not statistically significant (p=0.626). Conclusion: Conflicting with the literature, no differences were detected in corneal biomechanical properties, central corneal thickness and corneal endothelial cell density in Fuchs Heterochromic Iridocyclitis positive eyes. However, more studies with increasing number of patients are still needed.

The acoustic comfort level of a passenger vehicle is one of the most critical factors that affect customer preferences before purchasing. Recent studies on refining the engine noise lead to a more evident panorama for tire and wind noise due to the elimination of the masking effect of the engine. Furthermore, replacing the internal combustion engine with the electric motor will also push road noise to be the primary noise factor in vehicles. In this study, the road noise phenomenon is analyzed for both structure-borne and air-borne paths. Transfer path analyses and panel contribution analyses were performed on a reference vehicle to identify the main paths of road noise. Solutions to improve road noise levels were determined accordingly. Finally, improvements were confirmed by physical tests and subjective evaluations.

Acute myeloid leukemia (AML) is the most common form of acute leukemia and has the lowest 5-year survival rates. Current treatment strategies do not meet the expectations also. Therefore, there is a need to improve therapeutic approaches still. Boron, which is a natural trace element in human diet, is gaining attention with its important roles in cellular processes for the development of new anti-cancer drug candidates. For instance, bortezomib, a dipeptidyl boronic acid, has encouraging results in the treatment of multiple myeloma and mantle cell lymphoma. However, severe toxic effects and resistance development are the limitations to its application for AML treatment. Hence, the development of alternative boron-derived anti-AML agents is unmet need. Therefore, we aimed to evaluate anti-leukemic effect of two promising boron compounds, borax pentahydrate (BP) and disodium pentaborate decahydrate (DPD), and comparison of each other in terms of the capacity to trigger apoptosis on acute promyelocytic leukemia cells (HL-60). Cell viability was assessed by MTT assay. Apoptotic effects of the boron compounds on HL-60 cells were evaluated by annexin V/propidium iodide dyes and caspase 3/7 activity assay by flow cytometry. In addition, Bax/Bcl-2 and cleaved PARP levels were detected by western blotting. Although BP showed greater apoptosis-inducing capacity, we observed that both DPD (6 mM) and BP (24 mM) treatment showed anti-leukemic effect by triggering apoptotic pathway through increasing Bax/Bcl-2 ratio for the first time. Our study suggests that BP and DPD are the promising candidates for anti-AML drug development research, which may be confirmed by further wide-spectrum studies.

Amaç: Kronik Miyeloid Lösemi (KML), hematopoetik kök hücreden (HKH) köken alan miyeloproliferatif bir hastalıktır. MikroRNA'lar, transkripsiyon sonrası gen ekspresyonunu düzenlenleyen küçük kodlamayan RNA’lardır. miRNA’lar KML’nin progresyonunda, lösemik kök hücre büyümesi ve tirozin kinaz inhibitörü (TKİ) direncinin gelişmesinde hücre homeostazisini etkilemektedirler. Bu çalışmada KML lösemik hücresi ve KML lösemik kök hücresi (LKH) arasında değişen miRNA ekspresyon profillerinin incelenmesi amaçlanmıştır. Gereç ve yöntem: KML hücre hattı olan K562 hücrelerinden, manyetik hücre ayrımlama (MACS) yöntemi kullanılarak CD34+CD38- lösemik kök hücreleri ayrımlanmıştır. Ayrımlanan LKH’lerin saflığının %85-92 arasında olduğu akım sitometri yöntemi ile gösterilmiştir. K562 ve K562 LKH’leri arasında, gerçek zamanlı kantitatif PCR ile kanser kök hücre ilişkili 84 adet miRNA’nın ekspresyon değişimleri incelenmiştir. Bulgular: K562 ve K562 LKH’leri arasında, kök hücre ilişkili olduğu bilinen 84 adet miRNA’dan 7’sinin anlamlı düzeyde değiştiğini gözledik (P

Objectives: Microglial cells are the central regulators of inflammatory responses in the brain and spinal cord. In addition to surveillance during resting state, they become activated due to microbial molecules and pathological insults. Endogenously expressed Activated protein C (APC) is an anticoagulant molecule with anti-inflammatory and cytoprotective roles, mediated by one of its receptors, Endothelial protein C receptor (EPCR). This study aimed to examine the basal and inducible expression of EPCR and unravel the regulatory mediators of its expression in microglia. Methods: We studied probable effects of Lipopolysaccharide (LPS), Peptidoglycan (PGN), and Polyinosinic–polycytidylic acid [Poly(I:C)] on EPCR mRNA and protein levels in N9 mouse microglial cells by qPCR and flow cytometry. Then, Cyclosporin A (CsA) and Mithramycin A (MMA) were used to inhibit transcription factors in the promoter region of the EPCR gene, which are Nuclear factor of activated T-cells, cytoplasmic 1 (NFATC1), and specificity protein 1 (Sp1). Results: As a result, the Sp1 transcription factor’s chemical inhibition impaired the upregulating effects of LPS and PGN on EPCR expression. Conclusion: Thus, our data suggest that LPS and PGN gave rise to increased EPCR levels in microglia, mainly through the Sp1 transcription factor.

EgeUn###, Purpose: To investigate the effect of 1% tropicamide on anterior chamber aqueous flare (ACAF) measurements acquired with laser flare meter in patients with pseudoexfoliation. Methods: Thirty-three eyes of 33 patients with pseudoexfoliation were enrolled. Patients with the history of other ocular diseases, intraocular surgeries, and the presence of severe posterior synechia were excluded. Besides routine ophthalmological examination, ACAF levels were measured by laser flare meter device (Kowa FM 600) before and after instillation of 1% tropicamide. Results: The mean age of 33 patients was 67.3 +/- 7.1 (53-85) years. Patients had a mean best corrected visual acuity of 0.25 +/- 0.41 (1.80-0.00) logMAR, cup-to-disc ratio of 0.45 +/- 0.22 (0.2-1), and IOP of 15.33 +/- 2.82 (9-20) mmHg. Although the mean ACAF value increased from 14.68 +/- 8.40 (3.4-40.4) photon/ms predilation to 15.41 +/- 10.74 (3.8-46.8) photon/ms post-dilation, the difference was not statistically significant (p=0.835). Conclusions: ACAF values in patients with pseudoexfoliation did not significantly differ after instillation of 1% tropicamide., Ege UniversityEge University [2013-TIP-106], This study was supported by Ege University scientific research project number [2013-TIP-106].

Tyrosine kinase inhibitor (TKI) resistance is a major problem in chronic myeloid leukemia (CML). We generated a TKI-resistant K562 sub-population, K562-IR, under selective imatinib-mesylate pressure. K562-IR cells are CD34(-)/CD38(-), BCR-Abl-independent, proliferate slowly, highly adherent and form intact tumor spheroids. Loss of CD45 and other hematopoietic markers reveal these cells have diverged from their hematopoietic origin. CD34 negativity, high expression of E-cadherin and CD44; decreased levels of CD45 and beta-catenin do not fully confer with the leukemic stem cell (LSC) phenotype. Expression analyses reveal that K562-IR cells differentially express tissue/ organ development and differentiation genes. Our data suggest that the observed phenotypic shift is an adaptive process rendering cells under TKI stress to become oncogene independent. Cells develop transcriptional instability in search for a gene expression framework suitable for new environmental stresses, resulting in an adaptive phenotypic shift in which some cells partially display LSC-like properties. With leukemic/cancer stem cell targeted therapies underway, the difference between treating an entity and a spectrum of dynamic cellular states will have conclusive effects on the outcome., Dokuz Eylul University Scientific Research ProjectsDokuz Eylul University [:2012KBSAG092, 2009KBSAG029], Dokuz Eylul University Scientific Research Projects, grants no:2012KBSAG092 and 2009KBSAG029. the funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Purpose: Acute myeloid leukemia is the most common form of acute leukemia with genetic and epigenetic heterogeneity. Although current therapeutic agents provide successful remission, 5-year survival rates are still low. Insufficiency of targeting leukemia stem cells is considered as the main obstacle that causes drug resistance and relapse. Phytochemicals remain a promising source for targeted drug research. Studies showed that Casticin has antiproliferative effects on leukemic cells, but its effects on leukemic stem cells are still unclear. In this study, we aimed to investigate the antiproliferative capacity of Casticin on acute myeloid leukemia stem-like KG1a cells and its relatively mature parental KG1 cells in comparison with healthy peripheral blood mononuclear cells PBMC . Method: The antiproliferative effects of Casticin on cells and IC50 values were determined by MTT test. The effects of Casticin on caspase 3/7 activity, apoptosis and necrosis in cells were evaluated by flow cytometry and TUNEL assays. Results: 2 μM Casticin treatment for 24 h was increased apoptotic cell death and caspase 3/7 activation in KG1 27.2%; 17.30%; p

PurposeTo investigate the effects of 1% cyclopentolate hydrochloride and 1% tropicamide eye drops on aqueous flare measurements by using the laser flare meter.MethodsOne hundred forty eight eyes of 83 patients with inactive uveitis were enrolled. The patients were randomly assigned to receive either 1% tropicamide (Group 1) or 1% cyclopentolate hydrochloride (Group 2) as the mydriatic agent. Best corrected visual acuity (BCVA), intraocular pressure (IOP), aqueous flare reaction levels measured by laser flare meter device (FM 600, Kowa, Kowa Company Ltd, Nagoya, Japan) before and post dilatation agents were evaluated.ResultsGroup 1 consisted of 75 eyes and Group 2 consisted of 77 eyes. The mean age of Group 1 patients was 34.8512.60 (range, 12-64) years; the mean age of Group 2 was 36.92 +/- 13.30 (range, 12-70) years (p>0.05). The mean BCVAs of two groups were 0.16 +/- 0.43 (range, 0.00-3.10) logMAR and 0.17 +/- 0.42 (range, 0.00-3.10) logMAR, respectively. There were no statistically significant differences between Groups 1 and 2 regarding gender or clinical characteristics (p>0.05). No significant differences were detected in pre- or post-dilatation values between two groups (p=0.470, p=0.998).Conclusions As a result, anterior chamber flare values in uveitis patients do not differ significantly between 1% tropicamide and 1% cyclopentolate hydrochloride, and both agents can be safely used for dilatation during examination of patients with uveitis., 2013-TIP-106, This study was produced from Ege University scientific research project number 2013-TIP-106.

To evaluate the effect of bimatoprost/timolol maleate fixed combination (BTFC), latanoprost/timolol maleate fixed combination (LTFC), and travoprost/timolol maleate fixed combination (TTFC) on 24-h intraocular pressure (IOP) in patients with open-angle glaucoma. This prospective, observer-masked, randomized study included 50 patients with primary open-angle glaucoma. All patients were using hypotensive lipids and timolol maleate fixed combination treatment for ≥4 weeks and had an IOP ≤ 21 mmHg. Group 1 (n = 18) received BTFC, group 2 (n = 14) received LTFC, and group 3 (n = 18) received TTFC. All patients were hospitalized, and IOP was monitored for 24-h (10:00, 14:00, 18:00, 22:00, 02:00, and 06:00). Mean diurnal IOP variation measurements were taken between 06:00 and 18:00, and mean nocturnal IOP variation measurements were taken between 22:00 and 02:00. Mean IOP and IOP variation in the three groups were compared. Mean 24-h IOP did not differ significantly between the three groups (group 1: 14.6 ± 2.9 mmHg; group 2: 14.1 ± 3.7 mmHg and group 3: 15.8 ± 2.0 mmHg; P > 0.05). Mean diurnal IOP variation was 4.6 ± 2.3 mmHg in group 1, 5.8 ± 2.4 mmHg in group 2, and 4.3 ± 1.7 mmHg in group 3, and mean nocturnal IOP variation was 3.2 ± 2.8 mmHg in group 1, 2.9 ± 1.9 mmHg in group 2, and 3.0 ± 1.6 mmHg group 3. There were not any significant differences in diurnal or nocturnal IOP variation between the three groups (P

WOS: 000508845700008, PubMed: 32021609, Myhre syndrome is a rare autosomal dominant multisystemic disorder. Typical features of this disorder include distinctive facial appearance, deafness, intellectual disability, cardiovascular abnormalities, short stature, brachydactyly, and skeletal anomalies. Gain-of-function mutations in the SMAD4 gene are responsible for this syndrome. Herein, we present a 9.6-year-old Turkish girl with molecularly confirmed Myhre syndrome who had novel findings including bilateral Axenfield Rieger anomaly with secondary glaucoma and bilateral enlarged vestibular aqueducts.

Purpose To evaluate ocular surface changes and meibomian gland scores in patients with oligoarticular juvenile idiopathic arthritis. Materials and methods This prospective study was conducted at Ege University School of Medicine, Department of Ophthalmology. A total of 34 eyes of 17 patients with oligoarticular juvenile idiopathic arthritis and 30 right eyes of 30 age and gender-matched healthy subjects were included. Besides ophthalmic examination Schirmer 1 test, tear film break up time, Oxford staining scale and meibography were performed. Results There was no statistically significant differences between groups in terms of age, mean intraocular pressure, mean Schirmer 1 test value, tear film break up time and Oxford staining score. the median upper and lower eyelid meiboscore were 1 +/- 0.60 (IQR = 1), and 0 +/- 0.34 (IQR = 0) in Group 1, and they were 1 +/- 0.56 (IQR = 0), 1 +/- 0.12 (IQR = 1) in Group 2. Also, mean upper and lower meiboscores were statistically similar (pvalues 0.068 and 0.545, respectively). However, the median total meiboscore was 1 +/- 0.42 (IQR = 1) in Group 1 and 1 +/- 0.66 (IQR = 1) in Group 2. the difference was statistically significant (p = 0.041). Conclusion Aqueous-deficient dry eye is a well-known condition in patients with rheumatologic diseases. However, evaporative dry eye and meibomian glands were not studied earlier. the current study demonstrated that total meiboscores of oligoarticular juvenile idiopathic arthritis patients are higher than normal subjects, which indicates a possible evaporative dry eye tendency in this entity.

Thromboembolism is one of the most common complications during induction therapy of pediatric acute lymphoblastic leukemia (ALL). Procoagulant microparticles in the circulation may cause thromboembolic events. The aim of our study was to determine the levels of apoptotic, platelet-derived, endothelial-derived, and tissue factor-positive microparticles of children with ALL at diagnosis and during induction therapy.Sixteen precursor B-cell ALL cases and 30 healthy children between 1 and 18 years of age were included. Microparticle levels were analyzed from peripheral blood samples at initial diagnosis, on days 12 and 13 (before and after the first L-asparaginase administration), and on day 33 of ALL-BFM 2000 treatment protocol. Microparticle levels were analyzed by using flow cytometry.At initial diagnosis, platelet, endothelial-derived, and tissue factor-positive microparticle levels were significantly high in children with ALL. They increased significantly after prednisone and L-asparaginase administration. Apoptotic microparticle levels were not elevated at diagnosis, but remained high during all induction therapy period. None of the patients had evidence of thromboembolism during induction therapy.Our study demonstrated that children with ALL have increased levels of apoptotic, platelet-derived, endothelial-derived, and tissue factor-positive microprticles during induction therapy. Further studies are needed in larger groups of patients in order to evaluate the risk of elevated microprticles for development of thromboembolism during induction therapy period in children with ALL.

Background:Anaplastic Thyroid Cancer (ATC) is one of the most lethal and aggressive human malignancies. Studies have shown that Cancer Stem-Cell (CSC) phenotype is mainly responsible for ATC aggressiveness. Cytostatic compounds are mostly ineffective because of multidrug resistance mechanisms driven by the CSC phenotype. Taxanes have limited efficacy. Recently, CSC inhibition using plant-derived, less toxic compounds, which have anti-cancer efficacy, has become a novel treatment modality. The aim of the study was to evaluate the anti-cancer activity of two natural compounds (curcumin and deguelin) on ATC cells and their CSC properties. In addition, the efficacies of these compounds were compared with that of docetaxel.Methods:Besides control, five treatment groups were formed. ATC cells (CAL-62) were treated with curcumin, deguelin, docetaxel, and their combinations (curcumin+docetaxel, deguelin+docetaxel) at previously determined IC50 doses. Stemness was analyzed by quantitative estimation of sphere formation in matrigel, expression of several cell surface markers (CD133, CD90, Nanog, and OCT3/4) using flow cytometry, and quantification of the hypoxic status [Oxidative Stress Index (OSI) and Superoxide Dismutase (SOD) activity]. The anti-cancer efficacies of these compounds and their combinations were evaluated by determining the alterations in the cell cycle, apoptosis, and tumoral cell migration.Results:Both the natural compounds (particularly curcumin) significantly suppressed the spheroid formation and cellular motility in matrigel as well as suppressed the accumulation of cells in the G0/1 phase, in which the maximum CSC activity is observed. The compounds did not suppress the expression of CSC markers, but twothirds of the cells expressed CD90. Deguelin was found to be particularly effective in inducing apoptosis similar to docetaxel at IC50 concentrations. Curcumin reduced the OSI and deguelin enhanced the SOD activity, even in docetaxel pre-treated cells.Conclusion:A large proportion of anaplastic tumors might consist of heterogeneous CSC population. Curcumin and deguelin have anti-cancer and several anti-stem cell activities against ATC cells. These natural compounds are capable of altering the aggressive behavior of ATC cells through the inhibition of the CSC phenotype. As a novel therapeutic target, CD90 should be investigated in other ATC cell lines and in vivo models.

WOS: 000491942400027, PubMed: 30710254, PurposeRetinal vasculitis and vein occlusions are common causes of serious visual loss in Behcet's disease. We aimed to evaluate the optical coherence tomography angiography (OCTA) findings of Behcet uveitis (BU) patients.MethodsWe evaluated 32 eyes of 16 patients with BU and 30 eyes of 15 healthy controls. Superficial capillary plexus (SCP) and deeper capillary plexuses (DCP) were evaluated using OCTA RTVue XR AVANTI.ResultsOn SCP, nonperfusion/hypoperfusion areas (NPA) were seen in 10 eyes, perifoveal capillary arcade disruption (PCAD) was seen in 10 eyes, capillary network disorganization (CND) was seen in 7 eyes and intraretinal cystoid spaces (ICS) were seen in 2 eyes. on DCP, NPA were seen in 13 eyes, PCAD was seen in 11 eyes, CND was seen in 7 eyes and ICS were seen in 4 eyes.ConclusionWe showed that DCP were affected more than SCP in these patients. in addition, capillary vessel density of BU group was significantly lower than control group.

EgeUn###, Purpose: To evaluate the ocular surface and meibography of patients with inactive Behçet’s uveitis. Methods: Twenty-five right eyes of 25 patients with inactive Behçet’s uveitis (Group 1) and 25 right eyes of 25 healthy individuals (Group 2) were enrolled. Detailed eye examination along with Schirmer 1 test, tear film break-up time (t-BUT), ocular surface staining with fluorescein and Oxford scoring, and ocular surface disease index (OSDI) score assessment were performed. Lower and upper eyelid Meibomian glands were examined with infrared filter of slit-lamp biomicroscope (SL-D701 with DC-4 digital camera and BG-5 background illuminator, TOPCON, Tokyo, Japan (from grade 0 (no dropout of Meibomian glands) to grade 3 (gland dropout >2/3 of the total Meibomian glands)). Results: The mean ages were 36.84 ± 7.39 (range, 23–59) and 33.88 ± 8.25 (range, 18–55) in Group 1 and Group 2, respectively (p = 0.547). When compared with Group 2, in Group 1, best-corrected visual acuity (0.28 vs. 0.00 logMAR, p

Purpose To evaluate the efficacy and safety of Ex-PRESS mini glaucoma shunt implantation with preoperative intracameral bevacizumab injection in eyes with refractory neovascular glaucoma. Methods A retrospective chart review of patients with medically uncontrolled neovascular glaucoma who had received 50-µL intracameral bevacizumab (1.25 mg) before undergoing Ex-PRESS mini glaucoma shunt implantation was performed. Success was defined as a postoperative intraocular pressure (IOP) between 5 and 21 mm Hg without (complete success) or with or without (qualified success) glaucoma medications and no additional glaucoma surgery, or loss of light perception. Results In total, 33 eyes of 33 patients (15 female, 18 male) were enrolled in the study. The mean age of the study population was 61.2 years (range 36-78). The mean IOP decreased from 41.0 mm Hg (range 24-72) to 17.6 mm Hg (range 8-28) over a mean follow-up of 20.9 months (range 6-60) (pConclusions Ex-PRESS mini glaucoma shunt implantation with preoperative bevacizumab injection may be an effective alternative procedure for refractory neovascular glaucoma.

Hilal Kocdor,1,2 Halil Ates,1 Suleyman Aydin,3 Ruksan Cehreli,1 Firat Soyarat,2 Pinar Kemanli,2 Duygu Harmanci,2 Hakan Cengiz,2 Mehmet Ali Kocdor4 1Institute of Oncology, Dokuz Eylul University, 2Department of Molecular Medicine, Institute of Health Sciences, Dokuz Eylul University, Izmir Turkey; 3Department of Biochemistry, Firat University School of Medicine, Elazig, 4Department of Surgery, School of Medicine, Dokuz Eylul University, Izmir, Turkey Background: Exposure to exogenous zinc results in increased apoptosis, growth inhibition, and altered oxidative stress in cancer cells. Previous studies also suggested that zinc sensitizes some cancer cells to cytotoxic agents depending on the p53 status. Therefore, zinc supplementation may show anticancer efficacy solely and may increase docetaxel-induced cytotoxicity in non-small-cell lung cancer cells.Methods: Here, we report the effects of several concentrations of zinc combined with docetaxel on p53-wild-type (A549) and p53-null (H1299) cells. We evaluated cellular viability, apoptosis, and cell cycle progression as well as oxidative stress parameters, including superoxide dismutase, glutathione peroxidase, and malondialdehyde levels.Results: Zinc reduced the viability of A549 cells and increased the apoptotic response in both cell lines in a dose-dependent manner. Zinc also amplified the docetaxel effects and reduced its inhibitory concentration 50 (IC50) values. The superoxide dismutase levels increased in all treatment groups; however, glutathione peroxidase was slightly increased in the combination treatments. Zinc also caused malondialdehyde elevations at 50µM and 100µM.Conclusion: Zinc has anticancer efficacy against non-small-cell lung cancer cells in the presence of functionally active p53 and enhances docetaxel efficacy in both p53-wild-type and p53-deficient cancer cells. Keywords: lung cancer, zinc, docetaxel, A549, H1299

WOS: 000383720500009, PubMed ID: 27330389, Bilateral acute iris transillumination (BAIT) is a recently defined disease characterized with bilateral acute, severe pigment dispersion of iris and pupil sphincter paralysis. The etiopathogenesis of the disease is unknown, but antibiotics such as moxifloxacin, clarithromycin, viral infections, and fumigation therapies were considered as probable etiologic factors. A 33-year-old female was referred to our clinic for acute iridocyclitis refractory to azathioprine, colchicum and corticosteroid treatments. Ophthalmic examination revealed bilateral pigment dispersion, significant iris transillumination, heavy pigment deposition in iridocorneal angle, and elevated intraocular pressure. Upon systemic evaluation she was found to have bacterial urinary tract infection. BAIT is an important cause of pigment dispersion and clinicians must be vigilant for this condition to avoid unnecessary diagnostic tests and treatment.

To evaluate the clinical findings and possible risk factors of patients with aphakic glaucoma following congenital cataract surgery and identify the factors affecting response to glaucoma treatment. A retrospective chart review of 173 patients was performed who underwent congenital cataract surgery before the age of 12 months and 40 eyes of 25 patients with aphakic glaucoma were enrolled. Age of the patients at the time of the cataract surgery, postoperative complications, additional ocular pathologies and the type of glaucoma treatment needed were investigated. Mean age of 25 patients at the time of cataract surgery was 3.31 ± 2.28 (range 1–11) months with a mean follow-up period of 79 ± 30.5 (32–176) months. Out of 40 eyes, medical therapy was effective in 20 (50%) eyes, whereas 20 (50%) eyes needed surgery for glaucoma. In these 20 eyes, 6 (30%) eyes underwent only 1, 4 (20%) eyes underwent 2 and 10 (50%) eyes underwent 3 or more procedures. Age at the time of cataract surgery, pupillary membrane formation and additional ocular pathologies were not significantly associated both with the need for glaucoma surgery or the number of operations (p ≥ 0.05). Aphakic glaucoma following congenital cataract surgery is a serious complication which requires surgery in half (50%) of the patients. Usually, more than one surgical procedure (70%) is needed. It can be detected even years after cataract surgery (range 0.3–94 months), so long-term careful follow-up is necessary.

To investigate the correlation of Scheimpflug camera system and two noncontact specular microscopes in terms of central corneal thickness (CCT) and corneal endothelial cell morphology measurements. One hundred eyes of 50 healthy subjects were examined by Pentacam Scheimpflug Analyzer, CEM-530 (Nidek Co, Ltd, Gamagori, Japan) and CellChek XL (Konan Medical, California, USA) via fully automated image analysis with no corrections made. Measurement differences and agreement between instruments were determined by intraclass correlation analysis. The mean age of the subjects was 36.74 ± 8.59 (range 22–57). CCTs were well correlated among all devices, with having CEM-530 the thinnest and CellChek XL the thickest measurements (intraclass correlation coefficient (ICC) = 0.83; p

ResumenJustificativa y objetivos: La elevación de la presión intraocular (PIO), que disminuye la presión de perfusión del nervio óptico, es aumentada por el posicionamiento en decúbito ventral. El objetivo de nuestro estudio, fue comparar el efecto de la rotación lateral de la cabeza a 45o en decúbito ventral en el aumento de la PIO de ojos posicionados hacia arriba y ojos posicionados hacia abajo en pacientes sometidos a la nefrolitotomia percutánea (NLPC).Métodos: Cuarenta y cinco pacientes fueron aleatoriamente divididos en dos grupos. La PIO de los pacientes fue registrada bilateralmente en posición supina antes del inicio de la operación. Los pacientes fueron posicionados en decúbito ventral. La cabeza fue posicionada sobre un apoyo sin compresión externa directa en ambos ojos. Los pacientes del Grupo I fueron estrictamente mantenidos en pronación neutra, mientras que los pacientes del Grupo II fueron posicionados en pronación con rotación de la cabeza a 45° hacia el lado derecho. Al final de la operación, los pacientes fueron reposicionados en supinación y la PIO fue inmediatamente medida. Resultados: No hubo diferencia entre los datos demográficos, la duración de la cirugía, la pérdida de sangre y la reposición de líquido de los pacientes. Los valores postquirúrgicos de la PIO en decúbito ventral aumentaron significativamente en comparación con los valores preoperatorios en ambos grupos (p < 0,05). Después de la cirugía en decúbito ventral, los valores de la PIO en los ojos posicionados hacia arriba en el Grupo II fueron significativamente menores que en el Grupo I y en los ojos posicionados hacia abajo en el Grupo II (p < 0,05).Conclusiones: La posición en decúbito ventral aumenta la PIO. En los pacientes posicionados en decúbito ventral con rotación lateral de la cabeza a 45o, la PIO en los ojos posicionados hacia arriba fue significativamente menor.

To evaluate the learning curve of non-penetrating glaucoma surgery (NPGS). The study included 32 eyes of 27 patients’ (20 male and 7 female) with medically uncontrolled glaucoma. Non-penetrating glaucoma surgeries performed by trainees under control of an experienced surgeon between 2005 and 2007 at our tertiary referral hospital were evaluated. Residents were separated into two groups. Humanistic training model applied to the one in the first group, he studied with experimental models before performing NPGS. Two residents in the second group performed NPGS after a conventional training model. Surgeries of the residents were recorded on video and intraoperative parameters were scored by the experienced surgeon at the end of the study. Postoperative intraocular pressure, absolute and total success rates were analyzed. In the first group 19 eyes of 16 patients and in the second group 13 eyes of 11 patients had been operated by residents. Intraoperative parameters and complication rates were not statistically significant between groups (p > 0.05, Chi-square). The duration of surgery was 32.7 ± 5.6 min in the first group and 45 ± 3.8 min in the second group. The difference was statistically significant (p

It has been shown that imatinib mesylate, a drug used in the treatment of chronic myelogenous leukemia, inhibits the effect of stem cell factor, which has a central role in erythropoiesis. In some polycythemia vera (PV) patients, it has inhibited autonomous erythroid colony growth in vitro and decreased the need for phlebotomy. In this study we have investigated the effect of insulin like growth factor (IGF)-I, stem cell factor (SCF) and erythropoietin (Epo) with interleukin (IL)-3, granulocyte macrophage-colony stimulating factor (GM-CSF) and granulocyte-colony stimulating factor (G-CSF) in the presence of imatinib mesylate on the erythroid progenitors derived from peripheral blood mononuclear cells of three patients with PV and four healthy controls in semisolid medium. Erythroid colony formation from hematopoietic progenitors obtained from healthy controls was observed only in the presence of all cytokines. However, the number of erythroid colonies could not reach that of patients with PV. Inhibition of imatinib mesylate on erythroid colony growth was evident. Hematopoietic progenitors of patients with PV displayed two types of colony formation: the first type was exogenous cytokine-independent and was hypersensitive to current cytokines, and the second displayed hypersensitivity to current exogenous cytokines, but was exogenous cytokine-dependent. For both types, the inhibitory effect of imatinib mesylate was striking in the presence of all cytokines including IL-3, GM-CSF and Epo. There is no direct evidence yet that imatinib mesylate could inhibit the effect of IL-3, G-CSF, GM-CSF, Epo and IGF-I on erythropoiesis. Considering former studies together with results of this study, it can be argued that imatinib mesylate is effective in PV on the intersecting signal transduction mechanisms in which stem cell factor and its receptor may have a part.Kronik myeloid lösemi tedavisinde kullanılan imatinib mesilat aynı zamanda kök hücre faktörünü de inhibe etmektedir. Imatinib mesilatın bazı polistemia veralı hastalarda otonom eritroid koloni gelişimini inhibe ettiği ve flebotomi ihtiyacını azalttığı da gösterilmiştir. Bu çalışmada, imatinib mesilat varlığında, polistemia veralı üç hasta ile sağlıklı dört kontrolden elde edilen periferik kan eritroid öncül hücreleri üzerine yarı-katı ortamda insülin benzeri büyüme faktörü-l (IGF-l), kök hücre faktörü (SCF) ve eritropoietin (EPO) ile interlökin-3 (IL-3), granülosit-koloni stimule edici faktörün (GM-CSF) ve granülosit-koloni stimule edici faktörünün (G-CSF) etkisi araştırıldı. Sağlıklı kontrollerden elde edilen hematopoietik öncü hücrelerden eritroid koloni gelişimi sadece tüm sitokinlerin varlığında gözlendi. Bununla birlikte eritroid kolonilerin sayısı polistemia veralı hastalardan elde edilen sayılara ulaşamadı. Imatinib mesilatın eritroid koloni gelişimi üzerindeki inhibe edici etkisi belirgindi. Polistemia veralı hastaların hematopoietik öncüllerinden iki tip eritroid koloni gelişimi gözlendi; ilki eksojen sitokinlerden bağımsız ve sitokinlere aşırı duyarlılık gösteren, ikincisi ise eksojen sitokinlere aşırı duyarlılık gösteren tip idi. Her iki tipte de IL-3, GM-CSF ve EPO de dahil olmak üzere, sitokinlerin varlığında imatinib mesilatın inhibe edici etkisi belirgindi. Imatinib mesilatın bu etkisinin IL-3, G-CSF, GM-CSF, EPO ve IGF-l üzerine olduğunu söylemek için henüz yeterli kanıt yoktur. Bu çalışmanın sonuçları daha önceki çalışmalardan elde edilen bilgilerle birlikte değerlendirildiğinde, imatinib mesilatın eritroid koloni gelişimini inhibe edici etkisinin kök hücre faktörünün ve reseptörlerinin rol aldığı sinyal ileti yolları üzerinden olduğu söylenebilir.

Fludarabine-containing combinations have additive cell killing against leukemic blasts in vitro. It has also been shown that imatinib mesylate combined with fludarabine or cladribine had an additive effect on CML CFU-GM cells. In this regard, we aimed to investigate the effect of fludarabine-imatinib mesylate combination against CML blastic phase cell lines K562 and Meg-01. XTT test was performed for proliferation and inhibition assay. According to obtained data, five different effective concentrations of each drug in 25 different combinations were tested. Results of the combination studies were analyzed with isobologram. At IC20, imatinib mesylate and fludarabine combination showed synergism and strong synergism in K562 and Meg-01 cells, respectively. At IC50 and IC75, combination indexes (CI) indicated strong synergism and synergism. Based on our results, the fludarabine- based chemotherapy regimens can be used for those patients with CML blastic phase in combination with imatinib mesylate.In vitro koşullarda fludarabin içeren kombinasyonların lösemik blastlar üzerinde ve fludarabin ya da kladribinin imatinib mesilat ile kombinasyonlarının KML CFU-GM hücrelerine karşı aditif etkinliğe sahip oldukları gösterilmiştir. Bu gözlemlere dayanarak biz de fludarabin ve imatinib mesilat kombinasyonunun KML blastik faz hücre serileri K562 ve Meg-01 üzerine olan etkinliğini araştırmayı planladık. Proliferasyon ve inhibisyon göstergesi olarak XTT testini kullandık. Elde edilen verilere göre, her ilacın beş farklı etkin konsantrasyonu 25 farklı kombinasyon halinde test edildi. Kombinasyon çalışmalarının sonuçları izobologram ile analiz edildi. İmatinib mesilat ve fludarabinin kombinasyonunun K562 ve Meg-01 hücre serileri için IC20 kombinasyon indeksi değerleri sırası ile sinerjistik ve güçlü sinerjistik, IC50 ve IC75 değerlerinde de güçlü sinerjistik ve sinerjistik etkinliği göstermekte idi. Bu sonuçlar KML blastik fazdaki hastalar için imatinib mesilat ile kombine edilen fludarabin bazlı rejimlerin kullanılabileceğini göstermektedir.

Multiple myeloma (MM) is characterized by malignant proliferation of plasmocytes and their precursors. T regulatory cells (Tregs) have a role in immunosuppression and control of autoimmunity, and are currently an important topic in the study of immune response to tumor cells. The correlation between Tregs and autologous peripheral blood stem cell transplantation (APBSCT) in MM has not been studied. The aim of this study was to compare CD4+CD25+FOXP3+ Treg, CD200, and PD-1 levels in MM patients that did and did not undergo APBSCT.Peripheral blood samples were collected from 28 MM patients ranging in age from 41 to 78 years for analysis of CD4CD25+ FOXP3+ Tregs, PD-1 (CD279), and CD200. Peripheral blood mononuclear cells were isolated via density gradient centrifugation. Four-color flow cytometry was performed. Using a sequential gating strategy, Tregs were identified as CD4+CD25+FOXP3+ T-cells. Results were analyzed using the Mann Whitney U non-parametric test and a compare means test. p values0.05 were considered statistically significant.The study included 28 MM patients (10 female and 18 male). In all, 11 of the patients underwent APBSCT. The level of Tregs identified as CD4+CD25+FOXP3+ T-cells was higher in the patients that underwent APBSCT (p=0.042). CD200 and PD-1 levels did not significantly differ between the 2 groups (p=0.711 and p=0.404, respectively). There weren't any statistically significant differences in CD200, PD-1, or CD4+CD25+FOXP3+ T-cell levels between the patients that did and did not undergo APBSCT (p0.05).Treg levels were higher in the patients that underwent APBSCT. Tregs are crucial for the induction and maintenance of peripheral tolerance to self-antigens. In addition, Tregs can suppress immune responses to tumor antigens; however, APBSCT and Treg levels were not correlated with CD200 or PD-1 expression. Relationship of Tregs with prognosis needs to be determined by studies that include larger cohorts.AMAÇ: Multipl miyelom (MM) plazmositlerin ve bunların öncü hücrelerinin habis proliferasyonu ile kendini gösteren bir hastalıktır. T düzenleyici (regülatör) hücreler (Treg) immünsüpresyonda ve otoimmün sistemin denetiminde rol oynarlar. Ayrıca tümör hücrelerine karşı oluşan immün yanıttaki rolleri de güncel bir araştırma konusudur. Treg hücreleri MM’da otolog çevre kanı kök hücre nakli (APBSCT) ile ilişkili olarak daha önce araştırılmamıştır. Bu çalışmanın amacı, CD4+ CD25+ FoxP3+ Treg hücreleri ile, CD200 ve PD–1 ‘in APBSCT yapılmış ve yapılmamış MM hastalarındaki düzeylerini karşılaştırmaktır. YÖNTEMLER: Yaşları 41 ile 78 arasında 28 MM hastasından CD4+ CD25+ FoxP3+ Treg hücreleri ile, CD200 ve PD–1 (CD279) analizi için çevre kanı örnekleri alındı. Mononükleer hücreler dansite gradient santrifüj yöntemi ile ayrıldı. Dört renkli akış sitometri ile uygulandı. Ardışık kapılamalar (gating) ile Treg hücreleri CD4+ CD25+ FoxP3+ T hücreleri olarak tanımlandı. Sonuçlar Mann Whitney U nonparametrik testi ve Compare Means testleri ile analiz edildi. P değerleri0.05 olanlar istatistiksel açıdan anlamlı kabul edildi.Bu çalışma 28 MM hastası (10 kadın, 18 erkek) içermektedir. Otolog çevresel kan kök hücre nakli 11 hastaya uygulanmıştır. CD4+ Treg hücreler CD4+ CD25+ FoxP3+ olarak saptanmış olup APBSCT alan hastalarda daha yüksek bulunmuştur (p=0.042). CD200 ve PD-1 iki grup arasında istatistiksel anlamlı bir sonuç göstermemiştir (sırasıyla; p=0.711 ve p=0.404). APBSCT yapılan ve yapılmayan gruplar arasında CD200, PD-1 ve CD4+CD25+FOXP3+ düzeyleri karşılaştırıldığında istatistiksel anlamlı bir sonuç bulunmamıştır (p0.05). SONUÇ: Bu çalışmada Treg hücreleri APBSCT yapılmış hastalarda daha yüksek düzeyde bulunmuştur. Treg hücrelerinin bireyin kendi hücrelerine karşı periferik toleransın indüklenmesinde ve korunmasında çok önemli rolü olduğu bilinmektedir. Buna ek olarak, Treg hücreleri tümör antijenlerine karşı oluşturulacak immün yanıtı baskılayabilmektedir. Ne var ki, çalışmamızda APBSCT veya Treg hücre düzeyleri CD200 ve PD-1 ekspresyonları ile korelasyon göstermemiştir. Prognoz ile ilişkileri daha fazla sayıda olgu grupları içeren çalışmalarla aydınlatılabilir.

WOS: 000374665200009, PubMed ID: 27800256, We present a case of transpupillary argon laser cyclophotocoagulation (TALC) in a patient with traumatic aniridia and aphakia secondary to blunt trauma who had previous bilateral trabeculectomy. Four months after the trauma the patient's intraocular pressure (IOP) rose to 35 mmHg despite topical antiglaucomatous medication. Inferior 180 degrees cyclophotocoagulation was performed with transpupillary argon laser in the first session and his IOP fell to values of 12-17 mmHg. Twelve weeks after TALC, his IOP rose to 22 mmHg and we had to apply TALC to the residual ciliary processes. Seven months later his IOP was 13 mmHg with topical dorzolamide/timolol and latanoprost administration. TALC may be an effective treatment alternative for lowering IOP in patients with visible ciliary processes who do not respond to conventional medical or laser treatment.

To evaluate the intraocular pressure (IOP) control and graft survival after Ex-PRESS mini glaucoma shunt implantation in refractory postpenetrating keratoplasty glaucoma.The study included postpenetrating keratoplasty glaucoma cases unresponsive to medical antiglaucomatous therapy in whom 15 Ex-PRESS mini glaucoma shunt implantation was carried out. All glaucoma shunt implantations were performed in a separate session after penetrating keratoplasty. Nine operations were performed under general anesthesia and 6 were performed under local anesthesia. Topical antibiotherapy and topical corticosteroids were used during the postoperative first month.Mean age of the study population was 37.4 years (range: 10 to 80 y). IOP decreased from 41.46 mm Hg (range: 26 to 80 mm Hg) to 12.06 mm Hg (range: 8 to 25 mm Hg) over a mean follow-up of 12.2 months (range: 8 to 19 mo) (P0.001; Wilcoxon signed rank test). IOP was below 21 mm Hg in 14 of 15 eyes (93.3%) with or without antiglaucomatous drugs. Complete success (IOP21 mm Hg without medication) rate was 86.6%. Average number of antiglaucomatous drug usage decreased from 3.20 (range: 2 to 4) preoperatively to 0.26 postoperatively (range: 0 to 3) (P0.001; Wilcoxon signed rank test). In 93.3% of the cases, the decrease in IOP was 30% or above postoperatively. After Ex-PRESS implantation, clear grafts remained clear while edematous grafts became clearer due to IOP decrease. Neither biomicroscopy nor pachymetry showed worsening of preoperatively opaque grafts.Ex-PRESS mini glaucoma shunt implantation may be an effective procedure for refractory postpenetrating keratoplasty glaucoma with acceptable graft failure rates in short term.

The Reichert ocular response analyzer (ORA) measures corneal biomechanical properties in vivo by monitoring and analyzing the corneal behavior when its structure is submitted to a force induced by an air jet. This study was designed to examine corneal biomechanical properties and intraocular pressure in patients with systemic sclerosis (SSc) and to compare with control eyes.ORA measurements were performed on the right eyes of 29 patients with SSc (group 1) and 29 healthy people who served as the control group (group 2). Corneal hysteresis, corneal resistance factor (CRF), and intraocular pressure [Goldmann correlated (IOPg) and corneal compensated] were recorded with ORA.Mean age of patients with SSc and control groups were 51.7 +/- 11.1 and 50.3 +/- 10.8 years, respectively. Mean (+/-SD) of the corneal hysteresis and CRF readings were 9.8 +/- 1.7 versus 9.5 +/- 1.2 mm Hg (P0.05) and 10.0 +/- 1.5 versus 9.2 +/- 1.4 mm Hg (P0.05), in groups 1 and 2, respectively. Mean (+/-SD) of the IOPg and intraocular pressure corneal-compensated recordings were 15.9 +/- 2.5 versus 14.1 +/- 2.4 mm Hg (P0.05) and 16.9 +/- 3.2 versus 15.6 +/- 2.9 mm Hg (P0.05), in groups 1 and 2, respectively. Statistical analysis revealed significant differences for CRF and IOPg between the study groups.The mean CRF and IOPg values of patients with SSc were higher when compared with normal controls. According to the results of our study, one can conclude that corneal biomechanical properties would be changed in patients with SSc and this can be determined by CRF.

Behçet’s disease (BD) is a multisystem disorder. Venous as well as arterial thrombosis is a common complication of BD but exact pathogenetic mechanism of the thrombotic tendency is not well known. This study aimed to evaluate circulating activated platelets and platelet reactivity in Behçet’s patients. Twenty-two Behçet’s patients (4 female, 18 male; mean age 38.6 ± 10.9 years) and 20 control subjects (8 female, 12 male; mean age 38.8 ± 9.4 years) were included. Those patients who had hypertension, hyperlipidemia, peripheral or coronary artery disease, hepatic or renal function abnormality, and who were using aspirin and other platelet-active drugs were excluded. Platelet activity and reactivity to adenosine diphosphate (ADP) were measured by whole blood flow cytometry. We assessed markers of platelet degranulation (P-selectin; CD62P) and the activated glycoprotein IIb/IIIa receptor (PAC1 binding to fibrinogen binding site) before and after stimulation with ADP. Platelet P-selectin expression was not significantly different between patients and control subjects both at baseline (p=0.420) and after stimulation (p=0.56). Baseline (p=0.001) and ADP-stimulated (p=0.003) PAC1 binding was significantly higher in Behçet’s patients than in the control group. Clinical activity has no effect on P-selectin expression and PAC1 binding. There is evidence of platelet activity and hyperreactivity in patients with BD and this may contribute to a prothrombotic state. In addition to aspirin, other antiplatelet drugs may be useful in the prevention and treatment of thrombosis in Behçet’s patients.

Purpose: To compare surgically induced corneal refractive change following trabeculectomy with the nonpenetrating trabecular filtering surgeries with and without implant. Setting: Department of Ophthalmology, Ege University School of Medicine, Izmir, Turkey. Methods: A consecutive series of 34 patients (34 eyes) with uncontrolled open-angle glaucoma had trabecular filtering surgery. Patients were assigned randomly to receive viscocanalostomy (12 patients), nonpenetrating deep sclerectomy (NPDS) with T-flux® implant (10 patients), and trabeculectomy (12 patients). Autokeratometry and computerized corneal videokeratoscopy with the Topcon KR-7000P autokeratorefractometer were performed preoperatively and 1 day and 1, 3, and 6 months postoperatively to analyze surgically induced keratometric and topographic astigmatism. Results: Thirty patients (11 trabeculectomy, 11 viscocanalostomy, and 8 NPDS with nonabsorbable implant) completed the study. Mean patient age was 61.7 years ± 10.9 (SD) (range 37 to 81) and did not differ among groups. Postoperative intraocular pressure (IOP) levels and visual acuity (logMAR values) did not differ among groups compared with preoperative levels. Average induced astigmatism was lower in the NPDS group than the trabeculectomy group at postoperative month 3 and 6 based on autokeratometry values ( P = .023 and .042, respectively). Nonpenetrating surgeries resulted in less induced astigmatism in the early postoperative period and less against-the-rule shift over 6 months. Conclusion: Despite larger flap size and surgical area, nonpenetrating trabecular surgeries induced less astigmatism than trabeculectomy.

Leukemic infiltration of the gingiva is most commonly reported to be associated with monocytic subtypes of acute myeloblastic leukemia (AML) but rarely with myelodysplastic syndromes (MDS). Here we report a case of CD56(+) chronic myelomonocytic leukemia (CMML) who developed gingival involvement simultaneously when the leukocyte count elevated. At that time no increase in peripheral or bone marrow blasts were observed. Gingival hypertrophy regressed with the treatment of hydroxyurea. Three months later, bone marrow blast count elevated and the patient was treated with two courses of AML-like regimen and then one course of consolidation therapy. The patient is in complete hematological remission for one and a half years. Similar to other extramedullary involvements, gingival hypertrophy in CMML can be a harbinger of the disease entering a more aggressive phase requiring systemic chemotherapy.

Background: Many adults who undergo glaucoma filtering surgery also need surgical treatment of coexisting cataract. Recent reports of the use of new alternative nonpenetrating techniques in combination with phacoemulsification have given encouraging results. The purpose of this study was to compare the safety and efficacy of viscocanalostomy and phacoviscocanalostomy in the management of medically uncontrolled open-angle glaucoma. Methods: Twenty patients who underwent phacoviscocanalostomy in one eye each were enrolled in the study. Twenty matching patients who underwent viscocanalostomy in one eye each at our institution were selected as the control group. Postoperative reductions in intraocular pressure (10P) and number of antiglaucoma medications were compared between the groups. Visual acuity and complications were secondary outcomes. Results: Significant reductions of IOP and of use of antiglaucoma medication occurred in both groups ( p p >0.05). The mean IOP reduction was 34% in the eyes that underwent viscocanalostomy alone and 38% in the eyes that underwent phacoviscocanalostomy. The success rates of the two procedures were also comparable ( p >0.05). In the combined-surgery group the best-corrected visual acuity improved by 2 or more lines in 18 eyes (90%). Intraoperative complications did not occur in either group. Interpretation: Combining phacoemulsification with viscocanalostomy did not have a negative effect on the 10P control achieved by viscocanalostomy alone and did not increase the complication rate. Phacoviscocanalostomy was safe and effective in the surgical management of eyes with both glaucoma and cataract.

Background: Deep sclerectomy is one of the two main types of nonpenetrating surgical methods of treating open-angle glaucoma. We aimed to determine, in a prospective study, the efficacy, success rate and complications of deep sclerectomy with implantation of a nonabsorbable drain made of highly hydrophilic acrylic (T-Flux). Methods: Twenty-five patients (25 eyes) with medically uncontrolled open-angle glaucoma were treated by deep sclerectomy with implantation of the T-Flux drain. We determined the rates of intraocular pressure (IOP) reduction, surgical success (four categories) and complications. To evaluate the efficacy of this new implant in detail, we compared the success rates with those in a group of patients matched for age, sex, diagnosis, preoperative IOP, number of preoperative antiglaucoma medications and previous ocular surgery who underwent successful viscocanalostomy. Results: For two eyes in the deep-sclerectomy group, surgery was converted to standard trabeculectomy owing to perforation of the trabeculo-Descemet's membrane during dissection of the corneal stroma. The following results apply to the remaining 23 eyes. After a mean follow-up period of 16.21 (standard deviation [SD] 3.93) months, the mean IOP had fallen from 26.26 (SD 4.3) mm Hg preoperatively to 17.60 (SD 4.35) mm Hg at the last postoperative visit (p = 0.000). The rate of complete success (IOP < 21 mm Hg without medication) was 86.9% at 1 month, 56.5% at 12 months and 39. 1 % at the last visit. The rates of qualified success (IOP < 21 mm Hg with or without medication) were 95.6%, 91.3% and 82.6%, respectively. No postoperative complications of the type that might occur after trabeculectomy were observed. Three eyes with an insufficient reduction in IOP underwent goniopuncture with a neodymium:YAG laser. Statistical analysis of the success rates revealed that deep sclerectomy with T-Flux implantation was comparable to viscocanalostomy at all postoperative visits (p < 0.05). Interpretation: A statistically significant drop of IOP with few postoperative complications over the short term was achieved with deep sclerectomy and T-Flux implantation. The success rates were comparable to, and not significantly better than, those of viscocanalostomy.

Objective: Although the platelet destruction shows a primary role in the thrombocytopenia of idiopathic thrombocytopenic purpura (ITP), it has been demonstrated that impaired platelet production may also contribute to the severity of thrombocytopenia in ITP. The present study examined megakaryocyte apoptosis in bone marrow aspirates of children with acute and chronic ITP and investigated the role of megakaryocyte apoptosis in ITP pathophysiology. Methods: Thirteen children diagnosed with acute ITP and eight children diagnosed with chronic ITP comprised the study group. Ten children, who were hospitalized for scoliosis operation but healthy otherwise, comprised the control group. In all children, megakaryocytes were isolated from the same amount of bone marrow aspirate samples using MACS CD61 MicroBeads (Miltenyl Biotec, Auburn, CA, USA). Megakaryocyte apoptosis was studied with transferase-mediated d-UTP-bitin nick end-labeling method. Results: Isolated megakaryocyte counts did not differ significantly between acute ITP, chronic ITP and control groups. The percentage of apoptotic megakaryocytes did not differ significantly between acute ITP group and control group and between chronic ITP group and control group. The percentage of apoptotic megakaryocytes in patients with chronic ITP was significantly lower than the patients with acute ITP. There was no correlation between the percentage of apoptotic megakaryocytes and platelet counts of the cases. Conclusions: Increased megakaryocytic apoptosis does not play a role in the pathogenesis of dysmegakaryopoiesis and impaired platelet production in children with ITP. Decreased megakaryocyte apoptosis in cases with chronic ITP may be due to suppression of megakaryocyte maturation, as the terminal phase of the megakaryocyte lifespan is characterized by the onset of apoptosis.