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WOS:000564350300001 In this research, Erzincan Tulum cheese was packaged in its original packaging material, the skin bag, small intestine, and appendix to observe the changes in its physical, chemical, and textural properties during storage day. Lactic acid% values increased in all Tulum cheeses throughout storage stage. At the end of the storage period, the highest value was determined in the sample filled in the small intestine (20.10%). All fatty acid values were increased, and the highest increase was identified in oleic acid (C 18:1) (skin bag 2.18%), linoleic acid (18:2) (appendix 0.41%), and palmitic acid (C 16:0) (small intestine 0.34%), respectively. All organic acids increased in stored sample. The highest increase among organic acids was determined to be 4.47% in lactic acid. As a result of the Texture Profile Analyses (TPA), the hardness, and adhesiveness of Tulum cheeses increased during storage periods, whereas the springiness, cohesiveness, and chewiness values decreased. Gumminess value declined in the sample filled into the appendix (with a value of 36.01), whereas it increased in the other two samples. The highest increase in hardness values was 2,520.27 N at given storage time was in the samples filled into appendix while the highest adhesive values of -49.82 were determined in the sample filled into small intestine. Practical Application Tulum cheese is usually produced by filling sheep or goat skin bag. Goat or sheep skin bag are not always available, and the amount of cheese produced in them is excessive. Therefore, cheeses were also filled to small intestine and appendix. At the end of the study, there were no negative effects on cheeses filled with intestine and appendix. The use of small intestine and appendix has helped to develop a product that will be appreciated by the consumers with no adverse effects in the physicochemical and textural properties of cheese.

Gıdalar, hammaddenin tedarik edilmesinden son ürünün eldesine kadar geçen süreçte, raf ömrünün uzatılması, tekstür, tat veya aroma iyileştirilmesi ya da maliyetin düşürülmesi gibi çeşitli istemlerle veya istem dışı; fiziksel ya da kimyasal müdahalelere maruz kalmaktadır. Bu müdahalelerin tüketicinin sağlığı ve refahı açısından İslami boyutlarda takibi ve denetimi, helal gıda konsepti kapsamına girmektedir. Günümüzde gelişen teknolojiye paralel olarak üreticilerin haksız kazanç elde etme istekleri gibi sebeplerden ötürü gıda üretiminde taklit ve tağşiş oranları giderek artmaktadır. Bu derlemede, helal gıda üretimi ve takibinde önem arz eden ve doğrulama ve tağşiş belirlenmesi amacıyla kullanılan vibrasyonel spektroskopik yöntemlerden yakın kızılötesi spektroskopisi (NIR), Fourier dönüşümlü kızıl ötesi spektroskopi (FTIR), Raman spektroskopisi (RS) ve üstün uzaysal görüntüleme (HSI) metotları çalışma prensipleri ve gıda grupları bazında ele alınmıştır.

This present research, the proximate analyses, the antioxidant capacity and phenolic composition of Sinapis alba (yellow mustard seed), Brassica nigra (black mustard seed), Brassica juncea (brown mustard seed) and their autoclaved samples were evaluated. The antioxidant capacity of mustard seeds was analysed by examining antiradical activity, Fe2+ chelating activity, H2O2 scavenging and total phenolics. The mustard seeds were autoclaved to inhibit myrosinase activity. The level of antioxidant capacity and the phenolics of the mustard seeds were increased with autoclave treatment. The antiradical activity of mustard seeds were determined ACL×YM (0.810) followed by ACL×BRM (0.750), UNACLxYM (0.680), UNACLxBRM (0.600), ACLxBLM (0.590) and UNACLxBLM (0.450) types respectively (P < 0.05).

Over the years, fats have been widely used in foods for different purposes including improving texture, aroma, and mouthfeel. Processing methods used in manufacturing solid fats might cause some adverse effects including a high amount of saturated and trans-fatty acids. To eliminate these negative effects, many studies have been conducted using different methods in the past decades. Oleogels, which can be defined as liquid oil entrapped within a thermoreversible, three-dimensional gel network using oleogelators such as waxes, monoglycerides, phospholipids, and phytosterols, have been tremendously used in many food formulations to reduce the amount of saturated and trans-fatty acids. Numerous food applications of oleogels are reported including meat, dairy, and bakery products. Overall, the main objective of this chapter is to outline the current state of knowledge on production, application, and potential effects of edible oleogels used in food formulations, and future trends and concerns will be discussed. © 2020 Elsevier Inc. All rights reserved.

Tiroid bezi hematomları akut solunum sıkıntısına neden olması nedeniyle hızlı değerlendirme ve müdahale gerektiren acil bir patolojidir. Hematomun bası etkisine bağlı solunum sıkıntısı derecesi değişebilir ve müdahale kararında belirleyicidir. Boynuna aldığı darbe sonrasında akut solunum sıkıntısı gelişen 38 yaşında bilinen bir hastalığı olmayan olgumuz, fizik muayene ve radyolojik tetkikler sonrasında acil hastalıkları, kulak burun boğaz, genel cerrahi ve radyoloji uzmanı tarafından birlikte değerlendirildi. Boyun ultrasonunda (USG) tiroid sol lobda yaklaşık 6*4 cm boyutunda, sol karotiskommunis arteri yaylandıran, kistikkomponentleri ön planda heterojen ekojenitelinodüler imaj izlendi. Tanımlanan bölgeye travma öyküsü olması ve öncesinde hastanın kistiknodüler guatr öyküsü bulunmaması nedeniyle sonografik bulgular öncelikle hematom lehine değerlendirildi. Bilgisayarlı Boyun Tomografisi ‘Tiroid sol lobunda 57*44 mm boyutunda hipodensnodül izlenmiş olup trakeayı sağa deviye etmektedir’ şeklinde raporlandı. Tiroidhematomlarında solunum sıkıntısının derecesine göre; takip ve oksijen desteği, USG eşliğinde aspirasyon, cerrahi müdahale (hemitiroidektomi, total tiroidektomi, kanama kontrolü), entübasyon ve entübasyon yapılamazsa trakeotomiinferior tedavi seçenekleri arasındadır. Biz bu olguda oldukça nadir gözüken travmatiktiroidhematomundaultrason eşliğinde yapılan aspirasyon yöntemi ile tedavi yaklaşımımızı sunduk. Anahtar kelimeler: Tiroid, Hematom, Ultrason.

WOS:000499659400028 In this research, the effects of cooking by convection oven and cooking by sous-vide method on the physicochemical, textural, sensorial and microbiological of gluteus medius cuts were investigated. For the sous-vide method, the meat was vacuumed sealed in special packaging material (Mylar (R) Cook) before being stored at + 1 degrees C for 0, 15, and 30 days. The samples cooked with the sous-vide method had higher moisture content (P < 0.001) and lower cooking loss than oven roasted samples. TBARS content was affected by cooking method (P < 0.01) and storage time (P < 0.01). The 2-thiobarbituric acid reactive substances (TBARS) values of the convection oven samples were higher than those cooked with sous-vide method. The WBSF values were affected by the cooking methods. The samples cooking with oven significantly lower shear (P < 0.0001) force values than those for the sous-vide method. Samples cooked by the convection oven had higher L* (lightness), a* (redness), b* (yellowness) than the cooked with sous-vide method (P < 0.0001). The sliced meat samples cooked by oven were given higher sensory ratings than those cooked by sous-vide except texture scores.

Purpose: In this experimental study, the effects of systemic memantine administration on the retinal ultrastructure of experimentally induced glaucomatous rats were investigated. Methods: Twenty-four Wistar albino rats were included in this study. Glaucoma was induced by injecting sodium hyaluronate into the anterior chamber of the rats for a period of three weeks. As a control, 8 rats were sham treated (Group C). Glaucoma induced animals were divided into two groups; Group M ( n = 8) received a single daily dose of 10 mg/kg memantine, and Group G received the same volume of saline ( n = 8), via intraperitoneal route for a period of six weeks, starting with the induction of glaucoma. Then, all rats were sacrificed and the retinas were prepared for electron microscopic examination. Electron microscopic damage findings were graded between 0 and 4 and mean damage scores for each cell or layer was calculated for each group. Statistical comparison was made between group G and group M. Results: Including the photoreceptor cells, marked ultrastructural changes were observed in the retinas of the animals in group G. The ultrastructural changes in group M were modest and there was no significant cell death. Statistical findings indicated these results. Conclusion: Results of the present study suggest that memantine treatment, when started in the early phase of glaucomatous process, may help to preserve the retinal ultrastructure and thus prevent neuronal injury in experimentally induced glaucoma.

This study investigated the effect of yellow, black, and brown mustard seeds on color, lipid oxidation (thiobarbituric acid-reactive substances [TBARS]), and micro-biological and sensory qualities of meatballs during storage. Heat treatment of mustard seeds affected the TBARS value of meatball samples (p

Ham fındıktan Lactobacillus delbrueckii subsp. bulgaricus ve Streptococcus thermophilus ticari suşları kullanılarak sağlığıteşvik edici, fonksiyonel özellikte fermente bir ürün elde edilmiştir. İlkaşamada, ultrasonikasyon uygulaması ile fındık sütünün homojenizasyonusağlanmıştır. Elde edilen fermente ürününün pH, titre edilebilir asitlik, serumayrılma kapasitesi, protein içeriği, yağ içeriği ve kül içeriği sırasıyla 4.95,1.25 g laktik asit/100mL, %28.00, %2.60, %7.03 ve %0.66 olarak bulunmuştur.Reolojik analizlerden elde edilen veriler fermente fındık sütünün Newtonianolmayan psödoplastik akış davranışı sergilediğini ve yapısının viskozdan dahaelastik olduğunu göstermiştir. Duyusal analiz, renk, aroma, tipik yoğurt kokusuve genel kabul edilebilirlik gibi fermente fındık sütünün bazı niteliklerininAyran’dan daha az takdir edildiğini, ancak diğer bazı özelliklerin tatmin ediciolduğu sonucuna varılmıştır., Raw hazelnut milk were used todevelop new plant-based fermented product using commercial starter mixcontaining Lactobacillus delbrueckii subsp. bulgaricus and Streptococcus thermophilus strains in order to address the currentdemand for health promoting and functional plant-based dairy-like products. ThepH, titratable acidity (TA), serum separation (SS), protein content, fatcontent and ash content of fermented product were found to be 4.95, 1.25 glactic acid/ 100 mL, 28.00%, 2.60%, 7.03% and 0.66%, respectively. Fermentedhazelnut milk demonstrated non-Newtonian pseudoplastic flow behavior and it’sstructure was more predominantly elastic than viscous. Sensory analysis showedthat some attributes of fermented hazelnut milk such as color, aroma,consistency, typical yoghurt odor and overall acceptability were lessappreciated than Ayran (commercial cow milk yogurt drink) whereas some otherattributes were found as satisfying.

The increasing rate of consciousness on innovative changes in foods has been increasingly grew the demand for the information about metabolism of these foods. Data about bioaccessibility and bioavailability of food components become more vital for both consumers and producers in the context of developing new healthier foods. Both nutrition and food researchers try to develop methods that allow user to obtain sufficient results of bioaccessibility and bioavailability of food compounds. Therefore, this study will summarize the TIM system, a novel system that mimics the human gastrointestinal system by all means, including working principles and studies performed in this system. In vivo and in vitro studies cannot be used as useful tool for measuring bioaccessibility and bioavailability of food components because of the physiological differences between human and animal. TIM studies were shown that this novel system could be easily used for the monitoring gastrointestinal movements of foods. In conclusion, TIM systems provide adequate data including digestibility, bioaccessibility and bioavailability of many different food products. By mimicking the GI tract , TIM system is a promising tool for the investigation of digestion, absorption components and health promoting aspects of foods.

PurposeTo determine a way to prevent the formation of adhesions and delay the time of suture adjustment in the course of adjustable strabismus surgery, an animal study was performed to assess and compare the effects of mitomycin C (Mit-C) and viscoelastic material Viscoat (sodium hyaluronate 3% and chondroitin sulphate 4%, Alcon, Fort Worth, TX).MethodsRight eyes of 47 rabbits were divided into three groups. After recession of the superior rectus muscle (SRM), Mit-C was administered beneath and over the SRM in Group M (16 eyes), Viscoat was administered beneath and over SRM in Group V (16 eyes), and ringer lactate was administered in Group C (15 eyes). SRM then recessed 5 mm with adjustable strabismus surgery technique. Animals in each group were subdivided into 1 and 2, where 1 = adjustment 1 week postoperatively and 2 = adjustment 3 weeks postoperatively. Delayed adjustment was performed in M1group (6 eyes), V1group (6 eyes), and C1group (7 eyes) after 1 week; in M2group (6 eyes), V2 group (6 eyes), and C2group (6 eyes) after 3 weeks. Histopathologic examinations were performed for the remaining 10 eyes without suture adjustment at the end of first and third weeks after adjustable strabismus surgery. The possible length and the necessary force to adjust and the degree of adhesions were recorded.ResultsWhen length and strength of the adjustment, adhesions between muscle and sclera, and adhesions between muscle and conjunctiva were taken into consideration, there was no statistically significant difference among M, V, and C groups at postoperative weeks 1 and 3. The force needed for adjustment in M1group was statistically lower than M2group.ConclusionsThe intraoperative use of Mit-C (0.4 mg/mL) may decrease adhesion formation in the early postoperative period, especially in the first week. The intraoperative use of Viscoat was not effective in reducing postoperative adhesions and delaying adjustment.

Nanoliposomes are among the most commonly investigated colloidal delivery systems in food and nutraceuticals research. Since they have the capacity to encapsulate and deliver both hydrophilic and hydrophobic bioactives, nanoliposomes have been utilized in a number of studies and industrial products. In this review, some of the most recent advances in the preparation of active material bearing nanoliposomes are summarized with a special emphasis on new manufacture methodologies, stability during storage, and upon digestion, determination, and monitoring of encapsulation efficiency, enhancement of anticarcinogenic, and antimicrobial activities of encapsulated compounds, and the possibilities of incorporation in food systems. Due to the versatility, bioactivity, nonimmunogenicity, and nontoxicity of bioactive bearing nanoliposomes, we anticipate that their utilization in foods and nutraceuticals has strong potential, especially along with the developments in continuous modes of liposome production, increasing commercial availability of inexpensive sources of phospholipids and easy-to-prepare liposomal dispersions, such as proliposomes.

WOS: 000438931700009 Nanoencapsulation systems that bear enzymes, proteins, bioactive peptides, and biological molecules are among the most commonly investigated delivery systems in food and nutraceuticals research. Although the majority of protein based materials in foods are of hydrophilic nature, especially among peptides and biological molecules, there are more hydrophobic materials which leads to the necessity of generating a wide variety of nanoencapsulation systems for the delivery of biological molecules. In this chapter, nanoencapsulation systems for biological molecules are dealt with emphasis on their preparation, stability, safety, relevance to biological systems, and applicability to industrial processes. Therefore, some of the most recent advances in the preparation of such nanoencapsulation systems are presented here. Nanoencapsulation methods reviewed here include lipid based formulations; casein, cyclodextrin, and nanocrystal nanocapsules; protein and carbohydrate nanogels; nanotubes; starch nanoparticles and finally encapsulation materials that are based on electrohydrodynamic processes. Due to the versatility, bioactivity, nonimmunogenicity, and nontoxicity of the majority of these systems, there is a good potential in their implementation in industrial food products and nutraceuticals. Increasing demand and manufacture capacities are anticipated along with developments that enhance continuous mode of production at industrial scale.

PURPOSE To evaluate the short-term effectiveness of intraductal meibomian gland probing using modified Maskin cannulas in patients with obstructive meibomian gland dysfunction. METHODS The study prospectively included 58 eyes of 30 patients with a diagnosis of meibomian gland dysfunction who were refractory to medical treatment for at least 6 months. The patients were divided into 4 groups according to the number of probing procedures applied. During probing, sterile modified Maskin probes 2, 2.5, 4, and 6 mm in length were used. A tarsal massage was recommended after medical treatment. Preoperatively, then postoperatively at 1 week, 1 month, and 3 months, the Schirmer 1 test was performed, tear break-up time was measured, and images of the anterior segment were recorded. In addition, the Ocular Surface Disease Index questionnaire was completed at baseline and at 3 months. RESULTS In all groups, there were no statistically significant differences between Schirmer 1 test results at preoperative and postoperative 3 months, but tear break-up time values measured at baseline and at 3 months differed significantly (5 seconds, 13 seconds, P < 0.001). In the analyses of anterior segment photographs of all patients, statistically significant postprocedural decreases in conjunctival hyperemia (P < 0.0001) and eyelid margin vascularization (P = 0.004) were detected, and the later Ocular Surface Disease Index scores showed a significant improvement between preop and 3 months. CONCLUSIONS A procedure using modified Maskin probes was effective and reliable in the short term for patients with meibomian gland dysfunction.

Purpose To investigate the association of age-related macular degeneration (AMD) with plasma antiphospholipid antibody levels. Methods This prospective study included 19 patients diagnosed as having dry-type AMD, 23 patients with exudative-type AMD, and 25 control subjects. Venous blood samples of the participants were obtained. Anticardiolipin antibodies (aCL) isotypes IgG and IgM were measured by means of an enzyme-linked immunosorbent assay. Lupus anticoagulant (LA) antibodies were measured by the dilute Russell viper venom time screen test. Results The mean aCL IgG concentration in patients with exudative-type AMD was significantly higher than in patients with dry-type AMD and control subjects. The mean ± SE of aCL IgG levels in patients with exudative-type AMD and dry-type AMD and control subjects was 5.46 ± 1.26; 2.55 ± 0.78; and 0.32 ± 0.1, respectively. The mean aCL IgM levels and LA levels in the 3 groups were not statistically different. Conclusions Our findings suggest that elevated levels of serum aCL, a risk factor for cardiovascular and cerebrovascular diseases, may be associated with exudative-type AMD.

To evaluate the 6- month daytime efficacy of a fixed combination of timolol and brimonidine (BTFC) versus a timolol and dorzolamide fixed combination (DTFC) as a first choice therapy in patients with pseudoexfoliation glaucoma (PXG).This study was a randomized, prospective, investigator-masked, 6-month comparison of twice-daily administration of BTFC versus DTFC in 60 newly diagnosed PXG patients.Mean baseline untreated IOPs were 25.5 ± 2.6 mmHg and 26.2 ± 2.1 mmHg in the DTFC and BTFC groups, respectively. Mean intraocular pressure (IOP) reductions ranged from -7.3 ± 1.9 to -8.1 ± 2.0 mmHg for the DTFC group and from -7.5 ± 2.0 to -8.6 ± 2.6 mmHg for the BTFC group. No significant differences between the two treatment groups could be found. At month 6, the mean diurnal IOP was 17.5 ± 2.5 mmHg (31.3%) for the DTFC group and 18.0 ± 2.8 mm Hg (31.7%) for BTFC. As compared with baseline, mean diurnal IOP decreased by 7.9 ± 1.9 mmHg in the DTFC and 8.2 ± 1.5 mmHg in the BTFC, the difference between the groups was not statistically significant (p = 0.6). No statistical difference in terms of adverse events was found either.Both fixed combinations were effective at lowering IOP in PXG. This study suggests that the daytime diurnal IOP is not statistically different when DTFC or BTFC is used as a first choice therapy in patients with PXG.

PURPOSE To evaluate the systemic high sensitivity C-reactive protein (hsCRP) levels in patients with pseudoexfoliation syndrome (XFS) and pseudoexfoliation glaucoma (XFG). MATERIALS AND METHODS We prospectively examined 31 patients with XFS, 26 with XFG, and 25 controls. To the study patients with the exclusion of serious hypertension that do not have any cardiovascular and cerebrovascular disease and that diagnosed as XFS and XFG have been included. Each patient passed through a detailed blood sampling including hsCRP, biochemistry, and lipid profile. Plasma C-reactive protein (CRP) levels were measured with nephelometric method by using Beckman IMMAGE hsCRP reagent. RESULTS Each group had similar demographic parameters including age, sex, body mass index, heart rate, and blood pressure. When we compared with controls, there was no statistically significant difference in the hsCRP and biochemistry results between the 3 groups. When all patients with pseudoexfoliation (PEX) compared with controls there was no difference. CONCLUSIONS Our findings indicated no difference in the hsCRP level between XFS, XFG, and controls. This study suggests that CRP is not a predictive marker of inflammation and peripheral endothelial dysfunction in XFS, which is accepted as a systemic disorder.

OBJECTIVE Single-dose subconjunctival platelet-rich plasma (sPRP) injections with or without antibiotic treatment were investigated for their effect on corneal epithelial wound healing in a rabbit model. MATERIALS AND METHODS A total of 24 rabbits were used in this study. After collecting intracardiac blood samples from 16 rabbits, platelet-rich plasma was obtained by centrifugation. Animals were divided into 3 groups. A mechanical corneal epithelial defect of 7-mm diameter was created on the central cornea of the right eye of each animal. Group 1 (n = 8) received only sPRP, whereas group 2 (n = 8) received sPRP with topical antibiotic throughout the study. The third group (n = 8) served as the control group. Each animal was examined daily under biomicroscope for 10 days. Epithelial defect was measured in horizontal and vertical diameter with a 1/100 sensitive micrometer, and area of the defect was calculated. One animal was sacrificed in each group on the third and seventh day, and all remaining animals were sacrificed on the 10th day. Corneal histopathology was investigated for epithelial regeneration, presence of inflammation, and structural integrity of fibroblasts. All data were statistically analyzed for difference between the study groups. RESULTS Group 1 had a significantly smaller size in horizontal and vertical defect diameters on each day as compared with the control group. Healing of the epithelial defect in group 1 was found to be significantly different than that in the control group (P < 0.05). No significant difference was observed between group 2 and control group except for the first day. Group 1 had a significantly better healing process after the fourth day as compared with group 2. Histopathological investigations revealed a steady fibroblast migration, quicker epithelial regeneration, and less inflammation in group 1 as compared with the other 2 groups. DISCUSSION AND CONCLUSIONS sPRP seems to improve corneal epithelial wound healing. However, antibiotic and sPRP combination may have a retarded healing effect as compared with platelet-rich plasma alone.

The aim of the study was to evaluate the variation in retinal nerve fibre layer (RNFL), optic nerve head (ONH) and macular measurements in healthy Turkish subjects using Stratus optical coherence tomography (OCT). The design is a cross-sectional study of 398 eyes in 199 normal subjects aged between 5 and 70 years. The participants underwent a detailed ophthalmologic examination including imaging with Stratus OCT. RNFL, optic disc and macula fast scan methods were used to obtain the peripapillary RNFL thickness, ONH and macular parameters. The effects on the findings of age, gender and laterality of the eye tested were assessed. The average RNFL thickness and the thickness measured in the superior and temporal quadrants were statistically significantly negatively correlated with age. Similar results were found for mean macular thickness, macular RNFL thickness and for total macular volume. There was no effect of age on ONH measurements. The RNFL thickness in the temporal quadrant was significantly greater ...

Objective: To evaluate the ability of retinal nerve fibre layer (RNFL) thickness and optic nerve head (ONH) measurements, as determined by optical coherence tomography (OCT), to discriminate between normal eyesight and glaucoma and also among the different stages of glaucoma. Design: Observational cross-sectional study. Participants: Eighty-one controls and 213 glaucoma patients were enrolled in the study. Methods: The discriminating powers of OCT parameters for the detection of glaucoma and subgroups were compared by the area under the receiver operating characteristic (AUROC) curves. Results: The best RNFL thickness parameters for discriminating between early glaucoma and control eyes were inferior (0.74 [SE 0.04] μm), average (0.74 [SD 0.03] μm), and superior (0.68 [SD 0.03] μm). Among the ONH parameters, the best AUROC curve values were cup area (0.83 [SD 0.33]), cup/disc (C/D) area ratio (0.82 [SD 0.03]), and vertical integrated rim area (VIRA) (0.82 [SD 0.03]). The best AUROC values belonged to the RNFL thickness and were inferior (0.80 [SD 0.03]), superior (0.79 [SD 0.03]), and 6 o'clock (0.78 [SD 0.03]). The highest AUROC values were horizontal integrated rim width (HIRW) (0.74 [SD 0.04]), VIRA (0.64 [SD 0.04]), and rim area (0.63 [SD 0.04]) among the ONH parameters for early versus moderate glaucoma. The best AUROC values were inferior (0.81 [SD 0.03]), 6 o'clock (0.79 [SD 0.03]), and superior (0.78 [SD 0.04]) among the RNFL, and the best AUROC values were cup area (0.81 [SD 0.03]),VIRA (0.81 [SD 0.03]), and C/D area ratio (0.80 [SD 0.03]) among the ONH parameters, for moderate versus advanced glaucoma. Conclusions: RNFL and ONH OCT parameters might provide information for determining glaucomatous damage.

Background To measure the parapapillary retinal nerve fiber layer and macular thickness and macular volume in vivo and to evaluate whether retinal structural changes and visual cortical responses may be related to the clinical severity of the PD. Methods We included 17 patients with Parkinson’s disease and 11 healthy subjects of a similar age. Unified Parkinson’s disease rating scale scores in Parkinson’s disease and control subjects were assessed for clinical evaluation. The retinal nerve fiber layer thickness, macular thickness and volume were measured by commercially available optical coherence tomography Model 3000 unit. Peak latencies of P100 component were measured by pattern visual evoked potential examination. Results The mean retinal nerve fiber layer average thickness was significantly reduced in Parkinson’s disease patients (98.76 ± 10.90 μm) when compared with those of control subjects (114.54 ± 5.72) (P < 0.05). The retinal thickness reduction was statistically significant in superior inner macula; temporal, nasal and inferior quadrants of outer macula (P < 0.05)(Table 2). The mean total macular volume of Parkinson’s disease patients (6.82 ± 0.32 mm3) was significantly reduced when compared with those of control subjects (7.09 ± 0.23 mm3). Highly significant inverse correlation between foveal retinal thickness and total and motor subscores of Unified Parkinson’s disease rating scale was observed in Parkinson’s disease patients, respectively (r = −0.660; P = 0.004), (r = −0.625, P = 0.007). There was a moderate nearly significant inverse correlation between total macular volume and P100 latency in PD (r = −0.328; P = 0.058). Conclusions In Parkinson’s disease patients there is a reduction of retinal nerve fiber layer thickness, macular thickness and volume evaluated in vivo by optical coherence tomography. Reduced foveal thickness which is not found to be statistically different from normal is correlated to the severity of disease.

Objective: To evaluate the retinal nerve fiber layer (RNFL) thickness in patients with unilateral pseudoexfoliation syndrome (PXS) without glaucoma by using optical coherence tomography (OCT). Methods: 22 patients with unilateral PXS were evaluated. Group 1 included the eyes with the pseudoexfoliation, group 2 included the fellow eyes; 18 age-matched normal control eyes were assessed in group 3. The mean and segmental RNFL thickness in eyes with pseudoexfoliation and their fellow eyes in patients with unilateral PXS was compared to age-matched control subject eyes. Results: The RNFL in patients with PXS were significantly thinner than controls in all quadrants except the nasal quadrant with regard to segmental analysis (p < 0.05). This RNFL loss was apparent at 7, 10 and 11 o’clock of the PXS eyes with regard to clock hour position (p < 0.05). In the fellow eyes, no significant difference in RNFL measurement was found except the temporal quadrant when compared with the controls. In the analysis with regard to clock hour position, no significant reduction in RNFL thickness was found except in the 11-o’clock segment. In PXS eyes, RNFL thicknesses at the inferior quadrant and the 1-, 2- and 5-o’clock segments were significantly lower than in non-PXS eyes (p < 0.05). Conclusions: This study suggests that PXS without glaucoma may be associated with a thinner RNFL compared with those of age-matched control subjects and non-PXS fellow eyes. Further studies are needed to clarify the relationship between the decrease in RNFL thickness and the development of glaucomatous damage in eyes with pseudoexfoliation.

Purpose: To compare the subfoveal, parafoveal, and peripapillary choroidal thickness in amblyopic eyes with those of fellow and control eyes. Methods: This institutional study involved 114 eyes from 38 patients with unilateral amblyopia and 19 healthy children, aged 6 to 17 years. The cause of amblyopia was identified as hyperopic anisometropia in 17 cases and strabismus in 21 cases. All patients underwent central macular thickness (CMT) and choroidal thickness measurement at seven retinal sites with spectral-domain optical coherence tomography (OCT). Statistical analysis was performed to compare the CMT and choroidal thickness of amblyopic and fellow eyes with control eyes. Results: Average CMT was 248.31 ± 24.18 µm in amblyopic eyes, 249.76 ± 26.08 µm in fellow eyes, and 243.65 ± 31.96 µm in controls ( P = .604). Average subfoveal choroidal thickness was 394.15 ± 71.03 µm in amblyopic eyes, 356.07 ± 79.93 µm in fellow eyes, and 319.44 ± 87.29 µm in controls ( P = .000). The choroidal thickness of the subfoveal area and at 750-µm intervals temporal and nasal to the fovea was significantly thicker in amblyopic eyes than in controls ( P < .05). The choroidal thickness was significantly thicker in amblyopic eyes than in fellow eyes only at 750 µm nasal to the fovea. Type and depth of amblyopia did not differ significantly between foveal or parafoveal choroidal thickness ( P > .05). There was a significant negative correlation between the nasal peripapillary choroidal thickness and the axial length in the amblyopic eyes ( r = −0.37, P = .022). The choroidal thickness in the peripapillary area was not significantly different in the three groups ( P > .05). Conclusions: This study demonstrated that choroidal thickness can be measured by spectral-domain OCT in children with amblyopia. Subfoveal choroidal thickness in amblyopic eyes was significantly thicker than in control eyes. The amblyopic process may involve the choroid, but not the macula. However, further evaluation is needed. [ J Pediatr Ophthalmol Strabismus . 2015;52(3):159–166.]

PURPOSE. To determine the incidence and severity of hearing loss in different frequencies in patients with pseudoexfoliation. Furthermore, possible links between homocysteine and pseudoexfoliation were evaluated. METHODS. Seventy-five consecutive patients with pseudoexfoliation and 75 sex- and age-matched subjects without pseudoexfoliation as control group were included in this prospective case-control study. Pure-tone audiometry was obtained in all subjects in both groups. Blood samples were obtained from 70 patients with pseudoexfoliation after overnight fasting for levels of homocysteine and analyzed by routine laboratory measurements. RESULTS. Fifty-two (69%) patients with pseudoexfoliation and 39 (52%) controls had sensorineural hearing loss in speech frequencies. The difference between pseudoexfoliation and control group with regard to the frequency of sensorineural hearing loss in speech frequencies was statistically significant (p=0.03). No relationship was found between the degree of glaucomatous damage and hearing threshold variables in the patients with pseudoexfoliation glaucoma. Plasma homocysteine levels showed no significant difference when patients with pseudoexfoliation and hearing loss were compared with patients with pseudoexfoliation and normal hearing threshold (p=0.5). Hyperhomocysteinemia was found in 58% (29/50) of pseudoexfoliation patients with hearing loss, and 55 % (11/20) of pseudoexfoliation patients with normal hearing threshold (p=0.8). No statistically significant correlation was found between plasma homocysteine and hearing loss in patients with pseudoexfoliation. CONCLUSIONS. These findings suggest an association between sensorineural hearing loss and pseudoexfoliation in patients with pseudoexfoliation and glaucoma. The severity of hearing loss was not correlated with the degree of glaucomatous damage. There is no association between increased homocysteine levels and hearing loss in patients with pseudoexfoliation.

Objective: To investigate the effectiveness of topical anesthesia with sedation using intranasal midazolam in patients with symptomatic congenital nasolacrimal duct obstruction undergoing probing. Patiente and Methods: In this prospective study, probing was performed with general anesthesia (30 cases) and with topical anesthesia using intranasal midazolam (0.3 mg/kg; 44 cases) in 74 patients who were divided into two groups, those 6 to 36 months old and those older than 36 months. The groups were compared after 12 to 48 months (mean, 18.2 months). Resulte: For the patients 6 to 36 months old, the success rate was 80% in the group who received general anesthesia and 88.9% in the group who received topical anesthesia with intranasal midazolam; the difference between the two groups was not statistically significant (P > .05). For the patients older than 36 months, the success rate was 20% in the group who received general anesthesia and 25% in the group who received topical anesthesia with intranasal midazolam; there was no statistically significant difference between the two groups (P>.05). Conclusions: Probing with topical anesthesia in the office setting is usually recommended for patients younger than 8 months. Our results show that this is suitable for children until 4 years of age with the support of intranasal midazolam sedation. Probing under topical anesthesia with intranasal midazolam is cost-effective, safe, and comparable in efficacy to probing under general anesthesia but with less risk.

Purpose: To evaluate ischemic changes in brain magnetic resonance images in patients with pseudoexfoliation syndrome (PXS) and pseudoexfoliation glaucoma (PXG) and compare them with age- and sex-matched control subjects. Methods: This case-control study involved 16 consecutive patients with PXS, 21 patients with PXG and 18 healthy age- and sex-matched control subjects. Each subject underwent a comprehensive ophthalmological examination. In all participants, an axial T1-, T2- and proton-density-weighted and coronal cerebral 1.5-tesla magnetic resonance imaging (MRI) scan was made. White matter hyperintensities (WMH) were considered present if these were hyperintense on both proton-density- and T2-weighted images and not hypointense on T1-weighted images. White matter lesions were classified into two parts as the subcortical and periventricular regions. We used a validated rating scale of subcortical WMH: 0 = absent, 1 = punctuate foci, 2 = beginning confluence of foci and 3 = large confluent areas. Periventricular white matter lesions were classified on a scale of 0 (no white matter lesions), 1 (pencil-thin periventricular lining), 2 (thick lining) or 3 (large confluent white matter lesions). Results: The proportions of persons with WMH were 93.7% for patients with PXS, 95.2% for patients with PXG and 55.5% for control subjects. The numbers of white matter lesions in patients with PXS and PXG were significantly greater than in the control subjects (p < 0.05). White matter lesions at subcortical locations in patients with PXG were significantly more frequent than in the control subjects (80.9 vs. 33.3%; p < 0.05). The proportion of patients with subcortical WMH was 56.2% in PXS; no significant difference was found in subcortical WMH between PXS and controls. The proportions of patients with periventricular WMH were 93% in PXS, 90.4% in PXG and 44.4% in controls. White matter lesions at periventricular locations in patients with PXG and PXS were significantly more frequent than in the control subjects (p < 0.05). The difference between the pseudoexfoliation groups and controls with regard to the size of periventricular and subcortical white matter lesions was statically significant (p < 0.05). When patients with PXS were compared with PXG patients, there was no statistically significant difference in the number, size and scale of white matter lesions. Conclusion: We found a significantly higher prevalence of MRI-defined WMH in patients with a clinical diagnosis of pseudoexfoliation with or without glaucoma versus control subjects. We think that the findings in this study may shed light on a possible link between ischemic brain lesions and pseudoexfoliation, which is not related with the presence of glaucomatous optic neuropathy. Further investigations are required to resolve the underlying associations.

Purpose: To determine the clinical sedative effect and dosage of intranasal midazolam in refraction and fundus examination of children with strabismus. Patients and Methods: Refraction and fundus examination with (n = 28) and without (n = 24) sedation were performed in 52 children with strabismus whose ages ranged from 7 to 26 months. We delivered a 5-mg/mL solution of midazolam via a syringe for 60 seconds to provide a dose of 0.2 mg/kg. We repeated the dose to a maximum of 0.3 mg/kg if there was no clinical sedative response after 10 to 15 minutes. The ease of examination and sedation for each patient was scored by a blinded observer. The groups were evaluated for ease of examination and the time needed to complete it. Results: We obtained clinically adequate sedation at a mean (± standard deviation) of 15 minutes (± 2.69 minutes). Sedation was achieved with a mean dose of 2.64 mg/kg (± 0.66 mg/kg). Children receiving midazolam had significantly calmer examination scores. The time needed to complete the examination was statistically significantly shorter for these children than for children not receiving sedation ( P < .05). Conclusions: Intranasal midazolam is a beneficial drug and method of delivery for the sedation of anxious children with strabismus undergoing refraction and fundus examination. Sedation prior to examination is effective in reducing the anxiety and time associated with ophthalmologic examination of children with strabismus. J Pediatr Ophthalmol Strabismus 2005;42:355–359.

Purpose To compare the adherence of Staphylococcus epidermidis on AcrySof (Alcon) and poly(methyl methacrylate) (PMMA) intraocular lenses (IOLs) treated with vancomycin, teicoplanin, and cefuroxime. Setting Kocaeli University, School of Medicine, Kocaeli, Turkey. Methods The lenses were contaminated with S epidermidis solutions containing 10 8 colony- forming units. Intraocular lenses were placed in sterile triptic soy broth after being held in antibiotic solutions for 15 minutes. After that, sonication and vortex procedures were performed to remove all the attached bacteria that could not be removed by antibiotics. Ten microliters from each broth were taken and inoculated into sheep blood agar. The colonies were counted overnight. The statistical analyses were made using Mann-Whitney U and Kruskal-Wallis tests, and a P value less than 0.05 was considered statistically significant. Results Regarding the inhibitory effect of antibiotics on bacterial adhesion, there was no statistically significant difference between AcrySof and PMMA lenses. In the cefuroxime group, the mean numbers of colony-forming units on AcrySof and PMMA lenses were 35.2 ± 6.94 and 30.8 ± 18.69, respectively ( P >.05). In the teicoplanin group, the mean number of colony-forming units on AcrySof lenses was 100.1 ± 20.97 and 70.6 ± 43.75 on the PMMA lenses. The adherence in the vancomycin group was 245 ± 273.74 colony-forming units for AcrySof lenses and 159.8 ± 101.94 for PMMA lenses ( P >.05). Regarding the inhibitory effect of antibiotics, cefuroxime was the most effective, followed by teicoplanin and vancomycin, respectively. Overall, the mean numbers of colony-forming units on the lenses that were held in cefuroxime, teicoplanin, and vancomycin solutions were 33.0 ± 13.90, 85.35 ± 36.66, and 202.4 ± 205.74, respectively ( P = .000). Conclusions The results suggest that cefuroxime, teicoplanin, and vancomycin significantly inhibit bacterial adherence to IOLs. The effect of cefuroxime on adherence inhibition was significantly higher than that of teicoplanin and vancomycin. Bacterial adherence is an important factor in bacterial virulence. Antibiotics, especially cefuroxime, can successfully inhibit bacterial adherence.

Purpose: To compare the short-term ocular hypotensive efficacy and side effects of 0.2% brimonidine and 0.5% apraclonidine in patients with elevated intraocular pressure (IOP). Methods: We performed a double-masked, placebo-controlled study to compare the efficacy of the application of 0.2% brimonidine and 0.5% apraclonidine for the effect of IOP, systemic blood pressure and heart rate in 20 newly diagnosed ocular hypertensive patients. Effects on the untreated fellow eye and ocular side effects were also determined. All measurements were performed 1, 2, 4, 6 and 8 h after the instillation of one drop. Results: Brimonidine and apraclonidine significantly reduced IOP from baseline at all observation times. No significant difference was observed between the treatment groups. IOP decreased significantly in the untreated fellow eye in the brimonidine group at 4-, 6- and 8-hour checks and at 6-hour checks in the apraclonidine group when compared with placebo. Blood pressure and heart rate decreased significantly in the brimonidine group compared with placebo. Apraclonidine did not affect blood pressure or heart rate any differently than placebo. The pupil diameter and the interpalpebral fissure width significantly increased in the apraclonidine group, but not in the brimonidine group. There were no significant differences in the overall incidence of foreign body sensation, burning and stinging and dry mouth in the treatment groups. Conclusions: In the short-term, brimonidine was effective in reducing IOP in patients with elevated IOP and was equivalent in efficacy to apraclonidine. On the other hand, a significant change in blood pressure and heart rate was observed with brimonidine; there was no change at all in the apraclonidine group.

Team-based learning (TBL) is an interactive and analytic teaching strategy. TBL is a learner-centered strategy that uses a very structured individual and group accountability process and requires small groups to work together to solve problems. This study served to investigate whether the TBL concept could be modified and adopted to the fifth-year cornea module of an ophthalmology course. Questionnaires (using a Likert scale of 1–5) were distributed to 169 fifth-year medical students attending the cornea module applied as TBL in an ophthalmology course. The questionnaire consisted of two categories: the TBL format (7 items) and an open-ended question about the class (1 item). Feedback was then evaluated. The majority of students felt that modified TBL sessions were better at fulfilling learning objectives (121 students, 71.59%), enabled better understanding (134 students, 79.28%), were more interesting (146 students, 86.39%), ensured greater student participation (123 students, 72.78%), and involved greater effort on the part of students (148 students, 87.57%) compared with traditional teaching methods. Most of the students (129 students, 76.33%) agreed that more such sessions should be organized in the future. In conclusion, after adjustments to improve weaknesses, such as the short time allocation and students' lack of prior background, the outcomes of this modified TBL approach on the cornea module of an ophthalmology course provide a good basis for its continuation.

In a double-blind study, room-temperature lidocaine was injected randomly into 1 eyelid of 40 patients during facial anesthesia. The other eyelid of the same eye received injection of warm lidocaine (group 1) or bicarbonate-buffered lidocaine (group 2). Based on a pain scale, warming or buffering lidocaine did not significantly reduce the amount of infiltration pain. Buffering lidocaine was effective in reducing the quality of pain, as judged by the patient's report of dominant pain.

PURPOSE To report a case of progressive indocyanine green (ICG) toxicity that occurred after pars plana vitrectomy for an epiretinal membrane. METHODS The patient underwent pars plana vitrectomy for an epiretinal membrane. After fluid--air exchange, ICG was spread only on the macular area, and air-fluid exchange was performed immediately. The epiretinal membrane was removed with serrated forceps. RESULTS Although the preoperative visual acuity was 0.6, it was 0.2 in the first postoperative month, and fundus fluorescein angiography revealed retinal pigment epithelium atrophy in the macula that matched the area of ICG application. Visual acuity in the fourth postoperative month was 0.1, and there was optic atrophy. During the sixth postoperative month, visual acuity was hand movements, and there were multiple retinal holes in the macula and sclerosis of the arteries. CONCLUSION This study demonstrates that intravitreal use of ICG might have toxic effects on the retina. Unnecessary use of ICG should be avoided, and care must be taken when using intravitreal ICG.

Purpose Povidone iodine has been proven to be a valuable antiseptic solution in preparing the eye for surgery and is an alternative to postoperative topical antibiotics. No study has addressed the intraocular toxicity of povidone iodine after injection into the anterior chamber. We investigated the potential toxicity of povidone iodine on the corneal endothelium after injections into the anterior chamber in a rabbit model. Methods In this study we used 24 eyes of 12 albino rabbits. The eyes were divided into the following three groups according to the drugs tested: group A, 5% povidone iodine; group B, 10% povidone iodine; group C, balanced salt solution. The injected eyes were evaluated by biomicroscopy, specular microscopy, corneal pachymetry, and transmission and scanning electron microscopy. Results Corneal edema was observed in all eyes of groups A and B. In groups A and C, the endothelial cell morphology was not significantly changed and the mean endothelial cell count of the eyes did not change significantly (p = 0.5054). There was no significant difference in corneal thickness between groups A and C (p = 0.3823), but there was a significant difference between groups B and C ( = 0.0002). Transmission and scanning electron microscopy results were normal in group C but not in groups A and B. Conclusion Povidone iodine in both 5% and 10% concentrations demonstrates severe toxicity when one drop of either concentration is placed directly in the anterior chamber. When povidone iodine is used in preparing the eye for intraocular surgery and as an alternative to postoperative antibiotics, the inadvertent leakage of povidone iodine into the anterior chamber must definitely be prevented.

A placebo-controlled, prospective study was undertaken to determine whether apraclonidine has an additive effect in eyes treated with timolol and pilocarpine. Twelve patients with primary open-angle glaucoma while on continuing therapy with timolol 0.5% twice daily and pilocarpine 4% four times a day in both eyes for 3 months were included in the study. A single drop of apraclonidine 1% or placebo was added to treatment with timolol and pilocarpine. Intraocular pressure (IOP) was measured on both days before a single drop of test medications in both eyes as well as 2, 4, 6, 8 and 12 h later. The fall in IOP with apraclonidine was significantly greater than with placebo at all time intervals (p < 0.05). This study suggests that apraclonidine provides an additive IOP-lowering effect to timolol and pilocarpine for at least 12 h after single-drop applications.

Objective To compare the effect of subconjunctivally injected bevacizumab, etanercept and the combination of both drugs on experimental corneal neovascularization in rats. Design Experimental study. Participants 28 male Wistar–Albino rats. Methods Right corneas of rats were cauterized by silver nitrate sticks. Rats were divided randomly and equally into 4 groups so that each group contained 7 subjects. Immediately after the cauterization, 0.05 ml normal saline was injected subconjunctivally in group 1 (control group); 0.05 ml (1.25 mg) bevacizumab was injected subconjunctivally in group 2; 0.05 ml (1.25 mg) etanercept was injected subconjunctivally in group 3; 0.05 ml (1.25 mg) bevacizumab and 0.05 ml (1.25 mg) etanercept was injected subconjunctivally in group 4. The rats were euthanized on the 8th day, and digital photographs were obtained before the eyes were enucleated. The area of corneal neovascularization was calculated from digital photographs. Corneal sections were analyzed by histopathologically. Results The burn stimulus score was +1 or higher in all eyes. The difference of the neovascularization score between groups was found to be statistically significant (p = 0.001). The area of corneal neovascularization was 79.8% in group 1, 43.2% in group 2, 54.5% in group 3, and 34.8% in group 4. In group 4, corneal neovascularization was inhibited more than in the other groups. Histologic examination showed that the treatment groups had less neovascularization, inflammation, and fibroblast activity than the control group (p Conclusions Our study has shown that etanercept does have some antiangiogenic and anti-inflammatory effects in treatment of corneal neovascularization. The combination of bevacizumab and etanercept may be a promising approach in the treatment of corneal neovascularization.

To evaluate the levels of serum antiphospholipid antibodies in patients with pseudoexfoliation syndrome (PXS), pseudoexfoliation glaucoma (PXG), primary open-angle glaucoma, and healthy controls.This prospective study included 17 patients with PXS, 19 patients with pseudoexfoliation glaucoma, 15 patients with primary open-angle glaucoma, and 19 normal individuals. Venous blood samples were obtained in the morning after an overnight 8-hour fasting. Anticardiolipin antibodies, isotypes IgG and IgM were measured by means of an enzyme-linked immunosorbent assay. Lupus anticoagulant antibodies were measured by dilute Russell viper venom time screen test.Mean±standard mean of error of anticardiolipin antibody IgG levels in patients with PXS and PEG were significantly higher than those of the controls (P0.05). The mean lupus anticoagulant antibody levels of the controls were not statistically different from the levels of patients with PXS, pseudoexfoliation glaucoma, and primary open-angle glaucoma (P0.05). The anticardiolipin antibody IgG concentrations above the cutoff value of 15 GPL/mL were found in 8 patients (21.05%) with pseudoexfoliation. There was no individual in the control group having anticardiolipin antibody IgG level above the cutoff value (P0.05).Elevated serum antiphospholipid antibodies, a risk factor for cardiovascular and cerebrovascular disease, is more common in patients with PXS and pseudoexfoliation glaucoma than in the healthy controls and in patients with primary open-angle glaucoma.

BACKGROUND: We aimed to review the epidemiology and visual outcome of patients with open globe injuries in the northwest part of Turkey. METHODS: All patients admitted to the Department of Ophthalmology, Kocaeli University Faculty of Medicine with open globe injuries between 2004-2008 were reviewed retrospectively. RESULTS: Ninety-five eyes of 95 patients, aged between 3 and 79 years, were reviewed. The type of open eye injury was laceration in 76 eyes (80%) and rupture in 19 eyes (20%). In all age groups, projectile objects were the most common cause of injury. In patients 18 years and older, sharp objects (11.1%) were the least prevalent cause of open globe injuries; however, traumas with sharp objects were common in patients younger than 18 years (38.1%) (p=0.01). In patients younger than 18 years, most injuries occurred at home (68.3%), while in patients 18 years and older, the majority of ocular traumas occurred at work (59.2%) (p=0.000). Isolated Zone I lesions showed more improvement in visual acuity than other zones (p=0.043). CONCLUSION: Open globe injury in northwest Turkey varied with age and gender. Education and safety precautions are essential to prevent open eye injuries. Language: en