Effects of mitoxantrone on excitation-contraction coupling in guinea pig ventricular myocytes

The mechanisms of the inotropic effect of mitoxantrone (MTO), a synthetic dihydroxyanthracenedione derivative with antineoplastic activity, was investigated in guinea pig ventricular myocytes using whole-cell patch-clamp methods combined with fura-2 fluorescence and cell-edge tracking techniques. In right ventricular papillary muscles, 30 microM MTO increased isometric force of contraction as well as action potential duration (APD) in a time-dependent manner. The force of contraction was increased approximately 3-fold within 4 h. This positive inotropic effect was accompanied by a prolongation of time to peak force and relaxation time. In current-clamped single myocytes treated with 30 microM MTO for 30 min, an increase of cell shortening by 77% and a prolongation of APD by 19% was observed. Peak amplitude of the intracellular Ca(2+) transients was also increased by 10%. The contribution of APD prolongation to the enhancement of cell shortening induced by MTO was assessed by clamping control myocytes with action potentials of various duration. Prolongation of APD(90) (ADP measured at 90% of repolarization) by 24% led to an increase of cell shortening by 13%. When the cells were clamped by an action potential with constant APD, MTO still caused an increase of cell shortening by 59% within 30 min. No increase of the peak intracellular Ca(2+) transients, however, was observed under this condition. We conclude that both the APD prolongation and a direct interaction with the contractile proteins contributed to the positive inotropic effect of MTO.

The full-field temporal contrast sensitivity test for glaucoma: influence of cataract

PURPOSE

To determine the influence of lens opacities on temporal contrast sensitivity, measured by the full-field flicker test ("Erlangen flicker test").

METHODS

Thirty-six consecutive patients (mean age 71.1+/-11.6 years, 12 male, 24 female, refractive error -1.5+/-3.8 dpt) with cataract (visual acuity 0.21+/-0.16, retinal acuity 0.56+/-0.32, no glaucoma) were studied. Temporal contrast sensitivity (full-field flicker test, 37.1 Hz) and lens opacity (back scatter Lens Opacity Meter, Interzeag) were measured preoperatively and on the 3rd postoperative day.

STATISTICS

nonparametric tests (Wilcoxon-test, Spearman correlation coefficient, Mann-Whitney U-test).

RESULTS

No significant difference was seen in temporal contrast sensitivity pre- and postoperatively, but there was a significant difference in lens opacity measurements pre- and postoperatively. No significant correlation was found between temporal contrast sensitivity and lens opacity values preoperatively and postoperatively.

CONCLUSION

The temporal contrast sensitivity, measured by the full-field flicker test, seems to be independent of lens opacity due to the range of cataract included in this study. The data indicate that the full-field flicker test is useful for early glaucoma detection even in patients with cataract formations.

Pregnancy switches adrenergic signal transduction in rat and human uterine myocytes as probed by BKCa channel activity

1. We used large conductance Ca2+-activated K+ (BKCa) channel activity as a probe to characterize the inhibitory/stimulatory G protein (Gi/Gs) signalling pathways in intact cells from pregnant (PM) and non-pregnant (NPM) myometrium. 2. Isoprenaline (10 microM) enhanced the outward current (Iout) in PM cells and inhibited Iout in NPM cells. Additional application of the alpha2-adrenoceptor (alpha2-AR) agonist clonidine (10 microM) further enhanced the isoprenaline-modulated Iout in PM cells but partially antagonized Iout in NPM cells. Clonidine alone did not affect Iout. The specific cAMP kinase (PKA) inhibitor H-89 (1 microM) abolished the effects of isoprenaline and clonidine. The specific BKCa channel blocker iberiotoxin (0.1 microM) inhibited Iout by approximately 80 %; the residual current was insensitive to isoprenaline. 3. Inhibition of Gi activity by either pertussis toxin or the GTPase activating protein RGS16 abolished inhibitory as well as stimulatory effects of clonidine on Iout. 4. Transducin-alpha, a scavenger of Gi betagamma dimers, converted the stimulatory action of clonidine on Iout into an inhibitory effect. Free transducin-betagamma enhanced both the stimulatory and the inhibitory effects of isoprenaline on Iout. 5. The results demonstrate that BKCa channel activity is a sensitive probe to follow adenylyl cyclase-cAMP-PKA signalling in myometrial smooth muscle cells. Both Gialpha-mediated inhibition and Gibetagamma-mediated stimulation can occur in the same cell, irrespective of pregnancy. It is speculated that the coupling between alpha2-AR and Gi proteins is more efficient during pregnancy and that Gibetagamma at high levels simply override the inhibitory action of Gi alpha.

Multivariate approach for quantification of morphologic and functional damage in glaucoma

PURPOSE

To determine the usefulness of confirmatory factor analysis in examination of morphometric, electrophysiological, and psychophysical quantitative methods that measure the extent of global glaucomatous damage without referring to a preselected gold standard.

METHODS

In a cross-sectional clinical study, 406 eyes of 203 glaucoma patients and 200 eyes of 100 normal control subjects 18 to 70 years old underwent optic disc morphometry, automated perimetry, measurement of temporal contrast sensitivity by a full-field flicker test, blue-on-yellow visually evoked potential (VEP), and black-and-white pattern-reversal electroretinogram (ERG). Diagnosis of glaucoma was based on a qualitative classification of the optic nerve head and retinal nerve fiber layer independent of intraocular pressure and visual field. Confirmatory factor analysis was performed in the patient group as a whole and in a subgroup showing moderate to advanced glaucomatous optic nerve head damage.

RESULTS

The confirmatory factor analysis models explained the data satisfactorily (P > 0.18, all patients; P > 0.34, subgroup). Global glaucomatous damage was quantified best by the mean defect of automated perimetry (r = 0.81; r = 0.87), followed by the area of the neuroretinal rim (r = 0.64; r = 0.73), the full-field flicker test (r = 0.59; r = 0.65), the pattern-reversal ERG amplitude (r = 0.54; r = 0.55), and the VEP peak time (r = 0.55; r = 0.54).

CONCLUSIONS

Confirmatory factor analysis allows quantification of the validity of established and new procedures that measure global glaucomatous damage using cross-sectional data. The results are not dependent on the preselection of a specific gold standard. Psychophysical testing and morphometry quantified glaucomatous damage best, compared with electrophysiological procedures.

Regulation of intracellular calcium by a signalling complex of IRAG, IP3 receptor and cGMP kinase Ibeta

Calcium release from the endoplasmic reticulum controls a number of cellular processes, including proliferation and contraction of smooth muscle and other cells. Calcium release from inositol 1,4,5-trisphosphate (IP3)-sensitive stores is negatively regulated by binding of calmodulin to the IP3 receptor (IP3R) and the NO/cGMP/cGMP kinase I (cGKI) signalling pathway. Activation of cGKI decreases IP3-stimulated elevations in intracellular calcium, induces smooth muscle relaxation and contributes to the antiproliferative and pro-apoptotic effects of NO/cGMP. Here we show that, in microsomal smooth muscle membranes, cGKIbeta phosphorylated the IP3R and cGKIbeta, and a protein of relative molecular mass 125,000 which we now identify as the IP3R-associated cGMP kinase substrate (IRAG). These proteins were co-immunoprecipitated by antibodies directed against cGKI, IP3R or IRAG. IRAG was found in many tissues including aorta, trachea and uterus, and was localized perinuclearly after heterologous expression in COS-7 cells. Bradykinin-stimulated calcium release was not affected by the expression of either IRAG or cGKIbeta, which we tested in the absence and presence of cGMP. However, calcium release was inhibited after co-expression of IRAG and cGKIbeta in the presence of cGMP. These results identify IRAG as an essential NO/cGKI-dependent regulator of IP3-induced calcium release.

Migraine and tension headache in high-pressure and normal-pressure glaucoma

PURPOSE

To analyze the association of normal-pressure glaucoma and migraine.

METHODS

In a prospective study, 154 patients with glaucoma (56 normal-pressure subgroup and 98 high-pressure glaucoma subgroup), 55 patients with ocular hypertension, and 75 control subjects were analyzed by means of a standardized questionnaire based on International Headache Society criteria.

RESULTS

According to the questionnaire, 46 patients (17%) were classified as suffering from migraine and 20 (7%) from tension headache (episodic and chronic). The prevalence of headache, migraine, and tension headache did not vary significantly among control subjects, patients with ocular hypertension, and patients with glaucoma, but migraine was significantly more common in patients with normal-pressure glaucoma (28%) compared with control subjects (12%; P<.05) and patients with high-pressure glaucoma (10%; P<.01).

CONCLUSION

The results suggest an association of normal-pressure glaucoma and migraine and a potential, common vascular etiology of both diseases.

The full-field flicker test in glaucomas: influence of intraocular pressure and pattern of visual field losses

BACKGROUND

The purpose of this study was to evaluate how temporal contrast sensitivity (TCS) determined with full-field flicker stimuli is influenced by intraocular pressure and whether TCS is reduced in glaucoma patients with diffuse perimetric losses as well as in patients with localized visual field deficits.

METHODS

TCS was determined with sinusoidally flickering light (37.1 Hz) in a full-field bowl. Perimetric mean defect (MD) and cumulative defect curves (Octopus G1) were used to distinguish between patients with localized and diffuse field deficits. Normal subjects (296), low-tension glaucoma patients (98) and open-angle glaucoma patients with previously elevated intraocular pressure (541) were classified into five subgroups taking into account the depth of their visual field losses.

RESULTS

No significant correlation between full-field flicker sensitivity and prevailing intraocular pressure was found in normals (Y=1.36+0.006 X) or in patients (Y=0.95-0.0002 X). Analyses of validity at a predefined specificity of 90% reveal a reduction of TCS in patients with early (MD<5 dB) diffuse perimetric losses (sensitivity 69%) as well as in those showing localized visual field defects (sensitivity 65%). Sensitivity was 87% in patients with diffuse perimetric defects (MD 5-10 dB), 93% in a group of patients with both types of losses, and 100% in advanced glaucomas (MD>20 dB). The lack of TCS is similar in open-angle glaucomas and in field-loss-matched normal-tension glaucoma patients.

CONCLUSIONS

Significantly reduced TCS in patients with early diffuse perimetric losses as well as in those showing localized visual field defects indicates that localized damages can be associated with general deterioration of the ability to perceive flickering stimuli. Thus, this flicker test can be performed in a full-field bowl with no need for fixation. Considering its other clinical qualities (photopic conditions, low influence of prevailing intraocular pressure and media opacity) the test may be a useful, convenient supplementary procedure in glaucoma screening.

Temporal contrast sensitivity with peripheral and central stimulation in glaucoma diagnosis

AIMS

To evaluate temporal contrast sensitivity with full field, peripheral, and central stimulation and to determine the most sensitive corresponding retinal area for glaucoma damage.

METHODS

Temporal contrast sensitivity was determined either with a full field, a peripheral annular area from 30 degrees to 90 degrees, or a central area from 0 degree to 30 degrees at a frequency of 37.1 Hz. 232 eyes of 232 subjects were included. They were classified into four groups: eyes with ocular hypertension (OHT, n = 54), "preperimetric" glaucomas (n = 73) with glaucomatous optic disc abnormalities but no visual field loss, "perimetric" glaucomas (n = 53) with visual field loss, and 52 normals.

RESULTS

In all four groups, temporal contrast sensitivity was almost equal with full field and peripheral, but significantly higher than with central stimulation (p < 0.001). With regard to the diagnostic power of the three different stimulus areas, OHTs and glaucomas were found to be best discriminated from normals by peripheral stimulation.

CONCLUSIONS

According to these results, temporal contrast sensitivity seems to be determined by peripheral retinal areas. As the diagnostic power of the three different stimulus areas was best with the peripheral stimulation, this condition should be used for early glaucoma diagnosis.

Regulation of stably expressed and native BK channels from human myometrium by cGMP- and cAMP-dependent protein kinase

The cloned BK channel alpha subunit from human myometrium was stably expressed in Chinese hamster ovary cells, either alone (CHOalpha cells) or in combination with the auxiliary beta subunit (CHOalpha+beta cells). We studied basic channel properties and the effects of cGMP- and cAMP-dependent protein kinases on the BK channel activity. Coexpression of alpha and beta subunits enhanced the Ca2+ and voltage sensitivity of the BK channel, and decreased the inhibitory potency of iberiotoxin. Blocking and stimulating effects on BK channel activity by charybdotoxin and nitric oxide, respectively, were independent of the beta subunit. The cGMP kinase Ialpha and cAMP kinase failed to affect BK channel activity in CHOalpha and CHOalpha+beta cells at different [Ca2+]i and voltages. In contrast, BK channels in freshly isolated myometrial cells from postmenopausal women responded to cAMP kinase and cGMP kinase with a fourfold and twofold decrease in their open probability (NPo), respectively. These effects could be reversed by alkaline phosphatase and remained unaffected by the phosphatase inhibitor okadaic acid (100 nM). In 28% of myometrial cells, however, cAMP and cGMP kinases increased NPo 2-fold and 3.5-fold, respectively. This stimulation was enhanced rather than reversed by alkaline phosphatase and was abolished by 100 nM okadaic acid. The results suggest that in stably transfected CHO cells the expressed BK channel is not regulated by cAMP kinase and cGMP kinase. However, in native myometrial cells stimulatory and inhibitory regulation of BK channels by cAMP kinase and cGMP kinase was observed, suggesting that channel regulation by the protein kinases requires factors that are not provided by CHO cells. Alternatively, failure of regulation may have been due to the primary structure of the myometrial BK channel protein used in this study.

[Glaucoma and pregnancy--review of the literature with a case report]

BACKGROUND

Intraocular pressure usually decreases during pregnancy. Pregnancy-related physiological changes do not seem to cause progression of glaucoma.

PATIENT AND METHODS

The literature regarding glaucoma, ocular hypertension and pregnancy indexed in Medline is reviewed. In addition, we report on a 35-year-old patient with ocular hypertension and a known glaucoma family history, who was thoroughly examined before, during and after pregnancy (visual fields, optic disc measurements, 24-hours tension profile, sense physiology ["Erlanger flicker-test", pattern-reversal-ERG, blue-yellow-VEP], ocular perfusion).

RESULTS

Visual fields and optic disc measurements did not become worse during pregnancy. Also the other sensory parameters ("Erlanger flicker-test", pattern-reversal-ERG, blue-yellow-VEP) did not deteriorate. Intraocular pressure was reduced by 7 mm Hg during and 2 months after pregnancy. Systolic and diastolic blood velocity of the ophthalmic artery measured by dopplersonography was increased by 60% during pregnancy.

CONCLUSIONS

According to present knowledge pregnancy is associated with decreased intraocular pressure and does not seem to constitute a risk factor for progression of ocular hypertension or primary open angle glaucoma. Whether antiglaucomatous drug therapy during pregnancy is necessary awaits further evaluation.

A multivariate sensory model in glaucoma diagnosis

PURPOSE

To evaluate whether the combination of two psychophysical and two electrophysiological procedures improves diagnostic validity compared with single procedures.

METHODS

In a clinical study, 73 patients with glaucoma from the University Eye Hospital in Erlangen and 122 healthy control subjects from the university staff, ranging in age from 19 to 62 years, underwent measurement of temporal contrast sensitivity using a full-field flicker test, spatiotemporal contrast sensitivity, blue-on-yellow visual evoked potential (VEP), and a black-and-white, pattern-reversal electroretinogram. Diagnostic reference criteria included applanation tonometry, optic disc morphometry, and automated perimetry. Sensitivity was determined univariately with a fixed specificity of 80% and in a multivariate approach using logistic regression analysis. The classification rate was estimated using the leaving-one-out method. The correlation with intraocular pressure, visual field defects, and optic nerve defects was determined.

RESULTS

Contrast sensitivity measurements and the blue-on-yellow pattern-onset VEP showed comparable sensitivity (85%, 84%, and 85%) with 80% specificity, and a pattern-reversal electroretinogram showed lower sensitivity (64%). The first three methods contributed independent information to a diagnostic score. This score improved sensitivity to 94%, with a specificity of 89%. All procedures moderately correlated with the neuroretinal rim area of the optic disc (r=0.32-0.46). The psychophysical tests showed a higher correlation with visual field defects (r > 0.5) than the electrophysiological tests (r < 0.3).

CONCLUSIONS

The multivariate approach substantially increased the diagnostic validity compared with single procedures. This was probably because the diagnostic procedures under investigation tested different aspects of visual function.

Defective smooth muscle regulation in cGMP kinase I-deficient mice

Regulation of smooth muscle contractility is essential for many important biological processes such as tissue perfusion, cardiovascular haemostasis and gastrointestinal motility. While an increase in calcium initiates smooth muscle contraction, relaxation can be induced by cGMP or cAMP. cGMP-dependent protein kinase I (cGKI) has been suggested as a major mediator of the relaxant effects of both nucleotides. To study the biological role of cGKI and its postulated cross-activation by cAMP, we inactivated the gene coding for cGKI in mice. Loss of cGKI abolishes nitric oxide (NO)/cGMP-dependent relaxation of smooth muscle, resulting in severe vascular and intestinal dysfunctions. However, cGKI-deficient smooth muscle responded normally to cAMP, indicating that cAMP and cGMP signal via independent pathways, with cGKI being the specific mediator of the NO/cGMP effects in murine smooth muscle.

Frequency dependence in the action of the class III antiarrhythmic drug dofetilide is modulated by altering L-type calcium current and digitalis glucoside

We investigated how modulation of L-type calcium current affects the class II antiarrhythmic effect of dofetilide. Action-potential duration (APD) was determined in guinea pig papillary muscle by microelectrode techniques at different stimulation frequencies (0.5-3 Hz). The APD-prolonging effect (deltaAPD) of 10 nM dofetilide was reversed frequency dependent; it was 51 +/- 6 ms at 0.5 Hz and lower at 3 Hz, 21 +/- 3 ms. Either 10 microM diltiazem or 0.1 microM Bay K 8644 (BayK) was added to decrease or increase L-type calcium currents. In the presence of dofetilide + diltiazem, deltaAPD was reduced to 32 +/- 4 ms at 0.5 Hz but not affected at 3 Hz. Conversely, dofetilide + BayK further prolonged deltaAPD to 78 +/- 10 ms at 0.5 Hz but not at 3 Hz. When 10 microM dihydroouabain, a digitalis glucoside, was added to dofetilide, deltaAPD was more pronounced at 0.5 Hz and reduced at 3 Hz. We conclude that the reversed frequency-dependent effect of dofetilide on APD can be modulated by altering L-type calcium currents. With reduced calcium current, the frequency profile is less reversed and more favorable. The similarity of BayK and dihydroouabain in aggravating the reversed frequency-dependent effect of dofetilide is in line with a contribution of intracellular calcium to this reversed rate-dependent profile in the guinea pig ventricle.

Differential effect of beta-adrenergic stimulation on the frequency-dependent electrophysiologic actions of the new class III antiarrhythmics dofetilide, ambasilide, and chromanol 293B

INTRODUCTION

Blockade of the rapid delayed rectifier potassium current (IKr) as an important mechanism for current Class III antiarrhythmics is less effective in action potential prolongation during beta-adrenergic activation. We hypothesized that blockade of the increased slow IK (IKs) current during beta-adrenergic stimulation could improve action potential prolongation and tested this hypothesis by comparison of three different IK blockers: dofetilide, a selective blocker of IKr; ambasilide, a nonselective blocker of IK; and chromanol 293B, a selective blocker of IKs.

METHODS AND RESULTS

Transmembrane action potential duration was determined in guinea pig papillary muscles. After equilibration with the potassium channel blockers (dofetilide 10 nM, ambasilide 10 microM, chromanol 293B 10 microM), isoproterenol (10 and 100 nM) was added. The action potential prolonging effect of dofetilide was reduced in the presence of increasing concentrations of isoproterenol whereas the effect of ambasilide was much less reduced. In contrast, the effect of chromanol 293B clearly was increased in the presence of both concentrations of isoproterenol. No afterdepolarizations were observed after application of isoproterenol in control. Following isoproterenol, but not before, dofetilide and chromanol 293B induced early afterdepolarizations in 20% and 17% of the papillary muscles, whereas ambasilide and chromanol 293B induced delayed afterdepolarizations in 27% and 33%, respectively.

CONCLUSION

In contrast to dofetilide, the Class III effect of ambasilide is less reduced and the effect of chromanol 293B is enhanced during beta-adrenergic stimulation. Our data support the hypothesis that IKs blockade improves the efficacy of antiarrhythmics in action potential prolongation during beta-adrenergic activation; however, this effect may increase the risk of afterdepolarizations.

Large-field S-cone flicker test

BACKGROUND

Disturbances of blue color vision and of temporal contrast sensitivity can indicate early damage in glaucoma. For the present study a quick and easy test was devised which examines both functions at one time by testing the temporal contrast sensitivity of a blue flickering light on an intense yellow background.

METHODS

Large coextensive background and test fields (85 degrees) are used, making fixation uncritical. Detailed experiments were made in two normal subjects to derive spectral sensitivity curves from flicker-fusion frequency (FFF) versus intensity functions and to obtain complete temporal contrast-sensitivity (De Lange) curves under different levels of adaptation and test lights. After selection of appropriate luminances and one stimulation frequency from these experiments, test-retest variability was studied in four subjects in five repetitions. In addition, normal values were collected from 22 subjects.

RESULTS

Spectral sensitivities for two levels of FFF (15 Hz and 44 Hz) agree with Stiles' pi 1 at the low and with pi 4 at the high FFF. Temporal contrast-sensitivity curves show a low-frequency section with peak sensitivity at 1 Hz and a high-frequency section with a peak at around 4 Hz. From the basic experiments the following conditions for the clinical examination were selected: Background luminance 2600 cd/m2, test luminance at 451 nm 0.8 cd/m2, stimulation frequency 4 Hz. The test-retest variability showed an acceptable intraclass correlation co-efficient (0.6).

CONCLUSIONS

The present experiments carried out with a very large stimulus led to meaningful results which are in rather good agreement with results reported in the literature on small-field stimuli. The blue-on-yellow flicker test carried out under the conditions mentioned above is a quick and easy test which could be helpful in improving early glaucoma diagnosis.

[Value of blue-on-yellow VEP for early diagnosis in suspected glaucoma. Biostatistical considerations and results]

BACKGROUND

In the Erlangen glaucoma study, the blue-on-yellow VEP was shown to be able to discriminate between controls and manifest glaucoma patients. SCIENTIFIC QUESTIONS AND AIMS: In our investigation, we assessed the validity of the blue-on-yellow VEP for early diagnosis of glaucoma. With this aim, we compared different subgroups of glaucoma suspects. The main issue of the investigation was the biostatistical aspects of early diagnosis of glaucoma.

MATERIAL, METHODS AND RESULTS

Within a group of patients who were suspected of having ocular hypertensive glaucoma without visual field loss we compared 109 patients with optic disc damage [preperimetric (PPM) 47 +/- 11 years] and 91 patients without optic disc damage [ocular hypertension (OHT) 45 +/- 10 years]. We evaluated the N 1-amplitude and the peak latency of the blue-on-yellow VEP. The peak latency was significantly longer in the PPM group (first examination: OHT 118 +/- 9.5 ms, PPM 122.0 +/- 10.5 ms; second examination: 119.1 +/- 7.4/121.9 +/- 11.0 ms; third examination: 118.5 +/- 9.1/122.4 +/- 10.9 ms). The amplitude was reduced in the PPM group (P = 0.08). The differences between the two groups only allowed limited individual separation: (sensitivity of 42% for advanced optic disc damage with 80% specificity among OHT patients).

CONCLUSIONS

The reduced sensitivity of a diagnostic procedure within a group of glaucoma suspect patients compared with patients with manifest glaucoma might be explained by: (1) possible misclassifications of patients and (2) a smaller degree of loss of visual function in the early stages of the disease.

The full-field flicker test in early diagnosis of chronic open-angle glaucoma

PURPOSE

To evaluate whether the full-field flicker test, a psychophysical test employing full-field flickering stimuli to measure temporal contrast sensitivity, can detect glaucomatous optic nerve damage in patients with increased intraocular pressure and glaucomatous optic disk abnormalities but normal visual fields.

METHODS

Temporal contrast sensitivity was determined with a sinusoidally flickering light (frequency, 37.1 Hz) of constant mean photopic luminance (10 cd/m2) presented in a full-field bowl of 58-cm diameter. The prospective study included three groups of individuals: the "preperimetric" glaucoma group of 80 patients with increased intraocular pressure, glaucomatous optic disk abnormalities, and normal visual fields; the "perimetric" glaucoma group of 56 glaucomatous patients with increased intraocular pressure and glaucomatous changes of the optic disk and visual field; and the control group of 96 normal subjects.

RESULTS

Temporal contrast sensitivity was significantly (P < .001) lower in the two glaucoma groups than in the control group. In the preperimetric glaucoma group, 34% of the patients (27/ 80) were recognized by the full-field flicker test at a specificity of 99%. For all study subjects, temporal contrast sensitivity decreased significantly (P < .001) with decreasing neuroretinal rim area, enlarging peripapillary atrophy, and diminishing retinal nerve fiber layer visibility.

CONCLUSIONS

The full-field flicker test can detect glaucomatous optic nerve damage in patients with increased intraocular pressure, glaucomatous optic disk abnormalities, and normal visual fields. Considering its feasibility, simplicity, quick performance, and low costs, the full-field flicker test may be helpful in clinics and in screening examinations as a supplement to glaucoma diagnosis.

The effect of stimulus size on human cortical potentials evoked by chromatic patterns

The effect of stimulus size on the pattern onset-offset visual evoked potential elicited with stimuli of two different wavelengths is studied under intensive yellow adaptation: (1) The onset response obtained with a 460 nm pattern is of negative polarity (N1) and saturates in amplitude with a stimulus radius of 7 deg. The onset response obtained with a 550 nm pattern is of positive polarity and continues to increase up to the maximum size (32.2 deg). (2) The peak time of N1 (460 nm) decreases with increasing stimulus size, that of P1 (550 nm) remains constant. These results are discussed as reflecting either varying retinal and brain anatomy, or cone activity, color-opponent activity, or luminance contrast activity.

Contrast-sensitivity testing with scanning-laser ophthalmoscope stimulation in normal, ocular hypertensive, and glaucomatous patients

The purpose of this study was to test the usefulness of the scanning laser ophthalmoscope (SLO) as a stimulator for localized contrast-sensitivity (CS) measurements under visual control in normals and glaucomatous patients. The helium-neon laser (630 nm) of a Rodenstock SLO was used to generate a localized square-wave stripe pattern and a fixation mark while an infrared laser (780 nm) visualized the eye's fundus. Thus, measurements with unstable fixation could be discarded. The spatio-temporal CS was determined with a localized alternating pattern as follows: 5 Hz, 2.88 cycles/degree; stimulus diameter 2 degrees; test location central, temporal upper, and temporal lower retinal area. The subjects included 47 controls, 23 ocular hypertensive patients (intraocular pressure > 21 mmHg, normal optic disc, no visual field defect), 27 "preperimetric" glaucoma patients (intraocular pressure > 21 mmHg, early glaucomatous optic disc damage, no visual field defect), and 41 "perimetric" glaucoma patients with glaucomatous defects of the optic disc and perimetric losses. Nonparametric tests (Wilcoxon, Spearman) were used for statistical analyses. Among the three locations tested, CS values recorded for the temporal lower retinal areas showed the strongest reduction in glaucomas ("preperimetric" P = 0.002, "perimetric" P < 0.0001) and a significant correlation with the perimetric mean defect of the stimulated area (r = 0.65, P < 0.001). In all, 95% of glaucomatous eyes with extensive visual field losses were recognized as pathologic at a specificity of 80%. Spatiotemporal CS of temporal retinal areas is sensitive to glaucoma. The present study confirms the feasibility of using the SLO system for localized CS measurements, in normals and patients.

[Sensory physiology and biomorphology of the optic papilla: analysis of correlation in normal persons]

BACKGROUND

The aim of the present study was to investigate whether the morphological variability of the optic disc has an influence on sensory test procedures.

PATIENTS AND METHODS

In 52 eyes of 52 normal persons psychophysical (perimetry, color vision, contrast sensitivity) and electrophysiological (pattern-ERG and pattern-VEP) tests and planimetric papillometry were performed. A correlation analysis was made between sensory tests and area of optic disc (1.79 to 5.2 mm2) and neuroretinal rim.

RESULTS

There was no significant correlation between perimetry, color vision, pattern-ERG, pattern-VEP, spatio-temporal and temporal contrast sensitivity on the one hand and optic disc area or neuroretinal rim area on the other.

CONCLUSION

Results of psychophysical and electrophysiological tests do not have to be corrected with respect to the neuroretinal rim area.

Protein phosphatase 2A is essential for the activation of Ca2+-activated K+ currents by cGMP-dependent protein kinase in tracheal smooth muscle and Chinese hamster ovary cells

The regulation of Ca2+-activated K+ channels (KCa channels) by cGMP-dependent protein kinase (cGMP kinase) and its molecular mechanism were investigated in Chinese hamster ovary (CHO) and tracheal smooth muscle cells. In CHO wild-type cells (CHO-WT cells) and in CHO cells stably transfected with cGMP kinase Ialpha (CHO-cGK cells), KCa channels with intermediate conductance (approximately 50 picosiemens) were identified. Due to the basal activity of cGMP kinase, Ca2+-activated K+ currents had a higher sensitivity toward the cytosolic Ca2+ concentration in CHO-cGK cells than in CHO-WT cells. Dialysis of the active fragment of cGMP kinase (300 n) into CHO-WT cells or of cGMP into CHO-cGK cells increased the Ca2+-activated K+ current, while the catalytic subunit of cAMP-dependent protein kinase (cAMP kinase) was without effect. In cell-attached patches obtained from freshly isolated bovine tracheal smooth muscle cells, the open state probability (NPo) of maxi-KCa channels (conductance of approximately 260 picosiemens) was enhanced by 300 microM 8-(4-chlorophenylthio)-cGMP, a specific and potent activator of cGMP kinase. In contrast, 1 microM isoprenaline, 20 microM forskolin, and 3 mM 8-bromo-cAMP failed to enhance KCa channel activity. In excised inside-out patches, only the active fragment of cGMP kinase (but not that of cAMP kinase) increased NPo when applied to the cytosolic side of the patch. The enhancement of NPo by cGMP kinase was inhibited in CHO cells as well as in tracheal smooth muscle cells by the cGMP kinase inhibitor KT 5823 (1 microM) and the protein phosphatase (PP) inhibitors microcystin (5 microM) and okadaic acid (10 nM). The catalytic subunit of PP2A (but not that of PP1) mimicked the effect of cGMP kinase on NPo in excised inside-out patches. The results show that cGMP kinase regulates two different KCa channels in two unrelated cell types by the same indirect mechanism, which requires the activity of PP2A. The regulation of the KCa channel is specific for cGMP kinase and is not mimicked by cAMP kinase.

Color axis evaluation of the Farnsworth Munsell 100-hue test in primary open-angle glaucoma and normal-pressure glaucoma

BACKGROUND

It was the aim of the present study to analyze a separate color-axis evaluation of the Farnsworth Munsell 100-hue test (FM 100) in primary open-angle glaucoma (POAG) and normal pressure glaucoma (NPG).

PATIENTS AND METHODS

One eye of each of 112 individuals (age 35-65 years, visual acuity > 20/28, myopia < -7.5 D) was included. The groups consisted of 62 normal subjects and 50 glaucoma patients (33 POAG and 17 NPG). We evaluated the FM 100 overall error score and the error scores of the protan, deutan and tritan axes. The results were compared with perimetric (Octopus G1 mean defect) and morphometric data of the optic disc.

RESULTS

All error scores were significantly higher in the glaucoma group than in the normal group. In an age-related evaluation, differences were significant in age groups above 45 years. No significant differences were found between the POAG and NPG groups. The sensitivity of the overall score to identify glaucoma was 62% (specificity 80%). In the glaucoma group the overall score and the protan score increased significantly with the mean defect (r > 0.3, P < 0.01). Several scores increased slightly with decreasing neuroretinal rim area, but not on a significant level. Separate color-axis evaluations did not show any stronger correlations and did not reveal any differences between POAG eyes and NPG eyes. This was true even for the tritan axis error.

CONCLUSIONS

Although FM 100 error scores are higher in glaucoma eyes and increase with glaucomatous damage, they do not separate well. In the sample of this study, separate color-axis evaluation did not improve the diagnostic value. With the FM100 a different pattern of color vision defects in POAG and NPG eyes could not be detected.

Quadrant pattern ERG with SLO stimulation in normals and glaucoma patients

BACKGROUND

The pattern ERG (PERG) is one of the promising methods for investigation of glaucoma and may detect it at an early stage. The purpose of this study was to test the usefulness of the scanning laser ophthalmoscope (SLO) as a stimulator for evoking quadrant PERGs under visual control in normal and glaucoma eyes.

METHODS

The helium-neon laser of a Rodenstock SLO was used for quadrant stimulation (18 degrees x 29 degrees pattern size), while an infrared laser visualized the eye's fundus. Steady-state pattern-reversal ERGs were recorded in response to stripe patterns (8.33 Hz, 0.5 cycles/deg) in four retinal quadrants. Corresponding visual field defects were determined with the Octopus perimeter (G1, peridata). The subjects were 28 controls and 34 glaucoma patients with visual field losses and papillometric defects.

RESULTS

Amplitudes of nasal retinal areas (which include the blind spot) are smaller than those of temporal ones, and temporal lower responses are the largest. PERG amplitudes of all quadrants are significantly reduced in glaucoma (sensitivity 82%, specificity 80%). The differences between upper and lower quadrant PERGs are correlated with the differences between localized visual field defects of the same areas, (r = 0.46, P = 0.02).

CONCLUSIONS

The study demonstrates the feasibility of the SLO system for evoking localized PERG in normals and patients and shows the reduction of quadrant ERG amplitudes in glaucoma using the laser system.

Differential class III antiarrhythmic effects of ambasilide and dofetilide at different extracellular potassium and pacing frequencies

We studied the effect of two new class II antiarrhythmics, ambasilide and dofetilide, on the action potential duration (APD) of guinea pig right ventricular papillary muscle at different extracellular potassium concentrations ([K+e]) and pacing frequencies. Under normal [K+e], both drugs significantly prolonged APD90 (APD at 90% repolarization) at 0.5 Hz. The effect of ambasilide was well preserved at rapid pacing rates, independent of [K+e]. The effect of dofetilide was markedly reduced with increasing pacing rate, especially in high [K+e]. Therefore, ambasilide may be useful in treating tachyarrhythmias in normal, as well as in altered [K+e] conditions.