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Due to rising demand worldwide it is becoming increasingly more difficult to satisfy the needs for human corneal transplants. At this point transplantation is the only possible cure for endothelial diseases, such as Fuchs endothelial dystrophy. In this article we present descemetectomy, a circumscribed removal of Descemet's membrane (DMx) without subsequent transplantation, as new possible treatment option on the basis of a clinical case.

Background: The German ophthalmological training is still a very individually organized system with only one final oral examination at the end of the 5-year residency. At the beginning of 2013 a new residency program was introduced at the department of ophthalmology of the Heinrich-Heine University Duesseldorf. This study evaluated the resident satisfaction with the new concept., Material and Methods: The new residency program consists of three main changes: firstly a structured training with fixed rotation in the various subdisciplines of ophthalmology, secondly a list of practical skills examinations that has to be completed during the 5-year program and thirdly annual intermediate oral examinations. The satisfaction of the residents with the new program was anonymously evaluated with a Likert scale-based questionnaire with 15 items and additional free text comments., Results: (1) The structured training was mostly rated positively and 9 out of 12 of residents favored a continuation of the training concept in this form. (2) Only 7 out of 11 residents (64 %) wanted to continue the practical skills examinations in this form and only approximately half of the residents saw a positive effect of these examinations. (3) Regarding the annual examinations 8 out of 11 residents (73 %) reported that the examinations helped them to assess their skills better, 91 % (10 out of 11) reported a learning motivation, 90 % (9 out of 10) an improvement in learning due to the examinations and 73 % (8 out of 11) were of the opinion that the examinations should take place regularly., Discussion: The structured training and the annual examinations were positively evaluated. These changes could be effectively implemented even with a relatively small personnel structure. In comparison the practical skill examinations were rated relatively negatively, probably because of the further increase of daily work. The number of skills to be demonstrated is currently reduced and the integration of testing into the clinical routine of examiners and examinees is under revision.

Supernumerary centrosomes and aneuploidy are associated with a malignant phenotype of tumor cells. Centrosomal clustering is a mechanism used by cancer cells with supernumerary centrosomes to solve the threatening problem of multipolar spindles. Griseofulvin is an antifungal substance that interferes with the microtubule apparatus and inhibits centrosomal clustering. It has also been demonstrated that griseofulvin inhibits the growth of tumor cells in vitro and in vivo. However, it is not yet known whether treatment with griseofulvin inhibits growth of adrenocortical tumor cells. We studied the viability and antiproliferative effects of griseofulvin on cultured NCI-H295R adrenocortical carcinoma cells using Wst-1-, BrdUrd-, and [³H]-thymidine assays. For the detection of apoptosis we used a caspase 3/7 cleavage assay and light microscopy techniques. We observed that incubation with griseofulvin for 24-48 h leads to a decrease in the viability and proliferation of NCI-H295R cells in a dose-dependent manner. Significant effects could be observed after incubation with griseofulvin as measured by Wst-1-, BrdUrd-, and [³H]dT- uptake assays. Apoptosis of NCI-H295R cells was increased in a dose-dependent manner up to 4.5-fold after incubation with griseofulvin 40 μM for 24 h as shown by caspase 3/7 cleavage assay and light microscopy. With regard to new treatment strategies for adrenocortical cancer, griseofulvin, and possibly other agents, which interfere with the microtubule apparatus and inhibit centrosomal clustering, may turn out to be interesting targets for further research., (© Georg Thieme Verlag KG Stuttgart · New York.)