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There are many corneal diseases that can be detected using an eye-care device called videokeratograph. The videokeratograph is based on the principle of an apparatus called Placido disc and is used to precisely measure the anterior surface of the cornea. This disc contains rings alternately white and black, which are reflected on the patient's cornea during the examination. The device can find anomalies by analyzing the reflected image, using image-processing algorithms. Although the efficiency of most commercial videokeratographs is acceptable, manufacturers do not disseminate to the scientific community the technique used in the image analysis algorithms. This makes it difficult for the specialized researcher in order to find better algorithms for the image-processing and, consequently, increase the instrument's precision. In this work we have segmented the Placido disc in polar coordinates by implementing a diagonal section of the image, in the radial direction. The objective is to find the inflection points in the signal obtained. In this paper the signal is studied by using the Mumford-Shah segmentation method. The results are compared to those obtained with other classic methods in the literature, e.g. Marr-Hildreth filters, numerical derivative, Fourier derivative, morphological Laplacian and Canny derivative. The best result was achieved by using the Mumford-Shah functional. Using this technique it was possible to find the inflection positions with higher accuracy. The method did not detect any false inflection. Mumford-Shah's method demonstrated also a high precision in the task of eliminating noises from the original signal.

The purpose of this paper is to warn the ophthalmologist about the possibility of facing rare cases of corneal dystrophies. Clinical findings of a case of posterior amorphous dystrophy were correlated with refraction, topography, and ultrasound biomicroscopy.

Purpose: To determine the prevalence of conjunctivochalasis in patients with immune thyroid diseases, to determine whether there is any association between the 2 diseases, and to determine cytologic study of conjunctivochalasis through the cytology impression test., Methods: A clinical prospective cohort study carried out by the External Diseases Department in the Ophthalmology Sector and the Thyroid Department in the Endocrinology Sector at Federal University of Sao Paulo (UNIFESP). The patients included were divided into 2 groups following these inclusion criteria: a control group of 25 patients without thyroid diseases, confirmed after clinical and laboratory examinations (thyroid hormones), or any other ocular diseases. The study group consisted of 31 patients with thyroid diseases, the diagnosis of which was confirmed by the Endocrinology Sector. The thyroidopathies included were autoimmune diseases but excluded nonautoimmune diseases. A protocol endorsed by the UNIFESP was followed, using clinical and ophthalmological history, biomicroscopy, and impression cytology., Results: Fifty-two percent of patients without thyroid diseases and 88% of patients with thyroid diseases presented with conjunctivochalasis. The risk ratio was 1.705 (Pr > chi(2) = 0.0038), indicating that there is an association between them. For the impression cytology in inferior bulbar conjunctiva, there was an association between the result of the impression cytology and conjunctivochalasis (Pearson chi(2) = 10.1190 Pr = 0.006)., Conclusion: The prevalence of conjunctivochalasis in patients with autoimmune thyroid diseases was 88%. Patients with autoimmune thyroidopathy presented higher percentages of conjunctivochalasis than the control group, confirming the association between them. The cytologic study showed the highest prevalence of abnormal surface features in eyes with conjunctivochalasis.

The objective is to evaluate the effects of phototherapeutic keratectomy (PTK) in bullous keratopathy patients. Phototherapeutic keratectomy was performed in a pseudophakic patient with corneal decompensation after lens extraction, with the excimer laser Nidek EC 5000 after manual corneal epithelial debridement. There was no pain after fifteen days the laser application and during the eight months of follow-up. Visual acuity was unchanged. The phototherapeutic keratectomy excimer laser must be considered one more alternative for pain treatment in bullous keratopathy of pseudophakic patients.

Objective: Videokeratography (VK) has been a widespread technology for corneal surface analysis since the mid 1980s. Most manufactures use personal computers attached to a Placido disc apparatus in order to capture and process digital images. Although precision reported by most manufactures are within very good limits, none of them have disclosed, probably due to proprietary reasons, the nature of the algorithm used in their image-processing phase. This is a problem when researchers want to reproduce or test their own curvature or elevation algorithms on Placido images generated on different commercial videokeratographs or even compare their algorithms on data from different manufactures. Our main objective in this work was to develop certain basic techniques for Placido image edge detection and to compare the results of each algorithm in terms of precision at the image level and also the consequences for axial curvature computations. We also propose that manufactures come forward and at least explain which image-processing technique is used in their own algorithms so other researchers and laboratories can make better use of their data to improve VK algorithms., Material/methods: Placido images from an Eyesys system 2000 were captured for four different spherical surfaces. Each image was saved in bitmap format at the hard disk of an IBM computer. Six different image-processing algorithms were developed using different techniques well documented in the literature. The six methods were as follows: (1) first order numerical derivative, (2) first and (3) second order Fourier derivative, (4) the Marr-Hildreth filter, (5) Canny's method and (6) Mathematical Morphology. Each algorithm was tested on each of the Placido images., Results: Edge radial distance from center of Placido image was compared for each algorithm and a computer simulation of the VK system. The simulated image was used as absolute reference. Another approach was to calculate Axial dioptric power using, again, well documented procedures, and compare the results for each image detection algorithm. Mean deviation in terms of pixels/millimeters/dioptric power for all spheres for methods (1-6) were, respectively, (1) 33.1695/0.7961/0.79, (2) 32.79/0.7870/0.7724, (3) 60.7150/1.4572/1.4192, (4)18.97/0.4553/0.4572, (5) 46.33/1.1119/1.0917 and (6) 20.55/0.4932/0.48., Discussion: All methods have great deviation propagation in terms of dioptric power calculations when the axial algorithm is used and the absolute reference simulated edges are used to generate the calibration curves. This indicates that researchers should be more careful when using resulting image processing files from different videokeratographs to compare their own curvature or elevation algorithms among different instruments or even to measure the absolute precision of their new algorithms.

Purpose: To evaluate the percentage of ophthalmologic patients who search for a second opinion and to verify the main reason for this search., Methods: The methodology of the present study consists of a direct interview with 806 ophthalmologic patients, attended at a specialized hospital, through an adequately elaborated questionnaire, containing variables that can be related to the search for this second opinion., Results: It was observed that 32% of the ophthalmologic patients ask for a second opinion and, of these, 31% search for other physicians in order to confirm the diagnosis., Conclusion: Most search for the second opinion in Ophthalmology is directly linked to the doctor/patient relationship. Such situation serves to warn the present professional teaching, pointing to the need for dedication, effort and greater investment in learning, regarding both the present and the future professionals. In addition, it is important to emphasize the necessity in improving the working conditions and wages. Maybe, the review of these aspects can contribute to decrease the mentioned problems.

Bryothamnion seaforthii, a red alga common to the Northeastern coast of Brazil, was used to prepare the protein fraction F0/60 by ammonium sulfate precipitation. The chromatography of F0/60 on DEAE-Sephadel column resulted in two lectin fractions, PI and PII, which have antinociceptive properties in rodents. We determined the antinociceptive activity of the PII fraction and of a carbohydrate-containing fraction (CF) in mice. The CF was prepared from the dried algae, after digestion with 100 mM sodium acetate, pH 6.0, containing 5 mM cysteine, EDTA and 0.4% papain, at 60 masculine C. A 10% cetylpyridinium chloride was added to the filtrate, and the precipitate was dissolved with 2 M NaCl:ethanol (100:15, v/v) followed by the carbohydrate precipitation with ethanol. The final precipitate, in acetone, was dried at 25 masculine C. The PII fraction markedly inhibited acetic acid-induced abdominal writhing after ip administration (control: 27.1 +/- 2.20; PII 0.1 mg/kg: 5.5 +/- 1.85; 1 mg/kg: 1.6 +/- 0.72 writhes/20 min) and after oral administration (control: 32.0 +/- 3.32; PII 0.1 mg/kg: 13.1 +/- 2.50; 1 mg/kg: 9.4 +/- 3.96 writhes/20 min). PII was also effective against both phases of pain induced by 1% formalin (control, ip: 48.2 +/- 2.40 and 27.7 +/- 2.56 s; PII: 1 mg/kg, ip: 34.3 +/- 5.13 and 5.6 +/- 2.14 s; control, po: 44.5 +/- 3.52 and 25.6 +/- 2.39 s; PII 5 mg/kg, po: 26.5 +/- 4.67 and 15.3 +/- 3.54 s for the 1st and 2nd phases, respectively) and in the hot-plate test. The CF (ip) also displayed significant antinociceptive properties in all tests but at higher doses (1 and 5 mg/kg, ip and po). Thus, CF at the dose of 5 mg/kg significantly inhibited writhes (ip: 7.1 +/- 2.47 and po: 14.5 +/- 2.40 writhes/20 min) as well as the 1st (po: 19.6 +/- 1.74 s) and 2nd (po: 7.1 +/- 2.24 s) phases of the formalin test compared to controls ip and po. The antinociceptive effects of both the PII and CF in the formalin and hot-plate tests were prevented at least partially by pretreatment with the opioid receptor antagonist naloxone (2 mg/kg, sc). Moreover, both fractions retained antinociceptive activity in the acetic acid-induced writhing test following heating, a procedure which abolished the hemagglutinating activity of the fraction, presumably due to lectins also present. Finally, both fractions also prolonged the barbiturate-induced sleeping time. These results indicate that carbohydrate molecules present in the PII (26.8% carbohydrate) and CF (21% of the alga dried weight) obtained from B. seaforthii display pronounced antinociceptive activity which is resistant to heat denaturation and is mediated by an opioid mechanism, as indicated by naloxone inhibition.

We report the antinociceptive activity, determined by the writhing, formalin and hot-plate tests in mice, of crude (F0/60), lectin and carbohydrate fractions isolated by ammonium sulfate precipitation (0 to 60%) from Bryothamnion seaforthii and B. triquetrum, species of red algae. Not only fraction F0/60 but also lectins from both species significantly inhibited acetic acid-induced abdominal contractions after intraperitoneal or oral administrations. In the formalin test, lectins (1 and 5 mg/kg, ip, and 5 to 20 mg/kg, po) inhibited the 1st and 2nd phases (5 and 20 min, respectively), but the effect occurred predominantly on the 2nd phase. The effects of the lectins were totally or partially reversed by naloxone (2 mg/kg, sc) in the 1st and 2nd phases, respectively. Experiments performed with lectins in the absence and presence of avidin (1 mg/kg, ip) and D-mannose (1 mg/kg, ip) showed that avidin did not interfere with the effect of B. seaforthii lectin but partially reversed the effect of B. triquetrum lectin. D-Mannose completely reversed the effects of both species. F0/60 fractions from both algae significantly increased the latency time in response to thermal stimuli, and naloxone reversed antinociception, indicating the involvement of the opioid system in both the peripheral and central effects of the fractions. In the writhing test, the carbohydrate fractions were the most active, inhibiting the contractions by 71 and 79% (B. triquetrum) and by 46 and 69% (B. seaforthii) at doses of 1 and 5 mg/kg, ip, respectively. Sulfated carbohydrate fractions of B. seaforthii and B. triquetrum, containing only about 5% protein as contaminants, are probably responsible for the antinociceptive effects of these red algae.

We report the first case of human infection by Phaeoisaria clematidis. This fungus caused a corneal ulcer in a Brazilian man who had previously suffered an eye injury. Diagnosis was established by positive direct examination and repeated cultures. The isolate was clearly resistant in vitro to the six antifungal agents tested.

OBJECTIVE: To evaluate the occurrence of intestinal colonization in newborns by multidrug-resistant enterobacteria strains (MDRES) during hospital stay after birth. We used selective media in an attempt to determine the relationship between isolation of these strains and some of the presumed colonization risk factors. METHOD: A sequencial inclusion study of 30 newborns was carried out in the neonatal unit of the HUPE, State University Hospital, a general 600-bed tertiary care hospital. We obtained clinical and epidemiological information from medical records and collected a fecal sample from each newborn, which was plated in gentamicin (8mg/ml) medium and potassium tellurite (25mg/ml) medium. The isolated strains were biochemically identified and also submitted to tests of antimicrobial susceptibility. Nine MDRES were submitted to an assay for plasmid conjugational transfer. RESULTS: We isolated 56 distinct MDRES from 14 among 30 newborns (46.7%). Klebsiella pneumoniae was the most common bacterial species (38/56 (68%). We found statistical association between individual MDRES isolation and presence of 3 or 4 of the following colonization risk factors considered: antimicrobial use, low weight (<2.500g), more than 6 days of hospitalization and artificial milk feeding (p< 0.02). We could detect plasmid resistance transfer by bacterial conjugation for 8 among 9 MDRES. CONCLUSION: The seletive cultura media were useful to detect the high frequence of newborns colonized by MDRES in association with well established infection risk factors. We emphasize the importance of reinforcing control rules aiming at preventing intestinal colonization viewed as a risk of nosocomial infection.

The widespread bad harvests of 1972 in various regions of the world, the consequent reduction in grain reserves, the rapid rise in food prices almost everywhere and its impact on inflation, all have served to draw renewed attention to the problem of hunger which affects millions of human beings in the world today. During the 1974 United Nations World Food Conference many important matters relating to this problem were debated: the creation of international grain reserves; problems concerning world trade of foodstuffs; the current difficulties with certain key agricultural production factors, such as fertilizers; the necessity for organizing a worldwide information system on the situation; and prospects of various harvests and threats of famine in underdeveloped countries. It is often the case that discussion of the hunger problem does not correspond to the gravity of the crisis; true causes of the present situation are not examined, and measures are not adopted that will once and for all--for the first time--abolish hunger. In view of the prospect that the real issues are often ignored, the Transnational Institute provides this analysis in an attempt to clarify what must be done to abolish hunger in the belief that this is within the reach of humanity when and if we are determined to end the irrationalities of the present economic system and the relations of domination which some individuals and countries seek to continue.

The traditional strategies proposed for development of the agricultural production of the underdeveloped countries are examined in this article. It is shown that the application of these strategies in the past has proven insufficient to eliminate world hunger. The limitations of these strategies are discussed and proposals are made for achieving the agricultural development in the underdeveloped world that will be necessary to eliminate hunger in the near future.