Internists, Cardiologist (heart)
6 years of experience

Accepting new patients
Regents of the University of Michigan
20321 Farmington Rd
Livonia, MI 48152
Locations and availability (18)

Education ?

Medical School
American University of the Caribbean (2004)

Affiliations ?

Dr. Ghanbari is affiliated with 2 hospitals.

Hospital Affilations



  • University of Michigan Hospitals & Health Centers
    1500 E Medical Center Dr, Ann Arbor, MI 48109
    • Currently 3 of 4 crosses
    Top 50%
  • Ann Arbor Veterans Affairs Medical Center
    2215 Fuller Rd, Ann Arbor, MI 48105
  • Publications & Research

    Dr. Ghanbari has contributed to 49 publications.
    Title Electromagnetic Interference Between External Defibrillator and Cardiac Resynchronization Therapy-pacemaker (crt-p) Devices.
    Date January 2012
    Journal Pacing and Clinical Electrophysiology : Pace

    Implantable heart rhythm devices are susceptible to interference in hospitals where electromagnetic interference (EMI) sources are ubiquitous.

    Title Small Calibre Polyhedral Oligomeric Silsesquioxane Nanocomposite Cardiovascular Grafts: Influence of Porosity on the Structure, Haemocompatibility and Mechanical Properties.
    Date January 2012
    Journal Acta Biomaterialia

    There is a significant worldwide demand for a small calibre vascular graft for use as a bypass or replacement conduit. An important feature in determining the success of a graft is the wall structure, which includes porosity, pore size and pore interconnectivity, as these play a crucial role in determining the long-term patency of a bypass graft. In this study we fabricate a small diameter (<5mm) vascular graft from polyhedral oligomeric silsesquioxane-poly(carbonate urea)urethane (POSS-PCU) via an extrusion, phase inversion method using an automated, custom built machine. Through the dispersion of a porogen, sodium bicarbonate (NaHCO(3)), in controlled concentrations (0-55%) we were able to produce grafts with well-defined pore morphologies. The impact of NaHCO(3) concentration on the structure of the graft wall and its influence on the mechanical and haemocompatibility properties are evaluated here. Scanning electron microscopy and mercury porosimetry were used to characterise graft structure. Atomic force microscopy elucidated any changes in surface morphology. The addition of NaHCO(3) improved the pore interconnectivity and increasing the concentration of NaHCO(3) led to grafts with rougher surfaces and larger pore sizes. The ultimate tensile strength and suture retention decreased with increasing concentrations of NaHCO(3), while graft compliance increased. To evaluate haemocompatibility platelets and peripheral blood mononuclear cells (PBMC) were incubated on a range of different graft samples. Platelet adhesion, PBMC surface receptor expression (CD14, CD86, CD69 and HLA-DR) and cytokine release (PF4, IL-1β, IL-6, IL-10, TNFα) were all measured. Increasing numbers of platelets adhered to grafts produced with no NaHCO(3), which exhibited a smooth surface morphology, and PBMC adherent on these grafts expressed higher levels of CD14 and CD86. Whilst the different graft samples induced varying levels of cytokine secretion in vitro, no distinct pattern suggesting a non-trivial relationship was observed.

    Title Massive Bilateral Choroidal Detachment Induced by Administration of Topiramate.
    Date November 2011
    Journal Case Reports in Ophthalmology

    Topiramate is a sulfa-derivative antiepileptic drug which is also used for other indications such as essential tremor. A 79-year-old male was admitted to our center due to acute bilateral painless decline of vision. One month before admission, he had experienced essential tremor and treatment with topiramate 50 mg/day and propranolol 40 mg/day. Best-corrected visual acuity was 20/800 OD and 20/600 OS. Both eyes had normal anterior chamber depths and irides. Intraocular pressure was 10 mm Hg in the right eye and 11 mm Hg in the left eye. Retinal examination showed notable choroidal detachments in all quadrants of the periphery, which were confirmed by ultrasonography. Refraction showed no myopic shift. The administration of topiramate was discontinued as a potential causative agent for this condition. During follow-up, choroidal detachment and visual acuity gradually resolved. In this study, we described the first case of isolated massive choroidal detachment induced by topiramate.

    Title Cardiovascular Application of Polyhedral Oligomeric Silsesquioxane Nanomaterials: a Glimpse into Prospective Horizons.
    Date September 2011
    Journal International Journal of Nanomedicine

    Revolutionary advances in nanotechnology propose novel materials with superior properties for biomedical application. One of the most promising nanomaterials for biomedical application is polyhedral oligomeric silsesquioxane (POSS), an amazing nanocage consisting of an inner inorganic framework of silicon and oxygen atoms and an outer shell of organic groups. The unique properties of this nanoparticle has led to the development of a wide range of nanostructured copolymers with significantly enhanced properties including improved mechanical, chemical, and physical characteristics. Since POSS nanomaterials are highly biocompatible, biomedical application of POSS nanostructures has been intensely explored. One of the most promising areas of application of POSS nanomaterials is the development of cardiovascular implants. The incorporation of POSS into biocompatible polymers has resulted in advanced nanocomposite materials with improved hemocompatibility, antithrombogenicity, enhanced mechanical and surface properties, calcification resistance, and reduced inflammatory response, which make these materials the material of choice for cardiovascular implants. These highly versatile POSS derivatives have opened new horizons to the field of cardiovascular implant. Currently, application of POSS containing polymers in the development of new generation cardiovascular implants including heart valve prostheses, bypass grafts, and coronary stents is under intensive investigation, with encouraging outcomes.

    Title Endogenous Klebsiella Endophthalmitis Associated with Liver Abscess: First Case Report from Iran.
    Date July 2011
    Journal Case Reports in Ophthalmology

    To report the first case of endogenous Klebsiella endophthalmitis associated with liver abscess in Iran.

    Title The Anti-calcification Potential of a Silsesquioxane Nanocomposite Polymer Under in Vitro Conditions: Potential Material for Synthetic Leaflet Heart Valve.
    Date January 2011
    Journal Acta Biomaterialia

    Calcification currently represents a major cause of failure of biological tissue heart valves. It is a complex phenomenon influenced by a number of biochemical and mechanical factors. Recent advances in material science offer new polymers with improved properties, potentially suitable for synthetic leaflets heart valves manufacturing. In this study, the calcification-resistance efficacy and mechanical and surface properties of a new nanocomposite polymeric material (polyhedral oligomeric silsesquioxane-poly(carbonate-urea)urethane; POSS-PCU) which has been developed by our group are assessed by means of in vitro testing. In particular, thin sheets of nanocomposite, glutaraldehyde-fixed bovine pericardium (BP) and polyurethane (PU) were exposed to a calcium solution into a specially designed in vitro accelerated physiological pulsatile pressure system for a period of 31days and a total of 4×10(7) cycles. The samples were investigated for signs of calcification after exposure to calcium solution by means of X-ray, microscopic and chemical inspections. Mechanical and surface properties were also studied using stress-strain behaviour and surface morphology and hydrophobicity. Comparison shows that, in the experimental conditions, the level of calcification for the nanocomposite is considerably lower than for the fixed BP (p=0.008) and PU samples (p=0.015). Also, mechanical properties were unchanged in POSS-PCU, while there was a significant deterioration in PU samples (p<0.05). Hydrophobicity was significantly reduced in both the POSS-PCU and PU samples (p<0.0001). However, the POSS-PCU nanocomposite remained more hydrophobic than the PU sample (p<0.0001). Less platelet adhered to the POSS-PCU compared to the PU (p<0.0001). These results indicate that the use of this nanocomposite in synthetic leaflets heart valves may lead to potential advantages in terms of long-term performances and durability.

    Title Icd Therapy in Women: Are Men from Mars and Women from Venus?
    Date November 2010
    Journal Heart Rhythm : the Official Journal of the Heart Rhythm Society
    Title The Effect of Hesa-a (natural Drug) on Visual Acuity in Age Related Macular Degeneration: a Randomized Double Blind Controlled Clinical Trial.
    Date September 2010
    Journal African Journal of Traditional, Complementary, and Alternative Medicines : Ajtcam / African Networks on Ethnomedicines

    We investigated the clinical efficacy and safety of HESA-A (a drug of herbal-marine origin) in the treatment of age related macular degeneration (AMD). In a randomized double blind clinical trial 280 eyes of 280 (157 F, 123 M) patients with wet and dry AMD were randomly assigned in treatment or placebo groups. Patients in treatment group received HESA-A tablet 25 mg/Kg twice a day orally and controls received placebo with the same method for 4 weeks. Visual acuity at baseline and after one month of treatment was measured and compared between two groups. All patients were followed up for 5 months after treatment. Mean patients' age was 69.06+/-8.49 years. At the end of study visual acuity improved significantly from 1.69+/-0.65 LogMar to 1.03+/- 0.40 LogMar in treatment group but not in controls (P: 0.000 and P: 0.67 in treatment and control groups respectively). No drug reaction or recurrence was reported during the study and 5-month post treatment follow up period in HESA-A treated group. This study showed significant efficacy and safety of HESA-A in improvement of visual acuity in AMD patients in short term.

    Title Causes and Anatomical Site of Blindness and Severe Visual Loss in Isfahan, Islamic Republic of Iran.
    Date September 2010
    Journal Eastern Mediterranean Health Journal = La Revue De Santé De La Méditerranée Orientale = Al-majallah Al-ṣiḥḥīyah Li-sharq Al-mutawassiṭ

    This study in 2005 evaluated the causes and major anatomical site of blindness and severe visual loss at a school for blind children in Isfahan province, Islamic Republic of Iran. All 211 students were examined according to the modified WHO/PBL eye examination record: 70.4% were blind, 24.3% had severe visual loss and 5.3% were visually impaired. The major causes of abnormality were hereditary factors (42.7%), prenatal/neonatal (18.5%) and unknown etiology (35.5%). The main sites of abnormality were the retina (62.6%), whole globe (17.5%), lens (7.1%) and optic nerve (7.1%). A high proportion of parents were in a consanguineous marriage (49.2%). The pattern of blindness in Isfahan encompasses characteristics of both developed and developing countries.

    Title Catheter Ablation of Ventricular Tachycardia in Structurally Normal Hearts.
    Date August 2010
    Journal Expert Review of Cardiovascular Therapy

    Ventricular tachycardia (VT) in patients without structural heart disease can be observed in 10% of patients presenting with ventricular arrhythmias. These VTs are characterized by QRS morphology, ventricular origin and their response to pharmacologic agents. It is essential to rule out structural heart disease in this population as this can significantly alter the management and the long-term prognosis. These VTs generally have a benign course and therapeutic options are aimed at relieving symptoms related to the arrhythmia. Medical therapy is effective in many patients and radiofrequency offers a cure to those who are refractory to medical therapy. Careful attention to the electrocardiogram can help localize the origin of the VTs, which is crucial when planning an ablation strategy.

    Title Permanent Pacemaker Implantation Following Aortic Valve Replacement: Current Prevalence and Clinical Predictors.
    Date August 2010
    Journal Pacing and Clinical Electrophysiology : Pace

    The incidence of conduction disease requiring permanent pacemaker (PPM) implantation following aortic valve replacement (AVR) ranges from 3% to 6%. Data concerning the potential risks for PPM requirement associated with certain valve types have been conflicting and controversial. We sought to evaluate the prevalence, predictors for PPM implantation, and PPM dependency during follow-up in patients undergoing AVR.

    Title Cardiac Resynchronization Therapy Device Implantation in Patients with Therapeutic International Normalized Ratios.
    Date August 2010
    Journal Pacing and Clinical Electrophysiology : Pace

    Many patients who need cardiac resynchronization therapy (CRT) require chronic anticoagulation. Current guidelines recommend discontinuation of warfarin and the initiation of anticoagulant "bridging" therapy during these procedures. We evaluated the safety of CRT-device (CRT-D) implantation without interruption of warfarin therapy.

    Title A Protocol for Patients with Cardiovascular Implantable Devices Undergoing Magnetic Resonance Imaging (mri): Should Defibrillation Threshold Testing Be Performed Post-(mri).
    Date July 2010
    Journal Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing

    Magnetic resonance imaging (MRI) in patients with Cardiovascular Implantable Electronic Devices (CIED) has not been approved by the Food and Drug Administration. Recent data suggests MRI as a relative rather than absolute contraindication in CIED patients. Recently, the American Heart Association has recommended defibrillation threshold testing (DFTT) in implantable cardioverter defibrillator (ICD) patients undergoing MRI. We evaluated the feasibility and safety of a protocol for MRI in CIED patients, incorporating the new recommendations on DFTT.

    Title Imaging Modalities in Cardiac Electrophysiology.
    Date March 2010
    Journal Future Cardiology

    Cardiac imaging, both noninvasive and invasive, has become a crucial part of evaluating patients during the electrophysiology procedure experience. These anatomical data allow electrophysiologists to not only assess who is an appropriate candidate for each procedure, but also to determine the rate of success from these procedures. This article incorporates a review of the various cardiac imaging techniques available today, with a focus on atrial arrhythmias, ventricular arrhythmias and device therapy.

    Title Pro-arrhythmia in Atrial Fibrillation Suppression Pacing Algorithms.
    Date February 2010
    Journal Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology

    Atrial overdrive pacing algorithms have been partially effective in controlling atrial fibrillation (AF). A 76-year-old man with history of a cardiomyopathy and paroxysmal AF underwent implant of a dual-chamber ICD. After enabling preferential pacing (PP) algorithms, marked control of his AF was demonstrated, but with inappropriate ICD shocks secondary to a typical AV nodal re-entrant tachycardia. After successful slow pathway modification, no further episodes were documented with suppression of his AF burden with PP algorithms enabled.

    Title Unilateral Absence of a Left Pulmonary Artery: Successful Therapeutic Response to a Combination of Bosentan and Warfarin.
    Date December 2009
    Journal Circulation. Cardiovascular Imaging
    Title Ablation Strategies for Atrial Fibrillation.
    Date December 2009
    Journal Expert Review of Cardiovascular Therapy

    Atrial fibrillation remains the most common arrhythmia in the USA and is associated with an increased risk for stroke, congestive heart failure and overall mortality. There has been a tremendous advance in the field of catheter ablation of atrial fibrillation that has resulted in better outcomes for patients. The approach for ablation of atrial fibrillation can be different depending on patients' presentation of paroxysmal or persistent atrial fibrillation. Pulmonary vein isolation remains the cornerstone of any ablation strategy for atrial fibrillation; however, further ablation, end points of the procedure, clinical end points for successful ablation and appropriate follow-up remain controversial. We aim to discuss these different approaches and the major controversies in catheter ablation of atrial fibrillation.

    Title A Novel Nanocomposite Polymer for Development of Synthetic Heart Valve Leaflets.
    Date November 2009
    Journal Acta Biomaterialia

    A novel nanocomposite polymer with a polycarbonate soft segment (PCU) and polyhedral oligomeric silsesquioxanes (POSS) nanoparticle (POSS-PCU) has been selected for a synthetic heart valve due to its superior biocompatibility and in vivo biostability. However, the development of synthetic heart valves from polymeric materials requires an understanding of the basic mechanical and surface properties of the polymer. In this study, the mechanical properties of POSS-PCU, including tensile strength, tear strength and hardness, were tested and compared to control (PCU). The surface property was analyzed using contact angle measurement and the resistance to platelet adhesion was also investigated. POSS-PCU (hardness 84+/-0.8 Shore A) demonstrated significantly higher tensile strength 53.6+/-3.4 and 55.9+/-3.9Nmm(-2) at 25 and 37 degrees C, respectively) than PCU (33.8+/-2.1 and 28.8+/-3.4Nmm(-2) at 25 and 37 degrees C, respectively). Tensile strength and elongation at break of POSS-PCU was significantly higher than PCU at both 25 and 37 degrees C (P<0.001). POSS-PCU showed a relatively low Young's modulus (25.9+/-1.9 and 26.2+/-2.0Nmm(-2)) which was significantly greater in comparison with control PCU (9.1+/-0.9 and 8.4+/-0.5Nmm(-2)) at 25 and 37 degrees C, respectively, with 100mum thickness. There was no significant difference (P>0.05) in tear strength between POSS-PCU and PCU at 25 degrees C. However, tear strength increased significantly (P<0.001) (at 37 degrees C) as the thickness increased from 100microm (51.0+/-3.3Nmm(-1)) to 200microm (63+/-1.5Nmm(-1)). The surface of POSS-PCU was significantly less hydrophilic than that of PCU.

    Title Effectiveness of Implantable Cardioverter-defibrillators for the Primary Prevention of Sudden Cardiac Death in Women with Advanced Heart Failure: a Meta-analysis of Randomized Controlled Trials.
    Date October 2009
    Journal Archives of Internal Medicine

    Numerous clinical trials have established a role for implantable cardioverter-defibrillators in the prevention of sudden cardiac death in patients with heart failure. However, questions remain that regard the clinical benefit of these therapies in different patient subgroups. Specifically, the role of implantable cardioverter-defibrillators in women with heart failure for the primary prevention of sudden cardiac death has not been well established. Our objective is to determine whether implantable cardioverter-defibrillators reduce mortality in women with advanced heart failure.

    Title Angiomyxoma of the Larynx: Case Report of a Rare Tumor.
    Date September 2009
    Journal Ear, Nose, & Throat Journal

    Laryngeal spindle cell neoplasms are uncommon tumors, frequently misdiagnosed as reactive lesions or mesenchymal malignancies. One of the rare mesenchymal tumors of the larynx is myxoid spindle cell tumor (angiomyxoma), a benign proliferative lesion. It is considered the laryngeal counterpart of the aggressive angiomyxoma of the pelvis and perineum. Although benign, angiomyxomas have a propensity for local recurrence due to their tendency to infiltrate surrounding tissues. They commonly appear encapsulated, but simple enucleation does not provide adequate treatment; excision should include a margin of normal tissue around the tumor. We describe a case of laryngeal angiomyxoma in a 40-year-old man that, to the best of our knowledge, is only the second such case reported in the literature. The tumor in our case showed no histologic evidence of aggressive behavior, but because of the potential for local recurrence, close follow-up was warranted.

    Title Polymeric Heart Valves: New Materials, Emerging Hopes.
    Date July 2009
    Journal Trends in Biotechnology

    Heart valve (HV) replacements are among the most widely used cardiovascular devices and are in rising demand. Currently, clinically available devices are restricted to slightly modified mechanical and bioprosthetic valves. Polymeric HVs could represent an attractive alternative to the existing prostheses, merging the superior durability of mechanical valves and the enhanced haemodynamic function of bioprosthetic valves. After early unsatisfactory clinical results, polymeric HVs did not reach commercialization, mainly owing to their limited durability. Recent advances in polymers, nanomaterials and surface modification techniques together with the emergence of novel biomaterials have resulted in improved biocompatibility and biostability. Advances in HV design and fabrication methods could also lead to polymeric HVs that are suitable for long-lasting implantation. Considering all these progresses, it is likely that the new generation of polymeric HVs will find successful long-term clinical applications in future.

    Title Percutaneous Heart Valve Replacement: an Update.
    Date October 2008
    Journal Trends in Cardiovascular Medicine

    Valvular heart disease continues to be an important health care problem. Although surgical valve replacement remains the standard treatment, minimally invasive approaches for valve repair and replacement are becoming attractive alternatives among physicians and patients. In fact, percutaneous procedures can extend treatment to the increasing population of elderly patients with severe comorbidities who cannot withstand the stress of open heart surgery and to the younger patients at the early stage of valve disease, who are not treated until older ages to avoid multiple invasive surgeries. Feasibility of this technique has been shown in the first clinical experiences, and the early results are promising. However, it is clear that percutaneous valve replacement therapy is still at the early stage of development and requires enhanced implantation procedures and substantial design improvements as well as long-term follow-up to show the safety and effectiveness of this new treatment modality.

    Title Sexual Risk-taking Behaviors Among Boys Aged 15-18 Years in Tehran.
    Date October 2007
    Journal The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine

    PURPOSE: The purpose of this study is to evaluate the extent and potential correlates of sexual risk-taking behaviors among adolescent boys aged 15-18 in metropolitan Tehran. METHODS: Data were collected from a population-based, cross-sectional survey of adolescent males (ages 15-18) residing in Tehran, Iran. Of 1385 subjects, 382 reported sexual experience (27.7%). The article is mainly considering sexually experienced subjects. Two factors were considered as sexual risk-taking behavior ("not using condom or inconsistent condom use in sexual contacts" and "ever had multiple sexual partners in lifetime." Several other factors were considered as independent variables and their relations were assessed using t test, chi2 test, and logistic regression models. RESULTS: Having no access to Internet, feeling regretful at sexual debut, having one sexual partner in lifetime and lower knowledge of condoms are predictors of condom non-use. Older age, using alcoholic drinks, early sexual debut, and poor knowledge of reproductive physiology are predictors of multiple sexual partners among adolescent boys aged 15-18 years. CONCLUSION: Appropriate interventional programs should be implemented for adolescents in Iran to encourage and enable them to delay first sex and abstain unwanted and unplanned penetrative sex, to stress the health risks of alcohol use in terms of sexual health and finally to enhance their knowledge on different aspects of reproductive health particularly prevention against STI/HIV.

    Title Report of an Unusual Cause of Rhinolithiasis: an 'opioma'.
    Date June 2007
    Journal Ear, Nose, & Throat Journal

    We report an unusual case of unilateral rhinolith. The patient was a 21-year-old man who had a history of left-sided nasal obstruction and recurrent bouts of fetid, purulent rhinorrhea of several years'duration. The rhinolith, which had formed around an impacted foreign body, was extracted in several pieces under local anesthesia. Laboratory evaluation revealed that the foreign body was a hardened mixture of codeine and opium wrapped in a small sheet of nylon-what we called an "opioma."

    Title Expanding Cardiac Resynchronization for Systolic Heart Failure to Patients with Mechanical Dyssynchrony and Atrial Fibrillation.
    Date December 2005
    Journal Reviews in Cardiovascular Medicine

    Despite progress in the management of heart failure (HF) using pharmacotherapy, the mortality and morbidity associated with this condition remain unacceptably high. Cardiac resynchronization therapy (CRT), a left-sided pacing therapy for drug-refractory and highly symptomatic HF patients with ventricular conduction delay, has been shown to improve left ventricular (LV) systolic function, myocardial oxygen consumption, and New York Heart Association functional class and to inhibit or reverse LV chamber dilation and remodeling. Atrial fibrillation is common in patients with HF and is associated with significant worsening of HF and myocardial function. Only recently have trials been designed to specifically study CRT in patients with HF and chronic atrial fibrillation. These studies have shown that CRT with biventricular or univentricular LV pacing in patients with atrial fibrillation corrects mechanical dyssynchrony and results in significant and sustained improvement in functional capacity, LV ejection fraction, quality of life, and QRS duration.

    Title A Study of the Relation Between Body Mass Index and the Incidence of Age Related Macular Degeneration.
    Date September 2005
    Journal The British Journal of Ophthalmology

    BACKGROUND: Age related macular degeneration (ARMD) is the most frequent cause of blindness among the elderly. Obesity may be one of the risk factors of ARMD as suggested, yet not proved, by several studies. This study assesses the relation between body mass index (BMI) and the incidence of ARMD METHODS: This case-control study included 50 patients with ARMD and 80 subjects who were adjusted for age, sex, cigarette smoking, blood pressure, and diabetes. Data analysis was performed by SPSS V9.0 using Student's t and chi2 tests. RESULTS: 42% of the subjects in the case group and 35% of those in the control group were men. Mean age of subjects in the case and control groups was 69.9 years (62-77 years) and 64.08 years (56-71 years), respectively. Mean BMI measured 25.38 (range 21-29) and 30.24 (26-34) in the case and control groups, respectively (p>0.05). 12% of subjects in the case group were obese, 42% were overweight, and 14% were lean. 22.5% of subjects in the control group were obese, 45% were overweight, and 7.5% were lean (p>0.05). CONCLUSION: 43% of patients in this study were aged 70 years or older, which is similar to other studies. There was no significant difference in BMI between the case and control groups. Recent studies indicate that obesity is a probable risk factor for progression of ARMD, but there is no significant relation with the presence of ARMD. With multifactorial analysis, the authors could identify no significant relation between the presence of ARMD and the studied risk factors.

    Title Anatomic and Visual Outcomes of Scleral Buckling Versus Primary Vitrectomy in Pseudophakic and Aphakic Retinal Detachment: Six-month Follow-up Results of a Single Operation--report No. 1.
    Date August 2005
    Journal Ophthalmology

    PURPOSE: To compare the anatomic and visual results and complications of conventional scleral buckling versus primary vitrectomy for management of pseudophakic and aphakic retinal detachment. DESIGN: Prospective, randomized, multicenter clinical trial. PARTICIPANTS: Two hundred twenty-five eyes of 225 patients with pseudophakic or aphakic retinal detachment. INTERVENTION: Eligible eyes were assigned randomly either to conventional scleral buckling or primary vitrectomy without any buckle. MAIN OUTCOME MEASURES: Visual results, retinal reattachment rate, proliferative vitreoretinopathy, macular pucker, cystoid macular edema, choroidal detachment, intraocular pressure, extraocular muscle dysfunction, and anisometropia. RESULTS: There were no statistically significant differences between the 2 treatment groups regarding the single-operation retinal reattachment rate at the 1-, 2-, 4-, and 6-month follow-up examinations. Patients in the buckle group had 28% greater likelihood of anatomic success compared with those in the vitrectomy group (odds ratio, 1.28; 95% confidence interval, 0.73-2.24), indicating no statistically significant difference. Proliferative vitreoretinopathy was the main cause of anatomic failure in both groups and occurred independent of the surgical technique used. Best-corrected visual acuity at the 1-, 2-, 4-, and 6-month postoperative follow-up examinations showed no statistically significant difference between the 2 groups. Six months after surgery, 12.8% of eyes in the buckle group and 11.3% of eyes in the vitrectomy group achieved visual acuity of 20/40 or better. The difference between the 2 groups was not statistically significant. Corresponding figures were 66.3% and 64.5% for visual acuity of 20/200 or better in the buckle and vitrectomy groups, respectively, again with no statistically significant difference. There were no statistically significant differences in rates of complications. CONCLUSIONS: Scleral buckling and primary vitrectomy without an encircling band have comparable results in pseudophakic and aphakic retinal detachment. The choice of surgical technique depends on various factors, including patient compliance, cost of surgery, experience and capability of surgeons, and availability of appropriate instrumentation.

    Title Aberrant Expression of Metabotropic Glutamate Receptor 2 in the Vulnerable Neurons of Alzheimer's Disease.
    Date May 2004
    Journal Acta Neuropathologica

    Selective neuronal dysfunction and degeneration are defining features of Alzheimer's disease (AD). While the exact mechanism(s) contributing to this selective neuronal vulnerability remains to be elucidated, we hypothesized that the differential expression of metabotropic glutamate receptors (mGluRs) may play a key role in this process since the various mGluR groups differentially regulate neuronal cell death and survival. In the present study, we focused on the metabotropic glutamate receptor 2 (mGluR2), a subtype of group II mGluRs. The mGluR2 is expressed at low levels in pyramidal neurons in age-matched control cases, whereas we found a strikingly increased mGluR2 expression in AD, in a pattern that mirrored both the regional and cellular subtype of neuronal vulnerability to degeneration and neurofibrillary alterations. Immunoblot analysis confirmed the significant increase in the level of mGluR2 in AD compared with age-matched controls. Agonists for group II mGluRs activate extracellular receptor kinase (ERK), a kinase that is chronically activated in vulnerable neurons of AD. ERK is able to phosphorylate tau protein, so the up-regulation of mGluR2 in vulnerable neurons may represent the upstream mediator of abnormal tau phosphorylation in AD. Immunocytochemical examination revealed considerable overlap between mGluR2 and neurofibrillary alterations. Thus, it is likely that mGluR2 represents a novel therapeutic target for AD.

    Title Aggravation of Proliferative Diabetic Retinopathy After Laser in Situ Keratomileusis.
    Date January 2004
    Journal Journal of Cataract and Refractive Surgery

    We describe a patient with proliferative diabetic retinopathy who had laser in situ keratomileusis (LASIK). Rapid progression and pronounced aggravation of diabetic retinopathy occurred after LASIK, resulting in severe visual loss in both eyes.

    Title Oxidative Damage in the Olfactory System in Alzheimer's Disease.
    Date January 2004
    Journal Acta Neuropathologica

    Increased oxidative damage is a prominent and early feature of vulnerable neurons in Alzheimer's disease (AD). However, while damage to proteins, sugars, lipids, nucleic acids and organelles such as lysosomes, mitochondria, and endoplasmic reticulum are evident, the source of increased reactive oxygen species has not been determined. Furthermore, a major limitation in further determining the source, as well as finding a means to arrest damage, is the paucity of cellular models directly homologous to AD since the vulnerable neurons of the brain in AD cannot be studied in vitro. Here, we examined the olfactory epithelium in situ to see if neurons there exhibit a similar pathological oxidative balance to vulnerable neurons in AD. In biopsy specimens, (eight AD and three controls) we found that neurons, and also the surrounding epithelial cells, show an increase in oxidative damage for a subset of the markers increased in the brain of cases of AD. Lipid peroxidation and heme oxygenase-1, a stress response protein, were increased, while nucleic acid or protein oxidation, demonstrated in vulnerable neurons in AD, were not increased. These findings highlight the systemic nature of oxidative abnormalities in AD, but that different cell types may express this abnormality by a different array of oxidative stress markers, supporting the potential for using olfactory neurons or other cells derived from AD patients in culture to understand the mechanistic basis for increased oxidative damage in AD and as a model to screen compounds for therapeutic intervention.

    Title Incidence of and Risk Factors for Diabetic Retinopathy in Isfahan, Iran.
    Date May 2003
    Journal Ophthalmic Epidemiology

    BACKGROUND: Evidence on the incidence of and risk factors for diabetic retinopathy is mainly derived from studies in developed countries. Locally derived evidence is required for planning a well-coordinated approach to this public health problem in developing countries. OBJECTIVE: The objectives of the present study were to estimate the incidence of and risk factors for the development of diabetic retinopathy using routinely collected data from a clinical information system at the Isfahan Endocrinology and Metabolism Research Center, Iran, for non-insulin-dependent (insulin-treated and non-insulin-treated) diabetes. METHOD: During the mean (standard deviation (SD)) follow-up period of 5.1 (2.1) (range 1-9) years, 549 diabetic patients (161 male and 388 female) from the Isfahan Endocrinology and Metabolism Research Center outpatient clinics at Amin University Hospital, Iran, were examined. The mean (SD) age of the participants was 45.7 (9.3) years with a mean (SD) duration of diabetes of 6.9 (5.7) years at initial registration. RESULTS: Among the 549 patients free of retinopathy at initial registration with at least one follow-up visit between 1992 and 2001, the incidence of any retinopathy was 89.4 (95% confidence interval (CI): 79.0, 101.0) [96.1 (95% CI: 76.7, 118.0) in males and 86.6 (95% CI: 74.5, 99.9) in females] per 1000 person-years based on 2786 person-years of follow-up. The incidence rate of retinopathy was 60% greater among insulin-treated than non-insulin-treated non-insulin-dependent diabetes mellitus (NIDDM) clinic attenders. The incidence of any retinopathy was greater with older age, longer duration of diabetes, higher diastolic blood pressure and poor metabolic control. Using a Cox's Proportional Hazards Model for insulin-treated and non-insulin-treated NIDDM diabetes separately, poor metabolic control was a significant independent predictor of retinopathy for insulin-treated and non-insulin-treated NIDDM patients. When all variables were entered in the model, age, poor metabolic control and fasting blood glucose were significant predictors of retinopathy. In the insulin-treated group, fasting blood glucose was also a significant predictor of retinopathy. Systolic and diastolic blood pressure, gender, smoking, proteinuria, body mass index and creatinine had no significant independent association with retinopathy when other covariates were considered. CONCLUSION: These data suggest that diabetic retinopathy in this population of Iranian non-insulin-dependent diabetic patients is common, being found in almost half of the patients after a mean 5-year follow-up. Poor metabolic control is the major risk factor.

    Title Essential Function of Wnt-4 for Tubulogenesis in the Xenopus Pronephric Kidney.
    Date August 2002
    Journal Developmental Biology

    In the vertebrate embryo, development of the excretory system is characterized by the successive formation of three distinct kidneys: the pronephros, mesonephros, and metanephros. While tubulogenesis in the metanephric kidney is critically dependent on the signaling molecule Wnt-4, it is unknown whether Wnt signaling is equally required for the formation of renal epithelia in the other embryonic kidney forms. We therefore investigated the expression of Wnt genes during the pronephric kidney development in Xenopus. Wnt4 was found to be associated with developing pronephric tubules, but was absent from the pronephric duct. Onset of pronephric Wnt-4 expression coincided with mesenchyme-to-epithelium transformation. To investigate Wnt-4 gene function, we performed gain- and loss-of-function experiments. Misexpression of Wnt4 in the intermediate and lateral mesoderm caused abnormal morphogenesis of the pronephric tubules, but was not sufficient to initiate ectopic tubule formation. We used a morpholino antisense oligonucleotide-based gene knockdown strategy to disrupt Wnt-4 gene function. Xenopus embryos injected with antisense Wnt-4 morpholinos developed normally, but marker gene and morphological analysis revealed a complete absence of pronephric tubules. Pronephric duct development was largely unaffected, indicating that ductogenesis may occur normally in the absence of pronephric tubules. Our results show that, as in the metanephric kidney, Wnt-4 is critically required for tubulogenesis in the pronephric kidney, indicating that a common, evolutionary conserved gene regulatory network may control tubulogenesis in different vertebrate excretory organs.

    Title Oxidative Damage is the Earliest Event in Alzheimer Disease.
    Date August 2001
    Journal Journal of Neuropathology and Experimental Neurology

    Recently, we demonstrated a significant increase of an oxidized nucleoside derived from RNA, 8-hydroxyguanosine (8OHG), and an oxidized amino acid, nitrotyrosine in vulnerable neurons of patients with Alzheimer disease (AD). To determine whether oxidative damage is an early- or end-stage event in the process of neurodegeneration in AD, we investigated the relationship between neuronal 8OHG and nitrotyrosine and histological and clinical variables, i.e. amyloid-beta (A beta) plaques and neurofibrillary tangles (NFT), as well as duration of dementia and apolipoprotein E (ApoE) genotype. Our findings show that oxidative damage is quantitatively greatest early in the disease and reduces with disease progression. Surprisingly, we found that increases in A beta deposition are associated with decreased oxidative damage. These relationships are more significant in ApoE epsilon4 carriers. Moreover, neurons with NFT show a 40%-56% decrease in relative 8OHG levels compared with neurons free of NFT. Our observations indicate that increased oxidative damage is an early event in AD that decreases with disease progression and lesion formation. These findings suggest that AD is associated with compensatory changes that reduce damage from reactive oxygen.

    Title Molecular Cloning and Embryonic Expression of Xenopus Six Homeobox Genes.
    Date July 2001
    Journal Mechanisms of Development

    Six genes are vertebrate homologues of the homeobox-containing gene sine oculis, which plays an essential role in controlling Drosophila compound eye development. Here we report the identification and expression patterns of all three subfamilies of Xenopus Six genes. Two Six2 subfamily genes (Six1, Six2) showed very similar expression patterns in cranial ganglia, otic placodes and the eyes. Non-neural expression of Six1 and Six2 was observed with mesodermal head mesenchyme, somites and their derivatives, the muscle anlagen of the embryonic trunk. In addition, Six2 expression was also found with mesenchyme associated with the developing stomach and pronephros. Expression of Six3 subfamily genes (Six3.1, Six3.2, Six6.1, and Six6.2) was restricted to the developing head, where expression was especially observed in derivatives of the forebrain (eyes, optic stalks, the hypothalamus and pituitary gland). Interestingly, expression of all Six3 subfamily members but Six6.2 was also found with the pineal gland primordium and the tegmentum. Expression of Six4 subfamily genes (Six4.1, Six4.2) was present in the developing visceral arches, placodal derivatives (otic vesicle, olfactory system), head mesenchyme and the eye. The observed dynamic expression patterns are largely conserved between lower and higher vertebrates and imply important roles of Six family genes not only in eye formation and myogenesis, but also in the development of the gut, the kidney and of placode-derived structures.

    Title Biochemical Assay for Ad7c-ntp in Urine As an Alzheimer's Disease Marker.
    Date December 1998
    Journal Journal of Clinical Laboratory Analysis

    A reliable and specific immunoassay has been developed to detect and measure AD7C-NTP, a biochemical marker for Alzheimer's disease, in urine. The urine samples are first processed by centrifugation and ultrafiltration to fractionate and concentrate AD7C-NTP. The urinaryAD7C-NTP has the same molecular weight asAD7C-NTP in brain and cerebrospinal fluid by size exclusion chromatography. It has also retained the binding properties to the monoclonal and polyclonal antibodies developed against recombinantly produced AD7C-NTP. This assay is an enzyme linked sandwich immunoassay (ELSIA) using 96 well microtiter plates. The plate surface is coated with a monoclonal antibody (N314) which has a high affinity and specificity for AD7C-NTP, capturing it effectively from the samples. The detection was achieved using a polyclonal antibody (ADRI). The utility of the assay has been demonstrated using urine specimens from Alzheimer's disease (AD) patients and non-Alzheimer's controls. UrinaryAD7C-NTP in the AD group (2.5 ng/mL, n=66) was significantly higher than the non-AD group (0.8 ng/mL, n=134).Using 1.5 ng/mL as cut off, in this patient population, specificity and sensitivity of urinary AD7C-NTP were comparable to CSFAD7C-NTP.

    Title Possible Relationship Between Conditions Associated with Chronic Hypoxia and Brain Mitochondrial Dna Deletions.
    Date March 1996
    Journal Archives of Biochemistry and Biophysics

    The brain relies heavily on aerobic metabolism which requires functional mitochondria. Mitochondria are subcellular organelles with their own genome which codes for 13 essential protein subunits. By employing PCR assays to examine brain tissue from 43 age-comparable individuals (between ages 34 and 73), we found a correlation between mitochondrial DNA deletion mutations, mtDNA4977 deletions, and conditions associated with chronic hypoxia. In prior studies, utilizing only 6 to 12 clinical samples, mtDNA4977 deletions were reported to increase in specific regions of the brain with aging. However, we found 12-fold and 5-fold higher levels of mtDNA4977 deletions in the putamen and the superior frontal gyrus of the cortex, respectively, from individuals who had conditions associated with chronic hypoxia when compared with individuals without evidence of such conditions. These findings suggest that chronic hypoxia should be more closely examined in the pathophysiology of central nervous system diseases.

    Title Heat Shock Proteins Protect Against Stress-related Phosphorylation of Tau in Neuronal Pc12 Cells That Have Acquired Thermotolerance.
    Date October 1994
    Journal The Journal of Neuroscience : the Official Journal of the Society for Neuroscience

    A68, or PHF-tau, is an abnormally phosphorylated form of the microtubule-associated protein tau, which is a primary protein constituent of paired helical filaments (PHFs) and, ultimately, of Alzheimer's disease-associated neurofibrillary tangles (NFTs). Previously, we have shown that in heat-shocked neuronal PC12 cells, tau is hyperphosphorylated and transformed to an A68-like state as determined by immunologic and biochemical criteria. In the present study, we investigated the role of heat shock protein of 72 kDa (hsp72) in the protection of tau against hyperphosphorylation during heat shock. Neuronal PC12 cells were exposed either directly to a heat shock (45 degrees C for 30 min) or to a conditioning heat stress (43 degrees C for 90 min followed by a 4 hr recovery at 37 degrees C) followed by the heat shock. Hsp72 was maximally induced immediately after heat shock in conditioned (acquired thermotolerant, ATT) cells, while unconditioned (nonacquired thermotolerant, non-ATT) cells required 9 hr of recovery to exhibit maximal hsp72 induction. The differential time course of hsp72 induction during recovery of ATT and non-ATT cells correlated with the presence of normal tau. Immediately after the heat shock, when hsps were maximally induced, ATT cells exhibited the normal form of tau. With longer recovery times, the levels of hsp72 were reduced and tau was hyperphosphorylated. A similar correlation was observed in non-ATT cells. In the presence of L-azetidyl 2-carboxylic acid, ATT cells synthesized nonfunctional hsp72, as exhibited by the inability of the cells to recover from the effects of heat shock.(ABSTRACT TRUNCATED AT 250 WORDS)

    Title Similarities Between Beta Amyloid Peptides 1-40 and 40-1: Effects on Aggregation, Toxicity in Vitro, and Injection in Young and Aged Rats.
    Date March 1994
    Journal Experimental Neurology

    Peptides corresponding to the first 40 amino acids of beta amyloid peptide (beta 1-40) and the reverse sequence (beta 40-1) were synthesized, purified, and compared for their ability to aggregate and cause toxicity in vitro to human neuroblastoma cells (SH-SY5Y), as well as for effects following injection into young or aged rats. Aggregation of both peptides produced similar sedimentation velocity profiles and resulted in significant toxicity in vitro with no observable differences between beta 1-40 and beta 40-1. In addition, when injected into the cortex of young rats, beta 1-40 was more toxic than beta 40-1 although both resulted in significant lesions. However, in aged rats the two peptides resulted in lesions of similar size. Alz 50 staining and abnormal neurites were associated with both beta 1-40 and beta 40-1 lesions; however, no evidence of plaques or tangles was found in either age group. While both peptides were toxic in vitro, only beta 1-40 elicited Alz 50 staining of SH-SY5Y cells. Electron microscopic examination of beta 1-40 and beta 40-1 aggregates showed that beta 1-40 formed fibrillar structures whereas beta 40-1 resulted in amorphous particles. Thus, although both peptides were toxic to cultured cells and aged rats, the toxicities may have resulted from different mechanisms.

    Title Alzheimer's-disease-related Protein in Geriatric Schizophrenic Patients with Cognitive Impairment.
    Date November 1993
    Journal The American Journal of Psychiatry

    The authors compared Alz-50 immunoreactivity in the brain tissue of nine cognitively impaired elderly schizophrenic patients and 13 elderly comparison subjects, both without neuritic plaques or neurofibrillary tangles, and 13 patients with Alzheimer's disease. Alz-50 reactivity was absent in the schizophrenic patients, indicating that geriatric, cognitively impaired patients are unlikely to display the pathology of Alzheimer's disease.

    Title Reliability and Usefulness of a New Immunochemical Assay for Alzheimer's Disease.
    Date February 1993
    Journal Archives of Neurology

    OBJECTIVE--To assess the reliability and usefulness of a new sandwich enzyme-linked immunoassay (ALZ-EIA) that detects Alzheimer's disease-associated proteins in the diagnosis of Alzheimer's disease. DESIGN--The reliability of the assay was assessed between two laboratories. Sensitivity and specificity of a diagnostic algorithm based on the results of the ALZ-EIA were determined using the Consortium to Establish a Registry for Alzheimer's Disease neuropathological diagnoses as the "gold standard." SETTING--Autopsy cases were obtained from a teaching hospital with a specialized Alzheimer Disease Diagnostic and Treatment Center. CASES--Brain tissue was selected from 24 cases with dementia and 10 normal controls. MAIN OUTCOME MEASURES--Optical density measurements from the ALZ-EIA in the hippocampus and three neocortical regions. RESULTS--A 95% concordance in ALZ-EIA activity was found between the two laboratories, and an 85% concordance was found between ALZ-EIA and the Consortium to Establish a Registry for Alzheimer's Disease diagnoses. Perfect agreement was obtained for "typical" Alzheimer's disease cases (those with plaques and tangles), while discrepancies occurred for "atypical" cases (those with predominantly plaques or tangles). CONCLUSIONS--The ALZ-EIA provides a highly reliable method of assessing neurofibrillary degeneration. Its clinical usefulness as a diagnostic test would be enhanced by the availability of a complementary assay for beta-amyloid.

    Title Stabilization of the N-terminal Residues of Luteinizing Hormone-releasing Hormone Agonists and the Effect on Pharmacokinetics.
    Date November 1992
    Journal Journal of Medicinal Chemistry

    To stabilize leuprolide (1) against chymotrypsin and intestinal degradation several agonists of LHRH (2-12), modified at position 1, 2, or 3 and/or containing N-alpha-methyl at positions 1, 2, or 4, were synthesized by SPPS. These agonists were tested in vitro for (a) rat pituitary LHRH receptor binding, (b) LH release from rat pituitary cells, (c) stability against chymotrypsin, and (d) stability against rat intestinal degradation. The clearances of the compounds in the rat were determined using a RIA. Complete stabilization against chymotrypsin (t1/2) and lumenal degradation (T1/2) was achieved with substitution of NMe-Ser4 in leuprolide; however, with an increase in clearance. Substitution with 1-Nal3 increased both t1/2 and T1/2, while substitution with NAc-Sar1 increased only T1/2. [NAcSar1,NMeSer4,D-Trp6,Pro9NHEt]LHRH (12), the doubly stabilized analogue, was tested in the rat by both iv and id administrations, and its bioavailabilities were measured. No significant improvement in id absorption over leuprolide was observed.

    Title Quantitative Assessment of Alz-50 Immunoreactivity in Alzheimer's Disease.
    Date March 1992
    Journal Journal of Geriatric Psychiatry and Neurology

    A quantitative assay for ALZ-50 immunoreactivity was evaluated in samples of superior temporal gyrus taken at autopsy from 13 Alzheimer patients and 11 controls. The assayable immunoreactivity appears to be stable for at least 24 hours postmortem but was lost with formalin fixation. The mean value of the Alzheimer patients was tenfold higher than that of the controls (P less than .002). The values of four Alzheimer samples overlapped with the low levels seen in controls, but no controls had elevated levels. In this sample population, therefore, the assay had a sensitivity of 69% and specificity of 100%.

    Title Recent Advances in the Neurochemical Pathology of Alzheimer's Disease. Studies of Neuropeptides, Cholinergic Function and Alzheimer's Disease-associated Protein.
    Date February 1992
    Journal Annals of the New York Academy of Sciences

    Our findings from three postmortem tissue studies in Alzheimer's disease (AD) are presented. We investigated (1) alterations in somatostatin (SRIF) and corticotropin-releasing factor (CRF) in AD; (2) regulatory changes in presynaptic cholinergic function in AD; and (3) use of Alzheimer's disease-associated protein (ADAP) as a diagnostic test for AD in postmortem tissue. Taken together, these findings reveal marked reductions in SRIF and CRF concentrations in many cerebrocortical areas in AD, a marked up-regulation of cholinergic neuronal activity in surviving cholinergic neurons in AD, and excellent specificity and sensitivity for the use of the ADAP assay as a diagnostic test for AD in postmortem tissue.

    Title Alterations in Alzheimer's Disease-associated Protein in Alzheimer's Disease Frontal and Temporal Cortex.
    Date January 1992
    Journal Archives of General Psychiatry

    Alzheimer's disease (AD)-associated protein is present in brain and cerebrospinal fluid of patients with AD but not in adult, nondemented, normal controls. This protein may represent an abnormal epitope of the "tau" microtubule-associated protein and has been detected before the appearance of senile plaques and neurofibrillary tangles. The amount of AD-associated protein in the frontal and temporal cortices in 93 cases of neuropathologically confirmed AD was compared with the amount that was present in 20 cases without AD. The amount of AD-associated protein was significantly increased in the cases of AD for both brain regions compared with that in the cases without AD. The presence of high levels of this protein is a useful adjunct, postmortem marker of the presence of AD and may eventually lead to tests that allow early detection of individuals at risk for this disease.

    Title Determination of Phosphatidylcholine and Disaturated Phosphatidylcholine Content in Lung Surfactant by High Performance Liquid Chromatography.
    Date August 1989
    Journal Journal of Lipid Research

    A rapid isocratic method for determining the total phosphatidylcholine and disaturated phosphatidylcholine levels in lung surfactant preparations by high performance liquid chromatography (HPLC) is described. The analysis was performed on a 3.9 x 300 mm mu-Porasil column with detection by refractive index. The lipids were eluted with a solvent system of chloroform-acetonitrile-methanol-water-85% phosphoric acid 650:650:500:130:2 (v/v/v/v/v). A 4.6 x 30 mm silica guard column was used in place of an injector loop which served as a sample concentrator and purifier. Phosphatidylinositol, phosphatidylserine, phosphatidylethanolamine, and phosphatidylglycerol, all known components of lung surfactants, were eluted from the loop column and were prevented from reaching the analytical column. Sphingomyelin and lysophosphatidylcholine elute later than the phosphatidylcholines on the analytical column. The method was developed so that phosphatidylcholines elute as a single peak regardless of the fatty acid chain length (C12-C20). When the sample was first oxidized with a potassium permanganate-potassium metaperiodate solution, and potentially interfering oxidation products were removed by extraction into a basic aqueous phase, then only the disaturated phosphatidylcholines were analyzed.

    Title Involvement of Cyclic Nucleotides in the Beating Response of Rat Heart Cells in Culture.
    Date September 1976
    Journal Journal of Molecular and Cellular Cardiology
    Title Bursting Dense Microspheres (spherons) in Alzheimer's Diseasea Review of Studies (1980-1997) on Spherons and the Pathogenesis of Alzheimer's Disease.
    Journal Journal of Alzheimer's Disease : Jad

    This paper reviews our research studies during the past 17 years on the relationship of cerebral protein dense microspheres (DMS), termed spherons, and senile plaques (SP) in the aged human brain and in AD. Initially, correlative anatomical and pathological data suggested that spherons may evolve into SP. This led to morphometric studies which strongly supported the theory. Biochemical studies were undertaken which showed that spherons could be isolated to homogeneity from brain tissue and contained the markers associated with SP. Experiments in vitro with spherons, and with inoculation of spherons into animals, reproduced SP lesion characteristics. To test the validity of using spherons for drug screening, experimental drugs were tested, a few of which are capable of blocking the formation of spheron-induced experimental SP.

    Title A Case of Rhinolithiasis.
    Journal Ear, Nose, & Throat Journal
    Title Acute Retinal Necrosis After Herpetic Encephalitis.
    Journal Case Reports in Ophthalmology

    PURPOSE: To report a case of unilateral acute retinal necrosis after herpetic encephalitis CASE REPORT: A young man was referred with a chief complaint of blurred vision and pain of the left eye 1 month after herpetic encephalitis in the left frontotemporal lobe. The patient had multiple foci of retinitis in the retinal periphery associated with vitritis, blot retinal hemorrhage and retinal arteriolitis. The impression of acute retinal necrosis was confirmed by polymerase chain reaction of aqueous humor by detecting herpes simplex virus type 2; therefore, the patient received intravenous acyclovir. CONCLUSION: Herpetic encephalitis may be a risk factor for acute retinal necrosis. The virus may reach the eye by the trans-axonal route. Prophylaxis with acyclovir may be necessary after herpetic encephalitis to prevent acute retinal necrosis.

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