Thesis (Ph. D.)--University of Washington, 2001. / Vita. Includes bibliographical references (leaves 86-89).

Thesis (Ph. D.)--University of Oklahoma. / Bibliography: leaves 120-130.

Ischemic stroke is a devastating cerebrovascular disease resulting in high mortality rate and distressing sequelae such as hemiplegia, ataxia and even visual impairment. Retinal ischemia refers to a common pathological feature shared by many blinding diseases including retinal vascular occlusions, diabetic retinopathy, glaucoma, and retinopathy of prematurity. Ischemia/reperfusion injury is implicated in both of these pathological conditions, which greatly impact on one’s daily life. The eventual consequence of the insult is irreversible neuronal cell death and functional deterioration. Apart from current symptomatic treatment for these diseases, researchers and clinicians are dedicated to look for ideal neuroprotectant to meet the clinical needs. Traditional Chinese medicine has been received accumulating attention in recent years, and Lycium barbarum is one of them. The polysaccharides (LBP) utilized in the present study are the rich extracts of the fruit of Lycium barbarum that has been shown to exert many biological effects. This study aims to evaluate its protective effects in cerebral and retinal ischemia, which has not yet been fully investigated. A well-established rodent model, middle cerebral artery occlusion, was utilized in the present study to mimic cerebral and retinal ischemia/reperfusion injury. In the study of cerebral ischemia, both pre-treatment and post-treatment of LBP were explored. Seven-day LBP pre-treatment revealed significant protection against neurological deficits and cerebral infarction. Besides, it attenuated cerebral edema and glial activation, as well as preserved blood-brain barrier integrity. Further study showed that these beneficial effects of LBP pre-treatment might act via anti-apoptosis, antioxidation and anti-inflammation. However, similar findings were not noted in LBP post-treatment experiments, possibly due to the timing of intervention. In the investigation of retinal ischemia, the observation time was prolonged to 7 days after the insult. Electroretinogram was used to evaluate the functional alternation of retinal neurons. Sustained retinal dysfunction was induced by two-hour ischemia. LBP pre-treatment with continuous daily supplementation effectively alleviated visual dysfunction and protected the retina from morphological impairment including neuronal death, glial activation and blood-retinal barrier disruption. Similarly, these protective effects might be associated with the involvement of attenuation of apoptosis and oxidative stress. In conclusion, LBP pre-treatment with continuous daily supplementation protected the brain and retina, both functionally and morphologically, from ischemia/reperfusion injury. This dosing regimen hold great promise in serving as a prophylactic neuroprotectant in patients at high risk for ischemic stroke, as well as preserving normal visual function and reducing irreversible neuronal death in ischemic retinopathies. Further studies on the active ingredients and underlying mechanisms would be informative for better application of LBP in clinical situation. / published_or_final_version / Ophthalmology / Doctoral / Doctor of Philosophy

This dissertation combines various holographic techniques with application on the two- and three-dimensional imaging of ophthalmic tissue, fingerprints, and microsphere samples with micrometer resolution. Digital interference holography (DIH) uses scanned wavelengths to synthesize short-coherence interference tomographic images. We used DIH for in vitro imaging of human optic nerve head and retina. Tomographic images were produced by superposition of holograms. Holograms were obtained with a signal-to-noise ratio of approximately 50 dB. Optic nerve head characteristics (shape, diameter, cup depth, and cup width) were quantified with a few micron resolution (4.06 -4.8 microns). Multiple layers were distinguishable in cross-sectional images of the macula. To our knowledge, this is the first report of DIH use to image human macular and optic nerve tissue. Holographic phase microscopy is used to produce images of thin film patterns left by latent fingerprints. Two or more holographic phase images with different wavelengths are combined for optical phase unwrapping of images of patent prints. We demonstrated digital interference holography images of a plastic print, and latent prints. These demonstrations point to significant contributions to biometry by using digital interference holography to identify and quantify Level 1 (pattern), Level 2 (minutia points), and Level 3 (pores and ridge contours). Quantitative studies of physical and biological processes and precise non-contact manipulation of nanometer/micrometer trapped objects can be effectuated with nanometer accuracy due to the development of optical tweezers. A three-dimensional gradient trap is produced at the focus position of a high NA microscope objective. Particles are trapped axially and laterally due to the gradient force. The particle is confined in a potential well and the trap acts as a harmonic spring. The elastic constant or the stiffness along any axis is determined from the particle displacements in time along each specific axis. Thus, we report the sensing of small particles using optical trapping in combination with the digital Gabor holography to calibrate the optical force and the position and of the copolymer microsphere in the x, y, z direction with nm precision.

During optic cup morphogenesis, the neuroectodermal layers of the optic vesicle (OV) invaginate ventrally, and fuse at the choroid fissure (CF) along the proximo-distal axis such that the retina and retinal pigment epithelium (RPE) are confined within the cup. Failure of CF closure results in colobomas, which are characterized by the persistence of a cleft or hole at the back of the eye. While CF closure is a critical aspect of ocular development, the molecular and cellular mechanisms underlying this process are poorly understood. My research examined CF closure and colobomas using zebrafish as a model system. In the first study, I determined that early cell fate changes within the eye field could cause colobomas using the zebrafish mutant blowout. Colobomas in blowout resulted from defects in optic stalk morphogenesis whereby the optic stalk extended into the retina and impeded the edges of the CF from meeting and fusing. Positional cloning of blowout identified a nonsense mutation in patched1, a negative regulator of the Hedgehog pathway. Up-regulation of Hedgehog pathway activity causes disruption in the patterning of the OV into proximal and distal territories, revealing that cell fate determination, mediated by Hedgehog signaling, is intimately involved in regulating CF closure. In the second study, I examined Bcl6 function and regulation during zebrafish eye development. bcl6 encodes a transcriptional repressor expressed in the ventral retina during zebrafish eye development. Loss of Bcl6 function leads to colobomas along with up-regulation of p53, a previously known Bcl6 target, and an increase in the number of apoptotic cells in the retina, demonstrating that Bcl6 plays a critical role in preventing apoptosis in the retina during early eye development. I also showed that Vax1 and Vax2 act upstream of bcl6 in the ventral retina. Furthermore, I identified functional interactions between Bcl6, Bcor and Hdac1 during eye development, demonstrating that Bcl6 functions along with Bcor and Hdac1 to mediate cell survival by regulating p53 expression. Together my studies expand the gene regulatory network involved in cell fate determination and cell survival during CF closure and ventral retina formation, and provide mechanistic insight into coloboma formation. / text

published_or_final_version / abstract / toc / Anatomy / Master / Master of Philosophy

Στο πρώτο και δεύτερο κεφάλαιο γίνεται μια λεπτομερή ανάλυση της ανατομίας και φυσιολογίας του ανθρώπινου οφθαλμού ενώ στο τρίτο και τέταρτο γίνεται αναφορά στην ανατομία του βρογχικού δένδρου, μια εισαγωγή στην ένοια της επεμβατικής πνευμονολογίας καθώς και μια εκτενής ανάλυση για τις μεθόδους βρογχοσκόπισης με ιδιέταιρη έμφαση στην μεθόδο αυτοφθορισμού για την ανίχνευση πρώιμου πνευμονικού καρκίνου. Στο πέμπτο κεφάλαιο γίνεται μια εισαγωγή στην επεξεργασία ψηφιακής εικόνας. Γίνεται μια αναφορά στους τρόπους επεξεργασίας εικόνας, καταλήγοντας στην ειδική μέθοδο επεξεργασίας ψηφιακής εικόνας που είναι η τμηματοποίηση. Στο έκτο κεφάλαιο γίνεται ορισμός της τμηματοποίησης ψηφιακής εικόνας. Οι διάφορες μέθοδοι που αναλύονται εκτενώς είναι : 1. Εφαρμογή κατωφλίου 2. Ανίχνευση ασυνεχειών 3. Region-based τμηματοποίηση 4. Edge linking and boundary detection 5. Μορφολογικά watersheds Τελειώνοντας το έκτο κεφάλαιο γίνεται αναφορά σε εξειδικευμένες εφαρμογές σύγχρονων μεθόδων για οφθαλμιατρικές και εικόνες video-βρογχοσκοπίου. Ελπίζω να έχω αποδώσει σωστά το αντικείμενο της εργασίας ώστε να χρησιμοποιηθεί ως βοήθημα σε όποιον επιθυμεί να εμβαθύνει στους τόμεις που αναφέρομαι. Το πνεύμα της εργασίας είναι να οδηγήσει στην κατανόηση, όχι να διδάξει / The project can introduce us in the field of medical image processing. In the first and the second section there is a detailed reference about the anatomy and fusiology of the retina. In the third and fourth you can find information about bronchous anatomy and general methods for bronchoscopy. In the fifth there are several methods for image processing and especialy the segmentation method. In the sixth section there is an analysis of the segmentation method and finaly there are some examples of the above methods.

Στον αμφιβληστροειδή επιτελείται η μετατροπή δηλαδή της φωτεινής ενέργειας σε ηλεκτρικό ερέθισμα. Κύριος διεγερτικός διαβιβαστής στον αμφιβληστροειδή είναι το γλουταμινικό οξύ του οποίου η δράση επιτελείται μέσω ιοντοτρόπων, NMDA και μη NMDA, και μεταβοτρόπων υποδοχέων. Οι υποδοχείς ΝΜDA παρουσιάζουν ιδιαίτερα χαρακτηριστικά, όπως μεγάλη αγωγιμότητα ασβεστίου και τασεοεξαρτώμενη αναστολή από το Μg, ενώ φαίνεται να παίζουν ιδιαίτερο ρόλο σε διαδικασίες συναπτικής πλαστικότητας, στην ανάπτυξη του νευρικού συστήματος καθώς και στην διεγερσιτοξικότητα του γλουταμινικού. Στον αμφιβληστροειδή εντοπίζονται κυρίως στα γαγγλιακά και βραχύϊνα κύτταρα αλλά και σε διάμεσους νευρώνες. Οι υποδοχείς NMDA είναι ετερομερή που αποτελούνται από τις υπομονάδες NR1, NR2 και NR3. Το γονίδιο της βασικής λειτουργικής υπομονάδας NR1 περιέχει τρία εξόνια τα οποία υφίστανται εναλλακτικό μάτισμα προς δημιουργία οχτώ ισομορφών. Οι ισομορφές που περιλαμβάνουν το εξόνιο 21 ή C1 στο καρβοξυτελικό άκρο έχουν την χαρακτηριστική ιδιότητα φωσφορυλίωσης στην θρεονίνη 879 και στις σερίνες 890, 896 και 897. Η φωσφορυλίωση αποτελεί έναν από τους κυριότερους μηχανισμούς ρύθμισης των υποδοχέων του γλουταμινικού οξέος επηρεάζοντας τις ιδιότητες τους, την μεταφορά τους προς την κυτταρική μεμβράνη, αλλά και την υποκυτταρική κατανομή των υπομονάδων τους. Στόχος της εργασίας είναι η μελέτη της φωσφορυλιωμένης υπομονάδας NR1 του υποδοχέα NMDA στις θέσεις σερίνης 896 και 897 (NR1-Ser896 και NR1-Ser897) κατά την ανάπτυξη στον αμφιβληστροειδή. Για τον σκοπό αυτό χρησιμοποιήσαμε επίμυες Wistar ηλικιών 9, 14, 21, 35 και 60 ημερών. Με την μέθοδο ανοσοαποτύπωσης κατά Western μελετήσαμε τα επίπεδα της φωσφορυλιωμένης πρωτείνης. Η ΝR1-Ser897 παρουσιάζει ένα πρότυπο αύξησης μέχρι και την ηλικία των 35 ημερών με επακόλουθη πτώση σε αυτήν των 60 ημερών. Η NR1-Ser896 αυξάνεται μέχρι την ηλικία των 14 ημερών όπου και παρουσιάζει μια σταθερή πορεία μέχρι την ηλικία των 60 ημερών. Συμπερασματικά, οι φωσφορυλιώσεις στις διαφορετικές σερίνες της υπομονάδας NR1 του υποδοχέα NMDA παρουσιάζουν διαφορετικό αναπτυξιακό προφίλ και γενικότερα η φωσφορυλίωση αυτής της υπομονάδας φαίνεται ότι ρυθμίζεται αναπτυξιακά στον αμφιβληστροειδή. / The retina is responsible for the light conversion into nerve signals. Glutamate is the major excitatory neurotransmitter in the retina. Its actions are mediated by glutamate ionotropic (NMDA and non NMDA) and metabotropic receptors. The NMDA receptors (NMDARs) are permeable to Ca++ and are unique among glutamate receptors in that they are blocked by Mg++ in a voltage dependent manner. These receptors also seem to play an important role in the development of the nervous system, in synaptic plasticity as well as in glutamate neurotoxicity. In the retina they are expressed in many ganglion and amacrine cells and occasionally in horizontal and glial cells. Functional NMDARs are heteromers composed of the NR1 NR2 and NR3 subunits. The gene of the NR1 subunit has three exons which undergo alternative splicing to generate theoretically eight NR1 splice variants. Half of them include the exon 21 or C1 in carboxy-terminus domain which can be phosphorylated in the following residues: threonine 879 and serines 890,896 and 897. Protein phosphorylation has been recognized as a major mechanism for the regulation of glutamate receptor function, changing their properties and because of its proposed role in trafficking and targeting of the NMDARs, as well as in clustering NR1 subunits into receptor-rich domains. The aim of the present work is to study the phosphorylated subunit NR1 at the serine residues 896 and 897 of the NMDAR (NR1-Ser896 and NR1-Ser897) during retinal development. Wistar rats at postnatal days 9, 14, 21, 35 and 60 are used for the developmental studies. The protein levels of the phosphorylated NR1 subunit were evaluated in Western blots. NR1-Ser897 increased gradually with a peak value observed at postnatal day 35, followed by a decrease at P60. NR1-Ser 896 was also increased to its peak level at the age of 14 and its levels sustained until the age of 60.These data reveal that the developmental profiles of the phoshorylated NR1 subunits at the serine residues 896 and 897 are different, and that the phosphorylation of the NR1 subunit is, in general, subject to regulation during development of the retina

The precise structure of the adult Drosophila eye results from a coordinated process of cell sorting, differentiation and selective cell death in the retinal epithelium. Mutations in the gene echinus cause supernumerary pigment cells due to insufficient cell death. This study reports the identification of echinus and the characterization of its role in Drosophila retinal development. Using a combination of deletion mapping, gene expression analysis and genomic sequencing, echinus was cloned and several alleles were sequenced. echinus encodes a ~180kDa protein containing an ubiquitin hydrolase domain at its N-terminus and a polyglutamine tract at its C-terminus. echinus is expressed in the retina during pupal development and mutants of echinus have decreased levels of apoptosis during several stages of retinal development. Defects in the cell sorting process that precedes cell death are also observed in echinus loss-of-function mutants and echinus overexpression can cause defects in ommatidial rotation and the morphology of cone cells. echinus is a positive regulator of DE-cadherin and Enabled accumulation in adherens junctions of retinal epithelial cells. Genetic interactions were observed between echinus and the genes wingless, enabled and expanded. An immunofluorescence assay in Drosophila S2 cell cultured demonstrated that Echinus localizes to intracellular vesicles that do not appear to be endocytic in nature, and the C-terminal region of Echinus was shown to be necessary for this association. A protein interaction screen using an immunoprecipitation and mass spectrometry approach identified interactions between Echinus and the vesicle coat protein Clathrin, the scaffolding protein RACK1 and the casein kinase I epsilon (Dco). Co-immunoprecipitation additionally identified an interaction between Echinus and Enabled. This work has revealed echinus to be an important regulator of cell sorting and adherens junction formation in the developing retina and has identified multiple interactions between echinus and enabled, a regulator of the actin cytoskeleton.

Abnormal leukocyte adhesion (i.e. leukostasis) to retinal vascular endothelial cells occurs in early diabetes. The processes of leukostasis have been clearly demonstrated in the vascular endothelium of patients with diabetes. In non-proliferative DR, clinical outcomes are manifested by excessive permeability from inflammatory progression leading to inner blood retinal barrier disruption, endothelial cell damage and widespread capillary nonperfusion. Diabetes promotes vascular leakage in DR by upregulation of adhesion molecules. Moreover, many of the pathological changes in NPDR are related to abnormalities in retinal blood flow. Studies have shown that specific circulating markers of inflammatory activity and endothelial dysfunction are associated with clinical signs of diabetic retinopathy. However, few have found an association between circulating levels of inflammatory and endothelial dysfunctional markers and abnormal retinal hemodynamics in patients with non-proliferative DR. The specific aims of this thesis are as follows: (Chapter 3)To correlate baseline levels of inflammatory and endothelial dysfunction markers and 1) baseline retinal arteriolar hemodynamics and 2) any disturbance in retinal hemodynamics over 6-month time in terms of vessel diameter, blood velocity, maximum-to-minimum velocity ratio and volumetric flow. In Chapter 4: To correlate circulating levels of inflammatory and endothelial dysfunction markers and 1) baseline vascular reactivity and 2) any disturbance in vascular reactivity after 6-month time in terms of vessel diameter, blood velocity, maximum-to-minimum velocity ratio and volumetric flow in patients with increasing non-proliferative diabetic retinopathy (NPDR) severity. Methods for Chapter 3: Diabetes subjects were stratified into either mild-to-moderate (Group 2) or moderate-to-severe (Group 3) NPDR based on their retinopathy status. Age-matched non-diabetics were recruited as controls (Group 1). Forearm blood sample was collected to determine baseline levels of inflammatory and endothelial dysfunctional markers. At visit 1, baseline retinal hemodynamics was acquired using Canon Laser Blood Flowmeter. Patients returned for a visit 2 (6 month follow-up visit) and retinal hemodynamics was reassessed. Baseline levels of inflammatory and endothelial dysfunctional markers compared between groups and correlated with both baseline and change in retinal hemodynamic parameters over 6-month time. For Chapter 4: Diabetes subjects were stratified into either mild-to-moderate NPDR or moderate-to-severe NPDR based on their retinopathy status. Age-matched non-diabetics were recruited as controls. At visit 1, forearm blood sample was collected to determine levels of inflammatory and endothelial dysfunctional markers and baseline vascular reactivity response was acquired. Retinal blood flow data was acquired while subjects breathed air. Retinal blood flow measurements were then acquired after exposure to isocapnic hyperoxic stimuli. At visit 2 (6 month follow-up), retinal vascular reactivity was reassessed. Baseline levels of inflammatory and endothelial dysfunctional markers compared between groups and correlated with both magnitude of baseline and change in vascular reactivity in terms of retinal hemodynamics. Results of Chapter 3: Maximum-to-minimum velocity ratio (max: min) was found to be significantly elevated in the group 3 compared to group 1 at baseline (0.72 vs. 0.49, after Bonferroni correction P<0.01). Both sICAM-1 and sE-selectin were significantly elevated as a function of group (ANOVA p=0.02 and p=0.04). A post hoc Bonferroni test showed that Group 3 had significantly higher in both sICAM-1 and sE-selectin levels compared to Group 1 (234.0 vs. 151.5 ng/ml, P=0.02 and 53.4 vs. 27.6 ng/ml, P<0.01, respectively). Hemoglobin A1c was significantly elevated across the groups (ANOVA p<0.01). A post hoc Bonferroni test showed that Group 3 had significantly higher hemoglobin A1c level compared to Group 1 (7.9 vs. 5.6 % , P<0.01). There were no significant associations found between baseline markers of inflammation and baseline retinal hemodynamics across all groups. The Δ velocity was correlated with the baseline sICAM-1 (r=0.42, p=0.02) and A1c levels (r=0.37, p=0.04) in patients with NPDR. After adjustment for all other variables (A1c, hsCRP and vWF), Δ velocity, sICAM-1 and A1c were found not to be reliable predictors of baseline retinal hemodynamics. For Chapter 4: There were no significant differences in magnitude of retinal vascular reactivity in hemodynamic parameters between groups at visit 1 or visit 2. Over 6 months time, compliance was found to be significantly reduced in patients of Group 3 compared to Group 2 (-0.4 vs. 0.1, t-test p<0.01). Both sICAM-1 and sE-selectin were significantly elevated as a function of group (ANOVA p=0.02 and p<0.01). A post hoc Bonferroni test showed that Group 3 had significantly higher in both sICAM-1 and sE-selectin levels compared to Group 1 (243.4 vs. 157.3ngml, P<0.01 and 57.0 vs. 29.3 ng/ml, P<0.01, respectively). Hemoglobin A1c was significantly elevated across the groups (ANOVA p<0.01). A post hoc Bonferroni test showed that Group 3 had significantly higher hemoglobin A1c level compared to Group 1 (8.8 vs. 5.6 % , P<0.01). Baseline VR in blood velocity weakly correlates with sE-selectin (r=0.31, p=0.04) across all groups while sVCAM-1 was associated with VR in terms of blood flow (r=-0.62, p<0.01) in patients with mild-to-moderate NPDR. The ∆ blood flow after 6 months was found to be weakly associated with sE-selectin (r=0.46, p=0.03) across all groups. Finally, the ∆ blood velocity after 6 month time was found to be moderately correlated with baseline vWF Ag level (r=-0.78, p=0.02). Multiple regression analysis found that vascular inflammatory and endothelial function markers had weak predictive power for Δ hemodynamic parameters. Conclusions Chapter 3: We found weak associations between circulating markers and baseline or the disturbance in retinal hemodynamics after 6 months time. Overall, we found both an increase in rigidity of the arteriolar circulation and elevated inflammatory adhesion markers (sICAM-1 and sE-selectin) within the same population sample. Change in velocity over the follow-up period was correlated with sICAM-1 and A1c levels in patients with NPDR but the level of association was such that neither sICAM-1 nor A1c proved to reliably predict retinal hemodynamics. Finally, in Chapter 4 we demonstrated two important characteristics in early NPDR; 1) a disturbance in vascular reactivity in terms of compliance and 2) an increase in systemic markers of inflammation were found in patients with NPDR. Although systemic markers of vascular inflammation and endothelial dysfunction are not predictive of hemodynamic parameters, our study found moderate associations between baseline and disturbances in VR after 6 months time. Therefore, there is evidence that inflammation and vascular function may be related with respect to their development in NPDR.