Here we describe shifting bubble sign in manual dissection of deep anterior lamellar keratoplasty (DALK). This sign can be noticed in more than 99% of patients. It is very useful in phakic keratoconic eyes, the leading indication for DALK. We believe that our small modification can help surgeons early in learning curve to avoid inadvertent anterior chamber penetration during the final stages of DALK.

OBJECTIVES: Despite all the efforts and increased knowledge of rabies, the exact mechanisms of infection and mortality from the rabies virus are not well understood. To understand the mechanisms underlying the pathogenicity of rabies virus infection, it is crucial to study the tissue that the rabies virus naturally infects in humans. METHODS: Cerebellum brain tissue from 9 human post mortem cases from Iran, who had been infected with rabies virus, were examined histopathologically and immunohistochemically to evaluate the innate immune responses against the rabies virus. RESULTS: Histopathological examination revealed inflammation of the infected cerebellum and immunohistochemical analyses showed an increased immunoreactivity of heat shock protein 70, interleukin-6, interleukin-1, tumor necrosis factor-alpha, caspase-3, caspase-9, toll-like receptor3 and toll-like receptor4 in the infected brain tissue. CONCLUSION: These results indicated the involvement of innate immunity in rabies infected human brain tissue, which may aggravate the progression of this deadly disease.
Brain ; Caspase 3 ; Caspase 9 ; Central Nervous System ; Cerebellum ; HSP70 Heat-Shock Proteins ; Humans ; Immunity, Innate ; Immunohistochemistry ; Inflammation ; Interleukin-1 ; Interleukin-6 ; Iran ; Mortality ; Pathology ; Rabies virus ; Rabies ; Tumor Necrosis Factor-alpha ; Virulence