OBJECTIVE: To identify the glaucoma clinical practice patterns among the members of the Philippine Glaucoma Society (PGS) from 2015 to 2016 using an online survey. METHODS: An online link was sent to each consenting PGS member which directed them to two poll sites. These sites asked questions about demographics and their preferred clinical practice patterns. Frequency and percent distributions were used to analyze the data. RESULTS: There was a high response rate from PGS members at 97% (42 out of 43 members). More than half of respondents (51%, n=22) defined glaucoma as glaucomatous optic neuropathy with an evident visual field loss. IOP was routinely measured by 90% (n=38) of the respondents with majority preferring to use the Goldmann applanation tonometer (GAT) (98%, n=41). Gonioscopy was done on all new patients by all PGS members but only 62% did regular gonioscopy on follow-up consultations. Most of the respondents relied on the 90D lens (88%) to assess the optic nerve. Visual field examination (VFE) was routinely requested by all respondents. Pachymetry and anterior segment optical coherence tomography (AS-OCT) were used sparingly at only 43% and 12% respectively. Appositional angle closure was addressed by performing laser iridotomy with majority of the respondents preferring a site that is covered by the upper eyelid (57%). Prostaglandin analogues were the top choice as first-line monotherapy for eyes with open-angle glaucoma. Majority of the respondents (55%) opted to do laser trabeculoplasty (LTP) as an adjunct to medical therapy. Mitomycin-C was the preferred intraoperative antimetabolite for trabeculectomy by 98% (n=41). Ahmed (71%, n=30) was the more favored glaucoma drainage device (GDD) by our respondents over Baerveldt (19%, n=8). CONCLUSION: This survey showed majority of the glaucoma practices of PGS members appear to adhere to the current clinical practice guidelines.
Philippines ; Glaucoma ; Tetrahymenina ; Surveys and Questionnaires

OBJECTIVE: This study aimed to calculate and compare the costs of different brands of ocular hypotensive eye drops available in the Philippines. METHODS: This was a single-center research conducted at a local laboratory. Triplicate samples of 21 different brands of locally-available ocular hypotensive drops were tested. The mass of ten drops, total usable mass, number of drops per bottle, and mass of 200-µL aliquots were measured for each sample. These were used to calculate for the total usable bottle volume, drop volume, and number of drops per milliliter of each sample. Lastly, the daily, monthly, and annual costs were computed and compared. RESULTS: Available brands of β-blockers were the most affordable options for topical glaucoma therapy, with costs ranging from Php1,838 to 8,472 per year. Innovator brands of α-agonists and carbonic anhydrase inhibitors were the most expensive, with annual costs ranging from Php7,641 to 24,295 and Php7,361 to 25,327, respectively. Fixed-combination preparations, with yearly costs ranging from Php4,307 to 22,200, were generally more costeffective than individual preparations. The cost of topical anti-glaucoma therapy can amount up to 3.3 to 66.9% of a minimum-wage earner’s annual income depending on the number and combination of drugs being used. CONCLUSIONS: The price range of ocular hypotensive eye drops available in the Philippines is wide. Cost of therapy is an important consideration for patients who acquire medications through out-of-pocket expenditure. Optimization of bottle designs and volumes is crucial to maximize the cost-effectiveness of eye drop solutions. Information on the cost of therapy should be available to both patients and physicians.
Glaucoma ; Tetrahymenina ; Eye ; Ophthalmic Solutions ; Costs and Cost Analysis

Panax japonicus is a traditional Chinese medicine,and its principle components have shown certain pharmacological activities for cell damage,aging and cell apoptosis. In order to clarify the pharmacological mechanism and involved metabolic pathways of P. japonicas,the gene expression of Tetrahymena thermophila under P. japonicus treatment was analyzed through high-throughput transcriptome sequencing in this study. Based on the transcriptome analysis,3 544 differentially expressed genes were identified in control group,of which 1 945 genes showed up-regulated expression and 1 599 genes showed down-regulated expression. Under P. japonicas treatment in the experiment group,3 312 differentially expressed genes were screened,of which 1 `493 genes showed up-regulated expression and 1 819 genes showed down-regulated expression. GO enrichment analysis indicated that in control group,the genes in the cells in a series of fundamental biological process were down-regulated,such as DNA replication and protein synthesis; while the signal transduction process and fatty acids oxidizing process were enriched. Whereas in the experiment group,down-regulated genes were mainly enriched in oxidation-reduction,cofactor metabolic process and vitamin metabolic process; up-regulated genes were enriched in signal transduction process and protein modification process. In the analysis using KEGG database,cell cycle pathway was enhanced and autophagy pathway was inhibited under the condition of P. japonicas treatment. Real-time quantitative polymerase chain reaction( RT-qPCR) was used to detect the expression differences between 6 up-regulated and 4 down-regulated genes in related metabolic pathways. The RT-q PCR results and RNA-Seq data were highly correlated and consistent with each other. This study could provide important direction and basis for further study on the mechanism of cell growth regulation with the treatment of P. japonica.
Gene Expression ; Gene Expression Profiling ; Metabolic Networks and Pathways ; Panax ; chemistry ; Plants, Medicinal ; chemistry ; Tetrahymena thermophila ; drug effects ; genetics ; Transcriptome

This study was carried out to determine the pathogen-causing diarrhoea in sheep Ovis aries in the Qinghai Tibetan Plateau Area, China. A trophozoite was identified as species of ciliate alveolates infecting the sheep based on morphological characteristics examined by microscope. It was mostly spherical, colourless and transparent, with many vesicles. Macronucleus and contractile vacuoles could not be distinguished. Size of the trophozoite was 80–180×70–150 μm and its surface was covered with cilia. Molecular analysis based on sequences of 18S rRNA and ITS genes confirmed the ciliate species as Balantidium coli. According to the literature, there have been many epidemiological investigations of B. coli infection in pigs, monkeys and humans. To our knowledge, this was the first report of B. coli infections in sheep in the Qinghai Tibetan Plateau Area of China, or eleswhere around the world. Importantly, the sheep case was rare but raised our concern that B. coli may spread across species and expand its host range.
Balantidium ; China ; Cilia ; Haplorhini ; Host Specificity ; Humans ; Macronucleus ; Sheep ; Sheep, Domestic ; Swine ; Trophozoites ; Vacuoles

Annual proficiency surveys were conducted in March, May, and August of 2017 as the Korean Association of External Quality Assessment Service. Overall, four image samples (MPI-17-01, MPI-17-02, MPI-17-03, MPI-17-04) in the first trial, three image samples (MPI-17-05, MPI-17-06 , MPI-17-07) in the second trial, and a slide specimen (MPS-17-01) using parasite samples in the third trial were distributed to participating institutions. The first and second trial specimens were prepared by photographing slides made of formalin-ether concentrate of positive samples stored for educational purposes. The slide distributed in the third trial was prepared using cellophane tape, which was stored after diagnosis of the patients infected with Enterobius vermicularis . There were 191 participating institutions in the first, 204 in the second, and 212 in the third trial. The correct identification rates were 27.2% for MPI-17-01 Diphyllobothrium species (sp.), 96.6% for MPI-17-02 no parasite, 67.5% for MPI-17-03 Metagonimus yokogawai , 71.2% for MPI-17-04 Balantidium coli , 99.0% for MPI-17-05 Taenia sp., 99.0% for MPI-17-06 Trichuris trichiura , 92.7% for MPI-17-07 Cryptosporidium sp., and 96.7% for MPS-17-01 E. vermicularis . The current external quality assessment for clinical parasitology was performed using image samples and standard slides. Surveys of parasitic infections should be accompanied by continuous education on various parasitic infections, for which there was lack of experience of inspection in clinical laboratories. In the future, it will be necessary to establish a standard material using parasitic samples, and ultimately to conduct a survey on whole series of tests for the diagnosis of parasitic diseases.
Balantidium ; Cellophane ; Cryptosporidium ; Diagnosis ; Diphyllobothrium ; Education ; Enterobius ; Heterophyidae ; Humans ; Korea* ; Parasites ; Parasitic Diseases ; Parasitology* ; Quality Control ; Taenia ; Trichuris

Fluoroquinolone (FQ) antibiotics are an important class of synthetic antibacterial agents. These are the most extensively used drugs for treating bacterial infections in the field of both human and veterinary medicine. Herein, the antibacterial and pharmacological properties of four fluoroquinolones: lomefloxacin, norfloxacin, ciprofloxacin, and ofloxacin have been studied. The objective of this study was to analyze the antibacterial characteristics of the different fluoroquinolones. Also, the pharmacological properties of the compounds including the Lipinski rule of five, absorption, distribution, metabolism, and excretion, LD50, drug likeliness, and toxicity were evaluated. We found that among all four FQ molecules, ofloxacin showed the highest antibacterial activity through in silico assays with a strong interaction (−38.52 kJ/mol) with the antibacterial target protein (topoisomerase-II DNA gyrase enzyme). The pharmacological and pharmacokinetic analysis also showed that the compounds ciprofloxacin, ofloxacin, lomefloxacin and norfloxacin have good pharmacological properties. Notably, ofloxacin was found to possess an IGC50 (concentration needed to inhibit 50% growth) value of 0.286 μg/L against the Tetrahymena pyriformis protozoa. It also tested negative for the Ames toxicity test, showing its non-carcinogenic character.
Absorption ; Anti-Bacterial Agents ; Bacterial Infections ; Ciprofloxacin ; Computer Simulation ; DNA Gyrase ; Fluoroquinolones* ; Humans ; Lethal Dose 50 ; Metabolism ; Norfloxacin ; Ofloxacin ; Tetrahymena pyriformis ; Toxicity Tests ; Veterinary Medicine

PURPOSE/OBJECTIVE: This study aims to determine the reliability of the "VisualFields Easy" application in detecting visual field loss among ophthalmology patients; and to determine the sensitivity, specificity, positive predictive and negative predictive values of this examination using the Humphrey Visual Field Analyzer as the gold standard.

METHODS: This is an analytical study that enrolled subjects requiring visual field examination as part of the comprehensive evaluation of their ophthalmologic condition. Each subject was tested using the standard automated Humphrey Field Analyzer (Carl Zeiss Meditec, Inc., Germany) with the 30-2 Swedish Interactive Thresholding Algorithm (SITA) and the "VisualFields Easy" application (background = 10 cd / m2 ; size V target; 16-dB stimulus) loaded in an iPad 2 ver. 8.3. The print outs of each test were then interpreted independently by the principal investigator and verified by a glaucoma specialist as positive or negative for visual field defects and computation for sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were done.

RESULTS: The study included 137 eyes of 77 patients, 52 (68%) females and 25 (32%) males, age ranging from 18 to 82 years with a mean (SD) of 58 (+ 14) years. The mean test duration for the standard Humphrey perimetry was 7 minutes 50 seconds (SD + 0.08s), and 3 minutes 21 seconds (SD + 0.01s) for the "VisualFields Easy". Correlations of False Positives and False Negatives between the 2 tests were p=0.02 and p=0.03 respectively and that there was no statistically significant difference between the reliability parameters of the two tests. There were a total of 74 positives and 63 negatives visual field defects for the Humphrey. These were considered as the True Positive (TP) and True Negative (TN) values. For the "VisualFields Easy", there were 67 positives and 70 negatives. The results of the "VisualFields Easy" were plotted against the Humphrey perimetry. Sensitivity was computed at 91% and specificity at 100%. Likewise the Positive Predictive Value (PPV) was computed to be 100% and the Negative Predictive Value (NPV) was computed at 90%.

CONCLUSION: The "VisualFields Easy" application is a quick, easily accessible and fairly reliable way of measuring visual field abnormalities, both for glaucoma and neuro-ophthalmology patients. The application is not intended to replace standard automated perimetry machines, but it may have a role in detecting, documenting and monitoring visual field defects in low resource settings where visual field tests are not available.

Human ; Male ; Female ; Aged 80 And Over ; Aged ; Middle Aged ; Adult ; Visual Field Tests ; Visual Fields ; Ophthalmology ; Glaucoma ; Sensitivity And Specificity ; Tetrahymenina

Meiotic recombination is carried out through a specialized pathway for the formation and repair of DNA double-strand breaks (DSBs) made by the Spo11 protein. The present study shed light on the functional role of cyclin, CYC2, in Tetrahymena thermophila which has transcriptionally high expression level during meiosis process. Knocking out the CYC2 gene results in arrest of meiotic conjugation process at 2.5-3.5 h after conjugation initiation, before the meiosis division starts, and in company with the absence of DSBs. To investigate the underlying mechanism of this phenomenon, a complete transcriptome profile was performed between wild-type strain and CYC2 knock-out strain. Functional analysis of RNA-Seq results identifies related differentially expressed genes (DEGs) including SPO11 and these DEGs are enriched in DNA repair/mismatch repair (MMR) terms in homologous recombination (HR), which indicates that CYC2 could play a crucial role in meiosis by regulating SPO11 and participating in HR.
Cell Cycle Checkpoints ; Cyclins ; genetics ; metabolism ; DNA Breaks, Double-Stranded ; DNA Mismatch Repair ; DNA Repair ; Endodeoxyribonucleases ; genetics ; metabolism ; Homologous Recombination ; Meiosis ; Microscopy, Fluorescence ; Phenotype ; Protozoan Proteins ; genetics ; metabolism ; Real-Time Polymerase Chain Reaction ; Sequence Analysis, RNA ; Tetrahymena thermophila ; genetics ; metabolism ; Transcriptome

Ciliates are one of the oldest living eukaryotic unicellular organisms, widely distributed in the waters around the world. As a typical marine oligotrich ciliate, Strombidium sulcatum plays an important role in marine food webs and energy flow. Here we report the first deep sequencing and analyses of RNA-Seq data from Strombidium sulcatum. We generated 42,640 unigenes with an N50 of 1,451 bp after de novo assembly and removing rRNA, mitochondrial and bacteria contaminants. We employed SPOCS to detect orthologs from S. sulcatum and 17 other ciliates, and then carried out the phylogenomic reconstruction using 127 single copy orthologs. In phylogenomic analyses, concatenated trees have similar topological structures with concordance tree on the class level. Together with phylogenetic networks analysis, it aroused more doubts about the placement of Protocruzia, Mesodinium and Myrionecta. While epiplasmic proteins are known to be related to morphological characteristics, we found the potential relationship between gene expression of epiplasmic proteins and morphological characteristics. This work supports the use of high throughput approaches for phylogenomic analysis as well as correlation analysis between expression level of target genes and morphological characteristics.
Ciliophora ; genetics ; metabolism ; Phylogeny ; RNA, Protozoan ; genetics ; metabolism ; Transcriptome ; physiology

OBJECTIVE: To determine the demographic and clinical profile of glaucoma patients seen in a Philippine tertiary hospital from 2011 to 2014.

METHOD: Medical records of glaucoma patients managed at the outpatient ophthalmology clinic from October 2010 to August 2014 were reviewed. Diagnosis of glaucoma was based on the International Society of Geographic and Epidemiological Ophthalmology (ISGEO) guidelines. The demographics, clinical profile, functional severity scoring, and initial management of patients were described.

RESULT: Majority of the 570 patients were females (60.17%), with a mean age of 56.23 years. Eighty-five percent claimed to have no family history of glaucoma. The mean best-corrected visual acuity (BCVA) was 0.40, the mean intraocular pressure (IOP) was 23.56 mmHg, and the mean cup-to-disc (CD) ratio was 0.69. There were more primary type of glaucoma (55.48%) than secondary glaucoma. Mixed pattern was the most common type of visual field pattern at initial presentation. Majority of the defects were under GSS 2 stage 2 of mean deviation (MD) and loss variance (LV). Medical treatment was the most common initial management given to glaucoma patients.

CONCLUSION: The primary glaucomas were more common than the secondary glaucomas seen in a private tertiary hospital. Most had moderate visual field damage (mixed type pattern) and the most common initial management given was medical treatment.

KEYWORD: Glaucoma, Epidemiology, Primary open angle glaucoma, Primary angle closure glaucoma, Secondary glaucoma, Normal tension glaucoma, ISGEO guidelines

Human ; Male ; Female ; Middle Aged ; Intraocular Pressure ; Low Tension Glaucoma ; Ophthalmology ; Glaucoma, Angle-closure ; Glaucoma, Primary Open Angle ; Glaucoma, Open-angle ; Tetrahymenina