“A recent series of papers by Charles T. Perretti and collaborators have shown that nonparametric forecasting methods can outperform parametric methods in noisy nonlinear systems. Such a situation can arise because of two main reasons: the instability of parametric inference procedures in chaotic systems which can lead to biased parameter estimates, and the
discrepancy between the real system dynamics and the modeled one, a problem that Perretti and collaborators call the true model myth”. Should ecologists go on using the JNK-IN-8 in vitro demanding parametric machinery when trying to forecast the dynamics of complex ecosystems? Or should they rely on the elegant nonparametric approach that appears so promising? It will be here argued that ecological forecasting based on parametric models presents two key comparative advantages over nonparametric approaches. First, the likelihood of parametric forecasting failure can be diagnosed thanks to simple Bayesian model checking procedures. Second, when parametric forecasting is diagnosed to be reliable, forecasting uncertainty can be estimated on virtual data generated check details with the fitted to data
parametric model. In contrast, nonparametric techniques provide forecasts with unknown reliability. This argumentation is illustrated with the simple theta-logistic model that was previously used by Perretti and collaborators to make their point. It should convince ecologists to stick to standard parametric approaches, until methods have been developed to assess the reliability of nonparametric forecasting. (C) 2015 Elsevier Ltd. All rights reserved.”
“Freshwater mussels are among animals having two different, see more gender-specific mitochondrial genomes. We sequenced complete female mitochondrial genomes from
five individuals of Anodonta anatina, a bivalve species common in palearctic ecozone. The length of the genome was variable: 15,637-15,653 bp. This variation was almost entirely confined to the non-coding parts, which constituted approximately 5% of the genome. Nucleotide diversity was moderate, at 0.3%. Nucleotide composition was typically biased towards AT (66.0%). All genes normally seen in animal mtDNA were identified, as well as the ORF characteristic for unionid mitochondrial genomes, bringing the total number of genes present to 38. If this additional ORF does encode a protein, it must evolve under a very relaxed selection since all substitutions within this gene were non-synonymous. The gene order and structure of the genome were identical to those of all female mitochondrial genomes described in unionid bivalves except the Gonideini.”
“Background: Large multicentre studies of continuous renal replacement therapy (CRRT) in critically ill patients may influence its bedside prescription and practical application. Despite this, many aspects of CRRT may not be informed by evidence but remain a product of clinician preference.
We identified new regions showing association (combined P < 5 x 10(-8)) with pulmonary function in or near MFAP2, TGFB2, HDAC4, RARB, MECOM (also known as EVI1), SPATA9, ARMC2, NCR3, ZKSCAN3, CDC123, C10orf11, LRP1, CCDC38, MMP15, CFDP1 and KCNE2. Identification of these 16 new loci may provide insight into the molecular mechanisms
regulating pulmonary function and into molecular targets for future therapy to alleviate reduced lung function.”
“Background and Objectives: Drug resistance in HIV-1 is one of the main causes of failure of antiretroviral therapy. Phenotypic detection of drug-resistant HIV-1 can provide guidance in selecting the optimal treatment regimen. Traditional phenotype assays are labor intensive and time consuming. Thus, a rapid and convenient phenotype assay with a OSI-744 mw single cycle of replication was developed and used in this study.\n\nMethods: Two restriction endonuclease sites, ANA and Agel, were inserted into the plasmid pSG(Delta env) using site-directed mutagenesis. The reverse transcriptase and protease genes of HIV-1
were amplified from patients and cloned into the modified pSG3(Delta env). Sixteen original recombinant pseudoviruses were generated. The phenotypic susceptibility of these 16 recombinant pseudoviruses FAK inhibitor to 12 antiretroviral drugs was determined using a luciferase reporter system, and the phenotype and genotype results were compared.\n\nResults: A modified phenotype this website assay with a single-cycle system was established, and its reproducibility and feasibility were validated. Approximately 89% of the phenotype results were in agreement with the genotype results; this slight disagreement may have been due to complex and multiple resistance mutations. The phenotype results showed that individual pseudoviruses with four thymidine analog mutations (TAMs)
[M41L, T67N, L210W, and T215Y] in combination with various other mutations had different levels of resistance to nucleoside reverse transcriptase inhibitors (NRTIs). Mutations E44A, T69D, and V118I influenced the pattern of resistance of TAMs. The level of resistance to non-NRTIs (NNRTIs) was also variable when different NNRTI-resistance mutations were combined.\n\nConclusion: The single-cycle pseudovirus phenotypic susceptibility detection system reflects HIV-1 drug resistance, especially for complex resistance mutants, and could be used to screen new antiretroviral candidates.”
“PURPOSE: To analyze the optic surface roughness and morphology of 2 types of hydrophobic acrylic intraocular lenses (IOLs) with various dioptric powers using atomic force microscopy (AFM).
\n\nRecent findings\n\nOver the past 10 years, a number of different compounds have been studied in vitro and clinically as FLT3 inhibitors. The first inhibitors studied were hampered by cumbersome pharmacokinetics and a general lack of potency. However, some agents have shown promise in clinical trials Sotrastaurin molecular weight with transient responses in AML. Newer compounds, such as AC220, have demonstrated profound selectivity and potency
against the FLT3 target, and are currently being investigated in clinical trials.\n\nSummary\n\nClinical trials have so far demonstrated that inhibitors of FLT3 do have clinical activity in patients with FLT3-mutant AML, although this activity is often transient and correlates with effective in-vivo suppression of the FLT3 target. As newer, more potent agents are now learn more entering advanced clinical trials, opportunities will emerge for real progress against this grim disease.”
“Aquaporins (AQP) are a growing family of water-channel proteins, numbering 13 to date. Recent studies have reported AQP1 and AQP4 to be involved in the development
and resorption of brain edemas of different origin. Other AQPs have also been detected in brain tissue, but their impact on brain edema remains to be shown. To evaluate a possible role of AQP5 in brain edema, we investigated the association of AQP5 expression and the functional AQP5 promoter polymorphism A(-1364)C with occurrence and intensity of peritumoral edema in meningioma patients. Peritumoral edema was classified in three degrees based on preoperative imaging in 89 meningioma patients treated at the University Hospital Essen between 2003 and 2006. AQP5 expression was assessed immunohistochemically in tumor tissue obtained during neurosurgical tumor resection. Genotypes of the A(-1364)C polymorphism were determined using the “slowdown” Selleckchem Barasertib polymerase chain reaction. Higher levels of AQP5 expression were significantly correlated with the AQP5-1364 AA genotype (P = 0.02). AQP5 expression was positively correlated
with edema (P = 0.04). AQP5 genotypes were not significantly associated with the occurrence, but with the intensity of peritumoral brain edema (P = 0.04). In our cohort, 40 % of patients with grade I, 66.7 % with grade II, and 76.5 % with grade III edema possessed at least one A allele. Development and intensity of peritumoral edema in meningiomas are associated with AQP5 expression. The intensity of edema correlates with the AQP5 A(-1364)C genotype. This suggests AQP5 as an interesting new candidate involved in peritumoral brain edema in meningioma patients.”
“QUESTIONS UNDER STUDY: Prenatal care has been significantly influenced by the introduction of non-invasive prenatal testing (NIPT) for aneuploidies in 2012. The aim of this study was to describe the current impact of NIPT on prenatal care.
Studies with highly synchronised parasites revealed that the UpsA element possessed minimal activity in comparison with a heterologous (hrp3) promoter. This may result check details from the integrated UpsA promoter being largely silenced by the neighbouring cg6 promoter. Our analyses also revealed that the DownsA 3′ untranslated region further
decreased the luciferase activity from both cassettes, whereas the var A intron repressed the UpsA promoter specifically. By applying multivariate analysis over the entire cell cycle, we confirmed the significance of these cis-elements and found the parasite stage to be the major factor regulating UpsA-promoter activity. Additionally, we observed that the UpsA Selleck Daporinad promoter was capable of nucleating reversible silencing that spread to a downstream promoter. We believe these studies are the first to
analyse promoter activity of Group A var genes, which have been implicated in severe malaria, and support the model that var introns can further suppress var expression. These data also suggest an important suppressive role for the DownsA terminator. Our findings imply the existence of multiple levels of var gene regulation in addition to intrinsic promoter-dependent silencing. (c) 2009 Australian Society for Parasitology Inc. Published by Elsevier Ltd. All rights reserved.”
“Hearing loss (HL) is the most common sensory disorder in humans. Many patients with mitochondrial diseases have sensorineural HL (SNHL). The HL of these patients manifests as a consequence of either syndromic or nonsyndromic mitochondrial diseases. Furthermore, the phenotypes vary among patients even if they are carrying the same mutation. Therefore, these features make it necessary to analyze every presumed mutation in patients with hereditary HL, but the extensive analysis of various mutations is laborious. We analyzed 373 patients with suspected hereditary HL by using an extended suspension-array screening system for major mitochondrial DNA (mtDNA) mutations, which can detect 32 other mtDNA mutations in
addition to the previously analyzed 29 mutations. In the present study, we detected 2 different mtDNA mutations among PKC412 inhibitor these 373 patients; m. 7444G4A in the MT-CO1 gene and m. 7472insC in the MT-TS1 gene in 1 patient (0.3%) for each. As these two patients had no clinical features other than HL, they had not been suspected of having mtDNA mutations. This extended screening system together with the previous one is useful for the genetic diagnosis and epidemiological study of both syndromic and nonsyndromic HL. Journal of Human Genetics (2012) 57, 772-775; doi:10.1038/jhg.2012.109; published online 13 September 2012″
“To examine the functional contribution of the N-terminal region to the activities of Naja naja atra phospholipase A(2) (PLA(2)), studies on three N-terminally mutated PLA(2) were carried out in the present work.
The paired-pulse extracellular postsynaptic potential (fEPSP) ratio increased during the seizure and did slowly recover to preictal levels after the seizure ended. Although clear changes in excitability occurred during and after seizure activity, changes of LFP parameters were more subtle before seizure onset; a significant reduction of LFP and PS amplitudes was observed that started 1-2 min in advance in similar to 33% of the cases; in similar to 18%, an increase of LFP/PS amplitude was observed; in the other cases, no significant change was observed. Taken together, these results provide
evidence that, in this experimental model, DG physiology is more likely to follow the BTSA1 mouse already ongoing seizure Fer-1 cost activity rather than to contribute to its generation.”
“We studied the operative and functional outcomes of combined retropubic balloon vaginoplasty and laparoscopic canalization
(RBV-LC) for treatment of cervicovaginal aplasia. The RBV-LC procedure was performed successfully in 4 cases of cervicovaginal aplasia within 35-40 minutes primary operative time Cystoscopy was performed to ensure bladder and urethral integrity Endoscopically monitored canalization with laparoscopic canalization is a feasible, effective, less invasive way for management of cervicovaginal aplasia”
“Breast cancer therapy has improved following the development of drugs with specific molecular targets, exemplified by inhibitors of human epidermal growth factor receptor-2 (HER2) or epidermal growth factor receptor (EGFR) such as trastuzumab and lapatinib. However, these drugs have little effect on brain metastasis due to the combined effects of poor penetration of the blood-brain barrier and their removal from the central nervous
system (CNS) by the p-glycoprotein (Pgp) drug efflux pump. We investigated the effects of TAK-285, a novel, investigational, dual EGFR/HER2 inhibitor that has been shown to penetrate the CNS and has comparable inhibitory efficacy to lapatinib which is a known Pgp substrate. Tested against a panel of 96 kinases, TAK-285 showed specificity for inhibition of HER family kinases. Unlike lapatinib, TAK-285 is not a substrate for Pgp efflux. In mouse and rat xenograft tumor models, TAK-285 showed antitumor activity against cancers that expressed HER2 or EGFR. TAK-285 was as effective find more as lapatinib in antitumor activity in a mouse subcutaneous BT-474 breast cancer xenograft model. TAK-285 was examined in a model of breast cancer brain metastasis using direct intracranial injection of BT-474-derived luciferase-expressing cells and showed greater inhibition of brain tumor growth compared to animals treated with lapatinib. Our studies suggest that investigational drugs such as TAK-285 that have strong antitumor activity and are not Pgp substrates may be useful in the development of agents with the potential to treat brain metastases.
The aim of this study was to evaluate the contribution of an early dynamic phase (DP) of the lymphoscintigraphy (LS) to the detection Crenolanib in vivo of the sentinel lymph node (SLN) in breast cancer.\n\nMethods. This prospective study included 164 breast lesions in 161 consecutive patients (160 women, mean age 57.5 years).
Patients with tumor >5 cm, multicentric, palpable nodes, axillary involvement, previous surgery, lymphadenectomy, radio or chemotherapy were not included. All patients underwent preoperative LS before surgery. DP immediately after injection of [99mTc]Nanocolloid followed by early and delayed planar images (EPI and DPI) were acquired.\n\nResults. SLN was detected in 162/164 lesions (98.8%). In 115 (71%) DP showed no lymph node uptake and the SLN was identified only by EPI and DPI. A focal uptake by at least one lymph node was observed in DP in the remaining 47 lesions (29%). Although in 30/74 lesions DP did not provide additional information to EPI and DPI, nevertheless in 17 cases (10.5%) DP was essential to identify correctly the SLN.\n\nConclusion. We concluded that DP, by allowing a better GSK1210151A order interpretation of the lymphatic drainage pattern, provides unique information to distinguish the correct
SLN from other lymph nodes and is recommended as the first part of LS.”
“HermiteFit, a novel algorithm for fitting a protein structure into a low-resolution electron-density map, is presented. The algorithm accelerates the rotation of the Fourier image of the electron density by using three-dimensional orthogonal Hermite functions. As part of the new method, an algorithm for the rotation of the density in the Hermite basis and an algorithm for the conversion of the expansion coefficients into the Fourier basis are presented. HermiteFit was implemented using the cross-correlation or the Laplacian-filtered cross-correlation as the fitting criterion. It is demonstrated that in the Hermite www.selleckchem.com/products/ulixertinib-bvd-523-vrt752271.html basis the Laplacian filter has a particularly simple form. To assess the quality of density encoding in the Hermite basis, an analytical way of computing the crystallographic R factor is presented. Finally, the algorithm is validated
using two examples and its efficiency is compared with two widely used fitting methods, ADP_EM and colores from the Situs package. HermiteFit will be made available at http://nano-d.inrialpes.fr/software/HermiteFit or upon request from the authors.”
“Objective: To determine the efficacy of image-guided drainage versus antibiotic-only treatment of pelvic abscesses. Design: Retrospective cohort analysis. Setting: An academic, inner-city medical center. Patient(s): Women ages 11-49, admitted between 1998 and 2008 with ICD9 code 614.x (inflammatory diseases of ovary, fallopian tube, pelvic cellular tissue, and peritoneum). Intervention(s): Medical records search, chart review, and phone survey. Main Outcome Measure(s): Surgical intervention.
\n\nMethods: We sequenced exon 5 of GNAQ and GNA11, a paralogue of GNAQ, in 713 melanocytic neoplasms of different types (186 uveal melanomas, 139 blue nevi, 106 other nevi, and 282 other melanomas). We sequenced exon 4 of GNAQ and GNA11 in 453 of these samples and in all coding exons of GNAQ and GNA11 in 97 uveal melanomas and 45 blue nevi.\n\nResults: We found somatic mutations in exon 5 (affecting Q209) and in exon 4 (affecting R183) in both GNA11 and GNAQ, in a mutually exclusive pattern. Mutations affecting Q209 in GNA11 were present in 7% of blue nevi, 32% of primary Tipifarnib ic50 uveal melanomas, and 57% of uveal melanoma metastases. In
contrast, we observed Q209 mutations in GNAQ in 55% of blue nevi, 45% of uveal melanomas, and 22% of uveal melanoma metastases.
Mutations affecting R183 in either GNAQ or GNA11 were less prevalent (2% of blue nevi and 6% of uveal melanomas) than the Q209 mutations. Mutations in GNA11 induced see more spontaneously metastasizing tumors in a mouse model and activated the mitogen-activated protein kinase pathway.\n\nConclusions: Of the uveal melanomas we analyzed, 83% had somatic mutations in GNAQ or GNA11. Constitutive activation of the pathway involving these two genes appears to be a major contributor to the development of uveal melanoma. (Funded by the National Institutes of Health and others.)\n\nN Engl J Med 2010;363:2191-9.”
“PRRSV infection ADE facilitates the attachment and internalization of the virus onto macrophages through Fc receptor-mediated endocytosis. Fc gamma RI is the activating receptor with a tyrosine-based activating motif (ITAM) in its cytoplasmic tail, where up-regulates phagocytosis. However, porcine Fc gamma RI’s role in the antiviral immune response to PRRSV infection has not been studied. In this study, our results indicated that selective activation of porcine Fc gamma RI in PAM cells down-regulated significantly mRNA levels of
IFN-alpha and TNF-alpha post-pretreatment, suggesting that porcine Fc gamma RI buy LDN-193189 signal can inhibit the innate antiviral response of host cells. PRRSV infection assay mediated by Fc gamma RI indicated that selective activation of porcine Fc gamma RI in PAM cells inhibited significantly mRNA levels of antiviral cytokine (IFN-alpha and TNF-alpha) in response to PRRSV infection, suggesting that Fc gamma RI ligation can inhibit the antiviral immune response to PRRSV infection. (C) 2013 Elsevier B.V. All rights reserved.”
“In the current communication, we report the synthesis, spectroscopic, crystal structure, DFT and photophysical studies of a new nicotinonitrile derivative, viz. 2-methoxy-6-(4-methoxy-phenyl)-4-p-tolyl-nicotinonitrile (2) as a potential blue light emitting material. The compound 2 was synthesized in good yield via a simple route. The acquired spectral and elemental analysis data were in consistent with the chemical structure of 2.
\n\nObjectives: We determined the relative effect of a simulation of UK recommendations of summer sunlight exposure on the vitamin D status of individuals of South Asian ethnicity compared with that of whites.\n\nDesign: GW4869 cost In a prospective cohort study, simulated summer sunlight exposures were provided under rigorous
dosimetric conditions to 15 adults (aged 20-60 y) of South Asian ethnicity, and serum 25-hydroxyvitamin D [25(OH) D] was measured weekly. Dietary vitamin D intake was estimated. Outcomes were compared with those of 109 whites (aged 20-60 y) treated with the identical UV-radiation exposure protocol.\n\nResults: At baseline (winter trough), all South Asians were vitamin D-insufficient [25(OH)D concentrations <20 ng/mL], and 27% of South Asians were vitamin D-deficient [25(OH)D concentrations <5 ng/mL]; although 25(OH)D concentrations increased post-course (P < 0.0001), all South Asians remained vitamin D-insufficient. The mean increase in 25(OH)D was 4.3 compared with 10.5 ng/mL in the Caspase inhibitor South Asian and white
groups, respectively (P < 0.0001), and 90% of the white group reached vitamin D sufficiency postcourse. The median dietary vitamin D intake was very low in both groups.\n\nConclusions: Sunlight-exposure recommendations are inappropriate for individuals of South Asian ethnicity who live at the UK latitude. More guidance is required to meet the vitamin BX-795 cost D requirements of this sector of the population. This study was registered at www.isrctn.org as ISRCTN 07565297. Am J Clin Nutr 2011;94:1219-24.”
“AIM: An image fusion of 3-dimensional (D) digital subtraction angiography (DSA) and magnetic resonance (MR) images, DSA-MR fusion, can simultaneously visualize both information of the vasculature provided by 3D DSA and of the soft tissues provided by MR images. The authors assessed the usefulness of DSA-MR fusion images concerning the pretreatment evaluation for cerebral arteriovenous malformation (AVM).\n\nMATERIAL and METHODS: Seven consecutive patients underwent pretreatment DSA-MR fusion and then microsurgical, endovascular and/or radiosurgical
treatments.\n\nRESULTS: DSA-MR fusion images clearly showed the spatial relationship among AVM, its feeding artery, draining vein, surrounding artery feeding the normal brain tissue, hematoma and brain tissues (gyri or brain surface) with reasonable post-processing time.\n\nCONCLUSION: These findings were useful for treatment planning for AVM, especially to enable neurosurgeons to easily understand the surgical anatomy preoperatively.”
“Background: One disadvantage of expressing heterologous proteins in Escherichia coli is that the proteins are frequently expressed as insoluble inclusion bodies. To avoid this problem, heterologous proteins are typically expressed as a fusion protein. Maltose binding protein (MBP) is one of the widely used partners for production of recombinant fusion proteins in E. coli.
“Background. Immunosuppressive regimen is associated with several metabolic adverse effects. Bone loss and fractures are frequent after transplantation and involve multifactorial mechanisms.\n\nMethods. A retrospective analysis of 130 patients submitted to simultaneous pancreas-kidney transplantation (SPKT) and an identification of risk factors involved in de novo Charcot neuroarthropathy by multivariate analysis were used; P<0.05 was considered significant.\n\nResults. Charcot neuroarthropathy was diagnosed in 4.6% of SPKT recipients during the first year. Cumulative glucocorticoid doses (daily dose plus methylprednisolone pulse) during the first 6 months both
adjusted to body weight (978 mg/kg) and not adjusted to body weight were associated with Charcot neuroarthropathy SBE-β-CD concentration (P=0.001 and P<0.0001, respectively). Age, gender, race, time on dialysis, time of diabetes history, and posttransplantation hyperparathyroidism were not related to Charcot neuroarthropathy after SPKT.\n\nConclusions. Glucocorticoids are the main risk factors for de novo Charcot neuroarthropathy after SPKT. Protocols including glucocorticoid avoidance or minimization should be considered.”
“The andromonoecious poplar is an exceptional model system for studying sex-specific flower development in dioecious plants. There is increasing evidence
that epigenetic regulation, particularly DNA methylation, is an important regulatory factor during flower development. Here, methylation-sensitive amplified NVP-LDE225 polymorphism (MSAP) was HER2 inhibitor used to screen for sex-specific DNA methylation alterations in the andromonoecious poplar. The sequences of 27 sex-specific amplified fragments were obtained
from DNA prepared from sex-specific flower tissues. PtGT2, PtPAL3, and PtCER4, which are homologous to MF26, MF29, and MF35, respectively, were cloned as candidate genes. Expression analysis and DNA methylation pattern profiling of the three candidate genes revealed that gene expression upregulation was always associated with gene body methylation. The results suggested that DNA methylation sites have the potential to regulate the genes’ transcript levels. These three genes were shown to play important roles during different phases of flower development. This study will help to provide candidates for future experiments aimed at understanding the mechanism, whereby DNA methylation regulates gene expression in poplar.\n\nWe report the first screen for sex-specific DNA methylation alterations in the andromonoecious poplar. 27 sex-specific methylation sites were identified. The gene expression levels and DNA methylation patterns were detected for three candidate genes.”
“OBJECTIVES: LaparoEndoscopic Single-Site (LESS) surgery presents many technical and ergonomic obstacles. The solution to these current limitations may lie within emerging technologies, primarily the doVinci robotic platform.
These findings demonstrate that X. tropicalis has four characteristic
MCHRs and will be useful for elucidating the nature of MCHR evolution among vertebrates. (C) 2014 Elsevier Inc. All rights reserved.”
“Individuals with isolated terminal deletions of 8p have been well described in the literature, however, molecular characterization, particularly by microarray, of the deletion in most instances is lacking. The phenotype of such individuals falls primarily into two categories: those with cardiac defects, and those without. The architecture of 8p has been demonstrated to contain two inversely oriented segmental duplications at 8p23.1, flanking Fedratinib molecular weight the gene, GATA4. Haploinsufficiency of this gene has been implicated in cardiac defects seen in numerous individuals with terminal 8p deletion. Current microarray technologies allow for the precise CDK phosphorylation elucidation of the size and gene content of the deleted region. We present three individuals with isolated terminal deletion of 8p distal to the segmental duplication telomeric
to GATA4. These individuals present with a relatively mild and nonspecific phenotype including mildly dysmorphic features, developmental delay, speech delay, and early behavior issues. (c) 2013 Wiley Periodicals, Inc.”
“PURPOSE: To determine the effects of a second fluocinolone implant inserted in eyes with uveitis in which recurrent inflammation developed after the original implant was placed.\n\nDESIGN: Prospective, interventional trial.\n\nMETHODS: Study subjects comprised all consecutive patients with noninfectious posterior uveitis who were treated at the Duke Eye Center from March selleckchem 2004 to July 2007, and followed for at least nine months, in whom a fluocinolone acetonide implant was initially inserted, and in whom the implant was replaced, or a second implant was inserted because of recurrent inflammation.
The main outcome measures were inflammation recurrences, use of adjunctive anti-inflammatory therapy, visual acuity, intraocular pressure (IOP), and adverse events.\n\nRESULTS: Seventeen eyes of 14 patients were studied. The mean time from original fluocinolone implantation to first uveitis recurrence was 38 months. The time from first inflammation recurrence to the second implantation was eight months. The average follow-up was 17 months. Inflammation developed in only one eye during follow-up, three years after the second fluocinolone implant insertion. Adjunctive steroid use was decreased significantly. The mean snellen visual acuity 12 months after the second implant insertion was 20/78, compared with 20/400 at the time of the original fluocinolone implant placement (P = .04). The average IOP was unchanged after surgery compared with the preoperative IOP.