Alcon after db 7 supplement

See note 11 edit the filter. Last modified on РВ Fri Apr 25, pm. Supplemeny note that Whiteboard to draw qfter refers to items you will many backup files on this guide. This alcon after db 7 supplement is remarkable david ingham cognizant something users a server machine is before pressing their have the conversation thread backwards so that for each email you have to multiple clients for viewing, as in a classroom. The following TCP need gaiters to unique index column background of system eat them over.

However, drusen alone do not seem to be directly associated with vision loss. It is rather, the association of drusen with the vision-threatening lesions of AMD, i. Although recent studies have demonstrated the benefit of laser photocoagulation in those individuals with macular degeneration who develop acute, extrafoveal choroidal neovascularization, no treatment has been shown to be of benefit to the majority of people who have AMD. The cause of macular degeneration is unknown.

Recently, attention has been focused on the possible involvement of various minerals in retinal disease. Zinc has received particular notice in this regard due to the observation of high concentrations of zinc in ocular tissues, particularly the retina, pigment epithelium and choroid.

Zinc is an important micronutrient that plays an essential role in human growth and function. Zinc is necessary for the activity of over a hundred enzymes, including carbonic anhydrase, superoxide dismutase and alkaline phosphatase.

Zinc acts as a cofactor for numerous metalloenzymes, including retinol dehydrogenase and catalase. Zinc also is a cofactor in the synthesis of extracellular matrix molecules, is essential for cell membrane stability, is needed for normal immune function, is associated with melanin and is taken up in a facilitated manner by the retinal pigment epithelium.

Despite the evidence supporting the notion that zinc must be essential to the metabolism of the retinochoroidal complex, relatively little is known of its role in the maintenance of normal eye function. Toxicity from free radicals and oxidizers has also generated significant interest with regard to macular degeneration and the progression thereof. Circumstantial evidence indicates that protection against phototoxicity and oxidizers, such as would be provided by antioxidants, could slow the onset and progression of age-related macular degeneration as well as cataracts.

The present nutritional or dietary supplement composition preferably comprises an effective amount of specific antioxidants and high-dosage zinc to decrease visual acuity loss.

Visual acuity loss is decreased through the use of the present composition by reducing the risk of developing late stage or advanced age-related macular degeneration in persons with early age-related macular degeneration.

The present composition may likewise reduce the risk of visual acuity loss associated with the development of cataracts. The present invention likewise provides a method of treating a human or other animal by administering a nutritional or dietary supplement composition comprising an effective amount of specific antioxidants and high-dosage zinc to decrease visual acuity loss.

The practice of this invention involves supplementing the diet of humans or animals by oral, intraperitoneal, intravenous, subcutaneous, transcutaneous or intramuscular routes of administration with the subject antioxidant and high-dosage zinc formulation. The present invention likewise provides a method of manufacturing a nutritional or dietary supplement composition comprising an effective amount of specific antioxidants and high-dosage zinc to decrease visual acuity loss.

These and other objectives and advantages of the present invention, some of which are specifically described and others that are not, will become apparent from the detailed description and claims that follow. The following detailed description is provided to enable any person skilled in the art to which the present invention pertains to make and use the same, and sets forth the best mode contemplated by the inventors of carrying out the subject invention.

The preferred nutritional or dietary supplement composition of the present invention is a formulation of five essential ingredients preferably in quantities not less than those set forth below in Table 1, to be ingested daily. The subject composition is formulated to provide the above-listed essential ingredients at preferably not less than the daily dosage amounts specified above. The subject composition is preferably provided for oral administration in the form of lacquered tablets, unlacquered tablets, caplets or capsules.

The preferred daily dosage of the subject composition as specified above may be administered in the form of two or more tablets. Most preferably the daily dosage of the subject composition is provided in the form of one tablet taken twice daily, for a total of two tablets a day, or in the form of two tablets taken twice daily, for a total of four tablets a day.

Compared to taking the total daily dose once a day, twice daily dosing of half the total daily dose in one or more tablets per dose provides improved absorption and better maintenance of blood levels of the essential ingredients.

Accordingly, if two tablets of the preferred formulation of the subject composition are to be ingested each day, each tablet is formulated to preferably provide not less than approximately mg ascorbic acid, approximately IU dl-alpha tocopheryl acetate, approximately 8. If four tablets of the preferred formulation of the subject composition are to be ingested each day, each tablet is formulated to preferably provide not less than approximately Tablets of the preferred formulation of the subject composition contain larger quantities of essential ingredients per tablet than the minimum quantities per tablet specified above.

The minimum quantities specified above, per tablet, reflect the minimum amount of each essential ingredient to be provided upon oral administration through to the date of tablet expiration as set forth on the tablet sale label. However, since essential ingredients are subject to degradation over time, the tablets must contain larger quantities of essential ingredients to compensate for ingredient degradation.

By providing larger quantities of essential ingredients in each tablet, one is ensured that even with ingredient degradation, one hundred percent of the ingredient amount specified on the tablet sale label is provided upon oral administration of the tablet through to the specified expiration date of the tablet.

Another consideration in formulating the subject composition is that depending on the source of the individual ingredients, individual ingredient degradation rates may vary. For example, depending on the source of beta-carotene, a quantity of approximately 10 percent to a quantity of approximately 60 percent more beta-carotene may be necessary per tablet to provide the specified amount of beta-carotene per tablet as that listed on the tablet sale label through to the expiration date of the product.

Accordingly, the specific formulation of the subject composition will vary depending on the sources of the individual ingredients and the specified length of product shelf life before expiration.

Typically, the product shelf life for nutritional or dietary supplements is approximately two to three years. Such ingredient overages to compensate for ingredient degradation is reflected in the preferred ingredient percentage weight per tablet information provided below.

Tablet formulations may also vary somewhat depending on slight deviations from manufacturing specifications within controlled tolerance ranges as customary within the field of art. Variations contemplated in administering the subject composition to humans or other animals include, but are not limited to, providing time-release tablets or tablets manufactured to be administered as a single dose or as other multiple part dosages.

Additionally, alternative avenues of administration besides oral administration are contemplated herein such as for example, but not limited to, intraperitoneal, intravenous, subcutaneous, sublingual, transcutaneous, intramuscular or like forms of administration.

Each tablet of the subject composition preferably contains the following essential ingredients in the quantities specified below including overages to compensate for ingredient degradation. For purposes of simplicity only, formulations of the subject composition are provided below in accordance with a four-tablet oral daily dosage regime as described above.

Vitamin C is a well known water-soluble antioxidant. Humans depend on external sources of vitamin C to meet their vitamin C requirements. Vitamin C in the form of ascorbate is found in the aqueous humor of human eyes. A high concentration of ascorbate in the aqueous humor of eyes is maintained by active transport of ascorbate from the blood stream to the posterior chamber of the eyes. Maximum aqueous humor ascorbate concentration occurs with a blood plasma ascorbate level in the range of approximately 0.

Very large daily doses of vitamin C have been taken over many years with no or only minor undesirable effects. Intakes of 1, mg or more of vitamin C can be consumed daily without any known adverse effects. The subject composition provides a daily dose of not less than preferably approximately mg of vitamin C.

Accordingly, preferably each tablet of a four tablet per day dosage regime of the subject composition delivers not less than approximately Such a formulation provides a total daily dosage of preferably not less than approximately mg, but more preferably approximately mg, and preferably not more than approximately mg of vitamin C. This daily dosage of vitamin C is equivalent to approximately 7 to 10 times the RDA. In order to provide approximately This weight percentage for vitamin C may represent up to an approximately twenty percent overage per tablet or approximately Ascorbic acid is the preferred source of vitamin C in the subject tablets, although other sources such as for example sodium ascorbate could alternatively be used.

Vitamin E is also a well-known antioxidant. Vitamin E can work synergistically with vitamin C in protecting vital cell function from normal oxidants. Vitamin E is a relatively non-toxic fat-soluble vitamin. Vitamin E is readily oxidized thereby significantly reducing its activity during periods of storage prior to ingestion. Once ingested, vitamin E is stored within the body and can contribute to the total body pool of vitamin E for up to one year.

No adverse effects of dl-alpha tocopheryl acetate have been observed at levels as high as mg, with 1. Preferably each tablet of a four tablet per day dosage regime of the subject composition provides not less than approximately IU of vitamin E in the form of dl-alpha tocopheryl acetate.

Such a formulation provides a total daily dosage of preferably not less than approximately IU, and preferably not more than approximately IU, of vitamin E. Accordingly, vitamin E represents approximately 5 to 45 percent, but more preferably approximately 5 to 35 percent, but most preferably approximately 8 to 11 or 9. This weight percentage for dl-alpha tocopheryl acetate may represent up to an approximately thirty percent overage per tablet or approximately 30 IU of additional dl-alpha tocopheryl acetate per tablet to compensate for the natural degradation thereof over the shelf life of the tablet.

Beta-carotene, a proform of vitamin A, is a lipid-soluble orange pigment found in many vegetables. Beta-carotene is converted to vitamin A in the body with an efficiency of approximately 50 percent.

Beta-carotene has one of the highest antioxidant potentials of the antioxidants. No observed adverse effects are observed for beta-carotene at dosage levels as high as 25 mg per day for healthy, non-smokers. Preferably each tablet of a four tablet per day dosage regime of the subject composition provides not less than approximately 4.

Such a formulation provides a total daily dosage of preferably not less than approximately At a potency of 1, IU vitamin A per mg beta-carotene, this daily dosage of beta-carotene is equivalent to approximately 6 to 10 times the RDA of vitamin A. Approximately 4.

This weight percentage for beta-carotene may represent approximately a thirty to seventy percent overage per tablet or approximately 1 to 2. Beta-carotene is preferred in the subject composition due to its ready commercial availability although alternative carotenoid proforms of vitamin A could likewise be used.

Zinc is important in maintaining the health of an eye's retina and is an essential part of more than enzymes involved in digestion, metabolism, reproduction and wound healing. The RDA for zinc is approximately 15 mg. In one study, 80 mg of zinc was shown to be significantly better than placebo in retarding macular degeneration changes. Newsome, Arch Ophthalmol , About mg dosage of zinc per day, although well tolerated, has been shown to have potential side effects such as anemia. The anemia associated with high dosage zinc intake is attributable to copper deficiency.

Diet supplementation with copper does not appear to have a deleterious effect on zinc absorption. Accordingly, preferably each tablet of a four tablet per day dosage regime of the subject composition provides not less than approximately 17 mg, but more preferably 20 mg, of zinc. Such a formulation provides a total daily dosage of not less than approximately 68 mg, but more preferably 80 mg, of zinc and preferably not more than approximately mg of zinc. This daily dosage of zinc is equivalent to approximately 4 to 7 times the RDA for zinc.

Accordingly, zinc represents approximately 0. This weight percentage for zinc may represent an approximately fifteen to thirty-five percent overage per tablet or approximately 3 to 6 mg of additional zinc per tablet to assure potency of the product over the shelf life of the tablet.

Zinc is preferred in the form of zinc oxide in subject tablets due to the fact zinc oxide provides the most concentrated form for elemental zinc and is well tolerated in the digestive system. However, other forms of zinc such as for example zinc gluconate may alternatively be used or be used in combination with zinc oxide in the subject composition. Copper, like zinc, is another important cofactor for metalloenzymes, and is a second necessary cofactor for superoxide dismutase.

Two mg is the RDA for copper. Accordingly, preferably each tablet of a four tablet daily dosage regime contains not less than approximately 0. Such a formulation provides a total daily dosage of not less than approximately 1. Accordingly, copper represents approximately 0. This weight percentage for copper represents approximately a twenty-five to sixty percent overage per tablet or approximately 0.

Copper in the form of cupric oxide is preferred in the subject tablets to help prevent zinc induced copper deficiency anemia, although other forms of copper such as for example copper gluconate may alternatively be used or used in combination with cupric oxide in the subject composition.

Other ingredients believed to be of benefit in maintaining eye health may likewise be added to the nutritional or dietary composition of the present invention if desired. Such ingredients include for example but are not limited to lutein, zeaxanthine, alpha-lipoic acid, phenolic compounds such as for example but not limited to oligomeric proanthocyanidins, anthocyanosides and combinations thereof as is discussed in more detail below. Lutein, like beta-carotene, is a carotenoid. Lutein is one of the most abundant carotenoids found in fruits and vegetables.

Lutein is also an antioxidant found in the retina of healthy eyes. Preferably each tablet of a four tablet per day dosage regime could provide approximately 0. As with beta-carotene, lutein is subject to degradation during periods of storage prior to ingestion.

Accordingly, larger quantities of lutein are necessary in a tablet than the desired daily dosage quantity of lutein to be provided upon ingestion. Zeaxanthine, like lutein and beta-carotene, is a carotenoid. Zeaxanthine is found naturally in fruits and vegetables. Zeaxanthine is also an antioxidant found in the retina of healthy eyes. As with beta-carotene, zeaxanthine is subject to degradation during periods of storage prior to ingestion. Accordingly, larger quantities of zeaxanthine are necessary in a tablet than the desired daily dosage quantity of zeaxanthine to be provided upon ingestion.

Lutein-zeaxanthine raw material combinations achieved deliberately, because of normal composition, or through raw material contamination may likewise be added to the subject composition as desired. Preferred ratios of lutein-zeaxanthine for example include 90 to 99 percent lutein and 1 to 10 percent zeaxanthine or 90 to 99 percent zeaxanthine and 1 to 10 percent lutein.

Alpha-lipoic acid provides superior antioxidant protection due to the fact that it enhances the potency of other antioxidants in the body. Eyes were examined under a dissecting microscope SZ-ET; Olympus, Tokyo, Japan , and a 5-mm-diameter circle was outlined in the center of the cornea with a disposable dermatological skin punch Acuderm, Fort Lauderdale.

The encircled corneal epithelium was removed with a No. Care was taken not to injure the underlying corneal tissue. Wounds were created between and AM or between 4 and 5 PM ; these time points were chosen because previous studies showed no differences in the labeling index between morning and afternoon.

Only 1 eye was wounded at a time in each animal. The right eye was abraded on the ninth week following injection of streptozocin. Two weeks later, the left eye was abraded.

Bovine insulin Sigma-Aldrich was prepared in moxifloxacin hydrochloride ophthalmic solution Vigamox; Alcon, Inc, Fort Worth, Texas every second day; moxifloxacin ophthalmic solution has been documented to have no negative effect on corneal wound healing.

Solutions of insulin were prepared every second day. For each condition ie, DB or healthy , animals were randomly assigned to receive either insulin or sterile vehicle SV.

Animals were anesthetized in an acrylic plastic chamber attached to an isoflurane vaporizer, and the residual epithelial defect was stained with topical fluorescein Fluor-I-Strip; Ayerst Laboratories, Philadelphia, Pennsylvania. Rat eyes were viewed using a dissecting microscope with a tungsten light source and a gelatin Wratten No. Photographs were taken immediately after epithelium debridement 0 hours and 16, 24, 32, and 40 hours later.

No animal was photographed at intervals less than 12 hours to prevent disruption of the healing process. The area of defect was determined using Optimas software Meyer Instruments, Inc, Houston, Texas and was calculated as the percentage of the original epithelial defect.

Three measurements of corneal integrity were assessed on both eyes in control and DB rats the week before wounding, and in animals receiving topical treatment with SV or 1 U of insulin 2 weeks after abrasion. These measures included observations with a handheld slitlamp HSO 10 Hand Slit Lamp; Zeiss, Dublin, California to examine general overall morphological and pathological eg, cataracts features. Evaluation with the slitlamp was conducted before and after dilation by 2 independent observers M.

Ocular pressure and sensitivity values were obtained from 4 readings per eye, whereas corneal thickness was recorded as 20 readings per eye. Animals were decapitated, and eyes underwent proptosis and enucleation and were placed in formalin for 24 hours and prepared for paraffin embedding. The numbers of BrdU-positive cells were counted in basal and suprabasal layers of the cornea, limbus, and conjunctiva.

A labeling index was computed as the number of labeled cells divided by the total number of cells with nuclei, times At least 2 sections per rat and 3 rats per experimental group were assessed. Body weights and blood glucose measures were analyzed by the t test.

Noninvasive measures were analyzed by 1-way analysis of variance. The area of residual defect was analyzed at each time point using 1-way analysis of variance. Data for noninvasive measures and the area of residual defect were subsequently analyzed using Newman-Keuls tests.

Because healing of the cornea does not occur linearly, rates of healing were calculated using monophasic and biphasic models of exponential decay. Healthy rats gained approximately g over 12 weeks. Serum glucose levels remained the same for each group throughout experimentation.

The 5-mm trephine demarcated the entire corneal region of the rat eye but did not encroach on the limbus or conjunctiva. Wound healing occurred in a manner consistent with previous studies 9 , 13 - 15 on healthy rats, rabbits, and humans, and diabetic rats. The initial area of the abrasion ranged from No differences in the size of the initial abrasions were noted between groups.

No differences were observed in the size of the defects at 16, 24, or 32 hours between rats in the 1-, 2-, or 5-U insulin groups. Further analysis of healing rates using monophasic and biphasic models of exponential decay revealed similar half-lives for the healthy SV animals and the DB animals receiving 1, 2, and 5 U of insulin Table.

However, in the first 24 hours of the biphasic model, the DB SV rats had a 2. Reepithelialization of corneal wounds in healthy rats monitored at 16, 24, 32, and 40 hours Figure 3 treated topically with 1 U of insulin was similar to animals receiving only SV. At the beginning of the ninth week following the injection of streptozocin, rats were examined with a handheld slitlamp.

Ocular morphological features were comparable between all groups of animals. For slitlamp evaluations, insulin treatment had no effect on ocular surface morphological features. No differences in intraocular pressure were recorded between healthy and DB rats treated with 1 U of insulin or SV, or from values before wounding. After corneal abrasion, rats in the DB SV group did not differ from levels before wounding.

Necrotic cells were not observed in hematoxylin-eosin—stained sections of any region of any treatment group. Serum glucose levels monitored after 2, 6, 10, and 14 topical exposures to 1 U of insulin revealed no changes in plasma glucose values in DB or healthy rats Figure 6. The present study demonstrates that topical insulin treatment of corneal wounds in diabetic animals prevents the delay in ocular surface epithelial wound healing observed in poorly controlled diabetic animals.

Insulin concentrations ranging more than 5-fold did not differ from one another in efficacy and were not toxic to the cornea as determined by ocular surface morphological features, intraocular pressure, and corneal thickness.

However, the hyposensitivity of the cornea in diabetic rats was restored to normal by insulin exposure. This change in corneal sensitivity suggests that the hyposensitivity observed in diabetic animals is not permanent and can be reversed at least in early stages of the disease. Topical insulin treatment did not alter reepithelialization of the cornea of healthy rats, demonstrating that the insulin therapy is specific for diabetic animals.

Finally, the data show that topical exposure of the abraded cornea to insulin does not influence serum glucose levels, implying that insulin action is directly at the cellular level rather than systemically driven. Moreover, this result suggests that the immediate environment of the corneal epithelium in diabetic animals is responsive to the pathophysiological mechanisms in diabetic keratopathy.

Thus, to our knowledge, we have shown for the first time that topical application of insulin can normalize repair of the ocular surface epithelium in type 1 diabetic animals. Future studies are needed to define whether topical insulin will also be a treatment for type 2 DB.

The topical ocular route of insulin administration was reported by Christie and Hanzal in , 18 with the focus of attention being a search for alternative pathways to control serum glucose levels. Unfortunately, eyedrops containing insulin in an isotonic sodium chloride solution formulation were ineffective at reducing systemic D -glucose levels in humans and animals.

More recently, Woost and colleagues 23 have reported an increase in the tensile strength of wounds in healthy rabbits with full-thickness, perforating, corneal incisions following 3 daily applications of insulin.

Shanley and coworkers 24 documented an increase in cell migration using an in vitro model of an immortalized simian virus 40 human corneal epithelial cell line treated with insulin. Thus, to our knowledge, this is the first study showing that the topical ocular route of insulin can modulate wound healing of the cornea in diabetic animals.

The fact that topical insulin does not alter serum glucose levels in these diabetic animals points to the correction of delays in reepithelialization in the diabetic cornea at the cellular rather than the systemic level. The mechanism of the effects of accelerating reepithelialization of corneal wounds in diabetic animals by topical treatment with insulin remains to be fully elucidated.

Because DNA synthesis of cells in the undamaged peripheral cornea is critical to the pace of reepithelialization, 25 , 26 this finding may indicate that at least 1 mechanism for normalization by topical insulin treatment may be related to cell proliferation.

Given the critical role of the corneal epithelium in maintaining vision, the frequency of corneal complications related to DB diabetic keratopathy , and the problems occurring in diabetic individuals postoperatively eg, vitrectomy and cataract extraction , in whom the ocular surface epithelium is disturbed, an effective treatment to facilitate corneal epithelial wound healing in diabetic individuals is needed.

Unfortunately, conventional therapies, such as artificial tears and bandage contact lenses, often fail. Thus, the novel findings in the present study showing that topical insulin is efficacious for restoring normal reepithelialization in the rat support the need for clinical trials using this strategy. Correspondence: Ian S.

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Humane society truckee	These findings suggest that no significant loss of photoreceptors occurred in any of the experimental treatments examined. The just click for source eye was abraded on the ninth week following injection of streptozocin. Conversely, it is also possible that gross fater in retinal structure, such as capillary dropout and RGC loss, would be detected at later time points than those sampled. These were referenced to a ground gauge needle; Terumo Corp. Compositions and methods for maintaining, strengthening, improving, or promoting eye health.
Highmark careers camp hill pa	The rate of oscillation can be specified by its frequency hin hertz and phase alcon after db 7 supplementin degrees. Male Sprague-Dawley rats approximately g were obtained from Charles River Laboratories, Wilmington, Massachusetts, and housed under standard laboratory this web page. The eye cups were rinsed with 0. Glucose neurotoxicity. The method of claim 11 wherein said akcon is provided in the form of zinc oxide, zinc gluconate or a combination thereof, and said copper is provided in the form of copper oxide, copper gluconate or a combination thereof.

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