新生儿骶尾部畸胎瘤手术后肛门直肠功能的相关因素分析

目的评估新生儿骶尾部畸胎瘤手术后远期肛门直肠功能,并探讨其影响因素。方法选取2013年8月至2018年2月天津市儿童医院新生儿外科收治的97例新生儿骶尾部畸胎瘤患者,记录患者临床特征及肛门直肠功能障碍发生情况,对患者肛门直肠功能障碍的发生率及其危险因素进行分析。结果新生儿骶尾部畸胎瘤的Altman分型、肿瘤体积和术中残余肿瘤体积与术后肛门直肠功能的恢复相关(P<0.05),而性别、血清AFP水平、肿瘤性状和病理类型与肛门直肠功能障碍不相关(P>0.05);在Altman分型Ⅱ型和Ⅲ型的新生儿中,术后出现肛门直肠功能障碍和未发现肛门直肠功能障碍者比较,畸胎瘤大小差异具有统计学意义(P<0.05),而Ⅰ型新生儿中上述指标差异没有统计学意义(P>0.05)。结论肛门直肠功能的恢复与多种因素有关,术前对Altman分类、肿瘤体积和肿瘤位置关系的准确预判,可有效避免肿瘤生长、瘤体对盆底、肛门直肠周围组织及神经的压迫和侵犯,也可避免术中对重要组织脏器的损伤,并预防终末器官损害,改善患者的远期预后。     

Non-arteritic anterior ischemic optic neuropathy (NA-AION) after intravitreal injection of bevacizumab (Avastin®) for treatment of angoid streaks in pseudoxanthoma elasticum

Background

To report a case of nonarteritic anterior ischemic optic neuropathy (NA-AION) following intravitreal injection of bevacizumab (Avastin®).

Methods

Interventional case report with an 18-month follow-up.

Results

A 51-year-old male with pseudoxanthoma elasticum presented with NA-AION 2 weeks after treatment with intravitreal of bevazicumab (Avastin®) for choroidal neovascularisation secondary to angioid streaks. Except from a small optic disc without cupping he did not show further risk factors.

Discussion

Risk of NA-AION should be taken into consideration when deciding for intravitreal application of drugs including anti-vascular endothelial growth factors (VEGF) agents like bevacizumab (Avastin®) in the treatment of retinal vascular diseases.

     

Wavefront analysis of acrylic spherical and aspherical intraocular lenses

PURPOSE: To compare higher order wavefront aberrations in eyes implanted with acrylic aspherical intraocular lenses (IOLs) with a modified prolate anterior surface with conventional acrylic spherical IOLs by using the optical path difference method. METHODS: In a nonrandomized parallel cohort investigation, 36 eyes of 31 patients implanted with aspherical IOLs (Tecnis ZA9003) and 37 eyes of 23 age-matched patients implanted with spherical IOLs (SENSOR AR40e) were evaluated with a wavefront analyzer (OPD-Scan II) preoperatively and 1 month after surgery. The higher order aberrations for a 4.0-mm pupil diameter were expanded into Zernike's polynomial expression. Coma aberration, spherical aberration, and total higher order aberrations were evaluated as root mean square values. RESULTS: Postoperatively, coma and total higher order aberrations of spherical and aspherical IOLs significantly improved in both eyes. Spherical aberration improved in eyes with aspherical IOLs only (P < 0.01). CONCLUSION: After implantation of acrylic aspherical IOLs, postoperative higher order aberrations were not necessarily lower than after implantation of acrylic spherical IOLs, but compared with levels following implantation of acrylic spherical IOLs, a significant reduction in spherical aberration was achieved.     

Pathological findings of multifocal choroiditis with panuveitis and punctate inner choroidopathy

PURPOSE: To compare the pathological findings between multifocal choroiditis with panuveitis (MCP) and punctate inner choroidopathy (PIC). METHODS: Fourteen eyes of 14 patients clinically diagnosed as having MCP or PIC who underwent surgical excision of choroidal neovascularization (CNV) were studied. Immunohistochemical findings of the excised CNV in MCP (eight eyes) and PIC (six eyes) cases were compared. Antibodies against vascular endothelial growth factor (VEGF), CD68, CD3, and CD20 were used as primary antibodies. RESULTS: Expression of VEGF and CD68 in the CNV was observed in all MCF and PIC cases. In three of eight eyes with MCP, intraocular inflammatory findings were found clinically, while immunohistochemical study demonstrated infiltration of CD20-positive B lymphocytes in the CNV. No B lymphocyte infiltration was found in the six eyes with PIC. No differences in pathological findings were found between the five MCP eyes without intraocular inflammation and the six PIC eyes, with all eyes showing no B lymphocyte infiltration. CONCLUSIONS: In MPC cases showing clinical inflammatory findings, infiltration of B lymphocytes was also observed histopathologically, suggesting that the presence of inflammatory cells in the anterior chamber or vitreous body clinically is an indicator of active inflammatory CNV. However, this study clarifies that MCP eyes without intraocular inflammation and PIC eyes are not different in histopathological findings.     

Occurrence of <Emphasis Type="Italic">Demodex</Emphasis> species in patients with blepharitis and in healthy individuals: a 10-year observational study

Purpose

Two Demodex species (eyelash mites)—D. folliculorum and D brevis—are believed to be associated with human skin and eye diseases. However, the clinical significance of infection with Demodex species remains controversial.

Study design

The aim of this study was to estimate the prevalence of ocular demodicosis in patients with blepharitis as compared with the prevalence in the healthy population in Poland.

Methods

This case-control prospective study was carried out from 2007 to 2016. The enrolled patients (668) were divided into 2 groups: the study group, comprising 553 patients with blepharitis (349 women and 204 men, aged 17–88 years), and the control group, comprising 115 healthy volunteers without a history of ocular pathologies (78 women and 37 men, aged 17–88 years). A sample of 10 eyelashes was taken aseptically from each eye of the examined person and later studied under a light microscope.

Results

Demodex species were found in 62.4% (345/544) of the patients in the study group and in 24.3% (28/100) of the controls (P = .001, OR = 0.006). The overall prevalence was 55.8% (373/668) in all the examined participants. The presence of Demodex infection increased with age in both groups. No association of Demodex infection with gender was found (119/204 vs 226/349; P > .05, OR 1.086). A high mean number of mites was present more frequently in patients aged older than 50 years and in those who complained especially about itching (P < .05).

Conclusion

The prevalence of ocular demodicosis is significantly correlated with blepharitis and increases with age.

     

Optic disc edema as a possible complication of Imatinib mesylate (Gleevec)

BACKGROUND: Imatinib is effective for a variety of hematologic and nonhematologic malignancies. Well-known ocular side effects are periorbital edema, epiphora, extraocular muscle palsy, and blepharoconjunctivitis. However, optic disc edema has not been reported as a complication of imatinib mesylate. Herein, we describe a patient with chronic myeloid leukemia (CML) who developed optic disc edema during treatment with imatinib. CASE: A 14-year-old Korean girl was referred to ophthalmology for a 3-week history of photopsia in both eyes. She had started taking imatinib daily 2 months previously for CML. At the initial exam, slit lamp showed optic disc edema in both eyes, even though visual acuity was 20/20 and other optic nerve function evaluations were within normal limits. We recommended to the oncologist discontinuation of the imatinib treatment. OBSERVATIONS: When the patient was followed for 1 week after stopping imatinib treatment, the frequency of photopsia decreased and the optic disc edema improved. Because a second examination 3 weeks after discontinuation of imatinib revealed much improved optic disc edema, she restarted the imatinib treatment. No ocular side effects have been noted so far. CONCLUSIONS: Optic disc edema should be considered one of the complications associated with imatinib. We propose discontinuation of the treatment for a short period when optic disc edema occurs.     

CYP1A1 and CYP1B1 genetic polymorphisms and uterine leiomyoma risk in Chinese women

Purpose  The aim of the study was to evaluate the association of CYP1A1 and CYP1B1 polymorphisms with uterine leiomyoma in Chinese women. Methods  We investigated 100 women with clinically diagnosed uterine leiomyoma and 110 healthy normal subjects from Chinese women. The genetic distribution of two CYP1A1 polymorphisms at MspI, Ile462Val and four CYP1B1 polymorphisms at Arg48Gly, Ala119Ser, Leu432Val, Asp449Asp were analyzed by polymerase chain reaction–restriction fragment length polymorphism and DNA sequencing method. Results  All the SNPs showed polymorphisms in Chinese women. The genotype A/G and the allele G on Ile462Val was significantly different between uterine leiomyoma patients and controls (P < 0.05). Conclusion  These results suggest that the genotype of CYP1A1 Ile462Val was associated with the increased risk of uterine leiomyomas in Chinese women. Capsule This is the first report that demonstrates the polymorphism at Ile462Val of CYP1A1 to be associated with uterine leiomyoma in Chinese women.     

宫颈鳞癌脱落细胞人端粒酶逆转录酶mRNA的表达及意义

目的探讨宫颈鳞癌脱落细胞中人端粒酶逆转录酶(hTERT)mRNA的表达及其在宫颈鳞癌早期诊断中的作用。方法采用实时荧光定量RT-PCR技术,检测人宫颈癌Hela细胞株(细胞组)以及2008年4-10月广东省妇幼保健院经临床和病理证实的31例宫颈鳞癌(病例组)、21例正常或宫颈炎症(对照组)宫颈脱落细胞中hTERT mRNA的表达,以细胞组hTERT mRNA的表达作为定性、定量参照;对病例组及对照组同时采用液基薄层细胞学(TCT)检查。结果 (1)在病例组和对照组宫颈脱落细胞中hTERT mRNA阳性表达率分别为80.6%和9.5%,其相对定量表达水平NhTERT分别为0.4646～13.7823和0.0093～0.0816,差异均有统计学意义(P<0.05);(2)采用宫颈脱落细胞hTERT mRNA表达进行宫颈鳞癌筛查的灵敏度和特异度分别为80.6%和90.5%。结论宫颈鳞癌患者脱落细胞hTERT mRNA的阳性表达率及表达水平均异常增高,检测宫颈脱落细胞hTERT mRNA的表达,有助于宫颈鳞癌的早期诊断。