Distinct roles for GFRalpha1 and GFRalpha2 signalling in different cranial parasympathetic ganglia in vivo

Neurturin (NRTN), signalling via the GDNF family receptor alpha2 (GFRalpha2) and Ret tyrosine kinase, has recently been identified as an essential target-derived factor for many parasympathetic neurons. NRTN is expressed in salivary and lacrimal glands, while GFRalpha2 and Ret are expressed in the corresponding submandibular, otic and sphenopalatine ganglia. Here, we have characterized in more detail the role of GDNF and NRTN signalling in the development of cranial parasympathetic neurons and their target innervation. Gfra1 mRNA was expressed at E12 but not in newborn cranial parasympathetic ganglia, while Gfra2 mRNA and protein were strongly expressed in newborn and adult cranial parasympathetic neurons and their projections, respectively. In newborn GFRalpha1- or Ret-deficient mice, where many submandibular ganglion neurons were still present, the otic and sphenopalatine ganglia were completely missing. In contrast, in newborn GFRalpha2-deficient mice, most neurons in all these ganglia were present. In these mice, the loss and atrophy of the submandibular and otic neurons were amplified postnatally, accompanied by complete loss of innervation in some target regions and preservation in others. Surprisingly, GFRalpha2-deficient sphenopalatine neurons, whose targets were completely uninnervated, were not reduced in number and only slightly atrophied. Thus, GDNF signalling via GFRalpha1/Ret is essential in the early gangliogenesis of some, but not all, cranial parasympathetic neurons, whereas NRTN signalling through GFRalpha2/Ret is essential for the development and maintenance of parasympathetic target innervation. These results indicate that GDNF and NRTN have distinct functions in developing parasympathetic neurons, and suggest heterogeneity among and within different parasympathetic ganglia.     

Tear film lipid layer thickness measurement from Ocular Surface Analyzer as a marker to monitor treatment of meibomian gland dysfunction in a study comparing physiological detergent-free eyelid wipes with conventional therapy: A randomized trial

Purpose:To compare the efficacy of physiological, non-detergent eyelid wipes with conventional lid hygiene in patients with meibomian gland dysfunction (MGD).Methods:Fifty participants with MGD were recruited and randomized into two groups. Participants in group I used Evolve Pure™ Eyewipes twice a day to clean the eyelid debris along with standard therapy (antibiotic and lubricants) and participants in group II followed lid hygiene with warm compresses along with standard therapy. Symptoms, ocular surface assessment (lipid layer thickness, tear meniscus height, non-invasive tear film breakup time, and meibography), slit-lamp biomicroscopy (eyelash contamination, meibomian gland blockage, meibomian gland secretion, and meibomian gland telangiectasia) and tear film osmolarity were noted at baseline and 90 days after therapy.Results:Significant improvement in symptoms and signs of MGD was observed in both groups after treatment (P < 0.001); however, the clinical improvement was better with the use of eyelid wipes. Lipid layer thickness increased significantly in group I (P = 0.0006) and group II (P = 0.0002), which was maintained even after adjusting for sociodemographic variables such as age, sex, and severity score of symptoms and signs.Conclusion:Lipid layer thickness of the tear film is a sensitive marker in monitoring response to treatment in patients with MGD. The use of physiological detergent-free eyelid wipes is non-inferior to lid hygiene and warm compresses, which remains the mainstay for treatment of MGD; the clinical improvement with eyelid wipes was noted to be better.     

Clinical and histopathological profile of primary caruncular lesions

Purpose:To provide a retrospective analysis of lesions of the caruncle which have been very rarely reported in the literature.Methods:A retrospective review of all the caruncular lesions between January 2000 and January 2020 was done at a single tertiary eye care hospital. The lesions were classified as benign and malignant lesions. Clinicopathological correlation was done for the excised lesions.Results:A total of 87 caruncular lesions were included in the study. Males (59%) were affected more than females (41%). The mean age at presentation was 44 ± 20 years. The mean duration of complaint was 36 ± 62 months. A total of 36 patients underwent surgical excision whereas the rest opted for conservative management. Recurrence was noted in five patients. Fifteen different types of lesions were identified histopathologically. Benign lesions (78%) were far more common than malignant ones (22%). Epithelial inclusion cyst was the most common benign lesion and sebaceous gland carcinoma was the most common malignant lesion. Correct clinicopathological correlation was seen in 52.7% of the cases. Caruncular tuberculosis, oncocytoma, and basosquamous cell carcinoma were some of the rare lesions.Conclusion:Caruncular lesions are uncommon and very diverse, which makes clinical diagnosis challenging. Epithelial inclusion cyst and sebaceous gland carcinoma were the most common benign and malignant lesions respectively. Correct clinicopathological correlation was seen in more than half of the cases.     

122例非甲状腺来源的颈部囊性肿块临床分析

目的：探讨各种非甲状腺来源的颈部囊性肿块的特点,提高颈部肿块术前诊断的准确性,降低手术的盲目性和风险。方法：回顾性分析1999～2005年收治的非甲状腺来源的颈部囊性肿块122例。结果：资料表明,非甲状腺来源的颈部囊性肿块以先天性来源肿块最为多见,共84例,其中最常见的是甲状舌管囊肿;其次是感染性肿块30例,其中颌下腺囊肿25例;肿瘤来源最少见,共8例。主要根据肿块发生时间的长短,肿块的位置,颈部囊性肿块特异性表现和辅助检查来进行术前诊断。发现肿块的位置没有特殊性。根据某些肿块特征性的体征和穿刺检查,可明确诊断。结论：对非甲状腺来源的颈部囊性肿块,术前尽可能的明确诊断能有效地减少手术盲目性,降低手术并发症。     

引线硅胶管植入术治疗单纯泪小点狭窄或闭锁的疗效观察

目的:观察引线硅胶管植入术治疗单纯泪小点狭窄或闭锁的临床疗效。方法:单纯泪小点狭窄或闭锁患者42例72眼,按照年龄分成60岁以上及以下两组。局部麻醉下行引线硅胶管植入术,术后给予局部消炎抗感染治疗。术后冲洗泪道1次/wk,共4次,1～3mo后拔管,计算治愈率,并行卡方检验。结果:所有患者术中均成功植入引线硅胶管。平均观察14mo。治愈59眼(82%),好转8眼(11%),无效5眼(7%)。60岁以上组治愈率、有效率均较60岁以下组低。结论:引线硅胶管植入术治疗单纯泪小点狭窄或闭锁,操作简便、创伤小、效果好、值得临床推广。     

泪道硅膠插管及復方一枝蒿衝洗液治療泪道阻塞的療效評價

目的探索治療泪道阻塞的新器具、新藥液、新方法.方法實驗組99祗眼泪道阻塞(包括泪小管、泪總管、鼻泪管阻塞)病人采用硅膠管逆行置人插管,留管2～3個月,用復方一枝蒿泪道衝洗液定期衝洗.對照組36眼泪道阻塞用慶大霉素和地塞米鬆衝洗.結果觀察12個月以上,實驗組泪道通暢者達84眼(84.8%),對照組25眼(69.4%).結論泪道硅膠逆行插管及復方一枝蒿泪道衝洗治療泪道阻塞,爲該病種提供了一種新的治療途徑及方法.     

Ki-67 Labeling Index as a Marker of Malignancy in Ocular Surface Neoplasms

Purpose To evaluate the relationships among histopathological type, clinical malignant grade, and Ki-67 labeling index (LI) in sebaceous gland carcinoma (SGC), conjunctival squamous cell carcinoma (SCC), and conjunctival intraepithelial neoplasia (CIN), with pterygium and normal conjunctiva as controls.Methods This retrospective study was conducted at the Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan. We used tissue specimens obtained from 20 patients (four SGC, four SCC, four CIN, four pterygium, and four normal conjunctiva). Ki-67 immunohistochemical analysis was performed in all 20 cases.Results The Ki-67 labeling index (LI) was 46.1 ± 3.0% (average ± SD) in SGC, 28.4 ± 4.5% in SCC, 20.0 ± 7.2% in CIN, 9.0 ± 2.2% in pterygium, and 6.8 ± 2.3% in normal conjunctiva. Ki-67 LI was significantly (Mann-Whitney U test, P < 0.05) higher in SGC than in SCC, and higher, but not significantly, in SCC than in CIN. Ki-67 LI was significantly (P < 0.05) higher in SCC and CIN than in pterygium.Conclusions These results suggest that Ki-67 LI may be a sensitive marker for ocular malignant tumor grading. Jpn J Ophthalmol 2004;48:524–529 © Japanese Ophthalmological Society 2004     

激光泪道成形联合硅胶管植入术治疗上泪道阻塞的临床观察

目的:观察激光泪道成形联合硅胶管植入术治疗上泪道阻塞的临床效果。方法:上泪道阻塞患者128例148眼,全部有流泪病史,均经泪道冲洗检查确诊,行激光泪道成形联合硅胶管植入术,保留硅胶管1a,拔管后随访24mo,定期冲洗泪道,观察泪道通畅情况。结果:拔管后治愈120眼(81.08%),无流泪,泪道保持通畅;好转18眼(12.16%),流泪减轻,泪道通而不畅;无效10眼(6.76%),仍流泪,泪道冲洗不通。总有效率达93.24%。结论:激光泪道成形联合硅胶管植入术是治疗上泪道阻塞的有效方法。     

Association of dyslipidemia with severity of meibomian gland dysfunction in a tertiary care hospital of Uttarakhand region

AIM: To analyse the association between dyslipidemia and severity of meibomian gland dysfunction (MGD) in a tertiary care hospital of Uttarakhand region. METHODS: This prospective observational study was conducted over a period of one year including 50 consecutive patients of MGD. Patients underwent detailed history (including Ocular Surface Disease Index Questionnaire) and examination (including meibum quality, expressibility and numerical staining). MGD was graded according to the guidelines submitted by the International Workshop on Meibomian Gland Dysfunction and Management in 2011. Fasting lipid profile of all the patients was done. Various parameters of lipid profile including total cholesterol (TC), triglycerides (TG), low density lipoproteins (LDL), high density lipoproteins (HDL) and very low density lipoproteins (VLDL) were correlated with MGD severity. Chi-square test was done for statistical analysis (P<0.05). RESULTS: Stage 2 MGD was the most common disease entity (60%, n=30). A significant positive correlation was noted between increasing age and severity of MGD (P=0.004). High TC (>200 mg/dL), TG (>150 mg/dL), LDL (>130 mg/dL) and VLDL (>22 mg/dL) levels had a significant positive correlation with the severity of MGD (P=0.001, 0.019, 0.001, 0.016 respectively). CONCLUSION: Monitoring the fasting lipid levels may aid in establishing the severity of MGD and further studies may be conducted to establish the role of treatment of dyslipidemia in MGD.     

临床护理干预在乳腺纤维瘤手术中的应用

目的探究临床护理干预在乳腺纤维瘤手术中的应用,总结临床护理干预的重点。方法选择100例乳腺纤维瘤患者,对其进行手术临床护理干预,分析术前、术后的护理重点。结果 100例患者,16例患者在手术过程中放置引流条,通过临床护理干预,拔除引流条时间最短为18 h,最长为超过36 h。16例患者拔除引流条的平均时间为25 h。100例患者,进行临床护理干预,手术切口一期愈合为97例,愈合率为97.0%。结论对乳腺纤维瘤患者,需要做好临床护理,提高成功率,值得临床推广。