Kartagener＇s syndrome （KS） is an autosomal recessive genetic disease accounting for approximately 50% of the cases of primary ciliary dyskinesia （PCD）. As it is accompanied by many complications, PCD/KS severely ...Kartagener＇s syndrome （KS） is an autosomal recessive genetic disease accounting for approximately 50% of the cases of primary ciliary dyskinesia （PCD）. As it is accompanied by many complications, PCD/KS severely affects the patient＇s quality of life. Therapeutic approaches for PCD/KS aim to enhance prevention, facilitate rapid definitive diagnosis, avoid misdiagnosis, maintain active treatment, control infection and postpone the development of lesions. In male patients, sperm flagella may show impairment in or complete absence of the ability to swing, which ultimately results in male infertility. Assisted reproductive technology will certainly benefit such patients. For PCD/KS patients with completely immotile sperm, intracytoplasmic sperm injection may be very important and even indispensable. Considering the number of PCD/KS susceptibility genes and mutations that are being identified, more extensive genetic screening is indispensable in patients with these diseases. Moreover, further studies into the potential molecular mechanisms of these diseases are required. In this review, we summarize the available information on various aspects of this disease in order to delineate the therapeutic objectives more clearly, and clarify the efficacy of assisted reproductive technology as a means of treatment for patients with PCD/KS-associated infertility.展开更多
AIM: To evaluate the safety and the efficacy of the ultrasound ciliary plasty(UCP) on the intraocular pressure(IOP) control in glaucomatous eyes without previous glaucoma surgery.METHODS: A retrospective study include...AIM: To evaluate the safety and the efficacy of the ultrasound ciliary plasty(UCP) on the intraocular pressure(IOP) control in glaucomatous eyes without previous glaucoma surgery.METHODS: A retrospective study included patients with primary and secondary glaucoma who underwent UCP in Dar Al Shifa Hospital, Kuwait between January 2017 to June 2018. High-intensity focused ultrasound procedures were performed under peribulbar anesthesia using the 2^(nd) generation probe with 8 s duration of each of the 6 shots. Complete ophthalmologic examinations were scheduled pre-treatment, and at 1 d, 1 wk, 1, 3, 6 and 12 mo posttreatment. Primary outcomes were the IOP reduction and success rates at 12 mo, while the secondary outcomes were the occurrence of vision threatening complications and visual acuity.RESULTS: The records of 62 eyes of 62 patients were analyzed with mean age of 63.8 y(67.7% males). There was statistically significant reduction in the mean IOP from 35.2±8.3 mm Hg before treatment to 20.6±8.7 mm Hg at 12^(th) month(P<0.0005) with a mean percentage IOP reduction of 42.3% with significant reduction in the mean number of antiglaucomatous drugs from 3.2±0.4 before treatment to 2.1±1.02 at 12 mo(P<0.0005). Qualified success was achieved in 77.4% of eyes at 12 mo. No major intra-or posttreatment complications were reported.CONCLUSION: Second-generation UCP prove to be effective in reducing IOP in naive glaucoma patients with lower success rates in cases of neovascular and uveitic glaucomas.展开更多
This is a prospective interventional clinical study evaluating intraocular inflammation developed after Ultrasound Cyclo Plasty(UCP) for the treatment of glaucoma. Eighteen eyes of 18 patients were treated with UCP se...This is a prospective interventional clinical study evaluating intraocular inflammation developed after Ultrasound Cyclo Plasty(UCP) for the treatment of glaucoma. Eighteen eyes of 18 patients were treated with UCP second-generation probes(Eye OP1). After treatment, the mean intraocular pressure(IOP) significantly decreased from 26.8±7.2 to 18.8±6.1 mm Hg at day 1 and to 14.7±3.4 mm Hg at month 6(all P<0.001). Mean laser flare-cell photometry value steeply increased after surgery from 12.1±7.5 to 64.1±53.9 ph/ms(P=0.001) at day 1, and then progressively decreased to respectively 60.6±49.7 at day 7, 43.5±38.5 at day 14 and 28.2±18.3 at month 1(all P<0.05), returning at levels similar to baseline ones at month 3 and month 6(respectively 16.7±6.2 and 12.8±10.2, both P>0.05). A significant negative correlation was found between postoperative increase of aqueous flare values and anterior chamber depth(R=-0.568, P=0.014). This timeframe may be considered reasonable for repeating UCP treatment, when required.展开更多
Background Phakic intraocular lens （pIOL） implantation has been a popular means for the treatment of high ametropia Measurements of ciliary sulcus diameter is important for pIOL size determining. But till now, no pe...Background Phakic intraocular lens （pIOL） implantation has been a popular means for the treatment of high ametropia Measurements of ciliary sulcus diameter is important for pIOL size determining. But till now, no perfect system can directly measure it. The present study was to evaluate the accuracy, repeatability and reproducibility of direct sulcus diameter measurements obtained by a full-scale 50-megahertz （MHz） ultrasound biomicroscopy （UBM）. Methods A fresh cadaver human eye with a scale marker inserted through the posterior chamber plane from 3 o＇clock to 9 o＇clock meridian and 30 randomly selected eyes from 30 normal subjects were scanned by full-scale 50-MHz UBM in horizontal meridional scan plane. The distance between the scales and the whole length of the marker inside the cadaver eye were measured by the same observer using the ＂built-in＂ measurement tools and the indicating error of instrument was calculated. Reproducibility of the measurement was evaluated in 30 eyes by 2 operators using Blander and Altman plot test. Repeatability was evaluated from 10 successive eyes randomly selected from the 30 eyes by one operator. Results On a scale of 1 mm, the greatest indicating error was 40μm; the mean largest indicating error of 1 mm scale from the 10 images was （26_±14） μm; on a scale of 11 mm, the greatest indicating error was 70 μm; the error rate was 0.64%. The mean length of the needle inside the eye of the 10 images was 11.05 mm, with the mean indicating error of 47 μm, the average error rate was 0.43%. For ciliary sulcus diameter measurements in vivo, the coefficient of variation was 0.38%; the coefficients of repeatability for intra-observer and inter-observer measurements were 1.99% and 2.55%, respectively. The limits of agreement for intra-observer and inter-observer measurement were -0.41 mm to 0.48 mm and -0.59 mm to 0.58 mm, respectively. Conclusion The full-scale 50-MHz UBM can be a high accuracy and good repeatability means for direct measuring the ciliary sulcus d展开更多
Background Ciliary body tumors are usually difficult to diagnose and treat in early stages. However, treatment of such tumors has trended toward ocular conservation instead of enucleation. Local excision of ciliary bo...Background Ciliary body tumors are usually difficult to diagnose and treat in early stages. However, treatment of such tumors has trended toward ocular conservation instead of enucleation. Local excision of ciliary body tumors has become effective with the development of the modern vitrectomy, but long-term outcomes are still not clear. Therefore, we reported the outcome of locally excised ciliary body tumors after long-term follow-up. Methods Twenty-two patients （22 eyes）, who had been diagnosed with ciliary body tumors in Beijing Tongren Hospital from January 1996 to June 2001, were enrolled in this prospective cohort study. Localized lamellar sclera-ciliary excisions were performed. In some cases, vitrectomies, scleral graft transplantations, and further excisions of the anterior choroid were performed. Diagnoses were confirmed by histopathologic examination. Patients were followed from five to eleven years after surgery. Their visual acuity, intraocular pressure and local recurrence were recorded with descriptive percentages. Results After surgery, all patients maintained normal eyeball appearances. Six patients maintained circular pupils. The final best corrected visual acuities （BCVA） varied from 0.02-1.00, including 18 patients （81.82%） who had BCVA equal to or better than that before surgery. Fifteen patients （68.18%） had BCVA better than 0.3. Only two patients had intraocular pressure （lOP） of less than 10 mmHg and the other patients maintained normal lOP. Nine cases （40.91%） were given confirmed diagnosis of malignant melanoma, four （18.18%） of melanocytoma, six （27.27%） of nonpigmented ciliary epithelial adenoma, two （9.09%） of neurofibroma, and one （4.55%） of neurinoma. Twenty patients （90.91%） had no recurrence during the follow-up period. In one case melanocytoma recurred seven years after surgery and enucleation was performed. One patient, whose operation removed a malignant melanoma with a diameter of 16 mm, died of hepatic metastasis five years after th展开更多
A chemically extracted acellular allogeneic nerve graft can reduce postoperative immune rejection, similar to an autologous nerve graft, and can guide neural regeneration. However, it remains poorly understood whether...A chemically extracted acellular allogeneic nerve graft can reduce postoperative immune rejection, similar to an autologous nerve graft, and can guide neural regeneration. However, it remains poorly understood whether a chemically extracted acellular allogeneic nerve graft combined with neurotrophic factors provides a good local environment for neural regeneration. This study investigated the repair of injured rat sciatic nerve using a chemically extracted acellular allogeneic nerve graft combined with ciliary neurotrophic factor. An autologous nerve anastomosis group and a chemical acellular allogeneic nerve bridging group were prepared as controls. At 8 weeks after repair, sciatic functional index, evoked potential amplitude of the soleus muscle, triceps wet weight recovery rate, total number of myelinated nerve fibers and myelin sheath thickness were measured. For these indices, values in the three groups showed the autologous nerve anastomosis group 〉 chemically extracted acellular nerve graft ＋ ciliary neurotrophic factor group 〉 chemical acellular allogeneic nerve bridging group. These results suggest that chemically extracted acellular nerve grafts combined with ciliary neurotrophic factor can repair sciatic nerve defects, and that this repair is inferior to autologous nerve anastomosis, but superior to chemically extracted acellular allogeneic nerve bridging alone.展开更多
In this study, rabbit models of optic nerve injury were reproduced by the clamp method. After modeling, rabbit models were given one injection of 50 ng recombinant human ciliary neurotrophic factor into the vitreous b...In this study, rabbit models of optic nerve injury were reproduced by the clamp method. After modeling, rabbit models were given one injection of 50 ng recombinant human ciliary neurotrophic factor into the vitreous body and/or intragastric injection of 4 g/kg compound light granules containing Radix Angelicae Sinensis and Raidix Paeoniae Alba at 4 days after modeling, once per day for 30 consecutive days. After administration, the animals were sacrificed and the intraorbital optic nerve was harvested. Hematoxylin-eosin staining revealed that the injured optic nerve was thinner and optic nerve fibers were irregular. After treatment with recombinant human ciliary neurotrophic factor, the arrangement of optic nerve fibers was disordered but they were not markedly thinner. After treatment with compound light granules, the arrangement of optic nerve fibers was slightly disordered and their structure was intact. After combined treatment with recombinant human ciliary neurotrophic factor and compound light granules, the arrangement of optic nerve fibers was slightly disordered and the degree of injury was less than after either treatment alone. Results of tensile mechanical testing of the optic nerve showed that the tensile elastic limit strain, elastic limit stress, maximum stress and maximum strain of the injured optic nerve were significantly lower than the normal optic nerve. After treatment with recombinant human ciliary neurotrophic factor and/or compound light granules, the tensile elastic limit strain, elastic limit stress, maximum stress and maximum strain of the injured optic nerve were significantly increased, especially after the combined treatment. These experimental findings indicate that compound light granules and ciliary neurotrophic factor can alleviate optic nerve injury at the histological and biochemical levels, and the combined treatment is more effective than either treatment alone.展开更多
Primary ciliary dyskinesia （PCD） is an autosomal-recessive disorder resulting from the loss of normal ciliary function. Symptoms include neonatal respiratory distress, chronic sinusitis, bronchiectasis, situs invers...Primary ciliary dyskinesia （PCD） is an autosomal-recessive disorder resulting from the loss of normal ciliary function. Symptoms include neonatal respiratory distress, chronic sinusitis, bronchiectasis, situs inversus, and infertility. However, only 15 PCD-associated genes have been identified to cause male infertility to date. Owing to the genetic heterogeneity of PCD, comprehensive molecular genetic testing is not considered the standard of care. Here, we provide an update of the progress on the identification of genetic factors related to PCD associated with male infertility, summarizing the underlying molecular mechanisms, and discuss the clinical implications of these findings. Further research in this field will impact the diagnostic strategy for male infertility, enabling clinicians to provide patients with informed genetic counseling, and help to adopt the best course of treatment for developing directly targeted personalized medicine.展开更多
Ciliary neurotrophic factor has neuroprotective effects mediated through signal transducer and Janus kinase（JAK） 2/activator of transcription 3（STAT3） and phosphatidylinositol 3-kinase（PI3 K）/Akt signaling pathw...Ciliary neurotrophic factor has neuroprotective effects mediated through signal transducer and Janus kinase（JAK） 2/activator of transcription 3（STAT3） and phosphatidylinositol 3-kinase（PI3 K）/Akt signaling pathways.Whether ciliary neurotrophic factor is neuroprotective for glutamate-induced excitotoxicity of dorsal root ganglion neurons is poorly understood.In the present study,the in vitro neuroprotective effects of ciliary neurotrophic factor against glutamate-induced excitotoxicity were determined in a primary culture of dorsal root ganglion neurons from Wistar rat embryos at embryonic day 15.Whether the JAK2/STAT3 and PI3 K/Akt signaling pathways were related to the protective effects of ciliary neurotrophic factor was also determined.Glutamate exposure inhibited neurite outgrowth,cell viability,and growth-associated protein 43 expression and promoted apoptotic neuronal cell death,all of which were reversed by the administration of exogenous ciliary neurotrophic factor.Additionally,preincubation with either JAK2 inhibitor AG490 or PI3 K inhibitor LY294002 blocked the neuroprotective effect of ciliary neurotrophic factor.These data indicate that the two pathways JAK2/STAT3 and PI3 K/Akt play major roles in mediating the in vitro neuroprotective effects of ciliary neurotrophic factor on dorsal root ganglion neurons with glutamate-induced neurotoxicity.展开更多
The expression and clinical significance of relevant cytokines in otitis media (OM) are discussed, and the alterations to the pathological state of the otitis media mucosa are further understood through the study of c...The expression and clinical significance of relevant cytokines in otitis media (OM) are discussed, and the alterations to the pathological state of the otitis media mucosa are further understood through the study of cytokine transduction pathways. More and more studies have shown that relevant cell proliferation and inflammation progression pathways play a role in the development of otitis media, such as the Jun amino-terminal protein kinase (JNK) mitogen-activated protein kinase (MAPK) signaling pathway, the NF-κB signaling pathway, and the PI3K/AKT/PTEN pathway, which are involved in the proliferation of the middle ear mucosa during otitis media, which affects the mucosal cilia, motor function, Eustachian tube function, and the mucosal ciliary function. These studies provide new ideas for the treatment of otitis media and further explore the feasibility of immunotherapy in the future treatment of otitis media. In this paper, we present a review of the latest research progress on the expression of various cytokines in otitis media.展开更多
Aim:Dysplasia of the fibrous sheath(DFS)is an anomaly found in asthenozoospermic patients with extremely lowor absent motility.In order to determine the efficacy of ICSI in these patients,a retrospective analysis of I...Aim:Dysplasia of the fibrous sheath(DFS)is an anomaly found in asthenozoospermic patients with extremely lowor absent motility.In order to determine the efficacy of ICSI in these patients,a retrospective analysis of ICSI results inDFS patients has been done.Methods:Ten ICSI attempts were performed in 6 patients with diagnosis of Dysplasiaof the Fibrous Sheath studied by transmission and scanning electron microscopy.Results:In the cases studied,sperm concentration was(29.62±18.05)×10^(6)/mL,total motility was 1.14±1.31%.Progressive motility was 0%except for one case with 0.1%.One hundred and three preovulatory oocytes were obtained and 94 metaphaseⅡoocyteswere injected.Sixty-nine of them showed two pronuclei(fertilization rate:73.4%).Forty-nine embryos were ob-tained and 34 were transferred(mean:3.4 embryos per transfer).Five pregnancies were diagnosed byβ-hCG plasmalevel determinations that resulted to be one preclinical abortion,one clinical abortion and three deliveries.Anotherpregnancy(ongoing)was achieved from a cryopreserved embryo transfer.Conclusion:These results showed thatICSI provides a suitable solution for patients suffering from irreversible sperm defects such as DFS.Nevertheless,it ismandatory to inform couples of possible transmission risks to offspring,which are unknown at present.Only when theetiology of this problem is disclosed,it will be possible to assess the real genetic risk.展开更多
AIM： To explore the effect of ciliary neurotrophic factor （CNTF） on retinal ganglion cell （RGC）-5 induced by hydrogen peroxide （H2O2）. METHODS： After cell adherence, RGC-5 culture medium was changed to contai...AIM： To explore the effect of ciliary neurotrophic factor （CNTF） on retinal ganglion cell （RGC）-5 induced by hydrogen peroxide （H2O2）. METHODS： After cell adherence, RGC-5 culture medium was changed to contain different concentrations of H2O2 from 50 to 150 μmol/L at four time points （0.5, 1, 1.5 and 2h） to select the concentration and time point for H2O2 induced model. Two different ways of interventions for injured RGC-5 cells respectively were CNTF as an addition in the culture medium or recombinant lentiviral plasmid carrying CNTF gene transfecting bone mesenchymal stem cells （BMSCs） for co-culture with RGC-5. RESULTS： Compared to the control group, H2O2 led to RGC-5 death closely associated with concentrations and action time of H2O2 and we chose 125 μmol/L and 2h to establish the H2O2-induced model. While CNTF inhibited the loss of RGC-5 cells obviously with a dose-dependent survival rate. Nevertheless two administration routes had different survival rate yet higher rate in recombinant lentiviral plasmid group but there were no statistically significant differences. CONCLUSION： Both the two administration routes of CNTF have effects on RGC-5 cells induced by H2O2. If their own advantages were combined, there may be a better administration route.展开更多
Neurogenesis in the adult hippocampus plays a major role in cognitive ability of animals including learning and memory.Korean red ginseng (KRG) has long been known as a medicinal herb with the potential to improve lea...Neurogenesis in the adult hippocampus plays a major role in cognitive ability of animals including learning and memory.Korean red ginseng (KRG) has long been known as a medicinal herb with the potential to improve learning and memory;however,the mechanisms are still elusive.Therefore,we evaluated whether KRG can promote cognitive function and enhance neurogenesis in the hippocampus.Eight-week-old male C57BL/6 mice received 50 mg/kg of 5-bromo-2′-deoxyuridine (BrdU) intraperitoneally and 100 mg/kg of KRG or vehicle orally once a day for 14 days.Pole,Rotarod and Morris water maze tests were performed and the brains were collected after the last behavioral test.Changes in the numbers of BrdU- and BrdU/ doublecortin (DCX;a marker for neuronal precursor cells and immature neurons)-positive cells in the dentate gyrus and the gene expression of proliferating cell nuclear antigen (a marker for cell differentiation),cerebral dopamine neurotrophic factor and ciliary neurotrophic factor in the hippocampus were then investigated.KRG-treated mice came down the pole significantly faster and stood on the rotarod longer than vehicle-treated mice.The Morris water maze test showed that KRG administration enhanced the learning and memory abilities significantly.KRG also significantly increased BrdU- and BrdU/DCX-positive cells in the dentate gyrus as well as the proliferating cell nuclear antigen,cerebral dopamine neurotrophic factor and ciliary neurotrophic factor mRNA expression levels in the hippocampus compared to vehicle.Administration of KRG promotes learning and memory abilities,possibly by enhancing hippocampal neurogenesis.This study was approved by the Pusan National University Institutional Animal Care and Use Committee (approval No.PNU-2016-1071) on January 19,2016.展开更多
Background: The prevalence of Parkinson’s disease (PD), a chronic and progressive neurodegenerative disorder, is projected to increase twofold by 2030. Leucine-rich repeat kinase 2 (LRRK2) is the most commonly observ...Background: The prevalence of Parkinson’s disease (PD), a chronic and progressive neurodegenerative disorder, is projected to increase twofold by 2030. Leucine-rich repeat kinase 2 (LRRK2) is the most commonly observed gene in both familial and sporadic PD cases. Notably, there is a substantial augmentation in motor activity during both larval and adult stages of zebrafish lacking the lrrk2 gene. Nevertheless, the precise genetic abnormalities accountable for eliciting these phenotypes in zebrafish are yet to be elucidated. Methods: Real-time polymerase chain reaction (PCR) was conducted on zebrafish larvae at 6 days post fertilization (dpf) belonging to both the wild-type and lrk2(-/-) groups. Guide RNA was designed and subsequently employed in the PCR process. Electrophoresis was performed to facilitate identification. Results: The expression of CNTF mRNA was significantly diminished in lrrk2(-/-), in comparison to the wildtype zebrafish larvae. This finding implies that CNTF may have crucial implications in the regulated functioning of lrrk2, which is widely acknowledged as the predominant genetic factor contributing to hereditary PD. The primers for CNTF DNA were meticulously designed, and the electrophoresis results of the PCR product were subsequently presented. The wild type zebrafish embryos were meticulously prepared for micro-injection, and the resulting efficiency identification displayed the presence of the mutant PCR product, which exhibited the presence of several debris. Conclusions: The present study demonstrates the successful generation of CNTF mutant zebrafish using the CRISPR/Cas9 genome editing technique. Further investigations are necessary to deepen our understanding of the exogenous CNTF gene’s functionality.展开更多
Primary ciliary dyskinesia(PCD)is a rare disorder characterized by extensive genetic heterogeneity.However,in the genetic pathogenesis of PCD,copy number variation(CNV)has not received sufcient attention and has rarel...Primary ciliary dyskinesia(PCD)is a rare disorder characterized by extensive genetic heterogeneity.However,in the genetic pathogenesis of PCD,copy number variation(CNV)has not received sufcient attention and has rarely been reported,especially in China.Next-generation sequencing(NGS)followed by targeted CNV analysis was used in patients highly suspected to have PCD with negative results in routine whole-exome sequencing(WES)analysis.Quantitative real-time polymerase chain reaction(qPCR)and Sanger sequencing were used to confrm these CNVs.To further characterize the ciliary phenotypes,high-speed video microscopy analysis(HSVA),transmission electron microscopy(TEM),and immunofuorescence(IF)analysis were used.Patient 1(F1:II-1),a 0.6-year-old girl,came from a nonconsanguineous family-I.She presented with situs inversus totalis,neonatal respiratory distress,and sinusitis.The nasal nitric oxide level was markedly reduced.The respiratory cilia beat with reduced amplitude.TEM revealed shortened outer dynein arms(ODA)of cilia.chr5:13717907-13722661del spanning exons 71–72 was identifed by NGS-based CNV analysis.Patient 2(F2:IV-4),a 37-year-old man,and his eldest brother Patient 3(F2:IV-2)came from a consanguineous family-II.Both had sinusitis,bronchiectasis and situs inversus totalis.The respiratory cilia of Patient 2 and Patient 3 were found to be uniformly immotile,with ODA defects.Two novel homozygous deletions chr5:13720087_13733030delinsGTTTTC and chr5:13649539_13707643del,spanning exons 69–71 and exons 77–79 were identifed by NGS-based CNV analysis.Abnormalities in DNA copy number were confrmed by qPCR amplifcation.IF showed that the respiratory cilia of Patient 1 and Patient 2 were defcient in dynein axonemal heavy chain 5(DNAH5)protein expression.This report identifed three novel DNAH5 disease-associated variants by WES-based CNV analysis.Our study expands the genetic spectrum of PCD with DNAH5 in the Chinese population.展开更多
AIM:To determine the factors related to preoperative ocular characters that are predictive of insufficient vault(<250μm)after implantable collamer lens(ICL V4c;STAAR Surgical)implantation.METHODS:The participants ...AIM:To determine the factors related to preoperative ocular characters that are predictive of insufficient vault(<250μm)after implantable collamer lens(ICL V4c;STAAR Surgical)implantation.METHODS:The participants underwent ICL surgery and were divided into the low(<250μm)and normal(250-1000μm)vault groups based on the postoperative vault at 3mo.The preoperative biometric parameters and clinical outcomes were compared between the two groups.The relationship between the 3-month vault values and preoperative ocular parameters were evaluated by Generalized estimating equations.RESULTS:Sixteen(23 eyes)and 36 patients(63 eyes)were in the low and normal vault groups,respectively.All implantation procedures were uneventful with no cataract formation in the early postoperative period.The sulcusto-sulcus lens rise(STSL)and iris ciliary angle(ICA)were correlated with vault at 3mo after surgery.Every 0.1 mm increase in STSL was associated with 38.9μm decrease in the postoperative 3-month vault.A rise of 1 degree in ICA is associated with a reduction of 4μm in vault.CONCLUSION:Eyes with a narrow ciliary sulcus are associated with a higher rate of low vault after ICL implantation,suggesting a need for adjustments to the ICL size in these patients.Evaluating the characteristics of the ciliary sulcus contributes valuable information to predict low vault after surgery.展开更多
Objective:To evaluate the prevalence of primary iris and/or ciliary body cysts in eyes with shallow anterior chamber and their effect on the narrowing of the anterior chamber angle.Methods:Among the general physical c...Objective:To evaluate the prevalence of primary iris and/or ciliary body cysts in eyes with shallow anterior chamber and their effect on the narrowing of the anterior chamber angle.Methods:Among the general physical check-up population,subjects with shallow anterior chambers,as judged by van Herick technique,were recruited for further investigation.Ultrasound biomicroscope(UBM) was used to detect and measure the cysts located in the iris and/or ciliary body,the anterior chamber depth(ACD),the angle opening distance at 500 μm(AOD500),and the trabecular-iris angle(TIA).A-scan ultrasonography was used to measure the ocular biometry,including lens thickness,axial length,lens/axial length factor(LAF),and relative lens position(RLP).The effect of the cyst on narrowing the corresponding anterior chamber angle and the entire angle was evaluated by the UBM images,ocular biometry,and gonioscopic grading.The eye with unilateral cyst was compared with the eye without the cyst for further analysis.Results:Among the 727 subjects with shallow anterior chamber,primary iris and ciliary body cysts were detected in 250(34.4%) patients;among them 96(38.4%) patients showed unilateral single cyst,21(8.4%) patients had unilateral double cysts,and 42(16.8%) patients manifested unilateral multiple and multi-quadrants cysts.Plateau iris configuration was found in 140 of 361(38.8%) eyes with cysts.The mean size of total cysts was(0.6547±0.2319) mm.In evaluation of the effect of the cyst size and location on narrowing the corresponding angle to their position,the proportion of the cysts causing corresponding angle narrowing or closure among the cysts larger than 0.8 mm(113/121,93.4%) was found to be significantly higher than that of the cysts smaller than 0.8 mm(373/801,46.6%),and a significant higher proportion was also found in the cysts located at iridociliary sulcus(354/437,81.0%) than in that at the pars plicata(131/484,27.1%).In evaluating the effect of the cyst on the entire anterior chamber angle,the eyes with multiple and multi-q展开更多
BACKGROUND Primary ciliary dyskinesia(PCD)is an inherited autosomal-recessive disorder of impaired mucociliary clearance characterized by chronic respiratory diseases,otolaryngological diseases,central nervous system ...BACKGROUND Primary ciliary dyskinesia(PCD)is an inherited autosomal-recessive disorder of impaired mucociliary clearance characterized by chronic respiratory diseases,otolaryngological diseases,central nervous system abnormalities,reproductive system abnormalities,and cardiac function abnormalities.General anesthesia in these patients is associated with a higher incidence of respiratory complications than in patients without the disease.CASE SUMMARY A 16-year-old male patient was referred to the emergency room complaining of right ankle pain due to distal tibiofibular fracture.Three years prior,he had been diagnosed with PCD.At that time,he had experienced several episodes of pneumonia,sinusitis,and chronic middle ear infections,for which he underwent surgical interventions.At the current admission,he presented with cough and sputum but no other respiratory symptoms.A chest computed tomography scan revealed centrilobular ground-glass opacities in both lower lobes and a calcified nodule in the left lower lobe.For the surgical procedure and postoperative pain management,combined spinal-epidural anesthesia was employed.The patient’s postoperative pain score was measured by the numerical rating scale(NRS).On the day of surgery,his NRS was 5 points.By the second postoperative day,the NRS score had decreased to 2–3 points.The epidural catheter was removed on the fourth day following the operation.The patient was subsequently discharged no respiratory complications.CONCLUSION We performed combined spinal-epidural anesthesia in a patient with PCD.The patient experienced no additional respiratory complications and was discharged with a low NRS score for pain.展开更多
文摘Kartagener＇s syndrome （KS） is an autosomal recessive genetic disease accounting for approximately 50% of the cases of primary ciliary dyskinesia （PCD）. As it is accompanied by many complications, PCD/KS severely affects the patient＇s quality of life. Therapeutic approaches for PCD/KS aim to enhance prevention, facilitate rapid definitive diagnosis, avoid misdiagnosis, maintain active treatment, control infection and postpone the development of lesions. In male patients, sperm flagella may show impairment in or complete absence of the ability to swing, which ultimately results in male infertility. Assisted reproductive technology will certainly benefit such patients. For PCD/KS patients with completely immotile sperm, intracytoplasmic sperm injection may be very important and even indispensable. Considering the number of PCD/KS susceptibility genes and mutations that are being identified, more extensive genetic screening is indispensable in patients with these diseases. Moreover, further studies into the potential molecular mechanisms of these diseases are required. In this review, we summarize the available information on various aspects of this disease in order to delineate the therapeutic objectives more clearly, and clarify the efficacy of assisted reproductive technology as a means of treatment for patients with PCD/KS-associated infertility.
文摘AIM: To evaluate the safety and the efficacy of the ultrasound ciliary plasty(UCP) on the intraocular pressure(IOP) control in glaucomatous eyes without previous glaucoma surgery.METHODS: A retrospective study included patients with primary and secondary glaucoma who underwent UCP in Dar Al Shifa Hospital, Kuwait between January 2017 to June 2018. High-intensity focused ultrasound procedures were performed under peribulbar anesthesia using the 2^(nd) generation probe with 8 s duration of each of the 6 shots. Complete ophthalmologic examinations were scheduled pre-treatment, and at 1 d, 1 wk, 1, 3, 6 and 12 mo posttreatment. Primary outcomes were the IOP reduction and success rates at 12 mo, while the secondary outcomes were the occurrence of vision threatening complications and visual acuity.RESULTS: The records of 62 eyes of 62 patients were analyzed with mean age of 63.8 y(67.7% males). There was statistically significant reduction in the mean IOP from 35.2±8.3 mm Hg before treatment to 20.6±8.7 mm Hg at 12^(th) month(P<0.0005) with a mean percentage IOP reduction of 42.3% with significant reduction in the mean number of antiglaucomatous drugs from 3.2±0.4 before treatment to 2.1±1.02 at 12 mo(P<0.0005). Qualified success was achieved in 77.4% of eyes at 12 mo. No major intra-or posttreatment complications were reported.CONCLUSION: Second-generation UCP prove to be effective in reducing IOP in naive glaucoma patients with lower success rates in cases of neovascular and uveitic glaucomas.
文摘This is a prospective interventional clinical study evaluating intraocular inflammation developed after Ultrasound Cyclo Plasty(UCP) for the treatment of glaucoma. Eighteen eyes of 18 patients were treated with UCP second-generation probes(Eye OP1). After treatment, the mean intraocular pressure(IOP) significantly decreased from 26.8±7.2 to 18.8±6.1 mm Hg at day 1 and to 14.7±3.4 mm Hg at month 6(all P<0.001). Mean laser flare-cell photometry value steeply increased after surgery from 12.1±7.5 to 64.1±53.9 ph/ms(P=0.001) at day 1, and then progressively decreased to respectively 60.6±49.7 at day 7, 43.5±38.5 at day 14 and 28.2±18.3 at month 1(all P<0.05), returning at levels similar to baseline ones at month 3 and month 6(respectively 16.7±6.2 and 12.8±10.2, both P>0.05). A significant negative correlation was found between postoperative increase of aqueous flare values and anterior chamber depth(R=-0.568, P=0.014). This timeframe may be considered reasonable for repeating UCP treatment, when required.
文摘Background Phakic intraocular lens （pIOL） implantation has been a popular means for the treatment of high ametropia Measurements of ciliary sulcus diameter is important for pIOL size determining. But till now, no perfect system can directly measure it. The present study was to evaluate the accuracy, repeatability and reproducibility of direct sulcus diameter measurements obtained by a full-scale 50-megahertz （MHz） ultrasound biomicroscopy （UBM）. Methods A fresh cadaver human eye with a scale marker inserted through the posterior chamber plane from 3 o＇clock to 9 o＇clock meridian and 30 randomly selected eyes from 30 normal subjects were scanned by full-scale 50-MHz UBM in horizontal meridional scan plane. The distance between the scales and the whole length of the marker inside the cadaver eye were measured by the same observer using the ＂built-in＂ measurement tools and the indicating error of instrument was calculated. Reproducibility of the measurement was evaluated in 30 eyes by 2 operators using Blander and Altman plot test. Repeatability was evaluated from 10 successive eyes randomly selected from the 30 eyes by one operator. Results On a scale of 1 mm, the greatest indicating error was 40μm; the mean largest indicating error of 1 mm scale from the 10 images was （26_±14） μm; on a scale of 11 mm, the greatest indicating error was 70 μm; the error rate was 0.64%. The mean length of the needle inside the eye of the 10 images was 11.05 mm, with the mean indicating error of 47 μm, the average error rate was 0.43%. For ciliary sulcus diameter measurements in vivo, the coefficient of variation was 0.38%; the coefficients of repeatability for intra-observer and inter-observer measurements were 1.99% and 2.55%, respectively. The limits of agreement for intra-observer and inter-observer measurement were -0.41 mm to 0.48 mm and -0.59 mm to 0.58 mm, respectively. Conclusion The full-scale 50-MHz UBM can be a high accuracy and good repeatability means for direct measuring the ciliary sulcus d
基金This work was supported by the grants from the National Natural Science Foundation of China （No. 30571988）, the Beijing Natural Science Foundation （No. 7072019）, and the Capital Medical Development Foundation （No. 2002-2018）.
文摘Background Ciliary body tumors are usually difficult to diagnose and treat in early stages. However, treatment of such tumors has trended toward ocular conservation instead of enucleation. Local excision of ciliary body tumors has become effective with the development of the modern vitrectomy, but long-term outcomes are still not clear. Therefore, we reported the outcome of locally excised ciliary body tumors after long-term follow-up. Methods Twenty-two patients （22 eyes）, who had been diagnosed with ciliary body tumors in Beijing Tongren Hospital from January 1996 to June 2001, were enrolled in this prospective cohort study. Localized lamellar sclera-ciliary excisions were performed. In some cases, vitrectomies, scleral graft transplantations, and further excisions of the anterior choroid were performed. Diagnoses were confirmed by histopathologic examination. Patients were followed from five to eleven years after surgery. Their visual acuity, intraocular pressure and local recurrence were recorded with descriptive percentages. Results After surgery, all patients maintained normal eyeball appearances. Six patients maintained circular pupils. The final best corrected visual acuities （BCVA） varied from 0.02-1.00, including 18 patients （81.82%） who had BCVA equal to or better than that before surgery. Fifteen patients （68.18%） had BCVA better than 0.3. Only two patients had intraocular pressure （lOP） of less than 10 mmHg and the other patients maintained normal lOP. Nine cases （40.91%） were given confirmed diagnosis of malignant melanoma, four （18.18%） of melanocytoma, six （27.27%） of nonpigmented ciliary epithelial adenoma, two （9.09%） of neurofibroma, and one （4.55%） of neurinoma. Twenty patients （90.91%） had no recurrence during the follow-up period. In one case melanocytoma recurred seven years after surgery and enucleation was performed. One patient, whose operation removed a malignant melanoma with a diameter of 16 mm, died of hepatic metastasis five years after th
文摘A chemically extracted acellular allogeneic nerve graft can reduce postoperative immune rejection, similar to an autologous nerve graft, and can guide neural regeneration. However, it remains poorly understood whether a chemically extracted acellular allogeneic nerve graft combined with neurotrophic factors provides a good local environment for neural regeneration. This study investigated the repair of injured rat sciatic nerve using a chemically extracted acellular allogeneic nerve graft combined with ciliary neurotrophic factor. An autologous nerve anastomosis group and a chemical acellular allogeneic nerve bridging group were prepared as controls. At 8 weeks after repair, sciatic functional index, evoked potential amplitude of the soleus muscle, triceps wet weight recovery rate, total number of myelinated nerve fibers and myelin sheath thickness were measured. For these indices, values in the three groups showed the autologous nerve anastomosis group 〉 chemically extracted acellular nerve graft ＋ ciliary neurotrophic factor group 〉 chemical acellular allogeneic nerve bridging group. These results suggest that chemically extracted acellular nerve grafts combined with ciliary neurotrophic factor can repair sciatic nerve defects, and that this repair is inferior to autologous nerve anastomosis, but superior to chemically extracted acellular allogeneic nerve bridging alone.
文摘In this study, rabbit models of optic nerve injury were reproduced by the clamp method. After modeling, rabbit models were given one injection of 50 ng recombinant human ciliary neurotrophic factor into the vitreous body and/or intragastric injection of 4 g/kg compound light granules containing Radix Angelicae Sinensis and Raidix Paeoniae Alba at 4 days after modeling, once per day for 30 consecutive days. After administration, the animals were sacrificed and the intraorbital optic nerve was harvested. Hematoxylin-eosin staining revealed that the injured optic nerve was thinner and optic nerve fibers were irregular. After treatment with recombinant human ciliary neurotrophic factor, the arrangement of optic nerve fibers was disordered but they were not markedly thinner. After treatment with compound light granules, the arrangement of optic nerve fibers was slightly disordered and their structure was intact. After combined treatment with recombinant human ciliary neurotrophic factor and compound light granules, the arrangement of optic nerve fibers was slightly disordered and the degree of injury was less than after either treatment alone. Results of tensile mechanical testing of the optic nerve showed that the tensile elastic limit strain, elastic limit stress, maximum stress and maximum strain of the injured optic nerve were significantly lower than the normal optic nerve. After treatment with recombinant human ciliary neurotrophic factor and/or compound light granules, the tensile elastic limit strain, elastic limit stress, maximum stress and maximum strain of the injured optic nerve were significantly increased, especially after the combined treatment. These experimental findings indicate that compound light granules and ciliary neurotrophic factor can alleviate optic nerve injury at the histological and biochemical levels, and the combined treatment is more effective than either treatment alone.
文摘Primary ciliary dyskinesia （PCD） is an autosomal-recessive disorder resulting from the loss of normal ciliary function. Symptoms include neonatal respiratory distress, chronic sinusitis, bronchiectasis, situs inversus, and infertility. However, only 15 PCD-associated genes have been identified to cause male infertility to date. Owing to the genetic heterogeneity of PCD, comprehensive molecular genetic testing is not considered the standard of care. Here, we provide an update of the progress on the identification of genetic factors related to PCD associated with male infertility, summarizing the underlying molecular mechanisms, and discuss the clinical implications of these findings. Further research in this field will impact the diagnostic strategy for male infertility, enabling clinicians to provide patients with informed genetic counseling, and help to adopt the best course of treatment for developing directly targeted personalized medicine.
基金supported by the Natural Science Foundation of Shandong Province of China,No.ZR2014HQ065a grant from the Medical Science and Technology Development Project of Shandong Province of China,No.2015WS0445
文摘Ciliary neurotrophic factor has neuroprotective effects mediated through signal transducer and Janus kinase（JAK） 2/activator of transcription 3（STAT3） and phosphatidylinositol 3-kinase（PI3 K）/Akt signaling pathways.Whether ciliary neurotrophic factor is neuroprotective for glutamate-induced excitotoxicity of dorsal root ganglion neurons is poorly understood.In the present study,the in vitro neuroprotective effects of ciliary neurotrophic factor against glutamate-induced excitotoxicity were determined in a primary culture of dorsal root ganglion neurons from Wistar rat embryos at embryonic day 15.Whether the JAK2/STAT3 and PI3 K/Akt signaling pathways were related to the protective effects of ciliary neurotrophic factor was also determined.Glutamate exposure inhibited neurite outgrowth,cell viability,and growth-associated protein 43 expression and promoted apoptotic neuronal cell death,all of which were reversed by the administration of exogenous ciliary neurotrophic factor.Additionally,preincubation with either JAK2 inhibitor AG490 or PI3 K inhibitor LY294002 blocked the neuroprotective effect of ciliary neurotrophic factor.These data indicate that the two pathways JAK2/STAT3 and PI3 K/Akt play major roles in mediating the in vitro neuroprotective effects of ciliary neurotrophic factor on dorsal root ganglion neurons with glutamate-induced neurotoxicity.
文摘The expression and clinical significance of relevant cytokines in otitis media (OM) are discussed, and the alterations to the pathological state of the otitis media mucosa are further understood through the study of cytokine transduction pathways. More and more studies have shown that relevant cell proliferation and inflammation progression pathways play a role in the development of otitis media, such as the Jun amino-terminal protein kinase (JNK) mitogen-activated protein kinase (MAPK) signaling pathway, the NF-κB signaling pathway, and the PI3K/AKT/PTEN pathway, which are involved in the proliferation of the middle ear mucosa during otitis media, which affects the mucosal cilia, motor function, Eustachian tube function, and the mucosal ciliary function. These studies provide new ideas for the treatment of otitis media and further explore the feasibility of immunotherapy in the future treatment of otitis media. In this paper, we present a review of the latest research progress on the expression of various cytokines in otitis media.
文摘Aim:Dysplasia of the fibrous sheath(DFS)is an anomaly found in asthenozoospermic patients with extremely lowor absent motility.In order to determine the efficacy of ICSI in these patients,a retrospective analysis of ICSI results inDFS patients has been done.Methods:Ten ICSI attempts were performed in 6 patients with diagnosis of Dysplasiaof the Fibrous Sheath studied by transmission and scanning electron microscopy.Results:In the cases studied,sperm concentration was(29.62±18.05)×10^(6)/mL,total motility was 1.14±1.31%.Progressive motility was 0%except for one case with 0.1%.One hundred and three preovulatory oocytes were obtained and 94 metaphaseⅡoocyteswere injected.Sixty-nine of them showed two pronuclei(fertilization rate:73.4%).Forty-nine embryos were ob-tained and 34 were transferred(mean:3.4 embryos per transfer).Five pregnancies were diagnosed byβ-hCG plasmalevel determinations that resulted to be one preclinical abortion,one clinical abortion and three deliveries.Anotherpregnancy(ongoing)was achieved from a cryopreserved embryo transfer.Conclusion:These results showed thatICSI provides a suitable solution for patients suffering from irreversible sperm defects such as DFS.Nevertheless,it ismandatory to inform couples of possible transmission risks to offspring,which are unknown at present.Only when theetiology of this problem is disclosed,it will be possible to assess the real genetic risk.
基金Supported by Ph.D.Programs Foundation of Ministry of Education of China(No.20130141120052)
文摘AIM： To explore the effect of ciliary neurotrophic factor （CNTF） on retinal ganglion cell （RGC）-5 induced by hydrogen peroxide （H2O2）. METHODS： After cell adherence, RGC-5 culture medium was changed to contain different concentrations of H2O2 from 50 to 150 μmol/L at four time points （0.5, 1, 1.5 and 2h） to select the concentration and time point for H2O2 induced model. Two different ways of interventions for injured RGC-5 cells respectively were CNTF as an addition in the culture medium or recombinant lentiviral plasmid carrying CNTF gene transfecting bone mesenchymal stem cells （BMSCs） for co-culture with RGC-5. RESULTS： Compared to the control group, H2O2 led to RGC-5 death closely associated with concentrations and action time of H2O2 and we chose 125 μmol/L and 2h to establish the H2O2-induced model. While CNTF inhibited the loss of RGC-5 cells obviously with a dose-dependent survival rate. Nevertheless two administration routes had different survival rate yet higher rate in recombinant lentiviral plasmid group but there were no statistically significant differences. CONCLUSION： Both the two administration routes of CNTF have effects on RGC-5 cells induced by H2O2. If their own advantages were combined, there may be a better administration route.
基金supported by the Basic Science Research Program through the National Research Foundation of Korea(NRF) funded by the Ministry of Education(No.NRF-2016R1D1A3B03930920 to SK)the MSIP(No.NRF-2014R1A5A2009936 to SK)
文摘Neurogenesis in the adult hippocampus plays a major role in cognitive ability of animals including learning and memory.Korean red ginseng (KRG) has long been known as a medicinal herb with the potential to improve learning and memory;however,the mechanisms are still elusive.Therefore,we evaluated whether KRG can promote cognitive function and enhance neurogenesis in the hippocampus.Eight-week-old male C57BL/6 mice received 50 mg/kg of 5-bromo-2′-deoxyuridine (BrdU) intraperitoneally and 100 mg/kg of KRG or vehicle orally once a day for 14 days.Pole,Rotarod and Morris water maze tests were performed and the brains were collected after the last behavioral test.Changes in the numbers of BrdU- and BrdU/ doublecortin (DCX;a marker for neuronal precursor cells and immature neurons)-positive cells in the dentate gyrus and the gene expression of proliferating cell nuclear antigen (a marker for cell differentiation),cerebral dopamine neurotrophic factor and ciliary neurotrophic factor in the hippocampus were then investigated.KRG-treated mice came down the pole significantly faster and stood on the rotarod longer than vehicle-treated mice.The Morris water maze test showed that KRG administration enhanced the learning and memory abilities significantly.KRG also significantly increased BrdU- and BrdU/DCX-positive cells in the dentate gyrus as well as the proliferating cell nuclear antigen,cerebral dopamine neurotrophic factor and ciliary neurotrophic factor mRNA expression levels in the hippocampus compared to vehicle.Administration of KRG promotes learning and memory abilities,possibly by enhancing hippocampal neurogenesis.This study was approved by the Pusan National University Institutional Animal Care and Use Committee (approval No.PNU-2016-1071) on January 19,2016.
文摘Background: The prevalence of Parkinson’s disease (PD), a chronic and progressive neurodegenerative disorder, is projected to increase twofold by 2030. Leucine-rich repeat kinase 2 (LRRK2) is the most commonly observed gene in both familial and sporadic PD cases. Notably, there is a substantial augmentation in motor activity during both larval and adult stages of zebrafish lacking the lrrk2 gene. Nevertheless, the precise genetic abnormalities accountable for eliciting these phenotypes in zebrafish are yet to be elucidated. Methods: Real-time polymerase chain reaction (PCR) was conducted on zebrafish larvae at 6 days post fertilization (dpf) belonging to both the wild-type and lrk2(-/-) groups. Guide RNA was designed and subsequently employed in the PCR process. Electrophoresis was performed to facilitate identification. Results: The expression of CNTF mRNA was significantly diminished in lrrk2(-/-), in comparison to the wildtype zebrafish larvae. This finding implies that CNTF may have crucial implications in the regulated functioning of lrrk2, which is widely acknowledged as the predominant genetic factor contributing to hereditary PD. The primers for CNTF DNA were meticulously designed, and the electrophoresis results of the PCR product were subsequently presented. The wild type zebrafish embryos were meticulously prepared for micro-injection, and the resulting efficiency identification displayed the presence of the mutant PCR product, which exhibited the presence of several debris. Conclusions: The present study demonstrates the successful generation of CNTF mutant zebrafish using the CRISPR/Cas9 genome editing technique. Further investigations are necessary to deepen our understanding of the exogenous CNTF gene’s functionality.
基金Shanghai Natural Science Foundation of Science and Technology Innovation Action Plan(Grant Number:21ZR1410200 and 21ZR1409900).
文摘Primary ciliary dyskinesia(PCD)is a rare disorder characterized by extensive genetic heterogeneity.However,in the genetic pathogenesis of PCD,copy number variation(CNV)has not received sufcient attention and has rarely been reported,especially in China.Next-generation sequencing(NGS)followed by targeted CNV analysis was used in patients highly suspected to have PCD with negative results in routine whole-exome sequencing(WES)analysis.Quantitative real-time polymerase chain reaction(qPCR)and Sanger sequencing were used to confrm these CNVs.To further characterize the ciliary phenotypes,high-speed video microscopy analysis(HSVA),transmission electron microscopy(TEM),and immunofuorescence(IF)analysis were used.Patient 1(F1:II-1),a 0.6-year-old girl,came from a nonconsanguineous family-I.She presented with situs inversus totalis,neonatal respiratory distress,and sinusitis.The nasal nitric oxide level was markedly reduced.The respiratory cilia beat with reduced amplitude.TEM revealed shortened outer dynein arms(ODA)of cilia.chr5:13717907-13722661del spanning exons 71–72 was identifed by NGS-based CNV analysis.Patient 2(F2:IV-4),a 37-year-old man,and his eldest brother Patient 3(F2:IV-2)came from a consanguineous family-II.Both had sinusitis,bronchiectasis and situs inversus totalis.The respiratory cilia of Patient 2 and Patient 3 were found to be uniformly immotile,with ODA defects.Two novel homozygous deletions chr5:13720087_13733030delinsGTTTTC and chr5:13649539_13707643del,spanning exons 69–71 and exons 77–79 were identifed by NGS-based CNV analysis.Abnormalities in DNA copy number were confrmed by qPCR amplifcation.IF showed that the respiratory cilia of Patient 1 and Patient 2 were defcient in dynein axonemal heavy chain 5(DNAH5)protein expression.This report identifed three novel DNAH5 disease-associated variants by WES-based CNV analysis.Our study expands the genetic spectrum of PCD with DNAH5 in the Chinese population.
基金Supported by National Natural Science Foundation of China(No.81900910)Natural Science Foundation of Zhejiang Province(No.LQ19H120003)Basic Scientific Research Project of Wenzhou(No.Y2023809).
文摘AIM:To determine the factors related to preoperative ocular characters that are predictive of insufficient vault(<250μm)after implantable collamer lens(ICL V4c;STAAR Surgical)implantation.METHODS:The participants underwent ICL surgery and were divided into the low(<250μm)and normal(250-1000μm)vault groups based on the postoperative vault at 3mo.The preoperative biometric parameters and clinical outcomes were compared between the two groups.The relationship between the 3-month vault values and preoperative ocular parameters were evaluated by Generalized estimating equations.RESULTS:Sixteen(23 eyes)and 36 patients(63 eyes)were in the low and normal vault groups,respectively.All implantation procedures were uneventful with no cataract formation in the early postoperative period.The sulcusto-sulcus lens rise(STSL)and iris ciliary angle(ICA)were correlated with vault at 3mo after surgery.Every 0.1 mm increase in STSL was associated with 38.9μm decrease in the postoperative 3-month vault.A rise of 1 degree in ICA is associated with a reduction of 4μm in vault.CONCLUSION:Eyes with a narrow ciliary sulcus are associated with a higher rate of low vault after ICL implantation,suggesting a need for adjustments to the ICL size in these patients.Evaluating the characteristics of the ciliary sulcus contributes valuable information to predict low vault after surgery.
基金Project (No. 2012KYA107) supported by the Health Bureau of Zhejiang Province,China
文摘Objective:To evaluate the prevalence of primary iris and/or ciliary body cysts in eyes with shallow anterior chamber and their effect on the narrowing of the anterior chamber angle.Methods:Among the general physical check-up population,subjects with shallow anterior chambers,as judged by van Herick technique,were recruited for further investigation.Ultrasound biomicroscope(UBM) was used to detect and measure the cysts located in the iris and/or ciliary body,the anterior chamber depth(ACD),the angle opening distance at 500 μm(AOD500),and the trabecular-iris angle(TIA).A-scan ultrasonography was used to measure the ocular biometry,including lens thickness,axial length,lens/axial length factor(LAF),and relative lens position(RLP).The effect of the cyst on narrowing the corresponding anterior chamber angle and the entire angle was evaluated by the UBM images,ocular biometry,and gonioscopic grading.The eye with unilateral cyst was compared with the eye without the cyst for further analysis.Results:Among the 727 subjects with shallow anterior chamber,primary iris and ciliary body cysts were detected in 250(34.4%) patients;among them 96(38.4%) patients showed unilateral single cyst,21(8.4%) patients had unilateral double cysts,and 42(16.8%) patients manifested unilateral multiple and multi-quadrants cysts.Plateau iris configuration was found in 140 of 361(38.8%) eyes with cysts.The mean size of total cysts was(0.6547±0.2319) mm.In evaluation of the effect of the cyst size and location on narrowing the corresponding angle to their position,the proportion of the cysts causing corresponding angle narrowing or closure among the cysts larger than 0.8 mm(113/121,93.4%) was found to be significantly higher than that of the cysts smaller than 0.8 mm(373/801,46.6%),and a significant higher proportion was also found in the cysts located at iridociliary sulcus(354/437,81.0%) than in that at the pars plicata(131/484,27.1%).In evaluating the effect of the cyst on the entire anterior chamber angle,the eyes with multiple and multi-q
文摘BACKGROUND Primary ciliary dyskinesia(PCD)is an inherited autosomal-recessive disorder of impaired mucociliary clearance characterized by chronic respiratory diseases,otolaryngological diseases,central nervous system abnormalities,reproductive system abnormalities,and cardiac function abnormalities.General anesthesia in these patients is associated with a higher incidence of respiratory complications than in patients without the disease.CASE SUMMARY A 16-year-old male patient was referred to the emergency room complaining of right ankle pain due to distal tibiofibular fracture.Three years prior,he had been diagnosed with PCD.At that time,he had experienced several episodes of pneumonia,sinusitis,and chronic middle ear infections,for which he underwent surgical interventions.At the current admission,he presented with cough and sputum but no other respiratory symptoms.A chest computed tomography scan revealed centrilobular ground-glass opacities in both lower lobes and a calcified nodule in the left lower lobe.For the surgical procedure and postoperative pain management,combined spinal-epidural anesthesia was employed.The patient’s postoperative pain score was measured by the numerical rating scale(NRS).On the day of surgery,his NRS was 5 points.By the second postoperative day,the NRS score had decreased to 2–3 points.The epidural catheter was removed on the fourth day following the operation.The patient was subsequently discharged no respiratory complications.CONCLUSION We performed combined spinal-epidural anesthesia in a patient with PCD.The patient experienced no additional respiratory complications and was discharged with a low NRS score for pain.
