Aim :Recently,we reported typical endoscopic findings and an increment in γδ+ Tcells in the foregut among children with food-sensitive enteropathy other than coeliac disease.To find outthe extend to which the upregu...Aim :Recently,we reported typical endoscopic findings and an increment in γδ+ Tcells in the foregut among children with food-sensitive enteropathy other than coeliac disease.To find outthe extend to which the upregulation of the local immune response might explain gastrointestinal (GI)complaints of the foregut,we sought to exam ine by the increm ent in γδ+ T cells a 1-y consecutive series of children referred for recurrent G I com plaints to a ter- tiary-levelhospital.M ethods:A 1-y cohort of 102chil- dren scheduled for gastroduodenoscopy were exam ined for m ucosalhistology and the densities ofCD3+,αβ+ and γδ+ T-cell subsets from m id-duodenal specim ens.The final diagnostic categories were used in analysing the data. Results:Fifteen subjects showed villous atrophy and a high γδ+ T-cell density;the finding being com patible with coeliac disease (CD ).Atthe otherextrem e,20subjects in whom diagnostic G I diseases were ruled out showed low densities and served as controls.The subjects reporting GI symptom s after an open food challenge with m ilk and /or cereals (n = 18)as well as children rem ittingwith am ilk-or cereal-elim inating diet but not responding to a challenge (n = 23)also expressed significantly higher densities ofγδ+ T cells than the controls.In all,45of102 children could be considered to have an elevated γδ+ T-cell density as an indication of locally activated im m une re- sponse. Lack of villous architecture and lym phonodular hyperplasia of the duodenal bulb as an endoscopie finding and atopic derm atitis but not the presence of D Q2alleles showed a close association with these increased densities. Conclusion:Considering thatan elevated incidence ofj6+ T cells is an indication of m ucosal response against lum inal antigens,up to halfthe children with prolonged G I sym p- tom s have im m une m ediated disorder;CD and food allergy being the m ostobvious clinicalentities.展开更多
Purpose:To evaluate the prognostic influence of the presence of an operculum in macular hole and to correlate the prognosis for postoperative visual acuity(VA)with the size of the macular hole,its duration and preoper...Purpose:To evaluate the prognostic influence of the presence of an operculum in macular hole and to correlate the prognosis for postoperative visual acuity(VA)with the size of the macular hole,its duration and preoperative VA.Methods:We carried out a prospective study of 61 eyes of 59 patients with full thickness macular hole.All patients were examined with optical coherence tomography(OCT)in order to ascertain the presence of an operculum.The VA was measured with the ETDRS chart.A standard pars plana vitrectomy with inner limiting membrane peeling was performed in all cases and 20% C2F6 was used as tamponade.Results:Anatomical closure was obtained after one surgical procedure in 59/61(97%)patients.Linear regression analysis showed only baseline VA to be predictive of visual outcome(p < 0.001).The presence of an operculum preoperatively did not correlate with VA either pre-or postoperatively,nor with the anatomical closure rate.Conclusion:The finding that postoperative VA in macular hole correlates with preoperative VA seems to allow for good prediction of postoperative VA in macular hole surgery.However,the presence of an operculum is of no prognostic significance.展开更多
文摘Aim :Recently,we reported typical endoscopic findings and an increment in γδ+ Tcells in the foregut among children with food-sensitive enteropathy other than coeliac disease.To find outthe extend to which the upregulation of the local immune response might explain gastrointestinal (GI)complaints of the foregut,we sought to exam ine by the increm ent in γδ+ T cells a 1-y consecutive series of children referred for recurrent G I com plaints to a ter- tiary-levelhospital.M ethods:A 1-y cohort of 102chil- dren scheduled for gastroduodenoscopy were exam ined for m ucosalhistology and the densities ofCD3+,αβ+ and γδ+ T-cell subsets from m id-duodenal specim ens.The final diagnostic categories were used in analysing the data. Results:Fifteen subjects showed villous atrophy and a high γδ+ T-cell density;the finding being com patible with coeliac disease (CD ).Atthe otherextrem e,20subjects in whom diagnostic G I diseases were ruled out showed low densities and served as controls.The subjects reporting GI symptom s after an open food challenge with m ilk and /or cereals (n = 18)as well as children rem ittingwith am ilk-or cereal-elim inating diet but not responding to a challenge (n = 23)also expressed significantly higher densities ofγδ+ T cells than the controls.In all,45of102 children could be considered to have an elevated γδ+ T-cell density as an indication of locally activated im m une re- sponse. Lack of villous architecture and lym phonodular hyperplasia of the duodenal bulb as an endoscopie finding and atopic derm atitis but not the presence of D Q2alleles showed a close association with these increased densities. Conclusion:Considering thatan elevated incidence ofj6+ T cells is an indication of m ucosal response against lum inal antigens,up to halfthe children with prolonged G I sym p- tom s have im m une m ediated disorder;CD and food allergy being the m ostobvious clinicalentities.
文摘Purpose:To evaluate the prognostic influence of the presence of an operculum in macular hole and to correlate the prognosis for postoperative visual acuity(VA)with the size of the macular hole,its duration and preoperative VA.Methods:We carried out a prospective study of 61 eyes of 59 patients with full thickness macular hole.All patients were examined with optical coherence tomography(OCT)in order to ascertain the presence of an operculum.The VA was measured with the ETDRS chart.A standard pars plana vitrectomy with inner limiting membrane peeling was performed in all cases and 20% C2F6 was used as tamponade.Results:Anatomical closure was obtained after one surgical procedure in 59/61(97%)patients.Linear regression analysis showed only baseline VA to be predictive of visual outcome(p < 0.001).The presence of an operculum preoperatively did not correlate with VA either pre-or postoperatively,nor with the anatomical closure rate.Conclusion:The finding that postoperative VA in macular hole correlates with preoperative VA seems to allow for good prediction of postoperative VA in macular hole surgery.However,the presence of an operculum is of no prognostic significance.
