This paper maintains that when photons enter the pupil and reach the Inner Limiting Membrane （ILM）, they are reflected onto a point or centroid of the vitreous body, which could be the lens, to be transmitted by the...This paper maintains that when photons enter the pupil and reach the Inner Limiting Membrane （ILM）, they are reflected onto a point or centroid of the vitreous body, which could be the lens, to be transmitted by the Muiller cells to the Retinal Pigment Epithelium （RPE） hexagonal cells, where an almost complete image is formed in each of them, overlapping with the adjacent images, to be carried subsequently by each of the ganglion cell axons to a place where the single image we are aware of is formed. This process calls for a high degree of control and coordination, which must be effected by the horizontal, amacrine, and interplexiform cells, gap junctions and the feedback provided from the V1 area to the Lateral Geniculate Nucleus （LGN）. But, as the ILM covers the optic disc but not the fovea, the latter must produce the blind spot and the rays reflected radially from the centroid must have the same centre as the Muller cells in order to be able to channel them to the RPE cells.展开更多
AIM: To evaluate the outcome of sub-centimeter-sized nodules (SCSNs) detected during surveillance for hepatocellular carcinoma (HCC) in patients at risk. METHODS: We retrospectively analyzed a total of 142 patients wi...AIM: To evaluate the outcome of sub-centimeter-sized nodules (SCSNs) detected during surveillance for hepatocellular carcinoma (HCC) in patients at risk. METHODS: We retrospectively analyzed a total of 142 patients with liver cirrhosis or chronic hepatitis B or C without a prior history of HCC in whom a SCSN was detected during HCC surveillance. We calculated the rate of HCC development from SCSNs in the study population and analyzed the differences in the baseline clinical characteristics and imaging features between the patients with SCSNs that eventually developed into HCC and patients with SCSNs that did not develop into HCC.RESULTS: During 667 person-years of follow-up, HCC developed in 33 patients. The calculated HCC development rate was 4.9% per year. The cumulative one-, two-, three- and five-year HCC development rates were 5.6%, 10.6%, 14.1% and 20.4%, respectively. Upon baseline comparison, the HCC group was older (54.4 ± 8.3 years vs 48.9 ± 9.4 years; P = 0.003) and had lower albumin levels (3.56 ± 0.58 g/dL vs 3.84 ± 0.55 g/dL; P = 0.012) and higher baseline alpha-fetoprotein (AFP) levels (8.5 ng/mL vs 5.4 ng/mL; P = 0.035) compared to the non-HCC group. Nodule pattern and initial radiologic diagnosis also differed between the two groups. Multivariate analysis revealed that age [P = 0.012, odds ratio (OR) =1.075, 95% confidence interval (CI) =1.016-1.137], sex (P = 0.009, OR = 3.969, 95% CI: 1.403-11.226), and baseline AFP level (P = 0.024, OR = 1.039, 95% CI: 1.005-1.073) were independent risk factors for developing HCC. CONCLUSION: The overall risk of HCC development in patients with SCSNs is similar to that in liver cirrhosis patients. Patients with these risk factors need to be closely monitored during follow-up.展开更多
文摘This paper maintains that when photons enter the pupil and reach the Inner Limiting Membrane （ILM）, they are reflected onto a point or centroid of the vitreous body, which could be the lens, to be transmitted by the Muiller cells to the Retinal Pigment Epithelium （RPE） hexagonal cells, where an almost complete image is formed in each of them, overlapping with the adjacent images, to be carried subsequently by each of the ganglion cell axons to a place where the single image we are aware of is formed. This process calls for a high degree of control and coordination, which must be effected by the horizontal, amacrine, and interplexiform cells, gap junctions and the feedback provided from the V1 area to the Lateral Geniculate Nucleus （LGN）. But, as the ILM covers the optic disc but not the fovea, the latter must produce the blind spot and the rays reflected radially from the centroid must have the same centre as the Muller cells in order to be able to channel them to the RPE cells.
文摘AIM: To evaluate the outcome of sub-centimeter-sized nodules (SCSNs) detected during surveillance for hepatocellular carcinoma (HCC) in patients at risk. METHODS: We retrospectively analyzed a total of 142 patients with liver cirrhosis or chronic hepatitis B or C without a prior history of HCC in whom a SCSN was detected during HCC surveillance. We calculated the rate of HCC development from SCSNs in the study population and analyzed the differences in the baseline clinical characteristics and imaging features between the patients with SCSNs that eventually developed into HCC and patients with SCSNs that did not develop into HCC.RESULTS: During 667 person-years of follow-up, HCC developed in 33 patients. The calculated HCC development rate was 4.9% per year. The cumulative one-, two-, three- and five-year HCC development rates were 5.6%, 10.6%, 14.1% and 20.4%, respectively. Upon baseline comparison, the HCC group was older (54.4 ± 8.3 years vs 48.9 ± 9.4 years; P = 0.003) and had lower albumin levels (3.56 ± 0.58 g/dL vs 3.84 ± 0.55 g/dL; P = 0.012) and higher baseline alpha-fetoprotein (AFP) levels (8.5 ng/mL vs 5.4 ng/mL; P = 0.035) compared to the non-HCC group. Nodule pattern and initial radiologic diagnosis also differed between the two groups. Multivariate analysis revealed that age [P = 0.012, odds ratio (OR) =1.075, 95% confidence interval (CI) =1.016-1.137], sex (P = 0.009, OR = 3.969, 95% CI: 1.403-11.226), and baseline AFP level (P = 0.024, OR = 1.039, 95% CI: 1.005-1.073) were independent risk factors for developing HCC. CONCLUSION: The overall risk of HCC development in patients with SCSNs is similar to that in liver cirrhosis patients. Patients with these risk factors need to be closely monitored during follow-up.
