Outcomes of secondary sulcus intraocular lens implantation in unilateral anterior persistent fetal vasculature

AIM: To evaluate the surgical results of sulcus intraocular lens(IOL) implantation in children with unilateral anterior persistent fetal vasculature(PFV) underwent primary vitrectomy combined with lensectomy and preservation of the peripheral anterior capsule.METHODS: Twenty-two eyes of 22 children with unilateral anterior PFV who underwent sulcus secondary IOL implantation were analyzed. Main outcome measures were preoperative and postoperative visual acuity, and complications both intraoperatively and postoperatively. RESULTS: Review of 22 consecutive patients identified best-corrected visual acuity(BCVA) improvement from 1.37±0.84 to 0.73±0.57 logarithm of the minimal angle of resolution(logMAR) after IOL implantation(P<0.001) with a mean follow-up was 16.55±5.86 mo. Average age at secondary IOL implantation was 41.05±15.41 mo. Three eyes(13.64%) achieved BCVA of 0.3 logMAR at the final visit. Transient intraocular pressure rise(4 eyes; 18.18%), postoperative increased inflammation(3 eyes; 13.64%) and postoperative hypotony(2 eyes; 9.09%) were common complications.CONCLUSION: Properly preservation of the anterior lens capsule during the primary surgery facilitated secondary sulcus IOL implantation in pediatric patients with anterior PFV, with favorable postoperative visual outcomes and compatible percentage of complications.

Significance of Multimodality Therapy in Patients with a Superior Sulcus Tumor of the Lung: A Review Article

Despite the aggressive pursuit of diagnostic and treatment modalities for lung cancer, the treatment outcomes are still not satisfactory, and even patients with surgically resectable non-small cell lung cancer (NSCLC) are often at considerable risk of suffering recurrence and/or death from lung cancer. Regarding the treatment of patients with locally advanced, resectable NSCLC, several retrospective and prospective studies have shown the significance of multimodality treatments with preoperative chemoradiotherapy and surgical treatment. However, no definitive treatment strategies for locally advanced NSCLC patients have yet been established. One of the reasons for the lack of established treatment strategies for patients with locally advanced NSCLC is considered to be the heterogeneity of the population, i.e., cT4N0, cT3-4N1 and cT1a-3N2 tumors are included in stage IIIA disease, and superior sulcus tumors (SSTs) are also included in this classification. With regard to SST, two representative prospective phase II trials indicated the efficacy of surgical treatment following concurrent radiation and chemotherapy. In a study conducted by the Southwest Oncology Group, 110 patients with superior sulcus NSCLC were treated with two cycles of cisplatin and etoposide concurrently with 45 gray (Gy) of radiation, followed by surgical treatment and two additional cycles of chemotherapy postoperatively. The response rate (RR) to the preoperative chemoradiotherapy was 86%, and 83 patients (76%) were able to undergo complete resection. A pathological complete response (CR) was observed in 61 patients (56%), and the five-year survival of all patients and those undergoing complete resection was 44% and 54%, respectively. A phase II study conducted by the Japan Clinical Oncology Group examined the safety and efficacy of preoperative concurrent chemoradiotherapy using mitomycin, vinblastin and cisplatin followed by surgical treatment. Seventy-six patients with SST were enrolled in this study, and all received chemotherapy using two cycles of MVP concurrently with 45 Gy of radiation, followed by surgery. Neoadjuvant chemoradiotherapy resulted in a 61% RR, and pathological complete resection was successfully achieved in 51 patients (68%). A pathological CR was observed in 12 patients (16%), and the disease-free and overall survival rates at five years were 45% and 56%, respectively. Both studies showed the efficacy and tolerability of the multimodality treatment for SST, thus suggesting that multimodality treatment with preoperative chemoradiotherapy followed by surgery may therefore be an effective treatment for resectable SST. We herein review the results of retrospective and prospective studies while assessing the treatment outcomes of NSCLC patients with SST.

Comparative study of otolith and sulcus morphology for stock discrimination of yellow drum along the Chinese coast

Otolith morphology is widely used for fish stock identification. The sulcus, a structure on the medial side of the otolith, is an important feature in morphological analysis. This study was conducted to evaluate the feasibility of using sulcus morphology for stock identification and to compare its performance with commonly used otolith morphology analysis. Otoliths were collected and analyzed from three geographical groups (the Huanghe (Yellow) River estuary, HHE;the Jiaozhou Bay, JZB;and the Changjiang (Yangtze) River estuary, CJE) of yellow drum Nibea albiflora. The results show that the analysis of sulcus morphology based on shape indices (SIs), elliptic Fourier coefficients (EFc), and a combination of the two parameters identified stocks at overall classification rates of 51.0%, 72.5%, and 73.2%, respectively. These classification rates are similar to those obtained using otolith morphology analysis (57.0%, 73.8%, and 76.5% by SIs, EFc, and their combination, respectively). The findings suggest that sulcus morphology is comparable to the commonly used otolith morphology for identifying stocks of sciaenids, such as the yellow drum. For both otolith and sulcus morphology, EFc could identify the stocks more efficiently than SIs, while the combination of SIs and EFc was even better.

Sulcus and otolith outline analyses: complementary tools for stock discrimination in white croaker Pennahia argentata in northern Chinese coastal waters

This study analyzed and compared variations of the sulcus and otolith outlines of three geographic stocks(Huanghe(Yellow)River estuary(HHE),Jiaozhou Bay(JZB),and Changjiang(Yangtze)River estuary(CJE))of white croaker Pennahia argentata in northern Chinese coastal waters.The sulcus and otolith outline analyses via elliptical Fourier transform(EFT,i.e.,outline analysis)achieved an overall classifi cation rate of 80.4%and 87.2%,respectively.Based on a combination of sulcus and otolith shape indices(SIs)and two derivative ratios,a moderate discriminatory effi ciency of 64.7%was obtained.The results indicate that sulcus outline analysis could be used alone to discriminate white croaker stocks,and that both sulcus and otolith outline analyses discriminated the fi sh stocks at a higher classifi cation rate than the shape indices.The sulcus outline analysis provided complementary information to the whole otolith outline analysis for stock discrimination.Both the sulcus and otolith outline analyses effi ciently discriminated between the most geographically separated CJE and HHE stocks,indicating that they could be considered discrete stocks for fi shery management.

Introduction of longstanding complicated sulcus intraocular lens into the intact capsular bag

AIM:To propose a surgical technique that successfully reopened the empty and intact capsular bag after long periods of closure,with repositioning of the intraocular lens(IOL)from the ciliary sulcus into its preferred habitat inside the capsular bag.METHODS:This is a case series,prospective,and interventional study.The technique was first performed on an aphakic high myope with a closed posterior capsule for 18 y.Afterwards,five patients with recurrently displaced sulcus IOLs for a range of 1 mo to 7 y were performed for the same technique.During surgery,identifying a"telltale white line"was an important landmark for detecting the site of major adhesions between the edge of the capsulorhexis and the posterior capsule.These adhesions were freed using combined manual and viscoelastic dissection,followed by an easier freeing of adhesions along the whole capsular bag.The IOL was safely implanted,exchanged,or introduced from the sulcus into the fibrotic and closed capsular bag.Patients were followed up for a period ranging from 6 to 17 mo postoperatively.RESULTS:All the patients experienced a remarkable improvement in their subjective refraction.Slit lamp examination showed a postoperative centralized IOL in the bag.The follow up visits confirmed visual and IOL stability.CONCLUSION:This newly-introduced surgical technique facilitates the reopening of the empty yet intact capsular bag that has been closed by fibrotic proliferations,with secured implantation of the IOL inside the capsular bag.Patients with inadvertent implantation of IOLs into the ciliary sulcus,yet having an intact capsular bag,can benefit from this technique.

Liver surface depressions in the presence of diaphragmatic muscular bands on trans-illumination

Traditional descriptions of liver anatomy refer to a smooth,convex surface contacting the diaphragm.Surface depressions are recognized anatomic variants.There are many theories to explain the cause of the depressions.We discuss the theory that these are caused by hypertrophic muscular bands in the diaphragm.

Ultrasonographic Characteristics of Cortical Sulcus Development in the Human Fetus between 18 and 41 Weeks of Gestation

Background： Fetal brain development is a complicated process that continues throughout pregnancy. Fetal sulcus development has typical morphological features. Assessment of fetal sulcus development to understand the cortical maturation and development by prenatal ultrasound has become widespread. This study aimed to explore a reliable method to assess cortical sulcus and to describe the normal sonographic features of cortical sulcus development in the human fetus between 18 and 41 weeks of gestation. Methods： A cross-sectional study was designed to examine the fetal cortical sulcus development at 18-41 weeks of gestation. Ultrasound was used to examine the insula, sylvian fissure （SF）, parieto-occipital fissure （POF）, and calcarine fissure （CF）. Bland-Altman plots were used for assessing the concordance, and the intraclass correlation coefficient was used for assessing the reliability. Results： SF images were successfully obtained in 100% of participants at 22 weeks of gestation, while the POF images and CF images could be obtained in 100% at 23 weeks of gestation and 24 weeks of gestation, respectively. The SF width, temporal lobe depth, POF depth, and the CF depth increased with the developed gestation. The width of uncovered insula and the POF angle decreased with the developed gestation. By 23 weeks of gestation, the insula was beginning to be covered. Moreover, it completed at 35 weeks of gestation. The intra- and inter-observer agreements showed consistent reproducibility. Conclusions： This study defined standard views of the fetal sulcus as well as the normal reference ranges of these sulcus measurements between 18 and 41 weeks of gestation. Such ultrasonographic measurements could be used to identil fetuses at risk of fetal neurological structural disorders.

Accuracy and repeatability of direct ciliary sulcus diameter measurements by full-scale 50-megahertz ultrasound biomicroscopy

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 diameter and useful for size determining of posterior chamber pIOL.

Differential diagnosis of cervical radiculopathy and superior pulmonary sulcus tumor

Background The result would be disastrous if the superior pulmonary sulcus tumor （Pancoast tumor） was misdiagnosed as degenerative cervical spine diseases. The aim of this study was to investigate the differential diagnosis methods of cervical radiculopathy and superior pulmonary sulcus tumor. Methods Clinical manifestations, physical, and radiological findings of 10 patients, whose main complaints were radiating shoulder and arm pain and later were diagnosed with superior pulmonary sulcus tumor, were reviewed and compared with those of cervical radiculopathy. Results Superior pulmonary sulcus tumor patients have shorter mean history and fewer complaints of neck pain or limitation of neck movement. Physical examination showed almost normal cervical spine range of motion. Spurling＇s neck compression test was negative in all patients. Anteroposterior cervical radiographs showed the lack of pulmonary air at the top of the affected lung in all cases and first rib encroachment in one case. The diagnosis of superior pulmonary sulcus tumor can be further confirmed by CT and MRI. Conclusions By the method of combination of history, physical examination, and radiological findings, superior pulmonary sulcus tumor can be efficiently differentiated from cervical radiculopathy. Normal motion range of the cervical spine, negative Spurling＇s neck compression test, and the lack of pulmonary air at the top of the affected lung in anteroposterior cervical radiographs should be considered as indications for further chest radiograph examinations.

Increased representation of the non-dominant hand in pianists demonstrated by measurement of 3D morphology of the central sulcus

Background:Post-mortem and magnetic resonance imaging(MRI)studies of the central sulcus,as an indicator of motor cortex,have shown that in the general population there is greater representation of the dominant compared to the non-dominant hand.Studies of musicians,who are highly skilled in performing complex finger movements,have suggested this dominance is affected by musical training,but methods and findings have been mixed.Objective:In the present study,an automated image analysis pipeline using a 3D mesh approach was applied to measure central sulcus(CS)asymmetry on MR images obtained for a cohort of right-handed pianists and matched controls.Methods:The depth,length,and surface area(SA)of the CS and thickness of the cortical mantle adjacent to the CS were measured in each cerebral hemisphere by applying the BrainVISA Morphologist 2012 software pipeline to 3D T1-weighted MR images of the brain obtained for 15 right-handed pianists and 14 controls,matched with respect to age,sex,and handedness.Asymmetry indices(AIs)were calculated for each parameter and multivariate analysis of covariance(MANCOVA),and post hoc tests were performed to compare differences between the pianist and control groups.Results:A one-way MANCOVA across the four AIs,controlling for age and sex,revealed a significant main effect of group(P=0.04),and post hoc analysis revealed that while SA was significantly greater in the left than the right cerebral hemisphere in controls(P<0.001),there was no significant difference between left and right SA in the pianists(P=0.634).Independent samples t-tests revealed that the SA of right CS was significantly larger in pianists compared to controls(P=0.015),with no between-group differences in left CS.Conclusions:Application of an image analysis pipeline to 3D MR images has provided robust evidence of sig-nificantly increased representation of the non-dominant hand in the brain of pianists compared to age-,sex-,and handedness-matched controls.This finding supports prior research showing structural differences in the central sulcus in musicians and is interpreted to reflect the long-term motor training and high skill level of right-handed pianists in using their left hand.

Investigation of Bacteria Species Most Involved in Peri-Implantitis

Purpose: Currently, bacteriological examinations of implant treatments target periodontopathic bacteria such as red complex bacteria, including Porphyromonas gingivalis, and detect them qualitatively or quantitatively. However, it seems that those examinations do not reflect the peri-implant tissue conditions precisely, because periodontopathic bacteria are also frequently detected from healthy peri-implant sites. The purpose of the present study was to investigate bacteria species most involved in peri-implantitis using a PCR method. Methods: Polymerase chain reaction (PCR) primers in this study were designed based on partial sequences of 16S rDNA of bacteria species involved in peri-implantitis that were described in numerous previous studies. Peri-implant sulcus fluid (PISF) samples were collected from thirty periodontally healthy patients with implants (HI) and thirty patients with peri-implantitis (PI). Each detection frequency of bacteria species in PISFs of both groups was investigated using a PCR method, and was compared using Fisher’s exact test. Results: In PI group, detection frequencies of Corynebacterium durum, Fretibacterium fastidiosum and Slackia exigua were significantly higher than those of HI group (p P. gingivalis and Tannerella forsythia belonging to red complex were frequently detected in the PISF samples of HI group (p > 0.05). Conclusion: It was suggested that monitoring C. durum and F. fastidiosum levels in PISF samples was useful as a clinical indicator for the evaluation of peri-implant tissue conditions.

Dynamic changes of inflammation in ligation-induced rat periodontitis model

Objective:To study the dynamic changes of inflammation in rat models of periodontitis induced by ligation.Methods:Twenty-one healthy male SD rats were selected and randomly divided into 7 groups,namely normal control group and ligation group A-F(the ligation group A-F were ligated 1,3,5,7,14 and 21 days respectively,and then sacrificed).In addition to the normal control group,ligature was used to ligate the neck of the right maxillary first molar.The experimental periodontitis model was established in rats.By observing the changes in rat body weight within 21 days,we explored the intervention of ligature wires on inflammation.The impact of the process,through monitoring the debris index simplified(DIS),Sulcus Bleeding Index(SBI),Tooth Mobility(TM),to evaluate the periodontal inflammation of the target tooth within 21 days of ligation.In addition,in order to more accurately assess the dynamic changes of the alveolar bone during the inflammatory phase,we use CBCT Observe the alveolar bone resorption.Results:The body weight of the ligation group decreased during the 3 days after ligation,and compared with the normal control group,there was no statistically significant difference in body weight growth rate in the ligation group from 3 to 21 days(P≥0.05),indicating that due to the intervention of the ligation wire,the rat will have a 3-day adaptability phenomenon.The ligation of silk after day will not affect the growth and development of rats.The DIS on the ligated side was higher than that of the normal control on the first,third,fifth,and seventh days after the ligation.The side increased significantly(P<0.05),and the DIS value increased in the first 3 days,and gradually decreased on the 5th day,until the 21st day after ligation,compared with the normal control group,the difference was not statistically significant(P≥0.05);SDI on the ligation side increased significantly on the 5th day,and gradually decreased after reaching the peak on the 7th day(P<0.05),until there was no statistical difference between the ligation side and the normal control group on the 21st day(P≥0.05);The day began to change and gradually increased until the 21st day,which was statistically significant compared with the normal control group(P<0.05);the CEJ-ABC distance of the ligation group A,B,and C was not statistically significant compared with the normal controlgroup(P>0.05),the CEJ-ABC distance of the ligated group D,E,and F was significantly higher than that of the normal control group(P<0.05),and bone resorption was more significant in group F compared with D and E groups(P<0.01).Conclusion:Three days after the ligation of the ligature,it affects the molar eating in rats,and induces inflammation.Ligation-induced experimental periodontitis is in the acute inflammatory phase during 3-7 days of ligation,and turns to chronic inflammatory phase in 14-21 days.Our study provides a more precise definition of the occurrence and development of ligation-induced periodontitis in rats,which provides a new direction for the subsequent study of periodontitis models and provides a basis for better and more accurate clinical research.

Dermoscopic Features of Hyperpigmented Dots in Crista Cutis in Two Siblings in a Japanese Family with Inherited Acanthosis Nigricans

Acanthosis nigricans is characterized by papillomatous brownish lesions mainly in the intertriginous areas. We used dermoscopy to examine such lesions in a family with acanthosis nigricans. The dermoscopic images showed an aberrant skin structure of linear crista cutis and sulcus cutis, and hyperpigmented dots in crista cutis. The hyperpigmented dots, which could not be seen with the naked eyes, may contribute to the color of the pigmented skin. Dermoscopy can be useful for evaluating disorders involving the structure of area cutanea and a change in skin color.

Considerations in the management of single-piece intraocular lenses outside the capsular bag

AIM: To investigate the outcomes of off label singlepiece acrylic intraocular lenses(SPA-IOL) ciliary sulcus placement compared to three-piece IOL(3P-IOL). METHODS: The charts of eight consecutive eyes of patients who received sulcus-placed SPA-IOLs between 2006 and 2009 were reviewed. None of the patients underwent IOL exchange. Charts of six age-matched patients who received sulcus placed 3P-IOLs were reviewed as a control group. RESULTS: Mean follow up was 16 mo for SPA-IOL and 23 mo for 3P-IOL. Five of 8 patients in the SPA-IOL group required chronic use of IOP lowering medications at final follow up. Of these, one patient needed glaucoma implant surgery for uncontrolled IOP. One patient in the 3P-IOL group used chronic aqueous suppression pre- and postoperatively. Four of eight eyes with SPAIOL were treated with chronic topical steroids and or non-steroidal anti-inflammatory drugs for cystoid macu-la edema, chronic uveitis, pigment dispersion syndrome or a combination of the above, compared to none in the control group. Mean best-corrected visual acuity was 20/35 in the SPA-IOL group and 20/47 in the 3PIOL group.CONCLUSION: Sulcus placed SPA-IOLs are associated with increased ocular morbidity. In select cases good visual acuity may be achieved. Due to postoperative rotation of sulcus placed toric SPA-IOLs stable astigmatism correction cannot be achieved. Alternative intraocular lenses should be considered when in-the-bag placement of SPA-IOL is not possible.

Therapeutic effect of neurogrowth factor in the treatment of gingival pain and swelling in patients with dental pulp necrosis after root canal therapy

Objective: To explore the clinical efficacy of neurogrowth factor in the treatment of gingival pain and swelling in patients with dental pulp necrosis after root canal therapy and the effect on the serum inflammatory cytokines. Methods: A total of 156 patients with gingival pain and swelling after root canal therapy due to dental pulp necrosis were included in the study and randomized into the control group (n=78) and teh treatment group (n=78). The patients in the control group were given metronidazole tablets. On the above basis, the patients in the treatment group were given local injection of neurogrowth factors. 10-day treatment was regarded as one course, and the patients were continuously treated for 2 courses. The improvement of clinical symptoms before and after treatment in the two groups was evaluated. Gingival sulcus index and serum inflammatory cytokines before and after treatment in the two groups were detected and compared. Results: When compared with before treatment, the periodontal soft tissue swelling, tooth mobility, and periapical pain scores after treatment in the two groups were significantly reduced, and those in the treatment group were significantly lower than those in the control group. When compared with before treatment, the gingival sulcus bleeding index 1 and 2 courses after treatment in the two groups was significantly reduced, and that 2 courses after treatment was significantly lower than that after 1 course treatment. The gingival sulcus bleeding index 1 and 2 courses after treatment in the treatment group was significantly lower than that in the control group. When compared with before treatment, the serum IL-8 and IL-6 levels after treatment in the two groups, and TNF-α level after treatment in the treatment group were significantly reduced, and the above indicators in the treatment group were significantly lower than those in the control group. Conclusions: The neurogrowth factors in the treatment of gingival pain and swelling in patients with dental pulp necrosis after root canal therapy can effectively improve the clinical symptoms, and inhibit the inflammatory reaction, with a significant efficacy.