Vitreous inflammatory factors and serous retinal detachment in central retinal vein occlusion: a case control series

<p>Abstract</p> <p>Background</p> <p>This study investigated whether the vitreous fluid levels of soluble vascular endothelial growth factor receptor-2 (sVEGFR-2), pigment epithelium-derived factor (PEDF), and soluble intercellular adhesion molecule 1 (sICAM-1) were associated with the occurrence of serous retinal detachment (SRD) in patients with central retinal vein occlusion (CRVO).</p> <p>Methods</p> <p>We recruited 33 patients with CRVO and macular edema, as well as 18 controls with nonischemic ocular diseases. Eighteen of the 33 patients with CRVO showed SRD on optical coherence tomography of the macula (defined as subretinal accumulation of fluid with low reflectivity), while the other 15 patients only had cystoid macular edema (CME, defined as hyporeflective intraretinal cavities). Retinal ischemia was evaluated by measuring the area of capillary non-perfusion using fluorescein angiography and the public domain Scion Image program, while central macular thickness (CMT) was examined by optical coherence tomography. Vitreous fluid samples were obtained during pars plana vitrectomy and levels of the target molecules were measured by enzyme-linked immunosorbent assay.</p> <p>Results</p> <p>Ischemia was significantly more common in the SRD group (17/18 patients) than in the CME group (5/15 patients) (<it>P </it>< 0.001). The vitreous fluid level of sICAM-1 increased significantly across the three groups from the control group (4.98 ± 1.73 ng/ml) to the CME group (15.4 ± 10.1 ng/ml) and the SRD group (27.1 ± 17.7 ng/ml) (<it>p_trend</it>< 0.001). The vitreous fluid level of sVEGFR-2 also showed a significant increase across the three groups (1083 ± 541 pg/ml, 1181 ± 522 pg/ml, and 1535 ± 617 pg/ml, respectively, <it>p_trend</it>= 0.019). On the other hand, the vitreous fluid level of PEDF showed a significant decrease across the three groups (56.4 ± 40.0 ng/ml, 24.3 ± 17.3 ng/ml, and 16.4 ± 12.6 ng/ml, respectively, <it>p_trend</it>< 0.001).</p> <p>Conclusions</p> <p>Higher levels of inflammatory factors (sICAM-1 and sVEGFR-2) and lower levels of anti-inflammatory PEDF were observed in macular edema patients with SRD, suggesting that inflammation plays a key role in determining the severity of CRVO.</p

Heterochronous Adrenal Metastasis from Intrahepatic Cholangiocarcinoma: Report of a Case

We herein report a case of laparoscopic adrenalectomy for solitary adrenal metastasis from intrahepatic cholangiocarcinoma (ICC). Although the treatment of extrahepatic metastasis from primary liver tumors is essentially palliative, solitary metastasis from such tumors offers the possibility of a cure by surgical resection. The adrenal gland is an uncommon site for metastasis from ICC. A patient who had received a right hepatic lobectomy with lymph node resection for ICC later developed a heterochronous adrenal metastasis, and thus underwent laparoscopic adrenalectomy 30 months after the liver resection. To the best of our knowledge, this is the first case of adrenalectomy for heterochronous metastasis from ICC

Energy Transfer between Throats from a 10d Perspective

Strongly warped regions, also known as throats, are a common feature of the type IIB string theory landscape. If one of the throats is heated during cosmological evolution, the energy is subsequently transferred to other throats or to massless fields in the unwarped bulk of the Calabi-Yau orientifold. This energy transfer proceeds either by Hawking radiation from the black hole horizon in the heated throat or, at later times, by the decay of throat-localized Kaluza-Klein states. In both cases, we calculate in a 10d setup the energy transfer rate (respectively decay rate) as a function of the AdS scales of the throats and of their relative distance. Compared to existing results based on 5d models, we find a significant suppression of the energy transfer rates if the size of the embedding Calabi-Yau orientifold is much larger than the AdS radii of the throats. This effect can be partially compensated by a small distance between the throats. These results are relevant, e.g., for the analysis of reheating after brane inflation. Our calculation employs the dual gauge theory picture in which each throat is described by a strongly coupled 4d gauge theory, the degrees of freedom of which are localized at a certain position in the compact space.Comment: 25 pages; a comment adde

Cyclooxygenase-2 is Involved in the Progression of Thyroid Cancer

Although the inducible form of cyclooxygenase (COX), COX-2, is highly expressed in various cancers and it is also involved in cancer progression, its role in thyroid cancer is not fully understood. We assessed in the situ cyclooxygenase expression in normal thyroids (n=6), Graves\u27 thyroids (n=6), thyroid adenomas (n=12), thyroid follicular (n=15) and papillary carcinomas (n=30). In comparison to the constitutive expression of COX-1, COX-2 was highly expressed in thyroid cancers (90.0% of thyroid papillary carcinomas and 73.3% of thyroid follicular carcinomas) and moderately in thyroid adenomas (25.5%), but barely expressed in normal and Graves\u27 thyroid tissues. This quantitative assessment employed immunohistochemical methods. Thereafter we compared the effect of COX-2 inhibition on a human follicular thyroid carcinoma cell line (WRO), and a human papillary carcinoma cell line (NPA), using selective COX-2 inhibitor(NS-398). The treatment with 50 μM NS-398 suppressed the growth of the COX-2 expressing cells, NPA cells (37.7%;p<0.01) and WRO cells (10.1%;p<0.05). Moreover, at concentrations ? 100 μM, NS-398 induced cell death a mitochondrial dysfunction. In addition, 50 μM of NS-398 inhibited the activation of extracellular signal-regulated kinase in NPA cells after the stimulation with fetal bovine serum. Our results indicate that COX-2 is involved in the progression of thyroid cancer

Gravitational Instantons and Moduli Spaces of Topological 2-form Gravity

A topological version of four-dimensional (Euclidean) Einstein gravity which we propose regards anti-self-dual 2-forms and an anti-self-dual part of the frame connections as fundamental fields. The theory describes the moduli spaces of conformally self-dual Einstein manifolds for the non-zero cosmological constant case and Einstein-Kahlerian manifold with the vanishing real first Chern class for the zero cosmological constant. In the non-zero cosmological constant case, we evaluate the index of the elliptic complex associated with the moduli space and calculate the partition function. We also clarify the moduli space and its dimension for the zero cosmological constant case which are related to the Plebansky's heavenly equations.Comment: 36pages, LaTex, TIT/HEP-247/COSMO-4

Diagnosis of Lumbar Foraminal Stenosis using Diffusion Tensor Imaging

Diagnosis of lumbar foraminal stenosis remains difficult. Here, we report on a case in which bilateral lumbar foraminal stenosis was difficult to diagnose, and in which diffusion tensor imaging (DTI) was useful. The patient was a 52-year-old woman with low back pain and pain in both legs that was dominant on the right. Right lumbosacral nerve compression due to a massive uterine myoma was apparent, but the leg pain continued after a myomectomy was performed. No abnormalities were observed during nerve conduction studies. Computed tomography and magnetic resonance imaging indicated bilateral L5 lumbar foraminal stenosis. DTI imaging was done. The extraforaminal values were decreased and tractography was interrupted in the foraminal region. Bilateral L5 vertebral foraminal stenosis was treated by transforaminal lumbar interbody fusion and the pain in both legs disappeared. The case indicates the value of DTI for diagnosing vertebral foraminal stenosis

Discrimination between Lumbar Intraspinal Stenosis and Foraminal Stenosis using Diffusion Tensor Imaging Parameters: Preliminary Results

Study DesignRetrospective observational study.PurposeTo examine fractional anisotropy (FA) values and apparent diffusion coefficient (ADC) values of damaged nerves to discriminate between lumbar intraspinal stenosis (IS) and foraminal stenosis (FS) using diffusion tensor imaging (DTI)Overview of LiteratureIt is important in the selection of surgical procedure to discriminate between lumbar IS and FS, but such discrimination is difficult.MethodsThere were 9 cases of IS, 7 cases of FS, and 5 healthy controls. The regions of interest were established in the lumbar intraspinal zone (Iz), nerve root (N), and extraforaminal zone (Ez). The FA and ADC values were measured on the affected and unaffected sides of the nerves. The FA ratio and the ADC ratio were calculated as the affected side/unaffected side ×100 (%).ResultsIn the Ez, the FA value was significantly lower in FS than in IS (p<0.01). FA ratio was significantly lower in FS than in IS for the Ez (p<0.01). In the Iz, the ADC value was significantly higher in IS than FS (p<0.01). ADC ratio was significantly higher in FS than in IS for the N and Ez (p<0.05). For the Ez, receiver operating characteristic analysis of parameters revealed that the FA values showed a higher accuracy for the diagnosis of FS than the ADC values, and the FA value cut-off value was 0.42 (sensitivity: 85.7%, false positive: 11.1%) and the FA ratio cut-off value was 83.9% (sensitivity: 85.7%, false positive: 22.2%).ConclusionsThe low FA value in the extraforaminal zone suggests the presence of foraminal stenosis. When the FA value and FA ratio cut-off value were established as 0.42 and 83.9%, respectively, the accuracy was high for the diagnosis of foraminal stenosis. It may be possible to use DTI parameters to help in the discrimination between IS and FS

Visual acuity and foveal thickness after vitrectomy for macular edema associated with branch retinal vein occlusion: a case series

Abstract Background The mechanism by which vitrectomy improves macular edema in patients with branch retinal vein occlusion remains unclear, although intraocular levels of vascular endothelial growth factor have been suggested to influence the visual prognosis and macular edema. Methods A series of 54 consecutive patients (54 eyes) with branch retinal vein occlusion was studied prospectively. All patients underwent pars plana vitrectomy for treatment of macular edema. Best corrected visual acuity and retinal thickness (examined by optical coherence tomography) were assessed before and after surgery. The level of vascular endothelial growth factor in vitreous fluid harvested at operation was determined. Patients were followed for at least 6 months postoperatively. Results Both the visual acuity and the retinal thickness showed significant improvement at 6 months postoperatively (P = 0.0002 and P Conclusions These results suggest that the vitreous level of vascular endothelial growth factor might influence the visual prognosis and the response of macular edema to vitrectomy in patients with branch retinal vein occlusion.</p