Small High-Risk Uveal Melanomas Have a Lower Mortality Rate

Our aim was to determine whether size impacts on the difference in metastatic mortality of genetically high-risk (monosomy 3) uveal melanomas (UM). We undertook a retrospective analysis of data from a patient cohort with genetically characterized UM. All patients treated for UM in the Liverpool Ocular Oncology Centre between 2007 and 2014, who had a prognostic genetic tumor analysis. Patients were subdivided into those with small (≤2.5 mm thickness) and large (>2.5 mm thickness) tumors. Survival analyses were performed using Gray rank statistics to calculate absolute probabilities of dying as a result of metastatic UM. The 5-year absolute risk of metastatic mortality of those with small monosomy 3 UM was significantly lower (23%) compared to the larger tumor group (50%) (p = 0.003). Small disomy 3 UM also had a lower absolute risk of metastatic mortality (0.8%) than large disomy 3 UM (6.4%) (p = 0.007). Hazard rates showed similar differences even with lead time bias correction estimates. We therefore conclude that earlier treatment of all small UM, particularly monosomy 3 UM, reduces the risk of metastatic disease and death. Our results would support molecular studies of even small UM, rather than ‘watch-and-wait strategies’

Spontaneous Necrosis of a Large Choroidal Melanoma: Unusual Presentation in a 49-Year-Old Male

PurposeTo demonstrate a case of massive vitreous haemorrhage obscuring the underlying diagnosis of a large mixed-cell choroidal melanoma which had undergone spontaneous necrosis.Case reportA 49-year-old man in good general health suddenly lost vision in his right eye due to an extensive vitreous haemorrhage 1 day after a workout at the gym. He reported good vision prior to that without any symptoms of flashes, floaters, or shadows. He was referred to the vitreoretinal department of a tertiary eye hospital, where he presented with a drop in vision to light perception only in the right phakic eye. Pars plana vitrectomy was performed in the right eye, which revealed intraoperatively massive retinal ischemia and choroidal haemorrhage, but no obvious tumour mass that could have been biopsied. The vitrectomy cassette specimen was sent for histopathology, where "ghost-like" melanoma cells were identified. The eye was subsequently enucleated, revealing an extensively necrotic and haemorrhagic choroidal melanoma of mixed cell type with only small viable tumour foci at the base and almost complete lysis of the detached retina.ConclusionSome uveal melanomas (UMs) undergo spontaneous necrosis due to rapid growth, with the centre of the tumour outstripping its established blood supply in the "watershed area" of the eye, and becoming hypoxic with associated necrosis of intraocular structures. Such UMs are often associated with haemorrhage and/or inflammation and usually cause significant destruction of ocular tissues, resulting in enucleation as the only treatment option

A generalized Dynamic Energy Budget model including 3D shape changes for modeling small pelagic fish growth

International audienceUnderstanding pelagic fish growth patterns from early life stages to adulthood is fundamental to accurately predict larval survival and predator-prey dynamics, which are influenced by individual size. Dynamic Energy Budget (DEB) models constitute useful tools to predict and explain these patterns in changing environments. In DEB models, fish individuals are usually assumed to grow either isomorphically, or to experience a metabolic acceleration phase between birth (b) and metamorphosis (j), during which the shape coefficient changes and both the maximum surface-area specific assimilation rate and the energy conductance are multiplied by a metabolic acceleration coefficient function of structural length. Here we propose a different growth model based on a Dynamic Energy Budget model (modified as in Maury, 2019 to properly account for the size-dependence of maintenance) that captures deviations from pure isomorphy, allowing length and width to grow non-proportionally. Our model represents the fish’s structural body as an ellipsoid and differentially allocates volumetric growth to length, height and width as a function of the distance between the current shape and characteristic stage-dependent shape attractors (expressed as width/length and height/width ratios). The resulting changes of the structural surface-to-volume ratios due to changing shape mechanistically explain the “metabolic acceleration” phenomenon that is often invoked to interpret early life growth patterns. We estimated model parameters for the European anchovy Engraulis encrasicolus, using data covering growth at all life-stages, observed shapes at early life stages, transitions between life-stages, and reproduction. The calibrated model accurately reproduces the observed deviations from isomorphy, with exponential length-dominated growth until metamorphosis, then a shift to height- and width-dominated growth (with a corresponding deceleration of growth in length) until the adult shape is reached, and finally isomorphic (characteristic von Bertalanffy) length growth. These deviations from the usual von Bertalanffy growth model could profoundly affect our understanding of larval survival, predator-prey and ecosystem-dynamics

A generalized Dynamic Energy Budget model including 3D shape changes for modeling small pelagic fish growth

Understanding pelagic fish growth patterns from early life stages to adulthood is fundamental to accurately predict larval survival and predator-prey dynamics, which are influenced by individual size. Dynamic Energy Budget (DEB) models constitute useful tools to predict and explain these patterns in changing environments. In DEB models, fish individuals are usually assumed to grow either isomorphically, or to experience a metabolic acceleration phase between birth (b) and metamorphosis (j), during which the shape coefficient changes and both the maximum surface-area specific assimilation rate and the energy conductance are multiplied by a metabolic acceleration coefficient function of structural length. Here we propose a different growth model based on a Dynamic Energy Budget model (modified as in Maury, 2019 to properly account for the size-dependence of maintenance) that captures deviations from pure isomorphy, allowing length and width to grow non-proportionally. Our model represents the fish’s structural body as an ellipsoid and differentially allocates volumetric growth to length, height and width as a function of the distance between the current shape and characteristic stage-dependent shape attractors (expressed as width/length and height/width ratios). The resulting changes of the structural surface-to-volume ratios due to changing shape mechanistically explain the “metabolic acceleration” phenomenon that is often invoked to interpret early life growth patterns. We estimated model parameters for the European anchovy Engraulis encrasicolus, using data covering growth at all life-stages, observed shapes at early life stages, transitions between life-stages, and reproduction. The calibrated model accurately reproduces the observed deviations from isomorphy, with exponential length-dominated growth until metamorphosis, then a shift to height- and width-dominated growth (with a corresponding deceleration of growth in length) until the adult shape is reached, and finally isomorphic (characteristic von Bertalanffy) length growth. These deviations from the usual von Bertalanffy growth model could profoundly affect our understanding of larval survival, predator-prey and ecosystem-dynamics

Retinal and vitreous metastases from hepatocholangiocarcinoma.

BACKGROUND To report a case of metastatic hepatocholangiocarcinoma to the vitreous and retina. CASE PRESENTATION A 70-year-old male, who was recently diagnosed with hepatocholangiocarcinoma, was complaining of floaters in his right eye over the past 5 months and was referred to the Liverpool Ocular Oncology Centre. On presentation, his visual acuity in the right eye was 6/24. Fundus exam revealed a whitish, unilateral, full-thickness retinal lesion at the inferotemporal arcade of his right eye, with vitreous infiltration and subretinal fluid. The patient underwent 25G pars plana vitrectomy with biopsy, resection of the lesion and intravitreal bevacizumab injection. Histopathology testing of the surgical specimens confirmed the diagnosis of metastatic carcinoma to the eye. Two months postoperatively his visual acuity had improved to 6/7.5 and there was no sign of active disease in his right eye, while 9 months postoperatively his visual acuity decreased to 6/9.5 due to developing nuclear sclerotic cataract in his right eye. CONCLUSION The current report presents the first case of a hepatocholangiocarcinoma metastasis to the vitreous and retina

Intravitreal bevacizumab for retinal vein occlusion and early growth of epiretinal membrane: a possible secondary effect?

Aims To report the early development of epiretinal membranes (ERM) in eyes with retinal vein occlusions (RVO) treated with intravitreal bevacizumab and to describe possible mechanisms that may be involved in the growth and contraction of these lesions. Methods Retrospective and interventional study that included 25 eyes of 25 patients with RVO (16 eyes with central retinal vein occlusion and nine eyes with branch retinal vein occlusion). After an initial 2.5 mg/0.1 ml intravitreal bevacizumab injection all patients were followed-up every 6 weeks. Re-treatments were based on visual acuity and optical coherence tomography findings. Results Twenty-five eyes were treated with bevacizumab and followed for 8.3 (range 4.5-13.5) months. Four eyes developed an ERM within 6-7 weeks after the administration of bevacizumab. ERM was not associated with further deterioration of visual acuity or metamorphopsia in these patients. A rebound of macular oedema was observed in one patient with ERM and in two other patients. No other side effects were observed. Conclusions Intravitreal bevacizumab may be associated with an early growth of ERM in eyes with RVO, although a causative relationship cannot be established. Future randomised clinical trials are necessary to determine the efficacy and safety profile of this novel therapy

Reflux symptoms and vocal characteristics in adults with non-organic voice disorders

BACKGROUND : Laryngopharyngeal reflux (LPR) is prevalent and can lead to voice disorders, but its diagnosis is difficult, because of limited correlations between clinical symptoms and organic pathology. Various tools and methods have been explored to aid a diagnosis of LPR. OBJECTIVE : To investigate associations between reflux symptoms, acoustic-, perceptual-, and physical vocal characteristics, glottal function index (GFI), and vocal handicap index (VHI) in adults with non-organic voice disorders. METHODS : Data of 51 adults with non-organic voice disorders were collected, using a retrospective cohort explorative research design, at a private ear, nose and throat specialist practice in Gauteng, South Africa. Quantitative outcomes were compared between reflux symptom index (RSI), acoustic characteristics (jitter, shimmer and fundamental frequency [F0]), maximum phonation time, perceptual- (GRBASI) and physical vocal characteristics, GFI and VHI. RESULTS : The RSI showed positive fair correlations against GFI, VHIP and caffeine intake, indicating an increase in reflux symptoms with higher scores on the various measures. Moderate correlations were also found between GFI and VHIP, grade of hoarseness and jitter, strain and VHIP, strain and VHI total (VHIT) and between Asthenia and jitter. Very strong correlations were found within the various subsections of the VHI as well as between jitter and shimmer and between F0-male and physical symptoms of the VHI (VHIP). CONCLUSION : Results indicated associations between reflux symptoms, vocal characteristics, the GFI and the VHI. Based on the correlations found these tools used in conjunction could improve clinical diagnosis of LPR. Implications of these findings are promising, but further research is recommended. CONTRIBUTION : This study contributes to the body of knowledge to support the accurate clinical diagnosis of LPR using subjective measures to determine LPR symptoms, as well as acoustic analysis.http://www.sajcd.org.zaam2023Science, Mathematics and Technology EducationSpeech-Language Pathology and Audiolog

A generalized Dynamic Energy Budget model including 3D shape changes for modeling small pelagic fish growth

International audienceSmall pelagic fish (SPF) are key components of marine ecosystems, transporting energy from the lower to the upper trophic levels and thereby influencing the dynamics of the entire ecosystem. Understanding their complex growth patterns from early life stages to adulthood is fundamental to accurately predict larval survival and predator-prey dynamics, which are influenced by individual size. However, growth models are generally unable to accurately reproduce the growth acceleration and deceleration phases observed, particularly during early life stages. Here we propose a growth model based on a Dynamic Energy Budget model (modified as in Maury, 2019 to properly account for size-dependence of maintenance) that captures deviations from pure isomorphy. It represents the fish’s body as an ellipsoid and differentially allocates volumetric growth to length, height and width as a function of the distance between the current shape and characteristic stage-dependent shape attractors (expressed as width/length and height/width ratios). The resulting surface-to-volume ratios mechanistically explain the “metabolic acceleration” often invoked to explain early life growth patterns. We estimated model parameters for three important SPF species in the Benguela upwelling system, using data covering growth at all life-stages, transitions between life-stages, and reproduction. The calibrated models reproduced the observed deviations from isomorphy, with exponential length-dominated growth until metamorphosis, then a shift to height- and width-dominated growth (with a corresponding deceleration of length growth) until the adult shape is reached, and finally isomorphic (characteristic von Bertalanffy) length growth. These deviations from the usual von Bertalanffy growth model could profoundly affect our understanding of larval survival, predator-prey and ecosystem-dynamic

A generalized Dynamic Energy Budget model including 3D shape changes for modeling small pelagic fish growth

Small pelagic fish (SPF) are key components of marine ecosystems, transporting energy from the lower to the upper trophic levels and thereby influencing the dynamics of the entire ecosystem. Understanding their complex growth patterns from early life stages to adulthood is fundamental to accurately predict larval survival and predator-prey dynamics, which are influenced by individual size. However, growth models are generally unable to accurately reproduce the growth acceleration and deceleration phases observed, particularly during early life stages. Here we propose a growth model based on a Dynamic Energy Budget model (modified as in Maury, 2019 to properly account for size-dependence of maintenance) that captures deviations from pure isomorphy. It represents the fish’s body as an ellipsoid and differentially allocates volumetric growth to length, height and width as a function of the distance between the current shape and characteristic stage-dependent shape attractors (expressed as width/length and height/width ratios). The resulting surface-to-volume ratios mechanistically explain the “metabolic acceleration” often invoked to explain early life growth patterns. We estimated model parameters for three important SPF species in the Benguela upwelling system, using data covering growth at all life-stages, transitions between life-stages, and reproduction. The calibrated models reproduced the observed deviations from isomorphy, with exponential length-dominated growth until metamorphosis, then a shift to height- and width-dominated growth (with a corresponding deceleration of length growth) until the adult shape is reached, and finally isomorphic (characteristic von Bertalanffy) length growth. These deviations from the usual von Bertalanffy growth model could profoundly affect our understanding of larval survival, predator-prey and ecosystem-dynamic