ABSTRACT
·AIM: To explore whether the drainage angle could be reopened by surgery in patients with severe acute angle-closure glaucoma at " the greatest degree " of angle closure, and to study the treatment methods, such as double-paracentesis, phacoemulsification combined with goniosychialysis, and the effectiveness. ·METHODS: Retrospective observational case series. From November 2008, to November 2015, there were 33 patients with severe acute angle-closure glaucoma and 360° angle closure. Drug treatment showed no effect on them, so initial double-paracentesis ( anterior chamber paracentesis combined with vitreous paracentesis ) was applied. Then, either phacoemulsification combined with goniosychialysis or trabeculectomy surgery was performed after 7-14d, which was chosen based on the result of gonioscope during the surgery. The intraocular pressure, angle changes, and complications were observed. The follow-up period was 6mo to 3a. ·RESULTS: Of 33 participants enrolled, 32 had normal intraocular pressure after " double-paracentesis" ( 2 had normal intraocular pressure after laser peripheral iridotomy ). The mean intraocular pressure was significantly reduced from 53. 4 ± 10. 7mmHg to 16. 9 ± 13. 2mmHg ( t= 9. 21, P<0. 001 ) by applying " double-paracentesis", and 1 still had higher intraocular pressure. The mean intraocular pressure ( 16. 7 ± 4. 8mmHg ) was 0. 2mmHg lower after phacoemulsification than after" double- paracentesis " while there was no significant difference (t=0. 38,P>0. 05). One patient had abnormal intraocular pressure until 30d after phacoemulsification. Every participant had 360° angle closed before " double-paracentesis", 32 patients had opened angle ( mean 131. 8°± 111. 3°) after " double-paracentesis " and mean (228. 6°± 108. 3°) during phacoemulsification, and mean (234. 6°± 107. 2°) at 3mo after phacoemulsification. There was a significant difference between the post -paracentesis and intraoperative values ( t = 4. 52, P <0. 001 ). There was no difference between the intraoperative and postoperative values ( t = 0. 46, P>0. 05). No patients had serious adverse events. · CONCLUSION: For the " maximum degree " angle closure of severe acute angle-closure glaucoma, "double-paracentesis" combined with phacoemulsification can be chosen to open the angle gradually, and reduce intraocular pressure in vast majority of patients.
ABSTRACT
OBJECTIVE@#To develop a sensitive and accurate assay for detecting cinobufagin and resibufogenin in liver tissue using high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS).@*METHODS@#The homogenization of liver tissue with internal standard dexamethasone was extracted with dichloromethane. The extracts with methanol were purified through ProElut C18 solid phase extraction and tested in positive electrospray ionization with multiple reaction monitoring of HPLC-MS/MS.@*RESULTS@#The good linear relationship of cinobufagin and resibufogenin in liver tissue were 1-204 ng/g and 1-206 ng/g, respectively. The minimal detection threshold (S/N > or = 3) of this method was 0.3 ng/g for both cinobufagin and resibufogenin. The matrix effect was 96.5%-126.7%. The extraction recovery coefficient was 70.0%-82.3%. The precision of intra-day and inter-day was less than 10%.@*CONCLUSION@#This method is sensitive and reliable, and can be used in forensic toxicological analysis.
Subject(s)
Humans , Bufanolides/poisoning , Chromatography, High Pressure Liquid/methods , Forensic Toxicology , Liver/chemistry , Sensitivity and Specificity , Solvents/chemistry , Tandem Mass Spectrometry/methods , Tissue DistributionABSTRACT
OBJECTIVE@#To establish a method for determination of strychnine and brucine in formaldehyde fixed tissue by LC-MS/MS analysis.@*METHODS@#The samples were pretreated with solid phase extraction using SCX cartridges and separated on SB-C18 column with mobile phase 0.1% formic acid : 0.1% formic acid-acetonitrile (75:25). Electrospray ionization (ESI) source was utilized and operated in positive ion mode. Multiple reactions monitoring (MRM) mode was applied. External standard method was applied for quantitation.@*RESULTS@#The chromatographic separation of strychnine and brucine in formaldehyde fixed nephritic and hepatic tissues resulted successfully. The standard curve was linear in the range of 0.002-2.0 microg/g for strychnine and brucine in formaldehyde fixed tissues, and the correlation coefficient was more than 0.996. The limits of detection (LOD) of strychnine and brucine in nephritic tissues were 0.06ng/g and 0.03 ng/g, respectively. The LOD of both chemicals were 0.3 ng/g in hepatic tissues. The extraction recovery rate was more than 74.5%. The precision of intra-day and inter-day were both less than 8.2%.@*CONCLUSION@#Strychnine and brucine can be sensitive to be determined in formaldehyde fixed tissue by LC-MS/MS analysis. It can be applied in the forensic toxicological analysis.