Fibrin glue assisted amniotic membrane graft reconstruction of conjunctival fornix and canthus following excision of conjunctival tumours

Conjunctival tumors involving non?limbal locations, such as the fornix and canthus, are typically excised using a “non?touch” technique, often with a wide surgical margin. Reconstruction of these large defects can be difficult due to the contour of the ocular surface and are often complicated by shortening of the fornix, symblepharon formation, and restriction of eye movements. In our experience, the use of amniotic membrane grafts combined with the sealant properties of fibrin glue such as Tisseel® has improved our surgical outcomes during the reconstruction phase. We would like to highlight and describe our surgical technique using fibrin glue and squint hooks to aid amniotic membrane graft reconstruction for surgically challenging locations in the fornix and canthus following excision of conjunctival lesions, with excellent surgical outcomes.

Right fornix column infarction: a case report / 中华神经科杂志

Isolated fornix infarction is very rare in cerebral infarction. A case of right column fornix infarction with acute anterograde amnesia as the only manifestation who was diagnosed in the Fifth Affiliated Hospital of Sun Yat-Sen University in March 2020 was presented. The clinical symptoms were the inability to recall recent events, repeated speech. Head magnetic resonance suggested right fornix column infarction and diffusion tensor imaging showed reduction of right fornix fiber bundles. The symptoms improved significantly after conventional treatment of cerebral infarction and improving intelligence treatment.

The association between the duration of using ocular prosthesis and upper and lower conjunctival fornix depth

Background: Ocular prosthesis is needed to replace the content of eyeball lost due to several factors. Adequate retention of ocular prosthesis requires an adequate upper and lower conjunctival fornix depth. Objectives: The objectives of the study were to evaluate the association between the duration of using ocular prosthesis and upper and lower conjunctival fornix depth. Materials and Methods: A case–control study was conducted in 30 anophthalmic socket patients aged 22–77 that using ocular prosthesis more than 6 months. The contralateral eye with healthy socket was chosen as a control group. Upper and lower conjunctival fornix depth were measure using fornicometer. We design a fornix depth measurer for objective measurement of upper and lower conjunctival fornix depth. Results: From 30 anophthalmic socket patients, males were about 14 times more often than female, with the average age that was 51. The mean upper conjunctival fornix depth in males was 10.8 ± 0.6 and lower conjunctival fornix depth was 6.2 ± 0.8. The mean upper conjunctival fornix depth in females was 10.80± 0.6 and lower conjunctival fornix depth was 5.5 ± 0.7. There is medium relationship between upper conjunctival fornix depth and the duration of using prosthesis (cc = −0.435; P = 0.016) and there is high relationship between lower conjunctival fornix depth and the duration of using prosthesis (cc = −0.551; P = 0.002). Conclusions: There was a significant association between the duration of using ocular prosthesis and upper and lower conjunctival fornix depth.

New superior modified fornix-based twin-site phacotrabeculectomy

Phacotrabeculectomy is the preferred surgical management of coexisting visually significant cataract and moderate to advanced glaucoma. We report the surgical technique of a new modified fornix-based separate-site phacotrabeculectomy, with mitomycin C (MMC) application, in both primary open angle and angle closure glaucoma. In this new separate-site technique, both phaco and filtration are accommodated superiorly, side by side, hence called twin-site. This was achieved in an efficacious and safe manner with sparing of limbal stem cells without compromising safety. It is not only MMC-compatible but also has a low incidence of wound leak. The technique has no adverse consequence on the survival of the bleb, and we achieved complete success in 79.2% and total success in 93.1% in 130 eyes of 117 patients, in the intermediate term. Furthermore, the time taken for this separate-site surgical technique is comparable to published one-site procedures.

Comparison of Fornix and Stria Terminalis Connectivity among First-Episode Schizophrenia, Chronic Schizophrenia and Healthy Controls

OBJECTIVES: Disrupted integrities of the fornix and stria terminalis have been suggested in schizophrenia. However, very few studies have focused on the fornix and stria terminalis comparing first-episode schizophrenia (FESZ), chronic schizophrenia (CS), and healthy controls (HCs) with the application of diffusion-tensor imaging (DTI) technique. The objective of this study is to compare the connectivity of the fornix and stria terminalis among FESZ, CS, and HCs. METHODS: We included the 44 FESZ patients, 39 CS patients and 20 HCs in this study. Voxel-wise statistical analysis of the fractional anisotropy (FA) data was performed using Tract-Based Spatial Statistics to analyze the connectivity of fornix and stria terminalis. In addition, the Scale for the Assessment of Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms (SANS) were used to evaluate clinical symptom severities. RESULTS: There were no significant differences between the FESZ, CS, and HCs in age, sex, education years. The SAPS and SANS scores of the schizophrenia groups showed no significant differences. FA values of the right fornix cres/stria terminalis in the CS group were significantly lower than those in FESZ and HCs. There were no significant differences of FA values of the right fornix cres/stria terminalis between the FESZ and the HCs. Pearson correlation analyses revealed that significant correlation between FA values of the right fornix cres/stria terminalies of the the FESZ group and positive, negative symptom scales, and FA values of the right fornix cres/stria terminalis of the CS group and negative symptom scales. CONCLUSIONS: This study shows that FA values of the fornix and stria terminalis in the CS were lower than in the FESZ and the HCs. These results suggest that the fornix and stria terminalis can play a role in pathophysiology of schizophrenia. Thus current study can broaden our understanding of the pathophysiology of schizophrenia.

Comparison between ropivacaine and bupivacaine in deep topical fornix nerve block anesthesia in patients undergoing cataract surgery by phacoemulsification

Purpose: In this study, we intend to analyze ropivacaine and bupivacaine in various parameters during phacoemulsification under deep topical fornix nerve block (DTFNB), a known form of nerve block for phacoemulsification. Methods: This prospective randomized study was conducted on 100 patients undergoing elective cataract surgery by phacoemulsification under DTFNB. Patients were divided into two equal groups of fifty patients each, Groups B (bupivacaine) and Group R (ropivacaine). Two sponges, approximately 2 mm × 3 mm dimensions, saturated with either 0.5% bupivacaine or 0.75% ropivacaine were placed deep in the conjunctival fornices to perform the deep topical block. Both groups were evaluated for magnitude of pain and discomfort at various stages of phacoemulsification using a simple pain scoring system. The level of surgeon satisfaction, requirement for supplementary anesthesia, and surgical complications were also evaluated. Quantitative variables between the two groups were compared using unpaired t-test. Qualitative variables were correlated using Chi-square test. Results: Overall demographic parameters of patients were similar in both groups. Similar mean pain scores were found in the ropivacaine and bupivacaine groups, with no statistical significance. Surgical satisfaction and the need for supplemental anesthesia were also statistically insignificant. Conclusion: Ropivacaine is a good alternative for deep topical anesthesia as it has a better safety margin and lesser toxic effect than other comparable local anesthetic agents.

Fornix infarction / 国际脑血管病杂志

Fornix infarction is a kind of cerebral infarction in special sites with memory disorder as its main manifestation, which is rare in clinical practice. Because the isolated fornix infarction is not often accompanied by obvious positive signs of nervous system, the patients complained fewer symptoms. The related manifestations were mostly provided by family members, which is prone to misdiagnosis and missed diagnosis. This article reviews fornix infarction from the aspect of anatomy, blood supply, infarction etiology, clinical manifestations, possible mechanisms, and imaging features by summarizing the available case reports.

Observation of modified fornix-based approach for minimal incision surgery in the treatment of children with the horizontal strabismus / 眼科新进展

Objective To evaluate the modified foruix-based technique with Guyton hook as an approach for the treatment of children with horizontal strabismus.Methods The clinical data of 128 patients (170 eyes) who underwent horizontal strabismus surgery between January 2014 and June 2017 were retrospectively reviewed,including 60 males and 68 females.The mean age was 1.5-17.0 (6.5 ± 1.6) years.All procedures under general anesthesia were performed using the modified fornix-based conjunctival incision with Guyton hook,and the follow-up period was 6 to 12 months.The clinical and cosmetic outcomes of strabismus surgery,the complications and interventions related to the incision were assessed.Results At 3 months after surgery,orthophoria with excellent cosmetics was achieved in 119 patients (93％) with the deviation ≤ ± 10△.Together 102 eyes (60％) had no intraoperative suture.Moreover,the incision was sutured with one stitch in 45 eye (26.5％),in 20 (11.8％) with 2 stitches,and in 3 (1.8％) with 3 stitches.During the follow up period,there was no severe intraoperative or postoperative complications.The swelling and redness of conjunctiva recovered quickly.Patients' discomfort was alleviated in a few days after the surgery.No oblivious scarring was found along the incision lines.Conclusion The modified fornix-based approach with Guyton hook is an effective and safe method for minimal incision surgery in children with horizontal strabis.

Clinical application of autologous auricular cartilage in nasal tip plasty / 中华医学美学美容杂志

Objective To observe and discuss the application and clinical effect of different forms of ear cartilage in nasal tip plasty.Methods Auricular cartilage was used to prune it as "halberd" shape at first,and then the extended transplantation and the cartilage fornix reconstruction were carried out by using single or combined septum cartilage.Meanwhile,nasal tip plasty was performed by using "cap shape" or "shield shape" cartilage grafting.Results 136 patients were followed up for 6 to 24 months after operation.119 cases were satisfied,accounting for 87.5％,of which 11 cases (ear cartilage weakness) were not improved obviously,accounting for 8％.However,there were only 6 cases with the unsatisfactory feedback as the nasal tip that was decreased by 1～2 mm one year after the operation,accounting for 4.41％.Conclusions The auricular cartilage is pruned as "halberd" shape singly or combined with septal cartilage as an extended graft,reconstructing the cartilage fornix in the meantime,which is the way better than the traditional way of making nasal tip plasty to obtain the ideal nasal tip protrusion.

Fear memory and heart rate and blood pressure during conditioned fear in rats with hippocampal lesion or fimbria-fornix transection / 中华行为医学与脑科学杂志

Objective To investigate the effects of dorsal hippocampal lesions (DH) or fimbria-fornix transection (FF) on the learning and memory of conditioned fear and the heart rate and blood pressure in rats.Methods Nineteen male adult Wistar rats were used in this experiment.They were implanted telemetry sensors in their abdominal aortas.Two week later,six of the rats were subjected to permanent NMDA-induced neurotoxic lesions to the dorsal hippocampus (DH) and seven for the fimbria-fornix transection (FF)through stereotactic brain surgery,the left six were treated with saline as the control (Sham).All rats were subjected to a conditioned fear experiment.Meanwhile,changes in heart rate and blood pressure were measured.Results There was no significant difference in heart rate and blood pressure among the rats with the hippocampal operation or fimbria-fornix transection.In the acquisition of conditioned fear,there were significant difference in freezing time among the three group in both inter-trial-interval (ITI) and conditioned stimulus (CS) process (all P＜0.05).The freezing time of the FF group showed significantly lower than that of the Sham group (P＜0.05).There was no significant difference in heart rate and blood pressure among the three group(P＞0.05).In the test of conditioned contextual fear memory,the freezing time percentage in the FF group ((0.31±0.16) ％) significantly lower than that in the Sham group ((2.78± 1.23) ％) (P＜0.05)at the first 3 min of the test.There was a significant difference in heart rate among the three group.The heart rate of FF group ((436.42± 10.16) times/min) was significantly lower than that of the Sham group ((472.48±4.43) times/min,P＜0.01) and the DH group ((469.94 ±7.36)times/min,P＜0.01).In the test of conditioned tone fear memory.The freezing time percentage in FF group ((18.78±6.29) ％) was significantly lower than that in the Sham ((51.77±9.33)％,P＜0.01) and DH group ((59.19±8.13)％,P＜0.01),but the freezing time percentage between the later two groups had no difference (P=0.52).The synchronous telemetry measurement showed there was no significant difference both in the heart rate and the blood pressure among the groups (all P＞0.05) during the conditioned tone test.Conclusion The dorsal hippocampal lesions and fimbria-fornix transection in rats can significantly reduce the learning and memory ability in conditioned fear and scene fear in rats,and the effect of fimbria-fornix transection is more obvious.The decrease in,fear memory is not synchronously reflected in heart rate and blood pressure in rats.

Acute Fornix Deep Brain Stimulation Improves Hippocampal Glucose Metabolism in Aged Mice / 中华医学杂志(英文版)

<p><b>Background</b>A beneficial memory effect of acute fornix deep brain stimulation (DBS) has been reported in clinical studies. The aim of this study was to investigate the acute changes in glucose metabolism induced by fornix DBS.</p><p><b>Methods</b>First, the Morris water maze test and novel object recognition memory test were used to confirm declined memory in aged mice (C57BL/6, 20-22 months old). Then, four groups of mice were used as follows: aged mice with stimulation (n = 12), aged mice with sham-stimulation (n = 8), adult mice (3-4 months old) with stimulation (n = 12), and adult mice with sham-stimulation (n = 8). Ipsilateral hippocampal glucose metabolism and glutamate levels were measured in vivo by microdialysis before, during, and after fornix DBS treatment. Histological staining was used to verify the localization of electrodes and mice with inaccurate placement were excluded from subsequent analyses. The effects of fornix DBS on extracellular glucose, lactate, pyruvate, and glutamate levels over time were analyzed by repeated-measures analysis of variance followed by Fisher's least significant difference post hoc test.</p><p><b>Results</b>The aged mice had a higher basal lactate/pyruvate ratio (LPR) and lactate/glucose ratio (LGR) than the adult mice (LPR: 0.34 ± 0.04 vs. 0.13 ± 0.02, t = 4.626, P < 0.0001; LGR: 6.06 ± 0.59 vs. 4.14 ± 0.36, t = 2.823, P < 0.01). Fornix DBS decreased the ipsilateral hippocampal pyruvate and lactate levels (P < 0.05), but the glucose levels were not obviously changed in aged mice. Similarly, the LGR and LPR also decreased in aged mice after fornix DBS treatment (P < 0.05). Glucose metabolism in adult mice was not significantly influenced by fornix DBS. In addition, fornix DBS significantly decreased the ipsilateral hippocampal extracellular levels of glutamate in aged mice (P < 0.05), while significant alterations were not found in the adult mice.</p><p><b>Conclusions</b>The present study provides experimental evidence that fornix DBS could significantly improve hippocampal glucose metabolism in aged mice by promoting cellular aerobic respiration activity.</p>

Role of amniotic membrane transplantation in symblepharon / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the use of amniotic membrane transplantation(AMT)in symblepharon.<p>METHODS: This non-comparative interventional case study was conducted from January 2013 to December 2015 and included a consecutive series of 14 eyes of 12 patients. Patients were selected for permanent AMT. The amniotic patches were grafted for the treatment of symblepharon. Cryo-preserved or freeze-dried amniotic membrane(AM)was used. Regarded to the 14 eyes(12 patients), their age was ranged from 26-62y, with the mean age of 43.38±11.25, 10 eyes of 8 patients(4 males/4 females)were presented with symblepharon secondary to previous pterygium surgery, and 4 eyes of 4 patients(1 male/3 females)were presented with symblepharon secondary to previous strabismus surgery, at least 6mo after the last surgery. The outcome of success was defined as restoration of a stable-depth fornix and being free of scar or inflammation, and no motility restriction during the follow up of 6mo.<p>RESULTS: The mean follow-up period was 7±4.2mo(range 6-9mo). In all 14 eyes, complete epithelialization of AM was observed 3wk after surgery, resulting in a non-inflamed appearance of the surgical site. Eight eyes out of total 14 eyes showed successful fornix reconstruction with success rate(57%), the fornix was deep, and no recurrence was observed. Four eyes(29%)showed partial success with moderate depth of the fornix and moderate scar. Two eyes(14%)showed failure of reconstruction of the fornix with complete fornix obliteration. The visual acuity improved after surgery in 7 eyes while remained stable in 7 eyes. Post-operative complications from the AMT was very limited as severe conjunctival reaction and motility restriction was occurred only in one eye out of 14 eyes(7%)and pyogenic granuloma occurred in 2 eyes out of 14 eyes(14%)in the first 3mo after surgery and was managed with surgical excision, with local corticosteroid injection.<p>CONCLUSION: AMT alone is a safe and effective method for symblepharon. Considering the potential adverse effects associated with limbal excision, also, AMT is an effective method of fornix reconstruction for the repair of symblepharon in a variety of ocular surface disorders.

Avaliação anatômica comparativa dos acessos transcorioideo e transforniceal transcorioideo ao terceiro ventrículo / Comparative anatomical assessment of transchoroidal approach and transforniceal transchoroidal approach to the third ventricle

O acesso ao terceiro ventrículo constitui verdadeiro desafio ao neurocirurgião. Nesse contexto, estudos anatômicos e morfométricos são úteis para estabelecer as limitações e as vantagens de determinado acesso cirúrgico. O acesso transcorioideo é versátil e promove exposição adequada da região média e posterior do terceiro ventrículo. Entretanto, a coluna do fórnice limita a exposição da região anterior do terceiro ventrículo. Há evidências de que a secção ipsilateral da coluna do fórnice tenha pouca repercussão na função cognitiva. Esta tese compara a exposição anatômica proporcionada pelo acesso transforniceal transcorioideo com o do acesso transcorioideo e realiza avaliação morfométrica de estruturas relevantes e comuns aos dois acessos. Material e métodos: A exposição anatômica proporcionada pelos acessos transcaloso transcorioideo e transcaloso transforniceal transcorioideo foram comparadas em oito cadáveres não submetidos à conservação, utilizando o sistema de neuronavegação (Artis, Brasília, Brasil), para aferir a área de trabalho, a área de exposição microcirúrgica, a exposição angular no plano longitudinal e transversal de dois alvos anatômicos (túber cinéreo e aqueduto cerebral). Adicionalmente, foram quantificados a espessura do parênquima do lobo frontal direito, a espessura do tronco do corpo caloso, o diâmetro longitudinal do forame interventricular, a distância de trabalho da superfície cortical ao túber cinéreo e a distância de trabalho da superfície cortical até o aqueduto cerebral. Os valores obtidos foram submetidos a análise de estatística utilizando o teste de Wilcoxon. Resultados: Na avaliação quantitativa, o acesso transforniceal transcorioideo proporcionou maior área de trabalho (transforniceal transcorioideo = 150,299 +/- 11,147 mm2; transcorioideo = 121,421 +/- 7,698 mm2; p < 0,05), maior área de exposição microcirúrgica (transforniceal transcorioideo = 100,920 +/- 8,764 mm2; transcorioideo = 79,944 +/- 4,954 mm2; p <...

Approaches to the third ventricle constitute a formidable challenge to the neurosurgeon and, in this context, anatomical and morphometric studies are useful to establish the limitations and advantages of certain surgical approaches. The transchoroidal approach is a versatile one that promotes adequate exposure of the middle and posterior regions of the third ventricle. However, the column of fornix limits the exposure of the anterior third ventricle region. There is evidence that the ipsilateral section of the column of fornix has little effect on the cognitive function. This thesis compares the anatomical exposure using the transchoroidal transforniceal technique with the transchoroidal approach, and performs morphometric assessment of relevant structures common to both approaches. Material and methods: The anatomical exposure achieved through the transchoroidal transcallosal approach and transchoroidal transforniceal transcallosal were compared in 8 fresh cadavers using the neuronavigation system (Artis, Brasilia, Brazil), to assess the working area, microsurgical exposure area, to quantify the angular exposure in the longitudinal and cross-sectional planes to two anatomical targets (tuber cinereum and cerebral aqueduct), to measure the thickness of the right frontal lobe parenchyma, corpus callosum body thickness, longitudinal diameter of the interventricular foramen, working distance from the cortical surface to the tuber cinereum and working distance from the cortical surface to the cerebral aqueduct. The values obtained were submitted to statistical analysis using Wilcoxon's test. Results: In the quantitative assessment, the transchoroidal transforniceal approach provided: larger working area (transchoroidal transforniceal = 150.299 +/- 11.147 mm2; transchoroidal = 121.421 +/- 7.698 mm2; p < 0.05), larger area of microsurgical exposure (transforniceal transchoroidal = 100.920 +/- 8.764 mm2; transchoroidal...

Cavidades anoftálmicas atípicas en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer" / Atypical anophthalmic cavities observed in patients seen at "Ramón Pando Ferrer" Cuban Institute of Ophthalmology

OBJETIVO: describir el comportamiento de las cavidades anoftàlmicas atípicas. MÉTODOS: se realizó un estudio descriptivo prospectivo en pacientes con cavidades anoftálmicas atípicas atendidos en la consulta de Cirugía Plástica Ocular, en el período de enero de 2009 a julio de 2010. Se analizaron diferentes variables como sexo, edad, alteraciones de la cavidad y tratamiento quirúrgico. RESULTADOS: del total de los pacientes vistos en la consulta, 57 % pertenecían al sexo masculino. El 43 % se encontraba entre los 30 y 49 años. El 90,2 % presentó alteraciones conjuntivales, y la de mayor representatividad fue la retracción del fornix inferior, con el 33,8 %. Dentro de las técnicas quirúrgicas, la reinserción conjuntival del fondo de saco fue la más utilizada y se realizó en el 38 % de los pacientes. CONCLUSIONES: el mayor número de pacientes vistos pertenecen al sexo masculino y al grupo de edades entre 30 y 49 años. Predominaron las alteraciones conjuntivales y dentro de ellas la retracción del fornix inferior. La técnica más utilizada fue la reinserción de la conjuntiva.

OBJECTIVE: to describe the behavior of atypical anophthalmic cavities. METHODS: aprospective and descriptive study was conducted in patients with atypical anophthalmic cavities seen in the ocular plastic surgery service from January 2009 to July 2010. The analyzed variables were sex, age, cavity abnormalities, and surgical treatment. RESULTS: of all patients seen, 57 % were males and 43 % were 30 to 49 years-old. In this group, 90,2 % had conjunctival anomalies, being the inferior fornix retraction the most significant with 33.8 %. Among the surgical techniques used, the conjunctival reinsertion of the fornix was the most performed in 38% of cases. CONCLUSIONS: the highest number of patients was males and the predominant age group was 30-49 years; conjunctival alterations were predominant, mainly the inferior fornix retraction. The most used technique was the reintegration of the conjunctiva.

A Case of Conjunctival Inclusion Cyst Managed with Marsupialization

PURPOSE: We present a case with conjunctival inclusion cyst at inferior fornix treated by marsupialization. CASE SUMMARY: A 23-year-old woman visited our clinic complaining of left lower eyelid swelling. Ophthalmologic examination and CT scan showed a cystic mass from inferior conjunctival fornix to anterior orbit with shallow fornix and focal symblepharon. The cyst was effectively removed with marsupializaion. Postoperatively, there was no recurrence of cyst and the fornix was deepened. CONCLUSIONS: Marsupialization can be a considerable treatment option in conjunctival inclusion cyst, especially when accompanied by shallow fornix and symblepharon.

Clinical evaluation of relationship between dry eye and bubbles in the inferior conjunctiva fornix / 中华实验眼科杂志

Background Instability of tear film,increase of ocular surface temperature and tear evaporation are the associated factors of both bubbles and dry eye.But the relationship between dry eye and ocular surface bubbles is unclear.The bubbles are easily retained and checked in the inferior conjunctiva fornix.Objective This study aimed to study the relationship between dry eye and bubbles in the inferior conjunctiva fornix.Methods Sixty-four eyes of 32 patients with binocular irritative symptoms and bubbles or without bubbles in the inferior conjunctiva fornix were collected in Affiliated Tianyou Hospital of Wuhan University of Science and Technology from January to May,2012.The bubbles in the inferior conjunctiva fornix were examined by slit lamp microscope,and the break-up time (BUT) and Schirmer Ⅰ test (S Ⅰ t) were performed.The differences of BUT and S Ⅰ t between the two groups were compared using independent sample t test,and abnormality rate of examination indexes was statistical analyzed by CHI-Square test using a SPSS 11.5 software.Written informed consent was obtained prior to the clinical survey.Results In the 64 eyes of the bubbles group,incidence of dry eye was 75.00％,and the incidence of both BUT＜5 seconds and S Ⅰ t＜5 mm/5 minutes was 46.88％ ;while the incidence of BUT＜5 seconds or S Ⅰ t＜5 mm/5 minutes was 53.13％ and 57.81％,respectively.In 64 eyes without bubbles,incidence of dry eye was 31.25％,the incidence of both BUT＜5 seconds and S Ⅰ t＜5 mm/5 minutes was 18.75％,that of BUT＜5 seconds or S Ⅰ t＜5 mm/5 minutes was 21.88％ and 20.31％,respectively.The incidences of dry eye,both BUT＜5 seconds and S Ⅰ t＜5 mm/5 minutes,BUT ＜5 seconds,S Ⅰ t＜5 mm/5 minutes were significantly higher in the bubbles group than those of the without bubbles group (all at P=0.00).In the 68 eyes determined as dry eyes,48 eyes (48/68) were in the bubbles group and 20eyes (20/68) were in the without bubbles group,showing a significant difference between the two groups (x2 =24.60,P＜0.01).The incidences of both BUT＜5 seconds,S Ⅰ t＜5 mm/5 minutes were not significantly different between the two groups (x2 =0.01,P=0.95;x2 =1.06,P=0.30).Conclusions The bubbles in the inferior conjunctiva fornix is highly correlated with dry eye.

Precommissural Fornix in the Human Brain: A Diffusion Tensor Tractography Study

PURPOSE: Other than a single case report, no diffusion tensor tractography (DTT) studies of the precommissural fornix in the human brain have been conducted. In the current study, we attempted to visualize the precommissural fornix in the human brain using DTT. MATERIALS AND METHODS: We recruited 36 healthy volunteers for this study. Diffusion tensor images were scanned using a 1.5-T scanner, and the precommissural fornix was analyzed using Functional Magnetic Resonance Imaging of the Brain (FMRIB) software. Values of fractional anisotropy (FA), mean diffusivity (MD), and tract volume of the precommissural fornix were measured. RESULTS: The precommissural fornix originated from the hippocampal formation on each hemisphere as a crus; both crura were then joined to the body of the fornix. The body of the fornix continued anteriorly to the level just superior to the anterior commissure, where it divided into each column of the precommissural fornix. Each column descended anteriorly to the anterior commissure and terminated in the septal nuclei. Values of FA, MD, and tract volumes of the precommissural fornix did not differ between the right and left hemispheres (p>0.05). CONCLUSION: We believe that the methodology and results of this study would be helpful to future research on the precommissural fornix and in the elucidation of the pathology of diseases involving the precommissural fornix.

Fornix Injury in a Patient with Rotavirus Encephalopathy: Diffusion Tensor Tractography Study

Rotavirus encephalopathy (RE) is a benign afebrile seizure associated with acute gastroenteritis caused by rotavirus infection. We investigated the diffusion tensor tractography (DTT) findings of a patient with RE. The patient was a 30-month-old female that had experienced a brief, generalized convulsive seizure. On the day of admission, the patient had vomiting and experienced watery diarrhea. Her stool was positive for rotavirus antigen. At onset, the patient displayed a drowsy and delirious mental status; later, a splenial lesion of the corpus callosum was found on MRI. One week later, the patient's condition improved and the splenial lesion had disappeared by conventional MRI. Initial DTI showed decreased fractional anisotropy (FA) values of fornix, as well as of the corpus callosum. A follow-up DTT showed a restored interrupted right fonical crus and increased FA values of corpus callosum and fornix. These results highlight the implications of the probability of not only a corpus callosum injury, but a fornix injury as well, in this patient with RE.

Efectos del tratamiento con Compvit B, ácido orótico o la combinación de ambos sobre la recuperación de la memoria espacial en ratas con lesión de fimbria-fornix / Effects of treatment with Compvit B, orotic acid or their combination on the recovery of spatial memory in rats with fimbria-fornix lesion

Las vitaminoterapias han sido ampliamente utilizadas en neurología para el tratamiento de neuritis o la correción de déficit metabólicos. En Cuba, se produce desde hace algunos años el preparado vitamínico Compvit®, que contiene vitaminas B1, B6 y B12. El ácido orótico, también llamado vitamina B13, es un producto natural que ha mostrado acciones como nootrópico en estudios con animales jóvenes y viejos que acusan deterioro cognitivo. En el presente trabajo se reportan los resultados de un estudio realizado para evaluar las potencialidades terapéuticas del Compvit® y del ácido orótico, empleando la lesión del sistema fimbria-fornix, que afecta severamente las capacidades de aprendizaje de los animales. Los resultados confirman un efecto positivo de cada uno de los tratamientos vitamónicos mejorando las capacidades cognitivas afectadas por la lesión. Aunque ninguno de los productos empleados o su combinación fue capaz de elevar el rendimiento cognitivo al nivel de los animales sanos, todos logran mejorías signficativas en comparación con el placebo. Este trabajo constituye una evidencia adicional en favor del uso terapéutico de compuestos vitamínicos como parte del tratamiento neurorrestaurativo

Vitamin therapies have been widely used in Neurology for the treatment of neuritis or the correction of metabolic deficits. In Cuba, Compvit® (B1, B6 and B12 vitamins) have been produced since several years. Orotic acid, also called vitamin B13 is a natural product showing nootropic actions in studies with young and old cognitively impaired animals. The present paper reports the results of a study conducted to assess the therapeutic potentials of Compvit® and orotic acid, in the recovery of cognitive abilities in fimbria-fornix lesioned animals, a lesion known to severely impair learning abilities. The results confirm positive effects of each vitamin treatment to improve the cognitive abilities affected by lesion. Although none of the products used, neither their combination, was able to raise the cognitive performance to the level of non-lesioned animals, both of them achieve significant improvement compared to placebo. The present paper constitutes additional evidence favoring the therapeutic use of vitamin compounds as part of neurorestorative treatments

Absence of the Septum Pellucidum Associated with a Midline Fornical Nodule and Ventriculomegaly: A Report of Two Cases

We report two autopsy cases that revealed the partial absence of the septum pellucidum with ventriculomegaly. In each case, the brain showed mild dilatation of both frontal horns of the lateral ventricles, normal third and fourth ventricles and no aqueductal stenosis. The posterior portion of the septum pellucidum was absent and the fornices were fused in a single midline nodule, abnormally displaced to a caudal position and lodged in the foramina of Monro. The brain base showed no apparent abnormalities; the optic nerves were well developed. We conclude that the caudally displaced fornix in the absence of the septum pellucidum may have intermittently obstructed the foramina of Monro and induced mild ventriculomegaly.