Outcomes of 8 × 8 mm osteotomy in powered external dacryocystorhinostomy

Purpose: To study the endoscopic ostium characteristics and outcome of 8 × 8 mm osteotomy in external dacryocystorhinostomy (DCR) using the microdrill system. Methods: This prospective interventional pilot study was performed on 40 eyes of 40 patients with primary acquired nasolacrimal duct obstruction (NLDO) from June 2021 to September 2021 in patients undergoing external DCR. An 8 × 8 mm osteotomy was performed using round, cutting burr attached to a microdrill system. Success was defined as patent ostium on lacrimal syringing (anatomical) and a Munk score <3 (functional) at 12 months. Postoperative endoscopic ostium evaluation was done using a modified DCR ostium (DOS) scoring system at 12 months. Results: The mean age of the study participants was 42.41 ± 11.77 years and the male?to?female ratio was 1:4. The mean duration of surgery was 34.15 ± 1.66 minutes and that for osteotomy creation was 2.5 ± 0.69 minutes. The mean intraoperative blood loss was 83.37 ± 11.89 ml. Anatomical and functional success rates were 95% and 85%, respectively. The mean modified DOS score was “excellent” in 34 patients (85%), “good” in 1 patient (2.5%), “fair” in 4 patients (10%), and “poor” in 1 patient (2.5%). Complications included nasal mucosal injury in 10% (4/40) of patients, complete cicatricial closure of ostium in 2.5% (1/40), incomplete cicatricial closure in 10% (4/40), nasal synechiae in 5% (2/40), and canalicular stenosis in 2.5% (1/40). Conclusion: An 8 × 8 mm–sized osteotomy created by powered drill and covered by lacrimal sac–nasal mucosal flap anastomosis in external DCR is an effective technique that has minimal complications and shorter surgical time

Clinical Study on Surgical Outcomes of Endoscopic Dacryocystorhinostomy (DCR) between Powered and Non-Powered Techniques.

Dacryocystorhinostomy (DCR) is a bypass operation for tear drainage system which involves removal of bone adjacent to lacrimal sac and incorporating lacrimal sac with nasal mucosae. The operative approaches to lacrimal apparatus are external and endoscopic. In recent times advances in surgical technique and better standing of anatomy have made several changes in endoscopic DCR all aiming to improve results, reduce complications, and reduce operative time. Both costly powered and cost affective non-powered instruments are commonly used to make bone windows in endoscopic DCR. The aim of this study is to compare merits and demerits of powered instrument (Drill) and non-powered (Kerrison’s punch) DCR. METHODSA randomized comparative study of 60 patients in the age group of 21-70 yrs. who attended our outpatient department regularly and underwent endoscopic DCR procedure at our institution from June 2017 until Aug. 2019 was conducted. Patients were categorised into two groups of 30 patients each, one group which had patients who were operated conventionally by Kerrison’s punch and the group with patients who were operated by powered drill. Operative technique, surgical outcome and complications were compared between the two groups. RESULTSA total of 60 endoscopic endonasal DCRs were performed during the period. Male: female ratio; 1:5. 36 (60%) patients presented with watering of eye. Procedure success rate among Kerrison’s punch group was 93.33 % vs. 90% in powered drill group (p= 0.476). The complications rate in Kerrison’s punch group was 10% compared 20% in powered drill group (p= 0.032). The mean operating time among Kerrison punch group was 33.3 min which was significantly lower than that of powered drill group which was 78.3 min. CONCLUSIONSEndoscopic DCR is keyhole minimal invasive magic surgery. In a comparative study, Kerrison’s punch was found to be better tool for making bony window in terms of cost, operating time and complications when compared to powered drill. In terms of success rate of surgery and other factors, there was no significant difference between the two groups.

Compare Outcome in DCR with and without Silicon Tube Implantation

Introduction: Dacryocystorhinostomy (DCR) is the mostpopular operation for treating nasolacrimal duct obstruction orchronic dacryostenosis. Study aimed to compare the successrate of external dacryocystorhino stomy with and withoutsilicone intubation.Material and Methods: A total 223 were operated fornasolacrimal duct obstruction, at district hospital level. 70patients were operated with silicon tube intubation and 153 patients operated without silicon tube. The patency of lacrimaldrainage system was evaluated with lacrimal syringing. Age, gender, laterality, and lacrimal irrigation in the thirdmonth visit were recorded. Surgical success was acceptedas the patency of the formed ostium with lacrimal syringing/irrigation. Data was analysed using the average, standarddeviation, variation coefficient, and the statistical significancewas determined using test. Results: Success rate was higher 94.24% in patients withsilicone tube intubation, and 86.92% in without silicon tubeintubation, with p-value (p>0.05).Conclusion: Our findings suggest that success rate was higherin dacryocystorhinostomy with silicone intubation, althoughresults were not statistically significant.

Relationship between the expression of DcR3 and high-risk human papilloma virus infection in cervical carcinoma / 中华疾病控制杂志

@# Objective To explore the relationship between the expression of decoy receptor 3 (DcR3) and high-risk human papilloma virus(HR-HPV)infection in cervical carcinoma. Methods Immunohistochemistry and hybird capture Ⅱ assay were used to detect the expression of DcR3 and HR-HPV in 35 cases of normal cervical tissues(NCE), 39 cases of cervical intraepithelial neoplasm(CIN)and 44 cases of cervical squamous epithelial carcinoma(CSES). Specific HR-HPV16 E7 siRNA and nonspecific HR-HPV16 E7 siRNA were synthesized and transfected to SiHa cells by Lipofectamine. The expression of DcR3 at mRNA and protein levels was examined by real-time polymerase chain reaction and western blot. The growth inhibition was examined by MTT assay. Results In NCE, CIN and CSES, the positive expression rates of DcR3 were 8.6%(3/35), 48.7%(19/39)and 77.3%(34/44), respectively, and the expression intensity was increasing(2=36.942, P<0.001). In NCE, CIN and CSES, the infection rates of HR-HPV were 5.7%(2/35), 56.4%(22/39)and 93.2%(41/44), respectively(2=60.322, P<0.001) . The protein expression of DcR3 was positively correlated with the infection of HR-HPV in CSES(r=0.893, P=0.004). Conclusions DcR3 was highly expressed in cervical cancer. Its expression was positively correlated with HR-HPV infection, which may contribute to the occurrence and development of cervical cancer. HR-HPV silencing inhibited cellular growth and proliferation by down-regulating the expression of DcR3.

Bilateral simultaneous endoscopic dacryocystorhinostomy: outcome and impact on the quality of life of the patients

Introduction: Bilateral simultaneous endoscopic dacryocystorhinostomy (endo-DCR) has received little attention in the literature, thus many surgeons continue to address bilateral nasolacrimal duct obstruction at two stages, rather than in the same setting. Objective: To evaluate the feasibility and the outcome of simultaneous bilateral Endo- DCR and its impact on the quality of life of the patients. Methods: We have conducted a retrospective analysis of patients who underwent bilateral simultaneous endo-DCR between March 2013 and February 2017 at our tertiary care institution. The reviewed data included clinical presentation; operative details; success rate; pre and postoperative evaluation of the symptoms of the patients, using the Nasolacrimal Duct Obstruction Symptom Score Questionnaire; satisfaction of the patients, and improvement in the quality of life, assessed by the Glasgow Benefit Inventory (GBI) questionnaire. Results: Out of 128 cases in which endo-DCRs were performed, 13 were bilateral (26 sides). Postoperative success was documented in 24 of the 26 sides (92.3%), with a mean follow-up duration of 16.2 months. The two failed sides were reported in the same case. The preoperative symptom score ranged between 12 and 80 (mean ± standard deviation [SD]: 38.23 ± 15.7). The postoperative symptom score was significantly lower (mean ± SD: 5.4 ± 12.9). The success rates in unilateral and bilateral cases were comparable, with no statistically significant difference. A notable improvement in the quality of life of the patients was also reported, with a mean GBI score of 81.38 ± 12.37. Conclusion: Our results support that a simultaneous bilateral endo-DCR is a safe procedure that offers a high success rate, spares the patient from the stress of a second surgery, provides the patient with a bilateral resolution of the symptoms, and confers an immediate improvement in the quality of life of the patients (AU)

A Case of Fungal Ball Causing Acute Dacryocystitis

PURPOSE: We report a case of fungal ball after Endoscopic Dacryocystorhinostomy (DCR) in a 40-year-old female patient. CASE SUMMARY: A 40-year-old female patient was admitted to our hospital for left lower eyelid tenderness and bloody discharge from the lacrimal punctum. During a planned endoscopic DCR, the sac was opened after the osteotomy, and 2 fungal balls were found in the lacrimal sac. The masses were 7 × 5 mm and, 9 × 5 mm sized, irregularly shaped, and red in color. Aspergillus fumigatus was diagnosed pathologically. Postoperative paranasal sinus magnetic resonance imaging showed no residual fungal ball. During follow-up, the patient showed patent rhinostomy opening, and there was no evidence of fungal infection on nasal endoscopic finding. CONCLUSIONS: Although Aspergillus fumigatus is a rare cause of canalicular obstruction, fungal ball development in the lacrimal sac can cause acute dacryocystitis.

Prognostic Factors Associated with Surgical Time of Endonasal Dacryocystorhinostomy

PURPOSE: To determine the prognostic factors associated with surgical time of endonasal dacryocystorhinostomy (DCR). METHODS: From April 2009 to June 2014, 66 eyes of 66 patients who underwent endonasal DCR for 5-year periods were retrospectively evaluated with regard to surgical time and several other factors. The factors were patient factors (age, sex), category of diagnosis (inflammation and non-inflammation), and systemic factors (diabetes mellitus [DM], hypertension [HTN], anticoagulant agents, sinusitis history). We divided the study period into three subperiods and compared their surgical time. The anatomical factor of thickness of the maxillary frontal process was evaluated by computed tomography (CT), as was the existence of symptom recurrence after surgery and reoperation according to surgical time. A total of 66 cases (right: 31, left: 35) were included. Any case with concurrent surgery, abnormal structure of the nasal cavity, or bilateral DCR was excluded. RESULTS: Average surgical time was 49.95 minutes. Surgical time of endonasal DCR was short in inflammatory cases (p = 0.047), in the third surgical period (p = 0.001), and was correlated with thickness of the maxillary frontal process (p = 0.001). In addition, surgical time correlated with the existence of symptom recurrence after surgery and reoperation (p = 0.012). CONCLUSIONS: It is considered that surgeon skill affects surgical time, and the thickness of the maxillary frontal process by CT will aid in the prediction of surgical time and success rate of endonasal DCR.

Conventional DCR vs DCR implant method in chronic dacryocystitis

Background: Chronic dacryocystitis is the commonest cause of lacrimal passage obstruction indicates inflammation of lacrimal sac. Dacryocystorhinostomy (DCR) is the preliminary choice of surgical procedure in which lacrimal sac is connected with nasal mucosal flap by bypassing nasolacrimal duct. Objectives: This comparative study described and evaluated the effectiveness of conventional D.C.R method and D.C.R implant method in chronic dacryocystitis cases. Materials and methods: The present comparative study consisted of 200 patients with complaint of watering, pus discharge and diagnosed as chronic dacryocystitis. Out of which 160 cases were followed up for a period of 3-6 months. Study cases were operated by using “Pawar implant”. Results: Bleeding occurred during operation was much more in conventional D.C.R. (53.3%) method than D.C.R. implant method (7.7%). Complete patency of nasolacrimal duct was observed in 125 cases i.e. 76 cases in D.C.R. implant method, 35 cases in Conventional D.C.R. method and 14 cases in D.C.R implant after D.C.T done. Partial patency of naso lacrimal duct was observed in 22 cases and failure of patency was seen in 11 cases. Conclusion: D.C.R implant (Pawar Implant) method is secure, minimal time consuming, needs little incision, little bony ostium and less painful surgical modality for chronic dacryocystitis than conventional D.C.R method.

Management of Nasolacrimal-Cutaneous Fistula – A Maxillofacial Review and Sharing Experience.

Nasolacrimal cutaneous fistula can be presented with a complaint of discharge from an opening found below the eye and beside the nose. The patient’s history can be remarkable with repair of severe maxillofacial injuries. Examination reveals a nasolacrimal-cutaneous fistula extending from lacrimal sac to the overlying skin with co-existing nasolacrimal duct obstruction. To correct a lacrimal-cutaneous fistula, an endoscopic dacryocystorhinostomy should be performed to create a new opening to the lacrimal apparatus medially. Simultaneous irrigation and probing of the common canaliculus and fistula tract under direct visualization allows identification of the origin of the lacrimal fistula in relation to the internal ostium on the lateral lacrimal sac wall. Post-traumatic nasolacrimal disturbances are not uncommon findings in trauma patients and management of these chronic fistulas may be helpful for complete rehabilitation of the patient.

Over-expression vector construction of human DcR3 gene and its validation / 中国免疫学杂志

Objective:To construct the human DcR3 expression vector and verify its expression in vitro. Methods: 915 bp human DcR3 gene CDS was amplified from porcine lung tissues,and was cloned into eukaryotic expression vector pEF1a-IRES-DsRed-Express2 which show red fluorescence. And then pEF1a-IRES-DsRed-Express2-DcR3 was transfected into LX-2 cells by FuGene HD. Expression of mRNA and protein lever of Human DcR3 were detected by RT-PCR and Western blot. Results:The levels of DcR3 gene transcription and translation in the hepatic stellate cells were significantly increased after transfection with pEF1a-IRES-DsRed-Ex-press2-DcR3 by RT-PCR and Western blot analysis. Conclusion: DcR3 expression vector was successfully constructed and highly expressed in LX-2 cells.

Functional and radiological outcome in non-operative versus operative management of fracture clavicle

Background: Clavicle fractures are one of the most common bone injuries seen in adult population. Generally all the fracture clavicles were treated non-surgically by figure-eight bandage and surgical intervention like plating with cortical screws is infrequently required. Non-union rates, strength and endurance deficits are familiar in cases treated conservatively. We evaluated functional and radiological outcomes in non operative versus operative management of fracture clavicle, in patients visiting to orthopedic OPD in a tertiary care hospital in Andhra Pradesh. Material and methods: In a prospective clinical trial study of 80 patients, with displaced mid-shaft fractures of the clavicle were referred to Orthopedic OPD in a tertiary care hospital. These patients were deliberately placed into two treatment groups: non-surgical (with figure-eight bandage) and surgical (with DCR plate fixation). All patients of the surgical group underwent ORIF. Clinical examination, fracture radiography and shoulder scores were recorded for all patients at the end of 12 weeks. Shoulder function is measured by the constant shoulder score which includes the pain score, functional assessment, range of motion and strength measures. Patient satisfaction according to strength, shoulder function and pain was also assessed. Results: There were 32 patients in operative in which 23 males and 9 females whereas in nonoperative group (figure of eight) there were 35 males and 13 females. The mean age of the patient was 23±3.4 years in operative and 19±2.5 years in non-operative group. 61 fractures occurred on the right side and 10 on the left side. In the Surgical group mean time to reunion was 8±1.8 weeks where as it was 11.±2 weeks in non surgical group. The overall Constant shoulder score was 93.75% in surgical Koramutla Harsha Kumar, Jaya Someswar Narreddy. Functional and radiological outcome in non-operative versus operative management of fracture clavicle. IAIM, 2016; 3(3): 95-98. Page 96 group where as it was 87.50% in nonsurgical group. Additionally the percentage of patients with excellent results was more in surgical group than non- operative group (figure of eight). Conclusion: In both figure of eight bandage and plating, there was satisfactory union of clavicle but due to appropriate bone proximity in cortical screw and plating, excellent functional outcome in the terms of early mobilization and quick union was much appreciated.

Expression of decoy receptor 3 in pancreatic cancer tissue and its clinical significance / 中华肝胆外科杂志

Objective To detect the expressions of decoy receptor 3 (DcR3) in pancreatic cancer tissues and to analyze the significance of DcR3 in the diagnosis, treatment and prognosis of patients with pancreatic cancer.Methods The expressions of DcR3 in pancreatic cancer tissues (n =100), paracancer tissues (n =15) and normal tissues (n =15) were detected with immunohistochemical method (Envision method).Results The positive rate of DcR3 in pancreatic cancer tissues was significantly higher than that in adjacent-tumor pancreatic cancer tissues (86.0％ vs.46.6％, P ＜ 0.05).The positive rate of DcR3 in adjacent-tumor pancreatic cancer tissues was significantly higher than that in normal tissues (46.6％ vs.13.3％, P ＜ 0.05).In clinical stage Ⅲ, the positive rate of DcR3 was significantly higher than that in stage Ⅱ and stage Ⅰ (100％ vs.87.0％, P＜0.05;100％ vs.62.5％, P＜0.05).There were significant differences among the three groups (P ＜ 0.05).With lymph node metastasis, the DcR3 positive rate was significantly higher than that in the group without lymph node metastasis (93.4％ vs.79.6％, P ＜ 0.05).In poorly differentiated pancreatic cancer, the positive rate of DcR3 was significantly higher than that in the highly differentiated group (100％ vs.64.0％, P ＜0.05), the positive rate of DcR3 was significantly higher in the moderately differentiated group than that in the highly differentiated group (88.6％ vs.64.0％, P ＜ 0.05) , There were significant differences among the three groups (P ＜ 0.05).There was no significant difference in the positive rate of DcR3 between the different age groups or the different gender groups (P ＞ 0.05).Conclusions The expression levels of DcR3 in patients with pancreatic cancer gradually increased from normal tissues to paracancer tissues, to pancreas tissues.The expression level of DcR3 protein was closely related to clinical stage, degree of tissue differentiation and presence of lymph node metastasis, but not associated with age, sex, and tumor diameter size.

Action of DcR3 recombinant protein of myocardial tissue in diabetic rats / 中国免疫学杂志

Objective:To study the expression of DcR3 of myocardial tissue in diabetic mouse and normal rats and the impact of DcR3 recombinant protein to the expression of related molecules and myocardial cell apoptosis to discuss the action of DcR3 to myocardial cell apoptosis in Diabetic rats.Methods:Intraperitoneally injected streptozotocin one time to establish the model of Diabetic rats.Injected different doses of DcR3 recombinant protein to tail vein[1.2 mg/(rat? d),0.8 mg/(rat? d),0.4 mg/(rat? d)] 40 d. The expression of DcR3 mRNA, Fas mRNA and FasL mRNA of myocardial tissue was detected with RT-PCR;the expression of apoptosis related molecules Bcl-2 and Caspase-8 was analyzed with Western blot;the IL-1β, TNF-αand LFN-γof the blood was detected with double antibody sandwich ELISA;the percentage of myocardial cell apoptosis was observed with HE dyeing.Results:To compare the DcR3 treatment group with diabetic group,the expression DcR3 of myocardial tissue was high,the expression of Fas mRNA and FasL mRNA was descended.The Caspase-8 protein was ascended and the Bcl-2 protein was descended.The middle dose group was the most obvious.the IL-1β,TNF-αand IFN-γin the blood was descended differently in each DcR3 treatment group(P<0.05,P<0.01).The percentage of myocardial cell apoptosis was declined(P<0.05).Conclusion:DcR3 recombinant protein have the action of inhibiting the rats′myocardial cell apoptosis,the mechanism is related to competing with Fas,blocking-up FasL of inducing apoptosis, expressing DcR3 of myocardial cell,the descending of apoptosis related factors Caspase-8,the ascending of Bcl-2 and the reduction of cytokine levels.

Analysis of the Results Endonasal Dacryocystorhinostomy Related to Nasal Cavity State

PURPOSE: This study evaluated the relationship of nasal cavity state and surgical results after endonasal dacryocystorhinostomy (DCR). METHODS: We retrospectively analyzed 306 eyes of 204 patients between January 2007 and December 2011. The correlation between the existence of preoperative nasal cavity abnormality, postoperative nasal cavity complications after proper management of nasal cavity abnormality, and postoperative nasal cavity complications according to nasal packing material were investigated. We analyzed the success rates and the correlation between each set of factors. RESULTS: The success rate of primary operations performed six months after tube removal was 87.3% (267/306). The success rate after secondary revision, granuloma removal and punctoplasty was 90.5% (277/306). Postoperative nasal cavity complications were inspected in 40 eyes. Of the 306 eyes, patients treated with Nasopore showed significantly more postoperative nasal cavity complications (47.8%, 32/67) than in patients treated with Merocel (3.3%, 8/239). The rate of postoperative nasal cavity complications was 8.7% in patients with normal nasal cavity, 16.7% in patients who received treatment, and 20% in patients without treatment, with significant statistical increase if the nasal cavity was abnormal (p = 0.019). The incidence of complications influenced the primary success rate (p = 0.008); however, preoperative nasal cavity abnormalities were not correlated with primary success (p = 0.479). CONCLUSIONS: In the case of endonasal DCR, preoperative nasal cavity abnormality and type of nasal packing material used did not affect the success rate but significantly affected postoperative nasal cavity complications. In conclusion, endonasal DCR with preoperative treatment of nasal cavity abnormality and Merocel packing is expected to reduce postoperative nasal cavity complications and increase patient satisfaction.

Analysis of the Results Endonasal Dacryocystorhinostomy Related to Nasal Cavity State

PURPOSE: This study evaluated the relationship of nasal cavity state and surgical results after endonasal dacryocystorhinostomy (DCR). METHODS: We retrospectively analyzed 306 eyes of 204 patients between January 2007 and December 2011. The correlation between the existence of preoperative nasal cavity abnormality, postoperative nasal cavity complications after proper management of nasal cavity abnormality, and postoperative nasal cavity complications according to nasal packing material were investigated. We analyzed the success rates and the correlation between each set of factors. RESULTS: The success rate of primary operations performed six months after tube removal was 87.3% (267/306). The success rate after secondary revision, granuloma removal and punctoplasty was 90.5% (277/306). Postoperative nasal cavity complications were inspected in 40 eyes. Of the 306 eyes, patients treated with Nasopore showed significantly more postoperative nasal cavity complications (47.8%, 32/67) than in patients treated with Merocel (3.3%, 8/239). The rate of postoperative nasal cavity complications was 8.7% in patients with normal nasal cavity, 16.7% in patients who received treatment, and 20% in patients without treatment, with significant statistical increase if the nasal cavity was abnormal (p = 0.019). The incidence of complications influenced the primary success rate (p = 0.008); however, preoperative nasal cavity abnormalities were not correlated with primary success (p = 0.479). CONCLUSIONS: In the case of endonasal DCR, preoperative nasal cavity abnormality and type of nasal packing material used did not affect the success rate but significantly affected postoperative nasal cavity complications. In conclusion, endonasal DCR with preoperative treatment of nasal cavity abnormality and Merocel packing is expected to reduce postoperative nasal cavity complications and increase patient satisfaction.

A novel technique to recanalize the nasolacrimal duct with endodiathermy bipolar probe.

Aims: To evaluate a new approach for recanalization (RC) of nasolacrimal duct obstruction in the treatment of the symptomatic nasolacrimal duct obstruction (NLDO). Materials and Methods: A prospective, interventional, comparative study in 302 eyes of 209 patients of symptomatic nontraumatic NLDO. Eyes with previous failed surgery were excluded. One hundred and fifty‑one eyes underwent RC with 20 G endodiathermy bipolar probe connected to a 7 W diathermy followed by bicanalicular intubation under direct visualization. One hundred and fifty‑one eyes underwent standard external dacryocystorhinostomy (DCR). Follow‑up was for 24 months and evaluation was done on basis of change in symptoms and lacrimal syringing. Data was analyzed by Chi‑square test and unpaired t‑test. P value < 0.05 was considered statistically significant. Results: Success defined as an asymptomatic patient or freely patent syringing was 92.7% (140 eyes) in RC group and 83.44% (126 eyes) in DCR group. Success was significantly more (P ≤ 0.01) in RC than DCR group. Surgical time was significantly less in RC than DCR (P ≤ 0.001). In RC group, RC could not be performed in three eyes and had to be later taken up for DCR. Intubation after RC was not achieved in four eyes; however these eyes had a patent pathway till 24 months. Twenty‑two eyes had a premature extrusion of the tube; but the success rate in these (20 eyes) was comparable to the others within the group (P > 0.05). Two eyes in RC and one in DCR group had complications. Conclusions: RC with 20 G endodiathermy bipolar probe is a quick, simple, and effective alternative to standard external DCR.

The Efficacy of Preoperative Routine Otorhinolaryngologic Referral Before Endonasal Dacryocystorhinostomy

PURPOSE: To determine if routine otorhinolaryngologic referral prior to endonasal dacryocystorhinostomy (EN-DCR) is necessary. METHODS: Two hundred thirty-seven eyes of 178 patients who were supposed to undergo EN-DCR were prospectively analyzed. Nasal endoscopy was performed by an ophthalmologist and the patients who had severe abnormality were referred to an otorhinolaryngologist. The patients were classified into 3 groups after a preoperative examination by an ophthalmologist and an otorhinolaryngologist; the number and success rate of each group were then investigated. Group A consisted of patients who had no nasal cavity abnormality, Group B consisted of patients with a nasal cavity abnormality but who received no treatment, and Group C consisted of patients who had a nasal cavity abnormality and received otorhinolaryngologic treatment. RESULTS: The number of subjects in each group was 156 in Group A (87.7%), 12 in Group B (6.7%), and 10 in Group C (5.6%). The number of patients who were referred to the otorhinolaryngologist was 22 (12.3%). There was no statistical significance of success rate between the groups. CONCLUSIONS: Routine nasal endoscopic examination should be performed by an ophthalmologist prior to EN-DCR. Only patients with severe abnormal findings should be referred to an otorhinolaryngologist as the results from the present study show the percentage of patients having significant nasal abnormalities was found to be low (12%) and the success rate of EN-DCR revealed no statistical significance between the groups. This could help patients by saving time and expense.

The effect of HTLV-1 Tax protein on the DcR3 gene expression in T cells / 中华微生物学和免疫学杂志

Objective To explore the effect of HTLV-1 (human T-cell leukemia virus type 1 ) Tax protein on the DcR3 gene expression in T cells.Methods The construction of DcR3 (-1010 bp to +114 bp) luciferase reporter gene; MT2,TaxP,and Jurkat E6-1 cells were transfected with DcR3 luciferase reporter gene (pGL3-DcR3-1uc) using liposomes according to the manufacturer's instructions.For the control group,pGL3-basic replaced it respectively.At 48 h after incubation,luciferase activity was measured with a luciferase assay system; Jurkat cells were transfected with pCMV-Tax-Bam using liposomes,and total RNA was extracted from the cells at 48 h after incubation.Reverse transcription was performed using standard protocols.Then real time PCR with primers DcR3 and 3-actin was conducted;The expression of DcR3 protein was detected by flow cytometry in MT2,TaxP,and Jurkat cells.Results The construction of DcR3 luciferase reporter gene is identified correctly; The detection of luciferase activity showed that the luciferase activity of experimental group in MT2 cells was increased by (32.07±12.43)-fold,of which in TaxP cells was increased by ( 13.27±4.04)-fold,and the luciferase activity of experimental group in Jurkat cells was increased by ( 1.26±0.49 ) -fold.And there is statistic significance about the relative luciferase activity of experimental group in MT2 cells and TaxP cells compared to the relative lueiferase activity of experimental group in Jurkat cells respectively ( P＜0.01 ) ; The result of real-time PCR showed that the level of DcR3 mRNA in the experimental group was higher compared with the control group(P＜0.05) ; The result of FCM shows the expression of DcR3 protein in MT2,TaxP cells is higher than that in Jurkat cells( P＜0.05 ).Conclusion Tax protein can promote the expression of DcR3 gene in T cells.

The expression of DcR3 in gastrointestinal tumors / 肿瘤

Objective: To study the expression of decoy receptor 3 (DcR3) in gastrointestinal tumors and elucidate the relationship between DcR3 and gastrointestinal tumors. Methods: The human colon carcinoma cells (SW480), gastric cancer cells (SGC7901), hepatoma carcinoma cell (HepG2) and human fibroblasts (3T3) were cultured in vitro. The expression level of DcR3 mRNA was determined by RT-PCR. The level of DcR3 protein expression was detected by Western blotting. Results: The mRNA and protein expression levels of DcR3 were higher in the SW480 cells than those in SGC7901, HepG2, and 3T3 cells. The difference was significant (P <0.05). Conclusion: Over-expression of DcR3 gene in the colon carcinoma cells may be related with the initiation and development of colon cancer.

The Results of Revisional Surgery for the Failed Endonasal DCR

PURPOSE: This large case study evaluated the success rate of revisional surgery and the causes of failed endonasal dacryocystorhinostomy (DCR) with long-term follow-ups. METHODS: One hundred nine patients (114 eyes) who underwent revisional surgery for a failed endonasal DCR at the Department of Ophthalmology, Guro Hospital, Korea University between January 1995 and January 2005 were included in this retrospective study. We evaluated the causes of failed endonasal DCR and their success rates of revisional surgeries. RESULTS: The causes of surgical failure were membranous obstruction (83 eyes), granuloma (22 eyes), synechia (11 eyes), common canalicular obstruction (11 eyes), functional block (7 eyes), and canalicular obstruction (1 eye). The revisional surgeries were silicone tube intubation after granuloma removal, synechiolysis and membranectomy using Nd:YAG laser and trephination of canalicular obstruction, and endonasal conjunctivodacryocystorhinostomy (CDCR) for the parts of functional block and the canalicular obstruction. The overall success rates of the revisional surgeries were 83.3% (95/114 eyes). The mean follow-ups period was 18.97 months (range, 9~113 months). CONCLUSIONS: This is the first large case study in Korea on revisional surgery with long-term follow-ups, as far as we know. The overall success rates of endonasal DCR after receiving simple revisional surgery were comparable to those of the standard external DCR.