Management of intrascleral chestnut burr spines under ultrasound biomicroscopy guidance

Purpose: To explore the efficacy of ultrasound biomicroscopy (UBM) as a tool for detecting and localizing intrascleral chestnut burr spines. Methods: Individuals who were diagnosed with definitive or suspected intrascleral chestnut burr injuries between 2019 and 2020 were retrospectively reviewed. All patients underwent UBM to detect potential intrascleral spines. UBM imaging features were recorded and analyzed. Intrascleral spines were removed based upon UBM?guided localization. Patient clinical profiles, management, and treatment outcomes were recorded. Results: A total of 10 eyes (10 patients; 6 males, 4 females) were diagnosed with intrascleral spines over the study period, with an average patient age of 55 years (range: 39–71). Three of these 10 eyes exhibited involvement of the palpebrae and cornea, whereas three exhibited corneal involvement, and the remaining four patients exhibited only intrascleral spine injuries owing to their having undergone previous intracorneal spine extraction procedures. UBM features consistent with chestnut burr spines manifest a hyperechoic spot with a shadow. UBM enabled the precise localization of these spines and thus ensured their successful removal via a single surgery. During follow?up, two patients experienced vitreous hemorrhage due to a penetrating injury into the ciliary body that was gradually absorbed. All patients with eye irritation and red eyes progressed favorably, and no surgical complications were recorded. Conclusion: A retained scleral chestnut burr spine should be suspected if a patient complains of persistent eye irritation following intracorneal spine removal. UBM may be a valuable tool for detecting spines retained in the sclera, enabling the successful removal thereof.

Changes and significance of serum levels of VEGF, ES, TKLK, TSP and sICAM-1 in patients with diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To investigate the changes of serum levels of vascular endothelial growth factor ( VEGF ) , Endostatin (ES), thrombospondin (TSP), tissue kallikrein (TKLK) and soluble intercellular adhesion molecule-1 ( sICAM-1) in patients with diabetic retinopathy ( DR ) and its clinical significance.·METHODS:Selected 60 patients with non-proliferative diabetic retinopathy ( NPDR group ) , 60 patients with proliferative diabetic retinopathy ( PDR group ) were enrolled in this study. Sixty diabetic patients without diabetic retinopathy ( DM group ) and 60 healthy people ( control group) were also enrolled. Collection time was from January 2014 to December 2016. Serum levels of VEGF, ES, TSP, TKLK and sICAM-1 were measured and compared.·RESULTS: The levels of serum VEGF, TKLK and sICAM-1 in PDR group were significantly higher than those in NPDR group, DM group and control group ( P<0. 05). The ES of PDR group was significantly lower than that of NPDR group, DM group and control group ( P<0. 05). The levels of VEGF, TKLK and ES in the NPDR group were significantly higher than those in the DM group and the control group (P<0. 05). The serum VEGF in the NPDR group was positively correlated with the levels of ES, TKLK and sICAM-1 (P<0. 05). The serum VEGF of PDR group was positively related to the levels of TKLK and sICAM-1 (P<0. 05). There was no significant relationship between serum VEGF with ES and TSP in PDR group (P>0. 05).·CONCLUSION: The levels of serum ES, TSP, TKLK and sICAM - 1 in patients with DR have changed significantly, and the process of retinopathy has been affected by regulating the level of VEGF.

Differentiation between tuberculosis and leukemia in abdominal and pelvic lymph nodes: evaluation with contrast-enhanced multidetector computed tomography

PURPOSE: To compare the characteristics of tubercular vs. leukemic involvement of abdominopelvic lymph nodes using multidetector computed tomography (CT). MATERIALS AND METHODS: We retrospectively reviewed multidetector computed tomography features including lymph node size, shape, enhancement patterns, and anatomical distribution, in 106 consecutive patients with newly diagnosed, untreated tuberculosis (55 patients; 52%) or leukemia (51 patients; 48%). In patients with leukemia, 32 (62.7%) had chronic lymphocytic leukemia, and 19 (37.3%) had acute leukemias; of these, 10 (19.6%) had acute myeloid leukemia, and 9 (17.6%) had acute lymphocytic leukemia. RESULTS: The lower para-aortic (30.9% for tuberculosis, 63.2% for acute leukemias and 87.5% for chronic lymphocytic leukemia) and inguinal (9.1% for tuberculosis, 57.9% for acute leukemias and 53.1% for chronic lymphocytic leukemia) lymph nodes were involved more frequently in the three types of leukemia than in tuberculosis (both with p <0.017). Tuberculosis showed peripheral enhancement, frequently with a multilocular appearance, in 43 (78.2%) patients, whereas patients with leukemia (78.9% for acute myeloid leukemia and acute lymphocytic leukemia, 87.5% for chronic lymphocytic leukemia) demonstrated predominantly homogeneous enhancement (both with p <0.017). For the diagnosis of tuberculosis, the analysis showed that a peripheral enhancement pattern had a sensitivity of 78.2%, a specificity of 100%, and an accuracy of 88.7%. For the diagnosis of leukemia, the analysis showed that a homogeneous enhancement pattern was associated with a sensitivity of 84.3%, a specificity of 94.5%, and an accuracy of 89.6%. CONCLUSION: Our findings indicate that the anatomical distribution and enhancement patterns of lymphadenopathy seen on multidetector computed tomography are useful for differentiating between untreated tuberculosis and leukemia of the abdominopelvic lymph nodes. .

Thoracic Injuries in earthquake-related versus non-earthquake-related trauma patients: differentiation via Multi-detector Computed Tomography

PURPOSE: Massive earthquakes are harmful to humankind. This study of a historical cohort aimed to investigate the difference between earthquake-related crush thoracic traumas and thoracic traumas unrelated to earthquakes using a multi-detector Computed Tomography (CT). METHODS: We retrospectively compared an earthquake-exposed cohort of 215 thoracic trauma crush victims of the Sichuan earthquake to a cohort of 215 non-earthquake-related thoracic trauma patients, focusing on the lesions and coexisting injuries to the thoracic cage and the pulmonary parenchyma and pleura using a multi-detector CT. RESULTS: The incidence of rib fracture was elevated in the earthquake-exposed cohort (143 vs. 66 patients in the non-earthquake-exposed cohort, Risk Ratio (RR) = 2.2; p<0.001). Among these patients, those with more than 3 fractured ribs (106/143 vs. 41/66 patients, RR=1.2; p<0.05) or flail chest (45/143 vs. 11/66 patients, RR=1.9; p<0.05) were more frequently seen in the earthquake cohort. Earthquake-related crush injuries more frequently resulted in bilateral rib fractures (66/143 vs. 18/66 patients, RR= 1.7; p<0.01). Additionally, the incidence of non-rib fracture was higher in the earthquake cohort (85 vs. 60 patients, RR= 1.4; p<0.01). Pulmonary parenchymal and pleural injuries were more frequently seen in earthquake-related crush injuries (117 vs. 80 patients, RR=1.5 for parenchymal and 146 vs. 74 patients, RR = 2.0 for pleural injuries; p<0.001). Non-rib fractures, pulmonary parenchymal and pleural injuries had significant positive correlation with rib fractures in these two cohorts. CONCLUSIONS: Thoracic crush traumas resulting from the earthquake were life threatening with a high incidence of bony thoracic fractures. The ribs were frequently involved in bilateral and severe types of fractures, which were accompanied by non-rib fractures, pulmonary parenchymal and pleural injuries.

Adrenal sarcomatoid carcinoma: A rare case depicted on multi-detector row computed tomography.

Primary adrenal sarcomatoid carcinoma is rare malignant tumor with the characteristics of carcinoma and sarcoma. To date, only one case of primary sarcomatoid carcinoma in the adrenal gland was reported. We present here computed tomography appearance and pathological features of the case with primary adrenal sarcomatoid carcinoma confirmed by pathology. In addition, a brief review of the relevant literature is presented.

Study on the change of bFGF in reticular formation of medulla oblongata after primary brain-stem injury / 法医学杂志

OBJECTIVE@#To study the effect of primary brain-stem injury on the expression of basic fibroblast growth factor (bFGF) in the reticular formation of medulla oblongata.@*METHODS@#Immunohistochemical SABC was used to study the change of bFGF expression in the reticular formation of medulla oblongata after brain-stem injury by striking.@*RESULTS@#The numbers of positive cells and positive intensity of the study group in the reticular formation of medulla oblongata were significantly elevated than those of the control group and the postmortem injury group.@*CONCLUSION@#The expression of bFGF is elevated in reticular formation after brain-stem injury.

Study on the relationship between postmortem interval and the change of absorbance in vitreous humor of rabbit after death / 法医学杂志

OBJECTIVE@#To seek a exact method of estimating Postmortem interval (PMI).@*METHODS@#This study was preformed to investigate the relationship between postmortem interval and absorbance in vitreous humor of rabbit after death. The absorbance in vitreous humor of 48 rabbits after death were investigated with Model 754 spectrophotometer in apt wavelength (420 nm).@*RESULTS@#There exists positive linear regression association between postmortem interval (Y) and absorbance in vitreous humor (X) (r = 0.98327, P < 0.05), during rabbits after death 0 to 72 hours. The formula of linear regression is Y = 453.30 X + 0.75 (Y = postmortem interval = PMI, X = absorbance in vitreous humor).@*CONCLUSION@#The absorbance in vitreous humor can be as reference indicator to estimate PMI within hour 72.

Study on the relationship between PMI and the concentration of zincum and nickel in the vitreous humor of rabbit after death / 法医学杂志

OBJECTIVE@#To seek a exact method of estimating postmortem interval (PMI).@*METHODS@#This study detected the concentration of zincum(Zn) and nickel(Ni) in vitreous humor of rabbit at hour 96 after death and explored the relationship between their concentration and PMI using a method ICP-MS.@*RESULTS@#The concentration of Zn and Ni in vitreous humor of rabbit at hour 24 after death were related to PMI significantly; The formulae of the relationship between PMI and Zn concentrations is y = 0.1404x2 - 1.3351x + 3.8298 (within 24 h; R2 = 0.9202). The formula of the relationship between PMI and Ni concentrations is y = 0.0043x2 - 0.0596x + 0.2665(within 24 h; R2 = 0.9103).@*CONCLUSION@#The concentration of Zn and Ni in vitreous humor of rabbit may be a reference indicator to estimate early PMI.