ABSTRACT
PURPOSE: To determine the prevalence of anterior vitreous detachment (AVD) in routine bag-in-the-lens (BIL) cataract cases and possibly to identify risk factors for its presence. SETTING: University Hospital of Antwerp, Belgium. DESIGN: Prospective cross-sectional study. METHODS: Patients having routine BIL cataract surgery were included. Patients with traumatic cataract, previous intraocular surgeries, YAG laser treatment, intravitreal injection, or medical conditions that might affect normal ophthalmologic anatomy were excluded. Several parameters were collected from the patients' records, and their surgical videos/photographs/optical coherence tomography were evaluated. RESULTS: 99 eyes of 99 patients were included. Detectable AVD was observed in 62 eyes (63%). AVD was not present in 37 eyes (37%). The difference in prevalence of AVD between men and women was not statistically significant ( P = .55, Pearson χ 2 test). The Mann-Whitney U test for axial length was not statistically significant ( P = .38). However, it was statistically significant for age ( P < .005). A logistic regression model to ascertain the effect of age on the likelihood that patients had AVD did reach statistical significance (χ 2 (1) = 8.246, P < .005). CONCLUSIONS: The prevalence of AVD in a routine cataract population was 63%. Age was identified as a risk factor. This study model determined that the odds for AVD increase 5.3% with each year of patient age. These data allowed for better preoperative and postoperative assessment of complications. The BIL, by its mandatory primary posterior continuous curvilinear capsulorhexis, did not increase the risk for postoperative ocular complications in the posterior segment of the eye.
Subject(s)
Cataract , Phacoemulsification , Vitreous Detachment , Capsulorhexis/methods , Cataract/etiology , Cross-Sectional Studies , Humans , Lens Implantation, Intraocular/methods , Male , Phacoemulsification/adverse effects , Postoperative Complications/etiology , Prospective Studies , Tomography, Optical Coherence , Vitreous Detachment/complicationsABSTRACT
PURPOSE: Inflammatory breast cancer (IBC) is an aggressive form of breast cancer with elevated metastatic potential, characterized by tumor emboli in dermal and parenchymal lymph vessels. This study has investigated the hypothesis that TGFß signaling is implicated in the molecular biology of IBC. METHODS: TGFß1-induced cell motility and gene expression patterns were investigated in three IBC and three non-IBC (nIBC) cell lines. Tissue samples from IBC and nIBC patients were investigated for the expression of nuclear SMAD2, SMAD3, and SMAD4. SMAD protein levels were related to gene expression data. RESULTS: TGFß1-induced cell motility was strongly abrogated in IBC cells (P = 0.003). Genes differentially expressed between IBC and nIBC cells post TGFß1 exposure revealed attenuated expression of SMAD3 transcriptional regulators, but overexpression of MYC target genes in IBC. IBC patient samples demonstrated a near absence of SMAD3 and -4 expression in the primary tumor compared to nIBC patient samples (P < 0.001) and a further reduction of staining intensity in tumor emboli. Integration of gene and protein expression data revealed that a substantial fraction of the IBC signature genes correlated with SMAD3 and these genes are indicative of attenuated SMAD3 signaling in IBC. CONCLUSION: We demonstrate attenuated SMAD3 transcriptional activity and SMAD protein expression in IBC, together with obliterated TGFß1-induced IBC cell motility. The further reduction of nuclear SMAD expression levels in tumor emboli suggests that the activity of these transcription factors is involved in the metastatic dissemination of IBC cells, possibly by enabling collective invasion after partial EMT.
