Lacrimal ductal cyst of the medial orbit: a case report.

BACKGROUND: The lacrimal ductal cyst (dacryops) is an uncommon clinical entity. It occurs anywhere that lacrimal gland tissue is present but most often appears as an expanding mass in the region of the lacrimal gland. The presence involving the medial part of the orbit is rare, ectopic location can be misleading in the differential diagnosis of orbital masses. The authors report a 53-year-old man who presented with dacryops occurred in an unusual location with significant clinical presentations. CASE PRESENTATION: A 53-year-old man had a painless mass located in the right superomedial orbit accompanied with foreign body sensation and lachrymation for two months, which had rapidly grown within 10 days. Decrease of visual acuity, high intraocular pressure (IOP) and limitation of extraocular movements in the right eye were present. The result of visual evoked potential (VEP) test suggested the impaired function of the optic nerve. Magnetic resonance imaging (MRI) studies revealed the presence of an isolated cystic lesion. The mass was completely removed via a transcutaneous approach, histopathologic findings were consistent with the lacrimal ductal cyst. The ocular motility and high IOP returned to normal. There had been no post-operative complications or signs of recurrence over five months follow-up. CONCLUSION: Lacrimal ductal cysts can present in the medial orbit, clinicians should include this entity in the differential diagnosis of orbital masses and be aware of its variable presentations such as high IOP in this case. We comment on the fact that many reported cases of ectopic dacryops may be an extension of normal lacrimal gland tissue.

Antitumor effects of Farnesol in optic nerve sheath meningioma cell line and its effects on cell cycle progression, autophagy, cell migration and invasion.

PURPOSE: Farnesol has been shown to exhibit important anticancer potential. However, its antiproliferative effects have not been examined against the optic nerve sheath meningioma cells. In this study the potential of Farnesol in the treatment of optic nerve meningioma was evaluated by examining its antiproliferative effects against the HBL-52 cells. METHODS: The MTT assay was used to determine cell viability of HBL-52 cells. Autophagy was detected by transfection assay. The cell migration and invasion of HBL-52 cells was determined by transwell assay. Protein expression was checked by western blot assay. RESULTS: The results showed that Farnesol decreased significantly the viability of HBL-52 cells and showed an IC50 of 25 µM. The antiproliferative effects were due to the activation of the autophagy in the HBL-52 cells. The autophagy was also accompanied by upsurge of LC3 II and Beclin 1 expression. Farnesol also triggered the cell cycle arrest of the HBL-52 at the G2/M phase of the cell cycle which was accompanied by suppression of cyclin B1. The cell migration and invasion of the HBL-52 cells was also suppressed by Farnesol via inhibition of MMP-2 and 9 expressions. CONCLUSIONS: To sum up, Farnesol may prove beneficial in the treatment of optic nerve sheath meningioma as it has shown significant antiproliferative effects against this rare form of tumor.

Antitumor Effects of Chrysophanol in Malignant Optic Nerve Meningioma Cell Lines are Mediated via Caspase Activation, Induction of Mitochondrial Mediated Apoptosis, Mitochondrial Membrane Depolarization and Targeting the Mitogen-Activated Protein Kinase Signaling Pathway.

BACKGROUND: Anthroquinones are considered remarkable anticancer agents. Chrysophanol is an important anthroquinone and it has shown to have the potential to inhibit the growth of the range of cancers. However, there are no studies regarding the anticancer effects of chrysophanol against the malignant meningioma of optic nerve. In this review, the potential of chrysophanol in the treatment of malignant -meningioma of optic nerve was explored by evaluating its anticancer activity against the malignant meningioma CH157-MN cells. MATERIALS AND METHODS: The 3-(4,5-dimethylthiazol-2-Yl)-2,5-diphenyltetrazolium bromide assay was used for cell viability determination. The 4',6-diamidino-2-phenylindole (DAPI), acridine orange and ethidium bromide (AO/EB) and annexin V/PI assays were used to determine the induction of apoptosis. The potential of reactive oxygen species and the mitochondrial membrane was estimated by flow cytometry. Western blot analysis was performed to determine the protein expression. RESULTS: The results showed that chrysophanol caused significant decline in the viability of the CH157-MN cells and exhibited an IC50 of 30 µmol/L. Anticancer effects were found to be due to the induction of apoptosis as evident form the DAPI and AO/EB staining. The annexin V/PI staining revealed that the apoptotic cells increased from 1.77% in control to 37.21% at 60 µmol/L concentration of chrysophanol. The Bcl-2/Bax expression ratio was decreased and the caspases-3 and 9 were activated upon chrysophanol treatment of the CH157-MN cells. Chrysophanol also triggered the formation of reactive oxygen species and reduction of the mitochondrial membrane potential in the CH157-MN cells and also blocked the Mitogen-activated protein kinase signaling pathway. CONCLUSION: The findings of the present study suggest that chrysophanol may prove beneficial in the treatment of malignant meningioma of optic nerve. Key Message: The study revealed the anticancer potential of chrysophanol against the malignant optic nerve meningioma.

[New type of sutured titanium wire combined with titanium nail internal fixation for correction of serious old medial canthus deformity].

Objective: To evaluate the effectiveness of a new type of sutured titanium wire combined with titanium nail internal fixation in correction of serious old medial canthus deformity. Methods: Between March 2012 and June 2015, 18 patients with unilateral serious old medial canthus deformity were treated. There were 14 males and 4 females. The patient's age ranged from 23 to 62 years (mean, 42 years). The causes of deformity included accident injury in 10 cases, boxing injury in 4 cases, sharp device scratching in 3 cases, and animal bite in 1 case. All patients had been treated with suture or steel wire fixation in other hospitals to correct the medial canthus deformity and the deformity recurred. The interval between this operation and the first operation was 6 months to 2 years (mean, 16 months). The nasal root or medial canthus skin scar incision was used as the operative approach, and the adhesion of the medial canthus ligament to the adjacent tissues was fully loosened, then the tail end of the new type sutured titanium wire was fixed to the residual end of the medial canthus ligament. After passing through the scar tissue, the needle end of wire was fixed on the titanium nail in the bone wall of anterior lacrimal crest. The position and shape of the medial canthus angle was determined by adjusting the tightness of titanium wire. Results: All incisions healed by first intention. All patients were followed up 6-12 months (mean, 10 months). In 16 cases, the medial canthus deformity was obviously corrected, and the appearances of bilateral eyes were basically symmetrical, without exposure of titanium nail and titanium wire. The medial canthus was retreated at 2 mm after 6 months in 2 cases, who were satisfied with their appearance without reoperation. Conclusion: Application of the new type of suture titanium wire combined with titanium nail in the correction of serious old medial canthus deformity can achieve good effectiveness with the low recurrence rate.

[Study on the characteristics of optic nerve meningiomas in medical imageology,histopathology and immunohistochemistry].

OBJECTIVE: To determine the characteristics of optic nerve meningiomas in medical imageology (including CT and MRI), histopathology and immunohistochemical expression of Vimentin, CK, S-100, EMA in tumor cells. METHODS: This was a retrospective study on a serial of clinical cases. Forty-eight cases were collected from the past 21 years at the Department of Ophthalmology, West China Hospital, Sichuan University. All the cases underwent surgery and were confirmed as optic nerve meningiomas by histopathological test, including paraffin imbedded sectioning and HE staining. In addition, all the cases had medical records on CT and 17 cases had MIR scan. Immunohistochemical staining for VIMENTIN, CK, S-100, EMA was performed in the 21 cases. RESULTS: Characteristics of the CT scan include that, in 39 cases, among them 26 cases the tumors filled in the orbit especially at the orbital apex, which led to the disappearance of the black triangle. Three cases showed enlargement and calcification of optic nerve and therefore train track sign was seen. Three cases showed that the masses of optic nerve were close to the globe and another three cases showed that the masses were located in the peripheral orbit. Thirteen of 17 cases MRI disclosed the big orbital tumors and 5 cases could better show tumor extension to optic cross or intracranium. Histopathological tests demonstrated meningothelial or syncytial type in 39 cases, transitional or mixing type in 8 cases, fiber or fibroblast type in 3 cases and vascular type in 2 cases. Immunohistochemistry study verified the positive staining rate of VIMENTIN as 90.5%(21 cases), EMA 66.7%(15 cases), CK 42.8%(9 cases) and S-100 23.8%(5 cases), respectively. CONCLUSIONS: Characteristics of CT and MRI include enlargement and tumor-like expansion of optic nerve. Most of the tumors reach to orbital apex and show uneven density. Calcification may occur in the tumor. The main pathological type of the tumors is meningothelial. Positive immunohistochemiscal staining for VIMENTIN and EMA may be helpful in diagnosis.

Clinical and pathological observation and treatment of chronic orbital osteomyelitis.

PURPOSE: To evaluate diagnosis, treatment, and histopathologic changes of chronic orbital osteomyelitis. METHODS: We retrospectively analyzed the history, clinical manifestations, computed tomography (CT) scans, histopathology, treatment methods, and outcomes for 6 patients with chronic orbital osteomyelitis at the Department of Ophthalmology, West China Hospital, from January 1988 to January 2008. RESULTS: One of the 6 patients had a history of frontal sinusitis, 4 patients had a history of trauma, and the remaining patient had a history of lateral orbitotomy. All patients had red swelling of the skin at the orbital margin, fistula formation, and pus emerging repeatedly from the fistulae. CT scans showed that sequestrum and abscess had formed in all patients. Those patients were treated by radical debridement and antibiotics with satisfactory results. Histopathologic examination showed that in 6 patients the bone trabeculae disappeared from the sequestra, abscess formed around the sequestra, and vessel dilation occurred in the areas of pathologic change with inflammatory cell infiltration. Two sequestra were completely encapsulated by fibrous connective tissue and formed involucrum. CONCLUSIONS: Chronic orbital osteomyelitis was often found in patients with a traumatic history who had received improper or delayed treatment when injured. The main clinical features included low-grade inflammation, pus, sequestrum and fistulation. Pathologic characteristics were formation of sequestrum, abscess and involucrum. Clinical manifestations and CT scan allowed accurate diagnoses, and radical treatment using a combination of debridement and antibiotics provided satisfactory results.

Ampelopsin, a small molecule inhibitor of HIV-1 infection targeting HIV entry.

OBJECTIVE: To investigate the anti-HIV effects of ampelopsin and its interaction with HIV-1 coreceptor CXCR4. METHODS: Through anti-virus experiments in vitro, the inhibitory effect of ampelopsin on HIV-1 infection was verified. Chemotaxis assay was performed to show the ability to induce PBMCs migration by ampelopsin, RANTES and SDF-1alpha. Fluorescence labelling monoclonal antibody was utilized to observe the interaction of ampelopsin and CXCR4. Mice immunosuppressant model was also established to detail the role ampelopsin played in regulating cellular immunological functions. RESULTS: Ampelopsin could protect sensitive cells against HIV-1 infection and dramatically reduce HIV-1 antigen P24 expression. HIV-1SF33 attaching to MT-4 cells was interfered by ampelopsin, and the EC50 was 0.175 mg/mL for cellular protection and 0.024 mg/mL for P24 inhibition. At co-cultivating phase, EC50 was 0.229 mg/mL and 0.197 mg/mL respectively. Furthermore, the EC50 was 0.179 mg/mL and 0.348 mg/mL in acute infection. Human PBMCs migration was induced after being challenged with ampelopsin or chemokines, and synergistic action was observed during co-treatment. Ampelopsin alone resulted in maximal chemotaxis at 1 mg/mL. HIV-1 co-receptor CXCR4 on the surface of PBMCs was decreased by internalization, which indicated the effect of ampelopsin on CXCR4. About 70% CXCR4 was reduced by ampelopsin at 1 mg/mL. Ampelopsin also augmented cellular immunological functions in immunosuppressive mice. CONCLUSION: Ampelopsin displays a strong inhibitive role during HIV-1 absorption, incubation and acute infection. These results are coincident with its immune enhancement.