Background As myopia is a common ocular condition which has been reported as the risk factor of primary open angle glaucoma,it is of great importance to evaluate the optic disc morphology in myopic eyes.Objective This study was to evaluate the agreement of optic disc measurements between Cirrus high-density optical coherence tomography (HD-OCT) and Heidelberg retina tomograph (HRT) in myopic eyes;and to investigate the relationships between axial length (AL) and differences of optic disc parameters measured with the two devices.Methods One hundred and fifty myopic subjects were included in this prospective cross-sectional study.One eye from each subject was randomly selected for optic disc imaging by Cirrus HD-OCT and HRT2 in Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong from September to December in 2010 under the approval of Ethic Committee of this hospital and informed consent of each patient was received.Each subject received complete ophthalmic examinations including intraocular pressure (IOP) measurement,visual acuity,refraction,slit lamp,dilated fundus examination and perimetry.The subjects were divided into low (≤-3.00 D,35 eyes),moderate (-3.00 D＜SE＜-6.00 D,60 eyes) and high myopia (SE ≥-6.00 D,55 eyes) groups according to the refractive status.Measurement of axial length was performed with IOL master.Optic disc parameters including disc area,rim area,cup volume,vertical cup-to-disc ratio (VCDR) and average cup-to-disc area ratio (ACDR) were measured by Cirrus HD-OCT and HRT2,respectively.The OCT measurements were corrected for ocular magnification using the Littman's formula,and the results were compared between the instruments.The measurement agreement was evaluated using Bland-Altman plots.Pearson correlation analysis was used to evaluate the associations between AL and the measurement differences of the two instruments.Results The mean axial length and refraction were (25.62±1.10) mm and (-5.22±2.34) D,respectively.The corrected optic disc parameters were significantly larger than those without adjustment by using Cirrus HD-OCT (all at P＜ 0.001).In the high myopic group,the disc area measured by Cirrus HD-OCT was significantly larger than that by HRT2 (P＜0.001).In the moderate myopic group,the rim area measured by HRT2 was significantly larger than that by the Cirrus HD-OCT (P =0.040).The measurements of ACDR,VCDR and cup volume by Cirrus HD-OCT were all larger than those by HRT2 in the three myopic groups (all at P＜0.001).The 95％ limits of agreement (LoA) of disc area and rim area with the two devices were-0.64 to 0.74 and-0.74 mm to 0.62 mm2,respectively.The differences of disc area,rim area and cup volume measurements from the two devices were significantly and positively associated with axial length (r=0.158,0.148,0.156,all at P＜0.05).No significant correlation was detected between AL and the differences of ACDR and VCDR (r =0.012,0.093,both at P ＞ 0.05).Conclusions Optic disc parameters measured by Cirrus HD-OCT are affected by optical magnification in myopic eyes.Poor agreement is found across all of the disc measurements with Cirrus HD-OCT and HRT2.The two devices should not be used interchangeably for measurements of optic disc.Moreover,the differences between measurements of the two devices are significantly associated with AL.

Consensus ; Humans ; Lung Neoplasms ; diagnosis ; Mesothelioma ; diagnosis ; Practice Guidelines as Topic

OBJECTIVETo compare the results of pathological diagnosis of 41 patients with malignant mesothelioma between Chinese and Japanese experts, and to provide a basis for the standard for diagnosis of mesothelioma.

METHODSThe medical information and tissue samples of 41 patients with malignant mesothelioma were collected in a hospital in Zhejiang Province from 2003 to 2010. The expression levels of calretinin, Wilms' tumor suppressor gene (WT1), podoplanin (D2-40), cytokeratins (CK5/6, AE1/AE3, and CAM5.2), epithelial membrane antigen, carcinoembryonic antigen, BerEP4, MOC31, thyroid transcription factor-1, estrogen receptor, and progesterone receptor in tumor tissues were measured using immunohistochemical staining by Japanese experts, and the pathological classification and diagnosis were made. The results of diagnosis, pathological classification, immunohistochemical marker selection, and slide review were compared between Chinese and Japanese experts.

RESULTSTwenty-nine (70.7%) cases were diagnosed as mesothelioma by Japanese experts, among whom 12 (41.4%) cases were pleura mesothelioma, and 17 (58.6%) cases were peritoneal mesothelioma. Ten (24.4%) cases were confirmed without mesothelioma, and 2 (4.9%) cases were not confirmed due to insufficient information. Thirty-two (78.0%) cases were diagnosed as mesothelioma by Chinese experts, among whom 8 (25.0%) cases were pleura mesothelioma, and 24 (75.0%) cases were peritoneal mesothelioma. One (2.4%) case was confirmed without mesothelioma, and 8 (19.5%) cases were not confirmed. There were significant differences in the results of diagnosis between Chinese and Japanese experts. However, their pathological classifications of mesothelioma were similar. Significant differences in immunohistochemical marker selection and slide review were also found between Chinese and Japanese experts.

CONCLUSIONThe diagnostic skills of those pathological experts in this hospital remain to be further improved for mesothelioma diagnosis. A panel of immunohistochemical markers including at least 2 mesothelioma-positive and 2 mesothelioma-negative markers are recommended for the diagnosis of malignant mesothelioma.

Antigens, Neoplasm ; Biomarkers ; Biomarkers, Tumor ; Cell Adhesion Molecules ; China ; Diagnostic Techniques and Procedures ; standards ; Epithelial Cell Adhesion Molecule ; Humans ; Immunohistochemistry ; Japan ; Lung Neoplasms ; classification ; diagnosis ; Mesothelioma ; classification ; diagnosis ; Observer Variation

OBJECTIVETo compare the effects of oral treatment with tetrandrine (TD) and N-acetylcys-teine (NAC) separately or jointly on silica-exposed rats.

METHODS40 sprague-Dawly (SD) rats were randomly divided into normal saline group, quartz group, TD treatment group (50 mg/kg), NAC treatment group (500 mg/kg) and combined treatment group (TD: 50 mg/kg + NAC: 500 mg/kg). Rats in normal saline group and other groups received intratracheal instillation of normal saline and quartz dust suspension respectively. Treatment groups were given TD, NAC separately or jointly via esophagus the next day after instillation, once a day and six times a week for 30 consecutive days. At the end of experiment, the pathological changes of lung tissues were evaluated by the methods of Foot, HE and Masson staining, the level of hydroxyproline (HYP), malondjalde-hyde (MDA), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in lung tissues were measured by alkaline hydrolysis method, the barbituric acid method and enzyme-linked immunosorbent assay (ELISA) respectively.

RESULTSCompared with the quartz group, lymph nodes/body coefficients in all treatment groups and lung/body coefficient in combined treatment group were significantly decreased (P < 0.05). Pathology results showed that the normal saline group demonstrated no obvious evidence of lung damage. The quartz group lungs silicotic lesions focused on II~III level, the TD treatment group was mainly with I level, the NAC treatment group was mainly with I~II level, and the combined treatment group only showed little silicotic nodule, no obvious fibrosis. HYP content in TD treatment group and combined treatment group were significantly lower than that in the quartz group (P < 0.05), while it showed no obvious change in NAC treatment group. MDA content in lung tissues of each treatment group (TD treatment group, NAC treatment group and combined treatment group) were 18.80 ± 2.94, 20.13 ± 4.01 and 17.05 ± 3.52 nmol/ml respectively, which lower than in the quartz group (23.99 ± 3.26 nmol/ml). The level of IL-6 in lung tissues of the quartz group were 89.57 ± 8.78 pg/ml. After TD and NAC monotherapy, the IL-6 content decreased to 79.22 ± 9.65 pg/ml and 81.63 ± 5.72 pg/ml, and it decreased more significantly after combined medication (74.37 ± 3.17 pg/ml). The level of TNF-α in the quartz group were 59.05 ± 4.48 pg/ml. After TD and NAC monotherapy, the TNF-α content decreased to 50.48 ± 2.76 pg/ml and 54.28 ± 4.30 pg/ml, and it decreased more significantly after combined medication (49.10 ± 4.98 pg/ml).

CONCLUSIONNAC and TD could reduce MDA, TNF-α and IL-6 levels in lung tissue, and alleviate SiO2-induced pulmonary fibrosis in rats. Combined treatment with TD and NAC was more effective than TD or NAC treatment separately.

Acetylcysteine ; pharmacology ; Animals ; Benzylisoquinolines ; pharmacology ; Disease Models, Animal ; Dust ; Hydroxyproline ; metabolism ; Interleukin-6 ; metabolism ; Lung ; pathology ; Malondialdehyde ; metabolism ; Pulmonary Fibrosis ; chemically induced ; drug therapy ; Quartz ; toxicity ; Rats ; Rats, Wistar ; Silicon Dioxide ; toxicity ; Silicosis ; drug therapy ; Tumor Necrosis Factor-alpha ; metabolism