BACKGROUNDOlder subjects tend to have smaller ocular anterior segment. The present study aimed to measure anterior segment dimensions with optical coherence tomography (OCT) and quantitatively assess the effect of age and other factors.

METHODSAnterior segment OCT images were obtained in normal subjects residing in the greater Los Angeles area. Four line scans were acquired at the 90°, 45°, 0° and 135° meridians of each eye. Computer calipers acquired anterior segment dimensions of corneal diameter, anterior chamber width, corneal vault and anterior chamber depth on OCT images. Measurements from 4 meridians were averaged. Axial length and corneal power were measured by partial coherence interferometry. Univariate and multivariate analyses were performed to assess correlations.

RESULTSSixty-six eyes of 33 normal subjects (aged 22 - 65 years, 19 Asians, 14 Caucasians) were enrolled. For every 1 year of age, corneal diameter was 0.033 mm narrower (P < 0.01), anterior chamber width was 0.031 mm narrower (P < 0.01), corneal vault was 0.016 mm lower (P < 0.01), and anterior chamber depth was 0.025 mm lower (P < 0.01). Asian eyes had smaller corneal diameter (P = 0.035) and anterior chamber width (P = 0.015) compared with those of Caucasian eyes. Body height showed positive correlation with corneal diameter (0.039 mm per centimeter of height, P < 0.01) and corneal vault (0.024 mm per centimetre of height, P < 0.01). Gender did not have an independent effect on anterior segment dimensions.

CONCLUSIONSAnterior segment dimensions were smaller in older subjects. Age-related changes may affect the tolerability of long-term implants such as phakic intraocular lens.

Adult ; Age Factors ; Aged ; Anterior Eye Segment ; anatomy & histology ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Tomography, Optical Coherence

OBJECTIVETo discuss whether vascular endothelial growth factor (VEGF) in the peripheral blood can reflect the biological activities of pituitary adenomas.

METHODSThe concentrations of VEGF in peripheral blood were measured with ELISA in 203 patients with pituitary adenomas, 22 patients with pituitary hyperplasia, 7 patients with pituitary Rathke' pouch and 3 patients with pituitary abscess.

RESULTSThe serum VEGF levels were (366.8 +/- 211.1) pg/ml and (286.8 +/- 107.6) pg/ml in patients with pituitary adenomas and pituitary hyperhasia, respectively, which were higher than those in patients with pituitary Rathke' pouch [(180.5 +/- 61.7) pg/ml], patients with pituitary abscess [(147.5 +/- 46.3) pg/ml] and the health control [(180.8 +/- 56.2) pg/ml] (P < 0.05). In patients with pituitary adenomas, the VEGF levels were (380.0 +/- 234.5) pg/ml in macroadenomas and (380.1 +/- 2870.3) pg/ml in giant adenomas, higher than those in microadenomas [(294.6 +/- 111.6) pg/ml] and in pituitary hyperhasia respectively (P < 0.05). The serum VEGF levels were not significantly different in pituitary adenoma in terms of invasive growth, apoplexy, cyst and hormone secretory functions (P > 0.05).

CONCLUSIONSThe upregulation of serum VEGF expression may reflect the biological activities of pituitary adenoma. However, it may not be associated with pituitary Rathke' pouch, pituitary abscess, adenoma with invasiveness, apoplexy, cyst and hormone secretory function. The serum VEGF levels could be helpful in differentiating pituitary adenoma from pituitary Rathke' pouch and pituitary abscess.

Adenoma ; blood ; diagnosis ; Adult ; Diagnosis, Differential ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Hyperplasia ; blood ; diagnosis ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pituitary Diseases ; blood ; diagnosis ; Pituitary Neoplasms ; blood ; diagnosis ; Vascular Endothelial Growth Factor A ; blood

AIM: To investigate the curative effect of phacoemulsification and intraocular lens ( IOL ) implantation combined with goniosynechialysis in the treatment of age-related cataract merging with primary angle-closure glaucoma ( PACG) . · METHODS: Totally 80 patients with age-related cataract merging with PACG were in our hospital from January 2014 to January 2016. The preoperative average intraocular pressure ( IOP) was 33. 22 ± 3. 17mmHg; the average depth of anterior chamber was 2. 07 ± 0. 15mm;the dynamic situation of primary angle closure ≤1/2 cycle by gonioscope. They were randomly divided into Group A and B for doing a study. All the two groups were treated with phacoemulsification and intraocular lens implantation. And the Group A was with goniosynechialysis. The following up period was 2mo, and we observed the IOP, chamber depth and the anterior chamber angle. · RESULTS: The change of chamber depth and intraocular pressure about the two groups: the average intraocular pressure of the Group A was 15. 11 ± 3. 67mmHg,the chamber depth was 3. 11±0. 08mm;those of the Group B were 17. 24 ± 1. 67mmHg, 2. 76 ± 0. 15mm respectively; the differences had statistical significance (P<0. 05). Postoperatively, there were 28 eyes (70%) in Group A with fully open anterior chamber angle, and 18 eyes (45%) in Group B (P<0. 05). · CONCLUSION: The phacoemulsification and intraocular lens implantation combined with goniosynechialysis in the treatment of age-related cataract merging with primary angle-dosure glaucoma is safe and reliable. It's simple to operate, and do not increase the risk of surgery.

Objective To sythesize 99Tcm labeled asparagine-glycine-arginine (NGR)- interferon (INF)-α2a and investigate its biodistribution by scintigraphy in tumor bearing mice. Methods NGR-INFα2a was labeled with 99Tcm by a two-step method. Ethylenedicysteine (EC) and MDP were used as bifunctional and transferring chelating agents. The bioactivities of 99Tcm-NGR-IFN-EC-NGR-IFN-α2a, EC-NGRIFN-α2a and NGR-IFN-α2a were compared using least significant difference t-test. The hepatoma bearing mice models were established by subcutaneous injection of MHCC97-H cells. The mice were randomly divided into eight groups and 7.4 MBq 99Tcm-NGR-IFN-α2a was injected via the tail vein. The tissue uptake of the radiolabeled compound was measured as % ID/g. The scintigraphy was performed at 0.5, 1, 2, 4,6, 8, 12 and 24 h after injection. ROI were drawn around tumor and non-tumor tissue and the radioactivity ratio of T/NT was calculated. Results Both the labeling efficiency and radiochemical purity of 99Tcm-EC-NGR-IFN-α2a were more than 90%. The radiochemical purity was 71% after 24 h in saline. The bioactivity showed no significant difference among three compounds (t = 0.416, 0. 120 and 1. 300, all P >0.05). The tracer was mainly excreted through alimentary and urinary tract within 24 h after injection. The peak values of % ID/g in kidney, liver, interstinal tract and tumor were 41.5 ± 8.0_ (at 8 h), 31.3 ± 5.0(at 6 h), 36.0 ± 7.8 (at 6 h), 43.0 ± 4.8 (at 4 h), respectively. The tracer was cleared quickly from the blood and the highest T/NT ratio was 16.5. The optimal imaging time ranged from 4 to 8 h after injection. Conclusions The sythesis of 99Tcm-NGR-IFN-α2a is applicable and it may be used as a potential tumor imaging agent.

This study was aimed to retrospectively analyze and compare the clinical curative efficacy of patients with hematologic malignancies after G-CSF-mobilized sibling HLA-matched (sm) peripheral blood hematopoietic stem cell transplantation (sm-allo-PBHSCT) and sm-allo-PBHSCT combined with bone marrow transplantation (BMT). 100 patients received sm-allo-HSCT in a single center from October 2001 to October to 2010, included 38 patients received sm-allo-PBHSCT and 62 patients received sm-allo-PBHSCT combined with BMT. The myeloablative or reduced intensity conditioning regimens were chosen according to the condition of patients. All patients received standard cyclosporine (CsA) and mycophenolate mofetil (MMF) as prophylaxis for GVHD. The results showed that the rapid hematopoietic reconstitution was observed in all patients. The median time of ANC ≥ 0.5 × 10(9)/L in both groups were 12 days, the median time of platelet count ≥ 20 × 10(9)/L was 15 days in sm-allo-PBHSCT group and 16 days in sm-allo-PBHSCT + BMT group. The incidence of acute GVHD, acute GVHD of III-IV grade and chronic GVHD in sm-allo-PBHSCT and sm-allo-PBHSCT + BMT groups were 37.1% and 34.2%, 7.89% and 8.06%, 36.11% and 41.38% respectively, there were no statistical differences. The relapse rates were similar in two groups (sm-allo-PBHSCT 13.16% vs sm-allo-PBHSCT + BMT 12.9%). The 3-year disease-free survivals in sm-allo-PBHSC and sm-allo-PBHSCT + BMT groups were 57.1 ± 8.7% and 61.3 ± 6.4% respectively (p = 0.852). The 2-year overall survival of high-risk patients was 41.4 ± 12.8% in sm-allo-PBHSCT group, while 60.9 ± 9.6% in sm-allo-PBHSCT + BMT group (p = 0.071). It is concluded that the rhG-CSF mobilized sibling matched allo-PBHSCT + BMT is superior to the rhG-CSF mobilized sibling matched allo-PBHSCT in increasing the overall survival of high-risk hematologic malignancies.
Adolescent ; Adult ; Aged ; Bone Marrow Transplantation ; Child ; Child, Preschool ; Female ; Granulocyte Colony-Stimulating Factor ; therapeutic use ; HLA Antigens ; immunology ; Hematologic Diseases ; immunology ; therapy ; Humans ; Male ; Middle Aged ; Peripheral Blood Stem Cell Transplantation ; Retrospective Studies ; Siblings ; Tissue Donors ; Young Adult

OBJECTIVETo investigate the efficacy of the double-balloon and triple-channel catheter (DBTC) in the treatment of chronic bacterial prostatitis (CBP).

METHODSOne hundred and three CBP patients were randomly assigned to three different groups and received three different therapies, respectively: 1. 61 cases by transurethral perfusion and drainage with antibiotics with DBTC catheter; 2. 29 cases by intravenous antibiotics, and 3. 13 cases by transurethral irrigation with 0.9% saline. The lecithin, white blood cells (WBC) in expressed prostatic secretion (EPS) and Meares-Stamey's test fractionary urine culture pre- and post-therapies were compared.

RESULTSThe improvement rates of clinical symptoms and lecithin corpuscles were 81.9% and 68.9%, respectively. And the decline rate of WBC and bacteriological efficacy rate were 75.4% and 91.8%, respectively. There was a significant statistical difference between the DBTC group and the intravenous group in the lecithin, WBC and bacterial culture (P < 0.05, < 0.01 and < 0.01, respectively), and so was there between the saline group and the intravenous group in the decline of WBC(chi 2 = 5.6, P < 0.05), but with no difference in lecithin and bacterial culture. Among 61 patients treated with DBTC, 3 developed mild allergic reaction in urethra.

CONCLUSIONSTransurethral DBTC has a better clinical efficacy than traditional intravenous treatment for CBP. DBTC perfusion combined with other hypurgia holds obvious advantages of being safe, effective, easy and repeatable in the treatment of CBP.

Adolescent ; Adult ; Bacterial Infections ; complications ; therapy ; Catheterization ; methods ; Chronic Disease ; Humans ; Male ; Middle Aged ; Perfusion ; methods ; Prostate ; microbiology ; Prostatitis ; microbiology ; therapy

OBJECTIVETo discuss the etiology, diagnostic criteria and treatment of Nelson's syndrome.

METHODSTwenty-three patients with Nelson's syndrome who were treated in our department over the last 19 years were analyzed retrospectively. Removal of adenoma by the transsphenoidal approach was done in 21 patients and by transfrontal craniotomy in 2. The follow-up period ranged from six months to nine years.

RESULTSThe incidence of Nelson's syndrome was 7.7% in a series of 300 patients with Cushing's disease treated by microsurgery in the same period. Hyperpigmentation was relieved and adrenocorticotropic hormone (ACTH) levels decreased in all patients after tumor excision. Eight patients with visual disturbance improved after surgery. The curative and remission rates were 56.5% and 26.1%, respectively.

CONCLUSIONSTranssphenoidal microsurgical removal of pituitary ACTH adenoma is the first choice in the prevention and treatment of Nelson's syndrome. Regular follow-up examinations should be performed over a long time.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Microsurgery ; methods ; Middle Aged ; Nelson Syndrome ; epidemiology ; etiology ; surgery

OBJECTIVETo study the clinical characteristics, diagnosis and surgical effects of thyroid-stimulating hormone pituitary adenomas (TSH-omas).

METHODSThe clinical data of 19 patients (14 female and 5 male) with TSH-omas were analyzed retrospectively in this study from January 2001 to December 2008. The patients ranged from 20 to 70 years old (average 40.5 years old) and had disease histories from 1 to 228 months (average 55 months). Among these patients, 15 of them complained of thyrotoxicosis symptoms, while the other 4 patients' symptoms were associated with headache and/or visual disturbance caused by the tumor mass effect. Initially, 12 of the 15 patients with thyrotoxicosis symptoms were misdiagnosed with Grave's disease. As a result 2 of them received (131) Iodine, and one received subtotal thyroidectomy. All of these patients underwent transsphenoidal microsurgery.

RESULTSAverage follow-up period was 3.6 years (6 months-7 years). Pathological analysis of the surgical specimen showed pituitary adenoma in all patients, immunohistochemistry were positive for TSH in 17 cases, negative for TSH in 2, positive for growth hormone in 2, positive for prolactin in 1, and positive for adrenocorticotrophic hormone in 1. Postoperative MRI revealed that the tumors in 15 patients were removed totally, though 4 patients still had residual tumors. The thyroid hormone level tests suggested that 13 patients could be considered normal 3 months after their tumors were removed, though 2 of patients with normal postoperative MRI and thyroid hormones showed increased levels of TSH. For these 2 patients, tumors did not recur and their thyroid hormone levels returned to normal after pituitary radiotherapy. The cure rate was 11/19 after surgery and 13/19 after surgery plus pituitary radiotherapy.

CONCLUSIONSThe screening test for hyperthyroidism patients with high TSH levels is a key point to improve the accuracy rate in early diagnoses of TSH-omas. The transsphenoidal microsurgery is first choice to treat TSH-omas, while pituitary radiotherapy and somatostatin analogs are beneficially adjunctive therapies.

Adult ; Aged ; Female ; Humans ; Hyperthyroidism ; metabolism ; Male ; Middle Aged ; Pituitary Neoplasms ; diagnosis ; metabolism ; surgery ; Retrospective Studies ; Thyrotropin ; metabolism ; Young Adult

Objective of this study was to evaluate the efficacy and safety of haploidentical or unrelated donor hematopoietic stem cell transplantation (HSCT) for patients with severe aplastic anemia (SAA). Twenty patients with SAA received allogeneic HSCT from haploidentical or unrelated donors (14 from haploidentical donors and 6 from unrelated donors) from November 2005 to May 2011. Conditioning regimen consisted of fludarabine (FLU), cyclophosphamide (Cy) and anti-thymocyte immunoglobulin (ATG). The patients were administrated with G-CSF-primed bone marrow and mobilized peripheral blood as grafts from haploidentical donor or only mobilized peripheral blood from the unrelated donor. The results showed that the median time of neutrophil and platelet engraftment were 14 (11 - 20) d and 17 (13 - 31) d respectively. All patients who achieved engraftment had complete hematologic recovery with complete donor chimerism, except for two patients who developed graft failure in 2 months after transplantation. Four cases developed acute grade IIGVHD. The chronic GVHD occurred in 7 of the 16 evaluable cases (6 limited, 1 extensive). 14 patients got disease-free survival with follow-up to January 2012. The disease-free survival rate was 68.9%. It is concluded that the haploidentical or unrelated donor hematopoietic stem cell transplantation may become a viable therapeutic option for severe aplastic anemia patients who lack suitable human leukocyte antigen-matched donors and fail immunosuppressive therapy.
Adolescent ; Adult ; Anemia, Aplastic ; surgery ; Child ; Child, Preschool ; Female ; Hematopoietic Stem Cell Transplantation ; methods ; Humans ; Immunosuppressive Agents ; therapeutic use ; Male ; Transplantation Conditioning ; methods ; Transplantation, Homologous ; Unrelated Donors

OBJECTIVETo discuss the effects of adrenalectomy (ADX) on the treatment of Cushing's disease(CD).

METHODSClinical data of 15 cases of CD between January 1980 and December 2005 were analyzed to evaluate operative indications, complications and the changes of hypercortisolism and hormone levels pre- and post- adrenalectomy.

RESULTSAll the patients involved underwent transsphenoidal pituitary surgery previously. Repeated transsphenoidal surgery was performed in 4 cases. Pituitary radiotherapy was done in 4 cases. The average time from original transsphenoidal operation to ADX was 25.7 months. Pre- and post- adrenalectomy serum cortisol median level were 1156.4 nmol/L and 99.4 nmol/L, the 24 h urinary-free cortisol median level were 315.0 and 5.4 microg, respectively. Hormone replacement therapy was needed in all cases. Average follow-up period was 47 months (9-120 months). Nelson syndrome (NS) appeared in 5 cases (33.3%), while 10 cases showed no NS.

CONCLUSIONSADX is an effective and symptomatic treatment to relieve hypercortisolism caused by CD but with the risk of NS. Longtime hormone replacement therapy and follow up are needed after ADX.

Adolescent ; Adrenalectomy ; adverse effects ; methods ; Adrenocorticotropic Hormone ; blood ; Adult ; Child ; Female ; Follow-Up Studies ; Humans ; Hydrocortisone ; blood ; Male ; Middle Aged ; Nelson Syndrome ; etiology ; prevention & control ; Pituitary ACTH Hypersecretion ; blood ; surgery ; Postoperative Complications ; prevention & control ; Retrospective Studies ; Treatment Outcome