Objective: This study aims to determine recurrence and complication rates among patients who underwent three current pterygium treatment techniques: preoperative subpterygeal injection of mitomycin C, intraoperative application of mitomycin with pterygium excision and pterygium excision with conjunctival autograft. Methods: This is a randomized controlled clinical trial in a tertiary hospital. We included patients with diagnosed primary pterygium and who underwent either: A = pre-operative injection of 0.02% mitomycin C one month prior to pterygium excision; B = pterygium excision with intraoperative mitomycin C application; or C = pterygium excision with conjunctival autograft. Results: We included 111 patients: a total of 120 eyes randomized to 3 groups (A, B, C) at 40 eyes per group. After 24 months of follow-up, there was no significant difference in the recurrence rates among the groups (6/40 [15%] in groups A and B and 2/40 cases [5%] in group C; P=0.29). No complications were noted in groups B and C, while 1 case of scleral thinning was noted in group A. There was no significant difference in the complication rates among the three procedures (P=1.00). Conclusion There were no significant differences in the recurrence and complication rates among the three techniques. Careful patient selection and follow-up are recommended to prevent complications such as scleral thinning.
Pterygium Of Conjunctiva And Cornea ; Pterygium ; Mitomycin ; Autografts ; Conjunctiva ; Conjunctivitis ; Transplantation, Autologous

The treatment of total or near-total nasopharyngeal stenosis is challenging because of frequent restenosis. Many treatment strategies including scar release with CO₂ laser, mitomycin C application, balloon dilatation or nasopharyngeal stent had been proposed to reduce the restenosis of nasopharynx. But nasopharyngeal patency often fail even after multiple surgical trials. We report two successful cases of nasopharyngeal reconstruction with resurfacing by nasoseptal flap for patients with restenosis history.
Cicatrix ; Constriction, Pathologic ; Dilatation ; Humans ; Mitomycin ; Nasal Septum ; Nasopharyngeal Diseases ; Nasopharynx ; Stents ; Surgical Flaps

BACKGROUND: The esophagus is the most common part of gastrointestinal (GI) tract at the risk of stricture. Benign disorders are the leading causes of narrowing. Caustic ingestion is the most common cause of esophageal stricture in children, especially in developing countries. Clinical responses to the topical application of Mitomycin C in various medical procedures have been reported. PURPOSE: The study aimed to evaluate the methodology, efficacy, and side effects of Mitomycin C in the treatment of esophageal strictures. METHODS: This study included 30 children with resistant esophageal strictures. Upper GI endoscopy was performed up to the area of stricture, esophageal dilatation was done, endoscopy was repeated, and Mitomycin C was applied topically under direct endoscopic vision. The effect of the procedure was followed over a period of 3–5 years. RESULTS: The response to Mitomycin C was excellent (clinically and endoscopically) in 28 patients (93.3%) and good (endoscopically only) in 2 patients (6.7%). No side effects of topical Mitomycin C in children with esophageal strictures were reported in this study. CONCLUSION: Esophageal dilatation followed by local Mitomycin C application may be a useful strategy for treating resistant esophageal strictures.
Child ; Constriction, Pathologic ; Developing Countries ; Dilatation ; Eating ; Endoscopy ; Esophageal Stenosis ; Esophagus ; Humans ; Mitomycin

PURPOSE: To investigate the effects of valproic acid on the survival of cultured human Tenon's capsule fibroblasts (HTFBs). METHODS: Primary cultured HTFBs were exposed to 0, 0.25, 0.5, and 1.0 mM valproic acid with or without 0, 1.0, 2.5 µg/mL mitomycin C, and incubated for 5 days. Cell survival was assessed using an MTT (3-[4, 5-dimethylthiazol-2-yl]-2, 5-diphenyltetrazolium bromide) assay and the degree of apoptosis was assessed by flow cytometry using annexin-V/propidium iodide double staining. RESULTS: Valproic acid decreased the survival of HTFBs in a dose-dependent manner, and survival was further decreased by adding mitomycin C to valproic acid. Both valproic acid and mitomycin C induced apoptosis of HTFBs. Valproic acid induced less apoptosis than mitomycin C. CONCLUSIONS: Valproic acid decreased the cellular survival of HTFBs and induced apoptosis. The antiproliferative effects of valproic acid were further enhanced by the addition of mitomycin C.
Apoptosis ; Cell Survival ; Fibroblasts ; Flow Cytometry ; Humans ; Mitomycin ; Tenon Capsule ; Valproic Acid

PURPOSE: We report a case of conjunctival necrosis in a glaucoma patient who underwent Ahmed valve implantation and subtenon triamcinolone injection. CASE SUMMARY: subconjunctival injections of mitomycin C in her right eye. Ahmed valve implantation and subtenon triamcinolone injection were performed in the right eye. Four weeks later, conjunctival necrosis was observed. After debridement of necrotic tissue, an additional conjunctival autograft was needed because of recurrence of the conjunctival necrosis. After amniotic membrane transplantation was performed for one more recurrent conjunctival necrosis, conjunctival epithelialization was completed. CONCLUSIONS: Although conjunctival necrosis after periocular injection of triamcinolone is a rare complication, previous multiple usage of antimetabolites such as mitomycin C might be associated with a higher risk of developing conjunctival necrosis. In such cases, aggressive surgical intervention may be helpful in the reconstruction of the conjunctival epithelium.
Amnion ; Antimetabolites ; Autografts ; Debridement ; Epithelium ; Glaucoma ; Humans ; Injections, Intraocular ; Mitomycin ; Necrosis ; Recurrence ; Triamcinolone

PURPOSE: To investigate changes in ocular high-order aberrations (HOAs) resulting from phacotrabeculectomy and phacoemulsification. METHODS: We retrospectively reviewed 38 eyes of 38 glaucoma and cataract patients who underwent mitomycin C (MMC) augmented trabeculectomy with phacoemulsification and 34 eyes of 34 cataract patients who underwent phacoemulsifiction. For all patients, we measured the best corrected visual acuity (BCVA), intraocular pressure (IOP), keratometry, and HOAs (iTrace, Tracey Technologies, Houston, TX, USA) both preoperatively and postoperatively. RESULTS: IOP was significantly decreased after surgery in the combined group (p < 0.001). Entire eye, coma-like, and spherical-like high-order aberrations from each entire eye, corneal aberrations, and internal-optics aberration were increased until after 2 weeks, which then decreased until 3 months after phacotrabeculectomy. In the phacoemulsification group, entire eye (each p = 0.006, p =0.006), coma-like (each p = 0.006 and p = 0.005), and spherical-like high-order aberrations (each p = 0.008, p = 0.005) from entire eye and internal-optics aberrations were decreased. CONCLUSIONS: After cataract surgery, entire eye, coma-like, and spherical-like high-order aberrations were significantly decreased while aberrations did not change after combined operation. These results suggest that a change in high-order aberrations of internal optics results in a decrease in postoperative HOAs. In addition, the baseline HOAs of the cataract group were higher than those of the combined surgery group, and the effect of trabeculectomy on HOAs may offset the impact of cataract surgery in the combined surgery group.
Cataract ; Glaucoma ; Humans ; Intraocular Pressure ; Mitomycin ; Phacoemulsification ; Retrospective Studies ; Trabeculectomy ; Visual Acuity

Esophageal strictures are seldom in children. In many countries, accidental ingestion of corrosives is a major cause of risk for stricture formation. Therefore, their management is a challenge. Safety and long-term efficacy of esophageal dilation for benign esophageal strictures has been confirmed in children. Because most children with structures are toddlers or younger, balloon dilatation is often preferred over bouginage. There is increasing evidence that short duration administration of high doses steroids may be of benefit in some specific situation (IIb esophagitis according to Zargar classification). Mytomycin-C application needs to be further evaluated. Stenting was reported to be successful in some refractory cases.
Caustics ; Child* ; Constriction, Pathologic* ; Dilatation ; Eating ; Esophagitis ; Humans ; Mitomycin ; Stents ; Steroids

Esophageal strictures are seldom in children. In many countries, accidental ingestion of corrosives is a major cause of risk for stricture formation. Therefore, their management is a challenge. Safety and long-term efficacy of esophageal dilation for benign esophageal strictures has been confirmed in children. Because most children with structures are toddlers or younger, balloon dilatation is often preferred over bouginage. There is increasing evidence that short duration administration of high doses steroids may be of benefit in some specific situation (IIb esophagitis according to Zargar classification). Mytomycin-C application needs to be further evaluated. Stenting was reported to be successful in some refractory cases.
Caustics ; Child* ; Constriction, Pathologic* ; Dilatation ; Eating ; Esophagitis ; Humans ; Mitomycin ; Stents ; Steroids

Senescence-associated secretory phenotype (SASP) is often a concomitant result of cell senescence, embodied by the enhanced function of secretion. The SASP factors secreted by senescent cells include cytokines, proteases and chemokines, etc, which can exert great influence on local as well as systemic environment and participate in the process of cell senescence, immunoregulation, angiogenesis, cell proliferation and tumor invasion, etc. Relative to the abundance of SASP models in human cells, the in vitro SASP model derived from mouse cells is scarce at present. Therefore, the study aimed to establish a mouse SASP model to facilitate the research in the field. With this objective, we treated the INK4a-deficient mouse NIH-3T3 cells and the wildtype mouse embryonic fibroblasts (MEF) respectively with mitomycin C (MMC), an anticarcinoma drug which could induce DNA damage. The occurring of cell senescence was evaluated by cell morphology, β-gal staining, integration ratio of EdU and Western blot. Quantitative RT-PCR and ELISA were used to detect the expression and secretion of SASP factors, respectively. The results showed that, 8 days after the treatment of NIH-3T3 cells with MMC (1 μg/mL) for 12 h or 24 h, the cells became enlarged and the ratios of β-gal-positive (blue-stained) cells significantly increased, up to 77.4% and 90.4%, respectively. Meanwhile, the expression of P21 protein increased and the integration ratios of EdU significantly decreased (P < 0.01). Quantitative RT-PCR detection showed that the mRNA levels of several SASP genes, including IL-6, TNF-α, IL-1α and IL-1β increased evidently. ELISA detection further observed an enhanced secretion of IL-6 (P < 0.01). On the contrary, although wildtype MEF could also be induced into senescence by MMC treatment for 12 h or 24 h, embodied by the enlarged cell volume, increased ratios of β-gal-positive cells (up to 71.7% and 80.2%, respectively) and enhanced expression of P21 protein, the secretion of IL-6 displayed no significant change. Our study indicated that, although MMC could induce senescence in both mouse NIH-3T3 cells and wildtype MEF, only senescent NIH-3T3 cells displayed the canonical SASP phenomena. Current study suggested that senescent NIH-3T3 cells might be an appropriate in vitro SASP model of mouse cells.
Animals ; Cell Proliferation ; Cellular Senescence ; drug effects ; Cyclin-Dependent Kinase Inhibitor p21 ; genetics ; metabolism ; Cytokines ; genetics ; metabolism ; DNA Damage ; Fibroblasts ; drug effects ; Interleukin-6 ; secretion ; Mice ; Mitomycin ; pharmacology ; NIH 3T3 Cells ; Phenotype

PURPOSE: The purpose of this study was to explore the dosimetric difference between simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) and three-dimensional conformal radiotherapy (3DCRT), and the clinical outcomes of anal squamous cell carcinoma (ASCC) chemoradiotherapy featuring SIB-IMRT. MATERIALS AND METHODS: This study included ten patients with ASCC who underwent chemoradiotherapy using SIB-IMRT with 5-fluorouracil and mitomycin C. SIB-IMRT delivered 54 Gy to each primary tumor plus metastatic lymph nodes and 45 Gy to regional lymph nodes, in 30 fractions. Four patients received additional boosts to the primary tumors and metastatic lymph nodes; the median total dose was 54 Gy (range, 54 to 60 Gy). We additionally created 3DCRT plans following the Radiation Therapy Oncology Group 9811 protocol to allow dosimetric comparisons with SIB-IMRT. Locoregional control, overall survival, and toxicity were calculated for the clinical outcome evaluation. RESULTS: Compared to 3DCRT, SIB-IMRT significantly reduced doses to the external genitalia, bladder, and intestine, delivering the doses to target and elective nodal region. At a median follow-up time of 46 months, 3-year locoregional control and overall survival rates were 88.9% and 100%, respectively. Acute toxicities were treated conservatively. All patients completed radiotherapy with brief interruptions (range, 0 to 2 days). No patient experienced ≥grade 3 late toxicity during the follow-up period. CONCLUSION: The dosimetric advantages of SIB-IMRT appeared to reduce the toxicity of chemoradiotherapy for ASCC achieving high locoregional control in the extended period.
Anus Neoplasms ; Carcinoma, Squamous Cell* ; Chemoradiotherapy ; Epithelial Cells* ; Fluorouracil ; Follow-Up Studies ; Genitalia ; Humans ; Intestines ; Lymph Nodes ; Mitomycin ; Radiotherapy ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Conformal ; Radiotherapy, Intensity-Modulated* ; Survival Rate ; Treatment Outcome ; Urinary Bladder