bluuebunny/crossref_metadata_2025 huggingface dataset:
Bilateral choroidal ischaemia and serous retinal detachment in pre‐eclampsia
Authors: Sathish Srinivasan , Arnold Jennifer J
Published: March 2003

Serious retinal detachment secondary to choroidal ischaemia is an unusual but well‐documented cause of visual loss in pre‐eclampsia. Very few cases have been reported in the literature. We report a case of a 26‐year‐old multigravida with pre‐eclampsia who developed bilateral choroidal ischaemia with serious retinal detachments. There was spontaneous resolution of the serous detachment and the choroidal changes in the post‐partum period, with residual pigment epithelial changes. Serous retinal detachments in pre‐eclampsia are secondary to choroidal ischaemia and disturbances in the choroidal vascular supply.
Warfarin therapy and cataract surgery
Authors: Morris Ainsley , Elder Mark J
Published: March 2003

Purpose: Cataract extraction in the warfarinized patient poses special considerations. Warfarin will increase the haemorrhagic risk but, more importantly, cessation or reduction in anticoagulation may well lead to serious thromboembolic phenomena. The purpose of this study was to assess the impact that warfarinization has on cataract extraction.

Methods: One thousand consecutive cataract extractions performed at Christchurch Hospital between 1996 and 1998 were reviewed. Twenty‐eight patients (29 eyes) were on warfarin. Reasons for anticoagulation, modification to treatment regimen and postoperative outcome measures were available for 23 eyes or 79% of the study population.

Results: The preoperative international normalized ratio (INR) ranged from 1.00 to 2.40 ± 0.37 with a mean of 1.52. No thromboembolic phenomena occurred and four minor perioperative haemorrhages were noted, none of which affected the final visual outcome.

Conclusions: If warfarin is required to counteract serious thromboembolic tendencies, then it should not be ceased perioperatively. The small numbers of perioperative haemorrhages that did occur were not visually significant.
Acute haemorrhagic keratoconjunctivitis following laser in situ keratomileusis
Authors: Sharma Namrata , Dada Tanuj , Dada Vijay K , Vajpayee Rasik B
Published: March 2003

We report two cases of acute haemorrhagic keratoconjunctivitis which occurred following laser in situ keratomileusis (LASIK) during an ongoing epidemic. Both cases underwent preoperative investigation and surgery on the same day. The possible sources of contamination include the paramedical staff, the contact instruments used for performing preoperative investigation, surgeon, nurse, surgical instruments and eye drops. However, the flap was intact with no haze or regression and at 1 year follow up, the visual acuity was maintained at 6/6 in both the patients. We recommend greater caution while performing contact investigations and strict surgical asepsis during LASIK surgery, routinely as well as during epidemics of conjunctivitis.
Management of diabetic retinopathy by general practitioners in Victoria
Authors: McCarty Catherine A , Taylor Kathryn I , Keeffe Jill E
Published: March 2003

Purpose: To compare the self‐reported management of diabetic retinopathy by general practitioners to the National Health and Medical Research Council of Australia (NHMRC) Guidelines for the Management of Diabetic Retinopathy.

Methods: In 1994, a stratified (by urban/rural practice location) sample of 500 general practitioners in Victoria was surveyed in regard to their management of diabetic retinopathy. Following the release of the NHMRC Guidelines for the Management of Diabetic Retinopathy in 1997, these same general practitioners were sent a two‐page questionnaire related to their management of diabetic retinopathy.

Results: Completed questionnaires were received from 228 general practitioners (59% of original participants). Only 37% (79/216) of the general practitioners reported that they had received a copy of the guidelines. Of the general practitioners who had received the guidelines, 18% (14/79) said that they had not read them at all, while 65% (51/79) had read them partially and 18% (14/79) had read them in their entirety. At follow up, less than half (98/214) of general practitioners reported examining 50% or more of their patients for diabetic retinopathy, compared with 104/214 at baseline. General practitioners who had read the guidelines were more likely to report that not being sure what to do when changes were detected was a minor barrier or was not a barrier to them performing dilated ophthalmoscopy (93%vs 83%, χ2(1) = 3.67, P = 0.055). Nearly all of the general practitioners reported that they refer their patients with diabetes to an ophthalmologist or optometrist at least every 2 years as recommended. Seventy‐six per cent (170/224) of the general practitioners felt that 70% or more of their patients complied with their instructions to visit an ophthalmologist or optometrist.

Conclusion: The NHMRC guidelines for diabetic retinopathy appear to have had a positive effect on some of the attitudes of general practitioners who have read them, but more effort is needed to disseminate the guidelines to all general practitioners and to increase their uptake.
Comparison of subretinal fluid levels of two 0.3% ciprofloxacin‐containing eye drops
Authors: Çekiç Osman , Batman Coşar , Yaşar Ümit , Totan Yüksel , Başci Nursabah E , Bozkurt Atilla , Zilelioglu Orhan , Kayaalp S Oguz
Published: March 2003

Purpose: Two ophthalmic solutions of 0.3% ciprofloxacin eye drops are available in Turkey: Ciloxan and Siprogut. A previous study by the same authors was the first to report vitreous penetration of ciprofloxacin‐containing eye drops. The aim of the present study was to compare the levels of drug found in the subretinal fluid by the two products following local administration.

Methods: Forty‐three patients undergoing conventional retinal detachment surgery received either Ciloxan (22 patients) or Siprogut (21 patients). Beginning 6 h before surgery, two drops of solution were instilled onto the operative eye every 30 min for the first 3 h and then hourly for the next 3 h. Subretinal fluid samples were collected 30 min after administration of the last dose and were assayed for ciprofloxacin levels using a method involving high‐ performance liquid chromatography with fluorometric detection.

Results: The minimum and maximum subretinal fluid concentrations measured were 0.11 μg/mL and 0.65 μg/mL, respectively, with Ciloxan, and 0.08 μg/mL and 0.62 μg/mL, respectively, with Siprogut. There was no statistical difference between the subretinal fluid ciprofloxacin levels of the two products. The subretinal fluid drug levels attained by both products were below the minimum inhibitory concentrations of common ocular pathogens.

Conclusions: Ciloxan and Siprogut can penetrate subretinal fluid. The ocular bioavailability of ciprofloxacin after local administration is equivalent for both pharmaceutical products.
Effects of a non‐steroidal (ketorolac tromethamine) and a steroidal (dexamethasone) anti‐inflammatory drug on refractive state and ocular growth
Authors: Luu Chi D , Foo Hayley , Crewther Sheila G , Crewther David P
Published: March 2003

Topical steroidal anti‐inflammatory drugs (SAID) and non‐steroidal anti‐inflammatory drugs (NSAID) are known to affect fluid balance. The effects of twice daily topical applications of Maxidex (dexamethasone, a SAID), Acular (ketorolac, a NSAID), and saline were examined biometrically on the development of refractive errors and eye growth in chicks raised from days 3–12 wearing either a monocular +10 D, 0 D, or –10 D lens. Biometric analysis showed that neither SAID nor NSAID nor saline affected refractive error compensation but that the anti‐inflammatory drugs affected eye growth. In chicks reared with a +10 D lens, dexamethasone induced a decrease in axial length (AL), vitreous chamber (VC) and anterior chamber (AC) depth, while ketorolac only induced a decrease in AC. In –10 D lens chicks dexamethasone again induced a decrease in AL and VC, but did not affect AC depth, whereas ketorolac only induced an increase in AC depth. Taken together, these results suggest that anti‐inflammatory drugs can induce changes in ocular size without affecting refractive state and, as such, have implications for the management of progressive myopia.
Lacryglobin in human tears, a potential marker for cancer
Authors: Evans Victoria , Vockler Cassandra , Friedlander Michael , Walsh Bradley , Willcox Mark DP
Published: March 2003

Lacryglobin has been identified in human tears. This protein has high sequence homology to the mammaglobins, proteins upregulated in breast cancer and in breast cancer metastasis. In order to investigate the utility of tear screening for cancer, tear samples were collected from patients with different types of cancer and compared to controls. Tear samples were taken from five controls and eight breast, six lung, five colon, one prostate and three ovary cancer patients. Tears were analysed using 2‐D gel electrophoresis (n = 25) and 1‐D electrophoresis (n = 3). Lacryglobin was present in the following percentage of patients: breast cancer (88%), lung (83%), colon (100%), ovary (33%), prostate (100%) and controls (60%). Two control patients with lacryglobin had a family history of breast and prostate cancer. Lacryglobin was detected in some but not all tear samples and further studies are warranted to investigate its potential as a marker for cancer.
X‐ray turns a blind eye to ferrous metal
Authors: Vote Brendan JT , Simpson Allan J
Published: March 2003

The case is reported of a 31‐year‐old man with a retained metallic intraocular foreign body (IOFB) in the left eye who underwent magnetic resonance imaging (MRI) for investigation of a subsequent unrelated brachial plexus injury. Despite the patient providing good history of IOFB, the decision to proceed with MRI was based on screening orbit X‐ray which was reported as normal. A review of published reports regarding screening recommendations for MRI for patients with IOFB is provided. A minimum recommendation is for prescreening questionnaire; belief of the patient history is critical. If there is any doubt after history and examination by an ophthalmologist, then computed tomography imaging of the orbits is recommended. Whether screening by plain X‐ray imaging is worthwhile is debatable as the sensitivity and specificity of this modality is poor.
Fulminant orbital cellulitis with complete loss of vision
Authors: Connell Ben , Kamal Zahid , McNab Alan A
Published: March 2003

Bacterial orbital cellulitis is a condition that rarely presents with complete loss of vision. A case is reported of a 69‐year‐old man who presented with fulminant onset of proptosis, significant ophthalmoplegia and no perception of light. Computed tomography showed no evidence of paranasal sinus disease. Despite treatment with intravenous flucloxacillin, ceftriaxone and metronidazole, and later, penicillin after Streptococcus pyogenes was grown from tissue culture, there was no improvement in vision; however, ocular motility returned to normal.
Nd:YAG laser iridotomy in uveitic glaucoma
Authors: Spencer Narelle A , Hall Anthony JH , Stawell Richard J
Published: March 2003

Purpose: To determine the survival of Nd:YAG laser peripheral iridotomy in those patients with angle closure glaucoma and iris bombé associated with uveitis.

Methods: A retrospective review was performed on 11 patients of the Ocular Immunology Clinic of the Royal Victorian Eye and Ear Hospital who presented with uveitis, iris bombé due to extensive posterior synechiae and angle closure glaucoma. The date of iridotomy and where poss‐ible the degree of inflammation were noted, as was the date of failure of the iridotomy. A control group was constructed consisting of 65 patients who presented with acute angle closure glaucoma without a history of uveitis, who underwent Nd:YAG peripheral iridotomy. The survival of the peripheral iridotomies in the two groups was calculated using Kaplan–Meier survival analysis. Median survival was compared using log–rank test.

Results: In the study group of 11 patients, 28 iridotomies were performed on 15 eyes; of these 28 iridotomies, 17 failed. Using Kaplan–Meier survival analysis the median time to failure was 85 days. In the control group of 65 patients, 66 iridotomies were performed on 66 eyes. None of the iridotomies in the control group failed. There was a significant difference in the survival of the Nd:YAG iridotomies (P = 0.00015) between groups.

Conclusion: There is a high early failure rate of Nd:YAG iridotomies in patients with angle closure glaucoma and iris bombé associated with uveitis.
Gene transfer to ovine corneal endothelium
Authors: Klebe Sonja , Sykes Pamela J , Coster Douglas J , Bloom David C , Williams Keryn A
Published: March 2003

Purpose: Modification of a donor cornea by gene therapy has potential to modulate irreversible rejection, the major cause of corneal graft failure. The sheep is a useful model for the human in this respect, as ovine endothelial cells are amitotic. The aim of the study was to investigate the ability of various non‐viral and viral agents to transfer a reporter gene to ovine corneal endothelium.

Methods: The non‐viral agents Transfectin‐10, Transfectin‐20, Transfectin‐50, SuperFect, Effectene and CLONfectin were used to deliver the reporter gene, Escherichia coli lacZ, to ovine corneal endothelium in vitro. A Herpes simplex virus‐1 and an adenoviral vector each encoding E. coli lacZ were similarly tested. Infected corneas were organ‐cultured for up to 7 days in vitro to allow transfection efficiency, duration of gene expression and toxicity attributable to each vector to be compared.

Results: Scattered single or clusters of endothelial cells expressing the reporter gene were observed after transfection with CLONfectin, Transfectin‐10, Transfectin‐20 and Transfectin‐50. SuperFect and Effectene were virtually in‐effective. At best, the absolute number of infected cells per endothelial monolayer after 3 or 7 days of organ culture was estimated as < 0.01%. The Herpes simplex virus‐1 vector also failed to transduce ovine corneal endothelium efficiently. In contrast, transfection rates of up to 70% of endothelial cells were observed with the adenoviral vector.

Conclusion: Non‐viral vectors and Herpes simplex virus‐1 are unlikely to be suitable for gene therapy of corneal endothelium, because the efficiency of transfection is low compared with the rates achieved with adenoviral vectors.
Orbital teratoma: late presentation with normal vision
Authors: Mee Jared J , McKelvie Penny A , McNab Alan A
Published: March 2003

Orbital teratoma is a rare, rapidly growing tumour that usually presents with congenital proptosis. Visual outcome is usually poor. A case is described of orbital teratoma presenting in an 18‐month‐old child as an inferior orbital mass with normal vision and intermittent hypertropia. Computed tomography demonstrated a cystic mass containing a tooth adjacent to the inferior orbital fissure. Histology revealed tissues derived from all three germ cell layers. The tumour was removed with preservation of vision and resolution of the strabismus. Late presentation of an orbital tera­toma with a good visual outcome is exceptional.
Reading speed test for potential central vision measurement
Authors: Pesudovs Konrad , Patel Bhavesh , Bradbury John A , Elliott David B
Published: March 2003

This study examines the validity and reliability of a reading speed test as a measure of potential central vision. Reading speed was calculated in words per minute (wpm) from the time taken to read 30 words of 1.20 logMAR size text. Scores were obtained from subjects with cataract (n = 48), macular disease
(n = 35), peripheral vision loss
(n = 14) and normal eyes (n = 10). Subjects with macular disease (27.0 ± 13.2 wpm) read much slower than subjects with cataract (91.9 ± 13.6 wpm). Little difference was found between subjects with cataract, peripheral vision loss (91.5 ± 14.7 wpm) and normal eyes (103.8 ± 15.5 wpm). Repeat testing gave values within ± 16% of reading speed. These results suggest that a reading speed test using large text could be useful as a potential central vision test in cataract patients.
Posterior capsule opacification after cataract surgery in remote Australian Aboriginal patients
Authors: Hewitt Alex , Verma Nitin
Published: March 2003

Purpose: The aim of this retrospective study was to determine the rate of visually significant posterior capsular opacification formation after cataract surgery for Australian Aborigines living in rural or remote areas in the ‘Top End’ of the Northern Territory, Australia, and then to assess these patients’ outcomes after capsulotomy.

Methods: Aboriginal patients living in remote areas of the Top End of the Northern Territory who underwent cataract surgery between 1994 and 1999 were identified from records at the three major hospitals in the region. The presence of posterior capsular opacification (PCO) was determined by clinical examination. The primary endpoint for this study was the presence of axial opacification of the posterior capsule and the need for subsequent Nd:YAG posterior capsulotomy to improve sight. Linear regression analysis of the time from surgery to follow up and the number of eyes requiring Nd:YAG capsulotomy was performed. Operated eyes were grouped according to the interval between surgery and follow up (Group 1: follow up within 1 year of surgery, n= 25; Group 2: follow up 1−3 years after surgery, n= 42; Group 3: follow up 3−5 years after surgery, n= 51).

Results: One hundred and eighteen operated eyes were examined. Eyes in Group 3 were found to have the highest incidence of visually significant PCO (27.5%). There were more eyes requiring capsulotomy after 3 years than after 1 year following surgery. Linear regression analysis revealed an odds ratio of 1.4 (P = 0.07). All nine eyes in the 1−3 year group that had developed visually significant PCO had undergone extra‐capsular cataract extraction.

Conclusions: For the remote Aboriginal patient who has undergone cataract surgery, there is a relatively minor chance of developing PCO within the first postoperative year regardless of the type of surgery undertaken. This study illustrates that the longer the time after surgery the greater the chance of developing visually significant PCO. For the remote Aboriginal patient there is a high chance (approximately 28%) of developing visually significant PCO within 5 years after cataract surgery. These figures are lower than those reported from other parts of Australia.
Effect of diode laser contact transscleral pars plana photocoagulation on intraocular pressure in glaucoma
Authors: Ho Ching Lin , Wong Edmund YM , Chew Paul TK
Published: March 2003

Purpose: To evaluate the efficacy of diode laser contact transscleral pars plana photocoagulation (CTPPP) for intraocular pressure (IOP) control in glaucoma and its clinical application.

Method: A prospective, non‐randomized hospital‐based pilot study was conducted. Fourteen patients with poor visual acuity (VA worse than 6/60) and medically uncontrolled, refractory glaucoma were recruited, and CTPPP was performed after informed consent.

Results: Mean preoperative IOP was 41.0 mmHg (SD 12.6, range 27−70, n = 14). At 1 week postoperatively, IOP was reduced in 12 of 14 (86%) patients to a mean of 28.6 mmHg (SD 15.8, range 3−55, n = 14). This represented a mean decrease of 12.4 mmHg. Mean IOP was 34.0 mmHg (SD 17.4, range 5−71, n = 14) and 31.6 mmHg (SD 13.4, range 5−22, n = 12) at 4 and 12 weeks, respectively. The IOP reduction was significant at 1 week (P = 0.001, paired t‐test) and at 12 weeks (P = 0.04, paired t‐test). The two patients with preoperative pain reported abolition of pain after the procedure. Seven of 13 patients on preoperative antiglaucoma eye drops did not require eye drops postoperatively.

Conclusions: Diode laser CTPPP was found to significantly reduce IOP in the majority of patients at 1 week postoperatively, with less but still significant effect at 12 weeks. Its potential application as a procedure for short‐term IOP reduction in medically uncontrolled glaucoma requiring filtering surgery needs to be further investigated.
Mycosis fungoides causing severe lower eyelid ulceration
Authors: Game Justin A , Davies Rodger
Published: March 2003

Mycosis fungoides is a form of cutaneous malignant T‐cell lymphoma initially confined to the skin. A range of ophthalmic manifestations has been described; these usually appear in advanced disease. Lid involvement is most common and ranges from ectropion, usually cicatricial, to diffuse thickening and placoid tumours. A case of a 72‐year‐old man presenting with progressive, full thickness, lower eyelid ulceration is presented. The patient had a long history of placoid skin lesions, previously diagnosed as discoid lupus. Repeat biopsies of these lesions including the eyelid eventually revealed mycosis fungoides. The ulceration progressed to destroy most of the lower lid before the correct diagnosis was made. This type of eyelid involvement has not previously been reported in mycosis fungoides. This case also highlights the diagnostic difficulties encountered in the early phases of mycosis fungoides. If suspected, multiple biopsies are essential to establish the diagnosis.
Partial and significant reversal of progressive visual and neurological deficits in multiple sclerosis: a possible therapeutic effect
Authors: Milder Dan G
Published: March 2003

A 24‐year‐old woman developed over 18 months fluctuating and progressively increasing visual and cerebellar deficits, due to multiple sclerosis. The minimum visual acuities were 3/19 on the right and the perception of finger movement at 1 m on the left. She became able to walk only with a wide base and with support. Her condition deteriorated despite the use of methylprednisolone, prednisone and interferon beta‐1b, so these were ceased. Azathioprine, 25 mg daily increasing to 100 mg daily, reducing following abnormal liver function tests to 50 mg daily, and glatiramer acetate 20 mg daily were commenced. The visual acuities two months later were 3/7.5 on the right and 3/6 on the left and after 4 months 3/4.5 on the right and 3/3 on the left. She was able after 2 months to walk unaided on a narrow base and after 4 months to jog half a kilometre without difficulty. Progressive multiple sclerosis has been held to be irreversible. The response in the present case therefore raises the possibility of a drug effect. It indicates the need for trials of combined immunomodulatory and immunosuppressive therapies in progressive multiple sclerosis.
Dislocation of the lens: a complication after cyclocryotherapy
Authors: Sony Parul , Sharma Namrata , Pangtey Mayank S
Published: March 2003

An unusual complication is reported of a case of complete dislocation of the lens after cyclocryotherapy in a patient with neovascular glaucoma. To the best of the authors’ knowledge, no case of lens dislocation following cyclocryotherapy has previously been reported.
DETERMINING THE HORIZONTAL EXTENT OF EARLY GASTRIC CARCINOMA: TWO MODERN TECHNIQUES BASED ON DIFFERENCES IN THE MUCOSAL MICROVASCULAR ARCHITECTURE and DENSITY BETWEEN CARCINOMATOUS and NON‐CARCINOMATOUS MUCOSA
Authors: Yao Kenshi , Yao Tsuneyoshi , Iwashita Akinori
Published: March 2003

Two modern endoscopic techniques are presented with a view to determining the horizontal extent of gastric cancer. They are based on differences in the microvascular structure and density of early gastric cancer compared with those of the non‐cancerous background mucosa. One technique requires magnifying endoscopy which can identify microvascular architecture that shows the characteristic findings of carcinoma. The other technique is an image‐processing technique which enhances the differences in microvascular structure and density between carcinomatous mucosa and non‐carcinomatous mucosa. We demonstrate an example of these techniques applied to an intramucosal carcinoma of a differentiated type, the margin of which could not be determined simply by traditional endoscopy with dye spreading. Magnified observation could detect a demarcation line between the carcinoma and non‐carcinomatous mucosa. In addition, the image‐processing technique enhanced the contrast of redness between cancerous area and non‐cancerous mucosa. Both of these techniques are useful for detecting the precise extent of a carcinoma. The combined application of these techniques should be helpful in determining the precise horizontal extent of early gastric cancer.
Endoscopic Ultrasonography IN JAPAN: PRESENT STATUS and STANDARDIZATION
Authors: Kida Mitsuhiro
Published: March 2003

Since endoscopic ultrasonography (EUS) was developed in 1980, its application has been expanded into not only biliopancreas diseases, but also gastrointestinal diseases. Because of this EUS has become a indispensable diagnostic imaging examination. However, EUS has some problems, such as difficulty in understanding biliopancreas anatomy. Furthermore each enodosonographer has their own style of examination, therefore there is no standard EUS examination. This paper describes the status of EUS in Japan in 2001.
Diagnosis of Neoplastic Changes by Magnifying Colonoscopy in a Patient with Cronkhite–Canada Syndrome: A Case Report
Authors: Satoh Hirotake , Togashi Kazutomo , Konishi Fumio , Sakuma Kazuya , Nagai Hideo
Published: March 2003

The authors described a typical case of Cronkhite–Canada syndrome, in which the terminal ileum and entire colorectum were meticulously observed by magnifying colonoscopy. Colonoscopy revealed a remarkably reddish and rough mucosa with small white spots in the right side of the colon, where there were a small number of sessile polyps measuring less than 10 mm in diameter. On magnified views, the pit pattern of these polyps consisted of slightly enlarged pits with an obvious widening of the pericryptal space, which were compatible with that of non‐neoplastic change. Biopsy specimens showed histologically dilated glands without dysplastic changes. A large number of reddish, elliptic and sessile polyps were observed in the left side of the colon. The pit pattern and histology of these polyps were almost the same as those of the polyps in the right side. There were two small sessile polyps of a different type in the mid‐transverse colon and in the sigmoid colon. These polyps were diagnosed as having neoplastic changes, according to the pit pattern diagnosis and the histology of both was adenoma with slight atypia. According to a review of the worldwide reports, a patient with Cronkhite–Canada syndrome has a high risk of developing colorectal carcinoma. Based on our experience, magnifying colonoscopy may be useful for identifying neoplastic changes in patients with Cronkhite–Canada syndrome.
Value of telomerase activity in the differential diagnosis of benign and malignant ascites
Authors: Zhihua Deng , Hongpei Cai , Shi Li , Jianwei Shen
Published: March 2003

OBJECTIVE: To evaluate telomerase activity as a marker for the differentiation of benign and malignant ascites.

METHODS: Exfoliated cells were harvested from various kinds of ascitic fluid and telomerase activity was determined by TRAP‐PCR‐ELISA (tartrate‐resistant acid phosphatase–polymerase chain reaction–enzyme‐linked immunosorbent assay).

RESULTS: Telomerase activity could not be detected in the ascites of hepatic cirrhosis or peritoneal tuberculosis but was detected in 29 of 34 (85.2%) cancerous ascites.

CONCLUSIONS: Telomerase activity may be present in cancerous ascites and could be used as a marker for the differential diagnosis of benign and malignant ascites.
Expression of intercellular adhesion molecule‐1 in hepatic stellate cells
Authors: Lungen Lu , Minde Zeng , Jiangao Fan , Jing Hua , Jiqiang Li , Dekai Qiu , Zhuping Fan
Published: March 2003

OBJECTIVE: To explore the expression of intercellular adhesion molecule‐1 (ICAM‐1) in hepatic stellate cells (HSC).

METHODS: Via in situ perfusion with proteinase and collagenase and density‐gradient centrifugation with Nycodenz, HSC were isolated and cultured from the livers of both normal Wistar rats and the livers of rats treated with carbon tetrachloride. Expression of ICAM‐1 in HSC was detected by an immunohistochemistry assay and reverse transcription–polymerase chain reaction (RT‐PCR).

RESULTS: No ICAM‐1 was expressed in the freshly isolated HSC of normal rats, but ICAM‐1 was found in primary cultures of HSC at day 10 and in secondary cultures of HSC at day 7. Additionally, the intensity of the expression increased over time. Expression of ICAM‐1 was observed in freshly isolated HSC from the livers of rats treated with carbon tetrachloride.

CONCLUSIONS: Expression of ICAM‐1 is related to the activation of HSC, hepatic inflammation and hepatic fibrogenesis.
Effects of high‐intensity focused ultrasound and anti‐angiogenic agents on the ablation of experimental liver cancers
Authors: Shuqun Cheng , Xinda Zhou , Zhaoyou Tang , Yao Yu , Susu Bao , Dechu Qian
Published: March 2003

OBJECTIVE: To assess the efficacy of high‐intensity focused ultrasound (HIFU) when combined with heparin and cortisone acetate in treating experimental liver cancer LTNM4 implanted subcutaneously in nude mice.

METHODS: High‐intensity focused ultrasound treatment was administered with a focused 1.1 MHz transducer at a peak intensity of 750 W/cm2 for a continuous exposure of 20 s and, 1 day later, heparin (300 U/mL) was given orally in drinking water and an initial dose of 250 mg/kg cortisone acetate was injected subcutaneously into each mouse. Forty‐eight mice with tumors were randomly divided into four groups. Group I (n = 12) were controls; Group II (n = 12) received heparin and cortisone therapy; Group III (n = 12) received HIFU therapy only; Group IV (n = 12) received both HIFU, heparin and cortisone therapy.

RESULTS: Significant inhibition of tumor growth was seen in groups II, III and IV as compared with group I (P < 0.05), with the tumor growth inhibition rate on the 28th day being 86, 90 and 99%, respectively. All mice in group IV were cured, with no evidence of tumors by the 35th day and, histologically, no tumor cells remained.

CONCLUSIONS: The data suggest that HIFU can destroy liver cancer effectively and that HIFU combined with treatment using the anti‐angiogenic agents heparin and cortisone may constitute a comprehensive treatment to ablate liver cancer.
Recombinant human growth hormone and glutamine synergistically improve the adaptation of the remnant small intestine in rats with short bowel syndrome
Authors: Gu Yan , Xie Jianxin , Wu Zhaohan , Zhuo Huanchen
Published: March 2003

OBJECTIVE: To study the effects and the underlying mechanism of recombinant human growth hormone (rhGH) and glutamine (Gln) on the adaptation of the remnant small intestine in parenterally nourished, short bowel syndrome (SBS) rats.

METHOD: Four parenteral nutrition (PN) treatment groups of SBS rats were randomly arranged in a 2 × 2 factorial design as follows: (i) STD (standard PN) group (–rhGH, –Gln); (ii) Gln group (–rhGH, +Gln); (iii) rhGH group (+rhGH, –Gln); and (iv) rhGH + Gln group (+rhGH, +Gln). Morphological changes of the intestinal mucosa were investigated and the expression of proliferating cell nuclear antigen (PCNA) and the occurrence of apoptosis were observed by immunohistochemical staining and terminal deoxynucleotidyl transfer‐mediated dUTP‐biotin nick end‐labeling (TUNEL) methods. The level of intestinal insulin‐like growth factor‐1 (IGF‐1) mRNA was determined by northern blotting.

RESULTS: The mucosal thickness, villous height, crypt depth and villous surface area of the remnant small intestine in the rhGH + Gln group were increased significantly as compared with the other three experimental groups, and there were synergistic effects between rhGH and Gln (P < 0.01). The expression of PCNA was higher in the rhGH + Gln group than in the rhGH, Gln and STD groups (24.95 ± 3.93 vs 19.28 ± 3.25, 17.27 ± 3.38, and 8.37 ± 2.23 positive cells per crypt of Lieberkuhn, respectively; P < 0.01) but the rate of apoptosis was lower in the rhGH + Gln group than in the rhGH, Gln and STD groups (5.68 ± 2.07 vs 8.06 ± 2.33, 10.00 ± 2.24 and 22.32 ± 3.84 positive cells per 100 cells, respectively; P < 0.01). The intestinal IGF‐1 mRNA was also expressed at a higher level in the rhGH + Gln group than in the rhGH, Gln and STD groups (0.73 ± 0.05 vs 0.62 ± 0.04 vs 0.51 ± 0.04 and 0.41 ± 0.22, respectively; P < 0.05).

CONCLUSION: The synergistic combination of rhGH and Gln can significantly improve the adaptation of the remnant small intestine in parenterally fed SBS rats. An increase in cell proliferation and a decrease in cell apoptosis are both responsible for the intestinal adaptation. An increase in local IGF‐1 plays an important role in this process.
Trichosanthin‐induced apoptosis in gastric cancer is related to the downexpression of bcl‐2
Authors: Zhang Shu , Hu Meijie , Wu Yuxin , Jiang Shihu , Wu Yunlin , Yuan Yaozong
Published: March 2003

OBJECTIVE: To study: (i) the induction of apoptosis in gastric cancer cells by trichosanthin; and (ii) the relationship between apoptosis and the expression of bcl‐2.

METHODS: During in vitro experiments, morphological studies and the terminal deoxynucleotidyl transferase‐mediated dUTP–digoxigenin nick end‐labeling (TUNEL) method were used to detect apoptosis in gastric adenocarcinoma cell line SGC‐7901 before and after trichosanthin treatment. An immunohistochemical staining method and northern blot hybridization were used to detect the expression of the apoptosis‐related gene bcl‐2 before and after trichosanthin treatment.

RESULTS: When SGC‐7901 cells were treated with trichosanthin (0.1 μg/mL, 36 h), they presented some typical apoptotic morphological changes that were observed by fluorescent staining. These morphological changes included nuclear condensation and nucleosomal fragments forming a lunate body under the nuclear membrane. When SGC‐7901 cells were treated with trichosanthin (0.1 μg/mL) for 36, 42 or 48 h, TUNEL staining revealed a significant increase in the apoptotic index (AI), from 3.78 ± 1.11%, 3.98 ± 1.12% and 3.85 ± 1.08%, to 11.30 ± 2.33%, 10.22 ± 2.00% and 11.18 ± 1.85% (P < 0.01), respectively. When SGC‐7901 cells were treated with trichosanthin (0.1 μg/mL, 32 h), immunohistochemical staining revealed a decreased expression of the bcl‐2 protein product: the staining density decreased from ++/+++ to –/+ (P < 0.01). When SGC‐7901 cells were treated with trichosanthin (0.1 μg/mL, 24 h), northern blot hybridization showed a decreased expression of bcl‐2 RNA: hybridization decreased from 35.19 ± 2.34 to 22.27 ± 3.90 (P < 0.01).

CONCLUSIONS: Trichosanthin is able to induce apoptosis in gastric cancer. The apoptosis may be mediated by the downexpression of the apoptosis‐related gene bcl‐2.
Clinical symptoms and pedigree analysis in two families with benign familial persistently elevated α‐fetoprotein
Authors: Zhu Hongyao
Published: March 2003

OBJECTIVE: To evaluate the nature of persistently elevated α‐fetoprotein (AFP) in a family and the importance of correct recognition and diagnosis of familial AFP elevation.

METHODS: In 1984 and 1997, a series of AFP radio‐immunoassays from two families with persistently elevated AFP were investigated and the family pedigrees were subanalyzed.

RESULTS: Of the 29 members in the two families, 15 were examined. The AFP level of 10 people was persistently elevated, two of these had been misdiagnosed with primary hepatocellular carcinoma.

CONCLUSIONS: Familial elevation of AFP is benign in nature. It should be kept in mind during mass surveys of AFP.
Expression of COX‐1, COX‐2 and inducible nitric oxide synthase in superficial gastritis, mucosal dysplasia and gastric carcinoma
Authors: Luo Yuqin , Wu Kaichun , Sun Anhua , Pan Borong , Zhang Xueyong , Fan Daiming
Published: March 2003

OBJECTIVE: To investigate the significance of the expression of cyclooxygenase‐1 (COX‐1), cyclooxygenase‐2 (COX‐2) and inducible nitric oxide synthase (iNOS) in superficial gastritis, gastric mucosal dysplasia and gastric carcinoma, and to study the relationship between COX‐2, iNOS, gastric carcinoma and Helicobacter pylori infection.

METHODS: Polyclonal antibodies to COX‐1, COX‐2 and iNOS were used detect their expression and the status of H. pylori infection in 92 specimens of paraffin‐embedded gastric tissue. Of the 92 patients, 33 had superficial gastritis, 30 had gastric mucosal dysplasia and 29 had gastric cancer. Helicobacter pylori was detected by toluidine blue staining.

RESULTS: Expression of COX‐2 and iNOS in gastric cancer (65.5%, 62.1%) was significantly higher than that in gastritis (18.2%, 18.2%; P < 0.01). Expression of COX‐2 and iNOS in gastritis with H. pylori infection was higher than that in gastric mucosal dysplasia with H. pylori infection. The expression of COX‐2 and iNOS occurred concomitantly in gastritis, dysplasia and gastric cancer.

CONCLUSION: Inflammation and H. pylori infection may be able to stimulate the expression of COX‐2 and iNOS, which might be involved in gastric carcinogenesis.
Construction and identification of the eukaryotic expression vector of vaccinia virus expressing human interleukin‐2
Authors: Gao Hengjun , Zhu Hongyin , Gu Weiqi , Lou Yi , Ren Weiping , Xiao Shudong
Published: March 2003

OBJECTIVE: Cancer gene therapy using interleukin‐2 (IL‐2) has generated much interest because of the potent antitumor effect of this cytokine. There is ongoing research into one promising new gene therapy approach for cancer using the vaccinia virus vector. The purpose of this study was to construct a vaccinia eukaryotic expression vector, pMJ601, which contains human IL‐2 (hIL‐2; pMJ601hIL‐2) and can be used for the treatment of gastric carcinomas.

METHODS: Genetic engineering techniques such as plasmid extraction, agarose gel electrophoresis, restriction analysis, ligation, preparation of competent cells, transformation and DNA sequence analysis were used to clone the hIL‐2 gene into pBluescript II SK+/– and pMJ601 and identify these vectors.

RESULTS: Fragments of hIL‐2 DNA from pLXSN from an EcoR1–BamHI restriction enzyme digest were successfully cloned into pBluescript II SK+/–. In addition, hIL‐2 DNA from pBluescript II SK+/– with a SalI‐BamHI restriction enzyme digest was also successfully cloned into pMJ601.

CONCLUSION: Constructing a pMJ601 vector that expresses the hIL‐2 gene is an important step toward being able to treat gastric carcinoma using gene therapy.
Regulation of telomerase activity by recombinant human tumor necrosis factor in vitro
Authors: Xie Weifen , Lin Yong , Zhang Xingrong , Chen Weizhong , Zhang Xin , Zhang Zhongbing , Wang Hao
Published: March 2003

OBJECTIVE: To investigate the effect of recombinant human tumor necrosis factor (rhTNF) on telomerase activity and promoter expression of catalytic protein subunit–human telomerase reverse transcriptase (hTERT) in hepatoma cell lines HepG2 cells and HepG1‐6.

METHODS: The tartrate‐resistant acid phosphatase– enzyme‐linked immunosorbent assay method (TRAP‐ELISA) was used to determine telomerase activity in HepG2 and HepG1‐6 cells that had been treated with different concentrations of rhTNF. The plasmid TERTluc(800), which contained 800 bp of the hTERT promoter, was transiently transfected into HepG2 cells by using Lipofect, and different concentrations of rhTNF were added into the culture media 2 h later. The activity of the hTERT promoter was tested 48 h after transfection.

RESULTS: The telomerase activity of hepatoma cells was suppressed by rhTNF in a dose‐dependent manner. Furthermore, the transient transfection of HepG2 cells with the TERTluc(800) plasmid revealed that hTERT promoter activity is not affected by 10 IU/mL rhTNF, whereas the expression of the hTERT promoter is inhibited by rhTNF at concentrations ranging from 10 to 1000 IU/mL; the extent of inhibition is linearly related to the rhTNF concentration. The activity of the hTERT promoter in cells treated with 1000 IU/mL of rhTNF decreased to 60.3% of that of the control. No extra suppressive effect was observed when a concentration of 10 000 IU/mL was used.

CONCLUSIONS: These results suggest that the antitumor activity of rhTNF may be attributed to its inhibitory effect on hTERT promoter expression. Together with other studies, it may indicate that telomerase is not only involved in carcinogenesis, but is also one of the main targets of anticancer cytokines. Further analysis of the molecular mechanism underlying the regulation of telomerase by TNF and isolation of the related transcription factor may provide new means for cancer gene therapy.
Clinical efficacy analysis and safety evaluation of ultrasonographically guided percutaneous radiofrequency ablation in liver cancers
Authors: YUAN Ai Li , ZHANG Zhen Shu , HOU Shu Qin , GUO Wen , CUI Sheng Da , LIN Huan Jian , JIANG Bo , BAN Lan , LAN Lin
Published: March 2003

OBJECTIVE: To assess the clinical efficacy of radiofrequency (RF) ablation in treating liver cancers. The indications, contraindications and side‐effects of the technique were also evaluated.

METHODS: One hundred and fifty‐four patients with liver cancers were treated between May 1999 and July 2000. One hundred and thirty‐two cases were hepatocellular carcinomas (HCC) and 22 cases were metastatic liver cancers. The diameter of the cancers ranged from 1.5 to 19.0 cm, with a mean diameter of 7.07 cm. All patients were treated with RF2000TM RF under ultrasonographic guidance and the results and side effects were evaluated.

RESULTS: One hundred and fifty‐four patients were treated 182 times, with the average number of treatments for each patient being 1.18 and the average number of therapeutic points was 5.74. Symptoms improved after therapy and the levels of α‐fetoprotein (AFP) dropped from 1553.68 to 883.70 ng/mL. The AFP level declined in 60.8% of patients, remained unchanged in 32.7% of patients and was elevated in 6.5% of patients. After RF ablation, the size of the tumor was reduced in 87 cases (56.6%), stabilized in 52 cases (33.7%) and enlarged in 15 cases (9.7%). The common side‐effects of RF were local pain, fever and leukocytosis; no life‐threatening complications were observed.

CONCLUSIONS: Percutanous RF ablation of liver cancers is a simple, safe, effective method. It can be curative for small liver cancers but for large liver cancers multiple treatments combined with arterial chemoembolization therapy may be needed to enhance its effectiveness.
Clinical study of sulindac in the treatment of sporadic colorectal adenomas
Authors: QIAN Yue Qing , LU Yu Min , YE Si Mao
Published: March 2003

OBJECTIVE:  To investigate the efficacy of sulindac in the treatment of sporadic colorectal adenomas.

METHODS:  Thirty‐six patients who were diagnosed colonoscopically and pathologically with sporadic colorectal adenomas were randomly divided into two groups. The sulindac group took 400 mg sulindac daily for 4 months and the patients in the control group were given a placebo treatment for the same period of time. All patients underwent pancolono­scopy at the end of the study. The number, size, morphology, and degree of atypia of the adenomas were compared before and after treatment.

RESULTS:  Four patients were dropped from the study (three in the sulindac group, one in the control group). Sixteen patients in each group completed the trial. In the sulindac group, the average diameter of 59 adenomas before treatment was 3.6 ± 2.2 mm, which was significantly larger than that after treatment (2.4 ± 1.5 mm; P < 0.001). The morphology of adenomas also changed significantly. The degree of atypia of adenomas also decreased after treatment (P < 0.001). No severe side‐effects of sulindac were found during the study. In the control group, the average diameters of adenomas before and after treatment were 4.6 ± 2.5 mm and 3.7 ± 2.2 mm, respectively. There was no significant difference between the average diameters of the adenomas before or after treatment (P > 0.05), nor was there any change in the morphology or the degree of atypia of the adenomas.

CONCLUSIONS:  Sulindac is effective in reducing the size and degree of atypia of adenomas. This trial demonstrated that sulindac has a regressive effect on sporadic colorectal adenomas. However, its long‐term effect remains to be tested.
Prevalence of subclinical hepatic encephalopathy in patients with cirrhosis determined by psychometric tests
Authors: NIE Yu Qiang , LI Yu Yuan , SHA Wei Hong , ZENG Zheng , HU Zhong Wei , YANG Fu Ying , PING Li , JIA Lin
Published: March 2003

OBJECTIVE:  To investigate the prevalence of subclinical hepatic encephalopathy (SHE) in patients with stable hepatic cirrhosis.

METHODS:  One hundred and seventy‐five consecutive cirrhotic patients (mean age 53 years, range 27−72 years) without overt clinical encephalopathy were screened for SHE using the number connection test (NCT) part A and symbol digit test (SDT). Subclinical hepatic encephalopathy was defined as the presence of at least one abnormal psychometric test. The age‐corrected normal value was defined as the mean ± 2SD obtained from 356 subjects without liver disease and in normal mental condition. Illiterate patients and patients with concurrent use of alcohol or psychotropic drugs, and those with previous portosystemic shunt and were excluded.

RESULTS:  In different age subgroups, the NCT scores and SDT quotients for cirrhotic patients were significantly different compared with those for controls (P < 0.05−0.001). Fifty patients (28.6%) were found to be abnormal in both the NCT and SDT, 16 (9.1%) patients were abnormal only in the SDT and 34 patients (19.4%) only in the NCT. Taken together, SHE was diagnosed in 100 patients (57.1%) by using the two tests. The prevalence of SHE increased from 46.8% and 53.0% in Child−Pugh grades A and B, to 76.6% in Child−Pugh grade C (P < 0.05). No significant correlation was found between the development of SHE and the etiology of cirrhosis, patient age and smoking habit.

CONCLUSION:  By using a combination of NCT and SDT, SHE was diagnosed in 57.1% of cirrhotic patients without overt clinical encephalopathy. The prevalence of SHE was significantly correlated with the severity of liver cirrhosis.
Rapid induction of mRNA for Tec genes by hepatopoietin and partial hepatectomy
Authors: WANG Ge , LENG En Ren , HU Lu , WANG Jun , FANG Dian Chun , YANG Xiao Ming , ZHANG Yong , HE Fu Chu
Published: March 2003

OBJECTIVE:  To investigate how hepatopoietin (HPO) and partial hepatectomy induce the expression of immediate early genes.

METHODS:  mRNA expression related to liver regenera­tion was investigated within 1 h after a two‐thirds partial hepatectomy by representational difference analysis and with the addition of HPO in a primary cultured hepatocyte system by reverse transcription polymerase chain reaction.

RESULTS:  In the expressed sequence tag library, most of the genes identified were immediate early genes, and one Tec gene that might be associated with liver regeneration was found. Moreover, the Tec gene was rapidly induced after partial hepatectomy, with peak expression (7−10‐fold) within 1−2 h after the operation as identified by northern blotting. Hepato­poietin was able to rapidly induce the expression of immediate early genes (e.g. c‐fos, LRF‐1, Tec) in primary cultured rat hepatocytes. The c‐fos and LRF‐1 mRNA were also known to be induced during the early hours of liver regeneration, and increased after treatment of isolated hepatocytes with HPO. Addition of HPO resulted in rapid and transient induction of Tec mRNA with a peak at 0.5−2 h (3−5‐fold), which might be one of the molecular mechanisms of the effect of HPO on the stimulation of hepatocyte proliferation.

CONCLUSION:  Hepatopoietin and partial hepa­tectomy can rapidly induce the expression of the immediate early genes. Our results suggest that the Tec gene is an immediate early gene related to liver regeneration.