A follow-up study in children with status epilepticus during sleep: From clinical spectrum to outcome.

PURPOSE: To evaluate the correlation between clinical spectrum and therapeutic outcomes and neuropsychological deficits in children with status epilepticus during sleep (SES). METHODS: The clinical spectrum of patients with SES was defined as follows: status epilepticus of benign childhood epilepsy with centro-temporal spikes (SEBECTs), atypical benign focal epilepsy during childhood (ABFEC), non-idiopathic focal epilepsy (NIFE), and Landau-Kleffner syndrome (LKS). SES cases were divided into 4 groups according to neuropsychological findings before treatment: developmental delay/intellectual disability (DD/ID), cognitive impairment (CI), attention deficit and/or hyperactivity behaviors (AHD), and normal group (NG). The therapeutic outcomes were classified into 3 groups: satisfactory response, recurrence, and seizure control. RESULTS: A total of 39 cases (24 males and 15 females) were recruited, including 3 cases with SEBECTs, 26 with ABFEC, 8 with NIFE [2 with focal cortical dysplasia (FCD)], and 2 with LKS. There were 7 patients in the DD/ID group, 8 in the CI group, 19 in the AHD group, and 5 in the NG group. Neuropsychological outcomes were significantly different among clinical spectrum (P < 0.001), and neuropsychological deficits frequently occurred in the ABFEC group or in the NIFE group. Besides, 18 patients in the satisfactory group had satisfactory response to medicine or surgery (2 out of 18 cases with FCD), whereas recurrence was observed at least one session within one year in 16 cases in the recurrence group, and no improvement in spike-wave index and cognition/behavior was noted in 5 patients in the seizure control group, although seizure could be controlled. There were significant differences in therapeutic outcomes among clinical spectrum (P = 0.041), with the worst outcomes in the NIFE group (only 1 out of 8 with satisfactory good response). CONCLUSIONS: It is important to categorize patients with SES into epilepsy syndromes, including SEBECTs, ABFPEC, NIFE, and LKS; the clinical spectrum may be a significant determinant to influence the outcomes of SES, including neuropsychological deficits and therapeutic outcomes.

Anterior segment optical coherence tomography measurement of flap thickness after myopic LASIK using the Moria one use-plus microkeratome.

PURPOSE: To analyze the accuracy and consistency of corneal flap thickness created in myopic LASIK using the Moria One Use-Plus microkeratome compared with the Moria M2 Single Use 90-microm microkeratome. METHODS: Bilateral LASIK was performed in 68 myopic patients. Flaps were created using the One Use-Plus microkeratome in 82 eyes (41 patients) and the M2 90-microm microkeratome in 54 eyes (27 patients). Flap complications and visual outcomes were evaluated. Horizontal "High Res. Corneal" scan pattern of anterior segment optical coherence tomography (AS-OCT) was applied to measure flap thickness at five locations (0, +/-2, and +/-3.5 mm from the corneal vertex) on the first postoperative day. RESULTS: No significant differences were noted in flap complications and visual outcomes between groups. The central flap thickness was dramatically thinner in the One Use-Plus group (114.7+/-10.1 microm and 109.4+/-11.0 microm for right and left eyes, respectively) than in the M2 group (155.6+/-14.8 microm and 151.6+/-12.5 microm for right and left eyes, respectively) (P<.001). The One Use-Plus did not show a markedly better uniformity than the M2; the variation was mainly observed in the periphery. Multiple linear regression showed that for the One Use-Plus, the steeper the preoperative keratometry, the thicker the flap thickness, and for the M2, the thicker the preoperative pachymetry, the thicker the flap (P<.1). CONCLUSIONS: The One Use-Plus and M2 microkeratomes have similar safety and efficacy. The flap created by the One Use-Plus was much thinner than the flap created with the M2; however, the One Use-Plus can not realize a fully planar-shaped flap.

[Spherical aberration, contrast sensitivity and color discrimination after cataract surgery with the aspherical intraocular lens].

OBJECTIVE: To determine whether implantation of an intraocular lens (IOL) with a modified prolate anterior surface results in reduced spherical aberration and improved contrast sensitivity after cataract surgery. METHODS: Consecutively 72 eyes were selected from 53 senile cataract patients who had received phacoemulsification and IOL implantation in Peking University Eye Center. Each was randomly assigned to receive Tecnis Z9001 IOL or Sensar AR40e (both made by AMO). Three months after operation, the eyes underwent several tests including visual acuity, optometry and wavefront aberration examination. Mesopic contrast sensitivity test was measured with ROLAND BA-4 Contrastometer. RESULTS: The eyes treated with Tecnis Z9001 had significantly less spherical aberration. The eyes treated with Tecnis IOL got lower C12 coefficient and RMS4 than those with Sensar AR40e (P<0.05). The mesopic contrast sensitivity and color discrimination were not significantly different between the two IOL groups. CONCLUSION: A significant reduction in spherical aberration after Tecnis Z9001 IOL implantation was achieved, but mesopic contrast sensitivity was not affected by the aspheric silicone IOL as compared with spherical acrylic IOL.

[Comparison of laser in situ keratomileusis and laser-assisted subepithelial keratectomy for myopia more than -10.00 diopters].

OBJECTIVE: To compare the visual and refractive outcomes of laser in situ keratomileusis (LASIK) and laser-assisted subepithelial keratectomy (LASEK) in the treatment of severe myopia. METHODS: LASEK and LASIK were respectively performed on 165 eyes of 100 patients with super high myopia by using the Allegretto Wavelight-Wave 1,007 excimer laser, of which 10(6) eyes (62 patients) were treated with LASEK and 59 eyes (38 patients) with LASIK. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), remaining refractive error, corneal haze and complications were followed up in both groups for 12 months. RESULTS: At the end of 6 months and 12 months no significant statistic difference between LASEK and LASIK group in the clinical outcomes of refractive corrections (mean spherical equivalent, MSE). At the end of 1 week and 1 month postoperatively, UCVA in the LASIK eyes was better than in LASEK eyes. At the end of 3, 6, 12 months, it was almost the same in these two groups. The percentage of eyes with UCVA better than 1.0 (47.8% in LASEK, 52.5% in LASIK) was higher in LASEK group. There was no significant difference between the two groups in the percentage of eyes losing one or more lines of BSCVA in Snellen visual acuity chart. At the end of 12 months, the mean SE was within +/-0.5D of emmetropia in 9 eyes (13.2%) in the LASEK group and 11 eyes (18.6%) in the LASIK group and within +/-1.0D of emmetropia in 36 eyes (52.9%) in the LASEK group and 28 eyes (47.5%) in the LASIK group, respectively, the between-group differences were not statistically significant (P>0.05). There were more complaints of postoperative pain and discomfort after LASEK procedure. No severe vision threatening complications in these two groups were found. CONCLUSION: Both LASIK and LASEK are safe and effective in treating eyes with severe myopia.

Triterpenoid saponins from the roots of Cyathula officinalis and their inhibitory effects on nitric oxide production.

The present study was designed to investigate the chemical constituents of the roots of Cyathula officinalis. Compounds were isolated by silica gel, Sephadex LH-20, ODS column chromatography, and preparative HPLC. Their structures were determined on the basis of 1D and 2D NMR techniques, mass spectrometry, and chemical methods. One new oleanane-type triterpenoid saponin, 28-O-[α-L-rhamnopyranosyl-(1→3)-ß-D-glucuronopyranosyl-(1→3)-ß-D-glucopyranosyl] hederagenin (1), was isolated from the roots of Cyathula officinalis. The anti-inflammatory activities of the isolates were evaluated for their inhibitory effects against LPS-induced nitric oxide (NO) production in RAW 264.7 macrophages cells. Compounds 2, 4, and 6 exhibited moderate anti-inflammatory activities.

[Clinical study of higher order wavefront aberrations with a Tscherning aberrometer].

OBJECTIVE: To study the higher order aberrations of emmetropic and ametropic eyes with wavefront aberrometer. METHODS: Forty of cases 77 emmetropic and ametropic eyes were measured with an aberrometer based on Tscherning's principle with the pupils dilated. The Zernike coefficients and root mean square values of wavefront aberrations up to the 6th order were recorded and statistically analyzed. RESULTS: The C06, C07, C08, C12, C13, C14, C24, C26, and C27 were significantly different from zero under 7 mm pupil size and the C06, C10, C12, C23, and C24 were significantly different from zero under 4 mm pupil size. There was no significant difference of higher order wavefront aberrations between emmetropic and ametropic eyes. Comparing the age of 40 years or less with the age over 40 years, there were significant differences in RMS3 between the two under 7 mm pupil size, and statistical differences in RMS6 and RMSh between the two under 4 mm pupil size. CONCLUSION: There are certain higher order wavefront aberrations in the normal human eyes, especially with the pupils dilated. No differences are found in higher order aberrations between emmetropic and ametropic eyes. The higher order aberrations of the age over 40 years are more than those of the age of 40 years or younger.

Triptolide avoids cisplatin resistance and induces apoptosis via the reactive oxygen species/nuclear factor-κB pathway in SKOV3PT platinum-resistant human ovarian cancer cells.

An acquired resistance to platinum-based drugs has emerged as a significant impediment to effective ovarian cancer therapy. The present study explored the anticancer mechanisms of triptolide (TPL) in SKOV3PT platinum-resistant human ovarian cancer cells and observed that TPL activated caspase 3 and induced the dose-dependent apoptosis of the SKOV3PT cells. Furthermore, TPL inhibited complex I of the mitochondrial respiratory chain (MRC) followed by an increase of reactive oxygen species (ROS), which further inhibited nuclear factor (NF)-κB activation and resulted in the downregulation of anti-apoptotic proteins, Bcl-2 and X-linked inhibitor of apoptosis protein (XIAP). Notably, the pre-treatment with N-acetyl-L-cysteine (NAC) abolished the TPL-induced ROS generation, NF-κB inhibition and cell apoptosis, but did not affect the inhibitory effect of TPL on complex I activity. These results suggested that TPL negatively regulated the NF-κB pathway through mitochondria-derived ROS accumulation, promoting the apoptosis of the SKOV3PT cells. Furthermore, TPL synergistically enhanced the cytotoxicity of cisplatin against platinum-resistant ovarian cancer cells. Collectively, these findings suggest that TPL is able to overcome chemoresistance and that it may be an effective treatment for platinum-resistant ovarian cancer, either alone or as an adjuvant therapy.