Computed-tomography-based radiomic nomogram for predicting the risk of indeterminate small (5-20 mm) solid pulmonary nodules

PURPOSE: This study aims to develop a diagnostic model that combines computed tomography (CT) images and radiomic features to differentiate indeterminate small (5-20 mm) solid pulmonary nodules (SSPNs). METHODS: This study retrospectively enrolled 413 patients who had had SSPNs surgically removed and histologically confirmed between 2017 and 2019. The SSPNs included solid malignant pulmonary nodules (n = 210) and benign pulmonary nodules (n = 203). The least absolute shrinkage and selection operator was used for radiomic feature selection, and random forest algorithms were used for radiomic model construction. The clinical model and nomogram were established using univariate and multivariable logistic regression analyses combined with clinical symptoms, subjective CT findings, and radiomic features. The area under the curve (AUC) of the receiver operating characteristic curve was used to evaluate the performance of the models. RESULTS: The AUC for the clinical model was 0.77 in the training cohort [n = 289; 95% confidence interval (CI): 0.71-0.82; P = 0.001] and 0.75 in the validation cohort (n = 124; 95% CI: 0.66-0.83; P = 0.016). The AUCs for the nomogram were 0.92 (95% CI: 0.89-0.95; P < 0.001) and 0.85 (95% CI: 0.78-0.91; P < 0.001), respectively. The radiomic score (Rad-score), sex, pleural indentation, and age were the independent predictors that were used to build the nomogram. CONCLUSION: The radiomic nomogram derived from clinical features, subjective CT signs, and the Rad-score can potentially identify the risk of indeterminate SSPNs and aid in the patient's preoperative diagnosis.

The Recipient Vessel Hemodynamic Features Affect the Occurrence of Cerebral Edema in Moyamoya Disease After Surgical Revascularization: A Single-Center Retrospective Study.

Objective: In moyamoya disease (MMD) with direct or combined revascularization, the initially hemodynamic recipient features are likely one of the main causes of acute hemodynamic disruption. Previous studies have explored the relationship between recipient diameter or flow velocity and postoperative complications, but there are still no optimal selection criteria with multiple potential recipient vessels. Cerebral edema is one of the most common radiological manifestations in the acute postoperative period. This study assessed the hemodynamic characteristics of cortex vessels related to postoperative cerebral edema. Methods: All patients who had undergone direct or combined revascularization with preoperative digital subtraction angiography (DSA) between 2019 and 2021 were eligible for inclusion in this study. The application of DSA was performed and regular radiological examinations were employed after surgery. DSA was analyzed with the hemodynamic features within chosen recipient vessels. Cerebral edema was identified as a low-density image on CT or high signaling in the MRI T2 phase. The recipient hemodynamic characteristics and demographic presentation, as well as clinical data, were retrospectively analyzed in this study. Results: A total of 103 patients underwent direct or combined revascularization with preoperative DSA. The mean age of this enrolled cohort was 44.31 ± 10.386 years, in which bilaterally involved MMD accounted for the main part. The preliminary correlation analysis found preoperative disease period (p = 0.078), recipients observed in angiography (p = 0.002), and surgery on the left (p = 0.097) may be associated with cerebral edema. The following regression analysis confirmed low occurrence of cerebral edema was accompanied by recipients observed in angiography (p = 0.003). After subdividing by flow direction and hemodynamic sources, the incidence rate of anterograde direction, anterior sources, and posterior sources were significantly lower than undetected recipients. Conclusions: Cerebral edema is a common radiological manifestation in MMDs after surgery. In this study, the observation in angiography reliably identifies a variety of physiological or pathological recipient detection, flow direction, and hemodynamic sources in patients with MMD after revascularization, which indicates the selection strategy of potential recipients and highlights the importance of recipient observability in DSA. Meanwhile, vascular conditions determined by recipient hemodynamics meditate the occurrence of postoperative cerebral edema.

Clinical features and prognostic factors of cervical villoglandular adenocarcinoma.

BACKGROUND: Villoglandular adenocarcinoma is a rare sub-type of cervical adenocarcinoma. OBJECTIVE: To analyze the clinicopathological features and evaluate the prognosis of patients with villoglandular adenocarcinoma of the cervix. METHODS: Patient characteristics, procedure, pathology, and surgical outcomes were retrospectively reviewed in patients with villoglandular adenocarcinoma between November 2006 and June 2019 from multiple centers in China. In order to explore the difference between villoglandular adenocarcinoma and routine adenocarcinoma, patients (FIGO 2009 stage IA1-IB2) who had complete data during the same time period were included. RESULTS: A total of 60 patients with villoglandular adenocarcinoma and 104 with standard adenocarcinoma were included. The median age of the patients with villoglandular adenocarcinoma was 42 years (range 27-68). The most common 2009 FIGO stage was IB1 in 39 (65%) patients with villoglandular adenocarcinoma. A total of 23 patients underwent laparoscopic surgery (two total hysterectomies, 21 radical hysterectomies) and the other 37 patients underwent laparotomy (three total hysterectomies, 34 radical hysterectomies). A total of 56 patients underwent lymphadenectomy and three (5.4%) had positive lymph nodes. Fifteen (25%) patients had one or both ovaries preserved. Seven patients were lost to follow-up. The median follow-up time for the entire group was 50.2 months (range 5.1-154.6). No deaths or recurrences occurred. Excluding six patients with FIGO 2009 stage II, the 5-year disease-free survival of the 47 patients with villoglandular adenocarcinoma with FIGO 2009 stage I for whom there was follow-up, was significantly higher than that of the 104 patients with standard cervical adenocarcinoma (100% vs 92.2%, log-rank p=0.039). However, the 5-year overall survival of the two groups did not differ (100% vs 95.7%, log-rank p=0.11). CONCLUSION: Villoglandular adenocarcinoma has a favorable prognosis. Further studies are needed to provide more details of treatment strategies and prognosis.

In vitro antiviral efficacy of moroxydine hydrochloride and ribavirin against grass carp reovirus and giant salamander iridovirus.

Moroxydine hydrochloride (Mor) and ribavirin (Rib) have been reported to exhibit multi-antiviral activities against DNA and RNA viruses, but their antiviral activities and pharmacologies have seldom been studied in aquaculture. This paper has selected 3 aquatic viruses including a double-stranded RNA virus (grass carp reovirus, GCRV), a single-stranded RNA virus (spring viraemia of carp virus, SVCV) and a DNA virus (giant salamander iridovirus, GSIV) for antiviral testing. The results showed that Mor and Rib can effectively control the infection of GCRV and GSIV in respective host cells. Further study was undertaken to explore the antivirus efficiencies and pharmacological mechanisms of Mor and Rib on GCRV and GSIV in vitro. Briefly, compounds showed over 50% protective effects at 15.9 µg ml-1 except for the group of GSIV-infected epithelioma papulosum cyprinid (EPC) cells treated with Mor. Moreover, Mor and Rib blocked the virus-induced cytopathic effects and apoptosis in host cells to keep the normal cellular structure. The expression of VP1 (GCRV) and major capsid protein (MCP; GSIV) gene was also significantly inhibited in the virus-infected cells when treated with Mor and Rib. Cytotoxicity assay verified the 2 compounds had no toxic effects on grass carp ovary (GCO) cells and EPC cells at ≤96 µg ml-1. In conclusion, these results indicated that exposing GCRV-infected GCO cells and GSIV-infected EPC cells to Mor and Rib could elicit significant antiviral responses, and the 2 compounds have been shown to be promising agents for viral control in the aquaculture industry.

The Role of Hemosiderin Excision in Seizure Outcome in Cerebral Cavernous Malformation Surgery: A Systematic Review and Meta-Analysis.

BACKGROUND AND PURPOSE: Whether the excision of hemosiderin surrounding cerebral cavernous malformations (CCMs) is necessary to achieve a seizure-free result has been the subject of debate. Here, we report a systematic review of related literature up to Jan 1, 2015 including 594 patients to assess the effect of hemosiderin excision on seizure outcome in patients with CCMs by meta-analysis. METHODS: Ten studies comparing extended hemosiderin excision with only lesion resection were identified by searching the English-language literature. Meta-analyses, subgroup analyses and sensitivity analysis were conducted to determine the association between hemosiderin excision and seizure outcome after surgery. RESULTS: Seizure outcome was significantly improved in the patients who underwent an extended excision of the surrounding hemosiderin (OR, 0.62; 95% CI: 0.42-0.91; P = 0.01). In subgroup analysis, studies from Asia (OR, 0.42; 95% CI: 0.25-0.71; P = 0.001), male-majority (female ratio < 50%) studies (OR, 0.56; 95% CI: 0.33-0.96; P = 0.04), low occurrence rate of multiple CCMs (OR, 0.37; 95% CI: 0.20-0.71; P = 0.003), cohort studies (OR, 0.44; 95% CI: 0.28-0.68; P = 0.78), longer duration of seizure symptoms (> 1 year) before surgery (OR, 0.43; 95% CI: 0.22-0.84; P = 0.01), lesion diameter > 2 cm (OR, 0.41; 95% CI: 0.19-0.87; P = 0.02) and short-term (< 3 years) follow-up (OR, 0.48; 95% CI: 0.29-0.80; P = 0.005) tended to correlate with a significantly favorable outcome. CONCLUSION: Patients who underwent extended surrounding hemosiderin excision could exhibit significantly improved seizure outcomes compared to patients without hemosiderin excision. However, further well-designed prospective multiple-center RCT studies are still needed.

Recipient IL-6-572C/G genotype is associated with reduced incidence of acute rejection following liver transplantation.

OBJECTIVE: Acute rejection resulting from alloimmune responses is a major risk factor affecting patient survival following liver transplantation. Since interleukin (IL)-6 can mediate acute rejection, the association between IL-6 gene single nucleotide polymorphisms (SNPs) and incidence of acute rejection in liver transplant recipients was investigated. METHODS: Patients who received liver transplant between January 2005 and December 2010 were typed for IL6-572C/G (rs1800796) polymorphisms using the snapshot technique. Association between genotype and acute rejection was analysed using the SNP Statistics website: http://bioinfo.iconcologia.net/snpstats/start.htm. Allelic and genotypic distributions for rs1800796 were compared among 335 patients with or without acute rejection within the first 6 months following liver transplant. RESULTS: Incidence of acute rejection was 11.94%. A heterozygous CG genotype for IL6-572C/G was associated with a lower acute rejection rate compared with homozygous CC or GG genotypes. CONCLUSION: IL6-572 CG genotype may be related to protection from acute rejection following liver transplant in Han Chinese patients.

[Reconstruction of traumatic ear defect by retro-auricular expanded flap and cartilage graft].

OBJECTIVE: To investigate the therapeutic effect of retro-auricular expanded flap and cartilage graft for reconstruction of traumatic ear defect. METHODS: From Aug. 2008 to Aug. 2010, 10 cases of traumatic ear defects were treated with retro-auricular expanded flap and cartilage graft. The expanders (volume, 50 ml) were implanted subcutaneously at retro-auricular area on the first stage. Then the expansion began at 1 week after operation until the volume reached 60 ml. On the second stage, the ear defects were reconstructed with the expanded flaps, rib cartilage framework, as well as skin graft. RESULTS: All the wounds healed primarily without any complication. The patients were followed up for 6 months to 2 years with satisfactory cosmetic results. Good symmetry was achieved. CONCLUSIONS: It is an effective and reliable method to reconstruct traumatic ear defect by retro-auricular expanded flap and cartilage graft.

Considerations for two inoculation methods of rabbit hepatic tumors: Pathology and image features.

The rabbit VX2 hepatic tumor model has been widely used for the investigation of liver cancer. The present study was designed to compare two inoculation methods in order to identify an improved modality for establishing rabbit hepatic tumors. A total of 44 rabbits were randomly divided into 2 groups. All inoculations were performed by open laparotomy. In group 1, 22 rabbits received a VX2 tumor cell suspension in a volume of 0.2 ml, which was slowly injected into the rabbit liver parenchyma using an 18-gauge needle. In group 2, a 0.2-ml suspension of small, minced tumor fragments of a VX2 carcinoma, inserted into an 18-gauge needle, was implanted into the liver parenchyma. The tumor survival ratio, size and extrahepatic metastases were evaluated and compared using computed tomography (CT)-scan, angiography and pathological specimens. At 2 weeks following implantation, successful liver tumor growth was achieved in 14 out of the 22 rabbits in group 1 (63.6%) and 21 out of the 22 rabbits in group 2 (95.5%) (P<0.05). Further sub-analysis revealed that single nodular tumors in the liver were observed in 4 out of the 14 rabbits in group 1 (28.6%) and 14 out of the 21 rabbits in group 2 (66.7%), and that multinodular tumors in the liver were observed in 10 out of the 14 rabbits in group 1 (71.4%) and 7 out of the 21 rabbits in group 2 (33.3%) (P<0.05). Extrahepatic metastases were observed in 5 out of the 14 rabbits in group 1 (35.7%) and 1 of the 21 rabbits in group 2 (4.8%) (P<0.05). Imaging findings of hepatic tumors were in concordance with histopathology. In conclusion, direct implantation of VX2 tumor fragments into the liver using a fine needle achieved a higher success rate than injecting VX2 tumor cells. The rabbit hepatic tumors inoculated by this method may therefore be a more suitable animal model for investigating liver cancer.

In vitro labeling of endothelial progenitor cells isolated from peripheral blood with superparamagnetic iron oxide nanoparticles.

The transplantation of endothelial progenitor cells (EPCs) provides a novel method for the treatment of human tumors or vascular diseases. Magnetic resonance imaging (MRI) has proven to be effective in tracking transplanted stem cells by labeling the cells with superparamagnetic iron oxide (SPIO) nanoparticles. The SPIO has been used to label and track the EPCs; however, the effect of SPIO upon EPCs remains unclear on a cellular level. In the present study, EPCs were labeled with home-synthesized SPIO nanoparticles in vitro and the biological characteristics of the labeled EPCs were evaluated. The EPCs were isolated from the peripheral blood of New Zealand rabbits and cultured in fibronectin-coated culture flasks. The EPCs were labeled with home-synthesized SPIO nanoparticles at a final iron concentration of 20 µg/ml. Labeled EPCs were confirmed with transmission electron microscopy and Prussian blue staining. The quantity of iron/cell was detected by atomic absorption spectrometry. The membranous antigens of EPCs were detected by cytofluorimetric analysis. Cell viability and proliferative capability between the labeled and unlabeled EPCs were compared. The rabbit EPCs were effectively labeled and the labeling efficiency was approximately 95%. The SPIO nanoparticles were localized in the endosomal vesicles of the EPCs, which were confirmed by transmission electron microscopy. No significant differences were found in cell viability and proliferative capability between labeled and unlabeled EPCs (P>0.05). In conclusion, rabbit peripheral blood EPCs were effectively labeled by home-synthesized SPIO nanoparticles, without influencing their main biological characteristics.

Assessment of biological characteristics of mesenchymal stem cells labeled with superparamagnetic iron oxide particles in vitro.

Mesenchymal stem cell (MSC) transplantation provides a novel strategy for the treatment of human disease. MR imaging (MRI) is able to track transplanted stem cells labeled with superparamagnetic iron oxide (SPIO) in vivo. However, the effect of SPIO upon labeled MSCs remains unclear on a cellular level. In this study, the biological characteristics of rat MSCs labeled with home-synthesized SPIO particles were evaluated. The MSCs were isolated from the bone marrow of 5 adult Sprague-Dawley rats and labeled with home-synthesized SPIO particles at a final iron concentration of 20 µg/ml. Labeled MSCs were confirmed with Prussian blue staining and transmission electron microscopy. The quantity of iron per cell was determined by atomic absorption spectrometry. Cell viability, proliferation, membranous antigen and multiple differentiation ability were compared between labeled and unlabeled MSCs. The rat MSCs were effectively labeled and the labeling efficiency was approximately 100%, as revealed by Prussian blue staining. The SPIO particles located in the endosomal vesicles of the MSCs were confirmed by transmission electron microscopy. No significant differences were observed in cell viability, proliferation, membranous antigen and multiple differentiation ability between the labeled and unlabeled MSCs (P>0.05). In conclusion, MSCs are able to be effectively labeled by home-synthesized SPIO particles without influencing their main biological characteristics.

[Application of bi-pedicled frontal expanded flap for cervical cicatricial contracture].

OBJECTIVE: To investigate the therapeutic effect of bi-pedicled frontal expanded flap for cervical cicatricial contracture. METHODS: Tissue expanders were implanted under frontal muscle. After expansion, the frontal flaps were designed based on bilateral superficial temporal vessels and were transferred to the neck wound. The cervical spine movement and the mento-cervical angle was measured and analyzed by SPSS16.0 and t test. RESULTS: From September 2006 to May 2010, 7 patients were treated by this method. The range of active cervical movement was improved in all direction. The mento-cervical angle decreased from (152.7 +/- 1.9) to (90.7 +/- 2.2) degrees after operation. The patients were followed up for 5 months to 3 years with satisfactory result and no contracture recurrence. CONCLUSIONS: The bi-pedicled expanded frontal flap has a reliable blood supply and is very suitable for cervical cicatricial contracture with good functional and esthetic results, leaving less morbidity at donor site.

Development of a fiber-optic laser delivery system capable of delivering 213 and 266 nm pulsed Nd:YAG laser radiation for tissue ablation in a fluid environment.

Ultraviolet (UV) lasers have the capability to precisely remove tissue via ablation; however, due to strong absorption of the applicable portion the UV spectrum, their surgical use is currently limited to extraocular applications at the air/tissue boundary. Here we report the development and characterization of a fiber-optic laser delivery system capable of outputting high-fluence UV laser pulses to internal tissue surfaces. The system has been developed with a view to intraocular surgical applications and has been demonstrated to ablate ocular tissue at the fluid/tissue boundary. The fifth (213 nm) and fourth(266 nm) harmonics of a Nd:YAG laser were launched into optical fibers using a hollow glass taper to concentrate the beam. Standard and modified silica/silica optical fibers were used, all commercially available. The available energy and fluence as a function of optical fiber length was evaluated and maximized. The maximum fluence available to ablate tissue was affected by the wavelength dependence of the fiber transmission; this maximum fluence was greater for 266 nm pulses (8.4 J/cm2) than for 213 nm pulses (1.4 J/cm2). The type of silica/silica optical fiber used did not affect the transmission efficiency of 266 nm pulses, but transmission of 213 nm pulses was significantly greater through modified silica/silica optical fiber. The optical fiber transmission efficiency of 213 nm pulses decreased as a function of number of pulses transmitted, whereas the transmission efficiency of 266 nm radiation was unchanged. Single pulses have been used to ablate fresh porcine ocular tissue. In summary, we report a method for delivering the fifth (213 nm) and fourth (266 nm) harmonics of a Nd:YAG laser to the surface of immersed tissue, the reliability and stability of the system has been characterized, and proof of concept via tissue ablation of porcine ocular tissue demonstrates the potential for the intraocular surgical application of this technique.

[Optical and spectral parameters in Ce3+ -doped gadolinium gallium aluminum garnet glass-ceramics].

The crystalline phases of Ce3+ -doped gadolinium gallium aluminum garnet (GGAG) glass-ceramics were investigated by X-ray diffraction, and the fluorescence spectra were recorded under the pumping of blue light-emitting diode (LED) using an integrating sphere of 10-inch in diameter, which connected to a CCD detector. The spectral power distribution of the glass-ceramics was obtained from the measured spectra first, and then the quantum yield was derived based on the photon distribution. The quantum yield of Ce3+ emission in GGAG glass-ceramics is 29.2%, meanwhile, the color coordinates and the correlated color temperature (CCT) of combined white light were proved to be x = 0.319, y = 0.349 and 6086 K, respectively. Although the quantum yield is a little smaller than the value in Ce3+ -doped YAG glass-ceramics, the CCT of the combined white light is much smaller than that in the latter. The optical behavior of GGAG glass-ceramics provides new vision for developing comfortable LED lighting devices.

Ablation of intraocular tissue with fiber-optic probe-delivered 266-nm and 213-nm laser energy.

PURPOSE: To explore the tissue ablation properties of pulsed 266-nm and 213-nm laser radiation in porcine retina and the potential for 213-nm laser radiation to cut through human trabecular meshwork. METHODS: Segments of porcine retinas were used, and localized areas of tissue were exposed to 266-nm or 213-nm laser. Human trabecular meshwork from donor eyes was also ablated using pulsed 213-nm laser. Ocular tissue was bathed in fluid to mimic the intraocular environment. Single or multiple pulses at various fluence levels were delivered with a tapered fiber-optic probe. The tissue was then fixed for histologic examination. Ablation depth and extent of damage were measured and related to fluence level and number of pulses applied. RESULTS: Ablation of the inner retina was achieved by single pulses at fluence levels of 0.6 J/cm(2) and higher with 266-nm laser radiation and 0.2 J/cm(2) and higher with 213-nm laser radiation. At the same fluence, ablation depth was greater (P < 0.001) with 213-nm than 266-nm laser, with less collateral damage. Ablation of human trabecular meshwork using 213-nm laser was highly dependent on fluence after exposure to single and multiple pulses, allowing good control of ablation depth. CONCLUSIONS: Laser radiation at 213 nm has greater ablation efficiency, less collateral damage, and a more linear dose-response than ablation at 266 nm. Precise removal of human trabecular meshwork was demonstrated using pulsed 213-nm laser radiation.

[Surgical treatment and etiological analysis of polyotia].

OBJECTIVE: To explore the surgical treatment and pathologic mechanism of polyotia. METHODS: The operative methods for polyotia were flexible. The main procedures were aimed at the remodeling of tragus with the redundant tissue. Tissue transplantation was used to correct the depression deformity. Compound auricular tissue transplantation and Z-plasty were used for correction of the malformation at the posterior part of polyotia. RESULTS: From 2003 to 2008, 9 patients with polyotia were treated. The tragus was reconstructed after resection of redundant tissue. The depression deformity was corrected with tissue infilling in 6 cases. The compound auricular tissue transplantation was performed in 4 cases. Z-plasty at the lower ear lobe was performed in 2 cases. The appearance and the location of the reconstructed ears looked symmetric to the healthy ear. CONCLUSIONS: Natural and symmetric appearance of reconstructed ear can be achieved in polyotia. The abnormal migration of neural crest cell might be the pathologic mechanism of polyotia.

Study of retinal microvessels in a Rhesus monkey model of chronic high intraocular pressure.

OBJECTIVE: To investigate the changes in retinal vessels, especially macular capillaries, under high IOP using the Rhesus monkey high IOP model. METHODS: The trabecular meshwork of the adult Rhesus monkey was cauterized by laser to induce increased IOPs with different degrees of damage. The eyeballs were enucleated, and the optic nerves were stained with toluidine blue in semithick slices. Part of the retina was observed under electron microscope, and the rest was stained by the ADPase method. The damage levels of the optic nerve were evaluated by axon count, and the pathological appearance of the macular capillaries were observed. RESULTS: Five mildly damaged eyes, three moderately damaged eyes and three severely damaged eyes were evaluated. Dense and intact perifoveal vascular rings were observed in all the eyes. The vessels' area percentages, as well as area, perimeter and diameter of the foveal avascular zones, were measured, and no statistically differences were found among different groups (P-values were 0.269, 0.500, 0.951, and 0.555 separately). The ultra structures of the normal capillaries showed regular tubes and intact basement membranes, while lipoid substances in capillary tubes, swollen mitochondria in endothelial cell bodies, and uneven basement membranes were found in the high IOP-damaged eyes. CONCLUSIONS: Compared with normal eyes, no obvious differences were found in macular microvessels and foveal avascular zones in the Rhesus monkey model of high IOP. However, presence of swollen mitochondria in endothelial cells and lipoid substances in capillary tubes might suggest that high IOP could damage the capillary endothelial cells.

[Expression and clinical significance of matrix metalloproteinase in gastric stromal tumor].

OBJECTIVE: To investigate the expression and clinical significance of matrix metalloproteinase (MMP) in gastric stromal tumor (GST). METHODS: MMP-2 and MMP-9 expression were determined by immunohistochemistry in tumor tissues in 44 patients with GST, and their relationship with clinicopathologic factors of the neoplasm was also investigated. RESULTS: MMP-2 and MMP-9 were expressed in the cytoplasm in 84.1% (37/44) and 81.8% (36/44) of tumors, respectively. The positive rates of MMP-2 and MMP-9 increased significantly in parallel to the increase in tumor malignancy (P < 0.05) and associated with pattern of tumor growth, tumor size, and centre necrosis (P < 0.05). In addition, there was a statistically significant positive correlation between the expression of the two markers in GST (r = 0.6523, P < 0.05). Furthermore, the 5-year postoperative survival rates of patients with positive expressions of MMP-2 and MMP-9 were significantly lower than those of patients with negative expressions of the two markers (P < 0.05). CONCLUSION: Over expression of MMP-2 and MMP-9 can be served as objective markers to judge the malignant degree and, to predict the prognosis of patients with GST.

Increased levels of transforming growth factor-betal and -beta2 in the aqueous humor of patients with neovascular glaucoma.

BACKGROUND AND OBJECTIVE: To measure the concentrations of transforming growth factor-betal and beta2 (TGF-beta1 and TGF-beta2) in the aqueous humor of patients with neovascular glaucoma (NVG). PATIENTS AND METHODS: Patients were divided into four groups: NVG secondary to central retinal vein occlusion (group 1), NVG secondary to proliferative diabetic retinopathy (group 2), central retinal vein occlusion without rubeosis (group 3), and senile cataract (group 4). The total TGF-beta 1 and TGF-beta2 concentrations in the aqueous humor of the four groups were measured by enzyme linked immunosorbent assay. RESULTS: The mean concentrations of total TGF-betal were 600.7 +/-436.7 microg/mL in group 1, 802.0 +/-359.5 pg/mL in group 2, and undetectable in groups 3 and group 4 (P < .05). The mean concentrations of total TGF-beta2 were 6,307.9+/- 2,206.2 microg/mL in group 1, 5,908.0+/-2,033.2 microg/mL in group 2, 899.7+/- 425.6 microg/mL in group 3, and 385.7 +/-89.9 microg/mL in group 4. The total TGF-betal and TGF-beta2 concentrations in groups 1 and 2 were significantly higher than those in groups 3 and 4, whereas the total TGF-beta2 concentration in group 3 was significantly higher than that in group 4 (P < .05). There was no significant difference in the TGF-betal or TGF-beta2 concentrations between groups 1 and 2 (P> .05). CONCLUSIONS: The abnormally high concentrations of TGF-betal and TGF-beta2 in the aqueous humor of patients with NVG may explain some aspects of the pathogenesis of NVG and the high failure rate of filtering operations in NVG.