MDCT-Based Radiomics Features for the Differentiation of Serous Borderline Ovarian Tumors and Serous Malignant Ovarian Tumors.

OBJECTIVE: To investigate whether multidetector computed tomography (MDCT)-based radiomics features can discriminate between serous borderline ovarian tumors (SBOTs) and serous malignant ovarian tumors (SMOTs). PATIENTS AND METHODS: Eighty patients with SBOTs and 102 patients with SMOTs, confirmed by pathology (training set: n = 127; validation set: n = 55) from December 2017 to June 2020, were enrolled in this study. The interclass correlation coefficient (ICC) and least absolute shrinkage and selection operator (LASSO) regression were applied to select radiomics parameters derived from MDCT images on the arterial phase (AP), venous phase (VP), and equilibrium phase (EP). Receiver operating characteristic (ROC) analysis of each selected parameter was carried out. Heat maps were created to illustrate the distribution of the radiomics parameters. Three models incorporating selected radiomics parameters generated by support vector machine (SVM) classifiers in each phase were analyzed by ROC and compared using the DeLong test. RESULTS: The most predictive features selected by ICC and LASSO regression between SBOTs and SMOTs included 9 radiomics parameters on AP, VP, and EP each. Three models on AP, VP, and EP incorporating the selected features generated by SVM classifiers produced AUCs of 0.80 (accuracy, 0.75; sensitivity, 0.74; specificity, 0.75), 0.86 (accuracy, 0.78; sensitivity, 0.80; specificity, 0.75), and 0.73 (accuracy, 0.69; sensitivity, 0.71; specificity, 0.67), respectively. There were no significant differences in the AUCs among the three models (AP vs. VP, P = 0.199; AP vs. EP, P = 0.260; VP vs. EP, P = 0.793). CONCLUSION: MDCT-based radiomics features could be used as biomarkers for the differentiation of SBOTs and SMOTs.

Evaluation of Ovarian Tumors with Multidetector Computed Tomography and Tumor Markers: Differentiation of Stage I Serous Borderline Tumors and Stage I Serous Malignant Tumors Presenting as Solid-Cystic Mass.

BACKGROUND The aim of this study was to determine multidetector computed tomography (MDCT) features and tumor markers for differentiating stage I serous borderline ovarian tumors (SBOTs) from stage I serous malignant ovarian tumors (SMOTs). MATERIAL AND METHODS In total, 48 patients with stage I SBOTs and 54 patients with stage I SMOTs who underwent MDCT and tumor markers analysis were analyzed. MDCT features included location, shape, margins, texture, papillary projections, vascular abnormalities, size, and attenuation value. Tumor markers included serum cancer antigen 125 (CA125), carbohydrate antigen 19-9 (CA19-9), carcinoembryonic antigen (CEA), and human epididymis protein 4 (HE4). Parameters of clinical characteristic, MDCT features, and tumor markers were compared using a chi-square test and Mann-Whitney U tests. A binary logistic regression analysis was performed to detect predictors for SMOTs. A receiver operating characteristic (ROC) curve analysis was used to assess the potential diagnostic value of the quantitative parameters. Kappa and intraclass correlation coefficients were used to evaluate interobserver reproducibility for MDCT features. RESULTS Median ages between patients with SBOTs and SMOTs were significantly different. Compared with SBOTs, vascular abnormalities were significantly more common in SMOTs. CA125, HE4, the maximum thickness of the wall, the maximum thickness of the septa, and the maximum diameter of the solid portions were significantly higher in patients with SMOTs. A binary logistic regression analysis revealed that age, vascular abnormalities, and the maximum diameter of the solid portion were independent factors of SMOTs. ROC analysis was used to assess the potential diagnostic value for predicting SMOTs. Moderate or good interobserver reproducibility for MDCT features were identified. CONCLUSIONS Age, vascular abnormalities, and the maximum diameter of the solid portion were independent factors for differentiating SBOTs from SMOTs. The combined analysis of age, vascular abnormalities, and the maximum diameter of the solid portion may allow better differentiation between SBOTs and SMOTs.

Prevalence of the thoracic scoliosis in children and adolescents candidates for strabismus surgery: results from a 1935-patient cross-sectional study in China.

PURPOSE: No study so far has paid attention to strabismus-related spinal imbalance. This study aimed to determine the epidemiology of thoracic scoliosis in children and adolescents with strabismus and investigate the association of two diseases. METHODS AND DESIGN: A cross-sectional study. Study group consists of 1935 consecutive candidates for strabismus surgery (4-18 years); Control group consists of the age- and sex-matched patients with respiratory diseases. All subjects underwent a screening program based on chest plain radiographs using the Cobb method. Their demographic information, clinical variables and results of Cobb angle were recorded and analyzed. RESULTS: A significantly higher prevalence of thoracic scoliosis (289/1935, 14.94% versus 58/1935, 3.00%) was found in study group compared with control group. Among strabismic patients, the coronal thoracic scoliosis curve mainly distributed in right and in main thoracic (198/289) and in the curves 10°-19° (224/289); Age range 7-9 years (103/1935), female (179/1935) and concomitant exotropia patients (159/851) were more likely to have thoracic scoliosis. According to the logistic regression, thoracic scoliosis had no significant association with age, BMI, duration of illness and onset age (p > 0.05). However, gender, BCVA, type of strabismus and degree of strabismus showed a significant relationship with the prevalence of thoracic scoliosis (p < 0.05). CONCLUSIONS: With a pooled prevalence of 14.94%, strabismus patients showed a great higher risk of developing thoracic scoliosis. Screening for scoliosis in strabismus patients can be helpful to discover a high prevalence of potential coronal scoliosis. More attention should be paid to ophthalmological problems in patients with scoliosis. These slides can be retrieved under Electronic Supplementary Material.

Immediate early response gene 5 promotes irradiation combined with cisplatin-induced apoptosis in HeLa cells.

The objective of this study was to explore the action and mechanism of immediate early response gene 5 (IER5) on the apoptosis induced by irradiation combined with cisplatin in HeLa cells. The IER5 gene was knocked down using IER5-specific small interfering (si)RNA to generate HeLa cells stably expressing low levels of IER5 (HeLa-siIER5). Apoptosis was induced by 60Co γ-radiation, cisplatin, and radiation combined with cisplatin. Apoptosis and cell viability were evaluated by flow cytometry and Cell Counting Kit-8, respectively. Protein expression was determined by western blotting. Apoptosis was significantly inhibited in HeLa-siIER5 cells after γ-radiation combined with cisplatin exposure compared with siRNA control cells (P < 0.01). We also found that the expression of Bcl-2 was increased, and the levels of cleaved caspase-9 and cleaved PARP were reduced after γ-radiation combined with cisplatin treatment of HeLa-siIER5 cells. These results indicated that decreased expression of IER5 can reduce apoptosis induced by exposure to γ-radiation combined with cisplatin. Enhancing the expression of IER5 in tumor cells, and reducing its expression in normal cells, may be utilized as targeting strategies to improve the outcomes of chemo/radiotherapy for the treatment of patients with cervical cancer.

IER5 is involved in DNA Double-Strand Breaks Repair in Association with PAPR1 in Hela Cells.

The immediate early response gene 5 (IER5) is a radiation response gene induced in a dose-independent manner, and has been suggested to be a molecular biomarker for biodosimetry purposes upon radiation exposure. Here, we investigated the function of IER5 in DNA damage response and repair. We found that interference on IER5 expression significantly decreased the efficiency of repair of DNA double-strand breaks induced by ionizing radiations in Hela cells. We found that IER5 participates in the non-homologous end-joining pathway of DNA breaks repair. Additionally, we identified a number of potential IER5-interacting proteins through mass spectrometry-based protein assays. The interaction of IER5 protein with poly(ADP-Ribose) polymerase 1 (PARP1) and Ku70 was further confirmed by immunoprecipitation assays. We also found that Olaparib, a PARP1 inhibitor, affected the stability of IER5. These results indicate that targeting of IER5 may be a novel DNA damage response-related strategy to use during cervical cancer radiotherapy or chemotherapy.

[The clinical features and surgical treatment of masked bilateral superior oblique palsy].

OBJECTIVE: To investigate the clinical features, diagnosis and the management of masked bilateral superior oblique palsy (MBSOP). METHODS: Retrospectively analyzed the records of all 7 patients that met the clinical criteria for MBSOP in Zhongshan Ophthalmic Center between 1999 and 2003. The head tilt, vertical deviation in primary position and the action of obliquus pre- and postoperatively were collected in detail. RESULTS: All 7 patients were diagnosed as unilateral SOP in the first time. The average hypertropia in primary position preoperatively was 19.7(Delta) (range 6(Delta) to 30(Delta)). All patients had a head tilt, obvious unilateral inferior oblique overaction (+2 to +4) and mild superior oblique underaction (-1 to -2), and normal action in contralateral superior and inferior obliquus. Initial surgery consisted of ipsilateral inferior oblique weakening with (5 patients) or without (2 patients) ipsilateral superior rectus recession. The average hypertropia in primary position was 12.0(Delta) (range 0(Delta) to 20(Delta)) after the first operation. In 1 week to 4 years, all of the previously masked eye presented the inferior oblique overaction (+2 to +3) and superior oblique underaction (0 to -1). All patients underwent a second surgery in 4 months to 4 years after the initial surgery. The average hypertropia in primary position was 2.3(Delta) (range 0(Delta) to 7(Delta)) after the second operation. Postoperative alignment was excellent in all patients. CONCLUSIONS: Masked bilateral superior oblique palsy is quite difficult to detect before surgical correction of the initial manifest palsy. The possibility of an occult contralateral palsy should be considered in all undergoing surgery for unilateral SOP. The superior rectus recession and the inferior oblique weakening procedure should be performed at different stages. When the masked palsy becomes evident, a successful surgical outcome can usually be expected.

[The effect of weakening the overaction superior oblique muscles on the status of ocular torsion].

OBJECTIVE: To investigate the effect of weakening the superior oblique muscles on the status of ocular torsion. METHODS: Twenty-nine patients (58 eyes) underwent tenotomy or partial ectomy of bilateral superior oblique muscles for treatment of superior oblique overacting. Objective cyclodeviations were assessed by fundus photograph before and 7 days after the surgery. The photographs were transferred to a computer and then the fovea-disc angle was measured by a software for drawing pictures. Subjective cyclodeviations and binocular vision function were assessed by synoptophore. RESULTS: Fundus photography before surgery revealed that the intorsion was 10.48 degrees +/- 6.01 degrees for the right eye and was 9.37 degrees +/- 5.88 degrees for the left eye. The reduction of the cyclodeviations by weakening the superior oblique muscle for the right and left eye was 9.11 degrees +/- 7.09 degrees and 7.94 degrees +/- 4.76 degrees respectively. The comparisons of objective ocular torsion for both eyes showed high significant differences (P < 0.01) pre- and post-operatively. There were no significant differences (P > 0.05) between the effects of tenotomy or partial ectomy of bilateral superior oblique muscles. All patients showed no cyclotropia and normal binocular vision function was obtained with synoptophore before and after surgery. CONCLUSIONS: Weakening the overaction superior oblique could correct ocular incyclodeviation. Both tenotomy and partial ectomy of bilateral superior oblique muscles can treat ocular incyclodeviation effectively. The changes of subjective and objective cyclodeviations are inconsistent with each other.

[Clinical features of V patterns strabismus and its long-term effect of surgical treatment].

OBJECTIVE: To investigate the features and treatment of V patterns strabismus. METHODS: Pre- and post-operative deviation and oblique muscle action as well as binocular visual function were evaluated in sixty-three V pattern patients. The difference between upgaze and downgaze of deviation were recorded before and after operation. RESULTS: Sixty-two patients (98.4%) with binocular or unilateral inferior oblique overaction + 2 to + 3 were treated with inferior oblique weakening procedure and horizontal rectus recession-resection procedure. 1 patient with binocular inferior oblique overaction + 1 treated with horizontal recti recession-resection procedure. The difference between upgaze and downgaze is 25.6 prism diopters (PD) preoperatively and 4.5 PD postoperatively. The primary-position exotropia preoperatively of 48 V pattern exotropia is 37.2 PD, after surgery, the average deviation is 3.4 PD of esotropia [38 cases (79.2%) with deviation within +/- 10 PD]. 15 cases of V pattern esotropia had deviation 50.6 PD preoperatively, after surgery, the average deviation is 2.4 PD of esotropia [11 cases (73.3%) with deviation within 10 PD]. 21 patients (33.3%) obtained stereo visual function after surgery. CONCLUSION: V patterns always had inferior oblique over action and could be treated with the inferior oblique weakening procedure. The primary-position deviation should be treated by traditional horizontal rectus recession-resection procedure. The stereoscopic function had a good prognosis with surgery.

[The effect of weakening inferior oblique muscles on the status of ocular torsion].

OBJECTIVE: To understand the clinical significance of subjective and objective examination of cyclodeviations and investigate the effect of weakening inferior oblique muscles on the status of ocular torsion. METHODS: Twenty patients (40 eyes) with overacting inferior oblique muscles underwent bilateral myotomy or partial myectomy of inferior oblique muscles. Subjective cyclodeviations were measured before surgery as well as one week, two months after surgery by double maddox rod test (DMRT). Objective cyclodeviations were assessed by fundus photography before and 7 days after surgery in 15 cases. The photograph was transferred to a computer, and the fovea-disc angle was measured by means of drawing picture software. RESULTS: Nine patients with primary overaction of inferior oblique muscles were negative with DMRT before surgery, and only one case revealed incyclotropia 5.0 degrees tested two months after surgery. Four out of 11 patients with secondary overaction of inferior oblique muscles showed excyclotropia 2.5 degrees - 5.0 degrees with DMRT before surgery, and all patients indicated no subjective cyclotropia with DMRT two months after surgery. Fundus photography determination of the right eye revealed extorsion 16.83 degrees +/- 6.39 degrees, the left eye 14.92 degrees +/- 4.51 degrees before surgery. The reduction of the cyclodeviations by weakening inferior oblique muscle for the right and left eye was 13.07 degrees +/- 3.38 degrees and 10.54 degrees +/- 3.75 degrees respectively. The comparison of objective ocular torsion for both eyes showed high significant differences (P < 0.01) pre- and post-operatively. CONCLUSIONS: The results of subjective and objective examination of cyclodeviations in patients with primary or secondary overacting inferior oblique muscle early after birth were not consistent. Weakening inferior oblique muscle could correct excyclodeviation. There exist complicated compensatory mechanisms for subjective change of ocular torsion after surgery. The changes of subjective and objective cyclodeviations are still inconsistent.

[The effect of preventing anterior segment ischemia by preservation of anterior ciliary vessels in rabbit].

OBJECTIVE: To investigate the effect of preserving anterior ciliary vessels (ACVs) on the prevention of anterior segment ischemia syndrome (ASI) during the surgery of extraocular muscles. METHODS: Thirty-two adult New Zealand white rabbits were randomly divided into four groups. ACVs of the right eyes were preserved among all of the rabbits, and were cut off in all of the left eyes. Group A: internal and external recti were cut off in two eyes; Group B: superior and inferior recti were cut off in two eyes; Group C: internal, external and superior or inferior recti were cut off in two eyes; Group D: all of the recti were cut off in two eyes. All rabbits were observed under slit microscope. The intraocular pressure (IOP), the total protein and lactic acid in the aqueous humor were recorded preoperatively and postoperatively. Eyes were enucleated at the forth week postoperatively to obtain the iris and the ciliary body for histopathologic study and electron microscopy. RESULTS: No signs of ASI were observed in the right eyes of all four groups under the slit lamp and under the light and election microscopes. The IOP and levels of ingredients of aqueous humor (total protein and lactic acid) showed no difference between preoperative and postoperative interval. No obvious ASI was observed in the left eyes of group A. Mild reactions of ASI were observed in the left eyes of group B. Moderate to severe reactions of ASI were observed in the left eyes in group C and group D. The IOP reduced from (17.21 +/- 3.76) mm Hg (1 mm Hg = 0.133 kPa) preoperatively to (14.48 +/- 3.36) mm Hg postoperatively in group C (P < 0.05); and from (16.68 +/- 2.33) mm Hg reduced to(3.17 +/- 0.92) mm Hg in group D. (P < 0.05). The level of total protein and lactic acid in the aqueous humor increased from (505.3 +/- 5.0) mg/L and (7.54 +/- 0.47) g/L preoperatively to (811.9 +/- 44.4) mg/L and (11.00 +/- 3.59) g/L postoperatively in group C, respectively (P < 0.05). In group D, the level of total protein and lactic acid in the aqueous humor increased from (504.6 +/- 4.1) mg/L and (7.17 +/- 1.44) g/L preoperatively to (1025. 8 +/- 78.3) mg/L, (8.23 +/- 1.68) g/L postoperatively, respectively (P < 0.05). There were various histopathological changes under the light and electron microscope in groups C and D. While no obvious ischemic changes were observed in group A. CONCLUSION: Two vertical muscles cut off at one eye simultaneously would produce mild reactions of ischemia, while three or more muscles cut off simultaneously could obstruct blood flow in eyes and induce ASI. Preservation of the ACVs could avoid the occurrence of ASI.