[The clinicopathologic observation of 64 cases of eyelid and eyebrow pilomatrixoma].

OBJECTIVE: To study the clinicopathologic characteristics of eyelid and eyebrow pilomatrixoma. METHODS: It was a retrospective case series study. The clinical and pathological characteristics of 64 cases of eyelid pilomatrixoma who were treated in Tianjin Eye Hospital or Tianjin Gongan Hospital from May 2003 to October 2012 were reviewed and analysed. RESULTS: In 64 cases, 21 cases were male(32.8%), 43 were female( 67.2%). The age at the time of diagnosis ranged from 1 to 66 years, 27 cases(42.1%) were before age 10 years, 13 cases(20.3%) were before age 20 years, 11 cases(17.2%) were before age 30 years, 13 cases were beyond age 30 years. The tumors were more frequent in children and younger patients, mainly involved the eyebrow and upper lid, 42 cases (65.6%) were eyebrow, 18 cases (28.1%) were upper lid, 3 cases (4.7%) were lower lid, and 1 case was inner canthus, no prominently differences between right and left eyes were showed. The clinical features mainly presented with a slowly growing asymptomatic solid mass attached to the skin, which were frequently a round nodule, clearly demarcated and more hard, with skin overlying the lesion was normal or presented some reddish or bluish discoloration. The history of the most cases were several months to one year. The greatest diameter of tumors ranged from 4 mm to 16 mm besides one case was 3.2 cm. The tumors were consisted of darkly staining basaloid cells and shadow cells, which most cases associated with polynuclear giant cell reaction and chronic inflammation. There were 24 cases(37.5%) showed varying degrees of calcification and 6 cases showed ossification, one case was presented an epidermoid cyst in the tumor and one case associated with a pilomatrixoma on homolateral upper extremity skin. CONCLUSIONS: Pilomatrixoma is a benign neoplasm which is mainly consisted of basaloid cells and shadow cells, usually combined with inflammation, foreign body giant cells, calcification and ossification.If a child or young patient has a firm subcutaneous mass in the upper eyelid or eyebrow area, a pilomatrixoma should be suspected.

[Clinical and histopathological features of conjunctival myxoma and angiomyxoma].

OBJECTIVE: To explore the clinical and pathological features of conjunctival myxoma and angiomyxoma. METHODS: It was a retrospective case series study. The clinical and pathological features of 3 cases of conjunctival myxoma and 2 cases of conjunctival angiomyxoma were analyzed. These cases were treated from January 2005 to December 2010 at Tianjin Eye Hospital. Routine pathological examinations and immunohistochemical staining were performed, including staining for Vimentin, S-100, SMA and CD34. RESULTS: In the 5 patients, 2 cases were male and 3 cases were female. The mean age was (55.8 ± 14.8) years, ranging from 40 to 74 years. The tumors presented as yellow-pink, translucent, cystic and(or) with solid masses. Regarding the tumor location, 2 cases involved the temporal side, 1 case involved the nasal side, 1 case involved the nasal limbus and invaded the cornea, and 1 case involved the nasal, temporal and inferior parts. The lesions of the 5 cases were excised under local anaesthesia. Histopathological examination revealed that the conjunctival myxomas were composed of abundant mucoid material and relatively small numbers of small, ovoid, spindle and stellate shaped cells with sparse vessels. The histologic features of the conjunctival angiomyxoma were similar to those of myxomas with the exception of the former being characterized by a prominent vascular structure. The immunohistochemical staining showed that tumor cells were positive for Vimentin, but negative for S-100 protein; some tumor cells were positive for CD34 and SMA. The follow-up was performed in 4 cases post-operation. One case experienced recurrence 1 month after surgical excision. CONCLUSIONS: Most of the conjunctival myxoma and angiomyxoma appear as a local yellow-pink, translucent, cystic and(or) with solid mass, and some of which had multiple tumors. The preferred management route is complete surgical excision.

[Study on the structure and function of inferior oblique connective tissue in different mammals].

OBJECTIVE: The purpose of this research lied in studying the structure and function of connective tissue of inferior oblique (IO) in rhesus, rabbit and rat. METHODS: It was an experimental study. Two adult monkeys (rhesus), five adult rabbits and five adult Wistar rats were involved in this study. The gross anatomy of an orbit in each animal was observed. Meanwhile, the fellow orbit was processed with paraffin imbedding and coronal serial section. Masson trichrome stain was used to distinguish muscle and collagen, and Weigert stain was performed for identification of elastin. RESULTS: The connective tissue around IO muscle in rhesus, rabbits and rats all connected with inferior rectus (IR) and lateral rectus (LR), but the arrangements among them were not entirely similar. Only the connective tissue around IO in rhesus consisted of dense collagen, scattered elastic fiber, and connected closely with IR, LR Pulley. The connective tissue circling IO in rabbit and rat were crumbly, and was not connected closely with the connective tissue around IR. CONCLUSION: IR and LR Pulley has some mechanics link with IO in rhesus, and can play roles in covergence in rhesus.

[Study on the structure and function of superior oblique connective tissue in different mammals].

OBJECTIVE: The purpose of this research lied in studying the structure and function of connective tissue of superior oblique (SO) in rhesus and rabbit. METHODS: It was an experimental study. Two adult monkeys (rhesus) and five adult rabbits were involved in this study. The gross anatomy of an orbit in each animal was observed. Meanwhile, the fellow orbit was processed with paraffin imbedding and coronal serial section. Masson trichrome stain was used to distinguish muscle and collagen, and Weigert stain was performed for identification of elastin. RESULTS: Connective tissue around SO in both mammals thickened anteriorly, reflected in the trochlea along with the SO tendon, and became contiguous with the nasal aspect of the SR connective tissue ring, while the tendon passed inferior to the SR pulley to insert on the sclera. CONCLUSION: The contraction of SO OL can cause SR shift nasally. This may explain the mechanism of vestibulo-ocular reflex (VOR) partly.

[Clinicopathological observation of solitary fibrous tumor of the orbit].

OBJECTIVE: To study the clinicopathological characteristics of orbital solitary fibrous tumor. METHODS: It was a retrospective case series study. The clinical and pathological characteristics of 8 cases of orbital solitary fibrous tumor that were treated in Tianjin Eye Hospital from January 2003 to December 2011 were reviewed and analyzed. Immunohistochemical staining was performed, investigating the expression of CD34, vimentin, S-100 and SMA. RESULTS: In the 8 cases, 5 cases were male and 3 cases were female; 6 cases involved the right orbit and 2 cases involved the left orbit. Patients' ages ranged from 30 to 60 years, and the mean age was 41 years; duration of symptoms ranged from 2 months to 5 years. The locations of the tumor were in the superior or superotemporal orbit (5 cases), lacrimal sac and medial orbit (2 cases), or inferior orbit (1 case). The clinical features mainly included the swelling of the upper lid, unilateral painless orbital or lacrimal sac mass, proptosis and diplopia. CT scan usually revealed a moderately or intensely enhanced mass that was well-circumscribed. Complete tumor removal was performed in all cases. The tumor sizes ranged from 1.2 - 3.1 cm and appeared as a round or irregular oval mass with a thin fibrous capsule; incomplete capsule was found in 3 tumors. Microscopic observation revealed that the tumor was composed mainly of spindle or oval cells in a fascicular, storiform, hemangiopericytoma-like or a "patternless" pattern, with numerous thick bands of collagen that showed diffuse positive staining for CD34 and vimentin. Five cases had been followed-up from 6 to 86 months postoperatively, no evidence of local recurrence had been found in these patients. CONCLUSIONS: Orbital solitary fibrous tumor is a spindle cell tumor with diffuse positive staining for CD34 and vimentin. This tumor usually is well circumscribed and encapsulated. Complete excision is the preferred treatment. The tumor should be distinguished from other spindle cell tumors in the orbit.

Multimodal therapy in the management of primary orbital mesenchymal chondrosarcoma.

AIM: To evaluate the ophthalmic manifestations, radiographic features, and prognosis of Chinese patients with primary orbital mesenchymal chondrosarcoma (MCS). METHODS: The study included 6 cases with primary orbital MCS treated at Tianjin Eye Hospital from January 2009 to December 2019. Patitent ophthalmic manifestations, radiographic features, diagnosis, pathology, therapeutic regimens, and prognosis were retrospectively reviewed. RESULTS: Six patitents with primary orbital MCS were identified. The mean age at the first visit was 33y (range, 25-42y). All six patients displayed manifestations of exophthalmos, diplopia, limitation of eye displacement, upper eyelid oedema, decreased visual acuity and ptosis. The mean disease history and range were 5 and 2-8mo, respectively. The tumors were located in the superonasal extraconal compartment (2/6, 33.3%), intraconal compartment (2/6, 33.3%), and bitemporal extraconal compartment (2/6, 33.3%), respectively. Radiographic features were a well-defined, orbital mass with calcification and ossification on computed tomography (CT), and marked heterogenous enhancement on dynamic magnetic resonance imaging (MRI). Five patients were treated with tumor resection and one patient received orbital exenteration. Five patients in the cohort received postoperative radiation therapy, two patients received chemotherapy, and one patient did not receive postoperative adjuvant therapy because he refused. The histopathologic classification revealed a tumour composed of a mixture of mature chondroid tissue surrounded by small, round, and undifferentiated mesenchymal cells. Immunohistochemistry revealed Bcl-2, vimetin, CD99, and S-100 were expressed were expressed. After surgeries, two patients have developed a local recurrence. The median recurrence time of 58mo (52-64mo). One patient had distant recurrence included the lungs occurred 52mo after the initial surgery. CONCLUSION: The possibilty of orbital MCS need to be considered when a painless, slowly growing orbital mass with calcification and ossification. From our experience, trimodality treatment of radiation therapy, chemotherapy and surgery maybe the best option. Orbital MCS has a high tendency for late recurrence, regular long-term follow-up after complete excision is mandatory.

[The clinicopathologic observation of eosinophilic hyperplastic lymphogranuloma in the orbit].

OBJECTIVE: To improve the knowledge of the clinicopathologic features of eosinophilic hyperplastic lymphogranuloma (Kimura disease) in the orbit. METHODS: It was a retrospective case series study. The clinical and pathological characteristic of 9 cases of Kimura disease from the pathology department of Tianjin Eye Hospital were reviewed, immunohistochemical staining was performed, including for CD20, D79a, CD3, CD45Ro, CD34, Ki67 and IgE. RESULTS: In the 9 cases, 7 cases were male, 2 cases were female; the age of onset were from 13 to 62 years, medium age was 25 years; 7 cases were simple, 2 case were bilateral orbit. These lesions occurred in the superior or superotemporal quadrant of the orbit and the majority of cases extended into deep orbital tissues, 6 cases involved the lacrimal gland, 5 case involved the lateral rectus muscle. The clinical features mainly included lid swelling, eye redness, proptosis and palpable mass, and the disease course ranged from 6 months to 15 years. 3 lymph node enlargements in the submandibular regions and 1 subcutaneous nodule on the bilateral elbow were found in one case. The documentation of peripheral-blood eosinophilia (11% - 14%) was found in 3 cases. The pathological characteristics of Kimura disease were lymphoid tissue hyperplasia with prominent lymphoid follicles, conspicuous eosinophils infiltration and capillary proliferation. Immunohistochemical study in our cases revealed B cells in lymphoid follicles and mostly T cells in the interfollicular regions. CONCLUSION: Kimura disease of orbit is an uncommon lymphoid hyperplasia with prominent eosinophils infiltration and capillary vessels, which commonly occur superotemporal quadrant of the orbit, easy to involve lacrimal gland and lateral rectus muscle.

[The expression of Neuritin protein in the visual cortex of monocular form deprived adult rats].

OBJECTIVE: To investigate the expression of Neuritin protein in the visual cortex of normal (N90), monocular deprived (MD) and reverse suture (RS) adult Wistar rats, explore whether the visual cortex of adult rats remains the plasticity. METHODS: It was an experimental research. The 35 healthy rats were divided into 7 groups, 5 in every group. The time-point for normal control and MD groups is postnatal 90 days. The time-point for RS group is 6, 12, 24, 48 h and 1 week under the RS rats were exposed to light environment. MD and RS groups were sutured right eyelid at postnatal 14 days up to postnatal 90 days. That time the right eyes were opened and the same time tarsorrhaphy was performed on the left eyes in RS groups. The visual cortex of left cerebrum in the normal control group and MD group were obtained in P90 rats, and those of RS group were acquired in corresponding time points. Expression of the Neuritin protein in the visual cortex of rats was detected by immunohistochemistry stain methods. RESULTS: Expression of Neuritin protein A of the group of N90, MD, RS 6 h, RS 12 h, RS 24 h, RS 48 h, RS 1 week were 0.1097±0.0136, 0.0259±0.0057, 0.04751±0.0069, 0.05189±0.0057, 0.0649±0.0055, 0.0835±0.0097, 0.0845±0.0098 (F=105.57, P<0.05), the count in the visual cortex of rats were 163.90±5.82, 142.00±3.65, 150.00±5.46, 152.10±5.04, 156.40±5.25, 156.40±6.04, 155.80±6.54 (F=15.39, P<0.05). The expression of Neuritin protein in the visual cortex of rats in the MD group was considerably lower than that of the normal control group. The expression of Neuritin protein in the visual cortex of rats in the RS 6, 12, 24, 48 h and 1 week group was evidently higher than that in the MD group. CONCLUSIONS: The dynamic change of Neuritin protein expression in the visual cortex of the MD rats and RS rats indicates that the visual cortex of adult rats with MD beyond the sensitive period of visual development remain the plasticity to some extent. It provides an experimental basis for the amblyopic treatment in elder children and adults.

[Research of factors related to invasion and metastasis in choroidal melanoma].

OBJECTIVE: To investigate the expression of factors related to invasion and metastasis in choroidal melanoma and to determine their relationships with malignant features. METHODS: The expression of Connexin43 (Cx43), epithelial cadherin (E-cadherin), phosphatidylinositol 3-kinase (PI3K) and connective tissue growth factor (CTGF) in choroidal melanoma and nevi were detected by immunohistochemistry, and the correlation between these factors and clinicopathological features were analyzed. RESULTS: Positive rates of Cx43, E-cadherin, PI3K and CTGF were 74.07% (20/27), 44.4% (12/27), 74.07% (20/27) and 66.67% (18/27) in choroidal melanoma tissues, respectively; and 33.33% (5/15), 86.67% (13/15), 33.33% (5/15) and 20.00% (3/15) in the nevi tissues, respectively. There were significant differences in the expression of these markers between the two groups (χ(2) = 5.060, P = 0.024; χ(2) = 5.490, P = 0.019; χ(2) = 5.060, P = 0.024; χ(2) = 6.637, P = 0.010). The expression rates of Cx43 protein were 40% (4/10), 88.89% (8/9) and 100% (8/8) in spindle, mixed and epithelioid cell type, respectively. The expression of these data was related to histological type (χ(2) = 9.874, P = 0.007). The expression rates of PI3K protein were 42.86% (3/7), 75% (9/12) and 100% (8/8), in small, medium and large tumors, respectively, and their expression were co-related to the tumor size (χ(2) = 6.357, P = 0.042). Positive rates of Cx43, E-cadherin, PI3K and CTGF were 50% (6/12), 83.33% (10/12), 50% (6/12) and 41.66% (5/12), respectively, in choroidal melanoma tissues without sclera invasion and were 93.33% (14/15), 40% (6/15), 93.33% (14/15) and 86.67% (13/15), respectively, in choroidal melanoma tissues with violation involved the sclera. There were significant differences of the expression of these markers between the two groups (χ(2) = 4.457, P = 0.016; χ(2) = 3.546, P = 0.028; χ(2) = 4.457, P = 0.016; χ(2) = 4.218, P = 0.019). CONCLUSION: Increased expression of Cx43, PI3K and CTGF and decreased expression of E-cadherin are involved in the processes of invasion and metastasis of choroidal melanoma.

[Application of BIOMED-2 primers in immunoglobulin gene rearrangement analysis of ocular adnexal lymphoma: a pilot study].

OBJECTIVE: To assess the practical value of BIOMED-2 primers in the diagnosis of ocular adnexal lymphoma by PCR. METHODS: DNA was extracted from 63 formalin-fixed paraffin-embedded (FFPE) ocular adnexal lymphoma specimens. The DNA quality was evaluated by PCR-based amplification of housekeeping gene beta-actin. IgH(B) and IgK(B) primers of BIOMED-2 standardized clonality analysis system were used to evaluate the immunoglobin gene rearrangements. PCR products were analyzed using capillary electrophoresis and GeneScan software. RESULTS: 76.2% (48/63) of FFPE samples produced amplifiable DNA for detection of Ig gene rearrangements.Positive detection rates by BIOMED-2 IgH(B) and IgK(B) primers were 79.2% (38/48) and 68.8% (33/48), respectively, with a combined positive detection rate of 91.7% (44/48). CONCLUSIONS: IgH(B) and IgK(B) primers of BIOMED-2 are suitable for the detection of clonal rearrangements of Ig gene using FFPE specimens of ocular adnexal lymphomas.

[Clinical and pathological features of 26 cases of conjunctival melanoma].

OBJECTIVE: To improve the knowledge of clinical and pathological features of conjunctival melanoma, in order to have an early diagnosis and treatment. METHOD: Retrospective cases analysis. The clinical and pathological features of 26 cases of conjunctival melanoma were analyzed. These cases were treated from May in 1985 to June in 2007 in Tianjin Eye Hospital. Routine pathological examination and immunohistochemical staining of S-100 and HMB-45 were performed. RESULTS: The mean age was 53.4 years and ranging from 30.0 - 83.0 years. In these cases, 11 cases arose from primary acquired melanosis (PAM), 8 cases from conjunctival nevi or melanocytoma and 7 cases occurred de novo. Fourteen cases involved tarsal and bulbar conjunctiva, 6 cases involved bulbar conjunctiva only, 4 cases involved tarsal conjunctiva only and 2 cases were located at the limbus. Twenty two cases were epitheloid-cell-type melanoma, 4 cases were mixed-cell-type melanoma. There were 3 amelanotic melanomas, the tumor cells were positively stained with S-100 and HMB-45. The follow-up period was 1-18 years postoperatively in 14 cases. Among them, 12 cases showed 1-3 recurrences, 3 cases with preauricular lymph node metastasize, 1 cases with preauricular and submandibular lymph nodes metastasize; and 4 cases died from systematic extension or hepatic metastasis. CONCLUSIONS: Conjunctival melanoma mainly arises from malignant transformation of PAM or conjunctival nevi and consists of epitheloid melanotic tumor cells. The neighbor intraepithelial invasion and recurrence are common, particularly in diffuse type of tumors or tumors arising from PAM.

[Study of CPG15 expression in the visual cortex of normal and monocular form deprived development rats].

OBJECTIVE: To explore the expression of CPG15 mRNA and protein the visual cortex of normal and monocular form deprived development rats, To explore the association CPG15 with visual development. METHODS: It was an experimental research. one hundred healthy Wistar rats were divided into 10 groups: the time-point for normal group is postnatal 7, 14, 21, 28, 45 days. The time-point for MD group is postnatal 21, 28, 45 days, 10 in every group. MD groups were sutured right eyelid at postnatal 14 days, and to make the model of monocular form deprived. Rats were housed in alike environment. To detect the expression of Neuritin mRNA and immuno-positive neurons protein in the visual cortex of normal and monocular form deprived rats by SYBR green I real-time fluorescent polymerase chain reaction and immunohistochemistry stain methods. RESULT: We found that: (1) The expression of normal and MD rats visual cortex CPG15 mRNA and immuno-positive neurons and the IOD of protein, significant deviation existed among different ages with one-factor analysis of variance (P < 0.05), and reached its climax in P28 and MD28. (2) The expression of CPG15 mRNA and immuno-positive neurons and the IOD of protein in MD group obviously lower than the normal group in postnatal 21, 28, 45 days, there was statistically different in that ages (P < 0.05). CONCLUSION: The expression of CPG15 mRNA and immuno-positive neurons and the IOD of protein in the development normal and MD rats show that the stage change by development vision. Its expression correlated with visual experience and age factor, and there was a high expression in critical period, and obviously influence by monocular form deprived. So we supposed that CPG15 may affect development and maturation in the visual cortical neuron. It may be the one of molecular basis to participated in visual developmental plasticity.

[Preliminary report on prevention of adhesion after orbital trauma by chitosan membrane].

OBJECTIVE: To study the result and the mechanism of preventing postoperative adhesion after orbit trauma by chitosan membrane, and to observe the effects of chitosan membrane on optic nerve and visual function. METHODS: It was a self-control trail. Ten white rabbits (twenty eyes) were adopted in this experiment. Right eye on each rabbit was used in chitosan membrane experiment group and the left eye in control group. Trauma was made between superior rectus muscle and corresponding periosteum. Chitosan membrane was implanted between trauma tissues in the experimental group. F-VEP was tested 1 day before the operation and 6 days after operation in each rabbits. Degree of adhesion was evaluated by naked eyes; inflammatory score was evaluated by pathological examination and TGF-p3 impression was evaluated by immunohistochemical studies. RESULTS: F-VEP examination 6 days after the operation showed that the wave amplitude of Pt1 was (9.847 +/- 2.320) mV, latency of P1 was (71.700 +/- 5.144) ms. There was no difference between pre- and post-operative data (t = 0.974, 0.228; P > 0.01). Adhesion degree evaluation showed that there were 7 eyes with 1 score, 3 eyes with 2 score in the experimental group; while there were 1 eye with 2 score, 5 eyes with 3 score, 4 eyes with 4 score in the control group. There was a statistically significant difference (T = 59.00, P < 0.01) in adhesion degree between experimental group and control group. A statistically significant difference was presented in pathologic sheet score between the experimental and control groups. There were 6 eyes with 1 score, 4 eyes with 2 score in experimental group; while 2 eyes with 1 score, 4 eyes with 2 score, 4 eyes with 3 score in the control group. Immunohistochemical study showed strong positive in all slides of the experimental group, while only weakly positive in the control group. CONCLUSION: Chitosan membrane is effective on decreasing the synthesis of collagen fibrils and preventing adhesion after the orbit trauma in the rabbits.

A retrospective study of 2228 cases with eyelid tumors.

AIM: To describe the histopathologic and clinical features of eyelid tumor cases from Tianjin Eye Hospital during 2002 to 2015. METHODS: In this retrospective study, a total of 2228 cases of eyelid tumors with pathologic diagnoses were enrolled. The eyelid tumors were classified into three groups according to tumor origin: epidermal, adnexal and miscellaneous, including melanocytic, neural and vascular lesions. Inflammatory tumor-like lesions were excluded. The clinical characteristics of the eyelid tumors were analyzed, including age, gender and lesion location. RESULTS: Most eyelid tumors were epidermal in origin (1080, 48.5%), followed by miscellaneous (885, 39.7%) and adnexal tumors (263, 11.8%). Among all the tumors, 292 (13.1%) were malignant lesions, 1910 (85.7%) benign and 26 (1.1%) premalignant lesions. Most malignant tumors originated from epidermal cells (60.0%), followed by adnexal cells (34.6%). The most common malignant tumors were basal cell carcinomas (56.5%) followed by sebaceous carcinoma (34.6%), squamous cell carcinomas (3.8%) and lymphoma/plasmocytoma (1.7%). The benign and premalignant eyelid lesions mostly originated from epidermal cells (46.4%) followed by miscellaneous cell sources (45.2%), including melanocytic nevus (33.8%), seborrheic keratosis (13.7%), squamous cell papilloma (13.0%) and epidermal cysts (11.5%). CONCLUSION: Eyelid tumors are mostly epithelial in origin. Benign tumors are significantly more common than malignant tumors with an obvious female predominance, and the most frequent malignant tumor are basal cell carcinoma, sebaceous carcinoma and squamous cell carcinomas. The tumor clinical features varied among the different subtypes.

Positive relationship between number of negative lymph nodes and duration of gallbladder cancer cause-specific survival after surgery.

BACKGROUND: Although the prognostic implications of negative lymph nodes (NLNs) has been reported for a variety of tumors, little information has been published about the NLNs in gallbladder cancer (GBC). PATIENTS AND METHODS: In this study, clinicopathological characteristics and survival times of patients who had undergone surgery for GBC were collected from the Surveillance, Epidemiology, and End Results Program-registered TNM stage database and analyzed. Univariate and multivariate Cox proportional hazards models were used to identify the predictors of survival. RESULTS: It was found that a cutoff of one to two NLNs is optimal when assessing the association with survival, survival rates being consistently better with two or more NLNs than with fewer than two. This optimal cutoff value of 2 was identified as an independent prognostic factor by univariate and multivariate analyses (all P<0.001). Specifically, patients with two or more NLNs had better 5-year gallbladder cancer cause-specific survival than those with fewer than NLNs examined for stage I/II, stage III/IV, and all TNM stages (all P<0.001). CONCLUSION: Our findings indicate that the number of NLNs is an independent prognostic factor after GBC surgery, and, together with the number of positive lymph nodes, this will provide better prognostic information than the number of positive lymph nodes alone.

[Experimental study a new device of scleral flap stent on filtration surgery in normal sheep].

OBJECTIVE: To test the effectiveness and safety of a filtering drainage device, a scleral flap stent (SFS) made of poly methyl methacrylate (PMMA) in trabeculectomy (or filtering drainage-plasty) in sheep. METHODS: 32 of normal sheep were used. Trabeculectomy was performed in both eyes and the filtering drainage device, a SFS was randomly implanted under the scleral flap in one eye. After the surgery, the intraocular pressure (IOP) was measured by Schiotz tonometer; The filtering blebs and its histopathology was examined by a slit lamp, an ultrasound biomicroscope (UBM), and electronmicroscopy. RESULTS: The IOP in eyes with trabeculectomy plus SFS was statistically significant (P < 0.001) lower than that in eyes with trabeculectomy along at one month (11.38 +/- 1.20) mm Hg vs (14.05 +/- 0.93) mm Hg and at three months (11.95 +/- 1.18) mm Hg vs (15.2 +/- 1.09 mm Hg). Compared to the pre-operation, no difference in IOP was found at one month in eyes with trabeculectomy along (16.04 +/- 1.02) mm Hg vs (14.05 +/- 0.93) mm Hg. The filtering bleb was lasted more than 3 months in eyes with trabeculectomy plus SFS while existed only one month in eyes with trabeculectomy along by both slit lamp and UBM examination. The fibroblastic proliferation of filtering pathway and scar formation was found at one months post-operation in eyes with trabeculectomy along, however, the fibroblastic proliferation and the scar formation were found at three months and at six months after surgery in eyes with trabeculectomy plus SFS, respectively, by a light and electronmicroscopy examination. Tissue compliance was good and no elimination occurred. No toxic or adverse effects were observed in the following year post-operatively. CONCLUSION: SFS is a safe and effective newly designed filtering drainage device in lowering IOP when performed together with trabeculectomy.

[The suppression of the experimental autoimmune uveoretinitis with retinal S antigens by intranasal tolerance induction].

OBJECTIVE: The aim was to investigate the suppression of rat experimental autoimmune uveoretinitis( EAU) by induced immune tolerance via intranasal administration of retinal S antigens. METHODS: The bovine S antigen was purified from bovine retina by salt precipitation and ionic exchange chromatography, the female Lewis rats were used to induce immune tolerance by intranasal administration with purified bovine retinal S antigens and then the rats were used to produce the EAU model by retinal S antigens challenge. The rate of EAU occurrence, the clinical and histological scores, the skin delayed-type hypersensitivity and lymphocyte proliferation stimulated by retinal S antigen and concanavalin A were recorded. The adjunct effect of cyclophosphamide on tolerance induction was observed. RESULTS: After intranasal administration of retinal S antigens, EAU was induced in two of eight ( 25% ) rats in tolerant group, sis of six (100%) rats in control group , the difference of EAU induction rate was significant in tolerant group compared with control (P = 0. 0097) . The average onset time in tolerant group were 16. 5 days, the control group was 10. 3 days, the difference was significant ( F = 26. 32, P = 0. 000; q = 9. 723, P <0. 01). The average clinical scores of EAU in tolerant group were 0. 89, the control group was 3. 94, the difference was significant( F = 12. 48 ,P = 0. 000; q = 7. 904, P < 0. 01 ). The average histological scores of EAU in tolerant group were 1. 21, the control group was 4. 12, the difference was significant( F = 11. 80, P = 0. 000; q = 7. 510,P <0. 01). The histological features in tolerant group were iris blood vessels slightly dilation, few exudates in anterior chamber and vitreous cavity; there were slighter retina swallow and the photoreceptors damages in the tolerant group. The skin delayed-type hypersensitivity and the proliferative responses of lymphocytes stimulated by S antigen and concanavalin A in tolerant group were slighter than that in the control group. Intraperitoneal injection of cyclophosphamide enhanced the effect of immune tolerance slightly. Only intraperitoneal injection of cyclophosphamide did not diminish the severity of the rat EAU. CONCLUSION: The intranasal induced tolerance by retinal S antigens can suppress effectively the prevalence of rat experimental autoimmune uveoretinitis induced by retinal S antigens.

[Fluorescein angiography of retinal neovascularization model in mice].

OBJECTIVE: To investigate a high molecular weight fluorescein angiography in the application of retinal neovascularization model in mouse. METHODS: retinal neovascularization model was induced by exposure mouse to an environment containing high concentration of oxygen. High molecular weight fluorescein isothiocyanate dextran were perfused through the left ventricle directly, then the mouse eyes were enucleated and fixed with 4% paraformaldehyde. The retina was separated from the eyecup and flat mounting was performed on a gelatin coated slide. The vasculature was examined under fluorescent microscope. RESULT: The whole retinal vasculature was clearly visualized under fluorescent microscope. By focusing on different layer of the tissue, superficial, deep vascular plexus and connecting vessels also could be distinguished. The neovascular response occurred at the junction between the vascular and the avascular retina. CONCLUSION: High molecular weight fluorescein angiography can be applied for retinal neovascularization evaluation.

Expression of connexin 43 and E-cadherin in choroidal melanoma.

AIM: To investigate the expression of connexin 43 and epithelial cadherin (E-cadherin) in choroidal melanoma, to explore the clinical and pathological implications of expression of these proteins, and to determine their relations with malignant features. METHODS: The expression of connexin 43 and E-cadherin in choroidal melanoma were detected by immunohistochemistry and correlated with clinicopathological features. RESULTS: Positive rates of connexin 43 in choroidal melanomas and benign pigmented nevus tissues were 75% and 40% respectively with significant differences between the two groups (χ(2)=5.607, P=0.009). Positive rates of E-cadherin in choroidal melanomas and benign pigmented nevus tissues were 40% and 75% respectively with significant differences between the two groups (χ(2)=5.214, P=0.010). Significant overexpression of connexin 43 and reduction of E-cadherin expression was associated with the invasion to the sclera, and there were respectively significant differences between without and with scleral invasion groups (χ(2)=2.880, P=0.040; χ(2)=2.778, P=0.046). Overexpression of connexin 43 were correlated with tumor cell types and the expression of connexin 43 and E-cadherin may be correlated with each other. CONCLUSION: The increased expression of connexin 43 and the decreased expression of E-cadherin may be involved in the process of invasion of choroidal melanoma. The overepression of connexin 43 and reduction of E-cadherin may contribute to the development of choroidal melanoma.