Case Report: Non-negligible Epstein-Barr virus-associated posttransplant lymphoproliferative disorders in a lung transplant recipient.

Background: Posttransplant lymphoproliferative disorders (PTLDs) are uncommon but serious complications in patients following solid organ transplantation. Primary Epstein-Barr virus (EBV) infection is a risk factor for the development of PTLD, especially early-onset PTLD, in EBV-negative recipients. To date, however, there are no specific guidelines on the threshold of EBV-DNA load for therapeutic intervention, the source for measurement (e.g., blood, bronchoalveolar fluid), or the use of antiviral agents as prophylaxis for early PTLD prevention in EBV-mismatched patients. Methods: The present study describes a 56-year-old male lung transplant recipient diagnosed with EBV-associated PTLD. Results: This patient had a history of invasive fungal disease and Mucor and Aspergillus fumigatus infections in the early post-transplant period, necessitating antifungal therapy throughout the course of the disease. The patient was EBV-positive 15 days after transplantation, with lung CT showing multiple bilateral nodules of varying sizes beginning 98 days after transplantation. A lung biopsy showed PTLD, and next-generation sequencing (NGS) revealed EBV. This patient, however, did not receive any antiviral therapy for early PTLD prevention or any PTLD-related treatment. He died 204 days after lung transplantation. Conclusion: The present study describes a lung transplant recipient who developed EBV-associated PTLD, a non-negligible disease, after solid organ transplantation. Monitoring EBV-DNA load is important, as a sudden increase may be a sensitive indicator of PTLD. An earlier diagnosis may increase the likelihood of successful treatment.

Overexpression of the gibberellin 2-oxidase gene from Torenia fournieri induces dwarf phenotypes in the liliaceous monocotyledon Tricyrtis sp.

Gibberellins (GAs) are the plant hormones that control many aspects of plant growth and development, including stem elongation. Genes encoding enzymes related to the GA biosynthetic and metabolic pathway have been isolated and characterized in many plant species. Gibberellin 2-oxidase (GA2ox) catalyzes bioactive GAs or their immediate precursors to inactive forms; therefore, playing a direct role in determining the levels of bioactive GAs. In the present study, we produced transgenic plants of the liliaceous monocotyledon Tricyrtis sp. overexpressing the GA2ox gene from the linderniaceous dicotyledon Torenia fournieri (TfGA2ox2). All six transgenic plants exhibited dwarf phenotypes, and they could be classified into two classes according to the degree of dwarfism: three plants were moderately dwarf and three were severely dwarf. All of the transgenic plants had small or no flowers, and smaller, rounder and darker green leaves. Quantitative real-time reverse transcription-polymerase chain reaction (PCR) analysis showed that the TfGA2ox2 expression level generally correlated with the degree of dwarfism. The endogenous levels of bioactive GAs, GA1 and GA4, largely decreased in transgenic plants as shown by liquid chromatography-mass spectrometry (LC-MS) analysis, and the level also correlated with the degree of dwarfism. Exogenous treatment of transgenic plants with gibberellic acid (GA3) resulted in an increased shoot length, indicating that the GA signaling pathway might normally function in transgenic plants. Thus, morphological changes in transgenic plants may result from a decrease in the endogenous levels of bioactive GAs. Finally, a possibility of molecular breeding for plant form alteration in liliaceous ornamental plants by genetically engineering the GA metabolic pathway is discussed.

[Pseudo-accommodation with accommodating intraocular lens in patients at different ages].

OBJECTIVE: To compare the clinical performances of patients in different ages with implantation of a accommodating IOLs. METHODS: It was a retrospective study. Forty-seven eyes (47 patients) were enrolled in 3 groups for phacoemulsification and a accommodating IOL implantation. According to their ages, they were divided into 3 groups: ≤ 45 years, 46 - 59 years, and ≥ 60 years. Parameters analyzed after more than 3 months postoperation were uncorrected distance, best-corrected distance, uncorrected near, and distance-corrected near visual acuities; changes of anterior chamber depth(ACD) during accommodative measured using the ultrasound biomicroscopy (UBM);changes of ACD by instilling 2% pilocarpine using the A-ultrasonic scan; and the amplitude of accommodation using the pushing-up test. RESULTS: No significant difference was observed between distance and near visual acuities of IOL groups. The mean changes of ACD measured with UBM in the group of ≤ 45 years [(0.16 ± 0.12) mm] was significantly higher than the other age groups [46 - 59 years, (0.06 ± 0.06) mm, P = 0.00; ≥ 60 years, (0.07 ± 0.05) mm, P = 0.008)]. The mean changes of ACD stimulated by pilocarpine measured with A-ultrasonic scan in the group of ≥ 60 years [(0.17 ± 0.14) mm] was significantly lower than the other age groups [≤ 45 years, (0.68 ± 0.44) mm, P = 0.00; 46 - 59 years, (0.43 ± 0.20) mm, P = 0.00]. The accommodative amplitude of the ≥ 60 years groups ((2.32 ± 0.88) D) was lower than the group of ≤ 45 years [(2.87 ± 0.52) D, P = 0.005]. CONCLUSIONS: The accommodative amplitude of patients implanted with accommodating IOLs stepped down following the increase of age. However, no statistical differences were found in distance and near visual acuities between the different age groups.

[Long-term follow-up of flexible open-loop anterior chamber intraocular lenses implantation].

OBJECTIVE: To evaluate the long-term outcome in eyes had flexible open-loop anterior chamber intraocular lens (ACIOL) implantation. METHODS: Cataract extraction with primary flexible open-loop ACIOL and anterior vitrectomy were performed in 34 eyes (group I), and secondary AC IOL implantation were performed in 49 eyes (group II). Visual acuity, intraocular pressure (IOP), corneal endothelial cell, anterior chamber angle and the presence of associated complication were examined in a mean follow up of 4.8 years (range 3 to 7 years). RESULTS: The final best correct visual acuity was 0.5 or better in 65 eyes (78.3%). The IOP were (13.55 +/- 3.21) mm Hg preoperatively and (13.40 +/- 4.29) mm Hg (1 mm Hg = 0.133 kPa) at the last follow-up (t = 0.5427, P = 0.5888). In group I, the corneal endothelial cell density were (2497 +/- 629)/mm(2) preoperatively, while at the last follow-up it was (1995 +/- 648)/mm(2) and the rate of endothelial cell loss was (20.6 +/- 14.1)%; In group II, the corneal endothelial cell density before and after operation was (2459 +/- 681)/mm(2) and (2238 +/- 817)/mm(2) respectively. The rate endothelial cell loss was higher in group I compared with group II (P = 0.023). Postoperative complication include transient secondary glaucoma caused by block of pupil in 4 eyes and remain of viscoelastic substance in 3 eyes, hypotension in 5 eyes, persistent glaucoma in 2 eyes, hyphema in 2 eyes, IOLs slightly dislocation and shift in 3 eyes, pupil deformation in 1 eye, retina detachment in 2 eyes, and corneal decompensation in 2 eyes. CONCLUSIONS: Flexible open-loop ACIOL is relatively safe and effective in selected cataract surgery. Postoperative complication could be reduced if operative indication and surgical technique were emphasized.