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Eye (London, England) Aug 2023To analyse risk factors and long-term outcomes after rebubbling and graft detachment in Descemet membrane endothelial keratoplasty (DMEK).
OBJECTIVES
To analyse risk factors and long-term outcomes after rebubbling and graft detachment in Descemet membrane endothelial keratoplasty (DMEK).
METHODS
176 consecutive DMEK grafts of 125 patients performed by 8 surgeons with a standardised technique between January 2015 and July 2022 were analysed. Main outcome measures were graft detachments, rebubbling rate, postoperative outcomes, and risk factors for graft failure and rebubbling.
RESULTS
6 (3.4%) grafts required rebubbling (>1/3 area detached). 40 (22.7%) grafts developed self-resolving partial detachments (<1/3 area detached). The mean time to rebubble was 16 ± 9.4 days. Mean BSCVAs at 5 years postoperative were 0.03 ± 0.16, 0.03 ± 0.14, and 0.15 ± 0.31 logMAR in fully attached, partially detached and rebubbled grafts (P = 0.437). 5-year graft survival were 98%, 90%, and 83% in fully attached, partially detached and rebubbled eyes (P = 0.02). There was significantly greater endothelial cell loss (ECL) in the rebubbled eyes (P = 0.018). Intraoperative trauma was a risk factor for graft failure (HR 1.81; 95% CI: 1.33-2.50; P = 0.023). An indication for surgery other than Fuchs endothelial dystrophy was a risk factor for rebubbling (HR 5.28; 95% CI: 5.11-72.4; P = 0.007).
CONCLUSION
DMEK grafts had better graft survival if there was no partial detachment or rebubbling at 5 years postop. There was significant ECL associated with rebubbling. A standardised technique reduces rebubbling and graft failure risk.
Topics: Humans; Descemet Membrane; Descemet Stripping Endothelial Keratoplasty; Retrospective Studies; Visual Acuity; Fuchs' Endothelial Dystrophy; Graft Survival; Endothelium, Corneal
PubMed: 36522529
DOI: 10.1038/s41433-022-02362-2 -
Glycobiology Aug 2023Breast cancer (BC) is one of the leading causes of death in women, globally. A variety of biological processes results in metastasis, a poorly understood pathological... (Review)
Review
Breast cancer (BC) is one of the leading causes of death in women, globally. A variety of biological processes results in metastasis, a poorly understood pathological phenomenon, causing a high relapse rate. Glycosylation, microribonucleic acids (miRNAs) and epithelial to mesenchymal transition (EMT), have been shown to regulate this cascade where tumor cells detach from their primary site, enter the circulatory system and colonize distant sites. Integrated proteomics and glycomics approaches have been developed to probe the molecular mechanism regulating such metastasis. In this review, we describe specific aspects of glycosylation and its interrelation with miRNAs, EMT and multidrug resistance during BC progression and metastasis. We explore various approaches that determine the role of proteomes and glycosylation in BC diagnosis, therapy and drug discovery.
Topics: Humans; Female; MicroRNAs; Breast Neoplasms; Epithelial-Mesenchymal Transition; Glycosylation; Drug Resistance, Multiple; Neoplasm Metastasis
PubMed: 37283470
DOI: 10.1093/glycob/cwad046 -
Science Bulletin Dec 2023After two continents collide, plate convergence and orogenesis are sustained because subducted continental lithosphere continues pulling the surface plate. It remains...
After two continents collide, plate convergence and orogenesis are sustained because subducted continental lithosphere continues pulling the surface plate. It remains controversial how, why, and when continental plate convergence and collision slow down and eventually cease. We use an unprecedented data coverage and present a regional-scale seismic tomographic image of the mantle structure beneath the Tibetan Plateau. In the mantle transition zone, we identify multiple high-velocity anomalies and interpret them as detached pieces of the Indian continental slab. Facilitated by internal heterogeneity of the continental lithosphere, piecewise slab detachments could reduce the slab pull force, resulting in the Miocene slowdown of the India-Eurasia convergence and coeval diachronous potassic volcanism in southern Tibet. We propose that slab detachment is a mechanism that eventually will lead to the end of the Indo-Eurasian continental collision and the Himalayan orogeny.
PubMed: 37919155
DOI: 10.1016/j.scib.2023.10.017 -
Materials Horizons Jun 2024Reversible adhesion with on-demand attachment and detachment is used by many animals for their locomotion. However, achieving robust and switchable adhesion on rough...
Reversible adhesion with on-demand attachment and detachment is used by many animals for their locomotion. However, achieving robust and switchable adhesion on rough surfaces in artificial adhesives remains a significant challenge. Here, we present a snail mucus-inspired touch-initiate adhesive (TIA), showing robust adhesions on various surfaces. TIA is a polymeric hydrogel photo-cured with the presence of supersaturated sodium acetate (NaAc) in the precursor solution. TIA is soft and flexible at room temperature, allowing it to form conformal contact with objects with various surfaces. The contact with the target surface immediately initiates the crystallization of TIA, increasing the elastic modulus of TIA by an order of magnitude. The increased modulus and the interlocking with the target surfaces thus results in an adhesion strength up to 465.56 ± 84.05 kPa. TIA can be easily detached from the surface by heating to a temperature above 58 °C, showing an adhesion strength of 12.71 ± 2.73 kPa. The detached TIA, even cooled down to and kept at room temperature, is readily used for the subsequent adhesion. The study here not only provides a highly adhesive material for on-demand attachment to various surfaces, but also proposes a new design strategy to compose smart materials.
PubMed: 38932648
DOI: 10.1039/d4mh00331d -
Clinical Ophthalmology (Auckland, N.Z.) 2023Stage 4 and 5 retinopathy of prematurity (ROP) is a serious condition that may require surgical intervention at some point. Timely intervention is a key element and,...
BACKGROUND
Stage 4 and 5 retinopathy of prematurity (ROP) is a serious condition that may require surgical intervention at some point. Timely intervention is a key element and, with the peculiarity of eyes among this group that necessities a certain level of surgical standards, operations cannot be undertaken in any surgical eye center.
AIM OF THE STUDY
To recognize the outcomes of vitrectomy in Iraqi preterm babies with stage 4 and 5 ROP, and to study factors that might increase the risk of re-detachment in operated eyes.
METHODS
A prospective cohort study undertaken from November 2020 to June 2023 for Iraqi preterm babies presenting with stage 4 and 5 ROP requiring surgical intervention. Each patient had a follow-up duration of 9 months. The primary follow-up outcome was anatomical success rate (flat versus detached), and the secondary outcome was to identify the postoperative complications.
RESULTS
This study enrolled 19 children; 11 males and eight females (number of eyes operated on was was 31), with a mean gestational age of 29.4±2.1 weeks. There were six (19.4%) eyes that did not develop any complications, five (16.1%) eyes developed postoperative vitreous hemorrhage, five (16.1%) eyes developed cataract, three (9.7%) eyes underwent a second vitrectomy, and seven (22.6%) eyes developed secondary glaucoma. The surgical success rates were 90.9% for stage 4a, 57.1% for stage 4b, and 33.3% for stage 5a.
CONCLUSION
This study presented the first surgical experience for vitrectomy in children with retinopathy of prematurity in our country, and the results were encouraging with an overall surgical success rate of 64.5%, and 19.4% of eyes did not develop any complication until the 1-year of follow-up.
PubMed: 38170100
DOI: 10.2147/OPTH.S443810 -
Nature Reviews. Molecular Cell Biology Jun 2024Endosomes are central protein-sorting stations at the crossroads of numerous membrane trafficking pathways in all eukaryotes. They have a key role in protein homeostasis... (Review)
Review
Endosomes are central protein-sorting stations at the crossroads of numerous membrane trafficking pathways in all eukaryotes. They have a key role in protein homeostasis and cellular signalling and are involved in the pathogenesis of numerous diseases. Endosome-associated protein assemblies or coats collect transmembrane cargo proteins and concentrate them into retrieval domains. These domains can extend into tubular carriers, which then pinch off from the endosomal membrane and deliver the cargoes to appropriate subcellular compartments. Here we discuss novel insights into the structure of a number of tubular membrane coats that mediate the recruitment of cargoes into these carriers, focusing on sorting nexin-based coats such as Retromer, Commander and ESCPE-1. We summarize current and emerging views of how selective tubular endosomal carriers form and detach from endosomes by fission, highlighting structural aspects, conceptual challenges and open questions.
PubMed: 38886588
DOI: 10.1038/s41580-024-00746-8 -
Journal of Personality Dec 2023Borderline Personality Disorder (BPD) diagnosis comprises several constellations of trait, neurocognitive, and psychosocial alterations. Dimensional models of...
OBJECTIVE
Borderline Personality Disorder (BPD) diagnosis comprises several constellations of trait, neurocognitive, and psychosocial alterations. Dimensional models of psychopathology provide new opportunities to parse heterogeneity and create a stronger interface between individual characterization and psychosocial outcomes. However, dimensional models have focused on either traits or neurocognitive features, lacking integration to capture the multifaceted nature of BPD.
METHOD
We assessed 100 participants with BPD using a combination of tools stemming from trait (Alternative Model for Personality Disorders) and neurocognitive models (Research Domain Criteria; RDoC) to examine if trait-derived subgroups display distinctive social-processing and psychosocial profiles. We used two complementary analytical approaches: person-centered (k-means clustering) and construct-based (multiple factor analysis).
RESULTS
Our person-centered approach identified four subgroups with separable internalizing, detached, externalizing, and low psychopathology trait profiles. These profiles revealed distinctive patterns of affiliation, emotion recognition and mentalization performance in RDoC tasks, and psychosocial measures of quality of life and social connectedness. RDoC-based measures showed close construct proximity with negative affectivity, disinhibition, and antagonism trait domains, relative to the detachment domain, which had close proximity with self-knowledge.
CONCLUSIONS
Altogether, findings support consilience between trait-based and neurobiological frameworks and suggest that trait models are useful to parse BPD heterogeneity leading to unique social functioning profiles.
Topics: Humans; Borderline Personality Disorder; Quality of Life; Personality Disorders; Psychopathology; Social Interaction
PubMed: 36650906
DOI: 10.1111/jopy.12811 -
Radiology Case Reports Aug 2024Choroidal detachment (CD) is a rare and potentially vision-threatening complication of glaucoma surgery. Inflammation and prolonged ocular hypotony can promote fluid...
Choroidal detachment (CD) is a rare and potentially vision-threatening complication of glaucoma surgery. Inflammation and prolonged ocular hypotony can promote fluid accumulation between the choroid and sclera. Risk factors include trauma, advanced age, use of anticoagulant medications, systemic hypertension, atherosclerosis, and diabetes. CD ultrasound findings will show 2 layers, detaching as far anteriorly as the ciliary bodies, that protrude convexly into the vitreous without extending to the optic disc, often described as the appositional or In contrast, retinal detachments will show a distinct "V" shape due to the retina's fixation to the optic nerve head posteriorly. In the case of hemorrhagic CD, therapy should be targeted at reducing intraocular pressure. In this case, the patient was started on atropine and prednisolone drops and discontinued on all glaucoma medications in the left eye. While serous choroidal detachments are usually benign, persistent choroidal effusions may cause significant morbidity with hemorrhagic CD having a worse prognosis. Point of care ultrasound can help emergency physicians quickly distinguish between choroidal and retinal detachments and thus guide management in a safe and timely manner.
PubMed: 38737180
DOI: 10.1016/j.radcr.2024.04.017 -
Bioactive Materials Jul 2024Posttraumatic osteoarthritis (PTOA) patients are often diagnosed by X-ray imaging at a middle-late stage when drug interventions are less effective. Early PTOA is...
Posttraumatic osteoarthritis (PTOA) patients are often diagnosed by X-ray imaging at a middle-late stage when drug interventions are less effective. Early PTOA is characterized by overexpressed matrix metalloprotease 13 (MMP13). Herein, we constructed an integrated diagnosis and treatment micelle modified with MMP13 enzyme-detachable, cyanine 5 (Cy5)-containing PEG, black hole quencher-3 (BHQ3), and cRGD ligands and loaded with siRNA silencing MMP13 (siM13), namely ERMs@siM13. ERMs@siM13 could be cleaved by MMP13 in the diseased cartilage tissues to detach the PEG shell, causing cRGD exposure. Accordingly, the ligand exposure promoted micelle uptake by the diseased chondrocytes by binding to cell surface αvβ3 integrin, increasing intracellular siM13 delivery for on-demand MMP13 downregulation. Meanwhile, the Cy5 fluorescence was restored by detaching from the BHQ3-containing micelle, precisely reflecting the diseased cartilage state. In particular, the intensity of Cy5 fluorescence generated by ERMs@siM13 that hinged on the MMP13 levels could reflect the PTOA severity, enabling the physicians to adjust the therapeutic regimen. Finally, in the murine PTOA model, ERMs@siM13 could diagnose the early-stage PTOA, perform timely interventions, and monitor the OA progression level during treatment through a real-time detection of MMP13. Therefore, ERMs@siM13 represents an appealing approach for early-stage PTOA theranostics.
PubMed: 38689658
DOI: 10.1016/j.bioactmat.2024.04.010 -
Orthopaedics & Traumatology, Surgery &... Oct 2023The hamstring tendons (gracilis and semitendinosus) are often used as an autograft for anterior cruciate ligament (ACL) reconstruction. Healing of this graft involves a... (Review)
Review
INTRODUCTION
The hamstring tendons (gracilis and semitendinosus) are often used as an autograft for anterior cruciate ligament (ACL) reconstruction. Healing of this graft involves a slow biological process called ligamentization. To encourage this process, some authors have proposed preserving the insertion of the hamstring tendons.
HYPOTHESIS
Leaving the tibial insertion of the hamstring tendons intact will provide better early biological incorporation and superior tibial mechanical fixation resulting in various clinical advantages.
MATERIALS AND METHODS
In January 2022, a systematic literature review was carried out independently by two authors of the Medline, PubMed and Embase databases. The keywords used were "pedicular" or "pedicled" or "preservation of tibial attachment" or "hamstring tibial insertion" AND "ACL reconstruction". Each author's data was analyzed separately.
RESULTS
Sixteen articles were analyzed. Preserving the hamstring tibial insertion during ACL reconstruction improves the graft's biological incorporation during the initial postoperative phase according to clinical studies with MRI analysis and provides a mechanical advantage at the graft's tibial attachment according to biomechanical studies (construct up to 65% stiffer). There was no difference in the clinical and functional scores when compared to the conventional technique in which the hamstring tendons are detached from their tibial insertion.
DISCUSSION
The main conclusion of this systematic literature review was that preserving the hamstring tibial insertion during ACL reconstruction appears to improve the graft's ligamentization with biological and mechanical advantages relative to detaching the hamstring tendons. The clinical and functional results were comparable to other techniques. Prospective studies with large cohorts are still needed to confirm these findings.
LEVEL OF EVIDENCE
IV; Systematic review of literature.
Topics: Humans; Hamstring Tendons; Autografts; Hamstring Muscles; Prospective Studies; Anterior Cruciate Ligament Injuries; Transplantation, Autologous
PubMed: 36682410
DOI: 10.1016/j.otsr.2023.103556