A Case of Bilateral Central Serous Chorioretinopathy after Blunt Trauma

PURPOSE: To report a case of bilateral central serous chorioretinopathy (CSC) after blunt trauma with rapid remission. CASE SUMMARY: A 44-year-old man visited our clinic after blunt trauma around the right eye. At the first examination, no ocular problem was detected except a periorbital contusion. After one week, the patient complained of visual disturbance in his right eye. Fundus examination showed subretinal fluid in his right eye, and fluorescein angiography (FAG) showed typical smoke-stack pattern leakage, which lead to a diagnosis of CSC. Three days later, the patient complained of visual disturbance in his left eye, which was then also diagnosed as CSC. After 2 more weeks, the subretinal fluid in the right and left eyes had decreased. After 3 weeks, the subretinal fluid was almost completely absorbed in both eyes. CONCLUSIONS: Central serous chorioretinopathy can develop after blunt trauma, especially with a rapid clinical course. Thus, periodic ophthalmologic examination is needed after the first examination for blunt trauma of the eye.

Central Corneal Thickness in Korean Subjects with Primary Angle-Closure Glaucoma

PURPOSE: To compare the central corneal thickness (CCT) in eyes of Korean subjects with primary angle-closure glaucoma (PACG) to other patients with glaucoma and control subjects. METHODS: Medical records of patients who underwent examination for glaucoma and pre-operative examination for cataract surgery between March 2009 and August 2012 in our clinic were reviewed. CCT was compared in normal control eyes, primary open angle glaucoma (POAG) eyes and normal tension glaucoma (NTG) eyes. RESULTS: The mean CCT of POAG eyes was significantly larger than that of normal control eyes, NTG eyes and PACG eyes (p = 0.027, 0.009 and 0.008, respectively). There was no significant difference in mean CCT between normal control eyes, NTG eyes or PACG eyes. CONCLUSIONS: PACG eyes had a CCT similar to that of NTG or normal eyes in Korean subjects.

Central Corneal Thickness and Corneal Endothelial Cells in Pseudoexfoliation Syndrome

PURPOSE: To evaluate the central corneal thickness (CCT) and corneal endothelial cell density (ENDO) in pseudoexfoliation syndrome. METHODS: Medical records of patients who underwent a preoperative examination for cataract surgery and an examination for glaucoma were retrospectively reviewed. The present study included 44 patients (59 eyes) and age- and sex-matched controls. The total pseudoexfoliation patients divided into 2 groups, such as pseudoexfoliation syndrome (28 eyes) and pseudoexfoliative glaucoma (21 eyes) .The intraocular pressure (IOP), CCT, ENDO, corneal curvature (CC) and axial length (AL) were measured. RESULTS: The total pseudoexfoliation group showed significantly higher IOP (p = 0.001), thinner CCT (p = 0.003) and lower ENDO (p = 0.037). The pseudoexfoliation syndrome group showed significantly thinner CCT (p = 0.010) and lower EDNO (p = 0.041), but no significant difference in IOP (p = 0.941). There was no significant difference in CCT (p = 0.060) and ENDO (p = 0.171) between the pseudoexfoliative glaucoma group and controls, but the pseudoexfolliative glaucoma group showed significantly higher IOP (p < 0.001). CONCLUSIONS: The pseudoexfoliation group showed thinner CCT which should be taken into consideration when evaluating IOP with the applanation tonometer and diagnosing glaucoma, especially in pseudoexfoliation syndrome patients.

Comparison of Serum Homocysteine, Vitamin B12, Vitamin B6 and Folate Levels in Different Glaucoma Types

PURPOSE: To compare the levels of serum homocysteine, vitamin B12, vitamin B6 and folate in patients with normal-tension glaucoma, pseudoexfoliation glaucoma and high-tension glaucoma. METHODS: Thirty-two healthy subjects, 35 patients with normal-tension glaucoma, 22 patients with pseudoexfoliation glaucoma and 31 patients with high-tension glaucoma were included in the present study. Fasting venous samples were collected from all the participants. The levels of serum homocysteine, vitamin B12, vitamin B6 and folate were measured. One-way analysis of variance was used for the comparison of homocysteine, vitamin B12, vitamin B6 and folate levels among the 4 groups. RESULTS: The mean homocysteine levels in the pseudoexfoliation glaucoma and high-tension glaucoma group were 17.91 +/- 5.11 and 17.60 +/- 3.89 micromol/l, respectively, which were significantly higher than that of the control group (p = 0.014, p = 0.013, respectively). The mean vitamin B6 levels in the pseudoexfoliation glaucoma and high-tension glaucoma group were 17.67 +/- 14.32 and 17.00 +/- 10.58 nmol/l, respectively, which were significantly lower than that of the control group (p = 0.026, p = 0.008, respectively). CONCLUSIONS: Hyperhomocysteinemia may play a role as a risk factor in the development or progression of pseudoexfoliation glaucoma and high-tension glaucoma.

Presbyopia and contact lenses

Presbyopia as a result of a gradual decrement in visual function at near is one of most prevalent conditions causing patient concern and complaints in the 40 years and older age group. Many presbyopic patients believe the loss of accommodation represents a considerable decrease in their quality of life. Optical solutions to improve near vision in presbyopic patients can be classified as non-surgical or surgical. Among the non-surgical methods, several contact lens options for the presbyope include 1) single vision contact lens wear and reading glasses, 2) monovision in which one eye is optimally corrected for distance and the other eye is optimally corrected for near vision, and 3) bifocal/multifocal contact lenses. Most presbyopic patients who use computers should be considered for multifocal lenses because of their need for intermediate vision. Without severe dry eye and over 0.75 diopters astigmatism, most presbyopic patients prefer soft multifocal contact lenses to gas-permeable multifocal contact lenses. We suggest that multifocal contact lenses are effective for presbyopia because they provide good visual acuity at distance, intermediate, and near vision.

Effect of Sodium Hyaluronate and Cyclosporine A on Tear Film in Dry Eye Syndrome

PURPOSE: To evaluate the efficacy of topical 0.1% hyaluronate (HA) and 0.05% cyclosporine A on tear film parameters in dry eye syndrome patients. METHODS: Patients who were diagnosed with dry eye syndrome were treated with mbined with cyclosporine A (Group 2, 54 eyes). Ocular surface disease index (OSDI), tear film break-up time (BUT), Schirmer's test, and tear osmolarity were evaluated before treatment and at 1, 2, 3, and 6 months after treatment. RESULTS: OSDI was significantly improved at 2 months after treatment and Schirmer's test results significantly improved at 1 month after treatment in both groups. The BUT was significantly improved 3 months after treatment in Group 1 and at 1 month after treatment in Group 2. Tear osmolarity significantly improved at 1 month after treatment in both groups, but continuously improved up to 6 months after treatment only in Group 2. The BUT and Schirmer's test showed greater improvements in Group 2 than in Group 1. CONCLUSIONS: Combined treatment of topical 0.1% HA and 0.05% cyclosporine A may be more effective for improving dry eye syndrome.

Contrast Sensitivity and Color Vision Comparison Between Clear and Yellow-Tinted Intraocular Lens in Diabetic Retinopathy

PURPOSE: To compare contrast sensitivity and color vision after implantation of a clear intraocular lens (IOL) and a yellow-tinted IOL in diabetic retinopathy patients. METHODS: In the 50 eyes of 25 diabetic patients with non-proliferative diabetic retinopathy, clear IOLs were implanted in 25 eyes, and yellow-tinted IOLs were implanted in 25 fellow eyes. Three months after the surgery, contrast sensitivity function was measured with a vision contrast test system, and color discrimination was tested using the Farnsworth Munsell 100-hue test. RESULTS: Eyes implanted with yellow-tinted IOLs had significant differences in contrast sensitivity values compared to those of fellow eyes implanted with clear IOLs in both the moderate diabetic retinopathy group (6.0 cycles per degree) and the severe diabetic retinopathy group (throughout all spatial frequencies except 12.0 cycles per degree). The yellow-tinted IOL did not modify chromatic discrimination compared with that of the clear IOL. In the blue-yellow axis error score, however, there were significant differences between the clear IOL and the yellow-tinted IOL. CONCLUSIONS: With progressing diabetic retinopathy, the yellow-tinted IOL provided better contrast sensitivity than the clear IOL. The yellow-tinted IOL improved color vision in the blue-yellow chromatic axis without causing chromatic discrimination defects.

A Case of Cataract after Long-Term Use of Clonazepam in a Young Patient

PURPOSE: To report a case of cataract after long-term use of clonazepam in a young patient, with a similar appearance to cataract induced by other psychotropic agents. CASE SUMMARY: A 37-year-old woman complained of a visual disturbance in both eyes. The best-corrected visual acuity was 0.8 in the right eye and 0.6 in the left eye. Bilateral cortical cataract was observed on slit-lamp examination, and no other ophthalmic abnormalities were found. Potential risk factors for cataract were investigated, including past medical and family history, revealing a 20-year history of oral clonazepam (0.5-1 mg/day), for the neurological diagnosis of "chorea of unknown etiology". Detailed medication history did not reveal long-term use of any other drugs which could have induced the cataract. CONCLUSIONS: Because clonazepam use may induce cortical cataract, regular ophthalmologic examinations are necessary during long-term oral psychotropic therapy.

The Effect of Continuous Epidural Electrical Stimulation on Synapse and Neuronal Cell in Rat with Focal Ischemia

OBJECTIVE: To evaluate the effects of continuous epidural electrical stimulation (ES) on the behavioral recovery, and the molecular proliferation of synapse and neural cell in rats with photothrombotic stroke. METHOD: The male Sprague-Dawley rats were pre-trained on a single pellet reaching task (SPRT), and then received the photothrombotic infarction on dominant sensorimotor cortex (SMC) and implantation of electrode over the peri-lesion SMC surface. All rats were randomly assigned to one of two groups: anodal ES on infarcted SMC (ES group) and no ES on infarcted SMC (control group). Rats received daily SPRT and neurological examinations for 14 days. After the rats had been sacrificed, brain sections were immunostained for quantification of infarct volumes and evaluation of the structural remodeling markers (MAP2, synaptophysin and GFAP). RESULTS: The functional improvement of SPRT was significantly increased in the ES group compared to control group. There were no significant group differences in the infarct volumes, neurological examinations, structural remodeling markers. But, in the ES group, MAP2 and synaptophysin in affected peri-infarct area tended to increase compared with unaffected hemisphere. In affected hemisphere of ES group, many structural remodeling markers tended to increase compared with unaffected hemisphere. Especially, the staining of synaptophysin and GFAP in peri-infarct area showed more increased uptake than unaffected hemisphere in ES group and control group, respectively (p<0.05). CONCLUSION: The ES improved greatly the behavioral motor function after SMC infarction and induced the significant synaptogenesis with the widespread neuronal proliferation in peri-infarct area. Postischemic astrogliosis was not remarkable in ES group.

Changes in Laminin beta 1 Chain Expression in Renal Cortex by the Intervention with Cilazapril and Losartan on Adriamycin-Induced Nephropathy / 대한해부학회지

Laminin, an extracellular matrix glycoprotein, is distributed in the basement membrane of renal glomerulus. Laminin has been demonstrated to regulate the development and differentiation of glomeruli and play an important role in the filtering function of glomeruli. To address whether laminin beta 1 chain is associated with the pathogenic states of renal injury and recovery, nephropathy were induced by intravenous adriamycin injection and subsequently cured by treatment with antihypertensive drugs, cilazapril (angiotensin-converting enzyme inhibitor, ACEi) and lozartan (angiotensin receptor blockade, ARB), which have been known to be effective on renal protection. The results we obtained were as follows: 1. At 6 and 12 weeks after adriamycin injection, epithelial cells of proximal convoluted tubules exhibited intensive deposition of laminin beta 1 chain reactive gold particles. Cytoplasm of podocytes and mesangial cells in glomeruli showed an increase in the gold particle deposition as compared with that of controls. The mRNA level of laminin beta 1 chain was enhanced in the epithelial cells of proximal convoluted tubules. 2. Following cilazapril administration to adriamycin -induced nephropathy rats, laminin beta 1 chain reactive gold particle deposition was reduced in the epithelial cells of proximal convoluted tubules, podocytes, and mesangial cells. The level of laminin beta 1 chain transcripts was remarkably decreased in the epithelial cells of proximal convoluted tubules. 3. Following losartan administration to adriamycin -induced nephropathy rats, podocytes and mesangial cells were deposited with reduced number of laminin beta 1 chain reactive gold particles. The laminin beta 1 chain reactive gold particles and level of laminin beta 1 chain mRNA transcripts were remarkably reduced in the epithelial cells of proximal convoluted tubules. 4. Treatment with mixture of cilazapril and losartan to adriamycin -induced nephropathy rat resulted in a decrease in laminin beta 1 chain reactive gold particle deposition within the epithelial cells of proximal convoluted tubules, podocytes, and mesangial cells. Laminin beta 1 chain mRNA expression in the epithelial cells of proximal convoluted tubules nearly disappeared. These results consequently suggest that laminin beta 1 chain may be synthesized within the epithelial cells of proximal convoluted tubules, podocytes and mesangial cells and laminin beta 1 chain may play an important role on tissue recovery of the renal tissues injured by adriamycin.

Intrameniscal Ossicle of the Knee: A Case Report / 대한정형외과학회잡지

Intrameniscal ossicles are rare lesions in humans. They are usually located in the posterior horn of the medial meniscus and are frequently misdiagnosed on roentgenogram as intraarticular loose body. We report a case of meniscal ossicle that occured in a 58-year-old male who had diffuse pain and intermittent locking sensation in the knee. We successfully treated the case with arthroscopic resection of the intrameniscal ossicle and partial meniscectomy of the surrounding meniscus. There was no recurrence of symptom during more than six months after operation.

Changes in the expression of c-myc, RB and tyrosine-phosphorylated proteins during proliferation of NIH 3T3 cells induced by hyaluronic acid

We have shown that hyaluronic acid stimulates the proliferation of quiescent NIH 3T3 cells. We have shown that treatment of 1 mg/ml hyaluronic acid results in increase of tyrosine phosphorylation of two proteins, MW 124 kDa and 60 kDa as detected by anti-tyrosine antibodies by Western blot analysis. Maximum phosphorylation occurred within 2 h after addition of 1 mg/ml hyaluronic acid. Stimulation of proliferation was also accompanied by increase in c-Myc protein, which was inhibited by amlloride, an inhibitor of Na+/H+ antiporter and EGTA and increase in the steady state level of pRb, the RB gene product. These results suggest that the intracellular signal transduction pathways that mediate the stimulatory effects of hyaluronic acid on cellular proliferation are similar to those of growth factors.

Extra-adrenal Pheochromocytoma Causing Renal Artery Stenosis / 대한비뇨기과학회지

Extra-adrenal pheochromocytoma accounts for about 10 to 15 percent of all such tumors and the combination of pheochromocytoma and renal artery stenosis is rare. We report an unusual case of extra-adrenal pheochromocytoma causing renal artery stenosis which was developed in a 11-year-old boy and the literatures were reviewed.

Primary Carcinoma of the Ureter: Report of Two Cases / 대한비뇨기과학회지

Two cases of primary carcinoma of the ureter were reported with review of the literatures.