Inhibition of angiotensin converting enzyme increases PKCβI isoform expression via activation of substance P and bradykinin receptors in cultured astrocytes of mice

Background@#Angiotensin-converting enzyme inhibitor (ACEi) inhibits the catalysis of angiotensin I to angiotensin II and the degradation of substance P (SP) and bradykinin (BK). While the possible relationship between ACEi and SP in nociceptive mice was recently suggested, the effect of ACEi on signal transduction in astrocytes remains unclear. @*Objectives@#This study examined whether ACE inhibition with captopril or enalapril modulates the levels of SP and BK in primary cultured astrocytes and whether this change modulates PKC isoforms (PKCα, PKCβI, and PKCε) expression in cultured astrocytes. @*Methods@#Immunocytochemistry and Western blot analysis were performed to examine the changes in the levels of SP and BK and the expression of the PKC isoforms in primary cultured astrocytes, respectively. @*Results@#The treatment of captopril or enalapril increased the immunoreactivity of SP and BK significantly in glial fibrillary acidic protein-positive cultured astrocytes. These increases were suppressed by a pretreatment with an angiotensin-converting enzyme.In addition, treatment with captopril increased the expression of the PKCβI isoform in cultured astrocytes, while there were no changes in the expression of the PKCα and PKCε isoforms after the captopril treatment. The captopril-induced increased expression of the PKCβI isoform was inhibited by a pretreatment with the neurokinin-1 receptor antagonist, L-733,060, the BK B 1 receptor antagonist, R 715, or the BK B 2 receptor antagonist, HOE 140. @*Conclusions@#These results suggest that ACE inhibition with captopril or enalapril increases the levels of SP and BK in cultured astrocytes and that the activation of SP and BK receptors mediates the captopril-induced increase in the expression of the PKCβI isoform.

Non-Arteritic Ischemic Optic Neuropathy Following COVID-19 Vaccination in Korea: A Case Series

Background@#To report the clinical manifestations of non-arteritic anterior ischemic optic neuropathy (NAION) cases after coronavirus disease 2019 (COVID-19) vaccination in Korea. @*Methods@#This multicenter retrospective study included patients diagnosed with NAION within 42 days of COVID-19 vaccination. We collected data on vaccinations, demographic features, presence of vascular risk factors, ocular findings, and visual outcomes of patients with NAION. @*Results@#The study included 16 eyes of 14 patients (6 men, 8 women) with a mean age of 63.5 ± 9.1 (range, 43–77) years. The most common underlying disease was hypertension, accounting for 28.6% of patients with NAION. Seven patients (50.0%) had no vascular risk factors for NAION. The mean time from vaccination to onset was 13.8 ± 14.2 (range, 1–41) days. All 16 eyes had disc swelling at initial presentation, and 3 of them (18.8%) had peripapillary intraretinal and/or subretinal fluid with severe disc swelling. Peripapillary hemorrhage was found in 50% of the patients, and one (6.3%) patient had peripapillary cotton-wool spots. In eight fellow eyes for which we were able to review the fundus photographs, the horizontal cup/ disc ratio was less than 0.25 in four eyes (50.0%). The mean visual acuity was logMAR 0.6 ± 0.7 at the initial presentation and logMAR 0.7 ± 0.8 at the final visit. @*Conclusion@#Only 64% of patients with NAION after COVID-19 vaccination have known vascular and ocular risk factors relevant to ischemic optic neuropathy. This suggests that COVID-19 vaccination may increase the risk of NAION. However, overall clinical features and visual outcomes of the NAION patients after COVID-19 vaccination were similar to those of typical NAION.

Changes in Angle of Exodeviation According to Distance after Monocular Occlusion in Intermittent Exotropia

Purpose@#This study investigated changes in the angle of exodeviation at different distances and the characteristics of a group that showed an increased angle following monocular occlusion in intermittent exotropia. @*Methods@#In all, 102 patients diagnosed with basic intermittent exotropia were enrolled. The deviation angle was measured using a mirror at 33 cm, 3 m, 6 m, 12 m, and 6 m. Moreover, the deviation was measured at 33 cm and 3 m after patching the non-dominant eye for 1 hour. Patients with a higher deviation angle at 33 cm after occlusion were categorized as the ‘increased group’, whereas those with lower deviation angles were classified as the ‘stationary group’. @*Results@#There was a male-to-female ratio of 46:56 and an average age at surgery of 9.23 years. No significant differences were observed in deviation measurements taken at 3, 6, 12, and 6 m using a mirror. However, after occlusion, there was a significant increase in deviation at 33 cm (p < 0.01). The average log value of near stereoacuity was 1.96 ± 0.35 in the increased group and 2.16 ± 0.41 in the stationary group. The group with an increased near deviation after occlusion demonstrated a significantly improved near stereoacuity (p = 0.01) and an increased proportion of good results in the near Worth 4 dot test (p = 0.03). @*Conclusions@#Preoperative measurement of maximum deviation after 1 hour of monocular occlusion can help reduce recurrence and insufficient correction, particularly in patients with good fusional ability.

Improvement in Near Vision Following Silodosin Treatment in Patients With Lower Urinary Tract Symptoms / 대한배뇨장애요실금학회지

Purpose@#The objective of this study was to investigate the change in near visual function after the administration of oral silodosin to patients with lower urinary tract symptoms (LUTS). @*Methods@#This prospective study included treatment-naive patients who were scheduled to start treatment with silodosin for LUTS. A comprehensive ophthalmological evaluation including the near vision and the automated pupillometry was performed at baseline and after 3 months of silodosin treatment. For subjective assessment of near visual ability and satisfaction, a Near Activity Visual Questionnaire-10 (NAVQ-10) was also used at the same time (higher scores indicating worse quality). @*Results@#Of 23 patients enrolled in this study, 15 continued with silodosin (8 mg once daily) treatment for 3 months and completed a follow-up evaluation. The mean age of participants was 60.4±8.4 years. Distant visual acuity and spherical error were unchanged after silodosin treatment. However, near vision acuity (logMAR) was improved after treatment (right, 0.47±0.36 vs. 0.38±0.39, P=0.018; left, 0.41±0.37 vs. 0.31±0.34, P=0.068; both, 0.27±0.26 vs. 0.21±0.27, P=0.043). Pupil size under room light decreased significantly in both eyes (right, 3.77±0.60 vs. 3.16±0.58, P=0.001; left, 3.72±0.80 vs. 3.21±0.75, P=0.002). The Rasch scale at NAVQ-10 improved from 54.7±9.9 to 48.5±11.2 (P=0.004). @*Conclusions@#This preliminary study demonstrated that highly selective alpha-1A adrenergic receptor antagonists such as silodosin improve near visual acuity and quality in patients with LUTS/benign prostatic hyperplasia. Decrease in pupil size caused by inhibition of adrenergic alpha 1 mediated contraction of iris dilator muscle is a possible mechanism underlying improved near vision.

Improvement in Near Vision Following Silodosin Treatment in Patients With Lower Urinary Tract Symptoms / 대한배뇨장애요실금학회지

Purpose@#The objective of this study was to investigate the change in near visual function after the administration of oral silodosin to patients with lower urinary tract symptoms (LUTS). @*Methods@#This prospective study included treatment-naive patients who were scheduled to start treatment with silodosin for LUTS. A comprehensive ophthalmological evaluation including the near vision and the automated pupillometry was performed at baseline and after 3 months of silodosin treatment. For subjective assessment of near visual ability and satisfaction, a Near Activity Visual Questionnaire-10 (NAVQ-10) was also used at the same time (higher scores indicating worse quality). @*Results@#Of 23 patients enrolled in this study, 15 continued with silodosin (8 mg once daily) treatment for 3 months and completed a follow-up evaluation. The mean age of participants was 60.4±8.4 years. Distant visual acuity and spherical error were unchanged after silodosin treatment. However, near vision acuity (logMAR) was improved after treatment (right, 0.47±0.36 vs. 0.38±0.39, P=0.018; left, 0.41±0.37 vs. 0.31±0.34, P=0.068; both, 0.27±0.26 vs. 0.21±0.27, P=0.043). Pupil size under room light decreased significantly in both eyes (right, 3.77±0.60 vs. 3.16±0.58, P=0.001; left, 3.72±0.80 vs. 3.21±0.75, P=0.002). The Rasch scale at NAVQ-10 improved from 54.7±9.9 to 48.5±11.2 (P=0.004). @*Conclusions@#This preliminary study demonstrated that highly selective alpha-1A adrenergic receptor antagonists such as silodosin improve near visual acuity and quality in patients with LUTS/benign prostatic hyperplasia. Decrease in pupil size caused by inhibition of adrenergic alpha 1 mediated contraction of iris dilator muscle is a possible mechanism underlying improved near vision.

Analysis of the Conjunctival Microbiome in Patients with Atopic Keratoconjunctivitis and Healthy Individuals

Background@#Atopic dermatitis (AD) has been clarified that imbalance of bacterial and fungal communities in the skin and gut play key roles in immunologic dysfunction. Atopic keratoconjunctivitis (AKC), one of severe ophthalmic manifestation of AD, could be related with dysbiosis as same as AD. @*Objective@#In this case-control study, the roles of conjunctival microbial communities in AKC were evaluated by a comparative analysis with healthy controls (HCs). @*Methods@#16S rRNA sequencing was used to construct libraries of compositional information for a total of 30 volunteers including 20 patients with AKC and 10 HCs. @*Results@#In the results, variation in the conjunctival taxonomic composition was higher in patients with AKC than in the HC group. In an analysis of relative abundance at the genus level, some taxa significantly differed between groups, including Ralstonia, Staphylococcus, Pseudomonas, Proteus, Haemophilus, and Bifidobacterium(p＜0.05). Beta diversity was significantly higher in patients with AKC than in HCs (PERMANOVA, p=0.004). @*Conclusion@#The results indicated that the diversity and composition of the microbiome differs between patients with AKC and HCs.

Comparison of the Outcomes of Two- and Three-muscle Surgery in Exotropia over 45 Prism Diopters

PURPOSE: We report the outcomes of two- or three-muscle surgery on patients with large-angle exotropia exceeding 45 prism diopters (PDs). METHODS: We retrospectively analyzed data on 45 exotropia patients (> 45 PDs) who underwent two- or three-muscle surgery. We excluded patients with paralytic or restrictive strabismus, A- or V-pattern strabismus, a coexistent oblique dysfunction or nystagmus, and/or a history of prior extraocular muscle surgery. Only patients for whom at least 6 months of follow-up data were available were included. Successful surgery was defined as postoperative esotropia ≤ 5 PD, orthophoria, and exotropia ≤ 10 PD at the last visit. RESULTS: We included 45 patients, of whom 22 and 23 underwent two- and three-muscle surgery, respectively. The mean postoperative deviations were 9.5 and 2.7 PD in the two- and three-muscle groups, respectively; the overall success rates were 54.55% (12/22) and 91.30% (21/23). Subgroup analyses revealed that the surgical success rate of two-muscle operations was 66.67% (12/18) in 45–55 PD patients and 0% (0/4) in ≥ 55 PD patients; the success rates of three-muscle operations were 100% (7/7) and 87.50% (14/16). The success rate did not differ significantly between those with postoperative deviations of 45–55 PD (p = 0.137), but did between those who underwent two- and three-muscle operations to treat postoperative deviations of ≥ 55 PD (p = 0.003). CONCLUSIONS: Satisfactory results can be achieved via two-muscle surgery in patients with exotropia 55 PD, three-muscle surgery is superior to two-muscle surgery. Therefore, large-angle exotropia is optimally treated via three-muscle surgery.

Position and size of the sphenoid door jamb in the lateral orbital wall for the orbital decompression / 대한해부학회지

The aim of this study was to identify the three-dimensional topography of the sphenoid door jamb (SDJ) in the lateral orbital wall and to propose navigational guidelines for safe deep lateral decompression using surgical landmarks. The 120 orbits and SDJs of 60 subjects were three-dimensionally reconstructed using Mimics software. The mean volumes of the orbit and SDJ were 24.3 mm³ and 2.0 mm³, respectively. The mean distances from the lateral orbital margin (LOM) to the anterior and posterior margins of the SDJ were 13.2 and 36.3 mm, respectively. The mean distances from the superior orbital fissure to the LOM and to the posterior margin of the SDJ were 40.2 mm and 4.6 mm, respectively. The mean distances from the inferior orbital fissure (IOF) to the anterior and posterior margins of the SDJ were 3.8 mm and 20.5 mm, respectively. In the superior approach of the orbit, it can be predicted that the area up to 3 cm posterior from the LOM is safe, while 1 cm posterior from the safe zone could be a dangerous zone. In the inferior approach of the orbit, the safe area will be about 1 cm posterior from the anterior tip of the IOF, and the area up to 1 cm posterior from the safe zone should be approached with extreme care.

A Case of Traumatic Hypotony Maculopathy Treated by Intravitreal Air Injection

PURPOSE: To report a case of traumatic hypotony maculopathy treated by intravitreal air injection. CASE SUMMARY: A 20-year-old female presented with decreased visual acuity in the left eye 2 days after trauma. Best corrected visual acuity (BCVA) was 0.5 and the intraocular pressure (IOP) was 5 mm Hg. Indirect ophthalmoscopy revealed chorioretinal folds in the macular area. Gonioscopy showed angle recession from 4 to 7 o'clock. Initially, pressure patching and conservative management were performed on the left eye 10 days after examination. However, deterioration of the chorioretinal fold was observed without any change in IOP. Finally, intravitreal air injection (0.5 cc) was performed 10 days after the start of conservative treatments. Following air injection, the normalization of IOP and gradual reduction of chorioretinal fold was observed. BCVA improved to 1.0 and IOP was maintained between 12 and 14 mm Hg for 24 months after the air injection. CONCLUSIONS: Intravitreal air injection may safely and effectively treat traumatic hypotony maculopathy.

Comparison of Retinal Nerve Fiber Layer Thickness between Stratus and Spectralis OCT

PURPOSE: To compare the peripapillary retinal nerve fiber layer (RNFL) thickness of normal patients and those with various glaucoma diseases by time domain (Stratus) and spectral domain (Spectralis) optical coherence tomography (OCT). METHODS: The RNFL thickness as measured by the Stratus and Spectral OCT was compared (paired t-test). The relationship and agreement of RNFL thickness between the two OCT modalities were evaluated by Pearson correlation, Bland-Altman plot, and area under the receiver operating characteristic curve. RESULTS: Two-hundred seventeen eyes of 217 patients, including twenty-four normal eyes, ninety-one glaucoma suspects, seventy-six normal tension glaucoma cases, and twenty-six primary open angle glaucoma cases (POAG) were analyzed. The peripapillary RNFL thicknesses as measured by Stratus OCT were significantly greater than those measured by Spectralis OCT. However, in quadrant comparisons, the temporal RNFL thickness obtained using Stratus OCT were significantly less than those obtained using Spectralis OCT. Correlations between RNFL parameters were strong (Pearson correlation coefficient for mean RNFL thickness = 0.88); a high degree of correlation was found in the POAG group. Bland-Altman plotting demonstrated that agreement in the temporal quadrant was greater than any other quadrant. CONCLUSIONS: Both OCT systems were highly correlated and demonstrated strong agreement. However, absolute measurements of peripapillary RNFL thickness differed between Stratus OCT and Spectralis OCT. Thus, measurements with these instruments should not be considered interchangeable. The temporal quadrant was the only sector where RNFL thickness as measured by Spectralis OCT was greater than by Stratus OCT; this demonstrated greater agreement than other sectors.

The Effects of Nanoparticles for Irradiation / 영남의대학술지

BACKGROUND: To evaluate the changes in the radiation dose and temperature distribution on irradiated egg albumin and nanoparticle (Fe3O4) powder mixed egg albumin. METHODS: A new type of phantom was designed by fabricating a 30x30x30cm acryl square inside a 3x3x3cm small square and dividing it into two parts. In the control group, only egg albumin was irradiated, and in the test group, 25nm 20mg/cc, 25nm 40mg/cc, and 1 um 40 mg/cc nanoparticles with egg albumin were irradiated. The radiation isodose distributions and temperature changes were then observed. RESULTS: No significant changes were observed in the radiation dose and temperature distribution. CONCLUSION: The nanoparticles were considered not to have had any effect on the radiation dose and temperature distribution under the experimental conditions. Further studies can be conducted based on the changes in the mixture material.

Four Cases of Pars Plana Vitrectomy for Treatment of Symptomatic Lamellar Macular Holes

PURPOSE: To report the results of pars plana vitrectomy for the treatment of symptomatic lamellar macular holes. CASE SUMMARY: Pars plana vitrectomy with epiretinal membrane (ERM) and internal limiting membrane (ILM) stripping was performed for the treatment of lamellar holes in four patients who complained of vision loss or metamorphopsia. In three out of four patients, fluid-gas exchange with 14% C3F8 was performed and patients were instructed to maintain aprone position for 7 days after surgery. Postoperatively, the improvement of visual acuity, foveal contour, and disappearance of metamorphopsia were achieved in three patients. However, full-thickness macular hole (FTMH) developed in one patient after vitrectomy. Repeated fluid-gas exchange was performed and the patient was instructed to maintain a prone position, however, the FTMH did not close. CONCLUSIONS: In patients with visual loss or metamorphopsia, vitrectomy with ERM and ILM stripping appears to be a beneficial treatment. FTMH developed after surgery in one patient, therefore further study is needed to elucidate the prognostic factors for the development of FTMH.

Best Disease With Old-age Onset Misdiagnosed as Chronic Central Serous Chorioretinopathy: A Case Report

PURPOSE: To report a case of Best's disease with old-age-onset with unusual clinical features. CASE SUMMARY: A 68-year-old woman with a six-month history of using oral steroids complained of decreased vision in both eyes. Fundus examination revealed a circular area of macular elevation measuring approximately 1.5 disc diameter size in both eyes. Optical coherence tomography (OCT) showed serous retinal detachment, but pigment epithelial detachment was seen only on fluorescein angiography and indocyanine green angiography. The patient received a diagnosis of chronic central chorioretinopathy with choroidal neovascularization. Photodynamic therapy (PDT) and intravitreal bevacizumab (IVB) injections were prescribed as treatment, but were ineffective. For a definitive diagnosis, we performed an electro-oculogram (EOG) and the result was abnormal with an Arden ratio below 1.5 in both eyes. A final diagnosis of Best's disease was established. Spectral domain OCT findings at the last visit showed a clearly visible RPE split and a low reflective space between the split RPE layers, as well as a high reflectivity corresponding to the subretinal material. CONCLUSIONS: We report a case of Best's disease with old-age onset with unusual clinical features and abnormal EOG findings. Spectral domain OCT was helpful in evaluating the disease. Treatment with PDT and IVB was not effective.

Differential promoter methylation may be a key molecular mechanism in regulating BubR1 expression in cancer cells

The BubR1 mitotic-checkpoint protein monitors proper attachment of microtubules to kinetochores, and links regulation of chromosome-spindle attachment to mitotic-checkpoint signaling. Thus, disruption of BubR1 activity results in a loss of checkpoint control, chromosomal instability caused by a premature anaphase, and/or the early onset of tumorigenesis. The mechanisms by which deregulation and/or abnormalities of BubR1 expression operate, however, remain to be elucidated. In this study, we demonstrate that levels of BubR1 expression are significantly increased by demethylation. Bisulfite sequencing analysis revealed that the methylation status of two CpG sites in the essential BubR1 promoter appear to be associated with BubR1 expression levels. Associations of MBD2 and HDAC1 with the BubR1 promoter were significantly relieved by addition of 5-aza-2'-deoxycytidine, an irreversible DNA methyltransferase inhibitor. However, genomic DNA isolated from 31 patients with colorectal carcinomas exhibited a +84A/G polymorphic change in approximately 60% of patients, but this polymorphism had no effect on promoter activity. Our findings indicate that differential regulation of BubR1 expression is associated with changes in BubR1 promoter hypermethylation patterns, but not with promoter polymorphisms, thus providing a novel insight into the molecular regulation of BubR1 expression in human cancer cells.

Significance of Bioelectrical Impedance during Ischemia-Reperfusion Injury in the Rabbit's Liver

PURPOSE: During liver resection and transplantation, liver is damaged by ischemia-reperfusion injury. Until now, there is no approved method to measure or predict the extent of liver injury during the operation. This is the preliminary study to make the real time monitoring system by quantification of bioelectrical impedance and ischemia-reperfusion injury in liver. METHODS: Male Newzealand white rabbits(body weight 3.5-4.0 kg) were used. We observed changes of bioelectrical impedance during ischemia and reperfusion injury according to frequency(120 Hz-100 KHz). Bioelectrical impedance of liver tissue were measured every 5 minutes interval with two mono-polar needle coated with platinum using LCR meter (GS-4311B, ANDO, Japan). Cell viability was assessed by metabolic capacity of fatty acid (palmitic acid metabolic rate) and histologic examination (H&E stain) at every 30 minutes interval during 120 minutes ischemia. RESULTS: Liver bioelectrical impedance was changed significantly(p<0.05) during ischemia in lower frequency compared to those of higher frequency. Bioelectrical impedance(120 Hz) increased during ischemia and returned to base line level after reperfusion. The level of bioelectrical impedance(120 Hz) increased gradually after ischemia for 1 hour. After 1 hour, the level of bioelectrical impedance had tendency to maintain plateau. Palmitic acid oxidation rate were not changed significantly during 120 minutes ischemia and there were no significant difference in histologic examination. CONCLUSION: We found the possible role of bioelectrical impedance to measure and predict the extent of ischemia-reperfusion injury.

A Case of Congenital Onychodysplasia of the Index Fingers Associated with Dandy-Walker Variant / 대한피부과학회지

Congenital onychodysplasia of the index fingers (COIF) is a rare disorder characterized by various forms of nail dysplasia which are mainly limited to the index fingers. The aetiology of the disease is still a matter of debate. COIF is characterized by five criteria: congenital occurrence, unilateral or bilateral index finger involvement, variability of nail appearance, possible hereditary involvement, and frequently associated bone abnormalities. We report a case of COIF, which is associated with Dandy-Walker variant.

A Case of Irritant Dermatitis due to Ranunculus japonicus / 대한피부과학회지

Irritant dermatitis is the most frequent type of plant-related dermatitis. Plant families most commonly associated with irritation are Ranunculaceae, Euphorbiaceae, Cruciferae, Brassicaceae, Urticaceae, and Solanaceae. We report a case of irritant contact dermatitis caused by Ranunculus japonicus for the treatment of arthralgia in a 78 year old female.

A Case of Malignant Peripheral Nerve Sheath Tumor Arising from Neurofibromatosis during Pregnancy / 대한피부과학회지

Malignant Peripheral Nerve Sheath Tumor is a neoplasm that most often arises in anatomically discernible peripheral nerves or neurofibroma. This rare tumor usually has a strong association with neurofibromatosis type 1. Nearly half of these malignant tumors arise in individuals affected with neurofibromatosis type 1. Neurofibromas often first appear around the time of puberty, increase in size and number during pregnancy, and shrink after giving birth. Because growth hormone (GH) concentration increases during puberty and pregnancy, it is possible that GH influences the growth of these tumors. A 33-year-old pregnant woman presented with a 4-month history of a painful, huge mass growing on the right breast. She suffered from neurofibromatosis type 1, with multiple cafe au lait spots and neurofibromas. The clinical and histopathological findings showed a malignant peripheral nerve sheath tumor. We report a case of malignant peripheral nerve sheath tumor on the right breast in a pregnant woman with neurofibromatosis type 1.

Clinical Study on Birthmarks of Normal 446 Neonates / 대한피부과학회지

BACKGOUND: Birthmarks represent an excess of one or more of the normal components of skin. OBJECTIVE: This study was carried out to investigate the incidence and clinical feature of birth mark. METHODS: We examined 446 neonates admitted in the nursery of Soonchunhyang University Hospital from April 2003 to August 2004 RESULT: Mongolian spots were observed in 286 neonates, occurring most frequently on sacrococcyxgeal area. Salmon patches were observed in 103 neonates, occurring most frequently on the nape. Erythema toxicum were observed in 142 neonates, occurring most frequently on face. Pigmented nevi were observed in 8 neonates. Portwine stains were observed in 2 neonates. Strawberry hemangiomas were observed in 5 neonates. CONCLUSION: The prevalence of Mongolian spot in our study is lower than the prevalence reported by others. The prevalence of salmon patch, pigmented nevi and portwine stain in our study is similar to the prevalence reported by others.

A Case of Argyria Following Excessive Silver Pill Intake / 대한피부과학회지

Argyria is a rare cause of cutaneous discoloration due to silver deposition. We report a case of argyria occurring in a 38-year-old man due to excessive silver pill intake. He had a diffuse, bluish-gray pigmentation on his face and finger nails. ICPMS (inductively coupled plasma mass spectrometry) revealed that an excess of silver was present in the patient's blood, liver and skin tissue.