Liver X Receptor β Related to Tumor Progression and Ribosome Gene Expression in Papillary Thyroid Cancer

Background@#Intracellular lipid deposition has been reported in thyroid glands in obese animal and human. To understand the regulatory mechanism of lipid metabolism in thyroid cancer, we investigated the expression status of liver X receptor (LXR) and analyzed its clinicopathological characteristics and molecular biological features. @*Methods@#Expression status of LXR and its transcriptional targets in human cancers were analyzed using The Cancer Genome Atlas (TCGA). The gene-sets related to high LXRβ expression was investigated by gene set enrichment analysis (GSEA) using Kyoto Encyclopedia of Genes and Genomes (KEGG) signaling pathways and gene ontology biologic process. Quantitative reverse transcription polymerase chain reaction was performed in thyroid cancer samples using our validation cohort. @*Results@#In contrast to low expression of LXRα, LXRβ was highly expressed in thyroid cancer compared to the other types of human cancers. High LXRβ expression was correlated with the expression of LXRβ transcriptional targets genes, such as apolipoprotein C1 (APOC1), APOC2, apolipoprotein E (APOE), ATP binding cassette subfamily G member 8 (ABCG8), sterol regulatory elementbinding protein 1c (SREBP1c), and SPOT14. Furthermore, High LXRβ expression group indicated poor clinicopathological characteristics and aggressive molecular biological features independently from the drive mutation status. Mechanistically, high LXRβ expression was coordinately related to ribosome-related gene sets. @*Conclusion@#The mechanistic link between LXRβ and ribosomal activity will be addressed to develop new diagnostic and therapeutic targets in thyroid cancers.

Carbon Disulfide Retinopathy Caused by Chronic Carbon Disulfide Intoxication

Purpose@#We report a case of chronic carbon disulfide intoxication diagnosed via retinal changes induced by chronic carbon disulfide exposure in the workplace.Case summary: A 24-year-old female presented with blurred vision in the left eye 1 month in duration. She was a chemical analyst who was periodically exposed to chemicals (including carbon disulfide and benzene) in the workplace. At the first visit, the best-corrected visual acuities were 1.0 for both the right and left eyes. No anterior segment-specific finding was evident on slit-lamp examination. Fundoscopic examination and fluorescein fundus angiography revealed multiple microaneurysms and dot retinal hemorrhages in the left eye. The Goldmann visual field test did not yield specific findings. The color vision test, electroretinography, and electro-oculography showed that the Arden ratio of the right eye was 2.4 but that of the left eye was greatly reduced (to 1.7). @*Conclusions@#We report a case of chronic carbon disulfide retinopathy in a chemical analyst exposed to carbon disulfide within the accepted safe concentration range. Significantly, the case occurred after occupational, industrial accident standards had been introduced.

Clinical Outcomes of Idiopathic Epiretinal Membrane Removal in Patients 80 Years or Older

PURPOSE: To evaluate clinical outcomes of idiopathic epiretinal membrane removal in patients ≥ 80 years of age.METHODS: A retrospective review of medical records was performed with 56 patients who underwent vitrectomy and removal of idiopathic epiretinal membrane. In the ≥ 80 years of age group (n = 28), the best-corrected visual acuity (BCVA) and central macular thickness (CMT) before surgery were compared with those at the final follow-up. The amount of change in the BCVA after surgery was also compared between the ≥ 80 years of age group and the < 80 years of age group (n = 28).RESULTS: In the ≥ 80 years of age group, the mean follow-up period was 19.1 ± 17.0 months. Before surgery, 11 eyes were pseudophakic and 17 eyes were phakic. Combined cataract surgery was performed with epiretinal membrane removal in all 17 phakic eyes. The mean logarithm of the minimal angle of resolution BCVA was 0.75 ± 0.30 before surgery, which improved to 0.50 ± 0.30 at the final follow-up (p < 0.001). The CMT was 458.0 ± 79.7 µm before surgery, which decreased to 367.2 ± 83.4 µm at the final follow-up (p < 0.001). There was no significant difference in the amount of change in the BCVA after the surgery between the ≥ 80 years of age group and the < 80 years of age group (p = 0.547).CONCLUSIONS: In patients with idiopathic epiretinal membrane who were ≥ 80 years of age, the visual acuity was improved or maintained, and was accompanied with anatomical improvement after epiretinal membrane removal with or without cataract surgery. These results suggest the usefulness of epiretinal membrane removal in older patients.

Carbon Disulfide Retinopathy Caused by Chronic Carbon Disulfide Intoxication

Purpose@#We report a case of chronic carbon disulfide intoxication diagnosed via retinal changes induced by chronic carbon disulfide exposure in the workplace.Case summary: A 24-year-old female presented with blurred vision in the left eye 1 month in duration. She was a chemical analyst who was periodically exposed to chemicals (including carbon disulfide and benzene) in the workplace. At the first visit, the best-corrected visual acuities were 1.0 for both the right and left eyes. No anterior segment-specific finding was evident on slit-lamp examination. Fundoscopic examination and fluorescein fundus angiography revealed multiple microaneurysms and dot retinal hemorrhages in the left eye. The Goldmann visual field test did not yield specific findings. The color vision test, electroretinography, and electro-oculography showed that the Arden ratio of the right eye was 2.4 but that of the left eye was greatly reduced (to 1.7). @*Conclusions@#We report a case of chronic carbon disulfide retinopathy in a chemical analyst exposed to carbon disulfide within the accepted safe concentration range. Significantly, the case occurred after occupational, industrial accident standards had been introduced.

Comparison of Ocular Biometry and Refractive Outcomes Using IOL Master 700, IOL Master 500, and Ultrasound

PURPOSE: To compare the new swept-source optical coherence tomography based IOL Master 700 to both the partial coherence interferometry based IOL Master 500 and ultrasound A-scan in terms of the ocular biometry and the prediction of postoperative refractive outcomes. METHODS: A total 67 eyes of 55 patients who received cataract surgery were included in our study. The axial length, anterior chamber depth, and keratometry were measured using IOL Master 700, IOL Master 500, and A-scan. The predictive errors, which are the differences between predictive refraction and post-operative refraction 1 month after surgery, were also compared. RESULTS: Axial length measurements were not successful in 5 eyes measured using IOL Master 700 and in 12 eyes measured using IOL Master 500. The mean absolute postoperative refraction predictive errors were 0.63 ± 0.50 diopters, 0.66 ± 0.51 diopters, and 0.62 ± 0.51 diopters for IOL Master 700, IOL Master 500, and A-scan, respectively, and these values exhibited no statistically significant differences. The mean axial lengths were 24.25 ± 2.41 mm, 24.24 ± 2.40 mm, and 24.22 ± 2.39 mm; the mean anterior chamber depths were 3.09 ± 0.39 mm, 3.17 ± 0.39 mm, and 3.15 ± 0.46 mm; and the mean keratometry values were 44.12 ± 1.82 diopters, 44.57 ± 2.10 diopters, and 43.98 ± 1.84 diopters for the IOL Master 700, IOL Master 500, and A-scan groups, respectively. None of these parameters showed statistically significant differences between the three groups. Regarding pair-wise comparison, there were significant differences between the IOL Master 700 and the other devices. CONCLUSIONS: The ocular biometric measurements measured using IOL Master 700, IOL Master 500, and A-scan showed no significant differences. However, IOL Master 700 demonstrated a superior ability to successfully take biometric measurements compared to IOL Master 500. Therefore, IOL Master 700 is capable of measuring ocular biometry for cataract surgery in clinical practice.

Surgical outcomes of 2 3-gauge vitrectomy for the management of lens fragments dropped into the vitreous cavity during cataract surgery

To assess the clinical features and surgical outcomes of 23-Gauge [G] vitrectomy for lens fragments dropped into the vitreous during cataract surgery. A retrospective, non-comparative, interventional case series at a single medical center. The medical records of 45 eyes from 45 consecutive patients who were referred to our hospital for surgical retrieval of phacoemulsification dropped lens fragments and who underwent 23-G vitrectomy were retrospectively reviewed. Data pertaining to patient demographics, pre- and post-operative Snellen visual acuity, and postoperative complications were recorded. Factors associated with dropped lens fragments were also examined. Mean patient age was 68.18 +/- 11.47 years. The preoperative and postoperative mean logarithm of minimum angle of resolution [logMAR] visual acuity was 1.91 +/- 0.59 [Snellen equivalent 0.06 +/- 0.15] and 0.42 +/- 0.51 [Snellen equivalent 0.54 +/- 0.31], respectively. Forty-two eyes [93.3%] had dislocated lens fragments <50% of the total lens size. Two eyes [4.4%] had a large and hard lens nucleus, which necessitated the use of a 20-G fragmatome to efficiently and completely remove the lens material. At the final examination, 30 eyes [66.6%] had a visual acuity better than 20/40. Post-vitrectomy complications included elevated IOP for at least 3 months [n = 5 eyes, 11.1%], intraocular lens dislocation [n = 2 eyes, 4.4%], and cystoid macular edema [n = 1 eye, 2.2%]. No cases of postoperative endophthalmitis or retinal detachment were observed. A 23-G vitrectomy is safe and efficient for the surgical management of dropped lens fragments following cataract surgery

Optic Neuritis Mimicking Ischemic Optic Neuropathy and Optic Glioma

PURPOSE: To report a case of optic neuritis difficult to differentiate from ischemic optic neuropathy and optic nerve glioma. CASE SUMMARY: A 63-year-old male visited our clinic because of a sudden painless decrease in visual acuity in his right eye. He had a relative afferent pupillary defect and inferior altitudinal scotoma with disc pallor in his right eye. Ischemic optic neuropathy was suspected based on these clinical observations. However, a focal enhancing lesion was found in the intracranial portion of the right optic nerve on gadolinium-enhanced T1-weighted MRI. The radiologist's report revealed right intracranial optic glioma. Optic neurectomy was planned in accordance with the suspicion for optic glioma. However, a systemic mega-dose methylprednisolone therapy which is relatively less invasive was performed first based on the decision that optic neuritis should be distinguished from optic nerve glioma. The patient was hospitalized and 1 gram of methylprednisolone was injected intravenously daily for 3 days. The patient's visual acuity in the right eye improved from 0.1 before treatment to 0.3 after treatment. MRI scans at 8 months after steroid treatment showed disappearance of the previously enhanced lesion suspicious for optic glioma with developed atrophic change. The patient was finally diagnosed with optic neuritis based on these results. CONCLUSIONS: Careful differential diagnoses and therapeutic approaches to possible diseases are necessary because optic neuritis can manifest as a variety of clinical entities and imaging findings.

The Efficacy of Intravitreal Bevacizumab Injection in Patients with Acute Central Serous Chorioretinopathy

PURPOSE: To evaluate the efficacy of intravitreal bevacizumab injection (IVB) in acute central serous chorioretinopathy. METHODS: Retrospective chart review of 87 eyes of 80 patients. They received intravitreal bevacizumab injection (n = 40) and observed without any treatment or any medication (n = 47) for initial treatment of acute CSC. Patient demographics and best-corrected visual acuity (BCVA), central macular thickness (CMT) at baseline were analyzed. Then we had regular follow-ups of BCVA and CMT. RESULTS: All patients showed improvement in visual acuity and resolution of subretinal fluid following treatment. In the bevacizumab-treated group, the mean BCVA improved from 0.22 +/- to 0.11, mean CMT fell from 361.33 to 185.33 (microm) and recurrence rate was 47%. The conservative-treated group showed an improvement in BCVA from 0.23 at baseline to 0.14, mean CMT fell from 349.65 to 193.41 (microm) and recurrence rate was 70% (p = 0.130, p = 0.908 and p = 0.030, respectively). However, the change of BCVA and CMT of 2 groups showed no differences at any follow-up visit. Recurrence rate was significantly low in bevacizumab-treated group. CONCLUSIONS: The bevacizumab-treated group had relatively low rates of recurrence in acute CSC patients compared to the observation group. However, intravitreal bevacizumab showed no positive effect in BCVA and CMT of acute CSC patients compared to the observation group. Further investigation will be helpful to understand this therapy in patients with CSC.

Clinical Course after Intravitreal Bevacizumab Injection in Ischemic Central Retinal Vein Obstruction

PURPOSE: To determine the clinical outcome of intravitreal bevacizumab injection in patients with ischemic central retinal vein obstruction (CRVO). METHODS: The present study was conducted retrospectively on 56 eyes of 56 patients who were diagnosed with CRVO and classified according to ischemic and non-ischemic type and underwent an intravitreal bevacizumab injection. The present study measured changes in visual acuity and central macular thickness, neovascularization in the anterior segment, development of neovascular glaucoma and other clinical complications. RESULTS: The average number of bevacizumab injections in both groups was 2.07 and 1.62 in the ischemic type. No patients developed neovascular glaucoma in the non-ischemic type group, 14 of 26 eyes in the ischemic type group developed neovascular glaucoma and the mean time to diagnosis was 28.75 weeks. log MAR visual acuity of the ischemic type group prior to injection was 1.56 +/- 0.65 on average which improved to 1.44 +/- 0.97 (p = 0.45). CONCLUSIONS: Intravitreal bevacizumab injection improves the condition of cystic macular edema clinically, but does not affect the development of neovascular glaucoma and improvement of visual acuity in ischemic type CRVO.

A Case of Eccrine Angiomatous Hamartoma in Neurofibromatosis Type-1 Patient / 대한피부과학회지

Eccrine angiomatous hamartoma (EAH) is a rare, benign lesion characterized by an abnormal dermal proliferation of eccrine glands and vascular channels. It generally presents as a single asymptomatic nodule or plaque associated with pain or hyperhidrosis. It may be congenital or appear later in childhood. Thus far, there is only one case report of EAH arising in a American patient with known Neurofibromatosis type-1 (NF-1). We describe a second case of EAH in NF-1 patient and suggest some possibilities for the association of EAH with NF.

A Case of Linear Focal Elastosis on the Lower Extremities / 대한피부과학회지

Linear focal elastosis is an uncommon disorder which clinically manifests as band-like striae, and typically occur on the back. Histologically and ultrastructurally, there is a focal increase of elastic fibers. We report an unusual case of linear focal elastosis occurring exclusively on the legs of a 22-year-old man with psoriasis.

A Case of a Corn Developed on an Unusual Site / 대한피부과학회지

A corn is a circumscribed hyperkeratotic lesion with a central conical core of keratin that causes pain and inflammation. Corns result from hyperkeratosis, which is caused by an increase in keratinocyte activity associated with stimulation of the epidermis from chronic pressure or friction on the skin. The conical core in a corn, which is a thickening of the stratum corneum, is a protective response to the mechanical trauma. We experienced a man who developed a corn on the buttock, which is an unusual site.

A Clinical and Histopathologic Study of 20 cases of Lichen striatus / 대한피부과학회지

BACKGROUND: Lichen striatus(LS) is an uncommon dermatosis that generally affects children. LS can usually be identified by clinical history and histology of typical lesions. However, the clinical manifestations and the histologic features are diverse. OBJECTIVE: The aim of this study is to investigate clinical and histopathologic features of LS in Koreans. METHODS: Total 20 patients were included in this study. Data complied were sex, age, duration, distribution, symptoms, course and some histopathologic findings including hyperkeratosis, acanthosis, dyskeratosis, basal degeneration, perivascular lymphocytic infiltration, lichenoid infiltration and eccrine sweat gland inflammation. Seventeen cases were studied further by immunohistochemistry for interleukin(IL)-1beta to understand the biological basis of the disease. RESULTS AND CONCLUSIONS: 1. It was observed predominantly in females as the sex ratio of 1: 2.3. The mean age was 5.5 years and the mean duration was 17.7 months. 2. Most of patients were asymptomatic, but only five patients complained of mild itching. 3. It occured most frequently in the lower(11 cases), upper extremities(6 cases), axilla(1 case), anterior chest(1 case) and multiple location(1 case). Twelve cases were consisted of erythematous papules, and the rest appeared hypopigmented macules. 4. The lesions of 9 of 10 patients were almostly cleared in one year. Five of 9 were consisted of erythematous papules and four hypopigmented macules. One who had no change was consisted of hypopigmented macules. Therefore, there was no significant difference of prognosis between two groups. 5. Histologic examination revealed hyperkeratosis(65%), acanthosis(70%), parakeratosis(50%), exocytosis(95%), spongiosis(55%), dyskeratosis(70%), basal degeneration(90%) in epidermis, and colloid body(35%), lichenoid infiltration(65%), perivascular lymphocytic infiltration(95%) and eccrine sweat gland inflammation(50%) in dermis. 6. There was no significant difference between the papular group and the macular group, except parakeratosis and spongiosis, which were increased in the papular group as compared with the macular group. 7. IL-1beta was expressed diffusely in keratinocytes, endothelial cells, hair follicles and eccrine sweat glands. IL-1beta immunoreactivity was expressed in the entire epidermis in 15 of 17 cases. Most of the eccrine sweat glands showed intense immunolabeling in 12 of 17 cases. In contrast, only 2 cases of lichen planus were positive for epidermis and only 1 case for eccrine sweat gland. Therefore, we think that it is helpful for discriminating two diseases immunohistochemically.

A Case of Bullous Scabies Mimicking Epidermolysis Bullosa Aquisita / 대한피부과학회지

We report a case of bullous scabies in a 81-year-old male patient. He had severe pruritic, multiple tense bullae on erythematous base with erosions and crusts from which scabies mites were identified. Histopathologic findings(H&E) revealed subepidermal bulla and direct immunofluorescence showed linear deposition of IgG and C3 at the dermoepidermal junction and linear IgG, C3 deposition at the dermal side of the salt split skin test. However, no EBA or BP antigens were detected. Although skin lesions improved after antiscabietic and oral steroid treatments, pruritic bulla developed repeatedly with scabies reinfestation or discontinuation of oral treatment.

A Case of Kimura's Disease Presenting as a Rhinophyma-like Configuration

Kimura's disease is a benign, uncommon, chronic inflammatory condition that usually presents with painless subcutaneous nodules or plaques. Head and neck are the most frequently involved sites in Kimura's disease. Mandible is the most commonly involved, followed by neck, cheek, scalp and forehead. Other possible sites are oral cavity, inguinal area and extremities, but there have been no reports involving the nose, especially the one that looks like a rhinophyma. We describe a case of Kimura's disease presenting like a rhinophyma.

A Case of Norwegian Scabies Associated with Long-term Use of Systemic and Topical Corticosteroids / 대한피부과학회지

Norwegian scabies is a rare clinical variant of human infestation with Sarcoptes scabiei, distinguished from the common form of scabies by the presence of remarkable hyperkeratotic scaly crusted skin lesions. It is often seen in the physically or mentally handicapped, immunocompromised, and institutionalized persons. We report a case of Norwegian scabies occuring in a 71-year-old man with pulmonary tuberculosis. He had been treated with systemic and topical corticosteroids for extensive generalized pruritus since about 8 months before.

A Case of Supernumerary Nipple / 대한피부과학회지

Supernumerary nipple is a rare developmental anomaly occuring along the course of the embryological mammary lines, usually over the anterior aspect of the chest, axilla, and abdominal wall. We, herein, report a case of supernumerary nipple of the most common type in a 30-year-old woman, which has accessory nipples without aberrant gland tissue.

Two Cases of Corn Associated with Congenital Aphalangia and Anonychia / 대한피부과학회지

Absent terminal phalanges are often associated with corresponding omission of the associated nail. Lack of phalanges may arise in isolation or may be associated with other skeletal or dental abnormalities. We report two cases of corn associated with congenital aphalangia and anonychia in a 3-year-old child and a 22-year-old woman.

A Case of Plaque-Type Blue Nevus / 대한피부과학회지

Plaque-type blue nevus is a rare type of blue nevus, which shows numerous macules and papules within a circumscribed area. Histopathologically, it is reported to be common or cellular. A 24-year-old female presented with a 10.5x8.6 cm blue-black plaque on the right shoulder, which had existed since birth, and was characterized by multiple confluent or grouped blue-black macules and papules with intervening areas of blue discoloration. Histopathologic examination showed irregular bundles of numerous, greatly elongated, grouped, heavily melanin-laden melanocytes with long, branching dendritic processes in the reticular dermis. Numerous melanophages were intermingled with melanocytes. We, herein, report a case of plaque-type blue nevus with histopathologic finding of common blue nevus.

A Case of Rowell Syndrome with Kikuchi Disease / 대한피부과학회지

A 24-year-old woman presented with an erythema multiforme-like eruption on face, scalp and both extremities, intermittent fever, and cervical lymphadenopathy. The clinical and unusual laboratory findings were consistent with a diagnosis of Rowell's syndrome. The histopathology of cervical lymph node showed histiocytic necrotizing lymphadenitis, Kikuchi disease.