Three Various Cases of Retinal Hemorrhages Caused by Plasmodium vivax Malaria

PURPOSE: To report three various cases of retinal hemorrhages caused by Plasmodium vivax malaria. CASE SUMMARY: Two 55-year-old male patients and a 52-year-old male patient with cyclic high fever were admitted to the department of internal medicine. Three of the patients were diagnosed with malaria caused by P. vivax based on a peripheral blood smear. The patients were treated with hydroxychloroquine and premaquine but complained of decreased visual acuity. The patients were examined with funduscopy, fluorescein angiography, and optical coherence tomography. The first case showed 2 areas of retinal hemorrhages on the macular in the right eye and 1 area of retinal hemorrhage in the left eye. The second case showed many cotton-wool spots along with a number of small retinal hemorrhages and tortuous blood vessels in both eyes. The third case showed 1 area of retinal hemorrhage in the right eye and many cotton-wool spots in both eyes. CONCLUSIONS: P. vivax malaria rarely causes retinal hemorrhage. Manifestations of retinal hemorrhage and degree of visual acuity loss may vary among patients. P. vivax malaria should be considered when patients with unexplained high fever present with retinal hemorrhage, even without a history of overseas travel.

Inhibitory Effect of Gefitinib on the Proliferation of Lens Epithelial Cells

PURPOSE: To evaluate the effect of Gefitinib used for the treatment of non-small cell lung cancer on the proliferation of the lens epithelial cells and the activities of growth factors. METHODS: The cell samples were divided into a control group cultured in DMEM and three experimental groups. Group I was exposed to Gefitinib for 3 minutes; group II was exposed to growth factors; and for group III growth factors were added to each concentration of Gefitinib. MMT assays, BrdU staining and morphologically observations with a phase-contrast microscope were used to verify the degrees of cell proliferation. Western blot analysis was conducted to confirm the effects of Gefitinib on extracellular signal-regulated kinase phosphorylation and on type I collagen production. RESULTS: Lens epithelial cell proliferation in experimental group I was reduced to 76% and 56% for 1.00 micro M and 10.00 micro M of Gefitinib, respectively. Experimental group II showed a 140% increase in cell proliferation with EGF treatment. Experimental group III exhibited decreased lens epithelial cell proliferation with both EGF (86% and 66%), and TGF-beta2 (78% and 59%). BrdU staining demonstrated a significant decrease in cell proliferation in groups I and III exposed to more than 1.0 micro M Gefitinib, while group II showed an increase compared to the control group. Moreover, Western blot analysis revealed inhibiting effects on ERK phosphorylation and type I collagen production. CONCLUSIONS: In the culture of human lens epithelial cells, Gefitinib inhibited cell proliferation when used at a concentration above 1.00 (M for 3 minutes. Furthermore, the effects of EGF and TGF-beta2 were also inhibited.

Inhibitory Effect of Radiation on the Transdifferentiation of Lens Epithelial Cells into Fibroblasts

PURPOSE: We estimated the effectiveness of radiation on transdifferentiation of the lens epithelial cells into fibroblast. METHODS: The morphologic changes and number of fibroblasts were determined using a phase contrast microscope. The proliferation of lens epithelial cells was analyzed by PCNA and BrdU assay in the control group and in the experimental groups exposed to 500, 1000 or 2000 rad of X-ray on the 7th day of culture. Expression of type IV collagen was estimated by Western blot and apoptosis was investigated using TUNEL assay. RESULTS: The number of fibroblast transdifferentiated from lens epithelial cell was 300+/-1.58 in control group, and 240+/-1.58, 231.75+/-4.1E, and 213.50+/-0.22 in the group exposed to 500 (experimental group I), 1000 (experimental group II), and 2000 rad (experimental group III), respectively, on the 7th day of culture (radiation was decreased in a dose-dependent manner). The index of PCNA and count of BrdU labeling cells were 56+/-1.58% and 27.6+/-4.6 in control group; 26+/-1.56% and 18.4+/-8.5 in experimental group I; 24+/-1.60% and 17.2+/-4.2 in experimental group II; 16+/-1.58% and 8.6+/-2.4 in experimental group III, respectively. These results indicated that proliferation of lens epithelial cells was inhibited by radiation in a dose-dependant manner. The Western blot showed that the expression of collagen decreased in experimental groups I and II and markedly decreased in experimental group III, compared with control group. TUNEL showed no differences between the control and experimental groups I and II but showed increased apoptosis in experimental group III. CONCLUSIONS: Radiation may inhibit the transdifferentiation of lens epithelial cells into fibroblasts. It would be practicable that radiation suppresses proliferation of lens epithelial cells in posterior capsular opacity.