A Pathophysiological Validation of Collagenase II-Induced Biochemical Osteoarthritis Animal Model in Rabbit

BACKGROUND: Current dilemma working with surgically-induced OA (osteoarthritis) model include inconsistent pathological state due to various influence from surrounding tissues. On the contrary, biochemical induction of OA using collagenase II has several advantageous points in a sense that it does not involve surgery to induce model and the extent of induced cartilage degeneration is almost uniform. However, concerns still exists because biochemical OA model induce abrupt destruction of cartilage tissues through enzymatic digestion in a short period of time, and this might accompany systemic inflammatory response, which is rather a trait of RA (rheumatoid arthritis) than being a trait of OA. METHODS: To clear the concern about the systemic inflammatory response that might be caused by abrupt destruction of cartilage tissue, OA was induced to only one leg of an animal and the other leg was examined to confirm the presence of systemic degenerative effect. RESULTS: Although the cartilage tissues were rapidly degenerated during short period of time upon biochemical induction of OA, they did not accompanied with RA-like process based on the histology data showing degeneration of articular cartilage occurred only in the collagenase-injected knee joint. Scoring evaluation data indicated that the cartilage tissues in non-induced joint remained intact. Neutrophil count transiently increase between day 8 and day 16, and there were no significant change in other complete blood count profile showing a characteristics of OA disease. CONCLUSION: These study shows that biochemically induced cartilage degeneration truly represented uniform and reliable OA state.

The Change of Tear Film in Classification of Diabetic Retinopathy

PURPOSE: To determine the relationship between changes in the tear film according to the classification of diabetic retinopathy in patients with diabetes. METHODS: A total of 117 newly detected diabetic patients were included in this study. The classification of diabetic retinopathy was performed based on the Early Treatment Diabetic Retinopathy Study (ETDRS). The duration of diabetes and HbA1c were also investigated in patients who had undergone panretinal photocoagulation or insulin treatment. To examine the tear film function, we performed the tear break-up time test, the Schirmer I test, and the diagnostic fluorescein staining test of the ocular surface. The Cochet-Bonnet esthesiometer was also employed to examine the corneal sensitivity. RESULTS: As the severity of diabetic retinopathy progressed, the degree of ocular surface fluorescein staining increased significantly. There was no relationship between the duration of diabetes and the results of the tear film function test. Patients who had high blood HgA1c levels showed significant increases in tear break-up time and degree of ocular surface fluorescein staining. The patients who had undergone panretinal photocoagulation showed significant differences in tear break-up time and degree of ocular surface fluorescein staining. CONCLUSIONS: The diabetic patients with progressed diabetic retinopathy, uncontrolled blood HgA1c levels and who had previously undergone panretinal photocoagulation should be managed more carefully since those patients are more susceptible to ocular surface disorder with aggravation of tear film function.

Cultured Organisms and Antibiotic Susceptibility in Infectious Ocular Disease: Results Over a Ten-Year Period

PURPOSE: To investigate the ocular regional incidence, causative species and antibiotic susceptibility in patients with infectious ocular disease whose causative organism was isolated. METHODS: A total of 519 eyes in 519 patients with infectious ocular disease, who were diagnosed by smears and cultures from January 2000 to December 2009 were retrospectively reviewed. RESULTS: The mean age of the 519 patients was 54.0 years, and 66.1% of the patients were male. The most common systemic disease was diabetes mellitus. The most common previous ocular disease was keratoconjunctivitis. Specimens were most frequently swabbed from the cornea, where 81.2% were bacteria isolates and 18.8% fungi isolates. The most prevalent causative organism was Staphylococcus epidermidis, and the most prevalent fungus was Fusarium species. Vancomycin, ceftazidime, and fourth-generation fluoroquinolone maintained high antibiotic susceptibility. Methicillin-resistant Staphylococcus aureus and methicillin-resistant Staphylococcus epidermidis were increasing near the end of the reference period, and endophthalmitis was more common in methicillin-resistant Staphylococcus. CONCLUSIONS: Identifying the causative organism in infectious ocular disease by smears and cultures is essential. More effective treatment of infectious ocular disease would be possible by analyzing the frequent organism, clinical manifestations, and antibiotic susceptibility. More caution is necessary due to the increase in methicillin-resistant Staphylococcus.

A Case of Tarsal Fibroma

PURPOSE: To describe a case of tarsal fibroma in a patient with a tarsal conjunctival tumor. CASE SUMMARY: A 73-year-old male visited our clinic with sensations of irritation in his left upper eyelid that occurred one week prior. The patient did not have any evidence of external injuries, systemic inflammations, or any other specific findings except a history of hypertension. The best corrected visual acuity was 0.7 in the right and 0.8 in the left eye with normal IOP. On the slit-lamp biomicroscopic examinations, anterior segment showed no specific findings and the shapes and positions of the upper and lower eyelids were normal. Upon eversion of the upper eyelid, a definite solid 5 x 5-mm sized tumor with clear boundaries was observed in the upper tarsal conjunctiva. An excision biopsy was performed under local anesthesia. Gross examinations of the tumor revealed a 5 x 5 x 2-mm, gray, oval-shaped mass. On microscopic examinations, the tumor had minimal number of cells and was composed of dense collagens and scattered fibroblasts. Based on these findings, the patient was diagnosed with tarsal fibroma. The patient experienced no discomfort after the excision biopsy. At a one-year follow-up, there were no signs of recurrence. CONCLUSIONS: Although rare, tarsal fibroma should be considered in the differential diagnosis of solid tarsal lesions.