A Case of Muir-Torre Syndrome with Multiple Cancers of Bilateral Eyelids and Breast

We report a case of Muir-Torre syndrome (MTS) with a very rare combination of cancers, involving bilateral eyelid cancers and breast cancer. A 71-year-old female with a history of breast cancer from 18 years prior presented with bilateral eyelid tumors. One of her siblings had lung cancer, and another had pancreatic cancer. She underwent excisional biopsy of the eyelid tumors and histopathology revealed sebaceous carcinoma of the right eyelid and basal cell carcinoma of the left. She was diagnosed with MTS: a skin cancer associated with visceral malignancy. Immunohistochemical tests for mutS homolog 2 showed a lack of expression in both eyelid carcinomas.

Choroidal Venous Pulsations at an Arterio-venous Crossing in Polypoidal Choroidal Vasculopathy

It has been reported that pulsations in abnormal vessels are observed on indocyanine green (ICG) angiography in half of patients with polypoidal choroidal vasculopathy (PCV), although the mechanism of the pulsation is unknown. In this study, we report a case of PCV showing venous pulsations at an arterio-venous (A-V) crossing, and discuss a possible mechanism of polypoidal vessel formation and pulsations in PCV. A 66-year-old female presented with a reddish-orange elevated lesion and serous retinal detachment in the macula of her left eye, and was diagnosed as PCV. She was treated with photodynamic therapy (PDT), and followed-up through routine examinations, including ICG angiography. ICG angiography at presentation showed a branching vascular network and choroidal venules with dye leakage (polypoidal vessels) in the left eye. Pulsations, supposedly of venous origin, were observed at an A-V crossing in the abnormal vessels. Within 3 months after PDT, the polypoidal vessel ceased to leak and the pulsations vanished. The reddish-orange lesion gradually decreased in size with complete disappearance of retinal detachment. This study suggests that an unusual compression at an A-V crossing may make a venule polypoidal, and fluctuations of blood flow and pressure in the venule may cause pulsatile movements of the vessel wall.

Separate limbAl conjunctival autograft transplantation using the inferior conjunctiva for primary pterygium

Inferior limbAl conjunctival autograft transplantation has been described as a safe and effective treatment for primary pterygium. However, despite its multiple advantages, routine performance of this technique is difficult because the inferior conjunctiva is often too small to provide enough autograft material. To resolve this issue, we modified a technique, inferior separate limbAl conjunctival autograft transplantation, and evaluated its efficacy and safety. A total of 50 eyes of 47 patients were retrospectively studied. Our surgery consisted of a thorough pterygium excision followed by 0.02% mitomycin C application. Next, we performed inferior conjunctival autografting, in which limbal and bulbar conjunctival autografts were independently harvested and secured to the denuded limbus and the most posterior conjunctival defect at the pterygium excision site to ensure stem-cell restoration and deep fornix reconstruction, respectively; the bare sclera between the two grafts was exposed. The outcome was assessed with a three-point grading scale at the patient's last visit. The success and recurrence rates were 96.0% [48 of 50] and 0%, respectively, assessed at follow-ups occurring at a mean of 19.2 +/- 5.6 months after surgery. Only minimal complications were encountered. A combination of inferior separate limbAl conjunctival autograft transplantation with intraoperative 0.02% mitomycin C application is a safe and effective technique enabling the routine use of under-sized autografts harvested from the inferior conjunctiva after thorough pterygium excision

Antiproliferative effect of basic fibroblast growth factor-saporin mitotoxin on keratocytes in culture

We evaluated the effect of the conjugate of basic fibroblast growth factor (FGF2) and saporin (FGF2-SAP) on proliferation of cultured keratocytes. Cultured rabbit and human keratocytes were incubated in medium containing 0.01 to 100 nM of chemical conjugate of EGF2 conjugated by disulfide bond to saporin (CCFS1), FGF2 genetically fused to saporin (rFGF2-SAP), FGF2, or saporin for three hours or four days and cell proliferation was quantified four days after the drug treatment. Proliferation of rabbit and human keratocytes was effectively inhibited by three hour and by four day exposure to CCFS1 and rFGF2-SAP in a dose-dependent manner, whereas it was affected minimally by four day exposure to saporin. Their inhibitory effects were detected at concentrations above 0.1 or 1 nM, and were most prominent in serum-stimulated rabbit keratocytes. These results suggest a potential role for FGF2-SAP in limiting proliferation of keratocytes during corneal wound healing.