Purpose: To investigate the changes in peripapillary and macular vessel density in ethambutol-induced optic neuropathy using optical coherence tomography angiography (OCTA). Methods: The medical records of patients diagnosed with ethambutol-induced optic neuropathy were analyzed retrospectively. Patient age, sex, daily dose (mg/day/kg), treatment duration, best-corrected visual acuity (logMAR), color vision (Ishihara color plate tests), and mean deviation of visual field test were evaluated in non-pathological individuals with age and sex controlled as the normal control group. Peripapillary retinal nerve fiber layer (RNFL) thickness, macular ganglion cell/inner plexiform layer (GC/IPL) thickness, radial peripapillary capillary (RPC) density, and macular superficial capillary plexus (SCP) density were also compared between the patient and control groups. Results: The study included 22 patient eyes and 31 control group eyes. Comparing the OCTA results between the groups, there were no significant differences in peripapillary RNFL thickness, but the temporal RPC density was significantly (p = 0.025) lower in the patient group (48.00 ± 8.23%) than in controls (52.39 ± 5.58%). For macular structures, the mean GC/IPL thickness and whole SCP density were lower in the patients (p = 0.001 and p = 0.008, respectively). In the patients, the changes in peripapillary RNFL thickness and RPC density were significantly positively correlated (r = 0.811, p < 0.001), as were the mean macular GC/IPL thickness and whole SCP density (r = 0.445, p = 0.037). Conclusions Patients with ethambutol-induced optic neuropathy had significantly lower temporal RPC and macular SCP densities. Ethambutol toxicity may affect not only axonal degeneration but also peripapillary and macular vascular function.

Purpose: To report a case of excessive axial length elongation following vitrectomy for rhegmatogenous retinal detachment.Case summary: A 21-year-old male patient presented to our hospital with visual impairment. The patient had previously undergone computed tomography in our emergency room for a facial contusion 3 years prior to his current visit. Axial lengths of 27.23 mm in the right eye and 27.62 mm in the left eye were recorded at that time. The patient had no previous ocular history. Fundus examination revealed extensive retinal detachment with macular involvement and hypotony retinopathy in the left eye. Retinal detachment surgery was subsequently performed on the left eye. Following the surgery, intraocular pressure in the left eye increased and intraocular pressure-lowering medications were administered. At 3 months postoperatively, the patient developed additional retinal detachment in the right eye, prompting retinal detachment surgery. Unlike the contralateral eye, the intraocular pressure remained well-controlled postoperatively. Axial length measurement was performed due to the complaint of left eye protrusion. The axial lengths were 27.76 mm and 31.41 mm in the right and left eyes, respectively. There was a significant increase in the axial length of the left eye but not in that of the right eye compared to 3 years prior. Conclusions Gas tamponade, preoperative ocular hypotension, and postoperative ocular hypertension can cause excessive axial length elongation in cases of rhegmatogenous retinal detachment in young patients with high myopia.

A perfusion deficit of the aortic branch vessels in a patient with a type B aortic dissection is a challenging complication, as it leads to hemodynamic instability and doubles the mortality rate; however, the optimal management strategy in these cases remains controversial. Although surgical repair is still performed as the standard, endovascular approaches have been used recently as alternatives because of the high rate of perioperative complications. Herein, we report a patient with a type B aortic dissection and compromised renal and iliac arteries who was successfully treated by thoracic endovascular repair and insertion of a percutaneous stent. In addition, we adopted the chimney technique to preserve blood flow to the left subclavian artery due to the short proximal landing zone.
Aorta ; Aortic Diseases ; Hemodynamics ; Humans ; Iliac Artery ; Mortality ; Perfusion ; Stents ; Subclavian Artery

The target of rapamycin (TOR) signaling pathway is a conserved pathway that regulates eukaryotic cell growth in response to environmental cues. Chemical genomic approaches that profile rapamycin sensitivity of yeast deletion strains have given insights into the function of TOR signaling pathway. In the present study, we analyzed the rapamycin sensitivity of yeast deletion library strains on synthetic medium. As a result, we identified 130 strains that are hypersensitive or resistant to rapamycin compared with wild-type cells. Among them, 36 genes are newly identified to be related to rapamycin sensitivity. Moreover, we found 16 strains that show alteration in rapamycin sensitivity between complex and synthetic media. We suggest that these genes may be involved in part of TOR signaling activities that is differentially regulated by media composition.
Cues ; Eukaryotic Cells ; Saccharomyces ; Saccharomyces cerevisiae ; Sirolimus ; Yeasts

The best management strategy for angiographically intermediated coronary artery diseases remains controversial. Lesions, when coupled with spasm, can lead to catastrophic results and cardiogenic shock. We report a case of a 62-year-old man who had an intermediate coronary artery disease presenting with cardiogenic shock due to coronary spasm during a preoperative period.
Coronary Artery Disease* ; Coronary Vasospasm ; Humans ; Middle Aged ; Perioperative Period ; Preoperative Period ; Shock, Cardiogenic* ; Spasm*

Objective: Patients presenting with fingertip skin defect injuries without exposed bone can avail of two treatment options at the emergency department (ED). This study compared outcomes between dressing and composite graft (CG) using skin stump for patients visiting the ED with fingertip skin defect injuries without exposed bone. Methods: This was a single-center, retrospective, observational study. We reviewed 244 patients with fingertip skin defect injuries without exposed bone who visited the ED from September 2018 to February 2021. We compared the outcomes of the patients who were treated by CG using skin stump and those who received a dressing in the ED. Results: In all, 142 patients were treated by CG using skin stump, and 102 patients were given a dressing only. In the CG group, good outcomes were obtained in 140 patients, whereas additional skin graft treatment was required for two patients with bad outcomes. In the dressing group, 81 patients had good outcomes and 21 patients had bad outcomes which required additional skin graft treatment. Conclusion Results of our study revealed that compared to traditional dressing, ED treatment for fingertip skin defects without exposed bone showed good outcomes when administered CG using skin stump. Hence, we recommend that instead of simple dressing, CG using skin stump is the preferred mode of treatment for patients presenting in the ED with fingertip skin defect injuries without exposed bone.

Viral load and the duration of viral shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are important determinants of the transmission of coronavirus disease 2019.In this study, we examined the effects of viral doses on the lung and spleen of K18-hACE2 transgenic mice by temporal histological and transcriptional analyses. Approximately, 1×105 plaque-forming units (PFU) of SARS-CoV-2 induced strong host responses in the lungs from 2 days post inoculation (dpi) which did not recover until the mice died, whereas responses to the virus were obvious at 5 days, recovering to the basal state by 14 dpi at 1×102 PFU. Further, flow cytometry showed that number of CD8+ T cells continuously increased in 1×102 PFU-virusinfected lungs from 2 dpi, but not in 1×105 PFU-virus-infected lungs. In spleens, responses to the virus were prominent from 2 dpi, and number of B cells was significantly decreased at 1×105PFU; however, 1×102 PFU of virus induced very weak responses from 2 dpi which recovered by 10 dpi. Although the defense responses returned to normal and the mice survived, lung histology showed evidence of fibrosis, suggesting sequelae of SARS-CoV-2 infection. Our findings indicate that specific effectors of the immune response in the lung and spleen were either increased or depleted in response to doses of SARS-CoV-2. This study demonstrated that the response of local and systemic immune effectors to a viral infection varies with viral dose, which either exacerbates the severity of the infection or accelerates its elimination.