No abstract available.
Ehlers-Danlos Syndrome*

No abstract available.

Purpose: To assess the impact of toxoplasma immunoglobulin G (IgG) titers on the diagnosis of active ocular toxoplasmosis. Methods: We retrospectively analyzed the medical records of patients tested for toxoplasma IgG at our uveitis clinic. Active ocular toxoplasmosis was clinically diagnosed based on wide-angle fundus photography and disease progression. Patients with IgG titers ≥ 30 IU/mL were classified as seropositive-high titer, those with IgG titers of 1.6-30 IU/mL as seropositive-low titer, and the remaining patients as seronegative. We compared the proportion of active ocular toxoplasmosis among these groups. Additionally, we evaluated the sensitivity and specificity of each titer and attempted to determine an ideal reference titer for toxoplasma IgG in diagnosing active ocular toxoplasmosis. Results: Out of 824 patients, 86 (10.4%), 88 (10.7%), and 650 (78.9%) were categorized as seropositive-high titer, seropositivelow titer, and seronegative, respectively. Among these patients, 34 in the seropositive-high titer group and 2 in the seropositive- low titer group were clinically diagnosed with active ocular toxoplasmosis. The false-positive rate was significantly different between the groups, being 60.5% in the seropositive-high titer group and 97.7% in the seropositive-low titer group (p < 0.001). The receiver operating characteristic curve indicated that 37.70 IU/mL could be an ideal reference titer for diagnosing ocular toxoplasmosis. Conclusions The false-positive rate was notably lower (60.5%) in patients with IgG titers ≥ 30 IU/mL compared to those with titers of 1.6-30 IU/mL (97.7%). Therefore, not only the presence of IgG but also the level of titer appears to be important in diagnosing ocular toxoplasmosis.

Objectives: To determine whether the clinical aspect of aplastic anemia is influenced by pregnancy. METHODS: We reviewed 37 cases of pregnant aplastic anemia patients during Jan. 1989 to Dec. 1998, and examined age, parity, progress of pregnancy, termination methods, obstetrics & neonatal complications, hematologic change, and treatment modality by medical records. RESULTS: According to onset of disease, patients were divided into pre-pregnant diagnosed group(n=12) and during-pregnancy diagnosed group(n=25). Mean age of diagnosis was 29.4yr, 89.2% were nulliparous, and 51.4% were severe aplastic anemic patients. All patients underwent 50 pregnancy. Mean gestational period was 37wks, birth weight was 2569gram, and, except in 7 cases of abortion, 43 cases were delivered transvaginally or transabdominally(51.2% vs. 48.8%). Preeclampsia, eclampsia, preterm labor, restricted growth, and distress were complicated and decreased hemoglobin, hematocrit, reticulocyte, platelet were reversed after termination in pregnancy associated group. Treatment modality during pregnancy included transfusion, steroid, anti-lymphocytic globulin, anti-thymocytic globulin and IVGV, and remission rate was 45.5% in pregnancy associated group. CONCLUSION: We concluded that pregnancy is associated with aplastic anemia as a high risk factor, and intensive treatment is needed.
Anemia, Aplastic* ; Birth Weight ; Blood Platelets ; Diagnosis ; Eclampsia ; Female ; Hematocrit ; Humans ; Medical Records ; Obstetric Labor, Premature ; Obstetrics ; Parity ; Pre-Eclampsia ; Pregnancy* ; Reticulocytes ; Risk Factors

Purpose: To report a case of extensive syphilitic punctate inner retinitis (SPIR) triggering bilateral macular ischemia after intravitreal triamcinolone injections, and the multimodal retinal imaging findings.Case summary: A 69-year-old male patient with nonproliferative diabetic retinopathy was transferred to our hospital because of bilateral visual deterioration (to counting fingers) after the first intravitreal triamcinolone injection. Fundus examination revealed numerous yellow punctate precipitates in the superficial retinae, retinal arteriolitis, and vitritis. The punctate lesions and surrounding retinal regions showed decreased vascular density on optical coherence tomography angiography, and focal hypofluorescence on fluorescein angiography. The patient was positive for all of the Venereal Disease Research Laboratory test, the fluorescent treponemal antibody-absorption test, and Treponema pallidum hemagglutination; we diagnosed bilateral SPIR. After treatment with aqueous crystalline penicillin solutions (24 million units per day for 14 days), the punctate lesions reduced but arteriolitis progressed to obliterative vasculitis. After 6 months, the bilateral SPIR and vitritis resolved, and the bilateral visual acuity improved to 20/100. However, inner retinal and macular ischemia persisted because of capillary nonperfusion attributable to obliterative vasculitis. Conclusions Extensive SPIR can develop after an initial intravitreal steroid injection; the inner retinal ischemia and visual loss may persist after treatment because obliterative vasculitis develops. Therefore, patients scheduled for intravitreal steroid injections should be screened for syphilis infection.

Purpose: To evaluate the clinical outcomes and prognostic factors of double-dose aflibercept in patients with refractory neovascular age-related macular degeneration (nAMD). Methods: We reviewed the medical records of nAMD patients treated with a double dose of aflibercept (4 mg/0.1 mL) due to an inadequate response to standard 8-weekly intravitreal injections of 2 mg/0.05 mL aflibercept. The assessment at week 8 after treatment included changes in subretinal/intraretinal fluid (SRF/IRF) and best-corrected visual acuity, with patients showing absence or reduction in SRF/IRF classified as the response group. Baseline factors influencing clinical outcomes were analyzed, including central macular thickness (CMT), central choroidal thickness (CCT), size of choroidal neovascularization (CNV), CNV subtype, and maximum height of SRF and IRF. Results: The study included 95 eyes of 95 subjects, with 61 eyes (64.2%) categorized as the response group following double-dose treatment. Responders exhibited thicker CCT (290.4 μm vs. 194.0 μm, p < 0.001), thinner CMT (251.2 μm vs 311.1 μm, p = 0.018), smaller CNV area (2.718 mm2 vs. 3.964 mm2, p = 0.034), and a higher prevalence of type 1 CNV (85.2% vs. 58.8%, p = 0.011) compared to the non-response group. Multivariate binary logistic regression analysis identified thicker CCT (p < 0.001, r = 1.016), thinner CMT (p = 0.014, r = 0.988), smaller CNV area (p = 0.015, r = 0.662), and type 1 CNV (p = 0.001, r = 0.061) as factors associated with better anatomical outcomes. Conclusions Double-dose aflibercept was effective in 64% of patients with refractory nAMD, suggesting it may be considered for those with small CNV areas, thinner CMT, and thicker CCT.

Fourteen compounds were isolated from the stem of Angelica polymorpha. On the basis of spectral data, these compounds were identified as isoimperatorin (1), phellopterin (2), bergapten (3), xanthyletin (4), cnidilin (5), geijerine (6), (−)-3'-acetyl hamaudol (7), 7-demethylsuberosine (8), dehydrogeijerin (9), (−)-hamaudol (10), (+)-visamminol (11), divaricatol (12), scopoletin (13), and decursidate (14), respectively. Among them, compounds 4 - 6, 8, 9, 13, and 14 were isolated for the first time from A. polymorpha. Dehydrogeijerin (6) and geijerin (9) were isolated for the first time from genus Angelica. All isolates tested for inhibitory activity against acetylcholinesterae. Compounds 1 to 13 showed acetylcholinesterase inhibitory activity with IC₅₀ values ranging from 1.4 to 37.5 µM.
Acetylcholinesterase* ; Angelica* ; Cholinesterase Inhibitors* ; Chromones ; Coumarins ; Scopoletin

No abstract available.
Membranes* ; Pregnancy* ; Rupture*

PURPOSE: Vascular endothelial growth factor(VEGF) is recognized as a potent constituent of the vascularization and growth of solid tumors. We assessed the serum levels of VEGF and we evaluated its correlation to the clinicopathologic findings and clinical outcome of patients with renal cell carcinoma(RCC). MATERIALS AND METHODS: Serum samples were collected before surgery from patients with RCC. The levels of serum VEGF were assessed by using quantitative enzyme immunoassay. Comparison of the serum VEGF level with the tumor stage, grade, cell type and clinical outcome was performed, and the survival rate between the RCC patients above and below the mean VEGF level was evaluated. RESULTS: The mean follow-up was 5.1 years. The serum VEGF level was significantly higher in the patients with RCC(mean: 497pg/ml) than that in the controls(mean: 211pg/ml)(p<0.001). The serum VEGF level was correlated with the tumor size, the pathologic T stage and the clinical stage and histologic nuclear grade, but not with the histologic subtype. Patients with a lower VEGF level(<497pg/ml) showed longer survival(p=0.0207 on univariate analysis, p=0.04 on multivariate analysis). CONCLUSIONS: Our study indicated that the serum VEGF level was significantly correlated with the clinical or pathologic stage, the nuclear grade and adverse survival. These results suggest that the serum VEGF level could be a comparable prognostic factor to the tumor stage and grade.
Carcinoma, Renal Cell* ; Follow-Up Studies ; Humans ; Immunoenzyme Techniques ; Prognosis ; Survival Rate ; Vascular Endothelial Growth Factor A

Surgical remedy of nasal ala present a challenge to the reconstructive surgeon. As ala have anatomic complexity and a paired structure, reconstruction must be precise and aesthetically acceptable. The reconstruction of full-thickness ala defects often require staged surgical procedures, and they can introduce operational risks and consume extraordinary time and cost. However, a hinged turnover flap can offer a one-stage repair of full-thickness ala defects. With this procedure, satisfactory ala reconstruction was achieved in one step, and good aesthetic and functional results were obtained.