PURPOSE: To report a case in which radiotherapy damaged the microvasculatures of the retinal vessels and developed cotton-wool patches and retinal hemorrage as well as rubeosis iridis and intractable neovascular glaucoma. METHODS: A 64-year-old female presented with visual loss in her left eye two years after radiotherapy for malignant melanoma of the nasal cavity. The visual acuity of her left eye was counting fingers. Although any specific signs were not shown in the cornea or lens, multiple cotton-wool patches and retinal hemorrhages were noted around the optic disc. RESULTS: Multiple cotton-wool patches and retinal hemorrhages disappeared gradually. Finally, rubeosis iridis and intractable neovascular glaucoma developed which could not be controlled by panretinal photocoagulation. CONCLUSIONS: Radiotherapy for malignancy of the nasal cavity was associated with intractable neovascular glaucoma.
Cornea ; Female ; Fingers ; Glaucoma, Neovascular* ; Humans ; Light Coagulation ; Melanoma ; Middle Aged ; Nasal Cavity ; Radiotherapy ; Retinal Hemorrhage ; Retinal Vessels ; Retinaldehyde ; Visual Acuity

Incidence of aseptic loosening of hip prostheses is increasing in recent years. Previous studies suggested the involvement of proteinases and cytokines in the accelerated bone lysis associated with loosening. To investigate the role of matrix metalloproteinases (MMPs) in the loosening, Gelatin/Type IV collagenases, namely, 72 KDa matrix metalloproteinase (MMP)-2 type and 92 KDa MMP-9 type were analyzed in 14 cases of the loosened endoprostheses of the hip. Zymographic and densitometric analyses revealed production of MMP-2 ancl elevated induction of MMP-9 in tissue extracts from both the interface hetween hone and implants and the capsular tissues when compared with those in synovium obtained from a patient with a t'ractured femoral neck. MMP-9 showed stronger activity than MMP-2. In the sample of a fractured femoral neck, MMP-2 was detected, but MMP-9 was not detected. In matched samples, the activity of MMP-2 and MMP-9 in the interface tissues showed stronger activity than those in the capsular tissues. There was no difference between cemented and uncemented femoral prostheses. The state of prostheses(loosening, osteolysis, and cup wear) did not influence on the activity of MMP-2 and MMP-9. Theses findings suggest a role for MMP-2 and MMP-9 type gelatinase/Type IV collagenases in the degradation of extracellular matrix of periprosthetic tissues, where they may cause weakening of the connective tissue hed and the loosening of total hip replacement endoprostheses. Consequently. we could confirm the role of MMP cascade in aseptic loosening of total hip prostheses. The further study ahout other types of MMP and the inhihitor of MMP will be needed.
Arthroplasty, Replacement, Hip ; Collagenases ; Connective Tissue ; Cytokines ; Extracellular Matrix ; Femur Neck ; Hip Prosthesis* ; Hip* ; Humans ; Incidence ; Matrix Metalloproteinases* ; Osteolysis ; Peptide Hydrolases ; Prostheses and Implants ; Synovial Membrane ; Tissue Extracts

Morning glory syndrome is a rare congenital anomaly in optic disc, which is characterized by defect in optic disc due to optic nerve dysgenesis, abnormal retinal vessels, and chorioretinal pigment disturbance around optic disc. Retinal detachment in morning glory syndrome occurs in 26% to 38% of the cases, which is thought to be non-rhegmatogenous in nature and usually develops in posterior pole of the retina. Surgical treatment is indicated in cases with bullous and total retinal detachment in morning glory syndrome. The authors successfully reattached the detached retina in a 3 year old boy with morning glory syndrome using trans pars plana vitrectomy, scleral buckling, retinotomy, silicone oid injection, and endolaser photocoagulation. The authors followed up for 15 weeks after operation, and the vision of left eye was counting finger and the retina remained to be reattached.
Child, Preschool ; Fingers ; Humans ; Light Coagulation ; Male ; Optic Nerve ; Retina ; Retinal Detachment* ; Retinal Vessels ; Retinaldehyde* ; Scleral Buckling ; Silicones ; Vitrectomy

Adult albino rabbits were used in this study. The retina was treated with laser photocoagulation around the retinal break. The histopathologic findings were evaluated with light and electron microscopes to determine how quickly chorioretinal adhesion was produced after photocoagulation. Adhesion between the rod and cone layer and the pigment epithelium appeared within 1 hour after photocoagulation, probably due to direct burn effect of the laser. A scar tissue appeared in the chorioretinal lesion 5 days after photocoagulation, derived from the proteinaceous coagulum and accompanying fibrosis.
Adult ; Burns ; Cicatrix ; Epithelium ; Fibrosis ; Humans ; Light Coagulation* ; Rabbits ; Retina ; Retinal Perforations

An improved retinal tack and applicator have been increasingly used as an adjunct in the repair of complicated retinal detachments. We used this technique in 7 consecutive cases of complicated retinal detachment. After a mean follow-up of 3 months, anatomical reattachment including partial reattachment was achieved in 5 eyes among 7 eyes, and 6 eyes had improved vision or no change(one improved to 20/70). Retinal tacks appear to be a useful tool either temporarily or permanently in preventing retraction and detachment of the retina until adjunctive diathermy, cryopexy, or photocoagulation becomes effective.
Diathermy ; Follow-Up Studies ; Light Coagulation ; Retina ; Retinal Detachment* ; Retinaldehyde* ; Vitreoretinopathy, Proliferative

In vascular smooth muscle cells, reactive oxygen species (ROS) were known to mediate platelet-derived growth factor (PDGF)-induced cell proliferation and NADH/NADPH oxidase is the major source of ROS. NADH/NADPH oxidase is controlled by rac1 in non-phagocytic cells. In this study, we examined whether the inhibition of rac1 by adenoviral-mediated gene transfer of a dominant negative rac1 gene product (Ad.N17rac1) could reduce the proliferation of rat aortic vascular smooth muscle cells (RASMC) stimulated by PDGF via decreasing intracellular ROS. RASMC were stimulated by PDGF (80 ng/mL) with or without N-acetylcysteine 1 mM or infected with 100 mutiplicity of infection of Ad.N17rac1. Intracellular ROS levels were measured at 12 hr using carboxyl-2', 7'-dichlorodi-hydrofluorescein diacetate confocal microscopy. At 72 hr, cellular proliferation was evaluated by cell number counting and XTT assay. Compared with control, ROS levels were increased by 2-folds by PDGF. NAC and Ad.N17rac1 inhibited PDGF-induced increase of ROS by 77% and 65%, respectively. Cell number was increased by PDGF by 1.6-folds compared with control. NAC and Ad.N17rac1 inhibited PDGF-induced cellular growth by 45% and 87%, respectively. XTT assay also showed similar results. We concluded that inhibition of rac1 in RASMCs could reduce intracellular ROS levels and cellular proliferation induced by PDGF.
Adenoviridae/genetics ; Animal ; Aorta, Thoracic/cytology ; Cell Division/drug effects/physiology ; Cells, Cultured ; Gene Expression/physiology ; Gene Transfer Techniques ; Multienzyme Complexes/antagonists & inhibitors ; Muscle, Smooth, Vascular/*cytology/*metabolism ; NADH, NADPH Oxidoreductases/antagonists & inhibitors ; NADPH Oxidase/antagonists & inhibitors ; Platelet-Derived Growth Factor/*pharmacology ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species/*metabolism ; rac1 GTP-Binding Protein/*genetics/metabolism

Mitomycin C(MMC) is one of the alkylating agents, which is commonly used adjunctively to inhibit the over-growth of the fibroblasts in high-risk filtering surgery. However, it increases the incidence of the complications including persistent postoperative hypotony. The hypotony may be caused by the toxic effect of MMC on the ciliary epithelium. The morphological changes of the ciliary epithelium were evaluated using transmission electron microscope four and twelve weeks after the application of balanced salt solution(BSS) and MMC on the exposed sclera against the ciliary body in the rabbit eyes. There was no specific change in the ciliary epithelium four and twelve weeks after the application of BSS. Four weeks after the application of 0.2mg/ml of MMC, the mitochondria in the nonpigmented epithelium of the applied region were swollen mildly. The mitochondria of both pigmented and nonpigmented epithelia were swollen moderately in the region applied with 0.5mg/ml of MMC. Twelve weeks after the application of either 0.2 or 0.5mg/ml of MMC, the mitochondria were swollen markedly, the nuclear membranes in the pigmented and nonpigmented epithelia were wrinkled, and the heterochromatins of the nuclei faded in both applied and contralateral ciliary epithelia. These findings indicate that mitomycin C causes degenerative changes in the ciliary epithelium decrease aqueous production.
Alkylating Agents ; Ciliary Body ; Epithelium* ; Fibroblasts ; Filtering Surgery ; Heterochromatin ; Incidence ; Mitochondria ; Mitomycin* ; Nuclear Envelope ; Sclera

Orbital fractures are increasing in frequency with the rise in number of automobile accidents and the development of industries. It may be difficult to detect fractures with plain X-rarys of the orbit, because of the superimposition of the shadow by bony structures. Even minor alterations in head position can cause a significant change of shadow. Computed tomography is extremely accurate and can be diagnostic with respect to the location and size of the fractures, because it provides detailed visualization of both the bones and soft tissues of the orbits. We studied 89 patients with orbital fractures proven by computed tomography and the results are as follows: 1. Orbital fractures occurred most frequently between the ages of 11 and 40 years. 2. The causes of orbital fractures were traffic accidents(46.1%), contact with human bodies(24.7%), fall-down injuries(14.6%) and others(14.6%). 3. There was no significant difference in the incidence of orbital fracture between the right and left eyes. 4. In single wall fractures, medial wall fractures were most common, followed by factures of inferior, superior and lateral walls in order. 5. In combined wall fractures, medial and inferior wall fractures were most common.
Accidents, Traffic ; Automobiles ; Head ; Humans ; Incidence ; Orbit* ; Orbital Fractures*

Retinotomy, cutting of the retina, can be helpful in hte management of giant retinal tears, subretinal strands, and retinal incarceration. Relaxing retinotomies are used in the presence of retinal shortening or fibrous proliferation and contraction, and usually performed in the peripheral or equatorial retina. To fascilitate retinal attachment, the authors used intraocular scissors to perform radial retinotomy in the macula of two patients during vitrectomy surgery. We obtained a successful result using retinotomy in the macula as an adjunct to repair of retinal detachment with macular hole formation.
Humans ; Retina ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde ; Vitrectomy

Morning glory syndrome is a rare congenital anomaly in optic disc, which is characterized by defect in optic disc due to optic nerve dysgenesis, abnormal retinal vessels, and chorioretinal pigment disturbance around optic disc. Retinal detachment in morning glory syndrome occurs in 26% to 38% of the cases, which is thought to be non-rhegmatogenous in nature and usually develops in posterior pole of the retina. Surgical treatment is indicated in cases with bullous and total retinal detachment in morning glory syndrome. The authors successfully reattached the detached retina in a 3 year old boy with morning glory syndrome using trans pars plana vitrectomy, scleral buckling, retinotomy, silicone oid injection, and endolaser photocoagulation. The authors followed up for 15 weeks after operation, and the vision of left eye was counting finger and the retina remained to be reattached.
Child, Preschool ; Fingers ; Humans ; Light Coagulation ; Male ; Optic Nerve ; Retina ; Retinal Detachment* ; Retinal Vessels ; Retinaldehyde* ; Scleral Buckling ; Silicones ; Vitrectomy