This study was performed to investigate the changes of tear film and ocular surface in diabetic patients, as well as the ocular and systemic factors related to these changes. We assessed the scoring of keratoepitheliopathy, corneal sensitivity test, tear film break-up time (BUT), Schirmer test, and conjunctival impression cytology in 94 eyes of 47 patients with noninsulin-dependent diabetes mellitus and in 60 eyes of 30 normal subjects. The degree of keratoepitheliopathy was severe, and the corneal sensitivity, BUT, and tear secretion were significantly reduced in the diabetic patients. Conjunctival impression cytology showed a higher grade of conjunctival squamous metaplasia and lower goblet cell density in the diabetic patients. All parameters were related to the status of metabolic control, diabetic neuropathy, and stage of diabetic retinopathy. We think that diabetic patients with poor metabolic control, neuropathy, and advanced stage of retinopathy should be examined for tear film and ocular surface changes.
Adult ; Aged ; Comparative Study ; Corneal Diseases/etiology/*metabolism ; Diabetes Complications/*metabolism/pathology ; Epithelium, Corneal/*metabolism/pathology ; Female ; Goblet Cells/pathology ; Humans ; Male ; Middle Aged ; Risk Factors ; Tears/*metabolism

PURPOSE: To evaluate the factors affecting compliance with the use of 0.05% cyclosporine emulsion in patients with dry eye syndrome. METHODS: A total of 148 patients using 0.05% cyclosporine emulsion for dry eye were divided into two groups (compliant vs. non-compliant). The compliant group included the patients who used 0.05% cyclosporine emulsion more than 50% of frequency as they had been prescribed. We analyzed factors affecting compliance, including age, gender, severity of symptoms, side effects, use of topical steroid, socioeconomic status, associated systemic disease, number of eyedrops, visit interval, and detailed instruction about 0.05% cyclosporine emulsion. RESULTS: The compliant group included 124 patients (83.8%), and the non-compliant group included 24 patients (16.2%). Multivariate analysis showed that the factors associated with low compliance were severe symptoms, longer visit interval, side effects, lower socioeconomic status, and poor detailed instruction (P<0.05). In contrast, gender, associated systemic disease, and number of eyedrops did not affect the compliance for use of 0.05% cyclosporine emulsion. CONCLUSIONS: Special attention should be given to patients with the above risk factors to improve compliance with the use of 0.05% cyclosporine emulsion.
Compliance ; Cyclosporine ; Dry Eye Syndromes ; Eye ; Humans ; Multivariate Analysis ; Ophthalmic Solutions ; Risk Factors ; Social Class

PURPOSE: The objective of this study is to evaluate the therapeutic efficacy of ethylenediaminetetraacetic acid (EDTA) chelation and excimer laser phototherapeutic keratectomy (PTK) combined with amniotic membrane transplantation (AMT) for the treatment of band keratopathy (BK). METHODS: Eleven eyes in ten patients with BK received combined PTK (ablation zone of central 7.0-7.5 mm, depth of 50 microm), EDTA chelation (0.05 M, 3 minutes), and amniotic membrane transplantation using fibrin glue. Preand postoperative best corrected visual acuities, symptom changes, reepithelialization time, cosmesis, recurrence, and complications were analyzed. RESULTS: Visual acuity improved in three eyes (27.3%) and did not change in eight eyes (72.7%). Symptoms improved in all patients, and the mean reepithelialization time was 10.6+/-5.3 days. The cosmetic results were good in eight eyes (72.7%) and were fair in three eyes (27.3%). During the mean follow-up period of 11.4+/-6.1 months (range, 6 to 23 months), no postoperative complications or recurrences were observed. CONCLUSIONS: The combination of EDTA chelation, PTK, and AMT is safe and effective for the treatment of band keratopathy.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Amnion/*transplantation ; Chelating Agents/*therapeutic use ; Combined Modality Therapy ; Corneal Diseases/*therapy ; Edetic Acid/*therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Photorefractive Keratectomy/*methods ; Retrospective Studies ; Treatment Outcome ; Visual Acuity

No abstract available.

Gastric metastasis occurs in about 0.7% to 1.7%, of patients dying of solid tumors of extragastrointestinal origin. Metastatic disease involving the stomach is an unusual and difficult clinical problem and presenting symptoms include nonspecific epigastric pain and melena. In most cases of gastric metastasis, the histologic finding of the gastroscopic biopsy suggests the correct diagnosis. There are only a few reports of gastric metastasis from malignant melanoma. We report a case of malignat melanoma of gastric metastasis, which was diagnosed by gastroscopy.
Biopsy ; Diagnosis ; Gastroscopy* ; Humans ; Melanoma* ; Melena ; Neoplasm Metastasis* ; Stomach

Gastric metastasis occurs in about 0.7% to 1.7%, of patients dying of solid tumors of extragastrointestinal origin. Metastatic disease involving the stomach is an unusual and difficult clinical problem and presenting symptoms include nonspecific epigastric pain and melena. In most cases of gastric metastasis, the histologic finding of the gastroscopic biopsy suggests the correct diagnosis. There are only a few reports of gastric metastasis from malignant melanoma. We report a case of malignat melanoma of gastric metastasis, which was diagnosed by gastroscopy.
Biopsy ; Diagnosis ; Gastroscopy* ; Humans ; Melanoma* ; Melena ; Neoplasm Metastasis* ; Stomach

PURPOSE: To investigate the efficacy of a subconjunctival injection of alphaVbeta5 integrin antibody on corneal angiogenesis induced by chemical epithelial denudation in a rabbit eye model. METHODS: One week after debridement by heptanol, rabbits were treated with a subconjunctival injection of alphaVbeta5 integrin antibody or control immunoglobulin G weekly for 2 weeks. Rabbits that did not receive injection after debridement served as the untreated group. The percentage of neovascularized corneal area was calculated by biomicroscopy, and the sectioned area and number of new vessels were calculated by histological examinations. RESULTS: At 7 days after the first injection, alphaVbeta5 integrin antibody-treated eyes had 9.5% (P=0.02) and 6.8% (P=0.03) less neovascularized corneal area than vector-treated eyes and untreated eyes, respectively. At 7 days after the second injection, alphaVbeta5 integrin antibody-treated eyes had 21.1% (P=0.02) and 18.3% (P=0.02) less neovascularized corneal area than vector-treated eyes and untreated eyes, respectively. Light microscopic examination showed a smaller neovascularized corneal area and a reduced number of new vessels in the alphaVbeta5 integrin antibody-treated eyes compared to the control eyes. CONCLUSIONS: Subconjunctival injection of alphaVbeta5 integrin antibody effectively reduces experimental corneal neovascularization induced by chemical injury, and could be used as a corneal angiogenesis inhibitor in the future.
Corneal Neovascularization* ; Debridement ; Heptanol ; Immunoglobulin G ; Rabbits

PURPOSE: To evaluate the clinical effect of endonasal dacryocystorhinostomy as a primary treatment of acute dacryocystitis with lacrimal sac abscess formation. METHODS: The study comprised 14 patients with acute dacryocystitis and lacrimal sac abscess formation who underwent endonasal dacryocystorhinostomy as a primary treatment. Postoperative evaluations included symptoms of acute dacryocystitis, physical examination, and lacrimal irrigation. Success was defined as the absence of epiphora and good lacrimal irrigation at the last follow-up. RESULTS Of the patients, two were male and twelve were female. The mean age was 54.7 years and mean follow-up period was 8.3 months. Resolution of symptoms and signs of acute dacryocystitis occurred in all patients. In one patient, recurrence of acute dacryocystitis occurred 6 months after surgery. At last follow-up, epiphora and failure of lacrimal irrigation had developed in two patients. CONCLUSIONS: Endonasal dacryocystorhinostomy is considered a safe and effective primary treatment of acute dacryocystitis with lacrimal sac abscess formation.
Abscess ; Dacryocystitis* ; Dacryocystorhinostomy* ; Female ; Follow-Up Studies ; Humans ; Lacrimal Apparatus Diseases ; Male ; Physical Examination ; Recurrence