PURPOSE: To evaluate the accuracy of intraocular lens (IOL) power estimation and the factors associated with outcome in eyes undergoing combined phacovitrectomy for proliferative diabetic retinopathy. METHODS: We performed a retrospective case review of 39 consecutive patients (44 eyes) that underwent phacovitrectomy for proliferative diabetic retinopathy. Axial lengths were measured using ultrasound (A-scan) and/or optical biometry (IOL Master). Achieved and predicted refractions were compared to calculate the mean postoperative refractive prediction error (ME) and the mean absolute prediction error (MAE). Systemic conditions of patients and several preoperative and postoperative factors related to the postoperative refraction were analyzed. RESULTS: The ME of 44 eyes were -0.23 +/- 0.52 diopters (D) and -0.23 +/- 0.47 D after 3 and 6 months, respectively (range, -1.40~+0.79 D). There was no statistically significant difference in the refractive outcomes between the refractive errors (p = 0.959). The MAEs were 0.45 +/- 0.35 D and 0.40 +/- 0.33 D after 3 and 6 months, respectively with no statistical significant difference between the results (p = 0.196). When comparing ME in the 20 eyes that achieved both results, ultrasound was more accurate than optical biometry (p = 0.002, 0.002). The factors associated with more inaccurate ME and MAE after phacovitrectomy were diabetic nephropathy and neovascular glaucoma. CONCLUSIONS: Combined phacovitrectomy in proliferative diabetic retinopathy showed small biometric errors within the tolerable range in most cases. Patients with neovascular glaucoma and diabetic nephropathy had more inaccurate postoperative refractive power. Both optical biometry and ultrasound should be used to estimate axial lengths for improving the accuracy of IOL power calculation.
Biometry ; Diabetic Nephropathies ; Diabetic Retinopathy* ; Glaucoma, Neovascular ; Humans ; Lenses, Intraocular* ; Refractive Errors ; Retrospective Studies ; Ultrasonography

BACKGROUND: Fas and Fas ligand (FasL) are cell surface proteins that mediate apoptosis. Fas and FasL are expressed in normal epidermal cells, but are different in the expression patterns in epidermal layers. OBJECTIVE: The purpose of this study was to evaluate the expression of Fas and FasL in various skin diseases including non-tumorous diseases and tumors. METHOD: We performed immunohistochemical staining for Fas and FasL with monoclonal or polyclonal antibodies using frozen skin tissues from 29 patients. RESULTS: 1. In normal skin, Fas and FasL were expressed as intercellular and intracellular patterns. Fas was expressed in the basal and spinous layers, and FasL was expressed in the upper spinous and granular layers. 2. In psoriasis vulgaris and lichen planus, FasL expression was proportional to the degree of epidermal hyperplasia, such a relationship was not found in Fas expression. 3. In verruca vulgaris and herpes zoster, the upregulation of Fas and FasL expression was observed in lesional epidermis. 4. In skin tumors, Fas and FasL expression were observed in most tumor cells of Bowen's disease, keratoacanthoma, and squamous cell carcinoma. In basal cell carcinoma, FasL was expressed strongly and diffusely in the infiltrating tumor cells, but Fas was not expressed at all. CONCLUSION: Fas and FasL play an important role in the differentiating process of the epidermis by coordinate expression between them. In non-tumorous conditions and skin tumors, Fas and FasL might function as essential mediators of cellular turnover in pathogenesis of the skin diseases.
Antibodies ; Apoptosis ; Bowen's Disease ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Epidermis ; Fas Ligand Protein* ; Herpes Zoster ; Humans ; Hyperplasia ; Keratoacanthoma ; Lichen Planus ; Membrane Proteins ; Psoriasis ; Skin Diseases* ; Skin* ; Up-Regulation ; Warts

BACKGROUND: Fas and Fas ligand (FasL) are cell surface proteins that mediate apoptosis. Fas and FasL are expressed in normal epidermal cells, but are different in the expression patterns in epidermal layers. OBJECTIVE: The purpose of this study was to evaluate the expression of Fas and FasL in various skin diseases including non-tumorous diseases and tumors. METHOD: We performed immunohistochemical staining for Fas and FasL with monoclonal or polyclonal antibodies using frozen skin tissues from 29 patients. RESULTS: 1. In normal skin, Fas and FasL were expressed as intercellular and intracellular patterns. Fas was expressed in the basal and spinous layers, and FasL was expressed in the upper spinous and granular layers. 2. In psoriasis vulgaris and lichen planus, FasL expression was proportional to the degree of epidermal hyperplasia, such a relationship was not found in Fas expression. 3. In verruca vulgaris and herpes zoster, the upregulation of Fas and FasL expression was observed in lesional epidermis. 4. In skin tumors, Fas and FasL expression were observed in most tumor cells of Bowen's disease, keratoacanthoma, and squamous cell carcinoma. In basal cell carcinoma, FasL was expressed strongly and diffusely in the infiltrating tumor cells, but Fas was not expressed at all. CONCLUSION: Fas and FasL play an important role in the differentiating process of the epidermis by coordinate expression between them. In non-tumorous conditions and skin tumors, Fas and FasL might function as essential mediators of cellular turnover in pathogenesis of the skin diseases.
Antibodies ; Apoptosis ; Bowen's Disease ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Epidermis ; Fas Ligand Protein* ; Herpes Zoster ; Humans ; Hyperplasia ; Keratoacanthoma ; Lichen Planus ; Membrane Proteins ; Psoriasis ; Skin Diseases* ; Skin* ; Up-Regulation ; Warts

Rheumatoid nodules are the most common extra-articular presentations of rheumatoid arthritis. Although rheumatoid nodules can develop anywhere in the body, they develop most commonly in the subcutaneous region, where they are easily exposed to repetitive trauma or pressure. However, an infrascapular presentation has not yet been reported. We report a case of giant bilateral rheumatoid nodules that developed in the infrascapular area, complicating its distinction from elastofibroma dorsi on radiological examination.

BACKGROUND: Nitric oxide synthase (NOS) is known to mediate ultraviolet B (UVB)-induced skin inflammation However, there is still ambiguity as to which NOS isotype mediates the process in vivo. Furthermore, contradictory results have been reported on which cell types respond to UVB irradiation in vitro. OBJECTIVE: This study was performed to evaluate the change of inducible NOS (iNOS) expression in vivo as a result of UVB radiation on the skin of a rat. METHOD: To examine the time-course change in iNOS expression in the rat skin, the rats were exposed to 400 ml/cm2 of UVB radiation, and skin samples were taken at various time intervals up to 48 h. iNOS expression on the skin of a rat was evaluated by both Western blot analysis and immunohistochemical staining. RESULTS: From Western blot analysis, UVB irradiation induced inducible NOS (iNOS) expression in the epidermis at 12-48 h postirradiation with a peak expression at 24 h. Immunohistochemical staining revealed that UVB-induced iNOS expression was localized to the epidermis and infiltrating inflammatory cells in the upper dermis of the rat. CONCLUSION: iNOS was induced by UVB irradiation on the skin of a rat, mainly in the epidermis. Therefore, iNOS is supposed to be one of the major mediators with regard to inducing an inflammatory response in UVB-irradiated rat skin in vivo.
Animals ; Blotting, Western ; Dermis ; Epidermis ; Inflammation ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type II* ; Rats* ; Skin*

BACKGROUND: Peroxiredoxin(Prx) is a novel peroxidase family to remove hydrogen peroxide using thioredoxin system, which is consisted of thioredoxin, thioredoxin reductase and NADPH. Several enzymatic antioxidants, such as superoxide dismutase, catalase and peroxidases are known to be present in the normal skin. But very little is known on the expression of Prx in the normal skin. OBJECTIVE: The aim of this study was to evaluate the expression of Prx isotypes in the normal human and rat skin, and thus to understand the role of Prx in the skin. MATERIALS AND METHODS: In this study, expression of 5 isotypes of Prx was evaluated in the primary cultures of keratinocytes and fibroblasts from human and rat, HaCaT cells and A431 cells by Western blot analysis. Also, immunohistochemical study for Prx I-IV expression was performed in the rat fibroblasts. RESULTS: Western blot analysis provided strong signals for Prx I, II and III with the cell extracts of cultured cells from the human and rat. The signals for Prx IV were weakly positive in hK, A431, hF and rF. The signals for Prx VI were positive in human cells, but were negative in rat cells. The finding were also identified in the intact skin. From immunocytochemical study for Prx I-IV, they were stained positively as a reticulated pattern in the cytoplasm of rF without isotype-specific difference. The positive reaction was strong in perinuclear cytoplasm. CONCLUSIONS: This study shows that Prx is ubiquitously expressed in the normal human and rat skin with an isotype-specific expression by species and cell types.
Animals ; Antioxidants ; Blotting, Western ; Catalase ; Cell Extracts ; Cells, Cultured* ; Cytoplasm ; Fibroblasts ; Humans* ; Hydrogen Peroxide ; Keratinocytes ; NADP ; Peroxidase ; Peroxidases ; Peroxiredoxins* ; Rats* ; Skin* ; Superoxide Dismutase ; Thioredoxin-Disulfide Reductase ; Thioredoxins

An implant-supported fixed dental prosthesis (ISFDP) or an implant-supported overdenture (IOD) are good options when treating a completely edentulous jaw opposing natural teeth. However, an ISFDP for a full arch requires sufficient bone quality and quantity, which limits its application. Meanwhile, using an ISFDP as an abutment of a removable partial denture has been considered recently. This clinical report discusses the treatments applied to two patients with edentulous maxillas and opposing natural teeth: one was treated with an IOD and the other was treated with an ISFDP and removable partial denture. Follow-up and management were performed for 8 years.
Dental Implants ; Dental Prosthesis ; Dental Prosthesis, Implant-Supported ; Denture, Overlay ; Denture, Partial, Removable ; Follow-Up Studies* ; Humans ; Jaw, Edentulous ; Maxilla ; Prostheses and Implants* ; Prosthodontics ; Tooth

Amyloidogenesis is the key pathological phenomenon commonly observed in various neurodegenerative disorders. alpha-Synuclein is the major constituent of Lewy bodies as a common pathological signature of Lewy body diseases (LBDs) including Parkinson's disease (PD), PD with dementia (PDD), and Dementia with Lewy bodies (DLB). As proteins unfold, they would result in producing either ordered or disordered aggregates unless they are folded back to the native state by molecular chaperones or removed via proteolytic degradation. alpha-Synuclein known as a natively unfolded protein has self-assembled into the ordered protein aggregates of amyloid fibrils which comprise the radiating filaments found in Lewy bodies. Amyloid fibrils are generated via either a template-dependent or template-independent mechanism. The prevalent nucleation-dependent fibrillation accelerates the assembly process in the presence of seeds such as prefibrillar species. As a template-independent process, we have recently proposed the double-concerted fibrillation mechanism in which the oligomeric species of alpha-synuclein act as a growing unit to form the mature fibrils. Despite insufficient understanding of the toxic causes of alpha-synuclein, the oligomeric species have been suggested to be responsible for the cellular degeneration by influencing membrane stability while leaving the amyloid fibrils as a detoxification end product. Alternatively, the transition process from the oligomers to the fibrils has been proposed to affect cell viability. It is, therefore, expected to develop prophylactic and therapeutic strategies toward the synucleinopathies by studying cellular function of alpha-synuclein, molecular mechanism of its assembly into the amyloid fibrils, and their effects on cellular biogenesis. By studying cellular function of alpha-synuclein, its molecular mechanism of assembly into amyloid fibrils and their effects on cellular biogenesis, progress of prophylactic and therapeutic strategies toward synucleinopathy can be seen.
alpha-Synuclein ; Amyloid ; Amyloidosis ; Cell Survival ; Dementia ; Lewy Bodies ; Membranes ; Molecular Chaperones ; Neurodegenerative Diseases ; Parkinson Disease ; Proteins ; Seeds ; Organelle Biogenesis

PURPOSE: To report a case of Miller Fisher syndrome in a pediatric patient with gastroenteritis associated with seroconversion of Campylobacter jejuni titer during the development of neurological symptoms and positive anti-GQ1b IgG. CASE SUMMARY: An 8-year-old male patient visited our clinic with bilateral ophthalmoplegia, diplopia, and ptosis of the right upper lid. He had experienced gastroenteritis one week previous, and antibodies to Campylobacter jejuni were detected in his plasma. Ophthalmic examination revealed a corrected visual acuity of 20/20 in both eyes. Ocular motor examination revealed limitations in all positions of gaze. Neurologic examination demonstrated areflexia and ataxia. The serologic anti-GQ1b IgG test was positive. Intravenous immunoglobulin and steroid pulse therapy were started. Extraocular movement, ptosis, and ataxia gradually improved after one month of treatment. CONCLUSIONS: We confirmed a case of Miller Fisher syndrome in a pediatric patient with bilateral ophthalmoplegia, ptosis, and a positive anti-GQ1b antibody test.
Antibodies ; Ataxia ; Campylobacter jejuni ; Child ; Diplopia ; Gastroenteritis ; Humans ; Immunoglobulin G* ; Immunoglobulins ; Male ; Miller Fisher Syndrome* ; Neurologic Examination ; Ophthalmoplegia ; Plasma ; Visual Acuity

Methazolamide is a carbonic anhydrase inhibitor commonly used for lowering intraocular pressure in glaucoma and other ophthalmologic diseases. Carbonic anhydrase inhibitors are sulfonamide derivatives that are known to cause many adverse side effects, including dermatologic reactions. Recently, Stevens-Johnson syndrome (SJS) associated with methazolamide treatment has been reported in Japanese and Japanese Americans, and it suggested a relationship between genetic background and methazolamide-induced SJS. We report four cases of SJS induced by methazolamide. Methazolamide should be prescribed with caution in patients of Japanese or Korean descent.
Asian Americans ; Asian Continental Ancestry Group ; Carbonic Anhydrase Inhibitors ; Carbonic Anhydrases ; Glaucoma ; Humans ; Intraocular Pressure ; Methazolamide* ; Stevens-Johnson Syndrome*