A 60-year-old woman who had experienced two episodes of amaurosis fugax in her right eye presented with vision loss. Two weeks earlier, at a private clinic, she was diagnosed with impending central retinal vein occlusion (CRVO) of the right eye and received an intravitreal injection of bevacizumab. Two weeks after this injection she was diagnosed with ischemic CRVO. At 11-weeks post-presentation, extremely ischemic features were observed with fluorescein angiographic findings of severe vascular attenuation and extensive retinal capillary obliteration. At 22-weeks post-presentation she was diagnosed with neovascular glaucoma; she experienced no visual improvement over the following several months.
Antibodies, Monoclonal/*administration & dosage ; Disease Progression ; Female ; Fluorescein Angiography ; Glaucoma, Neovascular/complications ; Humans ; Injections, Intraocular ; Ischemia/diagnosis/*etiology/physiopathology ; Middle Aged ; Retinal Vein Occlusion/*complications/*drug therapy/physiopathology ; *Retinal Vessels ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Visual Acuity/drug effects ; Vitreous Body

No abstract available.
Mesenteric Artery, Superior*

OBJECTIVE: It has been suggested that the occurrence of persistent pain signal during the early postnatal period may alter an individual's response to pain later in life. The aim of this study is to assess whether neonatal nerve injury resulted in long-lasting consequences on nociceptive system in the rat. METHODS: We examined whether neuropathic pain behaviors and the changes of spinal neuropeptides (SP, CGRP, VIP and VIP) induced by peripheral nerve injury within 1 day after birth (Neonate group) were different from those at 8 weeks after birth (Mature group). RESULTS: The Neonate group showed more robust and long-lasting pain behaviors than the Mature group. Immunohistochemical findings demonstrated that spinal SP- & CGRP-immunoreactivities(ir) of the ipsilateral to the contralateral side increased in the Neonate group, whereas those decreased in the Mature group. In addition, increase in spinal VIP- & NPY-ir of the ipsilateral to the contralateral side was more robust in the Mature group than in the Neonate group. CONCLUSION: These results suggest that peripheral nerve injury in the early postnatal period may result in long-lasting and potentially detrimental alterations in nociceptive pathways.
Animals ; Humans ; Hyperalgesia ; Infant, Newborn ; Neuralgia* ; Neuropeptides* ; Parturition ; Peripheral Nerve Injuries* ; Peripheral Nerves* ; Rats*

PURPOSE: To report a case of a patient with cytomegalovirus (CMV) retinitis who was treated with oral valganciclovir. CASE SUMMARY: A 34-year-old man who had undergone anti-cancer chemotherapy for Non-Hodgkin lymphoma was referred to the ophthalmologic oncology clinic because of decreased vision in both eyes. Fundus examination showed white, opaque, and granular retinal lesions in both eyes, and a serologic test showed a positive response to CMV antibody IgG and a negative response to CMV antibody IgM. The patient received induction therapy with intravenous ganciclovir and maintenance therapy with oral valganciclovir 900 mg once daily. CMV retinitis reactivated 4 weeks after maintenance therapy was discontinued. At that point, the patient received induction therapy with oral valganciclovir 900 mg twice daily for 3 weeks and maintenance therapy with 900 mg once daily for 5 weeks. The retinal lesion disappeared and did not recur after oral administration of valganciclovir. The patient discontinued valganciclovir after 5 weeks of maintenance therapy, and CMV retinitis did not reactivate during 6 months of follow-up. CONCLUSIONS: Oral valganciclovir was clinically effective in the treatment of CMV retinitis in a patient who was treated with anti-cancer chemotherapy for non-Hodgkin lymphoma.
Administration, Oral ; Adult ; Cytomegalovirus ; Cytomegalovirus Retinitis ; Eye ; Follow-Up Studies ; Ganciclovir ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Lymphoma, Non-Hodgkin ; Retinaldehyde ; Retinitis ; Serologic Tests ; Vision, Ocular

PURPOSE: The purpose of this study is to correlate the MR findings with clinical stage and clinical outcome, and to describe the evolutional changes of abnormal MR findings of transverse myelitis. MATERIALS AND METHODS: Medical records and spinal MR images of 23 patients with both clinical and radiological diagnosis of transverse myelitis were retrospectively reviewed. MR findings were correlated with clinical stages including interval between MR imaging and full development of clinical symptoms, and compared with the clinical outcome. RESULTS: Diffuse high signal intensity of the spinal cord on T2-weighted image with mild cord bulging (67%) and focal contrast enhancement of the cord (75%) were observed within the first four weeks after full development of clinical symptoms. The findings decreased in extent or vanished later than four weeks on either initial or follow-up MR images. Most patients with either cord atrophy or focal hemorrhagewithin the cord lesion had poor clinical outcome. CONCLUSION: The MR findings of transverse myelitis are nonspecific, which may be seen in a variety of diseases. Serial MRIs, especially follow up examination over at least one month after full development of clinical symptoms are useful in the diagnosis of transverse myelitis and predicting its prognosis.
Atrophy ; Diagnosis ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Myelitis, Transverse* ; Prognosis ; Retrospective Studies ; Spinal Cord

OBJECTIVE: The resistance mechanisms of tumor cells to chemotherapeutic drugs are known as the followings; the alterations in the drug transport and activation, the enhanced expression of the DNA repair and replication and the decreased apoptosis. The aim of this study is to examine a relative difference on the level of the mRNA expression of the multidrug resistance (MDR)-related and the apoptosis-associated genes between cisplastin-sensitive and cisplatin-resistant human ovarian cancer cell line. METHODS: MDR-associated genes (lrp, mdr1/p-glycoprotein, mrp) and PKC isozymes (alpha, beta1, beta2, epsilon, eta, theta), DNA mismatch repair (MMR) genes (hMLH1, hMSH2, hMSH3, hMSH6), DNA topology-related genes (topoisomerase IIalpha and beta) and apoptosis-related genes (p53, p21, mdm2, fas (Apo-1), trail (Apo-2L) were analyzed in cisplatin-sensitive ovarian cancer cell line A2780 and -resistant cell line A2780cp by complementary DNA polymerase chain reaction. RESULTS: The mdr1 and PKC eta in mRNA level were expressed in A2780cp, but not in A2780. The mRNA expressions of lrp, p21 and mdm2 were more increased in A2780cp than drug sensitive variant A2780, but not significantly correlated. In contrast mRNA expression of hMLH1, a kind of DNA MMR gene, was remarkably decreased and mRNA expression of hMSH2 was slightly decrease in A2780cp. However, the levels of mrp, topo II alpha and beta, hMSH3, hMSH6, p53, fas and trail were not affected. CONCLUSION: These results showed that mdr1/p-gp expression may be an important determinant of MDR phenotype in resistant cell line to chemotherapeutic agents, and PKC isozymes and DNA MMR genes may be responsible for cisplatin resistant in ovarian cancer.
Apoptosis* ; Cell Line* ; Cisplatin* ; DNA ; DNA Mismatch Repair ; DNA Repair ; DNA, Complementary ; Drug Resistance, Multiple* ; Humans* ; Isoenzymes ; Ovarian Neoplasms* ; Phenotype ; Polymerase Chain Reaction ; RNA, Messenger

OBJECTIVE: The objectives of this study were to evaluate the reliability of the Korean version of Spinal Cord Independence Measure (SCIM) and to compare the sensitivity of the SCIM to functional changes of spinal cord injury (SCI) patients with that of the Functional Independence Measure (FIM). METHOD: Seventeen subjects with SCI were studied. The SCIM was translated and modified to convert as SCIM Korean-version. All patients were evaluated with the SCIM and the FIM by two raters every other week. To determine inter-rater reliability, the relationship between the SCIM scores obtained by two raters was evaluated by Kappa coefficient and linear regression. To determine relative sensitivity of the test to functional changes, changes in the scores on the SCIM and FIM were compared by McNemar test. RESULTS: The Kappa coefficient of the various individual tasks in SCIM ranged between 0.63 and 1.00. High correlations were also found between the total SCIM scores for the paired raters (r=0.99, p<0.01). The SCIM detected all the functional changes detected by FIM total scoring, but in 3 (14%) of 22 sequential test batteries, the FIM missed changes detected by SCIM total scoring. CONCLUSION: These results demonstrated that the SCIM is reliable and more sensitive than the FIM in reflecting the functional changes of SCI patients.
Humans ; Linear Models ; Spinal Cord Injuries* ; Spinal Cord*

OBJECTIVE: To evaluate the effect of methylphenidate on cognitive function especially on working memory and visuospatial attention in the patients with traumatic brain injury (TBI). METHOD: Eighteen subjects, 16 males and 2 females, with TBI were enrolled. Their mean age was 34.2 years old. A double-blind placebo-controlled study was designed. The baseline cognitive assessment was performed before the administration of drug. Two days after the baseline study, 20 mg of methylphenidate or placebo was administered. The second cognitive assessment was performed 2 hours after the treatment. The follow-up assessment conducted two days after the second test. Cognitive assessments consisted of 'one-back working memory task' and 'endogenous visuospatial attention task', designed using SuperLab Pro 2.0 software. RESULTS: In one-back working memory test, there was significant improvement of response accuracy in methylphenidate group in comparison with placebo group (p<0.01). Significant shortening of reaction time was also seen after the administration of drug in methylphenidate group (p<0.05). In endogenous visuospatial attention test, significant improvement of response accuracy was noticed after the administration of drug in methylphenidate group (p<0.05). CONCLUSION: These results demonstrated that the administration of methylphenidate was beneficial in improving cognitive function following TBI. The effect was prominent in the accuracy of working memory.
Brain Injuries* ; Brain* ; Female ; Follow-Up Studies ; Humans ; Male ; Memory, Short-Term ; Methylphenidate* ; Reaction Time

Remarkable developments in immuno-oncology have changed the landscape of gastric cancer (GC) treatment. Because immunotherapy intervenes with tumor immune response rather than directly targeting tumor cells, it is important to develop a greater understanding of tumor immunity. This review paper summarizes the tumor immune reaction and immune escape mechanisms while focusing on the role of T cells and their co-inhibitory signals, such as the immune checkpoint molecules programmed death-1 and programmed deathligand 1 (PD-L1). This paper also describes past clinical trials of immunotherapy for patients with GC and details their clinical implications. Strong predictive markers are essential to improve response to immunotherapy. Microsatellite instability, Epstein-Barr virus, PD-L1 expression, and tumor mutational burden are now regarded as potent predictive markers for immunotherapy in patients with GC. Novel immunotherapy and combination therapy targeting new immune checkpoint molecules such as lymphocyte-activation gene 3, T cell immunoglobulin, and mucin domain containing-3, and indoleamine 2,3-dioxygenase have been suggested, and trials are ongoing to evaluate their safety and efficacy. Immunotherapy is an important treatment option for patients with GC and has great potential for improving patient outcome, and further research in immuno-oncology should be carried out.

PURPOSE: To report a case of penetrating keratoplasty and cataract surgery for improving visual acuity in an adult with Peters' anomaly. CASE SUMMARY: A 70-year-old female patient presented with decreased visual acuity for a few years. The patient had a history of Peters' anomaly in both eyes and evisceration surgery of the right eye 4 years prior to presentation. The patient's visual acuity was measured as finger count 20 cm at the time of visitation due to Peters' anomaly and brunescent cataract. In the slit lamp examination, irregular margin corneal opacity with anterior synechiae was observed in the center of the cornea, while the peripheral cornea was relatively normal. Penetrating keratoplasty and cataract surgery were performed, and visual acuity improved by 0.04 at 1 week, 0.04 at 1 month, and 0.16 at 4 months after surgery. Visual acuity was measured using a Snellen chart, and the intraocular pressure was maintained within the normal range of 17-20 mmHg. CONCLUSIONS: If peripheral corneal invasion is not severe in adults with Peters' anomaly, penetrating keratoplasty and cataract surgery can be performed for the purpose of improving visual acuity.
Adult ; Aged ; Cataract* ; Cornea ; Corneal Opacity ; Female ; Fingers ; Humans ; Intraocular Pressure ; Keratoplasty, Penetrating* ; Reference Values ; Slit Lamp ; Visual Acuity*