Iris Metastasis of Non-small-cell Lung Cancer Confirmed via Aqueous Humor Cytology

Purpose@#To report an iris metastasis associated with non-small-cell lung cancer (NLC) confirmed via repeat aqueous humor cytology.Case summary: A 53-year-old female presented to our ophthalmology outpatient department with complaints of vision impairment and pain in the left eye 1 month in duration. In ophthalmologic examinations, the best-corrected visual acuities were 20/20 oculus dexter (OD) and 20/32 oculus sinister (OS). The intraocular pressures measured using standard Goldmann applanation tonometery were 12 mmHg OD and 42 mmHg OS. Slit-lamp examination revealed multiple iris nodules in the left eye. Thirteen months prior, the patient had been diagnosed with NLC and was on chemotherapy. Despite the maximal tolerated medical therapy, the intraocular pressure was not controlled. As an iris metastasis was suspected, anterior chamber paracentesis was performed for aqueous humor sampling. Cytological analysis did not reveal malignant cells. One week later, aqueous humor sampling was repeated. Malignant cells were histopathologically confirmed. Given the ocular metastasis, the oncologists changed the chemotherapy regimen. @*Conclusions@#When an NLC patient exhibits iris nodules, repeat aqueous humor cytology can confirm an iris metastasis.

Filtering Bleb Size in the Early Postoperative Period Affects the Long-term Surgical Outcome after Trabeculectomy

Purpose@#To investigate whether postoperative filtering bleb size affects the surgical outcome after trabeculectomy. @*Methods@#In this study, we retrospectively reviewed 145 medically uncontrolled glaucoma patients with intraocular pressure (IOP) values >21 mmHg before surgery and data from ≥2 years of follow-up. Postoperative IOP, filtering bleb size including extent and height, and other clinical factors were measured after trabeculectomy. We divided bleb extent into quadrants and bleb height by 0.5 intervals of corneal thickness. The main outcome measure was surgical success. We confirmed complete success when the IOP was ≤21 mmHg and decreased by >20% from baseline without medication or additional procedures. Qualified success used the same criteria but allowed for medication or additional procedures. Cases with reoperation or two consecutive IOP measurements <6 mmHg were considered failures. @*Results@#A total of 145 eyes of 145 patients was included. The average observation period was 30.8 ± 10.9 months. During multivariate Cox regression analysis, a larger extent of filtering bleb revealed significantly low hazard ratios in both complete and surgical success (0.509 and 0.494, respectively); however, there was no significant relationship between bleb height and surgical outcome. @*Conclusions@#The extent of the filtering bleb was associated with surgical outcomes of trabeculectomy in glaucoma patients.

Effect of Cyclosporine A-induced Senescence on Cultured Human Corneal Endothelial Cells

Purpose@#To investigate the in vitro effect of cyclosporine A (CsA)-induced senescence on human corneal endothelial cells (HCECs). @*Methods@#HCECs were cultured and incubated with 0-100 µM CsA. Senescence-associated β–galactosidase (SA-β-gal) staining was performed. Mitochondrial dehydrogenase activity was assessed using a WST-8 assay kit and mitochondrial membrane potential (∆Ψ m ) was measured using JC-1 dye. Intracellular and mitochondrial formation of reactive oxygen species (ROS) was measured with 2’,7’-dichlorodihydrofluorescein diacetate and MitoSOX probes. Intracellular and mitochondrial calcium levels were measured using Fluo-4 and Rhod-2, respectively. Protein expression was evaluated by Western blotting. @*Results@#CsA increased the percentage of SA-β-gal-positive cells (p = 0.003) and decreased mitochondrial dehydrogenase activity and ∆Ψ m in a dose-dependent manner (p = 0.029, pp = 0.004). Intracellular and mitochondrial ROS levels increased during incubation with CsA (p = 0.005). CsA at 100 µM increased mitochondrial calcium levels (p = 0.001), whereas intracellular calcium levels decreased at 100 µM CsA (p = 0.029). CsA activated GSK3β and ERK1/2 and reduced ZO-1 expression. @*Conclusions@#CsA induces senescence in HCECs through oxidative stress and via mitochondria-, GSK3β-, and ERK1/2-dependent pathways. Thus, concentrations of CsA should be monitored.

Predictors of Nursing Service Need for Nursing Homes Residents

PURPOSE: The purposes of this study were to explore the functional status of elderly residents and to analyze time use, and finally identify factors to predict nursing care needs in relation to functional status and health related variables. METHODS: In this study a descriptive-correlational design was used. Functional status of participants was obtained through interviews, and nursing care time was examined using a 1 min time-motion study with a standardized instrument developed by Korea Long-Term Care Planning Committee (2005). RESULTS: The mean total functional score was 65 (range 28-125) and mean total nursing care time was 144.15 min per day. There were significant positive relationships between total nursing care time, marital status, back pain, dementia, and vision impairment. Multiple regression analyses showed that a liner combination of number of illnesses, types of primary disease, ADL, IADL, cognitive function, nursing demand, and rehabilitation demand explained 42.8% of variance of total nursing time. ADL (beta=-.533) was the most significant predictor of nursing service need. CONCLUSION: Identifying factors that result in variations of service need has implications for adequate nursing service, estimation of optimum nurse to patient ratio, quality of care and patient safety.

The effects of BMP4 and BMP2 on Expression of Trophoblast-Specific Genes in Human Embryonic Stem Cells using SNU-hES3 cell line / 대한산부인과학회지

OBJECTIVE: Human embryonic stem cell derived from blastocyst randomly differentiates into multiple cell types during embryoid body development. Bone morphogenetic proteins (BMPs) are members of the transforming growth factor type beta superfamily. We have a question whether BMP2 and/or BMP4 can induce trophoblast specific genes in human ES cells using SNU hES3 cell line. METHODS: Human embryonic stem cell line (SNU hES3) was supplied by Miz Medi Hospital Seoul National University. Cultured hES cells were divided into small clumps and then allow for EB formation in differentiation medium. After EB formation, EBs were transferred onto gelatin coated dishes and given hES conditioned medium alone (control) or supplemented as following treatment for 6 days; rhBMP4 100 ng/mL; rhBMP2 100 ng/mL; BMP4 100 ng/mL +BMP2 100 ng/mL. RT PCR was performed for trophoblast specific genes. During culture, supernatant was collected and measured for estradiol (E2), progesterone, and hCG beta by enzymeimmuno assay (EIA) kit. RESULTS: BMP4 and BMP2 increase chorionic gonadotropin beta (hCG beta), glical cell missing 1 (GMC1), and CD9 as trophoblast specific gene markers confirmed by RT PCR. However, the non classical HLA class I molecule HLAG1, was not expressed in our studies. And we cannot find significant differences of the level of estradiol, hCG nd progesterone in this study. CONCLUSION: The results suggest that BMP 4 and 2 have an additive effect on induction of trophoblast related genes in SNU hES3 cell line. Although we failed to induce the differentiation of human ES cells to trophoblast, this study could provide the possibility for the differentiation of early human trophoblast cells and thus need further studies.