The effects of Syzygium aromaticum L. administration on lipid and muscle metabolism in obese rats subjected to moderate-intensity exercise / 한국영양학회지

Purpose@#This study examined whether regular moderate-intensity treadmill exercise (Ex) and Syzygium aromaticum L. (SA) administration can influence lipid and muscle metabolism in obese rats induced by a 60% high-fat diet (HFD). @*Methods@#Rats, except those in the Normal group, were exposed to a 60% HFD for 4 weeks to induce obesity. The obese rats were assigned randomly to three groups: HFD control group, HFD+Ex group, and HFD+Ex+SA group. Treadmill exercise was conducted five times a week for 4 weeks, with a 5° incline and a speed of 18 m/min (Week 1: 20 minutes; Weeks 2: 25 minutes; Weeks 3–4: 30 minutes). Serum analysis was performed. Western blot analysis was conducted on the liver and soleus muscle, and histopathological analysis was carried out on the liver and adipose tissues. @*Results@#The body weight change in the Ex groups was significantly lower than in the HFD control group, while the soleus muscle weight in the HFD+Ex group increased significantly.The histopathological examination in the Ex groups revealed a marked reduction in liver lipid accumulation and a decrease in adipocyte size in adipose tissue. Obesity induction increased leptin levels substantially, but Ex notably reversed these changes. Ex resulted in significant inhibition of ROS and ONOO− , whereas the serum inflammatory cytokine, IL-1β, and total cholesterol were reduced only by SA administration. Furthermore, the inflammatory proteins in the liver were inhibited more effectively when Ex was supplemented with SA.The expression of the muscle synthesis-related proteins and degradation proteins were modulated by Ex and Ex+SA. @*Conclusion@#Ex significantly affected lipid and muscle metabolism, and adding SA alleviated the inflammation.

Colletotrichum Jasminigenum-induced Infectious Sclerokeratitis: A Case Report

Purpose@#We present a case of Colletotrichum jasminigenum (C. jasminigenum)-induced Infectious sclerokeratitis.Case summary: An 81-year-old patient presented to our hospital with left eye pain and decreased vision that had started 7 days prior. He had a history of left eye pterygium excision a decade earlier. Examination using a slit lamp revealed a nasal conjunctival defect, scleral melting, deep stromal infiltration with a feathery margin, and hypopyon. Considering the suspicion of fungal sclerokeratitis, we performed a smear analysis and potassium hydroxide (KOH) and culture testing. The KOH test revealed hyphae, leading to systemic fluconazole and topical fluconazole and natamycin. Subsequently, we performed surgery, including debridement of the necrotic scleral area, conjunctival rotation and scleral grafting, and anterior chamber irrigation with intracameral and intravitreal voriconazole injections, due to progressive corneal infiltration and scleral melting. Additionally, we switched to using systemic and topical voriconazole. The culture yielded fungi, with DNA sequencing confirming C. jasminigenum as the causative agent. Following treatment, the lesion improved, and no signs of recurrence were observed. @*Conclusions@#Voriconazole is an effective treatment for C. jasminigenum-induced fungal sclerokeratitis.

Trichofolliculoma in the Medial Canthal Area

Purpose@#We report a case of trichofolliculoma located in the medial canthal area that was initially clinically suspected to be basal cell carcinoma.Case summary: A 93-year-old female patient presented to our hospital with a 1.2 × 1.4 cm mass in the right medial canthal area that had been present for 8 months. She had experienced continuous bleeding-like secretions during this time, leading to suspicion of basal cell carcinoma due to the absence of hair and a painless central ulcer lesion. Excision and biopsy were performed; the biopsy results revealed trichofolliculoma. The patient underwent complete resection and has remained recurrence-free for 6 months with regular follow-up observations. @*Conclusions@#Trichofolliculoma is a rare follicular hamartoma characterized by a nodule with dilated pores and dense hair in the center. Given its clinical similarity to benign and malignant tumors, such as basal cell carcinoma and squamous cell carcinoma, it is essential to differentiate this condition through excision and biopsy.

Epidemiology and Clinical Features Analysis of Orbital and Adnexal Lymphoma in the Western Area of Gyeongsangnam-do

Purpose@#We compared the epidemiology and clinical features of patients with orbital and adnexal lymphoma in western Gyeongsangnam-do with those reported previously, domestically and internationally. @*Methods@#Of the 25 patients diagnosed with lymphoproliferative disorder, a retrospective analysis was conducted on 21 patients with orbital and adnexal lymphoma between January 2010 and December 2021. @*Results@#In total, 21 patients were diagnosed with orbital and adnexal lymphoma, with an average annual incidence rate of 0.18 per 100,000 people, exceeding the national average in Korea. The median age of the patients was 57 years and the ratio of 1.1 to 1. The most common presenting symptoms included proptosis, conjunctival mass, conjunctival injection, eyelid swelling and epiphora. Primary and metastatic lesions accounted for 85.7% and 14.3% of cases, respectively. Histologically, the most common subtype was extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (90.4%). Furthermore, diffuse large B-cell lymphoma and NK/T-cell lymphoma of T-cell origin each accounted for 4.8% of cases. @*Conclusions@#The reported incidence rate in the present study exceeded the national average in Korea. However, no significant differences were observed in clinical symptoms, primary and metastatic lesions, histological classification, or post-treatment effects compared to findings from domestic and international studies.

A novel IRAK4/PIM1 inhibitor ameliorates rheumatoid arthritis and lymphoid malignancy by blocking the TLR/MYD88-mediated NF-κB pathway

Interleukin-1 receptor-associated kinase 4 (IRAK4) is a pivotal enzyme in the Toll-like receptor (TLR)/MYD88 dependent signaling pathway, which is highly activated in rheumatoid arthritis tissues and activated B cell-like diffuse large B-cell lymphoma (ABC-DLBCL). Inflammatory responses followed by IRAK4 activation promote B-cell proliferation and aggressiveness of lymphoma. Moreover, proviral integration site for Moloney murine leukemia virus 1 (PIM1) functions as an anti-apoptotic kinase in propagation of ABC-DLBCL with ibrutinib resistance. We developed a dual IRAK4/PIM1 inhibitor KIC-0101 that potently suppresses the NF-κB pathway and proinflammatory cytokine induction in vitro and in vivo. In rheumatoid arthritis mouse models, treatment with KIC-0101 significantly ameliorated cartilage damage and inflammation. KIC-0101 inhibited the nuclear translocation of NF-κB and activation of JAK/STAT pathway in ABC-DLBCLs. In addition, KIC-0101 exhibited an anti-tumor effect on ibrutinib-resistant cells by synergistic dual suppression of TLR/MYD88-mediated NF-κB pathway and PIM1 kinase. Our results suggest that KIC-0101 is a promising drug candidate for autoimmune diseases and ibrutinib-resistant B-cell lymphomas.

Squamous Cell Carcinoma in the Lacrimal Sac of Young Patient Who Had Conjunctival Squamous Papilloma

Purpose@#To report a squamous cell carcinoma in the lacrimal sac of a young patient.Case summary: A 30-year-old female patient who had a history of conjunctival squamous papilloma resected at 15 years of age complained of pain and a mass around the right lacrimal sac that had occurred 1 week prior. Antibiotic treatment for 10 days under suspicion of dacryocystitis did not relieve her symptoms. After being diagnosed with lacrimal sac obstruction after dacryocystography, a 1.7 × 1.7 cm round mass was found on orbit non-contrast computed tomography. Endonasal dacryocystorhinostomy and excisional biopsy were performed. Histopathological examination revealed the initial invasive squamous cell carcinoma. An additional resected tissue biopsy was performed later. The mass diagnosed as carcinoma was completely resected and it was confirmed that there were no malignant cells around the resected area. @*Conclusions@#Squamous cell carcinoma of the lacrimal sac is rare and is known to be less common in young patients. It is believed that this case should not exclude the possibility of malignant tumors of the lacrimal sac regardless of age. Given that squamous cell carcinoma of the lacrimal sac is associated with a high-risk of human papillomavirus, this disease should be considered if there is a history of papilloma.

Endophthalmitis and Retinal Detachment after Ocular Injury by Animal Inoculation Needle

Purpose@#To report a case of endophthalmitis and retinal detachment after injury caused by an animal inoculation needle. Case summary: A 39-year-old man received an injury to his left eye with an animal inoculation needle while vaccinating a pig came to the hospital due to decreased visual acuity. At initial presentation, the best-corrected visual acuity in the left eye was “counting fingers,” and slit lamp examination revealed corneal lacerations, anterior capsule rupture, and traumatic cataract. Ultrasonography showed no specific findings in the vitreous and retina. Primary corneal suture, phacoemulsification, anterior vitrectomy due to rupture of the posterior capsule and vitreous prolapse, intraocular lens implantation, and intravitreal antibiotic injection were performed. On day 1 postoperatively, vitrectomy, anterior chamber irrigation, intravitreal antibiotic injection, and silicone oil injection were performed as signs of endophthalmitis, such as hypopyon and retinal tear, and focal retinal detachment were observed during surgery. Silicone oil removal was performed 7 months after the operation and the best-corrected visual acuity was 0.6. There has been no recurrence during follow-up. @*Conclusions@#This is the first report in Korea of ocular injury caused by an animal inoculation needle. If the fundus is not observed in such injuries, there is a possibility of endophthalmitis and retinal detachment and early vitrectomy should be considered.

Squamous Cell Carcinoma in the Lacrimal Sac of Young Patient Who Had Conjunctival Squamous Papilloma

Purpose@#To report a squamous cell carcinoma in the lacrimal sac of a young patient.Case summary: A 30-year-old female patient who had a history of conjunctival squamous papilloma resected at 15 years of age complained of pain and a mass around the right lacrimal sac that had occurred 1 week prior. Antibiotic treatment for 10 days under suspicion of dacryocystitis did not relieve her symptoms. After being diagnosed with lacrimal sac obstruction after dacryocystography, a 1.7 × 1.7 cm round mass was found on orbit non-contrast computed tomography. Endonasal dacryocystorhinostomy and excisional biopsy were performed. Histopathological examination revealed the initial invasive squamous cell carcinoma. An additional resected tissue biopsy was performed later. The mass diagnosed as carcinoma was completely resected and it was confirmed that there were no malignant cells around the resected area. @*Conclusions@#Squamous cell carcinoma of the lacrimal sac is rare and is known to be less common in young patients. It is believed that this case should not exclude the possibility of malignant tumors of the lacrimal sac regardless of age. Given that squamous cell carcinoma of the lacrimal sac is associated with a high-risk of human papillomavirus, this disease should be considered if there is a history of papilloma.

Endophthalmitis and Retinal Detachment after Ocular Injury by Animal Inoculation Needle

Purpose@#To report a case of endophthalmitis and retinal detachment after injury caused by an animal inoculation needle. Case summary: A 39-year-old man received an injury to his left eye with an animal inoculation needle while vaccinating a pig came to the hospital due to decreased visual acuity. At initial presentation, the best-corrected visual acuity in the left eye was “counting fingers,” and slit lamp examination revealed corneal lacerations, anterior capsule rupture, and traumatic cataract. Ultrasonography showed no specific findings in the vitreous and retina. Primary corneal suture, phacoemulsification, anterior vitrectomy due to rupture of the posterior capsule and vitreous prolapse, intraocular lens implantation, and intravitreal antibiotic injection were performed. On day 1 postoperatively, vitrectomy, anterior chamber irrigation, intravitreal antibiotic injection, and silicone oil injection were performed as signs of endophthalmitis, such as hypopyon and retinal tear, and focal retinal detachment were observed during surgery. Silicone oil removal was performed 7 months after the operation and the best-corrected visual acuity was 0.6. There has been no recurrence during follow-up. @*Conclusions@#This is the first report in Korea of ocular injury caused by an animal inoculation needle. If the fundus is not observed in such injuries, there is a possibility of endophthalmitis and retinal detachment and early vitrectomy should be considered.

Microvasculature and Nerve Fiber Layer-Ganglion Cell Inner Plexiform Layer Thickness in Type 2 Diabetes

Purpose@#To investigate thickness of the nerve fiber layer-ganglion cell inner plexiform layer (NFL-GCIPL) complex and vessel density of the superficial and deep retinal vessels and choriocapillaris using swept source optical coherence tomography (SS-OCT) and angiography (OCTA) in type 2 diabetic patients without diabetic retinopathy (DR). @*Methods@#Sixty-four eyes of type 2 diabetic patients without DR were included. A control group of 54 eyes without diabetes was also recruited. All patients underwent multimodal imaging evaluation using SS-OCT and OCTA. @*Results@#Vessel density of the superficial and deep retinal vessels was not different between the study and control groups. A significant decrease in NFL-GCIPL complex thickness was observed in the study group compared to the control group. NFL-GCIPL thickness of the macula decreased with increased duration of diabetes. @*Conclusions@#These results suggest that neurodegeneration might be an early change in the development of DR.

Microvasculature and Nerve Fiber Layer-Ganglion Cell Inner Plexiform Layer Thickness in Type 2 Diabetes

Purpose@#To investigate thickness of the nerve fiber layer-ganglion cell inner plexiform layer (NFL-GCIPL) complex and vessel density of the superficial and deep retinal vessels and choriocapillaris using swept source optical coherence tomography (SS-OCT) and angiography (OCTA) in type 2 diabetic patients without diabetic retinopathy (DR). @*Methods@#Sixty-four eyes of type 2 diabetic patients without DR were included. A control group of 54 eyes without diabetes was also recruited. All patients underwent multimodal imaging evaluation using SS-OCT and OCTA. @*Results@#Vessel density of the superficial and deep retinal vessels was not different between the study and control groups. A significant decrease in NFL-GCIPL complex thickness was observed in the study group compared to the control group. NFL-GCIPL thickness of the macula decreased with increased duration of diabetes. @*Conclusions@#These results suggest that neurodegeneration might be an early change in the development of DR.

A Fungal Corneal Ulcer Caused by Talaromyces allahabadensis

Purpose@#Here, we report a case of a fungal corneal ulcer caused by Talaromyces allahabadensis (T. allahabadensis).Case summary: A 69-year-old male was admitted to our hospital with pain and hyperemia in his left eye after 2 months of treatmentat a local clinic for herpetic keratitis. The patient had a previous history of trauma to his left eye caused by a persimmon treebranch. He had a peripheral epithelial defect, stromal infiltration, and severe corneal edema in his left eye. Gram staining, a KOHsmear, and a culture were performed using corneal specimens; the results were all negative. With the assumption of herpetickeratitis, antiviral and empirical antibiotic treatments were started. After 2 weeks, the stromal infiltrations on his left eye increased,so we again conducted staining and culture studies. T. allahabadensis was isolated from a specimen, so treatment wasstarted using antifungal agents, and a conjunctival flap graft was performed due to the risk of a corneal perforation. @*Conclusions@#A case of corneal ulcer caused by T. allahabadensis in a patient with posttraumatic herpetic keratitis was successfullytreated with antifungal agents and conjunctival flap surgery.

Stromal Keratitis in a Patient with Congenital Hypogammaglobulinemia

Purpose@#We report a case of stromal keratitis in a patient with congenital hypogammaglobulinemia.Case summary: A 15-year-old boy presented with decreased visual acuity in the right eye. He had been diagnosed with congenital hypogammaglobulinemia at about 16 months of age and had received regular doses of intravenous immunoglobulin. The best-corrected visual acuity of the right eye was 0.02 and the intraocular pressure 11 mmHg. On anterior segment examination, thinning combined with stromal infiltration of the paracentral cornea was evident, but no epithelial defect was apparent. We scheduled detailed systemic examinations and laboratory investigations to rule out infectious keratitis. His serum immunoglubulin G (IgG) level was 328.9 mg/dL, thus less than that 3 months priorly (434.8 mg/dL). The lesion did not improve after prescription of topical antibiotics and steroid. The serum IgG level gradually increased to 394.4 mg/dL after immunoglobulin administration, and the corneal infiltration gradually decreased. After 5 months of treatment, the serum IgG levels ranged between 480 and 530 mg/dL; we noted no recurrence or worsening of the corneal lesion. @*Conclusions@#We report a case of stromal keratitis in a patient with congenital hypogammaglobulinemia; we prescribed intravenous immunoglobulin.

Genes Expressed in Steroid-exposed Lens Epithelial Cells as Revealed by Polymerase Chain Reaction

Purpose@#We investigated the expression levels of 84 genes in dexamethasone-exposed human lens epithelial cells using polymerase chain reaction (PCR) array analysis. @*Methods@#The viability and motility of lens epithelial cells were examined after treatment with dexamethasone at 0.01, 0.1, and 1 mg/mL; Western blot was used to evaluate the expression levels of fibronectin, α-smooth muscle actin (α-SMA), and E-cadherin. After 24, 48, and 72 hours of dexamethasone treatment at 0.1 mg/mL, the expression levels of 84 growth factors were analyzed using PCR array. @*Results@#Cell viability did not change significantly at dexamethasone levels of 0.01 or 0.1 mg/mL, but decreased markedly at 1 mg/mL; motility increased in a concentration-dependent manner at 0.01 and 0.1 mg/mL. Western blot showed that fibronectin levels increased significantly at all dexamethasone concentrations tested; the α-SMA level increased only at 0.01 mg/mL, and E-cadherin levels decreased significantly at all tested concentrations. PCR showed that the levels of FGF1, FGF2, IL-11, regulators of apoptosis (GDNF, IL-1β, and NRG2), and regulators of cell differentiation (BMP5, FGF1, FGF2, and FGF5) decreased more than twofold, whereas the levels of FGF9 and FGF19 increased more than twofold. @*Conclusions@#PCR performed after exposure of lens epithelial cells to dexamethasone may identify the genes involved in the development of steroid-induced cataracts.

Changes of Anterior Chamber Depth and Refractive Error after Phacovitrectomy with and without Posterior Capsulotomy

Purpose@#To compare the effect on changes in anterior chamber depth (ACD) and refractive error between subjects after combined phacovitrectomy with posterior capsulotomy using a vitrectomy probe and control subjects after combined phacovitrectomy without posterior capsulotomy. @*Methods@#A total of 20 eyes of 20 subjects who underwent combined phacovitrectomy with posterior capsulotomy using a vitrectomy probe were compared with 20 eyes of 20 control subjects who underwent only phacovitrectomy without posterior capsulotomy. The ACD was measured with Scheimpflug imaging (Pentacam ® ; OCULUS Optikgeräte GmbH, Wetzlar, Germany) before and after surgery. Also the preoperative desired refraction and postoperative refraction were compared using an auto keratorefractometor. @*Results@#The preoperative ACD of subjects with posterior capsulotomy was 2.56 ± 0.233 mm. The ACD was 3.54 ± 0.366 mm and 3.71 ± 0.424 mm at one and three months after surgery in subjects with posterior capsulotomy. The preoperative ACD of subjects without posterior capsulotomy was 2.53 ± 0.204 mm. The ACD was 3.09 ± 0.197 mm and 2.95 ± 0.295 mm at one and three months after surgery in subjects without posterior capsulotomy. There was no significant difference between the two groups in preoperative ACD, but ACD at one and three months after surgery was significantly different between the two groups.The desired refractory error was -0.32 ± 0.124 D in subjects with posterior capsulotomy, and -0.33 ± 0.142 D in the control group.The postoperative refraction was -0.62 ± 0.132 D in patients who underwent phacovitrectomy with posterior capsulotomy, and -0.91 ± 0.292 D in the control group. There was a significant difference in refraction three months after the surgery. @*Conclusions@#Combined phacovitrectomy with posterior capsulotomy using a vitrectomy probe may be a useful way to prevent myopic change caused by anterior migration of an intraocular lens compared with control subjects, without posterior capsulotomy, for three months after surgery.

Disorganization of Retinal Inner Layers in Diabetic Macular Edema Treated with a Dexamethasone Implant

Purpose@#To evaluate the correlation between visual acuity (VA) and the disorganization of retinal inner layers (DRIL) after use of an intravitreal dexamethasone implant to treat diabetic macular edema (DME). @*Methods@#The clinical records of 25 patients with DME treated with an intravitreal dexamethasone implant were reviewed. Best corrected visual acuity (BCVA) and spectral domain optical coherence tomography data were analyzed from each visit. @*Results@#The BCVAs at 1 month and 3 months after treatment were statistically significant with respect to the baseline BCVA of DME patients (p = 0.021, p < 0.001, respectively); however no statistically significant change was evident at the 6 months follow-up (p = 0.062). Also, the DRIL degree at 1 month and 3 months after treatment was statistically significant with respect to baseline DRIL (p = 0.034, p < 0.001); however, there was no statistically significant change at 6 months after treatment (p = 0.052). The BCVA at 6 months after treatment was positively and significantly correlated with the baseline BCVA (p < 0.001, R2 = 0.705), CRT (p = 0.032, R2 = 0.308), and DRIL extent (p = 0.024, R2 = 0.201). @*Conclusions@#The BCVA in patients after treatment with an intravitreal dexamethasone implant for DME was related to the change in the CRT after treatment. The baseline BCVA and change in the DRIL may be important indicators for predicting VA improvement in DME.

Disorganization of Retinal Inner Layers in Diabetic Macular Edema Treated with a Dexamethasone Implant

Purpose@#To evaluate the correlation between visual acuity (VA) and the disorganization of retinal inner layers (DRIL) after use of an intravitreal dexamethasone implant to treat diabetic macular edema (DME). @*Methods@#The clinical records of 25 patients with DME treated with an intravitreal dexamethasone implant were reviewed. Best corrected visual acuity (BCVA) and spectral domain optical coherence tomography data were analyzed from each visit. @*Results@#The BCVAs at 1 month and 3 months after treatment were statistically significant with respect to the baseline BCVA of DME patients (p = 0.021, p < 0.001, respectively); however no statistically significant change was evident at the 6 months follow-up (p = 0.062). Also, the DRIL degree at 1 month and 3 months after treatment was statistically significant with respect to baseline DRIL (p = 0.034, p < 0.001); however, there was no statistically significant change at 6 months after treatment (p = 0.052). The BCVA at 6 months after treatment was positively and significantly correlated with the baseline BCVA (p < 0.001, R2 = 0.705), CRT (p = 0.032, R2 = 0.308), and DRIL extent (p = 0.024, R2 = 0.201). @*Conclusions@#The BCVA in patients after treatment with an intravitreal dexamethasone implant for DME was related to the change in the CRT after treatment. The baseline BCVA and change in the DRIL may be important indicators for predicting VA improvement in DME.

Clinical Features and Treatment Outcomes in Patients with Infectious Scleritis

PURPOSE: To investigate risk factors, clinical features, pathogenic organisms, and outcomes in patients with infectious scleritis. METHODS: This study was a retrospective review of 20 patients with infectious scleritis who were admitted from January 2011 to December 2018 in a single tertiary hospital, with at least 3 months of follow-up. We analyzed age, risk factors, clinical manifestations, pathogenic organisms, treatment, and outcomes of infectious scleritis. RESULTS: The mean patient age was 69.2 ± 8.4 years and the mean duration of hospitalization was 11.3 ± 5.8 days. Furthermore, the mean duration of symptoms before presentation was 16.8 ± 13.9 days; patients were followed for a mean duration of 23.3 ± 25.4 months. All patients had prior pterygium surgery. Eighteen patients (90%) were culture-positive and Pseudomonas aeruginosa (P. aeruginosa) was identified in 12 eyes. In the acute stages, adjuvant surgical intervention was performed for 18 patients (90%) for these patients, the mean duration of hospitalization before surgery was 4.1 ± 4.4 days. CONCLUSIONS: The most common risk factor and pathogenic organism for infectious scleritis were prior pterygium surgery and P. aeruginosa, respectively. Identification of specific causative organisms and corresponding antibiotic treatment with adjuvant surgical intervention may improve visual prognosis in patients with infectious scleritis.

Clinical Aspects of Infectious Keratitis in Western Gyeongsangnamdo, Republic of Korea

PURPOSE: We investigated the regional characteristics and trends in causative agents, clinical features, and antibiotic susceptibility in infectious keratitis in western Gyeongnam province. METHODS: This retrospective chart review included 551 eyes of 551 patients with infectious keratitis, who were referred to our center from January 2004 to December 2017. The period of this study was divided into two terms of 7 years before and after 2011 to analyze the changes in causative organisms and antibiotic susceptibilities and to investigate the clinical features and regional characteristics in western Gyeongnam province. RESULTS: The most common occupation among patients was farming; the mean time taken for initial treatment was 8.6 days. The culture positivity rate was 35.8%, the most commonly isolated microorganisms were Staphylococcus epidermidis (14.5%) for Gram-positive bacteria and Pseudomona aeruginosa (13.5%) for Gram-negative bacteria. The distribution of culture-positive organisms before and after 2011 did not show any significant difference, but the increase in resistance to second and third generation quinolones was significantly greater in Gram-positive bacteria after 2011. There was no significant difference in clinical characteristics before and after 2011, but the hospital stay duration and treatment needs were significantly reduced. CONCLUSIONS: This was a large-scale study analyzing the clinical features of infectious keratitis in western Gyeognam province over a 14-year period. The results will help us understand the characteristics, microbiology, and community in infectious keratitis by analyzing patients referred to tertiary centers.

A Case of Orbital Lymph Node Misdiagnosed as a Dermoid

PURPOSE: We report our experience with a case of orbital lymph node which has not been previously reported in the Republic of Korea. CASE SUMMARY: A 24-year-old female patient with no underlying disease visited our hospital with a 2-month history of a mass at the lateral side of the left upper eyelid. On physical examination, a round, well-defined subcutaneous mass was palpable, and pain, swelling or a skin change were not reported or seen. The appearance, location, and imaging findings of the mass were suspected to be dermoid, and excisional biopsy was performed for accurate diagnosis and treatment. The 1.0 × 0.7 cm-sized, round-shaped and brown-colored mass was excised. The mass was well-defined but in the posterior part; it was attached to the periosteum. The mass was finally diagnosed as a lymph node with lymphadenitis by histopathological examination. No recurrence or new lesion was observed after surgery, and the patient did not complain of abnormal symptoms. CONCLUSIONS: A Complete orbital lymphoid tissue has not yet been found in the orbit, and lymph nodes are known to be absent. However, as in this case, when an orbital mass is observed, the possibility of lymph node should be considered and histopathological examination should be performed to confirm it.