Merkel Cell Carcinoma of Eyelid: A Rare Clinical Presentation and Diagnostic Challenge

The purpose of this paper is to report a case of rare localised (limited to eyelid) malignant eyelid tumor in a 70 year old Indian male. Histopathology confirmed it to be a Merkel cell carcinoma. Surgical excision and eyelid reconstruction was done successfully. No local or systemic recurrence has been noted at a follow up of 2 years. The well defined nature of a highly malignant tumor, its localised presentation and management is being described in following report.

Evaluation of antioxidants and argpyrimidine in normal and cataractous lenses in north Indian population

AIM： To assess the level of glutathione, thioltransferase, and argpyrimidine in nuclear and cortical cataractous lenses as well as in the clear lenses in the north Indian population.METHODS： Human cataractous lenses were collected from the patients who underwent extracapsular cataract extraction surgery; clear lenses were collected from the freshly donated eye bank eyes. Antioxidant molecules such as glutathione and thioltransferase enzyme activity were measured; simultaneously in these lenses a blue fluorophore argpyrimidine, an advanced glycation end（AGE） product level was assessed using high performance liquid chromatography（HPLC）.RESULTS： The protein concentration was found to be present at higher levels in the control lenses compared to cataract lenses. A significant decrease in the glutathione level was observed in the nuclear cataractous lenses compared to cortical cataractous（P=0.004） and clear lenses（P≤0.005）, but no significant change in the level of antioxidant enzyme thioltransferase was observed. Further, argpyrimidine a blue fluorophore（AGE） was found to be significantly higher in the nuclear cataract（P=0.013） compared to cortical cataract lenses.CONCLUSION： Antioxidants such as glutathione significantly decrease in age-related nuclear and cortical cataract and an AGE, argpyrimidine are present at significantly higher levels in nuclear cataract.

Large Anterior Mediastinal Mass: Intraoperative Transesophageal Echocardiography Guided Evaluation and Management

The authors report a case of Large Anterior mediastinal mass in which Transoesophageal Echocardiography (TEE) revealed a large mass that was compressing the right atrium, SVC, henceforth, TEE helped in guiding aspiration and surgical resection of the cystic mass. Therefore, through this case report, authors emphasize the importance of performing intraoperative real-time TEE in the mediastinal mass. This imaging technique helps in visualizing the external compression of cardio-vascular structure and aid in their management, obviating the possibility of large vascular structures from being injured by the surgeon during intraoperative manipulation.

穿透性角膜移植术治疗感染性角膜炎的疗效

BACKGROUND AND OBJECTIVE: To study the outcome of therapeutic penetrating kera toplasty in eyes with microbial keratitis. PATIENTS AND METHODS: A prospective d atabase on 134 therapeutic cornea transplants in 134 patients recorded demograph ic details on age and gender of the patient, indication for surgery, size of the donor and recipient bed, graft clarity, complications, and residualmorbidity. P atients included in this analysis had a minimum follow-up of 1 year. All patien ts underwent therapeutic penetrating keratoplasty by a similar method that invol ved a donor button that was oversized by 0.5 mm and 16 bites of interrupted sutu res. RESULTS: Most of the 134 ulcers needing therapeutic grafts were bacterial ( n=54) or fungal (n=54). One hundred eighteen eyes had perforation at presentatio n. One hundred six (90%) of the therapeutic grafts achieved anatomical success. The most common complication of glaucoma occurred in 22%of eyes with presurgic al perforated ulcers and 1%of nonperforated ulcers. Persistent epithelial defec ts were significantly more frequent in grafts of 9 mm or more (P=.05). CONCLUSIO NS: Our results con-firm that therapeutic penetrating keratoplasty for infectio ns is successful in restoring anatomic integrity in most eyes.