Bilateral blepharoptosis in a juvenile.

In adults, aponeurotic blepharoptosis is the most common type of ptosis. However, myogenic ptosis is the predominant cause, and bilateral aponeurotic ptosis is very rare among children. Here, we report a previously healthy 10-year-old Japanese girl with bilateral aponeurotic blepharoptosis who presented initially with bilateral blepharoptosis for about 4years.

Therapeutic potential of human adipose tissue-derived multi-lineage progenitor cells in liver fibrosis.

Introduction: Liver fibrosis is characterized by excessive accumulation of extracellular matrix. In a mouse model of liver fibrosis, systemic injection of bone marrow mesenchymal stem cells (BM-MSCs) was considered to rescue the diseased phenotype. The aim of this study was to assess the effectiveness of human adipose tissue-derived multi-lineage progenitor cells (hADMPCs) in improving liver fibrosis.

Congenital entropion: outcome of posterior layer advancement of lower eyelid retractors and histological study of orbicularis oculi muscle hypertrophy.

Purpose: To examine surgical outcomes of the posterior layer advancement of the lower eyelid retractors (LER) in patients with congenital entropion and to ascertain whether the pretarsal orbicularis oculi muscle (OOM) was hypertrophic or not.

Materials And Methods: This retrospective study included three Japanese patients with congenital entropion who underwent posterior layer advancement of the LER. We reviewed the surgical outcomes and postoperative complications, such as lower eyelid ectropion and retraction for each patient.

Comparison of bony nasolacrimal canal narrowing with or without primary acquired nasolacrimal duct obstruction in a Japanese population.

Purpose: To compare the minimum diameter of the nasolacrimal canal and its location between patients with or without primary acquired nasolacrimal duct obstruction (NLDO) in a Japanese population.

Methods: One hundred one patients with unilateral primary acquired NLDO (Group A, 101 affected sides; Group B, 101 unaffected sides) and 50 non-NLDO patients (Group C, 100 sides) were included. Anteroposterior and transverse diameters were measured at the canal entrance and the shortest point using contiguous 1-mm axial computed tomographic images.

Anatomy of anterior ethmoidal foramen, medial canthal tendon, and lacrimal fossa for transcutaneous anterior ethmoidal nerve block in Japanese individuals.

Purpose: To examine the anatomical relationships of the anterior ethmoidal foramen (AEF), medial canthal tendon (MCT), and lacrimal fossa (LF) in Japanese individuals.

Methods: Thirty-eight orbits from 19 Japanese cadavers (7 men and 12 women; average age at death, 89.3 years) were used in this experimental anatomical study.

Comparison of surgical outcomes between simple posterior layer advancement of lower eyelid retractors and combination with a lateral tarsal strip procedure for involutional entropion in a Japanese population.

Aims: To compare the effectiveness of simple posterior layer advancement of the lower eyelid retractor (LER) and combination surgery of posterior layer advancement of the LER with a lateral tarsal strip procedure for involutional lower eyelid entropion in a Japanese population.

Methods: 46 eyelids of 37 patients with horizontal laxity (Group A) and 47 eyelids of 42 patients without horizontal laxity (Group B) that underwent simple posterior layer advancement of the LER, and 47 eyelids of 37 patients with horizontal laxity that had the combination surgery (Group C) were retrospectively reviewed.

Results: All eyelids were judged as successfully corrected without recurrence in Groups B and C.

Role of notch signaling in the maintenance of human mesenchymal stem cells under hypoxic conditions.

Human adipose tissue-derived multilineage progenitor cells (hADMPCs) are attractive for cell therapy and tissue engineering because of their multipotency and ease of isolation without serial ethical issues. However, their limited in vitro lifespan in culture systems hinders their therapeutic application. Some somatic stem cells, including hADMPCs, are known to be localized in hypoxic regions; thus, hypoxia may be beneficial for ex vivo culture of these stem cells.

Orbital Compartment Syndrome in Eosinophilic Angiocentric Fibrosis.

A 43-year-old man reported right visual loss after biopsy of an intranasal mass, which improved after treatment at another hospital. On first examination at our hospital, his visual acuity was 1.2 OD, and MRI showed a right intraorbital mass involving the ethmoid sinus.

Combination of nasolabial v-y advancement flap and glabellar subcutaneous pedicled flap for reconstruction of medial canthal defect.

A 77-year-old woman presented with a 1-year history of a right medial canthal tumor, which was histopathologically diagnosed as a basal cell carcinoma. After removal of the tumor with a 4-mm safety margin, the defect occupied the areas superior and inferior to the medial canthal tendon. We first reconstructed the lower part of the defect using a nasolabial V-Y advancement flap to make an elliptic defect in the upper part.

Topical rebamipide treatment for superior limbic keratoconjunctivitis in patients with thyroid eye disease.

Purpose: To evaluate efficacy of topical rebamipide for superior limbic keratoconjunctivitis (SLK) in patients with thyroid eye disease.

Design: Retrospective, observational case series.

Methods: Thirty-three eyes from 20 thyroid eye disease patients with SLK who received topical rebamipide (Mucosta ophthalmic suspension unit dose 2%; Otsuka Pharmaceutical Co, Ltd; chemical name, (2RS)-2-(4-chlorobenzoylamino)-3-(2-oxo-1, 2-dihydroquinolin-4-yl) propanoic acid) were included.

Intraocular pressure change with eye positions before and after orbital decompression for thyroid eye disease.

Purpose: To examine intraocular pressure (IOP) changes in primary and upward gazes before and after orbital decompression in patients with thyroid eye disease.

Methods: Seventy-eight orbits of 40 patients who underwent orbital decompression between June 2010 and September 2012 were retrospectively reviewed. Subjects were divided in 2 groups according to the number of orbital walls removed: deep lateral orbital wall decompression group (Group A) or balanced decompression group (Group B).

Reconstruction of a congenital upper eyelid coloboma using a lamellar-based technique.

A 17-year-old woman presented with a left upper eyelid coloboma from birth, extending from the lateral side of the punctum to the center of the eyelid as much as 10 mm in width. The posterior lamella (tarsus) was lost completely in this area, but an anterior lamella defect was limited to 1 to 2 mm in height. The area was devoid of eyelashes.

Anatomy of deep lateral and medial orbital walls: implications in orbital decompression surgery.

Background: Isolated deep lateral and combined medial orbital wall decompressions (balanced decompression) are well accepted for treatment of disfiguring proptosis and compressive optic neuropathy in patients with Graves' orbitopathy. However, cerebrospinal fluid leakage and/or optic nerve injury occasionally occur during these operations.

Purpose: To describe the anatomy of the deep lateral and medial orbital walls and its surgical implications in orbital decompression.

Tightly regulated and homogeneous transgene expression in human adipose-derived mesenchymal stem cells by lentivirus with tet-off system.

Genetic modification of human adipose tissue-derived multilineage progenitor cells (hADMPCs) is highly valuable for their exploitation in therapeutic applications. Here, we have developed a novel single tet-off lentiviral vector platform. This vector combines (1) a modified tetracycline (tet)-response element composite promoter, (2) a multi-cistronic strategy to express an improved version of the tet-controlled transactivator and the blasticidin resistance gene under the control of a ubiquitous promoter, and (3) acceptor sites for easy recombination cloning of the gene of interest.

Intracoronary artery transplantation of cardiomyoblast-like cells from human adipose tissue-derived multi-lineage progenitor cells improve left ventricular dysfunction and survival in a swine model of chronic myocardial infarction.

Transplantation of human cardiomyoblast-like cells (hCLCs) from human adipose tissue-derived multi-lineage progenitor cells improved left ventricular function and survival of rats with myocardial infarction. Here we examined the effect of intracoronary artery transplantation of human CLCs in a swine model of chronic heart failure. Twenty-four pigs underwent balloon-occlusion of the first diagonal branch followed by reperfusion, with a second balloon-occlusion of the left ascending coronary artery 1 week later followed by reperfusion.

Human adipose tissue-derived multilineage progenitor cells exposed to oxidative stress induce neurite outgrowth in PC12 cells through p38 MAPK signaling.

Background: Adipose tissues contain populations of pluripotent mesenchymal stem cells that also secrete various cytokines and growth factors to support repair of damaged tissues. In this study, we examined the role of oxidative stress on human adipose-derived multilineage progenitor cells (hADMPCs) in neurite outgrowth in cells of the rat pheochromocytoma cell line (PC12).

Results: We found that glutathione depletion in hADMPCs, caused by treatment with buthionine sulfoximine (BSO), resulted in the promotion of neurite outgrowth in PC12 cells through upregulation of bone morphogenetic protein 2 (BMP2) and fibroblast growth factor 2 (FGF2) transcription in, and secretion from, hADMPCs.

Preaponeurotic fat advancement for prevention of unexpected higher eyelid crease in upper eyelid-lengthening surgery.

Purpose: To present a modified technique based on preaponeurotic fat advancement for preventing higher eyelid crease in upper eyelid-lengthening surgery.

Methods: Outcomes of Japanese patients with Graves' orbitopathy-related upper eyelid retraction who underwent transcutaneous upper eyelid-lengthening surgery were reviewed. The minimum follow-up period was 6 months.

Lateral canthal anatomy: a review.

The anatomy of the lateral canthus is analogous to that of the medial canthus, but with a less defined structure. Although the lateral canthal tendon occupies the major part of the lateral canthal anatomy, the lateral rectus capsulopalpebral fascia and other structures also play a significant role. Appropriate comprehension and consideration of the lateral canthal anatomy enable safe and effective performance in the lateral canthal surgeries.

Reshaping the eyebrow by follicular unit transplantation from excised eyebrow in extended infrabrow excision blepharoplasty.

Purpose: We report the reshaping of the eyebrow by follicular unit transplantation from excised eyebrow skin in extended infrabrow excision blepharoplasty.

Methods: The method was carried out in two patients with moderate or significant dermatochalasis. The areas to be excised from the infrabrow and intrabrow skin were decided upon and the area of hair transplantation was planned in the suprabrow area and the tail of the eyebrow.

Inferior oblique muscle origin: horizontal location in relation to ala nasi and its gender difference.

We studied the horizontal location of the inferior oblique muscle (IOM) origin in relation to the ipsilateral ala nasi and compared the results between genders in 76 orbits of 38 Japanese cadavers. Consequently, the IOM origin was located 1.2 mm laterally to the vertical line through the lateral margin of the ipsilateral ala nasi.

Anatomical relationship of Horner's muscle origin and posterior lacrimal crest.

Purpose: This study was designed to examine the distance from the posterior lacrimal crest to the posterior margin of the Horner's muscle origin (the PLC-HMO distance), considering their complex anatomical relationship.

Methods: Eight macroscopic specimens from 8 Japanese cadavers and 7 microscopic specimens from 7 Japanese cadavers, fixed in 10% buffered formalin, were analyzed. Macroscopically, the PLC-HMO distance was measured at 2 mm superior to the most posterior point of the muscle origin (Group A), directly at the most posterior point (Group B) and 2 mm inferior to the most posterior point (Group C).

Anatomy of Tenons capsule.

Background:   The microscopic and macroscopic anatomy of the anterior and posterior Tenons capsule is described.

Methods:   An observational anatomic study of twelve orbits of 6 cadavers (mean age 79.5 years) were examined microscopically and 8 orbits of 4 cadavers (mean age 76.

Congenital dacryocystocele: comparative findings of dacryoendoscopy and histopathology in a patient.

A full-term baby girl showed a bluish mass at birth in the right medial canthal area. She later demonstrated dacryocystitis and cellulitis. Although probing was performed, it was unsuccessful, and the dacryocystitis and cellulitis worsened.