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Background: Progressive outer retinal necrosis (PORN) is an ocular disease in individuals with AIDS and is associated with substantial morbidity. The optimal management of PORN and its clinical course in the HAART era is unclear., Objective: We report a case of successfully managed PORN that provides insight into the monitoring and treatment of this disease., Study Design: Intravitreal injections and intravenous therapy targeted towards varicella zoster virus (VZV) were used to treat PORN. HAART was initiated for HIV-1 therapy. Serial PCR for VZV was performed on aqueous humor to monitor the clinical course., Results: The presence of VZV DNA from aqueous humor correlated with clinical exacerbations of disease. Initiation of twice weekly intravitreal injections with dual antiviral drugs appeared to be an important therapeutic intervention that resulted in remission of PORN. Secondary prophylaxis against VZV was successfully withdrawn after HAART induced partial immune recovery., Conclusion: In addition to aggressive therapy with intravitreal injections, HAART and quantitative measurements of VZV DNA from aqueous humor have important roles in the management of PORN. A multidisciplinary approach involving specialists in infectious diseases, ophthalmology, and clinical microbiology will improve the chances for successful long-term outcomes.

The present study was undertaken to examine the effect of plasmin on sperm viability and sperm-oocyte interaction during in vitro fertilization in the pig. Porcine sperm, which were washed in Dulbecco's PBS were re-suspended and incubated in fertilization medium (mTBM; modified Tris-buffered medium) containing 0, 0.1, 1.0, 10.0 or 100.0ng/mL of plasmin. Sperm viability was not affected by plasmin treatment. Addition of plasmin in doses ranging from 0.1 to 100.0ng/mL for 2, 4 or 6h to washed boar sperm resulted in enhancement of acrosome reaction (AR) compared with untreated cells. The concentration of 0.1ng/mL plasmin (95+/-18 sperm/oocyte) had no effect on sperm binding, whereas 1.0ng/mL (123+/-21 sperm/oocyte), 10.0ng/mL (124+/-16 sperm/oocyte) and 100.0ng/mL (124+/-15 sperm/oocyte) of plasmin increased sperm binding compared with the control (83+/-15 sperm/oocyte). The zona pellucida solubility (zona dissolution time) was less in medium with 1.0ng/mL (123+/-24s), 10.0ng/mL (99+/-15s) or 100.0ng/mL (95+/-19s) plasmin compared with control (176+/-27s). When pig oocytes and sperm were co-incubated in various concentrations of plasmin for 6h, the penetration rate was greater in medium with 1.0ng/mL plasmin (77.5+/-3.1%) compared with the control. However, there were no differences in the polyspermic rates and mean number of sperm (MNS)/oocyte between the groups treated with plasmin and control. These results suggest that plasmin might play a role in events related to fertilization.

A 2.5-kilobase cDNA clone that encodes a 371-amino acid novel transcription factor was isolated from a human placenta cDNA library using a yeast one-hybrid system. The novel ets-related transcription factor (ERT) showed a homology with the ETS DNA-binding domain. Using constructs of the transforming growth factor-beta (TGF-beta) type II receptor (RII) promoter linked to the luciferase gene, we have demonstrated that ERT activates transcription of the TGF-beta RII gene through the 5'-TTTCCTGTTTCC-3' response element spanning nucleotides +13 to +24 and multiple additional ETS binding sites between -1816 and -82 of the TGF-beta RII promoter. A specific interaction between ERT and the ETS binding sites was also demonstrated using an electrophoretic mobility shift assay. Deletion mapping of ERT protein suggests that the transactivation domain resides in the amino terminus while the DNA-binding domain is localized to the carboxyl-terminal region. Our results suggest that ERT might be a major transcription factor involved in the transcriptional regulation of the TGF-beta RII gene.