Frequency of circulating TSHR(+) fibrocytes is markedly increased in patients with TAO, and they express proinflammatory chemokines in response to TSH. Because they infiltrate both orbit and thyroid in GD, they may represent the link between systemic immunoreactivity and organ-specific autoimmunity.

Argostemmateae (Rubiaceae, subfam. Rubioideae) are a mostly tropical Asian group of about 200 species currently classified in four morphologically distinct genera (Argostemma, Mouretia, Mycetia, Neohymenopogon). The monophyly of the tribe and Mycetia is strongly supported by molecular data, however, the tropical Asian genus Myrioneuron, traditionally associated with Mycetia based on its berry fruits, has not previously been investigated. The Bornean and Sulawesian genus Cyanoneuron, described based on the species of Myrioneuron with drupaceous fruits, had not been sequenced. Therefore, the phylogenetic positions of Cyanoneuron and Myrioneuron within Rubiaceae and their generic status have yet to be assessed with molecular data. These genera have tentatively been placed in tribe Spermacoceae (Rubioideae). We reconstructed a robust phylogeny of Rubioideae with sequence data from five plastid regions of 176 accessions and using the Bayesian Markov chain Monte Carlo and parsimony methods. Once the positions of Cyanoneuron and Myrioneuron were revealed, a robust phylogeny of the Spermacoceae alliance was reconstructed with the combined plastid and nuclear data (nrETS, nrITS) from 61 accessions to reassess its tribal limits. Mycetia and Myrioneuron are non-monophyletic and intermixed, and formed a well-supported clade diagnosed by berry fruits. We formally transfer Myrioneuron to Mycetia (older name), and present nine new combinations in the latter genus. Cyanoneuron was resolved with high support as monophyletic, and appears to be closely related to the Chinese monogeneric tribes Foonchewieae and Dunnieae. A new tribe Cyanoneuroneae is described to accommodate Cyanoneuron. This tribe is morphologically distinct from related tribes by its stipules apically divided into multiple linear segments, condensedcymose inflorescences and drupe-like fruits with numerous small seeds. A new key to the genera of Argostemmateae is provided.

Purpose: To describe postoperative management following ablative carbon dioxide laser resurfacing of the lower eyelids. Methods: A retrospective review of patients who consecutively underwent bilateral lower eyelid ablative carbon dioxide laser resurfacing by a single experienced oculoplastic surgeon over a 6-year period was conducted. Patient satisfaction, aesthetic outcomes, and postoperative complications were evaluated as adjunctive or monotherapy. Results: Among 424 patients included in the study, most were female (n = 356, 84.0%) and Caucasian (n = 404, 95.3%), with Fitzpatrick skin types II-III (n = 381, 89.9%). Mean age was 62.8 years (standard deviation: 9.7 years). Most (n = 324, 76.4%) underwent fractional ablative carbon dioxide laser resurfacing of the lower eyelids, whereas 91 (21.5%) received traditional laser resurfacing and 9 (2.1%) had both fractional and traditional laser resurfacing during the same session. At the time of lower eyelid laser resurfacing, most patients also underwent concurrent procedures, including upper (n = 321, 75.7%) and lower blepharoplasty (n = 348, 82.1%); a small proportion of patients (n = 39, 9.2%) did not undergo any concurrent surgical procedure. In addition to ablative laser resurfacing of the lower eyelids, 25 (5.9%) had upper eyelid laser resurfacing, 60 (14.2%) had full-face laser resurfacing, 55 (13.0%) had neck laser resurfacing, and 42 (9.9%) had additional treatment of solar lentigines or dyschromias on the face. Median follow-up duration was 3.9 months (interquartile range: 2.0–11.0 months). In the immediate postoperative period, 22 patients (5.2%) developed contact dermatitis from topical antibiotic eye drops and/or ointment prescribed postblepharoplasty. Postinflammatory hyperpigmentation was observed in 40 patients (9.4%) despite topical prophylaxis; all were eventually successfully treated with a combination of topical nonprescription and prescription creams and/or oral tranexamic acid. A localized herpetic outbreak occurred in 3 (0.7%) who underwent full-face laser resurfacing and 1 (0.2%) who underwent periocular laser resurfacing only; all were successfully treated with oral antiviral therapy. Two (0.5%) developed culture-proven atypical mycobacterial infection of the resurfaced lower eyelid skin and were treated with combination antibiotic therapy for several months until resolution. A small scar was noted in 4 patients (0.9%), which resolved after local corticosteroid injections. No patient developed persistent scarring or ectropion. Patient satisfaction was overall high, with 363 (85.6%) very satisfied and 48 (11.3%) satisfied with the aesthetic outcome of lower eyelid laser resurfacing. Conclusions: Ablative carbon dioxide laser resurfacing of the lower eyelids can be a useful tool in the armamentarium of the experienced oculoplastic surgeon, with excellent aesthetic results, high patient satisfaction, and low complication rates as adjunctive or monotherapy. Proper and timely management of postoperative complications is essential to maximizing successful cosmetic outcomes.

Objective To investigate the phenotypic and functional characteristics of peripheral and tissue-infiltrating stem cells, called fibrocytes in patients with idiopathic orbital inflammation (IOI). Methods Seven patients with IOI were studied. In the three patients requiring orbital biopsy, fibrocytes were identified in orbital tissue from patients with IOI compared to healthy controls using immunohistochemistry. Fibrocytes from the peripheral blood of all seven patients and controls were quantified and phenotyped by flow cytometry and immunofluorescence for expression of CD34, alpha smooth muscle actin, CD40 and Collagen 1. Quantitation of CD40-mediated IL-6 production was measured using ELISA. Results Orbital biopsy specimens from patients with IOI demonstrate tissue infiltration by fibrocytes (n=3). Fibrocytes are present in the peripheral blood of IOI patients (n= 7) but are scarce in healthy donors (n=19). Fibrocytes from IOI patients express substantial levels of CD40 and ligation of CD40 increases IL-6 expression. Conclusions Fibrocytes are present in the peripheral blood and orbital tissues of patients with IOI and constitutively express CD40 and express IL-6 in response to ligation. This site-specific predilection of CD34+ fibrocytes to sites of orbital inflammation and fibrosis may suggest a role in IOI. Moreover CD40-mediated activation cytokine production may contribute to the proinflammatory and profibrotic features of IOI and may provide a mechanism for future targeted therapy.