Magister Chirurgiae Dentium (MChD) / Oral lichen planus (OLP) is a T-cell mediated chronic inflammatory disease with different clinical types that remains inscrutable in respect of its pathogenetic mechanisms and effective therapy. Increased apoptosis may influence the histopathological criteria of oral lichen planus (decrease in thickness of the epithelium and band of inflammatory infiltrate). Null hypothesis: The apoptotic rate does not correlate with a decrease in the epithelial thickness as well as the thickness of the band of inflammatory infiltrate in OLP. Aim: The present study aims to quantify apoptotic activity and to correlate the apoptotic rate with epithelial thickness as well as thickness of the inflammatory infiltrate of OLP cases diagnosed at Tygerberg Hospital from 2006 – 2015. Further, the epithelial thickness and thickness of the inflammatory infiltrate were also assessed for their association, if any. Materials and Methods: The study sample comprised 17 diagnostically verified cases of OLP. Sections stained with Haematoxylin and Eosin (H&E) were used to identify and count the number of apoptotic cells as well as measure the thickness of epithelium and the thickness of the lymphocytic inflammatory infiltrate by using software morphometric analysis (Zen Blue lite 2012). Statistical analysis was applied to analyse the correlation between apoptotic cells and histopathological features of OLP. Results: The present study's results showed no statistically significant association between the apoptotic rate, the epithelial thickness and the thickness of the lymphocytic inflammatory infiltrate.

The vagina is the port of entry for sexually transmitted diseases in women. Its epithelium constitutes the luminal border, thus comprising an important defence barrier. The objective of this work was to investigate the mechanisms of importance in the immune defence of the vaginal epithelium of healthy, fertile women, and possible menstrual cycle changes. Effects of hormonal contraceptive usage on oestrogen receptor (ER) and progesterone receptor (PR) expression were studied. The contribution of epithelial cell to the immune defence was estimated by assaying their expression of antimicrobial defensins and the epithelial thickness. Vaginal biopsies and serum samples were collected during the follicular and luteal phases in regularly menstruating women (controls) and in users of combined oral contraceptives (COCs), levonorgestrel implants (LNGs), or depot-medroxyprogesterone acetate injections (DMPAs). Fifteen healthy women (aged 20–34 years) were enrolled in each group. Morphometry was performed on vaginal tissue stained with haematoxylin/eosin and by immunohistochemistry using monoclonal antibodies against immune cell markers, PR, and ER. Expression of mRNA for human α-defensins HD-5 and HD-6, and human β-defensins (HBD) 1 to 4 were determined by real-time qRT-PCR and in situ hybridization. In controls, the epithelium was 261 ± 16 μm thick and harboured 241 ± 35 leukocytes (CD45+) per mm2. T lymphocytes (CD3+) dominated. Both αβ T cells and γδ T cells were present with an approximate 4-fold dominance of αβ T cells. Cytotoxic T cells (CD8+) were more frequent than T helper cells (CD4:CD8 ratio: 0.7 ± 0.1). Macrophages (CD68+) constituted the second-largest population, followed by Langerhans cells (CD1a+). B cells, natural killer cells, monocytes and granulocytes were generally absent. No differences were found between the follicular and luteal phase. All four β-defensins analysed for were detected in vaginal epithelium and most samples expressed at least two. HBD-2 and HBD-3 were most frequent. HBD-3 and HBD-4 expressing cells were localized in the parabasal and intermediate cell layers. α-defensins were not detected. The epithelium was significantly thicker (333 ± 9 μm) in COC, LNG, and DMPA users than in controls, and commonly showed hyperplasia. In DMPA and LNG users the frequency of intraepithelial leukocytes (CD45+) was increased, explained by increased frequencies of both αβ and γδ T cells. In DMPA users there was also a selective increase in CD8+ T cells. PR expression was significantly reduced in DMPA users compared with controls, COC and LNG users. COC and particularly DMPA users often had undetectable levels of serum E2. In conclusion, both adaptive immunity, i.e. intraepithelial T cells, and innate defence mechanisms, i.e. intraepithelial macrophages and β-defensins, are believed to contribute to the immune defence in the human female lower genital tract. These parameters did not change during the menstrual cycle but hormonal contraceptive usage, especially DMPA, affected the quality of the epithelium. The use of DMPA and LNG was correlated with the accumulation of T cells within the epithelium. The effects of these changes on the risk of contracting infections are yet to be determined.

<strong>Purpose:</strong> Although orthokeratology (non-surgical corneal reshaping, Corneal Refractive Therapy, CRT®) has been used for almost a half century, contemporary CRT's outcomes and mechanisms still require investigation. A series of studies was designed to examine different aspects of non-surgical corneal reshaping for myopic and hyperopic corrections, including the efficacy and stability of this procedure, the effect of the lens material characteristics (Dk/t), and the corneal or superficial structural change (e. g. corneal/epithelial thickness) in corneal reshaping. <br /> <strong>Methods:</strong> In the CRT® for myopia (CRT1) study, 20 myopes wore CRT® lenses on one eye and control lenses on the contralateral eye (eye randomized) for one night while sleeping. Corneal topography and refractive error were measured the night prior to lens insertion, immediately after lens removal on the following morning and at 20 and 60 minutes and 3, 6 and 12 hours later. In the CRT® for hyperopia (CRTH) study, 20 ametropes wore CRT®H lenses on one eye for one night while sleeping, the contralateral eye (no lens wear) served as control (eye randomized). Corneal topography, aberrations and refractive error were measured the night prior to lens insertion, immediately after lens removal on the following morning and at 1 and 3, 6, 12 and 28 hours later. In the relatively long term (4 weeks) CRT® for myopia (CRT2) study, 23 myopes wore CRT® lenses overnight and removed their lenses on awakening. Visual Acuity (VA), subjective vision, refractive error, aberrations, and corneal topography were measured at baseline, immediately after lens removal on the first day and 14 hours later, and these measurements were repeated on days 4, 10, and 28. The treatment zone size was demarcated by the change in corneal curvature from negative to positive and vice versa, using tangential difference maps from the corneal topographer. In the study of effects of Dk/t on CRT® for myopia (CRTHDK), 20 myopic subjects were fit with Menicon Z (MZ) lenses (Dk/t=90. 6, Paragon CRT®) on one eye and an Equalens II (EII) CRT® lenses (Dk/t=47. 2) on the contralateral eye (eye randomized). Corneal topography, refractive error and aberrations were measured before lens insertion (baseline), and the following day after overnight lens wear, on lens removal and 1, 3, 6, 12 hours later. In the study of short term effects of CRT® for myopia and hyperopia (STOK), 20 ametropes wore CRT® and CRT®H lenses in a random order on one eye (randomly selected). The lenses were worn for 15, 30 and 60 minutes (randomly ordered, with each period taking place on a different day). Refractive error, aberrations, corneal topography, and corneal/epithelial thickness (using OCT) were measured before and after lens wear. The measurements were performed on the control eyes at 60 minutes only. <br /> <strong>Results:</strong> In the CRT1 study, after one night of CRT® for myopia, the central cornea flattened and the mid-periphery steepened, and myopia reduced. In the CRTH study, after one night of CRT® for hyperopia, the central cornea steepened and the para-central region flattened, myopia was induced or hyperopia was reduced, all aberrations except for the astigmatism increased and signed spherical aberration (SA) shifted from positive to negative. In the CRT2 study, after 4 weeks of CRT® lens wear, in general, the treatment zones stabilized by day 10, vision improved, myopia diminished, total aberration and defocus decreased and higher order aberrations (HOAs) including coma and SA increased. The visual, optical and subjective parameters became stable by day 10. In the CRTHDK study, after one night of CRT® (MZ vs. EII) lens wear, the central corneal curvature and aberration were similar with a slight exception: The mid-peripheral corneal steepening was greater in the EII (lower Dk/t) lens-wearing eyes compared to the MZ (higher Dk/t) eyes. In the STOK study, after brief CRT® and CRT®H lens wear, significant changes occurred from the 15 minutes time point: The corneal shape and optical performance changed in a predictable way; the central cornea swelled less than the mid-periphery after CRT® lens wear, whereas the central cornea swelled more than the para-central region after CRT®H lens wear; the central epithelium was thinner than the mid-periphery after CRT® lens wear and was thicker than the para-central region after CRT®H lens wear. <br /> <strong>Conclusion:</strong> After one night of lens wear, CRT® and CRTH® lenses were effective for myopia and hyperopia correction, respectively. In the 4 week CRT study, the treatment zone size changed during the first 10 days. Its size was associated with VA, refractive error, aberrations, and subjective vision. In the CRTHDK study, after one night of lens wear, changes in corneal shape were slightly different, with more mid-peripheral steepening in the lower Dk lens-wearing eyes compared to the higher Dk lens-wearing eyes. Changes in central corneal shape and optical performance were similar in both eyes. In the STOK study, CRT® lenses for myopia and hyperopia induced significant structural and optical changes in as little as 15 minutes. The cornea, particularly the epithelium, is remarkably moldable, with very rapid steepening and flattening possible in a small amount of time.

<strong>Purpose:</strong> Although orthokeratology (non-surgical corneal reshaping, Corneal Refractive Therapy, CRT®) has been used for almost a half century, contemporary CRT's outcomes and mechanisms still require investigation. A series of studies was designed to examine different aspects of non-surgical corneal reshaping for myopic and hyperopic corrections, including the efficacy and stability of this procedure, the effect of the lens material characteristics (Dk/t), and the corneal or superficial structural change (e. g. corneal/epithelial thickness) in corneal reshaping. <br /> <strong>Methods:</strong> In the CRT® for myopia (CRT1) study, 20 myopes wore CRT® lenses on one eye and control lenses on the contralateral eye (eye randomized) for one night while sleeping. Corneal topography and refractive error were measured the night prior to lens insertion, immediately after lens removal on the following morning and at 20 and 60 minutes and 3, 6 and 12 hours later. In the CRT® for hyperopia (CRTH) study, 20 ametropes wore CRT®H lenses on one eye for one night while sleeping, the contralateral eye (no lens wear) served as control (eye randomized). Corneal topography, aberrations and refractive error were measured the night prior to lens insertion, immediately after lens removal on the following morning and at 1 and 3, 6, 12 and 28 hours later. In the relatively long term (4 weeks) CRT® for myopia (CRT2) study, 23 myopes wore CRT® lenses overnight and removed their lenses on awakening. Visual Acuity (VA), subjective vision, refractive error, aberrations, and corneal topography were measured at baseline, immediately after lens removal on the first day and 14 hours later, and these measurements were repeated on days 4, 10, and 28. The treatment zone size was demarcated by the change in corneal curvature from negative to positive and vice versa, using tangential difference maps from the corneal topographer. In the study of effects of Dk/t on CRT® for myopia (CRTHDK), 20 myopic subjects were fit with Menicon Z (MZ) lenses (Dk/t=90. 6, Paragon CRT®) on one eye and an Equalens II (EII) CRT® lenses (Dk/t=47. 2) on the contralateral eye (eye randomized). Corneal topography, refractive error and aberrations were measured before lens insertion (baseline), and the following day after overnight lens wear, on lens removal and 1, 3, 6, 12 hours later. In the study of short term effects of CRT® for myopia and hyperopia (STOK), 20 ametropes wore CRT® and CRT®H lenses in a random order on one eye (randomly selected). The lenses were worn for 15, 30 and 60 minutes (randomly ordered, with each period taking place on a different day). Refractive error, aberrations, corneal topography, and corneal/epithelial thickness (using OCT) were measured before and after lens wear. The measurements were performed on the control eyes at 60 minutes only. <br /> <strong>Results:</strong> In the CRT1 study, after one night of CRT® for myopia, the central cornea flattened and the mid-periphery steepened, and myopia reduced. In the CRTH study, after one night of CRT® for hyperopia, the central cornea steepened and the para-central region flattened, myopia was induced or hyperopia was reduced, all aberrations except for the astigmatism increased and signed spherical aberration (SA) shifted from positive to negative. In the CRT2 study, after 4 weeks of CRT® lens wear, in general, the treatment zones stabilized by day 10, vision improved, myopia diminished, total aberration and defocus decreased and higher order aberrations (HOAs) including coma and SA increased. The visual, optical and subjective parameters became stable by day 10. In the CRTHDK study, after one night of CRT® (MZ vs. EII) lens wear, the central corneal curvature and aberration were similar with a slight exception: The mid-peripheral corneal steepening was greater in the EII (lower Dk/t) lens-wearing eyes compared to the MZ (higher Dk/t) eyes. In the STOK study, after brief CRT® and CRT®H lens wear, significant changes occurred from the 15 minutes time point: The corneal shape and optical performance changed in a predictable way; the central cornea swelled less than the mid-periphery after CRT® lens wear, whereas the central cornea swelled more than the para-central region after CRT®H lens wear; the central epithelium was thinner than the mid-periphery after CRT® lens wear and was thicker than the para-central region after CRT®H lens wear. <br /> <strong>Conclusion:</strong> After one night of lens wear, CRT® and CRTH® lenses were effective for myopia and hyperopia correction, respectively. In the 4 week CRT study, the treatment zone size changed during the first 10 days. Its size was associated with VA, refractive error, aberrations, and subjective vision. In the CRTHDK study, after one night of lens wear, changes in corneal shape were slightly different, with more mid-peripheral steepening in the lower Dk lens-wearing eyes compared to the higher Dk lens-wearing eyes. Changes in central corneal shape and optical performance were similar in both eyes. In the STOK study, CRT® lenses for myopia and hyperopia induced significant structural and optical changes in as little as 15 minutes. The cornea, particularly the epithelium, is remarkably moldable, with very rapid steepening and flattening possible in a small amount of time.