To understand the clinical course of human adenoviral (HAdV) conjunctivitis and establish a better treatment regimen, 38 eyes of 19 patients with HAdV-54 conjunctivitis for less than one week from ...onset were evaluated for clinical signs and symptoms and DNA copy numbers. A viral load of 104–105 is required to develop symptoms of HAdV conjunctivitis, as symptoms were present in eyes with viral loads of ≥104 at least once during the course. Next, it was observed that asymptomatic infections in the contralateral eyes are common, as the virus was detected in most eyes that did not develop conjunctivitis. Furthermore, there was no rapid decrease in the viral load in healed eyes; on the contrary, the viral load in the healed eyes on day 15 was significantly higher than that in the unhealed eyes. This was likely due to corticosteroid instillation, which rapidly alleviated symptoms but prolonged the duration of viral shedding. Recently, combination treatment with iodine and corticosteroids has been recommended for HAdV conjunctivitis. Assessing changes in the viral load and clinical symptoms would be helpful to better understand the clinical course of this disease.
Poly(n‐butyl acrylate) (PnBA) and silica nanoparticle composites were cast from toluene solutions and investigated via differential scanning calorimetry (DSC), Fourier‐transform infrared spectroscopy ...(FT‐IR), and X‐ray diffraction (XRD) analysis. The results suggested that the composites contained amorphous bulk and interfacial regions. The mobility of side chains at the interfaces between PnBA and the silica nanoparticles differed from the mobility of side chains in bulk PnBA. FT‐IR analysis showed that the difference in mobility was due to interactions between the carbonyl groups in PnBA and the silica surfaces. These results indicated that PnBA main chains near interfaces with silicon oxide were separated by a smaller distance than main chains in the bulk polymer.
Physical properties of polymer side interfacial region in polymer/inorganic nanoparticle composite are different from those of bulk region. The effect of interaction between poly(n‐butyl acrylate) (PnBA) and silicon oxide was investigated via X‐ray diffraction (XRD). XRD patterns show that PnBA has a smaller space between its main chains in the interfacial region. We find that PnBA has the interfacial region with lower mobility than the bulk region.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
The effects of tetrahydrofuran (THF) on the physical properties of poly(methyl methacrylate) at (PMMA)/silica nanoparticle interfaces in polymer nanocomposites were investigated via differential ...scanning calorimetry (DSC), Fourier transform infrared (FT-IR) spectroscopy, and X-ray diffraction (XRD) analysis. Amorphous structures containing PMMA chains with large numbers of trans-gauche conformers were observed in the annealed samples. The amorphous structures in the samples cast from THF suspensions contained PMMA chains rich in trans–trans conformers. These amorphous structures differed from those of neat PMMA prepared without silica. Although the polymer chain mobility was reduced due to interactions between PMMA and the silica nanoparticles, trans–trans-enriched PMMA chains within the amorphous structures were less affected by these interactions. When the amorphous structures were heated above the glass transition temperature of PMMA, the proportion of trans–gauche conformers increased.When the neat PMMA samples were dried at room temperature, the glass transition temperature (Tg) increases linearly with the decrease in the amount of residual solvent. However, even if the residual solvent is extrapolated to 0 wt%, the Tg is significantly lower than the bulk Tg despite no residual solvent. The Tg of heat-dried samples heat treated at 120 °C also increases linearly with decreasing residual solvent content. However, Tg was significantly different depending on the drying temperature even with the same residual solvent amount. These results indicated that the PMMA samples dried at room temperature have a distinctly different molecular mobility from the heated sample.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
To report endophthalmitis rates after cataract surgery and the incidence of complications after intracameral moxifloxacin injection.
Nineteen clinics in Japanese institutions.
Retrospective survey ...cohort study.
The number of surgeries and endophthalmitis cases in the past 4 years before and after the introduction of intracameral moxifloxacin was evaluated. The survey was performed by mail or interview in February 2013.
All institutions used total-replacement administration rather than small-volume injection. At 3 institutions, 50 to 100 μg/mL moxifloxacin; at 9 institutions, 100 to 300 μg/mL moxifloxacin; and at 7 institutions, 500 μg/mL moxifloxacin was administered. The highest concentration (500 μg/mL) was administered in 14,124 cases. Endophthalmitis cases occurred 1 month or sooner postoperatively in 8 of 15,958 cases (ie, 1 in 1955) without intracameral moxifloxacin administration and in 3 of 18,794 cases (ie, 1 in 6265) with intracameral moxifloxacin administration.
Intracameral moxifloxacin (50 to 500 μg/mL) administration decreased the risk for endophthalmitis by 3-fold. In more than 18,000 cases, moxifloxacin administration of 500 μg/mL or less did not result in severe complications, such as toxic anterior segment syndrome or corneal endothelial cell loss.
Rhabdophis tigrinus
(
R. tigrinus
) is a common colubrid snake that possesses a series of paired sac-like nuchal glands behind the head. When pressure is applied to the nuchal area, the thin skin ...over the nuchal glands can rupture and release secretions. In Japan, 19 cases of ophthalmia caused by the nuchal gland secretion of
R. tigrinus
have been reported. However, only one case has been documented in an English report. A 72-year old woman was sprayed by the nuchal gland fluid of
R. tigrinus
in her right eye. She presented with symptoms of eye pain and blurred vision. A slit-lamp examination revealed diffuse superficial keratitis, corneal stromal edema with Descemet membrane folds, and conjunctival injection. The best-corrected visual acuity (BCVA) of her right eye was 0.6. She was prescribed 0.5% moxifloxacin and 0.1% fluorometholone eye drops four times a day, and the symptoms resolved without sequelae within 5 days. The BCVA in the right eye improved to 1.0. In previous reports, ophthalmic examinations revealed conjunctivitis, keratitis, and corneal edema with Descemet membrane folds. Topical antibiotics and corticosteroid were prescribed in most cases, and eyes healed within 5-7 days without any sequelae. While corneal edema may resolve spontaneously in a few days when inhibition of the toxin has ceased, the use of topical steroids is recommended, as it can increase the activity of Na/K pumps that remained functional, thereby accelerating recovery. In fact, our patient used a topical steroid and recovered without sequelae.
Purpose
To verify the possibility that preoperative topical antibiotics are not essential as long as iodine disinfection is performed during surgery.
Study design
Crossover equivalence trial.
...Patients and methods
In 204 eyes of 102 patients who underwent routine bilateral cataract surgery, 1 eye was treated with intraoperative iodine, and the other, with preoperative topical antibiotics. For the intraoperative iodine eyes, 5 mL of 0.25% povidone-iodine was applied at 2 stages: (1) just after the placement of the speculum and (2) before intraocular lens (IOL) insertion. For the contralateral eyes, preoperative topical antibiotics were administered 3 days before surgery without intraoperative iodine. Conjunctival samples for culture were obtained at 3 time points: (a) presurgery, (b) beginning of surgery, and (c) postsurgery. Real-time polymerase chain reaction (PCR) samples were obtained at the beginning of surgery and before IOL insertion. Intracameral moxifloxacin was applied in all the cases.
Results
The respective positive bacterial culture rates for intraoperative iodine eyes and preoperative topical antibiotics eyes were 95.1% and 98.0% at (a), 7.8% and 5.9% at (b), and 60.8% and 62.7% at (c). A significant difference in the positive bacterial culture rate was not found at any time point. For the intraoperative iodine eyes, the bacterial DNA copy number at (b) was significantly lower than that for the preoperative topical antibiotics eyes.
Conclusions
The cleanliness of the operative field without using topical antibiotics was revealed to be equivalent to that of the conventional method (using preoperative antibiotics without intraoperative iodine) as long as intraoperative iodine was used.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Prophylactic intracameral injection of antibiotics is commonly used to prevent endophthalmitis after cataract surgery. However, devastating visual complications have been reported including ...hemorrhagic occlusive retinal vasculitis (HORV).To determine the toxic and inflammatory effects of moxifloxacin, cefuroxime, and vancomycin on human retinal vascular cells, human retinal vascular endothelial cells (RVEC) and pericytes were exposed to three antibiotics, and the adverse effects were assessed by membrane damage, loss of intrinsic esterase activity, kinetic cell viability, and inflammatory cytokine secretion. Their retinal toxicity was examined by live/dead assays after an intravitreal injection of the three antibiotics into mice eyes. In vascular cells in culture, membrane damage and loss of esterase activity were induced after exposure to the three antibiotics. The toxic effects were most obvious after moxifloxacin (RVEC, ≥125 μg/mL; pericytes, ≥1000 μg/mL) at 24 h. Cefuroxime also reduced esterase activity and the membrane integrity of vascular cells but were less toxic than moxifloxacin. Kinetic cell viability testing showed that 500 μg/mL of moxifloxacin exposure induced significant decrease (29%) in the viability as early as 1 h. When the inflammatory effects of the antibiotics were examined, a significant induction of IL-8 was observed especially by RVECs after exposure to cefuroxime or vancomycin which was exacerbated by L-alanyl-γ-D-glutamyl-meso-diaminopimelic acid (Tri-DAP), a NOD1 ligand. Intravitreal injections in mice showed that cefuroxime and vancomycin caused retinal and vascular toxicity extending to the inner nuclear layers. Collectively, moxifloxacin causes immediate damage to retinal vascular cells in vitro, while cefuroxime and vancomycin induced significant inflammatory effects on vascular endothelial cells and caused retinal toxicity. Surgeons need to be cautious of the toxicity when antibiotics are used prophylactically especially by intravitreal administration.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Purpose
To analyze the epidemiologic characteristics of an outbreak of human adenovirus type 54 (HAdV-54) on Oki Island, Shimane Prefecture, Japan, in 2017 and to assess the effectiveness of a ...compartmentalization method in controlling the incidence and spread.
Study design
Retrospective cohort study.
Methods
The infection was diagnosed in 136 individuals, and typing was confirmed by PCR and direct sequencing. The epidemiologic characteristics of the disease including the infection rate, incubation period, and basic reproductive number (R
0
), ie, number of cases directly infected by an infectious patient during the course of the disease, were investigated. The effectiveness of compartmentalization for infection control was determined by simulating the outbreak using the Susceptible-Exposed-Infectious-Recovered (SEIR) model.
Results
The majority of the HAdV-54-infected individuals were the children of 3 nursery schools (A, B, and C) and their parents on Oki Island. The infection rates in the 3 schools were 13.2%, 16.9%, and 17.2%, respectively. The one class of school B without the index case was initially compartmentalized, and the infection rate in this compartment was 0%. The incubation period was calculated to be 9.3 ± 3.5 days, and the disease duration, 13.0 ± 5.4 days. The R
0
was 1.43. Using these parameters, a SEIR model was constructed. The SEIR model well predicted the daily incidence of infection and indicated that the compartmentalization method provides effective reduction in the incidence of the infection, with much earlier control.
Conclusions
The compartmentalization method is effective to control HAdV-54 outbreaks.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Purpose
The aim of this study was to compare the efficacy of the topical regimens of iodine/steroids
vs
. antibiotics/steroids in acute to subacute adenoviral keratoconjunctivitis.
Study design
A ...prospective open-label study.
Patients and methods
Nineteen patients diagnosed with unilateral or bilateral adenoviral conjunctivitis at less than 1 week from onset were enrolled in this study. Patients were divided randomly into two groups; group 1 was treated with 1.5% levofloxacin with 0.1% fluorometholone administered four times a day and group 2 was treated with a sixfold dilution of polyvinyl alcohol iodine (PAI) solution with 0.1% fluorometholone four times a day. Conjunctival samples from all affected eyes were obtained for real-time PCR. The total scores of acute signs (i.e., eyelid edema, conjunctival injecton, conjunctival discharge, follicules, pseudomembranes, subconjunctival hemorrhage) and symptoms, HAdV DNA copy number, and the presence of multiple subepithelial corneal infiltrates (MSI) were evaluated every 5 visits up to Day 30 after diagnosis.
Results
Comparing the total scores of acute signs and symptoms and viral load, we observed no significant differences between the two groups. At day 15 after diagnosis the proportion of patients with MSI in group 2 (35.7%) was significantly lower than in group 1 (0%).
Conclusions
The impact of topical iodine/steroid therapy on acute signs and symptoms associated with adenoviral conjunctivitis is limited and not substantially different in the responses to antibiotics/steroids. However, this regimen results in a significant decrease in the incidence of MSI during the subacute phase of infection.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
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