PURPOSE: To report two cases of postoperative endophthalmitis caused by Streptococcus dysgalactiae subspecies equisimilis (SDSE), which appeared as hyperacute presentation and panophthalmitis. CASE SUMMARY: A 68-year-old male was treated with cataract surgery and was evaluated the next day (less than 24 hours after surgery) because of acute loss of vision. There was severe inflammation and the visual acuity was light perception. The patient underwent pars plana vitrectomy (PPV) with intravitreal antibiotic injection. The vitreous culture revealed SDSE. After PPV, regression of inflammation was observed, although the corneal edema had progressed. The cornea evolved to decompensate due to bullous keratopathy and visual acuity of the eye decreased to no light perception after 3 months. A 87-year-old male who underwent phacoemulsification and intraocular lens implantation 2 days previously was hospitalized due to severe ocular pain and visual loss. There was severe inflammation, and the visual acuity was no light perception. The patient received only intravitreal injections of antibiotics due to severe corneal necrosis. The aqueous humor revealed SDSE. Four days after intravitreal injection, erythema and swelling of the eyelid of the affected eye was observed, and diagnosed as panophthalmitis. After treatment with intravenous antibiotics, cellulitis of the eyelid was resolved. The eye progressed as phthisis after 3 months without recurrence. CONCLUSIONS: Postoperative SDSE endophthalmitis showed aggressive and hyperacute presentation, resulting in blindness despite prompt treatment. SDSE is an emerging organism and should be considered a potential cause of postoperative endophthalmitis.
Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; Aqueous Humor ; Blindness ; Cataract ; Cellulitis ; Cornea ; Corneal Edema ; Endophthalmitis ; Erythema ; Eye Infections ; Eyelids ; Humans ; Inflammation ; Intravitreal Injections ; Lens Implantation, Intraocular ; Male ; Necrosis ; Panophthalmitis ; Phacoemulsification ; Recurrence ; Streptococcus ; Visual Acuity ; Vitrectomy

OBJECTIVES: To explore the information sources and knowledge on infant vaccinations of pro-vaccination community members and anti- accination community members on the internet. METHODS: An online survey of 245 parents from three pro-vaccination communities and 92 parents from one antivaccination community was conducted from June 7 to June 23, 2006. RESULTS: Parents from pro-vaccination communities usually gained the information regarding vaccination efficacy and risk mainly from healthcare providers (49.8%) and mass media (47.7%). Pro-vaccination community members considered healthcare providers as the most credible sources of information on vaccination, whereas the anti-vaccination community members usually gained their information regarding vaccine efficiency and risk from Internet child-care cafes and online vaccination communities. Parents of the anti-vaccination community considered the internet as the most credible information source (77.6% for efficacy, 94.8% for risk). In addition, the major reason why anti-vaccination community members didn't vaccinate and, will not vaccinate, was concern about possible side effects of the vaccine. The knowledge level on infant vaccination, education and economic status was higher in the anti-vaccination community. CONCLUSIONS: On-line communities concerned with vaccination are getting popular. The influence of antivaccination parents on the Internet is expected to be high. The government and healthcare providers need to increase their efforts to improve the credibility of information about vaccination. Our findings suggest that online communication regarding vaccinations needs to be considered as a means to increase vaccination rates.
Adult ; Child, Preschool ; Female ; Health Education/*methods ; *Health Knowledge, Attitudes, Practice ; Health Personnel ; Humans ; Infant ; Internet/*utilization ; Male ; Parents ; Socioeconomic Factors ; *Vaccination

Reversible cerebral vasoconstriction syndrome (RCVS) is a heterogeneous group of cerebrovascular disease. The pathophysiology of RCVS is unknown, but a disturbance in cerebral vascular tone is one of hypothesis. Long-term use of Gonadotropin-releasing hormone (GnRH) agonists can induce a pseudomenopausal state in which estrogen production are suppressed. It might lead to reduced arterial relaxation by estrogen withdrawal. We report a case of RCVS after the injection of synthetic analogue of GnRH.
Cerebral Hemorrhage ; Cerebrovascular Disorders ; Estrogens ; Gonadotropin-Releasing Hormone* ; Gonadotropins* ; Hemorrhage* ; Injections, Subcutaneous* ; Relaxation ; Vasoconstriction*

Purpose: We evaluated the utility of peripheral vitrectomy featuring scleral indentation; we compared a group who underwent peripheral vitrectomy to a control group for whom vitrectomy was combined with scleral fixation of intraocular lenses (IOLs) in patients exhibiting IOL dislocations. Methods: From January 2018 to December 2020, 20 eyes of patients evidencing IOL dislocations that underwent total vitrectomy, IOL removal, and IOL scleral fixation were evaluated; peripheral vitrectomy with scleral indentation was performed in 10 patients. All operations were performed by the same surgeon. We excluded patients with follow-up periods less than 6 months, those with a history of retinal and/or glaucoma surgery, and patients with retinal abnormalities or glaucoma that might significantly compromise visual acuity. The postoperative best-corrected visual acuity, intraocular pressure, astigmatism changes, and complications were retrieved from the medical records. Results: Six months after surgery, the best corrected visual acuity was 0.95 (the Snellen measure) in the group who underwent peripheral vitrectomy featuring scleral indentation, and 0.60 in the control group (p = 0.029). The total astigmatism values were 0.48 diopter in the former and 2.80 diopter in the latter group; the difference was significant (p < 0.001). Conclusions In patients with IOL dislocations who underwent vitrectomy combined with IOL scleral fixation, improvements in visual acuity were further enhanced when peripheral vitrectomy was combined with scleral indentation. Complete removal of the peripheral vitreous may stabilize IOL positioning by the remnant vitreous.

PURPOSE: The purpose of this study was to determine whether there is a significant correlation between vertebral marrow fat fraction measured using Dixon quantitative chemical shift MRI (QCSI) and BMD on dual-energy X-ray absorptiometry (DXA). MATERIALS AND METHODS: This retrospective study included 68 healthy individuals [mean age, 50.7 years; range, 25-76; male/female (M/F) = 36/32] who underwent DXA of the L-spine and whole body MRI including QCSI of the L-spine and chemical shift MRI of the liver. The enrolled individuals were divided into subgroups according to sex and T-score [i.e., normal bone density (M/F=27/23) and osteopenia (M/F=9/9)]. Vertebral marrow (Dixon QCSI, TR/TE 10.2/4.8 ms) and hepatic fat fractions (chemical shift technique, TR/TE 110/4.9 and 2.2 ms) were calculated on MRI. We evaluated whether there were significant differences in age, body mass index (BMI), vertebral marrow fat fraction, or hepatic fat fraction among the subgroups. Whether or not the participant had reached menopause was also evaluated in females. The correlations among variables (i.e., age, BMI, vertebral marrow and hepatic fat fractions, BMD) were evaluated using Spearman's correlation method. RESULTS: There were no significant differences in age, BMI, or vertebral marrow and hepatic fat fractions between the two male subgroups (normal bone density vs. osteopenia). In female subjects, mean age in the osteopenic subgroup was greater than that in the normal subgroup (p=0.01). Presence of menopause was more common in the osteopenic subgroup [77.8% (7/9)] than the normal subgroup [26.1% (6/23), p<0.05]. The other variables showed no significant difference between female subgroups. The only significant correlation with marrow fat fraction after partial correlation analysis was that with age in the female subjects (r=0.43, p<0.05). CONCLUSION: The vertebral marrow fat fraction calculated using the Dixon QCSI does not precisely reflect the mild decrease in BMD for either sex.
Absorptiometry, Photon ; Body Mass Index ; Bone Density ; Bone Diseases, Metabolic ; Bone Marrow ; Female ; Humans ; Liver ; Male ; Menopause ; Retrospective Studies

OBJECTIVE: To evaluate the feasibility of coronary artery calcium scoring based on three virtual noncontrast-enhanced (VNC) images derived from single-source spectral dual-energy CT (DECT) as compared with true noncontrast-enhanced (TNC) images. MATERIALS AND METHODS: This prospective study was conducted with the approval of our Institutional Review Board. Ninety-seven patients underwent noncontrast CT followed by contrast-enhanced chest CT using single-source spectral DECT. Iodine eliminated VNC images were reconstructed using two kinds of 2-material decomposition algorithms (material density iodine-water pair [MDW], material density iodine-calcium pair [MDC]) and a material suppressed algorithm (material suppressed iodine [MSI]). Two readers independently quantified calcium on VNC and TNC images. The Spearman correlation coefficient test and Bland-Altman method were used for statistical analyses. RESULTS: Coronary artery calcium scores from all three VNC images showed excellent correlation with those from the TNC images (Spearman's correlation coefficient [ρ] = 0.94, 0.88, and 0.89 for MDW, MDC, and MSI, respectively; p < 0.001 for all pairs). Measured coronary calcium volumes from VNC images also correlated well with those from TNC images (ρ = 0.92, 0.87, and 0.91 for MDW, MDC, and MSI, respectively; p < 0.001 for all pairs). Among the three VNC images, coronary calcium from MDW correlated best with that from TNC. The coronary artery calcium scores and volumes were significantly lower from the VNC images than from the TNC images (p < 0.001 for all pairs). CONCLUSION: The use of VNC images from contrast-enhanced CT using dual-energy material decomposition/suppression is feasible for coronary calcium scoring. The absolute value from VNC tends to be smaller than that from TNC.
Calcium* ; Coronary Artery Disease ; Coronary Vessels* ; Ethics Committees, Research ; Humans ; Iodine ; Prospective Studies ; Tomography, X-Ray Computed

PURPOSE: The present study investigated the effects of triamcinolone acetonide (TA) on retinal vessel-related factors and retinal vascular leakage in the retina of oxygen-induced retinopathy (OIR) rats. METHODS: Sprague-Dawley rats used for OIR were exposed to hyperoxia from postnatal day 2 to day 14, then returned to normoxia from day 15 to day 30 and compared with control rats. On postnatal day 16, 2 microl of TA (4 mg/kg) was injected into the vitreous of the right eye in control and OIR rats. The Evans blue method was used for evaluating vascular leakage and RT-PCR was performed for confirmation of mRNA expression. RESULTS: In OIR rats exposed to hyperoxia, retinal vascular permeability increased when returned to normoxia. After intravitreal injection of TA, vascular permeability was decreased in OIR rats, but no changes were found in control rats. In OIR rats, mRNAs of HIF-1alpha, VEGF, SDF-1 and ICAM-1 were more expressed and down-regulated after intravitreal injection of TA. Occludin mRNA level was decreased in the hypoxic condition and up-regulated after TA treatment. CONCLUSIONS: The present study suggests the ability of TA to inhibit retinal vascular leakage in OIR rats and a possibility that TA controls expression of the HIF-1, VEGF, SDF-1, ICAM-1 and Occludin, which may protect retinal vascular destruction from hypoxic conditions; further studies are necessary to confirm changes in protein levels.
Animals ; Capillary Permeability ; Evans Blue ; Eye ; Hyperoxia ; Intercellular Adhesion Molecule-1 ; Intravitreal Injections ; Occludin ; Rats ; Rats, Sprague-Dawley ; Retina ; Retinaldehyde ; RNA, Messenger ; Triamcinolone ; Triamcinolone Acetonide ; Vascular Endothelial Growth Factor A

PURPOSE: The present study investigated the effects of triamcinolone acetonide (TA) on retinal vessel-related factors and retinal vascular leakage in the retina of oxygen-induced retinopathy (OIR) rats. METHODS: Sprague-Dawley rats used for OIR were exposed to hyperoxia from postnatal day 2 to day 14, then returned to normoxia from day 15 to day 30 and compared with control rats. On postnatal day 16, 2 microl of TA (4 mg/kg) was injected into the vitreous of the right eye in control and OIR rats. The Evans blue method was used for evaluating vascular leakage and RT-PCR was performed for confirmation of mRNA expression. RESULTS: In OIR rats exposed to hyperoxia, retinal vascular permeability increased when returned to normoxia. After intravitreal injection of TA, vascular permeability was decreased in OIR rats, but no changes were found in control rats. In OIR rats, mRNAs of HIF-1alpha, VEGF, SDF-1 and ICAM-1 were more expressed and down-regulated after intravitreal injection of TA. Occludin mRNA level was decreased in the hypoxic condition and up-regulated after TA treatment. CONCLUSIONS: The present study suggests the ability of TA to inhibit retinal vascular leakage in OIR rats and a possibility that TA controls expression of the HIF-1, VEGF, SDF-1, ICAM-1 and Occludin, which may protect retinal vascular destruction from hypoxic conditions; further studies are necessary to confirm changes in protein levels.
Animals ; Capillary Permeability ; Evans Blue ; Eye ; Hyperoxia ; Intercellular Adhesion Molecule-1 ; Intravitreal Injections ; Occludin ; Rats ; Rats, Sprague-Dawley ; Retina ; Retinaldehyde ; RNA, Messenger ; Triamcinolone ; Triamcinolone Acetonide ; Vascular Endothelial Growth Factor A

PURPOSE: To describe a case of macular hole (MH) in a 29-year-old non-myopic woman after uncomplicated delivery. CASE SUMMARY: A 29-year-old woman visited our clinic complaining of decreased visual acuity in her left eye after uncomplicated delivery. Fundoscopy and optical coherence tomography showed a full thickness macular hole in the left eye. However, we found not posterior vitreous detachment or vitreomacular traction in the posterior pole. The patient underwent pars plana vitrectomy, internal limiting membrane peeling, and SF6 gas tamponade. Three months after vitrectomy, the patient's visual acuity was improved and the macular hole was closed successfully. CONCLUSIONS: We experienced and treated a case of postpartum MH developed in a young woman without posterior vitreous detachment or vitreomacular traction in the posterior pole. This suggests another mechanism of MH formation. Postpartum MH was successfully treated by existing idiopathic macular hole surgery.
Adult ; Female ; Humans ; Membranes ; Postpartum Period* ; Retinal Perforations* ; Tomography, Optical Coherence ; Traction ; Visual Acuity ; Vitrectomy ; Vitreous Detachment

PURPOSE: To evaluate differences in self-identity in patients diagnosed with strabismus, patients who underwent strabismus surgery, and healthy control individuals. METHODS: Self-identity testing was done during a military service physical examination. There were three subject groups: subjects with strabismus (group 1), subjects who had undergone corrective strabismus surgery (group 2), and subjects free of strabismus (group 3). The self-identity test was comprised of six sub-sections (subjectivity, self-acceptance, future confidence, goal orientation, initiative, and familiarity). Statistical significance of the sub-sections was compared across the three groups. Correlations in age at the time of surgery and across the six sub-sections were investigated in group 2. RESULTS: A total of 351 subjects were enrolled in the study; 96 subjects were in group 1, 108 subjects were in group 2, and 147 subjects were in group 3. Significant differences were evident in subjectivity, self-acceptance, initiative and familiarity between groups 1 and 3. No significant differences were found between groups 2 and 3. In group 2, statistical significance was evident between age at surgery and initiative and familiarity (r = −0.333, p < 0.001; r = −0.433, p < 0.001, respectively). CONCLUSIONS: Self-identity is greater in non-strabismus subjects than strabismus subjects. Correction of strabismus may increase self-identity levels.
Adolescent ; Adult ; Eye Movements/*physiology ; *Facial Expression ; Female ; Humans ; Male ; Oculomotor Muscles/*physiopathology/surgery ; Ophthalmologic Surgical Procedures ; Retrospective Studies ; *Self Concept ; Strabismus/physiopathology/*psychology/surgery