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Koji Kanda,1 Kei Takayama,1 Toshio Enoki,2 Masaru Takeuchi1 1Department of Ophthalmology, National Defense Medical College, Tokorozawa, Japan; 2Enoki Eye Clinic, Sayama, Japan Objective: Penicillium species are abundant, generally saprophytic, and widely distributed in the environment. On rare occasions, they cause endophthalmitis in immunocompromised patients or in immunocompetent patients with uncontrolled diabetic mellitus or immunosuppressive agents. We report a case of endophthalmitis caused by Penicillium species in an immunocompetent patient without any disorders. Case presentation: A 67-year-old woman presented with ocular pain, hyperemia, and blurred vision in her right eye. She was in an immunocompetent condition and had received cataract surgery without complications 3 months ago. Severe cell infiltration and a clump of 3 mm diameter were found in the anterior chamber of the right eye, and there was no abnormality in the posterior segment. Serum β-d-glucan was not elevated; bacterial culture, histological analysis, and PCR using aqueous humor did not detect any pathogen (28S rDNA 2.4×102 copies/mL). However, because the clinical findings suggested fungal endophthalmitis, antifungal medication was initiated. The inflammation was gradually resolved with contraction of the clump; however, it recurred 47 days after the initiation by discontinuation of antifungal medication. Examination of culture identified Penicillium species in samples from both the anterior chamber and the vitreous. Conclusion: Chronic postoperative endophthalmitis by Penicillium species can occur in an immunocompetent patient without any systemic diseases. Keywords: endophthalmitis, immunocompetent, Penicillium, postcataract

Background: Thymic stromal lymphopoietin (TSLP) orchestrates eosinophilic inflammation, which may increase during asthma exacerbations. In contrast, microRNA-1 (miR-1) inhibits TSLP-mediated eosinophil trafficking in lung endothelium. Whether the balance of TSLP and miR-1 levels determines the response to oral corticosteroids (OCSs) during the treatment of asthma exacerbations remains unknown. Objective: Our aim was to investigate the involvement of TSLP/miR-1 axis in inflammatory response to OCS treatment for asthma exacerbations. Methods: We measured the concentrations of TSLP and other inflammatory cytokines and miR-1 expression during acute asthma exacerbations treated with standard OCSs in a real-life setting. A total of 28 consecutive patients with acute asthma exacerbations treated with OCS (prednisolone 30 mg/d) for 1 week at the emergency department were studied prospectively. Steroid responders were identified by a significant reduction in blood eosinophil counts, whereas paradoxical responders (PRs) showed no markedly decreased or even increased absolute blood eosinophil counts after OCS treatment. Differential white blood cell counts, blood cytokine levels, and miR-1 expression within and between groups were compared before and after OCS treatment. The baseline cytokine concentrations in both groups were compared with those of patients with stable asthma. Results: OCS treatment significantly reduced TSLP levels in steroid responders, whereas this effect did not occur in PRs (P = .006 and P = .742, respectively). In contrast, miR-1 expression was unchanged in steroid responders in response to OCS, whereas it was markedly reduced in the PRs, despite higher expression at baseline than in patients with stable asthma, which may account for slower resolution of the exacerbation. Conclusions: In some asthmatic patients with acute exacerbations who do not suppress eosinophils after a course of OCS, there is a paradoxical decrease in plasma miR-1 level and increase in TSLP level versus in steroid responders, which may result in slower clinical recovery.

The Josephson-vortex flow in stacks of intrinsic Josephson junctions in Bi2Sr2CaCu2O(sub y) single-crystals is studied. It is observed that the vortex flow tends to occur preferably in the highest velocity mode only in several junctions in the stack in low B below ~1 T.