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Daisuke Muramatsu,* Teruumi Minezaki,* Kinya Tsubota,* Yoshihiro Wakabayashi, Hiroshi GotoDepartment of Ophthalmology, Tokyo Medical University, Tokyo, Japan *These authors contributed equally to this work Purpose: To investigate the medical backgrounds of patients and the treatment periods from the onset of branch retinal artery occlusion to obtaining improved final visual acuity.Methods: This was a retrospective case series study. A total of 68 consecutive patients (69 eyes) with branch retinal artery occlusion who visited Tokyo Medical University Hospital from 2007 to 2012 were included in this study. All patients underwent ophthalmic examinations and visual acuity tests. We reviewed their medical records for systemic conditions, as well as the periods from onset of symptoms to treatment. Participants were categorized into 2 groups: group A (n=36), which received any treatment within 24 hours from onset, and group B (n=33), which visited our hospital after 24 hours from onset. Best corrected visual acuity (BCVA) changes from the first to final visit and the relationships between systemic condition and visiting time to BCVA were assessed.Results: At the first visit, 59% of the patients had BCVA over 20/40; the ratio was increased to 74% at the final visit. BCVA improved more than 2 lines for 35% of the patients and was unchanged for 57% of those receiving conventional treatment. BCVA over 20/40 was significantly lower in hyperlipidemia patients. Hypertension, diabetes mellitus, and significant carotid stenosis were not correlated. The mean BCVA at baseline (0.91±1.03) significantly recovered to 0.35±0.91 after treatment in group A (P

Daisuke Muramatsu1, Takuya Iwasaki2, Tsuyoshi Agawa1, Masahiko Usui1, Hiroshi Goto11Department of Ophthalmology, Tokyo Medical University, 2Department of Ophthalmology, Tokyo Medical University Ibaraki Medical Center, Tokyo, JapanAbstract: The authors present a rare case of large chorioretinal rupture caused by blunt traumatic injury of the globe. A 22-year-old woman sustained a blunt injury to her left eye. The best-corrected Snellen visual acuity was 2/20 in her left eye, and hyphema and vitreous hemorrhage were noted. The day after the injury occurred the vitreous hemorrhage had disappeared. Fundus examination revealed a crescent-shaped retinal rupture three disc diameters in size near the macula, and a choroidal rupture six disc diameters in size that was over the vascular arcade. Three days after the injury, vitrectomy with internal limiting membrane peeling was performed. Postoperative prone positioning was maintained for 4 days. Five days postoperatively, closure of the ruptured retina was confirmed. The visual acuity improved to 16/20 4 months after surgery and this was maintained over a 48-month period. In conclusion, early vitrectomy with internal limiting membrane peeling after injury was effective for a case involving severe blunt chorioretinal rupture with closed globe injury.Keywords: choroidal rupture, retinal rupture, traumatic macular hole, closed globe injury, internal limiting membrane

In iteroparous animals, individual decisions about when and how much to invest in reproduction are related to lifetime reproductive success, and the ability to assess one's own competitive ability in one's current condition is necessary for optimising the reproductive investment. Male fiddler crabs have an enlarged claw which is used for courtship and combat, but they sometimes lose the claw. The clawless males would have disadvantages in courtship and combat until they regenerated the claw. Here it is examined whether males modify their reproductive investment in response to their current condition. Most clawless males did not construct sand structures to attract females; thus, they invested little in current reproduction. Small males were also less likely to construct structures. Clawless and small males may invest little in current reproduction and instead allocate energy to claw regeneration or body growth for future reproduction, or invest in an alternative mating tactic, such as surface mating. [ABSTRACT FROM AUTHOR]

Abstract Background The β–(1 → 3),(1 → 6)-D-glucan extracellularly produced by Aureobasidium pullulans exhibits immunomodulatory activity, and is used for health supplements. To examine the effects of oral administration of the β–(1 → 3),(1 → 6)-D-glucan to domestic animals, a small scale study was conducted using Holstein cows and newborn Japanese Black calves. Findings Holstein cows of which somatic cell count was less than 3 x 105/ml were orally administered with or without the β-(1 → 3),(1 → 6)-D-glucan-enriched A. pullulans cultured fluid (AP-CF) for 3 months, and the properties of milk and serum cytokine expression were monitored. Somatic cell counts were not significantly changed by oral administration of AP-CF, whereas the concentration of solid non fat in the milk tended to increase in the AP-CF administered cows. The results of cytokine expression analysis in the serum using ELISA indicate that the expressions of tumor necrosis factor-α (TNF-α) and interleukin (IL)-6 in all cows which were orally administered with AP-CF became slightly lower than that of control cows after the two-month treatment. On the other hand, IL-8 expression tended to indicate a moderately higher level in all treated cows after the three-month administration of AP-CF in comparison with that of the control cows. Peripartum Japanese Black beef cows and their newborn calves were orally administered with AP-CF, and bacterial flora in the intestines of the calves were analyzed by T-RFLP (terminal restriction fragment length polymorphism). The results suggest that bacterial flora are tendentiously changed by oral administration of AP-CF. Conclusions Our data indicated the possibility that oral administration of the β–(1 → 3),(1 → 6)-D- glucan produced by A. pullulans affects cytokine expressions in the serum of Holstein cows, and influences bacterial flora in the intestines of Japanese Black calves. The findings may be helpful for further study on the efficacies of oral administration of β-(1 → 3),(1 → 6)-D-glucans on domestic animals.

Objective: This study was conducted to investigate the mechanisms of anaphylaxis in patients with osteoarthritis of the knee and hip after diclofenac etalhyaluronate [product name: JOYCLU® (JCL)] intra-articular injection and to determine the utility of tests to investigate the mechanism involved., Methods: In this observational study in Japan, patients aged ≥20 years with knee or hip osteoarthritis who received JCL intra-articular injection experienced anaphylactic symptoms considered related to JCL ('experienced patients') or did not experience allergic symptoms considered related to JCL ('non-experienced patients'). Basophil activation tests (BATs), specific immunoglobulin E (IgE) antibody testing by enzyme-linked immunosorbent assays (ELISAs) or immunochromatographic kit, and genome-wide association studies (GWASs) were conducted using patient blood and saliva., Results: Thirteen experienced patients and 14 non-experienced patients were tested. Seven experienced patients tested positive by BAT using diclofenac etalhyaluronate-containing test substances. Diclofenac-specific IgE antibodies were detected in four of seven BAT-positive patients but not in the non-experienced patients. Specific IgE antibody testing by immunochromatographic kit and genome-wide association study showed no clear results., Conclusions: These findings suggest that anaphylaxis occurs after JCL administration via an IgE-mediated mechanism and that diclofenac etalhyaluronate may be involved in this mechanism. BAT and diclofenac -specific IgE enzyme-linked immunosorbent assay may be useful tests for investigating the mechanisms of anaphylactic reactions after JCL administration., (© Japan College of Rheumatology 2023. Published by Oxford University Press.)

Background: Pediatric urinary tract infections are often treated with third-generation cephalosporins; however, the increasing prevalence of Escherichia coli resistant to cephalosporins has reduced their effectiveness. Although resistance is prevalent in Asia, the prescribing patterns and clinical effectiveness of antibiotics have mostly been reported in the United States. This study aimed to describe the prescription patterns and effectiveness of oral antibiotics for treating pediatric urinary tract infections in Japan., Methods: This descriptive study used data from a nationwide Japanese claims database. We identified patients <6 years old with urinary tract infections who received oral antibiotics between January 2016 and December 2020. Descriptive analyses were performed to assess prescription patterns. Moreover, logistic regression analyses were conducted to estimate the odds ratios (ORs) and 95% confidence intervals (95% CIs) for treatment failure among the commonly prescribed antibiotics and patient characteristics. Treatment failure was defined as the prescription of different antibiotics within 7 days of the primary prescription., Results: Of the 4,127 patients, 2,766 (67.0%) were prescribed third-generation cephalosporins, and 347 (8.4%) were prescribed amoxicillin. Trimethoprim-sulfamethoxazole and amoxicillin-clavulanate were prescribed to 63 (1.5%) and 50 (1.2%) patients, respectively. Treatment failure was observed in 118 (2.9%) patients and more often in amoxicillin-treated patients than in cefcapene pivoxil-treated patients [OR, 2.18 (95% CI: 1.04-4.58)]., Conclusions: Third-generation cephalosporins are the most commonly prescribed antibiotics for the initial therapy of pediatric urinary tract infections in Japan. Third-generation cephalosporins are still effective in Japan, despite the high prevalence of resistance against cephalosporins., Competing Interests: D.M. and T.Y. have received personal fees from Real World Data Co., Ltd. K.K. has received research funds from Eisai Co., Ltd., Kyowa Kirin Co., Ltd., Sumitomo Pharma Co., Ltd. and Real World Data Co., Ltd.; consulting fees from LEBER Inc., JMDC Inc., Shin Nippon Biomedical Laboratories Ltd., and Advanced Medical Care Inc.; executive compensation from Cancer Intelligence Care Systems, Inc.; and honoraria from Pharma Business Academy, and Toppan Inc. The other author has no funding or conflicts of interest to disclose., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)