Timolol promotes reactivation of latent HSV-1 in the mouse iontophoresis model.

The present study examined the effect of topical timolol, a nonspecific beta 1 and beta 2 blocker on reactivation and ocular shedding of latent HSV-1 in an improved mouse iontophoresis model. Latent trigeminal ganglionic infection was established in Balb/C mice following inoculation by corneal scarification with HSV-1 W strain, a clinical isolate, and confirmed by co-cultivation. On day 30, postinfection (pi), the mice were divided into two groups, and treatment begun with coded eye drops (timolol 0.5% or placebo) BID OU for 5 days. On day 31 pi, iontophoresis with 1% 6-hydroxydopamine was performed, and daily treatment with topical epinephrine and 1% prednisolone was administered. Reactivation and recovery of latent HSV-1 was determined by daily ocular swabs, and characteristic HSV-1 cytopathic effect in Vero cells. Results demonstrated that the timolol-treated group had a significantly greater number of positive eyes, multiple shedding episodes, and total shedding days compared to the control group. We conclude that beta blockade promotes recurrent ocular shedding induced by epinephrine in the mouse iontophoresis latency model.

Incidence of Moraxella conjunctival infection.

Thirty-three cases of Moraxella conjunctival infection, many incorrectly diagnosed as Chlamydia, epidemic keratoconjunctivitis, and herpes simplex infections, were confirmed by bacterial cultures and Giemsa staining during a one-year period. Although Moraxella conjunctivitis is associated with adolescent girls, 13 of our 27 female patients with Moraxella infection (48%) were 20 years or older. Although corneal involvement, preauricular adenopathy, and ocular nodules are not classically associated with Moraxella conjunctivitis, these symptoms were present in 15 cases (45%).

Review of cyanoacrylate tissue glues with emphasis on their otorhinolaryngological applications.

Cyanoacrylates were first synthesized by Ardis in 1949. However, it was not until Coover in 1959 discovered their adhesive properties that an interest arose in using these substances in surgical procedures. Over the past two decades the use of cyanoacrylates has been varied and widespread among the surgical specialties. methyl 2-cyanoacrylate (Eastman 910 Monomer), Isobutyl-cyanoacrylate (Bucrylate), and 2-cyano-butyl-acrylate (Histoacryl) were the most widely used. Because of its tissue toxicity methyl 2-cyanoacrylate was discarded. The consensus of various investigators was that the higher homologues, in particular Histoacryl could be safely used in human applications. The authors thought it would be important to ascertain how the academic departments of Otolaryngology perceived the role of cyanoacrylates within their specialty. A questionnaire was distributed to 115 academic centers: 47% of the departments responded and, of those, 34% indicated a current working knowledge of the cyanoacrylates. This response confirmed a very active interest in these tissue adhesives despite a lack of F.D.A. approval. The otologic applications of these adhesives has been well documented, but the literature is devoid of studies using cyanoacrylates in other aspects of Otolaryngology. The authors feel that these adhesives (in particular Histoacryl) have a role as an adjunctive technique in facial reconstructive and cosmetic surgery for autogenous cartilage grafting. A study using rabbits was designed to determine if Histoacryl could be used safely to overcome the technical difficulties (graft migration during healing and cartilage fracture during suturing) often encountered when performing autogenous onlay cartilage grafting. On the left ear of each rabbit, a cartilage graft was harvested and reimplanted at a second site on the same ear by suturing the perichondrium of the graft to the perichondrium of the donor site. On the right ear the graft was secured to the donor site with Histoacryl. The histological analysis of the rabbits' ears sacrificed at weekly intervals from 1 week to 1 month failed to demonstrate cartilage damage or tissue toxicity in the ears where Histoacryl was used. In conclusion, the authors contend that a role exists for the use of Histoacryl as an adjunctive technique in facial reconstructive and cosmetic surgery. The study will be continued to assess the long-term results of using Histoacryl for autogenous onlay cartilage grafting.

The effect of alpha blockade on iontophoresis-induced ocular shedding of latent HSV-1 W in different host animals.

Previous studies demonstrated that non-specific beta blockade promoted ocular shedding of latent HSV-1 in the mouse and rabbit iontophoresis models. The present study examined the effect of topical alpha blockers, thymoxamine and corynanthine, on reactivation and induced ocular shedding of latent HSV-1 W in different host animals. Latent trigeminal ganglionic infection was established in Balb/c mice and New Zealand rabbits following corneal inoculation with HSV-1 W strain, and later confirmed by co-cultivation. Treatment with coded eye drops (thymoxamine, corynanthine or BSS was begun one day prior to iontophoresis induction and continued BID OU for 5 days. Reactivation and recovery of latent HSV-1 was determined by daily ocular swabs, and characteristic HSV-1 cytopathic effect in Vero cells. In Balb/c mice, topical administration of thymoxamine 0.5% or corynanthine 5% significantly reduced the number of virus-positive eyes, virus-positive mice, and total virus-positive swabs per experiment, whereas the inhibitory effect was minimal in NZ rabbits. We conclude that alpha blockade may alter the reactivation signal that is mediated via the adrenergic system, and that different host factors (as expressed in different species) may play an important role in this process.