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Sample records for keratoplasty dsaek triple

  1. LASIK hipermetrópico pós-DSAEK (Descement Stripping Automated Endotelial Keratoplasty

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    Antonio Carlos Manhas Meireles

    Full Text Available RESUMO O DSAEK (Descemet stripping automated endotelial Keratoplasty é um dos procedimentos de escolha para tratamento das doenças que acometem o endotélio corneano. Apesar do sucesso terapêutico, o procedimento pode induzir uma hipermetropia residual. Em média a refração se estabiliza em um perído que varia de 6 a 12 meses após o transplante. O objetivo desse relato é descrever a evolução dessa opção terapêutica utilizada em um paciente de 54 anos portador de Distrofia de Fuchs. O paciente foi submetido ao transplante de córnea (DSAEK e a remoção do cristalino no mesmo tempo cirúrgico o que resultou em hipermetropia residual. Após 3 anos de acompanhamento apresentava-se com a melhor visão corrigida de 20/20 (Snellen no olho operado com uma refração de +3,25 -1,00 (5º. Optou-se por realização de LASIK (Laser assisted in situ Keratomileusis hipermetrópico, obtendo um resultado visual satisfatório.

  2. Reproducibility of Corneal Graft Thickness measurements with COLGATE in patients who have undergone DSAEK (Descemet Stripping Automated Endothelial Keratoplasty

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    Wong Melissa HY

    2012-08-01

    Full Text Available Abstract Background The CorneaL GrAft Thickness Evaluation (COLGATE system was recently developed to facilitate the evaluation of corneal graft thickness from OCT images. Graft thickness measurement can be a surrogate indicator for detecting graft failure or success. The purpose of this study was to determine the reproducibility of the COLGATE system in measuring DSAEK graft area between two observers. Methods This was a prospective case series in which 50 anterior segment OCT images of patients who had undergone DSAEK in either eye were analysed. Two observers (MW, AC independently obtained the image analysis for the graft area using both semi automated and automated method. One week later, each observer repeated the analysis for the same set of images. Bland-Altman analysis was performed to analyze inter and intra observer agreement. Results There was strong intraobserver correlation between the 2 semi automated readings obtained by both observers. (r = 0.936 and r = 0.962. Intraobserver ICC for observer 1 was 0.936 (95% CI 0.890 to 0.963 and 0.967 (95% CI 0.942 to 0.981 for observer 2. Likewise, there was also strong interobserver correlation (r = 0.913 and r = 0.969. The interobserver ICC for the first measurements was 0.911 (95% CI 0.849 to 0.949 and 0.968 (95% CI 0.945 to 0.982 for the second. There was statistical difference between the automatic and the semi automated readings for both observers (p = 0.006, p = 0.003. The automatic readings gave consistently higher values than the semi automated readings especially in thin grafts. Conclusion The analysis from the COLGATE programme can be reproducible between different observers. Care must be taken when interpreting the automated analysis as they tend to over estimate measurements.

  3. Changes in corneal sensation, epithelial damage, and tear function after descemet stripping automated endothelial keratoplasty.

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    Hirayama, Yumiko; Satake, Yoshiyuki; Hirayama, Masatoshi; Shimazaki-Den, Seika; Konomi, Kenji; Shimazaki, Jun

    2013-09-01

    To study the ocular surface changes in eyes after Descemet stripping automated endothelial keratoplasty (DSAEK) compared with those after penetrating keratoplasty (PKP). This prospective study compared the changes in 31 eyes of 28 patients who underwent DSAEK (DSAEK group) with those in 15 disease-matched eyes of 15 patients who underwent PKP (PKP group). Corneal epithelial integrity was evaluated using a fluorescein staining score. Corneal sensation was measured with a Cochet-Bonnet esthesiometer. Tear function was evaluated using the Schirmer test, tear clearance test, tear function index, and tear break-up time. The postoperative fluorescein staining score was significantly higher in the PKP group than in the DSAEK group (P = 0.02). Postoperative corneal sensation was significantly better in the DSAEK group than in the PKP group (P sensation after DSAEK was significantly better than the preoperative value (P = 0.02). There were no statistically significant changes in the Schirmer test, tear clearance test, tear function index, or break-up time before and after the surgery in both the DSAEK and PKP groups. No significant differences were observed between the DSAEK and PKP groups after the surgery. Corneal sensation was preserved, and epithelial damage was less severe after DSAEK compared with PKP. Preservation of corneal sensation may contribute to the early recovery of visual function and long-term maintenance of ocular surface health after DSAEK.

  4. Tectonic DSAEK for the Management of Impending Corneal Perforation

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    Enrique O. Graue-Hernandez

    2012-01-01

    Full Text Available Purpose. To report a case of severe corneal thinning secondary to dry eye treated with a tectonic Descemet stripping automated lamellar keratoplasty (DSAEK and amniotic membrane graft. Methods. A 72-year-old man with a history of long standing diabetes mellitus type 2 and dry eye presented with 80% corneal thinning and edema on the right eye and no signs of infectious disease, initially managed with topical unpreserved lubrication and 20% autologous serum drops. Eight weeks after, the defect advanced in size and depth until Descemetocele was formed. Thereafter, he underwent DSAEK for tectonic purposes. One month after the procedure, the posterior lamellar graft was well adhered but a 4 mm epithelial defect was still present. A multilayered amniotic membrane graft was then performed. Results. Ocular surface healed quickly and reepithelization occurred over a 2-week period. Eight months after, the ocular surface remained stable and structurally adequate. Conclusion. Tectonic DSAEK in conjunction with multilayered amniotic graft may not only provide structural support and avoid corneal perforation, but may also promote reepithelization and ocular surface healing and decrease concomitant inflammation.

  5. Evaluation of an interlaced triple procedure: penetrating keratoplasty, extracapsular cataract extraction, and nonopen-sky intraocular lens implantation.

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    Yang, Shuo; Wang, Bin; Zhang, Yangyang; Zhai, Hualei; Wang, Junyi; Wang, Shuang; Xie, Lixin

    2017-09-01

    To evaluate an interlaced triple procedure that involved penetrating keratoplasty (PKP), extracapsular cataract extraction (ECCE) using diathermy capsulotomy, and nonopen-sky intraocular lens (IOL) implantation.This retrospective study involved data from 34 patients who were diagnosed with severe corneal opacities and cataracts. These patients were divided into an interlaced procedure group (21 patients) and a traditional procedure group (13 patients). In the interlaced group, the method of continuous curvilinear capsulorhexis (CCC) was completed via diathermy capsulotomy. The donor corneal button was sutured at 8 positions (at equal intervals) using 10-0 nylon sutures, and the IOL was inserted into the capsular bag using a closed anterior chamber approach at the 10:30 to 12 o'clock positions between the sutures. In the traditional group, CCC was completed using side-port capsular forceps, and the IOL was implanted using an open anterior chamber approach.In the interlaced group, the CCC, open-sky, and total operation times were significantly shorter than in the traditional group (P < .05). Neither the best-corrected visual acuity (BCVA) nor corneal endothelial cell density was significantly different between the groups at 1 and 6 months after the operation.This interlaced triple procedure for the treatment of corneal diseases with cataracts appears to be feasible and practical.

  6. Opacification of hydrophilic intraocular lenses after Descemet stripping automated endothelial keratoplasty

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    Morgan-Warren PJ

    2015-02-01

    Full Text Available Peter J Morgan-Warren, Walter Andreatta, Amit K Patel Department of Ophthalmology, Solihull Hospital, Heart of England NHS Foundation Trust, Birmingham, UK Purpose: Opacification of hydrophilic acrylic intraocular lenses (IOLs is an emerging complication following Descemet stripping automated endothelial keratoplasty (DSAEK. We report six cases and review the current literature.Methods: In this retrospective, noncomparative, observational case series, patients with IOL opacification after previous DSAEK surgery were identified from corneal clinic records. Case notes were reviewed for demographic details, indication for DSAEK, IOL model, incidence of rebubbling, and postoperative course.Results: Six patients developed IOL opacification after DSAEK. All patients had Fuchs’ endothelial dystrophy and had previously received hydrophilic acrylic IOL models. Central anterior IOL opacification was noted in all six cases. Five cases (83% had required rebubbling due to dislocated graft tissue, and one had an early postoperative intraocular pressure (IOP rise. Five cases (83% were managed conservatively, and one case with a failed graft underwent redo DSAEK and IOL exchange.Conclusion: Repeated exposure to intracameral air, raised IOP, and other patient influences may be major etiological factors for IOL opacification after DSAEK. We advise avoiding hydrophilic acrylic IOL models in patients who may require future endothelial keratoplasty. Keywords: IOL, DSAEK, lamellar keratoplasty, endothelial corneal transplantation

  7. Intraocular lens opacification after Descemet's stripping automated endothelial keratoplasty

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    Meng-Sheng Lee

    2017-01-01

    Full Text Available Compared with conventional penetrating keratoplasty, Descemet's stripping automated endothelial keratoplasty (DSAEK more effectively maintain global integrity and rapid vision rehabilitation with less ocular surface disorders in patients with endothelial dysfunction. Here, we report a case of a 76-year-old woman who experienced opacification of a hydrophilic intraocular lens (IOL approximately 10 months after DSAEK. The patient with no history of systemic disease developed pseudophakic bullous keratopathy in the right eye 2 years after undergoing cataract surgery. The best-corrected visual acuity (BCVA of the right eye was Snellen 0.01 when presented to our hospital. DSAEK was arranged and performed smoothly. However, the graft detached over the upper part of the cornea on postoperative day 1. Thus, rebubbling was performed immediately. After the procedure, the graft was well attached, and the cornea became clear gradually. The BCVA returned to Snellen 0.6. However, progressive opacification over the anterior surface of the IOL was observed 10 months postoperatively. Vision deteriorated to 0.5 with various refractive errors during 2-year follow-up. IOL exchange may be considered if the vision is getting worse. IOL opacification may result from a direct contact between the IOL surface and exogenous air, particularly in a hydrophilic IOL, and can be a rare but significant complication after DSAEK. Clinicians planning to perform DSAEK should consider the composition of the IOL, the amount of intracameral air, duration of air filling, and high intraocular pressure.

  8. Topographic characteristics after Descemet's membrane endothelial keratoplasty and Descemet's stripping automated endothelial keratoplasty.

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    Takahiko Hayashi

    Full Text Available To investigate the topographic characteristics of the posterior corneal surface after Descemet's endothelial membrane keratoplasty (DMEK and Descemet's stripping automated endothelial keratoplasty (DSAEK and their effects on postoperative visual acuity.Nineteen eyes of 19 patients after DMEK, 23 eyes of 23 patients after DSAEK, and 18 eyes of 18 control subjects were retrospectively analyzed. Best spectacle-corrected visual acuity (BSCVA, aberration factors (higher-order aberrations [HOAs], spherical aberrations [SAs], and coma aberrations [Comas] at 6.0 mm were evaluated preoperatively and at 1, 3, and 6 months postoperatively. The posterior refractive pattern of the topography map was classified into 5 grades (0-5 (posterior color grade using anterior segment optical coherence tomography. Correlations between BSCVA and some factors (abbreviation factors, posterior color grade were analyzed.BSCVA was significantly better after DMEK than after DSAEK (P < 0.001. Posterior HOAs, SAs, and Comas after each type of endothelial keratoplasty were significantly greater compared to control (P < 0.01. Posterior HOAs, total/anterior/posterior SAs, and posterior color grade were significantly lower in the DMEK group than in the DSAEK group at 3 months (P < 0.024 [posterior HOAs], P = 0.047 [total SA], P < 0.001 [anterior SAs], P = 0.021 [posterior SAs], and P < 0.001 [posterior color grade] and 6 months postoperatively (P = 0.034 [posterior HOAs], P < 0.001 [total SAs], P < 0.001 [anterior SAs], P = 0.013 [posterior SAs], and P = 0.004 [posterior color grade]. BSCVA was significantly correlated with HOAs, SAs, and posterior color grade (P < 0.001 for all except anterior HOAs [P = 0.004].High posterior color grades were associated with larger aberration factors and had a negative effect on visual function after endothelial keratoplasty. Rapid improvement of visual function after DMEK may be attributed to less change at the posterior surface.

  9. Donor disc attachment assessment with intraoperative spectral optical coherence tomography during descemet stripping automated endothelial keratoplasty

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    Edward Wylegala

    2013-01-01

    Full Text Available Optical coherence tomography has already been proven to be useful for pre- and post-surgical anterior eye segment assessment, especially in lamellar keratoplasty procedures. There is no evidence for intraoperative usefulness of optical coherence tomography (OCT. We present a case report of the intraoperative donor disc attachment assessment with spectral-domain optical coherence tomography in case of Descemet stripping automated endothelial keratoplasty (DSAEK surgery combined with corneal incisions. The effectiveness of the performed corneal stab incisions was visualized directly by OCT scan analysis. OCT assisted DSAEK allows the assessment of the accuracy of the Descemet stripping and donor disc attachment.

  10. The use of postoperative slit-lamp optical coherence tomography to predict primary failure in descemet stripping automated endothelial keratoplasty.

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    Shih, Carolyn Y; Ritterband, David C; Palmiero, Pat-Michael; Seedor, John A; Papachristou, George; Harizman, Noga; Liebmann, Jeffrey M; Ritch, Robert

    2009-05-01

    To determine if central donor lenticle thickness as measured by slit-lamp optical coherence tomography (SL OCT; Heidelberg Engineering, Heidelberg, Germany) is predictive of primary donor failure in patients undergoing Descemet stripping automated endothelial keratoplasty (DSAEK). Retrospective cross-sectional study. Eighty-four patients who underwent DSAEK surgery by 2 surgeons (D.C.R. and J.A.S.) were enrolled. At each postoperative visit (postoperative day 1, week 1, month 1, and month 2), an SL OCT scan was obtained. Statistical differences in SL OCT measurements of successful and failed DSAEK procedures were measured using the Student t test. A successful DSAEK surgery was defined as having an anatomically attached, clear recipient corneal stroma and donor lenticle compatible with good vision 2 months after surgery. A failed DSAEK surgery was defined as an attached donor lenticle with SL evidence of corneal edema and thickening visible at 2 months or more. Ninety-three eyes of 84 consecutive patients who underwent DSAEK surgery also underwent postoperative SL OCT. After 2 months of follow-up, 82 (88%) procedures were successful and 11 (12%) procedures were failures. The average donor lenticle thickness in successful DSAEK eyes was 314 +/- 128 microm on postoperative day 1 as compared with failed DSAEK eyes, which averaged 532 +/- 259 microm (P = .0013). This was independent regardless of whether the lenticle was attached on the first postoperative visit. Seventy-nine (98%) successful DSAEK eyes had a lenticle thickness of or = 350 microm at the 1-week postoperative visit. Statistically significant differences in SL OCT thickness measurements were seen between successful and failed DSAEK cases at all examinations after postoperative week 1. Corneal thickness measurements made with SL OCT are an important predictor of DSAEK failure in both attached and detached lenticles within the first week of surgery. DSAEK lenticle thickness of 350 microm or less at 1 week

  11. [Descemet's stripping automated endothelial keratoplasty (DEAEK). Systematic review of clinical-effectiveness and safety].

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    Paz-Valiñas, L; de la Fuente-Cid, R; de Rojas-Silva, M V; López-Rodríguez, I; López-García, M

    2015-04-01

    To conduct a systematic review of the efficacy/effectiveness, safety and cost of Descemet's stripping automated endothelial keratoplasty (DSAEK) technique in patients with corneal endothelial failure. Comprehensive literature search conducted in the main biomedical databases from January-May 2012. Following a critical perusal of the total of 485 abstracts retrieved, 16 case series and one economic evaluation study were included. Corrected distance visual acuity and uncorrected distance visual acuity improved after treatment with DSAEK, attaining values of 0.6 to 0.8 and 0.5 respectively. The degree of post-DSAEK astigmatism was not significant with respect to baseline values. The main complications were graft dislocation-detachment (1.5-23%), primary failure (0-12%) and endothelial rejection (0.8-8.5%). In Fuchs' dystrophy and bullous keratopathy, data on the effectiveness of DSAEK indicate post-intervention improvement in uncorrected and corrected distance visual acuity. Astigmatism arising after DSAEK was not significant. The most significant post-DSAEK complications are linked to the viability of the graft, with the most frequent complications being dislocation-detachment and, to a lesser extent, endothelial rejection. The studies that assess DSAEK are case series, and for the most part retrospective. The quality of this type of studies is both low and limited. Copyright © 2012 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  12. Confocal microscopy findings in deep anterior lamellar keratoplasty performed after Descemet's stripping automated endothelial keratoplasty

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    Pang A

    2014-01-01

    Full Text Available Audrey Pang,1,2 Karim Mohamed-Noriega,1 Anita S Chan,1,3–5 Jodbhir S Mehta1,3 1Singapore National Eye Centre, 2Department of Ophthalmology, Tan Tock Seng Hospital, 3Singapore Eye Research Institute, 4Department of Histopathology, Pathology, Singapore General Hospital, 5Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Background: This study describes the in vivo confocal microscopy findings in two patients who had deep anterior lamellar keratoplasty (DALK following Descemet's stripping automated endothelial keratoplasty (DSAEK. Methods: The study reviewed the cases of two patients who first underwent DSAEK followed by DALK when their vision failed to improve due to residual stromal scarring. In the first case, a DSAEK was performed for a patient with pseudophakic bullous keratopathy. After surgery, the patient's vision failed to improve satisfactorily due to residual anterior stromal opacity and irregularity. Subsequently, the patient underwent a DALK. The same two consecutive operations were performed for a second patient with keratoconus whose previous penetrating keratoplasty had failed and had secondary graft ectasia. In vivo confocal microscopy was performed 2 months after the DALK surgery in both cases. Results: At 3 months after DALK, the best-corrected visual acuity was 6/30 in case 1 and 6/24 in case 2. In vivo confocal microscopy in both cases revealed the presence of quiescent keratocytes in the stroma layers of the DSAEK and DALK grafts, which was similar in the central and peripheral cornea. There was no activated keratocytes or haze noted in the interface between the grafts. Conclusion: Our short-term results show that performing a DALK after a DSAEK is an effective way of restoring cornea clarity in patients with residual anterior stromal opacity. In vivo confocal microscopy showed that there were no activated keratocytes seen in the interface of the grafts, which suggests

  13. Topographic hot spot before descemet stripping automated endothelial keratoplasty is associated with postoperative hyperopic shift.

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    Shimizu, Tsutomu; Yamaguchi, Takefumi; Satake, Yoshiyuki; Shimazaki, Jun

    2015-03-01

    The aim of this study was to investigate topographic "hot spots" on the anterior corneal surface before Descemet stripping automated endothelial keratoplasty (DSAEK) and their effects on postoperative visual acuity and hyperopic shift. Twenty-seven eyes of 27 patients with bullous keratopathy, who underwent DSAEK were studied. We defined a hot spot as a focal area with relatively high refractive power on the anterior corneal surface in eyes with bullous keratopathy. Refractive spherical equivalent, keratometric value, and corneal topography were retrospectively evaluated using anterior segment optical coherence tomography (AS-OCT). Hot spots were identified in 11 eyes (42.3%) before DSAEK and disappeared in 9 eyes of these eyes (81.8%) at 6 months after DSAEK. AS-OCT revealed focal epithelial thickening in the same areas as the hot spots. There was no significant difference in the postoperative visual acuity between eyes with and without hot spots (P > 0.05). The keratometric value of the anterior corneal surface significantly flattened from 45.7 ± 2.7 diopters (D) before DSAEK to 44.2 ± 2.7 D 1 month after DSAEK in eyes with hot spots (P = 0.01), whereas in eyes without hot spots, there were no significant differences in the keratometric values before and after DSAEK. At 6 months, the refractive change was +1.1 ± 1.3 D in eyes with hot spots and -0.2 ± 0.6 D in eyes without hot spots (P = 0.034). In eyes with focal epithelial thickening, topographic hot spots on the anterior corneal surface were observed using AS-OCT. The hot spots disappeared after DSAEK and had no influence on the postoperative visual acuity.

  14. New continuous air pumping technique to improve clinical outcomes of descemet-stripping automated endothelial keratoplasty in asian patients with previous ahmed glaucoma valve implantation.

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    Chang-Min Liang

    Full Text Available BACKGROUND: To evaluate the outcomes of Descemet-stripping automated endothelial keratoplasty (DSAEK with the use of continuous air pumping technique in Asian eyes with previous Ahmed glaucoma valve implantation. METHODS: The DSAEK procedure was modified in that complete air retention of the anterior chamber was maintained for 10 min using continuous air pumping at 30 mm Hg. The primary outcome measurement was graft survival, and postoperative clinical features including, rate of graft detachment, endothelial cell count, intraocular pressure (IOP, surgical time and cup/disc ratio were also recorded. RESULTS: A total of 13 eyes of 13 patients which underwent modified DSAEK and 6 eyes of 6 patients which underwent conventional DSAEK were included. There was a significant difference in graft survival curves between two groups (P = 0.029; the 1-year graft survival rates were estimated as 100% and 66.7% for patients with modified DSAEK and those with traditional DSAEK, respectively. The rate of graft detachment were 0% and 33.3% for the modified DSAEK and conventional DSAEK groups, respectively (P = 0.088. The significantly lowered surgical time for air tamponade was noted in the modified DSAEK group compared to that in the conventional DSAEK group [median (IQR: 10.0 (10.0, 10.0 min vs. 24.5 (22.0, 27.0 min; P<0.001] Postoperatively, patients in the modified DSAEK group had significantly lower IOP as compared to the conventional DSAEK group [12.0 (11.0, 15.0 mm Hg vs. 16.0 (15.0, 18.0 mm Hg; P = 0.047]. Modified DSAEK patients had higher endothelial cell counts as compared to conventional DSAEK patients [2148.0 (1964.0, 2218.0 vs. 1529.0 (713.0, 2014.0], but the difference did not reach statistical significance (P = 0.072. CONCLUSIONS: New continuous air pumping technique in DSAEK can be performed safely and effectively in patients with prior GDDs placement who have corneal failure.

  15. Descemet's stripping-automated endothelial keratoplasty for symptomatic thioridazine deposits in the cornea

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    Masoumeh Mohebbi

    2017-01-01

    Full Text Available The aim of this study was to use Descemet's Stripping-automated Endothelial Keratoplasty (DSAEK as a novel treatment to remove thioridazine corneal deposits. A 53-year-old female presented with a 3-month history of visual loss and glare. She had been taking thioridazine (100 mg/day for 1 year for a psychiatric disorder. Dense yellowish-brown deposits had developed in the posterior stroma. Thioridazine was discontinued, and she was switched to fluoxetine. One year after discontinuation of thioridazine, her symptoms and signs did not resolve. Standard DSAEK was performed on her left eye. Two weeks after DSAEK, an anterior subcapsular cataract was detected in the same eye. Phacoemulsification and intraocular lens implantation were performed after 3 months. The left cornea became completely clear after DSAEK, and the patient's best-corrected visual acuity improved from 20/40 to 20/20 at 1 month after cataract surgery. All-visual symptoms such as glare and halos improved postoperatively. We suggest that DSAEK can be used as a novel treatment to reduce vision problems caused by thioridazine-induced corneal deposits.

  16. Keratocyte apoptosis and not myofibroblast differentiation mark the graft/host interface at early time-points post-DSAEK in a cat model.

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    Adam J Weis

    Full Text Available To evaluate myofibroblast differentiation as an etiology of haze at the graft-host interface in a cat model of Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK.DSAEK was performed on 10 eyes of 5 adult domestic short-hair cats. In vivo corneal imaging with slit lamp, confocal, and optical coherence tomography (OCT were performed twice weekly. Cats were sacrificed and corneas harvested 4 hours, and 2, 4, 6, and 9 days post-DSAEK. Corneal sections were stained with the TUNEL method and immunohistochemistry was performed for α-smooth muscle actin (α-SMA and fibronectin with DAPI counterstain.At all in vivo imaging time-points, corneal OCT revealed an increase in backscatter of light and confocal imaging revealed an acellular zone at the graft-host interface. At all post-mortem time-points, immunohistochemistry revealed a complete absence of α-SMA staining at the graft-host interface. At 4 hours, extracellular fibronectin staining was identified along the graft-host interface and both fibronectin and TUNEL assay were positive within adjacent cells extending into the host stroma. By day 2, fibronectin and TUNEL staining diminished and a distinct acellular zone was present in the region of previously TUNEL-positive cells.OCT imaging consistently showed increased reflectivity at the graft-host interface in cat corneas in the days post-DSAEK. This was not associated with myofibroblast differentiation at the graft-host interface, but rather with apoptosis and the development of a subsequent acellular zone. The roles of extracellular matrix changes and keratocyte cell death and repopulation should be investigated further as potential contributors to the interface optical changes.

  17. Preparation of pre-cut corneas from fresh donated whole globes for Descemet's stripping automated keratoplasty: 3-year results at the Central Eye Bank of Iran.

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    Kanavi, Mozhgan Rezaei; Javadi, Mohammad Ali; Javadi, Fatemeh; Chamani, Tahereh

    2014-09-01

    To describe the technique and the results of the preparation of pre-cut corneas for Descemet's stripping automated endothelial keratoplasty (DSAEK) during a 3-year period at the Central Eye Bank of Iran (CEBI). The method of preparation of pre-cut corneas from donated whole globes at the CEBI is described and the frequency and percentage of pre-cut corneas prepared for DSAEK, between April 2009 and March 2012, are specified. Moreover, post-operative reports are reviewed for any complaints about using pre-cut tissues for DSAEK. Out of the 1,518 donated whole globes appropriate for DSAEK, 1,478 (97.4 %) pre-cut corneas were successfully prepared. The method of preparation failed in 40 (2.6 %) cases. Based on the eye bank post-operative reports, thickness of pre-cut tissues for DSAEK was deemed unacceptable in only 6 (0.4 %) cases prior to surgery; five of these were too thick and one was too thin. Preparation of pre-cut corneas, for DSAEK from donated whole globes, in the CEBI is a safe and easy method, with very good preservation of endothelial cells after the preparation of the pre-cut corneas and reduced risks from corneal manipulation.

  18. Candida Endophthalmitis After Descemet Stripping Automated Endothelial Keratoplasty With Grafts From Both Eyes of a Donor With Possible Systemic Candidiasis.

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    Palioura, Sotiria; Sivaraman, Kavitha; Joag, Madhura; Sise, Adam; Batlle, Juan F; Miller, Darlene; Espana, Edgar M; Amescua, Guillermo; Yoo, Sonia H; Galor, Anat; Karp, Carol L

    2018-04-01

    To report 2 cases with late postoperative Candida albicans interface keratitis and endophthalmitis after Descemet stripping automated endothelial keratoplasty (DSAEK) with corneal grafts originating from a single donor with a history of presumed pulmonary candidiasis. Two patients underwent uncomplicated DSAEK by 2 corneal surgeons at different surgery centers but with tissue from the same donor and were referred to the Bascom Palmer Eye Institute with multifocal infiltrates at the graft-host cornea interface 6 to 8 weeks later, and anterior chamber cultures that were positive for the same genetic strain of C. albicans. Immediate explantation of DSAEK lenticules and daily intracameral and instrastromal voriconazole and amphotericin injections failed to control the infection. Thus, both patients underwent therapeutic penetrating keratoplasty with intraocular lens explantation, pars plana vitrectomy, and serial postoperative intraocular antifungal injection. Both patients are doing well at 2 years postoperatively with best-corrected vision of 20/20 and 20/30+ with rigid gas permeable lenses. One patient required repeat optical penetrating keratoplasty and glaucoma tube implantation 1 year after the original surgery. Literature review reveals that donor lenticule explantation and intraocular antifungals are often inadequate to control fungal interface keratitis, and a therapeutic graft is commonly needed. Interface fungal keratitis and endophthalmitis due to infected donor corneal tissue is difficult to treat, and both recipients of grafts originating from the same donor are at risk of developing this challenging condition.

  19. Non-Descemet’s stripping automated endothelial keratoplasty for bullous keratopathy secondary to iridoschisis

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    Minezaki T

    2013-07-01

    Full Text Available Teruumi Minezaki, Takaaki Hattori, Hayate Nakagawa, Shigeto Kumakura, Hiroshi GotoDepartment of Ophthalmology, Tokyo Medical University, Shinjukuku, Tokyo, JapanPurpose: To report a case of bullous keratopathy secondary to iridoschisis treated by non-Descemet's stripping automated endothelial keratoplasty (nDSAEK.Case report: A 79-year-old woman was referred to our hospital with loss of vision in the left eye. Slit lamp examination of her left eye showed a shallow anterior chamber with cataract and schisis in the inferior quadrant of iris stroma. Bullous keratopathy secondary to iridoschisis was diagnosed. Cataract surgery with iridectomy succeeded to deepen the anterior chamber and remove the floating iris leaf, although corneal edema remained. Four days later, nDSAEK was performed, which resolved corneal edema and restored visual acuity.Conclusion: The two-step surgery of cataract surgery plus iridectomy followed by nDSAEK may be an effective strategy for treating bullous keratopathy secondary to iridoschisis.Keywords: iridoschisis, bullous keratopathy, non-Descemet's stripping automated endothelial keratoplasty

  20. Descemet Stripping Automated Endothelial Keratoplasty for Failed Penetrating Keratoplasty: Influence of the Graft-Host Junction on the Graft Survival Rate.

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    Omoto, Takashi; Sakisaka, Toshihiro; Toyono, Tetsuya; Yoshida, Junko; Shirakawa, Rika; Miyai, Takashi; Yamagami, Satoru; Usui, Tomohiko

    2018-04-01

    To investigate the clinical results of Descemet stripping automated endothelial keratoplasty (DSAEK) for failed penetrating keratoplasty (PK) and the influence of the graft-host junction (GHJ) on the graft survival rate. Data were retrospectively collected on patient demographics, visual outcomes, complications, and graft survival rate for 17 eyes of 16 patients who underwent DSAEK for failed PK. The graft survival rate was compared between the eyes when divided into a bump group and a well-aligned group according to the shape of the GHJ detected on anterior segment optical coherence tomography. The most common indication for initial PK was bullous keratopathy after glaucoma surgery (35.3%). Seven eyes (41.2%) were classified into the bump group and 10 eyes (58.8%) into the well-aligned group. The mean best-ever documented visual acuity (BDVA) after DSAEK was 0.33 logMAR. Postoperatively, almost 70% of eyes achieved a BDVA that was within 0.2 logMAR of their preoperative BDVA. Graft detachment occurred in 29.4% of eyes and primary graft failure in 17.6%. All primary failures occurred in the bump group. The cumulative graft survival rate was 82.3% at 1 year, 73.2% at 2 years, and 58.6% at 3 years. Graft failure was more likely in eyes in the bump group than in those in the well-aligned group (P = 0.037, Wilcoxon test). DSAEK for failed PK had a favorable outcome in this study. However, the GHJ should be assessed carefully before performing the procedure.

  1. Outcome of Descemet stripping automated endothelial keratoplasty in eyes with an Ahmed glaucoma valve.

    Science.gov (United States)

    Chiam, Patrick J; Cheeseman, Robert; Ho, Vivian W; Romano, Vito; Choudhary, Anshoo; Batterbury, Mark; Kaye, Stephen B; Willoughby, Colin E

    2017-05-01

    The purpose was to investigate the survival of Descemet stripping automated endothelial keratoplasty (DSAEK) in eyes with an Ahmed glaucoma valve (AGV). The study had a retrospective case-series of patients with an AGV in the anterior chamber undergoing a DSAEK. Included in the analysis were graft size, number of previous operations, post-operative glaucoma medications, post-operative intraocular pressure (IOP) control, graft size and donor factors (age, endothelial cell density, and post-mortem time). A generalised linear model with binary logistic regression was used to test for an effect on graft survival at 1 year and 1.5 years. Fourteen eyes from 13 patients were included. The survival rate of the first DSAEK at 6, 12, 18, 24 and 30-months was 85%, 71%, 50%, 36% and 30%, respectively. The mean duration to graft failure was 12.9 ± 6.2 months. Five of the seven failed first grafts went on to have a repeat DSAEK. The mean follow-up in this subgroup was 30.7 ± 18.4 months. The survival rate of second DSAEK at 6, 12, 18 and 24 months was 100% (5/5), 100% (5/5), 75% (3/4) and 67% (2/3). Only one second DSAEK failed in the duration of the study and went on to receive a third DSAEK which failed at 18-months. The mean IOP within the first year was significantly lower for grafts that survived at 1 and 1.5 years (17.4 mmHg, 16.9 mmHg) than for grafts that failed (19.4 mmHg, 19.4 mmHg) (p = 0.04, p = 0.009). DSAEK is a viable alternative to PK to restore visual function in eyes with an AGV sited in the anterior chamber. IOP is an important risk factor for graft failure.

  2. Intraocular pressure measurements and corneal biomechanical properties using a dynamic Scheimpflug analyzer, after several keratoplasty techniques, versus normal eyes.

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    Hugo, J; Granget, E; Ho Wang Yin, G; Sampo, M; Hoffart, L

    2018-01-01

    To evaluate the biomechanical properties of the cornea and their impact on intraocular pressure (IOP) measurement after lamellar keratoplasty, compared to healthy eyes, using a non-contact tonometer with a Scheimpflug camera. This study, from 2014 to 2015, included 22 primary DSAEK, 5 DALK, 6 DSAEK after PK, and 50 control eyes. Using a non-contact tonometer with a high-speed Scheimpflug camera (CORVIS ST, Oculus Optikgeräte GmbH, Wetzlar, Germany), several biomechanical parameters were recorded, including radius at highest concavity (R hc ) and defomation amplitude (DA). Central corneal thickness (CCT) and uncorrected IOP, were also recorded. For the control eyes only, a corrected IOP was calculated, based on age, central corneal thickness, and biomechanical parameters. R hc was significantly lower after DALK (R hc =5.54±0.71, P=0.007) and DSAEK (R hc =6.26±0.77, P=0.042) compared to control eyes (R hc =6.82±0.76). DA was higher after DALK and DSAEK, but not significantly (respectively 1.24±0.09 P=0.41 and 1.22±0.15, P=0.923) compared to normal eyes (1.18±0.15). Uncorrected IOP was not significantly different between post-keratoplasty and control eyes. In control eyes, the corrected IOP (15.23±1.88) was lower than the uncorrected IOP (16.10±2.34); a statistically significant positive correlation between R hc and CCT (R 2 =0.6020, P<0001), and a significant negative correlation between DA and CCT (R 2 =-0.641, P<0.0001) were found. Our study showed that, after lamellar keratoplasty, corneal biomechanics are altered. Corneas with higher ocular rigidity will show a lower DA and a higher R hc . Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  3. New techniques in lamellar keratoplasty.

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    Alio, Jorge L; Shah, Sunil; Barraquer, Carmen; Bilgihan, Kamil; Anwar, Mohammed; Melles, Gerrit R J

    2002-08-01

    In the past years, several lamellar keratoplasty surgical techniques have been developed, modified or improved in the past years, including microkeratome assisted anterior and posterior lamellar keratoplasty, anterior lamellar keratoplasty using air-dissection or visco-dissection, sutureless posterior lamellar keratoplasty, LASIK for postkeratoplasty astigmatism, and excimer laser assisted keratophakia for keratoconus or to manage complications after LASIK. These procedures may continue to gain interest as alternative procedures for a penetrating keratoplasty in the treatment of various corneal disorders.

  4. Long-Term Functional and Anatomical Outcome after Descemet Stripping Automated Endothelial Keratoplasty: A Prospective Single-Center Study

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    Jeroen van Rooij

    2018-01-01

    Full Text Available Purpose. To investigate the long-term anatomical and functional outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK. Methods. Prospective follow-up of 114 eyes (95 subjects after DSAEK for endothelial dysfunction. Measurements included best spectacle-corrected visual acuity (BSCVA, straylight, endothelial cell density (ECD, and graft thickness. Results. The mean follow-up time was 5.1 ± 1.5 years. Four grafts ultimately failed (after 5 to 7 years. From baseline up to 1 year after DSAEK, mean BSCVA improved by 0.30 logMAR. This beneficial effect remained until the last follow-up (LFU. After DSAEK, straylight was reduced. ECD sharply dropped by 900 cells/mm2 (33% immediately after surgery and, thereafter, steadily decreased at a rate of 11 cells/mm2 per month. No significant correlation was observed between graft thickness at 3 years and BSCVA. Conclusions. We observed a low graft failure rate and a normalization of graft thickness. Postoperative straylight remained elevated relative to the normal population. The sharp initial and the subsequent more gradual ECD decline are consistent with other studies. A significant and prolonged functional gain can be achieved by posterior lamellar grafting for endothelial dysfunction.

  5. Nomogram to Predict Graft Thickness in Descemet Stripping Automated Endothelial Keratoplasty: An Eye Bank Study.

    Science.gov (United States)

    Bae, Steven S; Menninga, Isaac; Hoshino, Richard; Humphreys, Christine; Chan, Clara C

    2018-06-01

    The purpose of this study was to develop a nomogram to predict postcut thickness of corneal grafts prepared at an eye bank for Descemet stripping automated endothelial keratoplasty (DSAEK). Retrospective chart review was performed of DSAEK graft preparations by 3 experienced technicians from April 2012 to May 2017 at the Eye Bank of Canada-Ontario Division. Variables collected included the following: donor demographics, death-to-preservation time, death-to-processing time, precut tissue thickness, postcut tissue thickness, microkeratome head size, endothelial cell count, cut technician, and rate of perforation. Linear regression models were generated for each microkeratome head size (300 and 350 μm). A total of 780 grafts were processed during the study period. Twelve preparation attempts resulted in perforation (1.5%) and were excluded. Mean precut tissue thickness was 510 ± 49 μm (range: 363-670 μm). Mean postcut tissue thickness was 114 ± 22 μm (range: 57-193 μm). Seventy-nine percent (608/768) of grafts were ≤130 μm. The linear regression models included precut thickness and donor age, which were able to predict the thickness to within 25 μm 80% of the time. We report a nomogram to predict thickness of DSAEK corneal grafts prepared in an eye bank setting, which was accurate to within 25 μm 80% of the time. Other eye banks could consider performing similar analyses.

  6. Hybrid Technique of Lamellar Keratoplasty (DMEK-S

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    Pavel Studeny

    2013-01-01

    Full Text Available Purpose: To evaluate the outcomes of the hybrid technique of posterior lamellar keratoplasty (DMEK-S. Materials and Methods: 71 eyes of 55 patients enrolled in a single-center study underwent posterior lamellar keratoplasty with a hybrid lamella DMEK-S implanted using a solution implantation technique, owing to endothelial dysfunction. The outcome measures studied were visual acuity and endothelial cell density. Results: The rate of endothelial cell loss caused by surgery was 43.8%. During followups, we observed the stabilization of postoperative findings, or at minimum a very low rate of corneal endothelial cell loss. The UCDVA and BCDVA dramatically improved postoperatively. The rebubbling rate in our group of patients was 61.9%. We replaced the lamella due to its failure or malfunction in 17 patients (23.9%. Conclusion: In summary, DMEK-S combines the advantages of DSEK/DSAEK and DMEK. The central zone of bare Descemet’s membrane and endothelium allows for very good visual outcomes, and the peripheral rim allows for better manipulation of the lamella during implantation. It is an effective method of treating the endothelial dysfunction of various etiologies, but the high complication rate needs to be addressed before widespread implementation of the technique in the future.

  7. Evolution of endothelial keratoplasty.

    Science.gov (United States)

    Price, Francis W; Price, Marianne O

    2013-11-01

    Endothelial keratoplasty has evolved into a popular alternative to penetrating keratoplasty (PK) for the treatment of endothelial dysfunction. Although the earliest iterations were challenging and were not widely adopted, the iteration known as Descemet stripping endothelial keratoplasty (DSEK) has gained widespread acceptance. DSEK combines a simplified technique for stripping dysfunctional endothelium from the host cornea and microkeratome dissection of the donor tissue, a step now commonly completed in advance by eye bank technicians. Studies show that a newer endothelial keratoplasty iteration, known as Descemet membrane endothelial keratoplasty (DMEK), provides an even faster and better visual recovery than DSEK does. In addition, DMEK significantly reduces the risk of immunologic graft rejection episodes compared with that in DSEK or in PK. Although the DMEK donor tissue, consisting of the bare endothelium and Descemet membrane without any stroma, is more challenging to prepare and position in the recipient eye, recent improvements in instrumentation and surgical techniques are increasing the ease and the reliability of the procedure. DSEK successfully mitigates 2 of the main liabilities of PK: ocular surface complications and structural problems (including induced astigmatism and perpetually weak wounds), whereas DMEK further mitigates the 2 principal remaining liabilities of PK: immunologic graft reactions and secondary glaucoma from prolonged topical corticosteroid use.

  8. Descemet Stripping Automated Endothelial Keratoplasty for Endothelial Dysfunction in Xeroderma Pigmentosum: A Clinicopathological Correlation and Review of Literature.

    Science.gov (United States)

    Vira, Divya; Fernandes, Merle; Mittal, Ruchi

    2016-07-01

    Xeroderma pigmentosum (XP) mainly affects the ocular surface; however, endothelial damage may also occur. We would like to report changes in the endothelial-Descemet layer and review the literature on similar findings in patients with XP, including the role of Descemet stripping automated endothelial keratoplasty (DSAEK) in the management of a 21-year-old man who presented with nonresolving corneal edema in the right eye after excision biopsy for conjunctival intraepithelial neoplasia. His best-corrected visual acuity (BCVA) was 20/200 in the right eye and 20/20 in the left eye. On general examination, there was patchy hyperpigmentation of the exposed areas of skin suggestive of XP. On examination of the right eye, there was stromal edema involving the exposed half of cornea. The left eye appeared normal. Pachymetry readings were 860 and 600 μm in the right and left eye, respectively. Descemet stripping automated endothelial keratoplasty was performed for endothelial dysfunction and the stripped endothelium, and Descemet membrane (DM) was sent for histopathologic evaluation. Postoperatively, the donor lenticule was well apposed and the overlying stromal edema resolved. The patient achieved a BCVA of 20/30 in the right eye without progression of corneal scarring at 1-year follow-up. In the meanwhile, however, the left eye developed corneal edema. Histopathology revealed gross attenuation of endothelial cells with uniform thickness of the DM. Corneal endothelial dysfunction in XP is amenable to treatment with DSAEK.

  9. Patients with Fuchs Endothelial Dystrophy and Cataract Undergoing Descemet Stripping Automated Endothelial Keratoplasty and Phacoemulsification with Intraocular Lens Implant: Staged versus Combined Procedure Outcomes.

    Science.gov (United States)

    Sykakis, Evripidis; Lam, Fook Chang; Georgoudis, Panagiotis; Hamada, Samer; Lake, Damian

    2015-01-01

    Purpose. To compare the surgical outcomes of staged and combined phacoemulsification with intraocular lens implant (phaco+IOL) and Descemet stripping automated endothelial keratoplasty (DSAEK) in patients with Fuchs' endothelial dystrophy and cataract. Setting. Corneoplastic Unit and Eye Bank, Queen Victoria Hospital, East Grinstead, UK. Methods. Retrospective study of patients who had combined phaco+IOL and DSAEK (group 1) or phaco+IOL followed within 2 months by DSAEK (group 2). Patients who had previous eye surgery or any other ocular comorbidities were excluded. Results. There were 28 eyes in group 1 and 31 in group 2. There were no significant differences in the demographics and corneal tissue characteristics of the two groups. The endothelial disc dislocation and rebubbling rate within 1 week in group 1 was 21.42% and in group 2 was 3.2% (P = 0.04), while the endothelial cell density at 12 months was 1510 ± 433 for group 1 and 1535 ± 482 for group 2 (P = 0.89). The mean 12-month logMAR visual acuity was 0.28 ± 0.24 for group 1 and 0.33 ± 0.15 for group 2 (P = 0.38). Conclusions. Although the combined procedure seems to be associated with a higher complication rate the final outcomes seem to be similar to both methods.

  10. Patients with Fuchs Endothelial Dystrophy and Cataract Undergoing Descemet Stripping Automated Endothelial Keratoplasty and Phacoemulsification with Intraocular Lens Implant: Staged versus Combined Procedure Outcomes

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    Evripidis Sykakis

    2015-01-01

    Full Text Available Purpose. To compare the surgical outcomes of staged and combined phacoemulsification with intraocular lens implant (phaco+IOL and Descemet stripping automated endothelial keratoplasty (DSAEK in patients with Fuchs’ endothelial dystrophy and cataract. Setting. Corneoplastic Unit and Eye Bank, Queen Victoria Hospital, East Grinstead, UK. Methods. Retrospective study of patients who had combined phaco+IOL and DSAEK (group 1 or phaco+IOL followed within 2 months by DSAEK (group 2. Patients who had previous eye surgery or any other ocular comorbidities were excluded. Results. There were 28 eyes in group 1 and 31 in group 2. There were no significant differences in the demographics and corneal tissue characteristics of the two groups. The endothelial disc dislocation and rebubbling rate within 1 week in group 1 was 21.42% and in group 2 was 3.2% P=0.04, while the endothelial cell density at 12 months was 1510±433 for group 1 and 1535±482 for group 2 P=0.89. The mean 12-month logMAR visual acuity was 0.28±0.24 for group 1 and 0.33±0.15 for group 2 P=0.38. Conclusions. Although the combined procedure seems to be associated with a higher complication rate the final outcomes seem to be similar to both methods.

  11. Modified Descemet’s Stripping Automated Endothelial Keratoplasty: The Use of Ophthalmic Viscoelastic Devices in Hypotonic Eyes That Had Undergone Glaucoma Filtering Surgeries

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    Itaru Oyakawa

    2018-01-01

    Full Text Available Purpose. Descemet’s stripping automated endothelial keratoplasty (DSAEK is more difficult in hypotonic eyes with filtering bleb, due to the difficulties in elevating the intraocular pressure (IOP. We report a new method that uses ophthalmic viscoelastic devices (OVDs to achieve good graft adhesion. Case Presentation. We performed modified DSAEK surgery on 2 eyes of 2 patients, who had previously undergone a trabeculectomy. Both eyes had functioning filtering blebs; the IOP was lower than 10 mmHg without medication. After the graft was inserted into the anterior chamber, the conjunctiva was penetrated, apart from the bleb, using a 30 G needle, and Healon V® was injected into the bleb until the encapsulated space was filled completely. Air was subsequently injected into the anterior chamber to promote the graft attachment to the back surface of the cornea. The IOP was elevated above 40 mmHg in both eyes 1 h after surgery and then decreased to less than 30 mmHg over the subsequent 3 h period. The implanted graft showed good adhesion and no dislocation. Conclusions. Our novel DSAEK procedure that adds one step of OVD injection into the filtering bleb may be useful for hypotonic eyes that had undergone filtering surgeries.

  12. Combined keratoplasty and cataract extraction.

    Science.gov (United States)

    Demeler, U; Hinzpeter, E N

    1977-04-01

    A short film showing our technique of combined penetrating keratoplasty and intracapsular cataract extraction was shown, and the postoperative results in 72 eyes after an average of 3 years were reported.

  13. Corneal iron ring after conductive keratoplasty.

    Science.gov (United States)

    Kymionis, George D; Naoumidi, Tatiana L; Aslanides, Ioannis M; Pallikaris, Ioannis G

    2003-08-01

    To report formation of corneal iron ring deposits after conductive keratoplasty. Observational case report. Case report. A 54-year-old woman underwent conductive keratoplasty for hyperopia. One year after conductive keratoplasty, iron ring pattern pigmentation was detected at the corneal epithelium of both eyes. This is the first report of the appearance of corneal iron ring deposits following conductive keratoplasty treatment in a patient. It is suggested that alterations in tear film stability, resulting from conductive keratoplasty-induced changes in corneal curvature, constitute the contributory factor for these deposits.

  14. Uneventful Anterior Migration of Intravitreal Ozurdex Implant in a Patient with Iris-Sutured Intraocular Lens and Descemet Stripping Automated Endothelial Keratoplasty.

    Science.gov (United States)

    Zafar, Andleeb; Aslanides, Ioannis M; Selimis, Vasileios; Tsoulnaras, Konstantinos I; Tabibian, David; Kymionis, George D

    2018-01-01

    We report here the case of a patient with anterior segment migration of intravitreal dexamethasone implant as well as its management and outcome. The patient had the following sequence of events: complicated cataract surgery, iris-sutured intraocular lens implant, followed by cystoid macular edema treated with intravitreal Avastin, retinal vein occlusion treated with intravitreal dexamethasone implant, corneal decompensation treated with Descemet stripping automated endothelial keratoplasty (DSAEK), and finally recurrence of macular edema treated with repeated intravitreal dexamethasone implant. Dexamethasone implant had completely dissolved from the eye 12 weeks after insertion without any complication. A conservative approach with regular monitoring in the situation of a quiet anterior segment without any corneal decompensation can provide enough time for the implant to dissolve without causing any complication to the involved eye, avoiding any additional surgical intervention, as presented in this case report. Despite the fact that the implant was left for natural dissolution, there were no adverse effects related to the graft or the eye.

  15. Challenges in pediatric endothelial keratoplasty

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    Vikas Mittal

    2014-01-01

    Full Text Available We performed endothelial keratoplasty (EK in three eyes of two siblings (2.5 years, male and 3.5 years, female with congenital hereditary endothelial dystrophy (CHED and report the intraoperative and postoperative difficulties. Repeated iris prolapse, apprehension of crystalline lens touch due to positive vitreous pressure, and need for frequent air injections to attach the graft were intraoperative challenges in all three eyes. These were addressed by use of Sheet′s glide instead of Busin′s glide during graft insertion and suturing of main and side ports before air injection. One eye had graft dislocation on second postoperative day due to eye rubbing by the child. Graft was repositioned with air and a venting incision was created. Postoperative examination required repeated general anesthesia. Corneal edema resolved completely in all three eyes. Present case series highlights the possible intraoperative and postoperative challenges and their solutions in pediatric EK for CHED.

  16. Femtosecond laser enabled keratoplasty for advanced keratoconus

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    Yathish Shivanna

    2013-01-01

    Full Text Available Purpose : To assess the efficacy and advantages of femtosecond laser enabled keratoplasty (FLEK over conventional penetrating keratoplasty (PKP in advanced keratoconus. Materials and Methods: Detailed review of literature of published randomized controlled trials of operative techniques in PKP and FLEK. Results: Fifteen studies were identified, analyzed, and compared with our outcome. FLEK was found to have better outcome in view of better and earlier stabilization uncorrected visual acuity (UCVA, best corrected visual acuity (BCVA, and better refractive outcomes with low astigmatism as compared with conventional PKP. Wound healing also was noticed to be earlier, enabling early suture removal in FLEK. Conclusions: Studies relating to FLEK have shown better results than conventional PKP, however further studies are needed to assess the safety and intraoperative complications of the procedure.

  17. Endothelial cell density after deep anterior lamellar keratoplasty (Melles technique)

    NARCIS (Netherlands)

    van Dooren, Bart T. H.; Mulder, Paul G. H.; Nieuwendaal, Carla P.; Beekhuis, W. Houdijn; Melles, Gerrit R. J.

    2004-01-01

    To measure the recipient endothelial cell loss after the Melles technique for deep anterior lamellar keratoplasty. In 21 eyes of 21 patients, a deep anterior lamellar keratoplasty procedure was performed. Before surgery and at 6, 12, and 24 months after surgery, specular microscopy was performed to

  18. Endothelial cell density after deep anterior lamellar keratoplasty (Melles technique)

    NARCIS (Netherlands)

    Van Dooren, BTH; Mulder, PGH; Nieuwendaal, CP; Beekhuis, WH; Melles, GRJ

    PURPOSE: To measure the recipient endothelial cell loss after the Melles technique for deep anterior lamellar keratoplasty. METHODS: In 21 eyes of 21 patients, a deep anterior lamellar keratoplasty procedure was performed. Before surgery and at 6, 12, and 24 months after surgery, specular microscopy

  19. Donor cross-linking for keratoplasty: a laboratory evaluation.

    Science.gov (United States)

    Mukherjee, Achyut; Hayes, Sally; Aslanides, Ioannis; Lanchares, Elena; Meek, Keith M

    2015-12-01

    This laboratory-based investigation compares the topographic outcomes of conventional penetrating keratoplasty with that of a novel procedure in which donor corneas are cross-linked prior to keratoplasty. Penetrating keratoplasty procedures with continuous running sutures were carried out in a porcine whole globe model. Sixty eyes were randomly paired as 'donor' and 'host' tissue before being assigned to one of two groups. In the cross-linked group, donor corneas underwent riboflavin/UVA cross-linking prior to being trephined and sutured to untreated hosts. In the conventional keratoplasty group, both host and donor corneas remained untreated prior to keratoplasty. Topographic and corneal wavefront measurements were performed following surgery, and technical aspects of the procedure evaluated. Mean keratometric astigmatism was significantly lower in the cross-linked donor group at 3.67D (SD 1.8 D), vs. 8.43 D (SD 2.4 D) in the conventional keratoplasty group (p < 0.005). Mean wavefront astigmatism was also significantly reduced in the cross-linked donor group 4.71 D (SD 2.1) vs. 8.29D (SD 3.6) in the conventional keratoplasty group (p < 0.005). Mean RMS higher order aberration was significantly lower in the cross-linked donor group at 1.79 um (SD 0.98), vs. 3.05 um (SD 1.9) in the conventional keratoplasty group (P = 0.02). Qualitative analysis revealed less tissue distortion at the graft-host junction in the cross-linked group. Cross-linking of donor corneas prior to keratoplasty reduces intraoperative induced astigmatism and aberrations in an animal model. Further studies are indicated to evaluate the implications of this potential modification of keratoplasty surgery.

  20. Uneventful Anterior Migration of Intravitreal Ozurdex Implant in a Patient with Iris-Sutured Intraocular Lens and Descemet Stripping Automated Endothelial Keratoplasty

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    Andleeb Zafar

    2018-02-01

    Full Text Available Purpose: We report here the case of a patient with anterior segment migration of intravitreal dexamethasone implant as well as its management and outcome. Methods: The patient had the following sequence of events: complicated cataract surgery, iris-sutured intraocular lens implant, followed by cystoid macular edema treated with intravitreal Avastin, retinal vein occlusion treated with intravitreal dexamethasone implant, corneal decompensation treated with Descemet stripping automated endothelial keratoplasty (DSAEK, and finally recurrence of macular edema treated with repeated intravitreal dexamethasone implant. Results: Dexamethasone implant had completely dissolved from the eye 12 weeks after insertion without any complication. Conclusion: A conservative approach with regular monitoring in the situation of a quiet anterior segment without any corneal decompensation can provide enough time for the implant to dissolve without causing any complication to the involved eye, avoiding any additional surgical intervention, as presented in this case report. Despite the fact that the implant was left for natural dissolution, there were no adverse effects related to the graft or the eye.

  1. [Remote results of high myopia surgical correction by tunnel keratoplasty ].

    Science.gov (United States)

    Dushin, N V; Beliaev, V S; Gonchar, P A; Barashkov, V I; Kravchinina, V V; Frolov, M A

    2000-01-01

    Remote results evidence high refraction efficiency of tunnel keratoplasty, stable results being observed for up to 15 years. A total of 104 operations (58 patients) were analyzed for a period of observation of more than 10 years. The patients' ages varied from 17 to 52 years, there were 34 women and 24 men. The main advantage of interlamellar refraction meridional keratoplasty is easiness of operation. At present it is the operation of choice for dosed reduction of eye refraction aimed at correction of high myopia and astigmatism. The possibility of correcting residual myopia after keratotomy and repair of refraction abnormalities resultant from perforating keratoplasty is particularly interesting. The possibility of regulating the corrective effect in remote periods by replacing the implants also deserves attention. Hence, low traumatism, high efficiency, and stability of the refraction effect once more confirm our recommendation to use tunnel keratoplasty in clinical practice.

  2. Indications of Optical Coherence Tomography in Keratoplasties: Literature Review

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    Thiago Trindade Nesi

    2012-01-01

    Full Text Available Optical coherence tomography (OCT of the anterior segment, in particular corneal OCT, has become a reliable tool for the cornea specialist, as it provides the acquisition of digital images at high resolution with a noncontact technology. In penetrating or lamellar keratoplasties, OCT can be used to assess central corneal thickness and pachymetry maps, as well as precise measurements of deep stromal opacities, thereby guiding the surgeon to choose the best treatment option. OCT has also been used to evaluate the keratoplasty postoperative period, for early identification of possible complications, such as secondary glaucoma or donor disc detachments in endothelial keratoplasties. Intraoperatively, OCT can be used to assess stromal bed regularity and transparency in anterior lamellar surgeries, especially for those techniques in which a bare Descemet’s membrane is the goal. The purpose of this paper is to review and discuss the role of OCT as a diagnostic tool in various types of keratoplasties.

  3. Intraocular pressure measurements after conductive keratoplasty.

    Science.gov (United States)

    Kymionis, George D; Naoumidi, Tatiana L; Aslanides, Ioannis M; Kumar, Vinod; Astyrakakis, Nikolaos I; Tsilimbaris, Miltiadis; Pallikaris, Ioannis G

    2005-01-01

    To determine the possible impact of conductive keratoplasty (CK) on intraocular pressure (IOP) measurements. A prospective, single-center, noncomparative interventional case series was performed. Baseline and postoperative IOPs were measured by Goldmann applanation tonometry in 32 eyes of 18 patients who underwent CK for hyperopia correction. Mean follow-up was 11.9 months (range: 8 to 18 months). After CK, a statistically significant decrease in the measured IOP was observed (before CK: 14.22+/-1.64 vs after CK: 12.66+/-2.21, P<.001). The change in IOP readings postoperatively was not correlated with age, sex, keratometric readings, or attempted correction. Despite the limitations due to the small number of patients enrolled in this study, the applanation tonometer appears to underestimate the true IOP after CK.

  4. Fuchs' dystrophy associated with radial keratotomy: Lamellar or perforating keratoplasty?

    Science.gov (United States)

    Rodriguez-Ausin, P; Antolin-Garcia, D; Santamaria Garcia, L; Blazquez-Fernandez, A-B

    2017-05-01

    A 70 year-old male patient with a history of radial keratotomy suffering from Fuchs' dystrophy and a cataract. The patient received a two-step surgery: lens phacoemulsification and intraocular lens implant, followed by descemet stripping automated endothelial keratoplasty in both eyes, four months later. There were no complications apart from a recurrent cystoid macular oedema in both eyes. The best corrected visual acuity was 20/40 both eyes, and the patient was satisfied. Descemet stripping automated endothelial keratoplasty may be considered as an alternative to penetrating keratoplasty in the case of endothelial dysfunction and radial keratotomy in patients with no corneal ectasia or significant stromal opacity. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Contact Lens Visual Rehabilitation in Keratoconus and Corneal Keratoplasty

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    Yelda Ozkurt

    2012-01-01

    Full Text Available Keratoconus is the most common corneal distrophy. It’s a noninflammatory progressive thinning process that leads to conical ectasia of the cornea, causing high myopia and astigmatism. Many treatment choices include spectacle correction and contact lens wear, collagen cross linking, intracorneal ring segments implantation and finally keratoplasty. Contact lenses are commonly used to reduce astigmatism and increase vision. There are various types of lenses are available. We reviewed soft contact lenses, rigid gas permeable contact lenses, piggyback contact lenses, hybrid contact lenses and scleral-semiscleral contact lenses in keratoconus management. The surgical option is keratoplasty, but even after sutur removal, high astigmatism may stil exists. Therefore, contact lens is an adequate treatment option to correct astigmatism after keratoplasty.

  6. Development prospects of keratoplasty in Moscow

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    E. M. Kildyushov

    2013-01-01

    Full Text Available A retrospective analysis of the statistical data for the years 2010‑2012 on mortality and the donor selection of the Bureau of Forensic Pathology of Moscow, Department of Forensic Pathology of Pirogov N. I. Russian National Research Medical University and ILab Eye Bank in order to determine the possible number of keratoplastic surgeries. The results of statistical data analysis testify to the fact that the number of available donor material is not sufficient to meet the needs for keratoplastic material and it is necessary to create eye banks, which would have provided this need. It is necessary to create eye banks, that possess a clear logistics chain of intake donor tissue, preliminary assessment of the donor tissue, laboratory diagnostics of the donor’s blood and delivery of tissue to the Bank. Theeye bank should not only produce preserved material for keratoplasty, but also carry out full morpho-functional assessment of material and its subsequent delivery to consumers in health facilities.

  7. Spontaneous wound dehiscence after penetrating keratoplasty

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    Alireza Foroutan

    2014-10-01

    Full Text Available Spontaneous wound separation may be developed even months after suture removal especially in the context of long-term corticosteroid therapy. A 68-year-old Caucasian woman presented to our cornea clinic with spontaneous wound dehiscence after her third penetrating keratoplasty (PKP which was performed three years ago. An Ahmed glaucoma valve (New World Medical, Ranchos Cucamonga, CA was inserted ten months after the third PKP, which successfully controlled intraocular pressure (IOP. At the examination, the last sutures were removed eight months ago and she was using flourometholone 0.1 % (Sina Darou, Tehran, Iran with a dose of once a day. There was one quadrant of wound dehiscence from 8 to 11 o`clock associated with anterior wound gape and severe corneal edema. Resuturing was performed for the patient. At the one month examination, the corneal edema was resolved and best corrected visual acuity was 20/200 mainly due to previous glaucomatous optic neuropathy. Caution about the prolonged use of corticosteroids is necessary. Topical immunosuppressives could be a promising choice in this field.

  8. Indications for and techniques of keratoplasty at Vietnam National Institute of Ophthalmology

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    Pham Ngoc Dong

    2016-03-01

    Full Text Available AIM: To report the indications for and techniques of corneal transplantation at Vietnam National Institute of Ophthalmology (VNIO over a period of 12y (2002-2013. METHODS: Records of patients who had undergone corneal transplantation at VNIO from January 1, 2002 to January 1, 2014 were reviewed to determine the indication for and type of corneal transplant performed. Patient age, gender, indication for corneal transplantation and surgical technique were recorded and analyzed. RESULTS: Corneal transplantation were underwent in 1390 eyes of 1278 patients with a mean age of 44.9±18.1y during the period under review. The most common indication was infectious corneal ulcer (n=670; 48.2%, followed by corneal scar (n=333, 24.0%, corneal dystrophy (n=138, 9.9% and failed graft (n=112, 8.1%. Nearly all procedures performed were penetrating keratoplasty (n=1300, 93.5%, with a few lamellar keratoplasty procedures performed: lamellar keratoplasty (n=52, 3.7%, Descemet’s stripping automated endothelial keratoplasty (n=27, 1.9% and deep anterior lamellar keratoplasty (n=11, 0.8%. CONCLUSION: While the most common indication for keratoplasty was infectious keratitis, nearly all indications for corneal transplantation were managed with penetrating keratoplasty. However, lamellar keratoplasty techniques, including deep anterior lamellar keratoplasty and Descemet’s stripping automated endothelial keratoplasty, are being performed with increasing frequency for isolated stromal and endothelial disorders, respectively.

  9. Simultaneous versus sequential penetrating keratoplasty and cataract surgery.

    Science.gov (United States)

    Hayashi, Ken; Hayashi, Hideyuki

    2006-10-01

    To compare the surgical outcomes of simultaneous penetrating keratoplasty and cataract surgery with those of sequential surgery. Thirty-nine eyes of 39 patients scheduled for simultaneous keratoplasty and cataract surgery and 23 eyes of 23 patients scheduled for sequential keratoplasty and secondary phacoemulsification surgery were recruited. Refractive error, regular and irregular corneal astigmatism determined by Fourier analysis, and endothelial cell loss were studied at 1 week and 3, 6, and 12 months after combined surgery in the simultaneous surgery group or after subsequent phacoemulsification surgery in the sequential surgery group. At 3 and more months after surgery, mean refractive error was significantly greater in the simultaneous surgery group than in the sequential surgery group, although no difference was seen at 1 week. The refractive error at 12 months was within 2 D of that targeted in 15 eyes (39%) in the simultaneous surgery group and within 2 D in 16 eyes (70%) in the sequential surgery group; the incidence was significantly greater in the sequential group (P = 0.0344). The regular and irregular astigmatism was not significantly different between the groups at 3 and more months after surgery. No significant difference was also found in the percentage of endothelial cell loss between the groups. Although corneal astigmatism and endothelial cell loss were not different, refractive error from target refraction was greater after simultaneous keratoplasty and cataract surgery than after sequential surgery, indicating a better outcome after sequential surgery than after simultaneous surgery.

  10. Clinical Validation of Point-Source Corneal Topography in Keratoplasty

    NARCIS (Netherlands)

    Vrijling, A C L; Braaf, B.; Snellenburg, J.J.; de Lange, F.; Zaal, M.J.W.; van der Heijde, G.L.; Sicam, V.A.D.P.

    2011-01-01

    Purpose. To validate the clinical performance of point-source corneal topography (PCT) in postpenetrating keratoplasty (PKP) eyes and to compare it with conventional Placido-based topography. Methods. Corneal elevation maps of the anterior corneal surface were obtained from 20 post-PKP corneas using

  11. Ceratoplastia penetrante e glaucoma Penetrating keratoplasty and glaucoma

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    Márcio Eulálio Barreto Soares

    2007-08-01

    Full Text Available O objetivo deste artigo é discutir os conhecimentos atuais sobre a abordagem clínica e terapêutica da ceratoplastia penetrante e do glaucoma a ela associado.The aim of this article is to make a review about glaucoma associated with penetrating keratoplasty, describing since its incidence and risk factors until the different options for treatment.

  12. Graft failure: III. Glaucoma escalation after penetrating keratoplasty.

    Science.gov (United States)

    Greenlee, Emily C; Kwon, Young H

    2008-06-01

    Glaucoma after penetrating keratoplasty is a frequently observed post-operative complication and is a risk factor for graft failure. Penetrating keratoplasty performed for aphakic and pseudophakic bullous keratopathy and inflammatory conditions are more likely to cause postoperative glaucoma compared with keratoconus and Fuchs' endothelial dystrophy. The intraocular pressure elevation may occur immediately after surgery or in the early to late postoperative period. Early postoperative causes of glaucoma include pre-existing glaucoma, retained viscoelastic, hyphema, inflammation, pupillary block, aqueous misdirection, or suprachoroidal hemorrhage. Late causes include pre-existing glaucoma, angle-closure glaucoma, ghost cell glaucoma, suprachoroidal hemorrhage, and steroid-induced glaucoma. Determining the cause of IOP elevation can help guide therapeutic intervention. Treatments for refractory glaucoma include topical anti-glaucoma medications such as beta-adrenergic blockers. Topical carbonic anhydrase inhibitors, miotic agents, adrenergic agonists, and prostaglandin analogs should be used with caution in the post-keratoplasty patient, because of the possibility of corneal decompensation, cystoid macular edema, or persistent inflammation. Various glaucoma surgical treatments have reported success in post-keratoplasty glaucoma. Trabeculectomy with mitomycin C can be successful in controlling IOP without the corneal toxicity noted with 5-fluorouracil. Glaucoma drainage devices have successfully controlled intraocular pressure in postkeratoplasty glaucoma; this is, however, associated with increased risk of graft failure. Placement of the tube through the pars plana may improve graft success compared with implantation within the anterior chamber. In addition, cyclophotocoagulation remains a useful procedure for eyes that have refractory glaucoma despite multiple surgical interventions.

  13. Comparação entre os resultados pós-operatórios de pacientes submetidos ao procedimento tríplice e transplante de córnea combinado a fixação secundária de lente intra-ocular Comparison between the postoperative results of triple procedure and combined penetrating keratoplasty/ transsclerally sutured posterior chamber lens implantation

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    Daniela Maggioni Pereira Leão

    2006-08-01

    Full Text Available OBJETIVO: Comparar os resultados pós-operatórios de 2 grupos de pacientes submetidos a transplante de córnea com técnicas e tempo cirúrgico diferentes, em relação à abordagem do cristalino e/ou lente intra-ocular. MÉTODOS: Neste estudo retrospectivo foram analisados 37 olhos de pacientes divididos em 2 grupos: extração de catarata, implante de lentes intra-oculares (LIO e transplante de córnea no mesmo tempo cirúrgico - grupo 1 (G1 e extração de catarata sem implante de lentes intra-oculares no primeiro tempo cirúrgico e fixação secundária de lentes intra-oculares associada a transplante de córnea no segundo tempo cirúrgico - grupo 2 (G2. As variáveis estudadas foram: acuidade visual, pressão intra-ocular (PIO, astigmatismo refracional, astigmatismo ceratométrico e complicações pós-operatórias. RESULTADOS: Foi observado melhora da acuidade visual nos 2 grupos (G1 pPURPOSE: To compare the outcomes of two surgical techniques of penetrating keratoplasty with different surgical time, regarding the crystalline and the intraocular lens. METHODS: This retrospective study included 37 patients' eyes divided into 2 groups: extracapsular cataract extraction, posterior chamber intraocular lens implantation and penetrating keratoplasty (Group 1, G1 and transscleral fixation of posterior chamber lens and penetrating keratoplasty (Group 2, G2. The following parameters were recorded: visual acuity, intraocular pressure, refractive astigmatism, complication and keratometric astigmatism. RESULTS: Visual acuity improved in the two groups (G1 p<0.001 and G2 p=0.008. In G2 a significant change for the worse of intraocular pressure outcome was observed when compared with the other group (p=0.014. Regarding refractive and keratometric astigmatism no significant differences between the groups were found. The follow-up was 11 months. CONCLUSION: The most important negative prognostic factor affecting visual acuity was the postkeratoplasty

  14. Endothelial keratoplasty using donor tissue not suitable for full-thickness penetrating keratoplasty.

    Science.gov (United States)

    Armour, Rebecca L; Ousley, Paula J; Wall, Jennifer; Hoar, Karen; Stoeger, Chris; Terry, Mark A

    2007-06-01

    To evaluate the use of corneal donor tissue deemed unsuitable for full-thickness penetrating keratoplasty (PK) for use in deep lamellar endothelial keratoplasty (DLEK) and to compare postoperative results to those of DLEK surgery using donor tissue that is suitable for PK. Small-incision DLEK surgery was performed using 39 donor corneas unsuitable for PK. Thirty-five donors had anterior scars or opacities, 3 donors had pterygia within the 8-mm zone, and 1 had prior LASIK. All donor preparation was completed by manual stromal dissection. The DLEK surgical and postoperative courses were reviewed. Preoperative and 6-month postoperative results of this study group were compared with a control group consisting of the first 55 consecutive small-incision DLEK patients receiving donor corneas that had no criteria excluding them from use in PK. Four eyes in the study group and 1 eye in the control group had the confounding variables of the presence of an anterior-chamber lens or surgical vitrectomy with macular disease in the recipient eye. There was no significant difference in preoperative measurements of best spectacle-corrected visual acuity (BSCVA; P = 0.372), donor endothelial cell density (ECD; P = 0.749), or corneal topography [surface regularity index (SRI), P = 0.485; or surface asymmetry index (SAI), P = 0.154] between the 2 groups. For the patients receiving corneas deemed unacceptable for PK, at 6 months after surgery, the vision (P = 0.002) and corneal topography measurements improved significantly from before surgery (SRI, P < 0.001; SAI, P < 0.001), and there was no significant change in refractive astigmatism (P = 0.240). There was a significant difference in the vision at 6 months postoperatively between the overall study group and the control group, with the mean vision of the study group at 20/56 and the control group at 20/43 (P = 0.015). If eyes with known cystoid macular edema (CME) and vitrectomy are removed from each group, there is no significant

  15. Microkeratome-assisted lamellar keratoplasty for keratoconus: stromal sandwich.

    Science.gov (United States)

    Bilgihan, Kamil; Ozdek, Sengül C; Sari, Ayça; Hasanreisoglu, Berati

    2003-07-01

    To evaluate microkeratome-assisted lamellar keratoplasty for the treatment of keratoconus when it is not possible to correct the astigmatic ametropia with contact lenses. Ophthalmology Department, School of Medicine, Gazi University, Ankara, Turkey. This prospective study comprised 9 eyes of 7 keratoconus patients with contact lens intolerance. The donor cornea was prepared with a microkeratome and punched with a 7.25 mm or 7.50 mm trephine. Following the creation of a standard 9.0 mm corneal flap in the host cornea, the donor stromal button was implanted under this corneal flap like a sandwich. Transepithelial photorefractive keratectomy or laser in situ keratomileusis was performed when the corneal topography and refraction stabilized by the end of the sixth postoperative month. Follow-up ranged from 7 to 22 months. All patients gained 5 or more lines (mean 7.2 lines +/- 1.6 [SD]), and no patient lost a line of vision. The mean corneal thickness was 432.7 +/- 36.1 micrometers preoperatively and 578.1 +/- 45.1 micrometers after refractive surgery. The early visual results of this surgical technique are promising and seem to be comparable to those with penetrating keratoplasty.

  16. [Interlamellar sectoral keratoplasty in the surgical correction of astigmatism].

    Science.gov (United States)

    Frolov, M A; Beliaev, V S; Dushin, N V; Kravchinina, V V; Barashkov, V I; Gonchar, P A

    1996-01-01

    A new original method of interlamellar sectorial keratoplasty is proposed for surgical correction of astigmatism. Eleven operations were carried out in 8 patients (11 eyes) with astigmatism of 4 to 7.0 diopters. Vision acuity without correction was 0.6 to 1.0 in 5 patients (7 eyes, 63.6%). In 2 patients (2 eyes, 18.2%) vision acuity without correction was 0.3 to 0.5 diopters, and in 2 more patients (2 eyes, 18.2%) it was from 0.1 to 0.3 diopters, that is, equal to the maximal vision acuity with the optimal correction. The refraction effect stabilized in 3-4 months. The highest refraction effect attained was 7.0 diopters. The patients were followed up for 3 months to 4 years. Clinical analysis of the operations confirmed the efficacy and reliability of the method and stability of refraction. Interlamellar sectorial keratoplasty is recommended for surgical correction of astigmatism.

  17. A case of acute postoperative keratitis after deep anterior lamellar keratoplasty by multidrug resistant Klebsiella

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    Leena Bajracharya

    2015-01-01

    Full Text Available A healthy lady of 42 years underwent deep anterior lamellar keratoplasty for granular dystrophy. The very next day, it was complicated by development of infectious keratitis. The organism was identified as multidrug resistant Klebsiella pneumoniae. Donor corneal button may be implicated in the transmission of infection in an otherwise uneventful surgery and follow-up. Nosocomial infections are usually severe, rapidly progressive and difficult to treat. Finally, the lady had to undergo therapeutic penetrating keratoplasty for complete resolution of infection.

  18. Excimer laser-assisted anterior lamellar keratoplasty for keratoconus, corneal problems after laser in situ keratomileusis, and corneal stromal opacities.

    Science.gov (United States)

    Bilgihan, Kamil; Ozdek, Sengül C; Sari, Ayça; Hasanreisoğlu, Berati

    2006-08-01

    To evaluate excimer laser-assisted anterior lamellar keratoplasty to augment thin corneas as in keratoconus ( .05). This technique presents a different modality for the treatment of keratoconus, post-LASIK corneal problems, and other corneal stromal opacities with anterior lamellar keratoplasty. Additional studies with more patients and longer follow-up will help determine the role of this technique as a substitute for penetrating keratoplasty in these patients.

  19. Corneal perforation after conductive keratoplasty with previous refractive surgery.

    Science.gov (United States)

    Kymionis, George D; Titze, Patrik; Markomanolakis, Marinos M; Aslanides, Ioannis M; Pallikaris, Ioannis G

    2003-12-01

    A 56-year-old woman had conductive keratoplasty (CK) for residual hyperopia and astigmatism. Three years before the procedure, the patient had arcuate keratotomy, followed by laser in situ keratomileusis 2 years later for high astigmatism correction in both eyes. During CK, a corneal perforation occurred in the right eye; during the postoperative examination, an iris perforation and anterior subcapsule opacification were seen beneath the perforation site. The perforation was managed with a bandage contact lens and an antibiotic-steroid ointment; it had a negative Seidel sign by the third day. The surgery in the left eye was uneventful. Three months after the procedure, the uncorrected visual acuity was 20/32 and the best corrected visual acuity 20/20 in both eyes with a significant improvement in corneal topography. Care must be taken to prevent CK-treated spots from coinciding with areas in the corneal stroma that might have been altered by previous refractive procedures.

  20. Deep anterior lamellar keratoplasty in the management of keratoconus

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    Rajesh Fogla

    2013-01-01

    Full Text Available Advanced cases of keratoconus often require surgical intervention to restore corneal anatomy and improve eyesight. Penetrating keratoplasty (PK although commonly performed has potential risk of immunological rejection and is now no longer automatically the first choice of surgery. DALK procedures have evolved, which allows surgical replacement of recipient′s corneal stroma, leaving behind healthy descemet membrane (DM and endothelium. This reduces the risk of allograft endothelial rejection and late graft failure. In recent times, DALK techniques have led to significant improvements in visual outcome and current results are comparable to PK. Big bubble technique of DALK has become the most popular among the various surgical techniques described. Manual near DM DALK also gives good outcome although the visual recovery is often delayed. Future integration of femtosecond laser technology along with diagnostic imaging technology is likely to further improve outcomes of DALK in keratoconus.

  1. [Interlamellar circular keratoplasty for correction of high myopia].

    Science.gov (United States)

    Beliaev, V S; Dushin, N V; Gonchar, P A; Frolov, M A; Barashkov, V I; Kravchinina, V V; Balikoev, T M

    1995-01-01

    A new method is proposed for the correction of high myopia: Interlamellar circular keratoplasty. This method has been used in 15 patients (17 eyes) aged 18 to 54 with 9 to 17 diopters myopia. Vision acuity attained was at least 0.5 in 10 (60.3%) patients; in 7 (35.2%) patients vision acuity was 0.3 without correction, that is, was equal to the maximal vision acuity with the optimal correction. The highest refraction effect was 15.0 diopters. The patients were followed up for 3 months to 16 years. The proposed method for the correction of high myopia is highly effective, simple, and is recommended for clinical practice.

  2. Complications and Management of Deep Anterior Lamellar Keratoplasty

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    Banu Torun Acar

    2014-10-01

    Full Text Available Objectives: To report the intraoperative and postoperative follow-up complications and management of these in deep anterior lamellar keratoplasty (DALK surgery. Materials and Methods: Two hundred eighty-four eyes of 252 patients followed up in our cornea clinic who underwent DALK using Anwar’s big-bubble technique with healthy Descemet’s membrane and endothelium were included in this study. Intraoperative and postoperative complications as well as the management and treatment of these complications were evaluated. Results: Big bubble was created in 220 (77.5% eyes of 284 eyes, and lamellar dissection was performed in 64 (22.5% eyes. Perforation occurred during trephination in 4 eyes, and the procedure was accomplished by penetrating keratoplasty (PK. Intraoperative microperforation occurred in 44 eyes. Perforation enlarged in 4 eyes and PK was performed. Operation was continued in 40 eyes with air injection into the anterior chamber. In postopertive follow-up period, double anterior chamber (DAC occurred in 32 of 40 eyes. DAC spontaneously regressed in 8 eyes, and air was given into the anterior chamber with a second surgical intervention in 24 eyes. DAC improved in 20 eyes. Four eyes underwent PK. Fungal keratitis evolved at the interface in one eye, because of no healing during the follow-up period, this eye underwent PK under antifungal therapy. Eyes with interface haze and Descemet’s membrane folds were followed. Conclusion: DALK is a difficult technique with a steep learning curve. In addition to the complications seen in PK, specific complications can occur in lamellar surgery. (Turk J Ophthalmol 2014; 44: 337-40

  3. Novel spatula and dissector for safer deep anterior lamellar keratoplasty

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    Gustavo ,2,3 Bonfadini

    2014-10-01

    Full Text Available Objective: We describe a novel spatula and dissector to facilitate the big-bubble technique in deep anterior lamellar keratoplasty (DALK. Methods: A 29-year-old man who was diagnosed with bilateral keratoconus underwent deep anterior lamellar keratoplasty (DALK. After 350μm partial thickness incision of the recipient cornea, the Bonfadini dissector was inserted at the deepest point in the peripheral incision and could be advanced to the center of the cornea safely because of its "semi-sharp" tip. After achieving the big-bubble (BB separation of Descemet membrane (DM from the overlying stroma, the anterior stromal disc was removed. Viscoelastic material was placed on the stromal bed to prevent uncontrolled collapse and perforation of DM during the paracentesis blade incision into the BB. We could detect the safe opening of the BB using the Bonfadini dissector by the leakage of air bubbles into the viscoelastic material. After injecting viscoelastic material into the BB space, we inserted the Bonfadini spatula into the bigbubble safely because of its curved profile and blunt edges. The groove along the length of the Bonfadini spatula enables safe and efficient incision or the residual stromal tissue using the pointed end of a sharp blade while protecting the underlying DM. After removal of posterior stroma, the donor button was sutured with 16 interrupted 10-0 nylon sutures. Results: This technique and the use of the Bonfadini spatula and dissector facilitate exposure of Descemet membrane. Conclusion: The smooth Bonfadini DALK spatula and dissector facilitate safe and efficient completion of DALK surgery.

  4. Comparison of graft survival following penetrating keratoplasty and Descemet's stripping endothelial keratoplasty in eyes with a glaucoma drainage device.

    Science.gov (United States)

    Iverson, Shawn M; Spierer, Oriel; Papachristou, George C; Feuer, William J; Shi, Wei; Greenfield, David S; O'Brien, Terrence P

    2018-02-01

    To compare corneal graft survival rates after penetrating keratoplasty (PK) and Descemet's stripping endothelial keratoplasty (DSEK) in patients with a glaucoma drainage device (GDD) or medically managed glaucoma. A retrospective chart review was conducted on consecutive patients who underwent primary PK or primary DSEK. Inclusion criteria consisted of eyes with a diagnosis of glaucoma prior to corneal transplantation and a minimum of 6 months of follow-up. Graft failure was defined as an edematous cornea with failure to maintain deturgescence lasting beyond a period of 1 month of intense steroid therapy or vascularization and scarring resulting in irreversible loss of central graft clarity. Corneal graft survival was calculated using Kaplan-Meier survival analysis. Patients were divided into four groups: GDD-PK, GDD-DSEK, medical-PK and medical-DSEK. Fifty-six eyes of 56 patients were identified as meeting inclusion criteria. Among eyes with a GDD, there was no difference in the proportion of failures between PK grafts (48%) and DSEK grafts (50%) (p = 0.90). Failure occurred earlier in DSEK recipients compared to PK recipients, 5.82 ± 6.77 months versus 14.40 ± 7.70 months, respectively (p = 0.04). A Kaplan-Meier analysis did not identify a difference between the four groups with respect to graft failure (p = 0.52). There is no significant difference in graft survival rates between medically and surgically treated glaucoma patients for either PK or DSEK grafts. In patients with GDD, graft failure occurs earlier in DSEK compared to PK.

  5. Development of a nomogram for femtosecond laser astigmatic keratotomy for astigmatism after keratoplasty.

    Science.gov (United States)

    St Clair, Ryan M; Sharma, Anushree; Huang, David; Yu, Fei; Goldich, Yakov; Rootman, David; Yoo, Sonia; Cabot, Florence; Jun, Jason; Zhang, Lijun; Aldave, Anthony J

    2016-04-01

    To develop a nomogram for femtosecond laser astigmatic keratotomy (AK) to treat post-keratoplasty astigmatism. Three academic medical centers. Retrospective interventional case series. A review of post-keratoplasty femtosecond laser AK was performed. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, manifest refraction, and keratometry were recorded preoperatively and 1, 3, 6, and 12 months postoperatively. The location, length, depth, and diameter of the AK incisions were recorded, and the surgically induced astigmatic correction was related to these variables using regression analysis. One hundred forty femtosecond laser AK procedures were performed after penetrating keratoplasty (PKP) (n = 129) or deep anterior lamellar keratoplasty (DALK) (n =11), with 89 procedures (80 PKP, 9 DALK) included in the analysis. The mean CDVA improved from 20/59 (0.47 logMAR ± 0.38 [SD]) preoperatively to 20/45 (0.35 ± 0.31 logMAR) postoperatively (P = .013) (n = 46). The mean keratometric astigmatism decreased from 8.26 ± 2.90 diopters (D) preoperatively to 3.62 ± 2.59 D postoperatively (P AK to treat post-keratoplasty astigmatism was generated using regression analysis. Femtosecond laser AK significantly improved UDVA and CDVA and significantly reduced keratometric astigmatism and refractive cylinder after keratoplasty. The nomogram generated should improve the accuracy of post-keratoplasty femtosecond laser AK. None of the authors has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  6. Evaluation of corneal biomechanical properties following penetrating keratoplasty using ocular response analyzer

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    Vanathi Murugesan

    2014-01-01

    Full Text Available Purpose: To evaluate corneal biomechanical properties in eyes that has undergone penetrating keratoplasty (PK. Materials and Methods: Retrospective observational study in a tertiary care centre. Data recorded included ocular response analyzer (ORA values of normal and post-keratoplasty eyes [corneal hysteresis (CH, corneal resistance factor (CRF, Goldmann-correlated intraocular pressure (IOPg, and cornea-compensated intraocular pressure (IOPcc], corneal topography, and central corneal thickness (CCT. Wilcoxon signed rank test was used to analyze the difference in ORA parameter between post-PK eyes and normal eyes. Correlation between parameters was evaluated with Spearman′s rho correlation. Results: The ORA study of 100 eyes of 50 normal subjects and 54 post-keratoplasty eyes of 51 patients showed CH of 8.340 ± 1.85 and 9.923 ± 1.558, CRF of 8.846 ± 2.39 and 9.577 ± 1.631 in post-PK eyes and normal eyes, respectively. CH and CRF did not correlate with post-keratoplasty astigmatism (P = 0.311 and 0.276, respectively while a significant correlation was observed with IOPg (P = 0.004 and IOPcc (P < 0.001. Conclusion: Biomechanical profiles were significantly decreased in post-keratoplasty eyes with significant correlation with higher IOP as compared with that in normal eyes.

  7. Wakeless triple soliton accelerator

    International Nuclear Information System (INIS)

    Mima, K.; Ohsuga, T.; Takabe, H.; Nishihara, K.; Tajima, T.; Zaidman, E.; Horton, W.

    1986-09-01

    We introduce and analyze the concept of a wakeless triple soliton accelerator in a plasma fiber. Under appropriate conditions the triple soliton with two electromagnetic and one electrostatic waves in the beat-wave resonance propagates with velocity c leaving no plasma wake behind, while the phase velocity of the electrostatic wave is made also c in the fiber

  8. Femtosecond laser-assisted keratoplasty in a child with corneal opacity:case report

    Directory of Open Access Journals (Sweden)

    E. Yu. Markova

    2014-01-01

    Full Text Available Corneal opacities are the fourth cause of blindness world-wide. Over the past two centuries, various corneal transplantation (i.e., keratoplasty methods have been developed and improved. Nowadays, femtolaserssisted keratoplasty is one of most promising techniques. Femtosecond laser have several advantages that provide additional surgical benefits. Among them, no thermal injury, the ability to cut deeply on a single plane and to perform various corneal profiles should be mentioned. In children, corneal disorders are of special importance while femtosecondassisted keraatoplasty case reports are rare. Here, we describe femtosecond laserssisted penetrating keratoplasty in a girl with a rough central corneal opacity.

  9. Update on the Management of High-Risk Penetrating Keratoplasty.

    Science.gov (United States)

    Jabbehdari, Sayena; Rafii, Alireza Baradaran; Yazdanpanah, Ghasem; Hamrah, Pedram; Holland, Edward J; Djalilian, Ali R

    2017-03-01

    In this article, we review the indications and latest management of high-risk penetrating keratoplasty. Despite the immune-privilege status of the cornea, immune-mediated graft rejection still remains the leading cause of corneal graft failure. This is particularly a problem in the high-risk graft recipients, namely patients with previous graft failure due to rejection and those with inflamed and vascularized corneal beds. A number of strategies including both local and systemic immunosuppression are currently used to increase the success rate of high-risk corneal grafts. Moreover, in cases of limbal stem cell deficiency, limbal stem cells transplantation is employed. Corticosteroids are still the top medication for prevention and treatment in cases of corneal graft rejection. Single and combined administration of immunosuppressive agents e.g. tacrolimus, cyclosporine and mycophenolate are promising adjunctive therapies for prolonging graft survival. In the future, cellular and molecular therapies should allow us to achieve immunologic tolerance even in high-risk grafts.

  10. Indications and Visual Outcome of Penetrating Keratoplasty in Tertiary Eye Care Institute in Uttarakhand

    Science.gov (United States)

    Gupta, Neeti; Dhasmana, Renu; Nagpal, Ramesh Chander; Bahadur, Harsh; Maitreya, Amit

    2016-01-01

    Introduction Corneal blindness forms significant proportion of visual blindness in developing countries and penetrating keratoplasty (PK) can restore vision for this. The prognosis of PK is dependent on the corneal diseases responsible for corneal blindness. Aim To evaluate the indications and visual outcome of PK in tertiary eye care institute in Uttarakhand. Materials and Methods Data was reviewed from the medical records of 145 PK done in Department of Ophthalmology, Himalayan Institute of Medical Sciences from January 2012 to October 2014. Analysis of data was done for evaluation of the indications and visual outcome by Paired student’s t-test for hypothesis testing of grouped values of preoperative and last follow-up best corrected visual acuity in cases of optical and therapeutic grafts. A p-value < 0.05 was considered statistically significant. Results In this study data of 145 eyes of 138 patients was reviewed. The most common indication for keratoplasty was corneal scarring including adherent leucoma 48 (33.10%). Therapeutic keratoplasty was done for 33 cases with maximum 30(20.68%) cases of infectious keratitis. One case of tectonic graft was included in therapeutic keratoplasty group for analysis. There was statistically significant difference (p=.0001) in best corrected visual acuity improvement from 1.39 logMAR+ 0.022(SD) preoperatively to 0.367 logMAR+0.44(SD) postoperatively and 1.4 logMAR+.000(SD) preoperatively to 0.16 logMAR+0.57(SD) postoperatively for optical and therapeutic grafts respectively. Conclusion Infective keratitis either active or healed was the major indication for keratoplasty. Poor prognosis indications were most common in this part of the country. The visual outcome following corneal transplantation was encouraging particularly in cases of optical keratoplasty. PMID:27504319

  11. Da Vinci Xi Robot-Assisted Penetrating Keratoplasty.

    Science.gov (United States)

    Chammas, Jimmy; Sauer, Arnaud; Pizzuto, Joëlle; Pouthier, Fabienne; Gaucher, David; Marescaux, Jacques; Mutter, Didier; Bourcier, Tristan

    2017-06-01

    This study aims (1) to investigate the feasibility of robot-assisted penetrating keratoplasty (PK) using the new Da Vinci Xi Surgical System and (2) to report what we believe to be the first use of this system in experimental eye surgery. Robot-assisted PK procedures were performed on human corneal transplants using the Da Vinci Xi Surgical System. After an 8-mm corneal trephination, four interrupted sutures and one 10.0 monofilament running suture were made. For each procedure, duration and successful completion of the surgery as well as any unexpected events were assessed. The depth of the corneal sutures was checked postoperatively using spectral-domain optical coherence tomography (SD-OCT). Robot-assisted PK was successfully performed on 12 corneas. The Da Vinci Xi Surgical System provided the necessary dexterity to perform the different steps of surgery. The mean duration of the procedures was 43.4 ± 8.9 minutes (range: 28.5-61.1 minutes). There were no unexpected intraoperative events. SD-OCT confirmed that the sutures were placed at the appropriate depth. We confirm the feasibility of robot-assisted PK with the new Da Vinci Surgical System and report the first use of the Xi model in experimental eye surgery. Operative time of robot-assisted PK surgery is now close to that of conventional manual surgery due to both improvement of the optical system and the presence of microsurgical instruments. Experimentations will allow the advantages of robot-assisted microsurgery to be identified while underlining the improvements and innovations necessary for clinical use.

  12. Da Vinci Xi Robot–Assisted Penetrating Keratoplasty

    Science.gov (United States)

    Chammas, Jimmy; Sauer, Arnaud; Pizzuto, Joëlle; Pouthier, Fabienne; Gaucher, David; Marescaux, Jacques; Mutter, Didier; Bourcier, Tristan

    2017-01-01

    Purpose This study aims (1) to investigate the feasibility of robot-assisted penetrating keratoplasty (PK) using the new Da Vinci Xi Surgical System and (2) to report what we believe to be the first use of this system in experimental eye surgery. Methods Robot-assisted PK procedures were performed on human corneal transplants using the Da Vinci Xi Surgical System. After an 8-mm corneal trephination, four interrupted sutures and one 10.0 monofilament running suture were made. For each procedure, duration and successful completion of the surgery as well as any unexpected events were assessed. The depth of the corneal sutures was checked postoperatively using spectral-domain optical coherence tomography (SD-OCT). Results Robot-assisted PK was successfully performed on 12 corneas. The Da Vinci Xi Surgical System provided the necessary dexterity to perform the different steps of surgery. The mean duration of the procedures was 43.4 ± 8.9 minutes (range: 28.5–61.1 minutes). There were no unexpected intraoperative events. SD-OCT confirmed that the sutures were placed at the appropriate depth. Conclusions We confirm the feasibility of robot-assisted PK with the new Da Vinci Surgical System and report the first use of the Xi model in experimental eye surgery. Operative time of robot-assisted PK surgery is now close to that of conventional manual surgery due to both improvement of the optical system and the presence of microsurgical instruments. Translational Relevance Experimentations will allow the advantages of robot-assisted microsurgery to be identified while underlining the improvements and innovations necessary for clinical use. PMID:28660096

  13. Photorefractive keratectomy for post-penetrating keratoplasty myopia and astigmatism.

    Science.gov (United States)

    Bilgihan, K; Ozdek, S C; Akata, F; Hasanreisoğlu, B

    2000-11-01

    To determine the safety, effectiveness, and predictability of photorefractive keratectomy (PRK) for the correction of myopia and astigmatism after penetrating keratoplasty. Gazi University, Medical School, Department of Ophthalmology, Ankara, Turkey. Photorefractive keratectomy was performed in 16 eyes of 16 patients with postkeratoplasty myopia and astigmatism who were unable to wear glasses due to anisometropia and were contact lens intolerant. They were examined for uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), and corneal transplant integrity before and after surgery. The mean follow-up after PRK was 26.0 months +/- 15.7 (SD) (range 12 to 63 months). The mean preoperative spherical equivalent refraction of -4.47 +/- 1.39 diopters (D) was -3.39 +/- 1.84 D (P >.05) at the last postoperative visit and the mean preoperative cylinder of -5.62 +/- 2.88 D was -3.23 +/- 1.70 D (P <.05); refractive regression correlated with the amount of ablation performed. The BSCVA decreased in 3 eyes (18.8%), and the UCVA decreased in 2 (12.5%). Six eyes (37.5%) had grade 2 to 3 haze, which resolved spontaneously in 4 eyes within a relatively long time but caused a decrease in BSCVA in 2 (12.5%). Two of the eyes (12.5%) had a rejection episode after PRK and were successfully treated with topical steroids. Photorefractive keratectomy to correct postkeratoplasty myopia and astigmatism appears to be less effective and less predictable than PRK for naturally occurring myopia and astigmatism. Corneal haze and refractive regression are more prevalent, and patient satisfaction is not good.

  14. Keratomycosis caused by Acremonium Recifei, treated with keratoplasty, Miconazole and Ketoconazole

    NARCIS (Netherlands)

    H.J. Simonsz (Huib)

    1983-01-01

    textabstractA patient is discussed who developed a fungal corneal ulcer due to Acremonium (Cephalosporium) Recifei after a piece of a coconut flew into his eye while he was cracking it. Treatment consisted of keratoplasty, Miconazole as ointment and intravenously, and Ketaconazole orally. Diagnosis

  15. Preparation and thickness profile of endothelial keratoplasty lenticules from donated whole eyes with previous photorefractive keratectomy

    Directory of Open Access Journals (Sweden)

    Mozhgan Rezaei Kanavi

    2017-01-01

    Conclusion: PRK donor whole eyes are potential sources for preparation of microkeratome-assisted thin endothelial keratoplasty lenticules with a high endothelial cell count. Although an asymmetric and significant increase in thickness was present at the peripheral cornea, neither attachment nor clarity of transplanted lenticules was affected by variations in thickness of precut corneas.

  16. Indications and outcomes of pediatric keratoplasty in a tertiary eye care center: A retrospective review.

    Science.gov (United States)

    Gulias-Cañizo, Rosario; Gonzalez-Salinas, Roberto; Hernandez-Zimbron, Luis Fernando; Hernandez-Quintela, Everardo; Sanchez-Huerta, Valeria

    2017-11-01

    To evaluate indications and outcomes of pediatric keratoplasty in a tertiary eye center, and identify factors that affect visual outcomes.We performed a retrospective review of penetrating keratoplasty in children aged 0 to 18 years between 1995 and 2011 in the Asociación para Evitar la Ceguera en México IAP, Hospital "Dr. Luis Sánchez Bulnes".A total of 574 penetrating keratoplasties were performed during the study interval. Median follow-up was 5.0 years. Main indications included keratoconus (55.58%), postherpetic scarring (9.58%), traumatic opacities (7.49%), and bullous keratopathy (6.09%). Rejection rates at 5 years were 27% overall, and among indications, keratoconus showed the best graft survival at 60-months follow-up (85%). The percentage of patients with best corrected visual acuity (BCVA) posttransplant >20/400 at 5 years in the nonrejection group was 81.25% and 82.74% in 10 years of age (YOA) groups, respectively, versus a BCVA posttransplant > 20/400 at 5 years in the rejection group of 53.68% and 51.72% in 10 YOA groups, respectively. There was a statistically significant reduced rejection rate between genders at 18 months of follow-up, favoring males.Despite being considered a high-risk procedure in children, penetrating keratoplasty can achieve good results, especially in patients with keratoconus. It can achieve significative improvements of visual acuity, provided there is an adequate follow-up and treatment adherence.

  17. Quality of vision in patients with fuchs endothelial dystrophy and after descemet stripping endothelial keratoplasty

    NARCIS (Netherlands)

    van der Meulen, Ivanka J. E.; Patel, Sanjay V.; Lapid-Gortzak, Ruth; Nieuwendaal, Carla P.; McLaren, Jay W.; van den Berg, Thomas J. T. P.

    2011-01-01

    To evaluate the quality of vision (visual acuity and straylight) in patients with Fuchs dystrophy and the improvement in visual quality after Descemet stripping endothelial keratoplasty (DSEK). There was an observational case series (Amsterdam group) and a prospective interventional case series

  18. Penetrating keratoplasty for treatment of corneal abscesses in horses – case report

    Directory of Open Access Journals (Sweden)

    Zita Makra

    2013-01-01

    Full Text Available This case report describes the surgical technique and outcome of allograft transplantation to treat full thickness corneal abscesses in three horses. In all three cases penetrating keratoplasty was performed. Each affected eye had an abscess within the corneal stroma. An initial full thickness circular corneal incision was made around the lesion. After excision of the stromal abscess the created defect was replaced with a larger diameter full thickness donor graft and the initial corneal incision was repaired. All of the horses that underwent penetrating keratoplasty procedure healed with a scar at the graft site and remained visual. Penetrating keratoplasty is an effective technique for surgical removal of medically nonresponsive full thickness stromal abscess in horses and results in a visual and cosmetically acceptable globe. The advantages of this technique compared to medical therapy are that there is less scarring, shorter healing times and less damage of the globe because of the concurrent uveitis. To the authors’ knowledge, clinical experience with penetrating keratoplasty in horses has not been reported in Europe so far.

  19. Laser in situ keratomileusis for residual hyperopic astigmatism after conductive keratoplasty.

    Science.gov (United States)

    Kymionis, George D; Aslanides, Ioannis M; Khoury, Aghlab N; Markomanolakis, Marinos M; Naoumidi, Tatiana; Pallikaris, loannis G

    2004-01-01

    To report a case of laser in situ keratomileusis (LASIK) in a patient with previous conductive keratoplasty. A 48-year-old man underwent conductive keratoplasty for low hyperopic astigmatism (manifest refraction OD: +2.25 -0.50 x 77 degrees; OS: +2.50 -0.50 x 105 degrees). Three months postoperatively, UCVA was 20/25 and BSCVA was 20/20 in both eyes; manifest refraction OD: -0.25 -0.75 x 110 degrees; OS: +0.75 -0.75 x 50 degrees. Sixteen months after the operation, regression of refractive outcome was (manifest) OD: +1.75 -1.25 x 90 degrees; OS: +2.50 -0.50 x 85 degrees; UCVA was 20/40 in the right eye and 20/63 in the left eye and BSCVA was 20/20 in both eyes. LASIK was performed for hyperopic regression in the left eye using an automated microkeratome (Alcon SKBM, 130-microm plate; Aesculap-Meditec MEL 70 excimer laser). LASIK was uneventful and no intraoperative or postoperative complications related to the previous conductive keratoplasty procedure or LASIK were observed. Three months after LASIK and 19 months after the initial conductive keratoplasty, the patient's left eye was emmetropic; UCVA was 20/20(-2), BSCVA was 20/20 and manifest refraction was +0.25 -0.25 x 35 degrees. There was a uniform increase in topographical steepening. Visual acuity, refraction and topographic findings remained unchanged at 6 months. Even though our experience is limited, treatment of hyperopia with LASIK in an eye with refractive regression following previous conductive keratoplasty resulted in a predicted refractive outcome, with no complications, and improvement in visual acuity at 6 months follow-up.

  20. Infectious crystalline keratopathy caused by Cladosporium sp. after penetrating keratoplasty: a case report

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    Stock RA

    2016-08-01

    Full Text Available Ricardo Alexandre Stock,1 Elcio Luiz Bonamigo,2 Emeline Cadore,3 Rafael Allan Oechsler4 1Corneal Transplant Section, Santa Terezinha University Hospital, 2Department of Ophthalmology and Bioethics, 3University of Western Santa Catarina, Joaçaba, 4Cornea Department, Oftalmo Center Blumenau, Blumenau, Santa Catarina, Brazil Background: Infectious crystalline keratopathy is a rare, progressive infection characterized by the insidious progression of branches and crystalline corneal opacities with minimal or no inflammation. This case report describes the evolution of an infectious crystalline keratopathy caused by Cladosporium sp., which developed after tectonic keratoplasty in a patient with a history of ocular trauma.Case presentation: A 40-year-old Brazilian male was the victim of firework-induced trauma to the left eye, which resulted in a corneal laceration that could not be sutured as well as a severe traumatic cataract. The patient underwent penetrating keratoplasty and phacoemulsification. During postoperative follow-up, another therapeutic keratoplasty was required because unresponsive infectious keratitis was observed. The infiltrate’s characteristics were suggestive of infectious crystalline keratopathy; in particular, the infiltrate was insidious and progressive, and grayish-white branches appeared in the anterior corneal stroma. As different therapies were administered, inflammatory reactions ranging from mild to severe were observed. The infection was unresponsive to typical antifungal drugs. This lack of response most likely occurred due to steroid treatment and the diffuse corneal spread of an atypical microorganism, which was subsequently identified in culture as Cladosporium sp. After the second therapeutic keratoplasty, the patient’s eye integrity was successfully reestablished.Conclusion: This study likely provides the first report describing a case of infectious crystalline keratopathy caused by Cladosporium sp. This case

  1. One-year follow-up of femtosecond laser-assisted penetrating keratoplasty

    Directory of Open Access Journals (Sweden)

    Tan JCH

    2013-02-01

    Full Text Available Johnson Choon-Hwai Tan, Wee-Jin HengNational Healthcare Group Eye Institute, Tan Tock Seng Hospital, SingaporeBackground: The purpose of this report is to describe the initial outcomes of femtosecond laser-assisted penetrating keratoplasty.Methods: This retrospective surgical case series consisted of 10 eyes from 10 patients undergoing penetrating keratoplasty at a tertiary center. Femtosecond laser was used to perform a zig-square incision on the donor cornea with matched dimensions on the recipient cornea. Outcomes measured included: unaided visual acuity and best spectacle-corrected visual acuity preoperatively and at one, 3, 6, and 12 months postoperatively; manifest refractive and topographic astigmatism at 3, 6, and 12 months postoperatively; and endothelial cell density loss, calculated at the end of the one-year follow-up period.Results: At one-year follow-up, there was an improvement in unaided visual acuity from a mean preoperative logMAR of 1.67 to 0.44, and best spectacle-corrected visual acuity from a mean preoperative logMAR of 1.33 to 0.13. By postoperative month 3, mean manifest refractive and topographic astigmatism was 2.31 ± 1.41 D and 2.59 ± 1.57 D, respectively. The mean reduction in endothelial cell density was 20.7% after one year of follow-up.Conclusion: Femtosecond laser-assisted penetrating keratoplasty provided a good visual outcome and early visual rehabilitation due to precise graft-host alignment and reduced astigmatism in the early postoperative months.Keywords: penetrating keratoplasty, femtosecond laser-assisted keratoplasty

  2. STUDY OF THE ANATOMICAL AND VISUAL RESULTS OF THERAPEUTIC PENETRATING KERATOPLASTY

    Directory of Open Access Journals (Sweden)

    Chhaya Ashok Shinde

    2017-03-01

    Full Text Available BACKGROUND Therapeutic penetrating keratoplasty for corneal infections restores anatomical integrity. Improvement in instrumentation and surgical techniques, better postoperative management have improved corneal transplant outcome. Purpose of the study was to know what are the anatomical and visual results after therapeutic keratoplasty and to judge what could be the factors affecting the results. MATERIALS AND METHODS Prospective, non-comparative, observational cohort study was done in 56 patient (56 eyes operated for therapeutic penetrating keratoplasty at tertiary care institute .Patients were reviewed for demographic data, postoperative best-corrected visual acuity, graft clarity, and complications. Pre-operative treatment in bacterial infections included Cefazolin 50 mg/ml and Tobramycin 1.4 % or gentamicin 1.4% half hourly, 1% atropine drops. Fungal infections were treated with Natamycin 5% suspension. Debridement was done. Amphotericin B was used against yeasts. Voriconazole (1% eye drops were given in Aspergillus species. With full aseptic precautions penetrating keratoplasty was carried out. The graft was 0.5 mm larger than the lesion. Keratoplasties were evaluated for (1 Graft clarity at 1 month and 1 year postoperative. (2 Cure of the infectious disease after surgery. (3 Anatomical success rate and visual results. RESULTS At the end of one year clear graft with bacterial keratitis was seen in 23 eyes (74.19% out of 31 eyes. In fungal keratitis clear graft was seen in 10 eyes (45.45% out of 22 eyes. 48.22% patients had vision of FC 1m-6/60 compared to preoperative vision at the end of one year. At the end of one year anatomical integrity was maintained in 53 (94.64% cases and it was lost in 5.36% patients. CONCLUSION Patients who underwent keratoplasty with 7.5 mm graft size had maximum graft clarity at the end of one year. Graft was clear in 36 patients (64.29% out of total 56 patients. At the end of 1 year vision improved to FC 1 mt

  3. CLINICAL OUTCOME OF PENETRATING KERATOPLASTY IN CORNEAL OPACITIES OF DIFFERENT AETIOLOGY- A CLINICAL STUDY

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    Dipak Bhuyan

    2017-01-01

    Full Text Available BACKGROUND Corneal transplantation or grafting is an operation in which abnormal corneal host tissue is replaced by healthy donor cornea. According to the World Health Organization (WHO, corneal diseases are among the major causes of vision loss and blindness in the world today after cataract and glaucoma. The aim of the study is to- 1. Evaluate the different aetiology of corneal opacity including active infective aetiology as indicated for penetrating keratoplasty. 2. Determine the clinical outcome of penetrating keratoplasty in relation to graft survival, graft rejection and peri-operative complications in different aetiology groups. 3. Determine the final visual outcome. MATERIALS AND METHODS Candidates for keratoplasty were selected from- 1. Eye Bank of Regional Institute of Ophthalmology (R.I.O. 2. R.I.O OPD. The study period was from September 2014 to August 2015. 30 cases were taken in the study. Descriptive statistics were applied to analyse the data wherever necessary. RESULTS 34.6±19.73 yrs. (mean±SD was the mean age at which transplants were done in the study. Out of total 30 cases, 13 (43.33% and 17 (56.66% were male and female, respectively. The different indications for penetrating keratoplasty are- Post ulcer corneal opacity in 14 cases (46.66%, posttraumatic corneal opacity 9 cases (30%, pseudophakic bullous keratopathy 4 cases (13.33%, corneal dystrophy in 2 cases (6.66% and non-healing corneal ulcer in 1 case (3.33%. 16 cases (53.33% showed clear graft till the last follow up while 11 (33.33% cases showed partially clear graft resulting in improved visual outcome while 3 cases (10.00% of the grafts were opaque due to graft failure. CONCLUSION The major indications for penetrating keratoplasty in this part of the world are post ulcer and posttraumatic corneal opacity and majority of them are illiterate agricultural workers who failed to get adequate treatment on time. Graft survival rate is high, which can be attributed to the

  4. The value-based medicine comparative effectiveness and cost-effectiveness of penetrating keratoplasty for keratoconus.

    Science.gov (United States)

    Roe, Richard H; Lass, Jonathan H; Brown, Gary C; Brown, Melissa M

    2008-10-01

    To perform a base case, comparative effectiveness, and cost-effectiveness (cost-utility) analysis of penetrating keratoplasty for patients with severe keratoconus. Visual acuity data were obtained from a large, retrospective multicenter study in which patients with keratoconus with less than 20/40 best corrected visual acuity and/or the inability to wear contact lenses underwent penetrating keratoplasty, with an average follow-up of 2.1 years. The results were combined with other retrospective studies investigating complication rates of penetrating keratoplasty. The data were then incorporated into a cost-utility model using patient preference-based, time trade-off utilities, computer-based decision analysis, and a net present value model to account for the time value of outcomes and money. The comparative effectiveness of the intervention is expressed in quality-of-life gain and QALYs (quality-adjusted life-years), and the cost-effectiveness results are expressed in the outcome of $/QALY (dollars spent per QALY). Penetrating keratoplasty in 1 eye for patients with severe keratoconus results in a comparative effectiveness (value gain) of 16.5% improvement in quality of life every day over the 44-year life expectancy of the average patient with severe keratoconus. Discounting the total value gain of 5.36 QALYs at a 3% annual discount rate yields 3.05 QALYs gained. The incremental cost for penetrating keratoplasty, including all complications, is $5934 ($5913 discounted at 3% per year). Thus, the incremental cost-utility (discounted at 3% annually) for this intervention is $5913/3.05 QALYs = $1942/QALY. If both eyes undergo corneal transplant, the total discounted value gain is 30% and the overall cost-utility is $2003. Surgery on the second eye confers a total discounted value gain of 2.5 QALYs, yielding a quality-of-life gain of 11.6% and a discounted cost-utility of $2238/QALY. Penetrating keratoplasty for patients with severe keratoconus seems to be a

  5. Almost convergence of triple sequences

    OpenAIRE

    Ayhan Esi; M.Necdet Catalbas

    2013-01-01

    In this paper we introduce and study the concepts of almost convergence and almost Cauchy for triple sequences. Weshow that the set of almost convergent triple sequences of 0's and 1's is of the first category and also almost everytriple sequence of 0's and 1's is not almost convergent.Keywords: almost convergence, P-convergent, triple sequence.

  6. A new vision through combined osteo-odonto-keratoplasty: A review

    Directory of Open Access Journals (Sweden)

    Lakshmi Shetty

    2014-01-01

    Full Text Available This is an extensive review of osteo-odonto-keratoplasty (OOKP where the vision is restored by using tooth as an implant in the environment of the eye. The window of the soul is our eye and the window of the eye is cornea. This review article aims at discussing the remarkable operation to regain the sight of patients with corneal blindness. In this procedure where a multidisciplinary approach from both oral and maxillofacial surgeon and ophthalmologist contributes to restore vision in the most severe cases of corneal blindness. This involves removing a canine tooth from the patient, shaping and drilling to allow implantation of an artificial plastic corneal device and finally implanting back into the eye few months later. The OOKP, is the keratoprosthesis of choice for end-stage corneal blindness not amenable to penetrating keratoplasty. This transplantation procedure has an autologous dental root-bone lamina complex and buccal mucosal graft to secure the optical cylinder which acts as a ray of vision for corneal blindness. This review comprises the indications, contraindications, and patient assessment and the surgical procedure, complications ,surgical inter professionalism and future scope of OOKP. The source of data for the review has been Pubmed, Medline and all the research studies and published reports on osteo-odonto-keratoplasty. In this complex procedure good results can be obtained with modern technology and expertise.

  7. Collagen crosslinking for ectasia following PRK performed in excimer laser-assisted keratoplasty for keratoconus.

    Science.gov (United States)

    Spadea, Leopoldo

    2012-01-01

    To report the results of corneal collagen crosslinking (CXL) in a patient with corneal ectasia developed after excimer laser-assisted lamellar keratoplasty for keratoconus and a secondary photorefractive keratectomy (PRK) for residual refractive error. A 33-year-old woman, who had originally been treated for keratoconus in the right eye by excimer laser-assisted lamellar keratoplasty, subsequently had her residual ametropia treated by topographically guided, transepithelial excimer laser PRK. Five years after PRK, the patient developed corneal ectasia showing concomitant visual changes of best spectacle-corrected visual acuity (BSCVA) reduced to 20/33 with a refraction of -6.00 +6.00 × 30. The minimum corneal thickness at the ectasia apex was 406 µm. A treatment of riboflavin-UVA-induced corneal CXL was performed on the right eye. Two years after the CXL treatment, the right eye improved to 20/20 BSCVA with a refraction of plano +1.00 × 50 while exhibiting a clear lamellar graft. Corneal CXL provided safe and effective management of ectasia developed after excimer laser-assisted lamellar keratoplasty and PRK.

  8. Descemet's membrane endothelial keratoplasty surgery: update on the evidence and hurdles to acceptance.

    Science.gov (United States)

    Price, Marianne O; Price, Francis W

    2013-07-01

    Descemet's stripping endothelial keratoplasty (DSEK) is the most popular treatment for endothelial dysfunction, but Descemet's membrane endothelial keratoplasty (DMEK) now provides better vision with lower risk of immunologic rejection. Although DMEK is more challenging, advances in instrumentation and techniques are reducing the learning curve. In contrast to DSEK, which includes posterior donor stroma, DMEK consists merely of donor endothelium and Descemet's membrane, so DMEK does not create a stromal interface and induces significantly less posterior surface aberrations, resulting in better vision. Furthermore, multiple centers report remarkably low (<1%) cumulative probability of immunologic graft rejection episodes through 2 years after DMEK. Initially, the biggest challenges were tissue loss in preparation and ensuring attachment. Subsequent improvements have reduced complication rates to levels experienced with DSEK. DMEK/DSEK hybrids and 'thin' DSEK also can provide better vision than standard DSEK; randomized controlled comparisons with DMEK are needed. DMEK provides an anatomically exact replacement of dysfunctional host endothelium and has set new benchmarks for rejection risk and visual outcomes following endothelial replacement. DMEK is providing new insights into how different corneal layers contribute to immunogenicity and immune tolerance and into the key factors that limit vision after endothelial keratoplasty.

  9. Keratorefractive Effect of High Intensity Focused Ultrasound Keratoplasty on Rabbit Eyes

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    Zhiyu Du

    2016-01-01

    Full Text Available Purpose. To evaluate high intensity focused ultrasound (HIFU as an innovation and noninvasive technique to correct presbyopia by altering corneal curvature in the rabbit eye. Methods. Eighteen enucleated rabbit eyes were treated with a prototype HIFU keratoplasty. According to the therapy power, these eyes were divided three groups: group 1 (1 W, group 2 (2 W, and group 3 (3 W. The change in corneal power was quantified by a Sirius Scheimpflug camera. Light microscopy (LM and transmission electron microscopy (TEM were performed to determine the effect on the corneal stroma. Results. In the treated eyes, the corneal curvature increases from 49.42 ± 0.30 diopters (D and 48.00 ± 1.95 D before procedure to 51.37 ± 1.11 D and 57.00 ± 1.84 D after HIFU keratoplasty application in groups 1 and 3, respectively. The major axis and minor axis of the focal region got longer when the powers of the HIFU got increased; the difference was statistically significant (p<0.05. LM and TEM showed HIFU-induced shrinkage of corneal stromal collagen with little disturbance to the underlying epithelium. Conclusions. We have preliminarily exploited HIFU to establish a new technique for correcting presbyopia. HIFU keratoplasty will be a good application prospect for treating presbyopia.

  10. Outcome of therapeutic penetrating keratoplasty in a tertiary eye care center in Nepal

    Directory of Open Access Journals (Sweden)

    Bajracharya L

    2015-12-01

    Full Text Available Leena Bajracharya, Reeta Gurung Department of Cornea, Tilganga Institute of Ophthalmology, Kathmandu, Nepal Background: Corneal ulcer is an important cause of blindness in developing countries. Therapeutic keratoplasty for infective keratitis is a frequently performed surgery in these countries.Objective: To find out the outcome of therapeutic keratoplasty for infective keratitis.Methods: Records of 5 years were reviewed of patients who underwent therapeutic keratoplasty from 2006 to 2010. Data collected included demographic parameters, indications for surgery, microbiology of the ulcers, type of surgery performed, and donor tissue details. In the follow-up period, ocular status was evaluated in terms of eradication of disease, anatomic success, graft clarity, visual acuity, and development of glaucoma and cataract.Results: In all, 180 eyes of 180 patients were enrolled in the study; 59.4% of the patients were male. Average age was 44.4±16.7 years. Overall, 71% of infective keratitis was perforated. A total of 101 (56% eyes were positive for organisms of which 49 showed pure fungus and 49 showed pure bacteria. The commonest fungus and bacteria isolated were Aspergillus and Streptococcus, respectively. Average follow-up period was 29±23 months. Overall cure rate of infection was 88.8%, anatomical success rate was 89.5%, and graft clarity was 37.2%. Overall, 43.4% had secondary glaucoma. In the postoperative course, 65.8% of phakic eyes had developed cataract. In all, 38.6% of graft had endothelial failure and 24% of the graft failed due to late infective keratitis. Overall functional success with a visual acuity above 6/60 was 25.4%. Bacterial keratitis had a significantly higher cure rate, anatomical success, and graft clarity compared to fungal keratitis.Conclusion: Therapeutic keratoplasty is an important procedure to save the eye and preserve vision in severe infective keratitis. There is a high incidence of postoperative glaucoma

  11. [Management of corneal endothelial decompensation with Descemet's membrane endothelial keratoplasty in a patient with Ahmed glaucoma valve implant].

    Science.gov (United States)

    Röck, T; Bartz-Schmidt, K-U; Röck, D; Yoeruek, E

    2014-05-01

    Currently, the main causes for developing bullous keratopathy are from problems related to intraocular surgery, trauma, infection, Fuchs' endothelial dystrophy and chronically elevated intraocular pressure. In the 1990s penetrating keratoplasty was once considered the therapy of choice for treatment of bullous keratopathy but in recent years it has been replaced by posterior lamellar keratoplasty. The Descemet membrane endothelial keratoplasty (DMEK) procedure represents the final development of posterior lamellar keratoplasty. The question now arises whether DMEK can be used in patients with bullous keratopathy and Ahmed glaucoma valve implant. A 72-year-old man was referred to our hospital for further evaluation with the diagnosis of bullous keratopathy and pseudoexfoliative glaucoma. The bullous keratopathy was caused by a variety of previous operations as well as decompensation of intraocular pressure. This article describes the therapy of bullous keratopathy by DMEK with existing Ahmed glaucoma valve implant. After surgery the cornea became clear and the best-corrected visual acuity improved from hand movement to 0.2. The intraocular pressure remained normal (10-14 mmHg) without antiglaucoma medication and the endothelial cell count decreased only slightly over a follow-up of 13 months. No complications were encountered. The DMEK surgical procedure seems to be possible in patients with Ahmed glaucoma valve implant and endothelial decompensation. However, further studies with a larger number of patients should follow to validate the replacement of penetrating keratoplasty and other posterior lamellar procedures by DMEK.

  12. Triple axis spectrometers

    International Nuclear Information System (INIS)

    Clausen, K.N.

    1997-01-01

    Conventional triple-axis neutron spectroscopy was developed by Brockhouse over thirty years ago' and remains today a versatile and powerful tool for probing the dynamics of condensed matter. The original design of the triple axis spectrometer is technically simple and probes momentum and energy space on a point-by-point basis. This ability to systematically probe the scattering function in a way which only requires a few angles to be moved under computer control and where the observed data in general can be analysed using a pencil and graph paper or a simple fitting routine, has been essential for the success of the method. These constraints were quite reasonable at the time the technique was developed. Advances in computer based data acquisition, neutron beam optics, and position sensitive area detectors have been gradually implemented on many triple axis spectrometer spectrometers, but the full potential of this has not been fully exploited yet. Further improvement in terms of efficiency (beyond point by point inspection) and increased sensitivity (use of focusing optics whenever the problem allows it) could easily be up to a factor of 10-20 over present instruments for many problems at a cost which is negligible compared to that of increasing the flux of the source. The real cost will be in complexity - finding the optimal set-up for a given scan and interpreting the data as the they are taken. On-line transformation of the data for an appropriate display in Q, ω space and analysis tools will be equally important for this task, and the success of these new ideas will crucially depend on how well we solve these problems. (author)

  13. Harmonic analysis on triple spaces

    DEFF Research Database (Denmark)

    Danielsen, Thomas Hjortgaard

    In this thesis we study examples of triple spaces, both their structure theory, their invariant differential operators as well as analysis on them. The first major results provide us with some examples of triple spaces which are strongly spherical, i.e. satisfy some conditions reminiscent...

  14. Teaching Triple Science: GCSE Chemistry

    Science.gov (United States)

    Learning and Skills Network (NJ3), 2007

    2007-01-01

    The Department for Children, Schools and Families (DCSF) has contracted with the Learning and Skills Network to support awareness and take-up of Triple Science GCSEs through the Triple Science Support Programme. This publication provides an introduction to teaching and learning approaches for the extension topics within GCSE Chemistry. It…

  15. Comparison the post operative refractive errors in same size corneal transplantation through deep lamellar keratoplasty and penetrating keratoplasty methods after sutures removing in keratoconus patients

    Directory of Open Access Journals (Sweden)

    Hasan Razmjoo

    2016-01-01

    Full Text Available Background: Corneal transplantation is a surgery in which cornea is replaced by a donated one and can be completely penetrating keratoplasty (PK or included a part of cornea deep lamellar keratoplasty (DLK. Although the functional results are limited by some complications, it is considered as one of the most successful surgeries. This study aimed to compare the refractive errors after same size corneal transplantation through DLK and PK methods in keratoconus patients over 20 years. Materials and Methods: This descriptive, analytical study was conducted in Feiz Hospital, Sadra and Persian Clinics of Isfahan in 2013–2014. In this study, 35 patients underwent corneal transplantation by PK and 35 patients by DLK, after removing the sutures, the patients were compared in terms of best corrected visual acuity (BCVA and refractive errors. Data were analyzed using Chi-square and t Student tests by SPSS software. Results: The BCVA mean in DLK and PK groups was 6/10 ± 2/10 and 5/10 ± 2/10, respectively, with no significant difference (P = 0.4. The results showed 9 cases of DLK and 6 cases of PK had normal (8/10 ≤ BCVA visual acuity (25.7% vs. 17.1%, 24 cases of DLK and 27 cases of PK had mild vision impairment (68.6% vs. 77.1% and 2 cases of the DLK group and 2 cases of PK had moderate vision impairment, (5.7% vs. 5.7%, there was no significant difference in “BCVA” (P = 0.83. Conclusions: Both methods were acceptably effective in improving BCVA, but according to previous articles (5,9,10 the DLK method due to fewer complications and less risk of rejection was superior to another method and in the absence of any prohibition this method is recommended.

  16. Sequential selective same-day suture removal in the management of post-keratoplasty astigmatism.

    Science.gov (United States)

    Fares, U; Mokashi, A A; Elalfy, M S; Dua, H S

    2013-09-01

    In a previous study, we proposed that corneal topography performed 30-40 min after the initial suture removal can identify the next set of sutures requiring removal, for the treatment of post-keratoplasty astigmatism. The aim of this study was to evaluate the effect of removing subsequent sets of sutures at the same sitting. 10/0 nylon interrupted sutures were placed, to secure the graft-host junction, at the time of keratoplasty. Topography was performed using Pentacam (Oculus) before suture removal. The sutures to be removed in the steep semi-meridians were identified and removed at the slit-lamp biomicroscope. Topography was repeated 30-40 min post suture removal, the new steep semi-meridians determined, and the next set of sutures to be removed were identified and removed accordingly. Topography was repeated 4-6 weeks later and the magnitude of topographic astigmatism was recorded. A paired-samples t-test was used to evaluate the impact of selective suture removal on reducing the magnitude of topographic and refractive astigmatism. Twenty eyes of 20 patients underwent sequential selective same-day suture removal (SSSS) after corneal transplantation. This study showed that the topographic astigmatism decreased by about 46.7% (3.68 D) and the refractive astigmatism decreased by about 37.7% (2.61 D) following SSSS. Vector calculations also show a significant reduction of both topographic and refractive astigmatism (P<0.001). SSSS may help patients to achieve satisfactory vision more quickly and reduce the number of follow-up visits required post keratoplasty.

  17. Customized photorefractive keratectomy to correct high ametropia after penetrating keratoplasty: A pilot study

    OpenAIRE

    De Rosa, Giuseppe; Boccia, Rosa; Santamaria, Carmine; Fabbozzi, Lorenzo; De Rosa, Luigi; Lanza, Michele

    2014-01-01

    Purpose: To evaluate preliminarily the safety and efficacy of customized photorefractive keratectomy (PRK) to correct ametropia and irregular astigmatism after penetrating keratoplasty (PK). Methods: This pilot study included five eyes of five patients with a mean spherical equivalent of −5.1 ± 1.46 D (range from −2.75 to −6.50 D). In all cases, ametropia and irregular astigmatism was corrected with topography-guided customized PRK. Ocular examinations with topographic analysis were perfor...

  18. Ahmed glaucoma valve in post-penetrating-keratoplasty glaucoma: A critically evaluated prospective clinical study

    Science.gov (United States)

    Panda, Anita; Prakash, Vadivelu Jaya; Dada, Tanuj; Gupta, Anoop Kishore; Khokhar, Sudarshan; Vanathi, Murugesan

    2011-01-01

    Aim: The aim was to evaluate the outcome of Ahmed glaucoma valve (AGV) in post-penetrating-keratoplasty glaucoma (PKPG). Materials and Methods: In this prospective study, 20 eyes of 20 adult patients with post-PKPG with intraocular pressure (IOP) >21 mmHg, on two or more antiglaucoma medications, underwent AG (model FP7) implantation and were followed up for a minimum of 6 months. Absolute success was defined as 5 glaucoma managed by AGV implantation revealed a satisfactory outcome up to 6 months of follow-up. PMID:21586837

  19. Bilateral triple renal arteries

    International Nuclear Information System (INIS)

    Pestemalci, Turan; Yildiz, Yusuf Zeki; Yildirim, Mehmet; Mavi, Ayfer; Gumusburun, Erdem

    2009-01-01

    Knowledge of the variations of the renal artery has grown in importance with increasing numbers of renal transplants, vascular reconstructions and various surgical and radio logic techniques being performed in recent years. We report the presence of bilateral triple renal arteries, discovered on routine dissection of a male cadaver. On the right side, one additional renal artery originated from the abdominal aorta (distributed to superior pole of the kidney) and one other originated from the right common iliac artery (distributed to lower pole of the kidney). On the left side, both additional renal arteries originated from the abdominal aorta. Our observation has been compared with variations described in the literature and their clinical importance has been emphasized. (author)

  20. [Endothelial keratoplasty: Descemet stripping (DSEK) using TAN EndoGlide™ device: case series].

    Science.gov (United States)

    Pazos, Henrique Santiago Baltar; Pazos, Paula Fernanda Morais Ramalho Baltar; Nogueira Filho, Pedro Antônio; Grisolia, Ana Beatriz Diniz; Silva, André Berger Emiliano; Gomes, José Álvaro Pereira

    2011-01-01

    To report the results of Descemet stripping endothelial keratoplasty (DSEK) using the TAN EndoGlideTM device to facilitate the insertion of the endothelial membrane. Prospective clinical study that included nine patients presenting corneal edema secondary to endothelial dysfunction. Best corrected visual acuity, refraction, central corneal thickness, endothelial cell density and complications were analyzed after a six-month follow-up. There was a significant improvement in the corneal edema and visual acuity in 7 patients (77.78%). The best corrected visual acuity ranged between 20/40 and 20/200. The average density of endothelial cells in six months varied between 1,305 cells/mm² and 2,346 cells/mm² with an average loss of 33.14% cells. Detachment of part of the graft was observed in one eye (11.11%) and primary failure of the endothelial transplantation occurred in 2 eyes (22.22%). The device TAN EndoGlideTM facilitates the introduction of the graft in Descemet stripping endothelial keratoplasty.

  1. Corneal collagen cross-linking in the stabilization of PRK, LASIK, thermal keratoplasty, and orthokeratology.

    Science.gov (United States)

    Nguyen, Michelle K; Chuck, Roy S

    2013-07-01

    To describe the use of corneal collagen cross-linking (CXL) and its efficacy in the stabilization of keratorefractive procedures, including PRK, laser in-situ keratomileusis (LASIK), thermal keratoplasty, and orthokeratology. Since its introduction, CXL has quickly gained interest in the treatment of ectactic disorders due to its ability to increase the biomechanical stability of the cornea. In its earliest use, it has shown to be effective in the treatment of both keratoconus and post-LASIK ectasia. More recent studies of CXL in combination with keratorefractive procedures have shown varying degrees of success. CXL with PRK has shown to be effective in slowing or halting the progression of keratoconus, pellucid marginal degeneration, and post-LASIK ectasia, in addition to potentially decreasing or delaying the need for penetrating keratoplasty. Several small case series have also demonstrated improved stability and efficacy of PRK and LASIK when combined with CXL, as well as a potentially decreased risk of postprocedure ectasia. In conjunction with thermokeratoplasty and orthokeratology, CXL has shown improved but only temporary results in the treatment of keratoconus. Future studies are needed to determine the efficacy and long-term stability of CXL in combination with keratorefractive procedures, as well as to address possible complications.

  2. Descemet membrane endothelial keratoplasty (DMEK) early stage graft failure in eyes with preexisting glaucoma.

    Science.gov (United States)

    Treder, Maximilian; Alnawaiseh, Maged; Eter, Nicole

    2017-07-01

    To evaluate the effect of a preexisting glaucoma on the early postoperative outcome of a descemet membrane endothelial keratoplasty (DMEK). All patients who underwent DMEK surgery at the Department of Ophthalmology of the University of Muenster with a follow-up of at least 3 months (90d) were included in this study. The best corrected distance visual acuity (BCDVA), the intraocular pressure (IOD), the rate of re-keratoplasty and the rebubbling rate were inter alia recorded. The results of patients with (group 1) and without a preexisting glaucoma (group 2) were compared. 74 eyes of 59 patients with a mean follow-up of 152 ± 70 days were included. 65 eyes were in group 1 and 9 eyes in group 2. The BCDVA significantly improved in both groups after surgery (p glaucoma compared to patients with a preexisting glaucoma. In the early stage outcome of DMEK no significant impact of a preexisting glaucoma was found.

  3. Clinical outcomes of trabeculectomy vs. Ahmed glaucoma valve implantation in patients with penetrating keratoplasty : (Trabeculectomy vs. Ahmed galucoma valve in patients with penetrating keratoplasty).

    Science.gov (United States)

    Akdemir, Mehmet Orcun; Acar, Banu Torun; Kokturk, Furuzan; Acar, Suphi

    2016-08-01

    The aim of this study was to compare the visual outcomes, intraocular pressure (IOP), and endothelial cell loss caused by trabeculectomy (TRAB) and Ahmed glaucoma valve (AGV) implantation in patients who had previously undergone penetrating keratoplasty (PKP). The data from all patients who underwent surgical treatment of glaucoma after PKP were reviewed at the Cornea Department of Haydarpasa Numune Education and Research Hospital. Eighteen patients who had undergone surgical treatment of glaucoma after PKP were included in this retrospective study. Time between PKP and glaucoma surgeries, visual acuity results, IOP results, endothelial cell counts (ECC) before the surgery, at 1st, 6th, and 12th month of surgery were recorded. Differences between two groups were evaluated. Mean loss of ECC was 315 cells/mm(2) in the AGV group and 197 cells/mm(2) in TRAB group at 12th month of glaucoma surgery. The difference between endothelial cell loss at 12th month of surgery was statistically significant and higher in AGV group (p glaucoma. Ahmed glaucoma valve had a significantly better IOP lowering but higher endothelial cell loss effect.

  4. Microsporidial infection masquerading as graft rejection post-Descemet's stripping automated endothelial keratoplasty

    Directory of Open Access Journals (Sweden)

    Lumbini Devi

    2017-01-01

    Full Text Available A 51-year-old immunocompetent male with a history of Fuchs' endothelial dystrophy and immature cataract who underwent Descemet's stripping automated endothelial keratoplasty with intraocular lens implantation in both eyes presented with redness and defective vision of 1-day duration in his left eye. Slit lamp examination revealed coarse superficial punctate lesions with graft edema. He was diagnosed with acute graft rejection and treated with topical steroids. Two days later, symptoms worsened in his left eye with the involvement of his right eye showing a similar clinical picture. An infectious etiology was suspected and in vivo confocal microscopy ordered, which revealed hyperreflective dots, highly suggestive of microsporidial spores. The patient was prescribed topical fluconazole 0.3% in both eyes. This unique presentation of bilateral graft edema following microsporidial keratoconjunctivitis in postgraft patients requires a high index of suspicion as it can be easily be mistaken for and mismanaged as acute graft rejection.

  5. [Astigmatic keratotomy with the femtosecond laser: correction of high astigmatisms after keratoplasty].

    Science.gov (United States)

    Kook, D; Bühren, J; Klaproth, O K; Bauch, A S; Derhartunian, V; Kohnen, T

    2011-02-01

    The purpose of this study was to evaluate a novel technique for the correction of postoperative astigmatism after penetrating keratoplasty with the use of the femtosecond laser creating astigmatic keratotomies (femto-AK) in the scope of a retrospective case series. Clinical data of ten eyes of nine patients with high residual astigmatism after penetrating keratoplasty undergoing paired femto-AK using a 60-kHz femtosecond laser (IntraLase™, AMO) were analyzed. A new software algorithm was used to create paired arcuate cuts deep into the donor corneal button with different cut angles. Target values were refraction, uncorrected visual acuity, best corrected visual acuity, topographic data (Orbscan®, Bausch & Lomb, Rochester, NY, USA), and corneal wavefront analysis using Visual Optics Lab (VOL)-Pro 7.14 Software (Sarver and Associates). Vector analysis was performed using the Holladay, Cravy and Koch formula. Statistical analysis was performed to detect significances between visits using Student's t test. All procedures were performed without any major complications. The mean follow-up was 13 months. The mean patient age was 48.7 years. The preoperative mean uncorrected visual acuity (logMAR) was 1.27, best corrected visual acuity 0.55, mean subjective cylinder -7.4 D, and mean topometric astigmatism 9.3 D. The postoperative mean uncorrected visual acuity (logMAR) was 1.12, best corrected visual acuity 0.47, mean subjective cylinder -4.1 D, and mean topometric astigmatism 6.5 D. Differences between corneal higher order aberrations showed a high standard deviation and were therefore not statistically significant. Astigmatic keratotomy using the femtosecond laser seems to be a safe and effective tool for the correction of higher corneal astigmatisms. Due to the biomechanical properties of the cornea and missing empirical data for the novel femto-AK technology, higher numbers of patients are necessary to develop optimal treatment nomograms.

  6. Comparison of synthetic glues and 10-0 nylon in rabbit lamellar keratoplasty.

    Science.gov (United States)

    Cho, Soon Young; Kim, Man Soo; Oh, Su Ja; Chung, Sung Kun

    2013-09-01

    To evaluate changes in mean keratometry and to compare wound repair with corneal lamellar grafts in rabbit eyes using human synthetic tissue adhesives and 10-0 nylon. Corneal grafts were made using a 6.0-mm-diameter trephine and blades in the eyes of 15 New Zealand white rabbits. Human fibrin tissue adhesive (Tisseel) was used in group 1, human fibrin tissue adhesive (Beriplast P) was used in group 2, polyethylene glycol adhesive (Coseal) was used in group 3, and 8 bite sutures with 10-0 nylon were used in group 4 (control) for lamellar keratoplasty. Four bite sutures were made with 10-0 nylon in groups 1, 2, and 3. Slit-lamp microscopy and keratometry were performed at 3 days and 1, 2, and 4 weeks after the surgery. Histopathologic and electromicroscopic examinations were performed 4 weeks after the surgery. No inflammation or corneal toxicity was seen in groups 1 and 2. Histologically, a few inflammatory cells were seen in groups 3 and 4. Groups 1, 2, and 3 showed no statistically significant changes in mean keratometry at 4 weeks postoperatively compared with preoperative mean keratometry (Wilcoxon signed-rank test, P = 0.178, 0.208, and 0.889, respectively). The control group showed significant changes in mean keratometry at 4 weeks postoperatively (Wilcoxon signed-rank test, P = 0.018). Human fibrin tissue adhesives were well tolerated in rabbit eyes, with no apparent corneal toxicity. Polyethylene glycol adhesive showed more inflammation and insufficient wound repair compared with human fibrin tissue adhesives. Therefore, human fibrin tissue adhesives can be used as an alternative to sutures in lamellar keratoplasty.

  7. Quantification of collagen ultrastructure after penetrating keratoplasty - implications for corneal biomechanics.

    Directory of Open Access Journals (Sweden)

    Craig Boote

    Full Text Available To quantify long-term changes in stromal collagen ultrastructure following penetrating keratoplasty (PK, and evaluate their possible implications for corneal biomechanics.A pair of 16 mm post-mortem corneo-scleral buttons was obtained from a patient receiving bilateral penetrating keratoplasty 12 (left/28 (right years previously. Small-angle x-ray scattering quantified collagen fibril spacing, diameter and spatial order at 0.5 mm or 0.25 mm intervals along linear scans across the graft margin. Corresponding control data was collected from two corneo-scleral buttons with no history of refractive surgery. Wide-angle x-ray scattering quantified collagen fibril orientation at 0.25 mm (horizontal×0.25 mm (vertical intervals across both PK specimens. Quantification of orientation changes in the graft margin were verified by equivalent analysis of data from a 13 year post-operative right PK specimen obtained from a second patient in a previous study, and comparison made with new and published data from normal corneas.Marked changes to normal fibril alignment, in favour of tangentially oriented collagen, were observed around the entire graft margin in all PK specimens. The total number of meridional fibrils in the wound margin was observed to decrease by up to 40%, with the number of tangentially oriented fibrils increasing by up to 46%. As a result, in some locations the number of fibrils aligned parallel to the wound outnumbered those spanning it by up to five times. Localised increases in fibril spacing and diameter, with an accompanying reduction in matrix order, were also evident.Abnormal collagen fibril size and spatial order within the PK graft margin are indicative of incomplete stromal wound remodelling and the long term persistence of fibrotic scar tissue. Lasting changes in collagen fibril orientation in and around PK wounds may alter corneal biomechanics and compromise the integrity of the graft-host interface in the long term.

  8. Quantification of Collagen Ultrastructure after Penetrating Keratoplasty – Implications for Corneal Biomechanics

    Science.gov (United States)

    Gardner, Steven J.; Kamma-Lorger, Christina S.; Hayes, Sally; Nielsen, Kim; Hjortdal, Jesper; Sorensen, Thomas; Terrill, Nicholas J.; Meek, Keith M.

    2013-01-01

    Purpose To quantify long-term changes in stromal collagen ultrastructure following penetrating keratoplasty (PK), and evaluate their possible implications for corneal biomechanics. Methods A pair of 16 mm post-mortem corneo-scleral buttons was obtained from a patient receiving bilateral penetrating keratoplasty 12 (left)/28 (right) years previously. Small-angle x-ray scattering quantified collagen fibril spacing, diameter and spatial order at 0.5 mm or 0.25 mm intervals along linear scans across the graft margin. Corresponding control data was collected from two corneo-scleral buttons with no history of refractive surgery. Wide-angle x-ray scattering quantified collagen fibril orientation at 0.25 mm (horizontal)×0.25 mm (vertical) intervals across both PK specimens. Quantification of orientation changes in the graft margin were verified by equivalent analysis of data from a 13 year post-operative right PK specimen obtained from a second patient in a previous study, and comparison made with new and published data from normal corneas. Results Marked changes to normal fibril alignment, in favour of tangentially oriented collagen, were observed around the entire graft margin in all PK specimens. The total number of meridional fibrils in the wound margin was observed to decrease by up to 40%, with the number of tangentially oriented fibrils increasing by up to 46%. As a result, in some locations the number of fibrils aligned parallel to the wound outnumbered those spanning it by up to five times. Localised increases in fibril spacing and diameter, with an accompanying reduction in matrix order, were also evident. Conclusions Abnormal collagen fibril size and spatial order within the PK graft margin are indicative of incomplete stromal wound remodelling and the long term persistence of fibrotic scar tissue. Lasting changes in collagen fibril orientation in and around PK wounds may alter corneal biomechanics and compromise the integrity of the graft-host interface in the

  9. Triple products of Eisenstein series

    Science.gov (United States)

    Venkatesh, Anil

    In this thesis, we construct a Massey triple product on the Deligne cohomology of the modular curve with coefficients in symmetric powers of the standard representation of the modular group. This result is obtained by constructing a Massey triple product on the extension groups in the category of admissible variations of mixed Hodge structure over the modular curve, which induces the desired construction on Deligne cohomology. The result extends Brown's construction of the cup product on Deligne cohomology to a higher cohomological product. Massey triple products on Deligne cohomology have been previously investigated by Deninger, who considered Deligne cohomology with trivial real coefficients. By working over the reals, Deninger was able to compute cohomology exclusively with differential forms. In this work, Deligne cohomology is studied over the rationals, which introduces an obstruction to applying Deninger's results. The obstruction arises from the fact that the integration map from the de Rham complex to the Eilenberg-MacLane complex of the modular group is not an algebra homomorphism. We compute the correction terms of the integration map as regularized iterated integrals of Eisenstein series, and show that these integrals arise in the cup product and Massey triple product on Deligne cohomology.

  10. Solution Patterns Predicting Pythagorean Triples

    Science.gov (United States)

    Ezenweani, Ugwunna Louis

    2013-01-01

    Pythagoras Theorem is an old mathematical treatise that has traversed the school curricula from secondary to tertiary levels. The patterns it produced are quite interesting that many researchers have tried to generate a kind of predictive approach to identifying triples. Two attempts, namely Diophantine equation and Brahmagupta trapezium presented…

  11. The Centroid of a Lie Triple Algebra

    Directory of Open Access Journals (Sweden)

    Xiaohong Liu

    2013-01-01

    Full Text Available General results on the centroids of Lie triple algebras are developed. Centroids of the tensor product of a Lie triple algebra and a unitary commutative associative algebra are studied. Furthermore, the centroid of the tensor product of a simple Lie triple algebra and a polynomial ring is completely determined.

  12. Microscopia confocal en operados de queratoplastia perforante Confocal microscopy in patients operated from penetrating keratoplasty

    Directory of Open Access Journals (Sweden)

    Zulema Gómez Castillo

    2009-06-01

    Full Text Available La microscopia confocal es un examen exploratorio, práctico y poco invasivo que permite conocer las características microscópicas del tejido corneal después del trasplante, por lo que constituye una herramienta muy útil en el manejo de los pacientes operados de queratoplastia. El presente trabajo tiene como finalidad describir las características del tejido corneal en pacientes operados de este tipo de trasplante, mediante la microscopia confocal in vivo. MÉTODOS: Se realizó un estudio descriptivo, de corte transversal, en 40 ojos de 40 pacientes operados de queratoplastia perforante, en el Servicio de Córnea del Instituto Cubano de Oftalmología "Ramón Pando Ferrer", de marzo de 2006 a marzo de 2007. Se confeccionó una historia clínica oftalmológica y se les realizó a todos el examen de microscopia confocal en el injerto corneal con el microscopio confocal CONFOSCAN 4. RESULTADOS: La queratopatía bullosa pseudofáquica fue la afección más frecuente previa a la cirugía y estuvo presente en el 77,5 % de los pacientes. En el 72,5 % de los intervenidos se encontró una disminución del grosor corneal. El epitelio presentó alteraciones en el 62,5 % de los pacientes. Todos presentaron afectación de la forma y el tamaño celular endotelial. En el 82,5 % de los pacientes se observó ausencia de plexos nerviosos. CONCLUSIONES: La microscopia confocal como nueva ciencia en el campo de la oftalmología, favorece el seguimiento evolutivo de las queratoplastias perforantes y con esto no solo a prevenir la aparición de posibles complicaciones, sino además de garantizar el éxito de la cirugía y la función refractiva de la córnea.Confocal microscopy is a practical, exploratory and less invassive examination that allows finding out the microscopic characteristics of the corneal tissue after transplantation, so it is a very useful tool for the management of patients operated from keratoplasty. The present paper was aimed at describing

  13. Electrospun nanofibrous SF/P(LLA-CL) membrane: a potential substratum for endothelial keratoplasty.

    Science.gov (United States)

    Chen, Junzhao; Yan, Chenxi; Zhu, Mengyu; Yao, Qinke; Shao, Chunyi; Lu, Wenjuan; Wang, Jing; Mo, Xiumei; Gu, Ping; Fu, Yao; Fan, Xianqun

    2015-01-01

    Cornea transplant technology has progressed markedly in recent decades, allowing surgeons to replace diseased corneal endothelium by a thin lamellar structure. A thin, transparent, biocompatible, tissue-engineered substratum with corneal endothelial cells for endothelial keratoplasty is currently of interest. Electrospinning a nanofibrous structure can simulate the extracellular matrix and have beneficial effects for cell culture. Silk fibroin (SF) has good biocompatibility but poor mechanical properties, while poly(L-lactic acid-co-ε-caprolactone) (P(LLA-CL)) has good mechanical properties but poor biocompatibility. Blending SF with P(LLA-CL) can maintain the advantages of both these materials and overcome their disadvantages. Blended electrospun nanofibrous membranes may be suitable for regeneration of the corneal endothelium. The aim of this study was to produce a tissue-engineered construct suitable for endothelial keratoplasty. Five scaffolds containing different SF:P(LLA-CL) blended ratios (100:0, 75:25, 50:50, 25:75, 0:100) were manufactured. A human corneal endothelial (B4G12) cell line was cultured on the membranes. Light transmission, speed of cell adherence, cell viability (live-dead test), cell proliferation (Ki-67, BrdU staining), and cell monolayer formation were detected on membranes with the different blended ratios, and expression of some functional genes was also detected by real-time polymerase chain reaction. Different blended ratios of scaffolds had different light transmittance properties. The 25:75 blended ratio membrane had the best transmittance among these scaffolds. All electrospun nanofibrous membranes showed improved speed of cell adherence when compared with the control group, especially when the P(LLA-CL) ratio increased. The 25:75 blended ratio membranes also had the highest cell proliferation. B4G12 cells could form a monolayer on all scaffolds, and most functional genes were also stably expressed on all scaffolds. Only two genes

  14. Modal planes are spectral triples

    International Nuclear Information System (INIS)

    Gayral, Victor; Iochum, Bruno; Schuecker, Thomas; Gracia-Bondia, Jose M.; Varilly, Joseph C.

    2003-09-01

    Axioms for nonunital spectral triples, extending those introduced in the unital case by Connes, are proposed. As a guide, and for the sake of their importance in noncommutative quantum field theory, the spaces R 2N endowed with Moyal products are intensively investigated. Some physical applications, such as the construction of noncommutative Wick monomials and the computation of the Connes-Lott functional action, are given for these noncommutative hyperplanes. (author)

  15. Novel method to avoid the open-sky condition in penetrating keratoplasty: covered cornea technique.

    Science.gov (United States)

    Arslan, Osman S; Unal, Mustafa; Arici, Ceyhun; Cicik, Erdoğan; Mangan, Serhat; Atalay, Eray

    2014-09-01

    The aim of this study was to present a novel technique to avoid the open-sky condition in pediatric and adult penetrating keratoplasty (PK). Seventy-two eyes of 65 infants and children and 44 eyes of 44 adult patients were operated on using this technique. After trephining the recipient cornea up to a depth of 50% to 70%, the anterior chamber was entered at 1 point. Then, only a 2 clock hour segment of the recipient button was incised, and this segment was sutured to the recipient rim with a single tight suture. The procedure was repeated until the entire recipient button was excised and resutured. The donor corneal button was sutured to the recipient corneal rim. The sutures between the recipient button and the rim were then cut off, and the recipient button was drawn out. None of the patients operated on with this technique developed complications related to the open-sky condition. Visual acuities, graft failure rates, and endothelial cell loss were comparable with the findings of studies performed for conventional PK. The technique described avoids the open-sky condition during the entire PK procedure. Endothelial cell loss rates are acceptable.

  16. Image-guided modified deep anterior lamellar keratoplasty (DALK) corneal transplant using intraoperative optical coherence tomography

    Science.gov (United States)

    Tao, Yuankai K.; LaBarbera, Michael; Ehlers, Justis P.; Srivastava, Sunil K.; Dupps, William J.

    2015-03-01

    Deep anterior lamellar keratoplasty (DALK) is an alternative to full-thickness corneal transplant and has advantages including the absence of allograft rejection; shortened duration of topical corticosteroid treatment and reduced associated risk of glaucoma, cataract, or infection; and enables use of grafts with poor endothelial quality. DALK begins by performing a trephination of approximately 80% stromal thickness, as measured by pachymetry. After removal of the anterior stoma, a needle is inserted into the residual stroma to inject air or viscoelastic to dissect Descemet's membrane. These procedures are inherently difficult and intraoperative rates of Descemet's membrane perforation between 4-39% have been reported. Optical coherence tomography (OCT) provides high-resolution images of tissue microstructures in the cornea, including Descemet's membrane, and allows quantitation of corneal layer thicknesses. Here, we use crosssectional intraoperative OCT (iOCT) measurements of corneal thickness during surgery and a novel micrometeradjustable biopsy punch to precision-cut the stroma down to Descemet's membrane. Our prototype cutting tool allows us to establish a dissection plane at the corneal endothelium interface, mitigates variability in cut-depths as a result of tremor, reduces procedure complexity, and reduces complication rates. iOCT-guided modified DALK procedures were performed on 47 cadaveric porcine eyes by non-experts and achieved a perforation rate of ~5% with a mean corneal dissection time care.

  17. Delayed-Onset Post-Keratoplasty Endophthalmitis Caused by Vancomycin-Resistant Enterococcus faecium

    Directory of Open Access Journals (Sweden)

    Julio C. Hernandez-Camarena

    2012-10-01

    Full Text Available Background: Vancomycin-resistant Enterococcus (VRE endophthalmitis after penetrating keratoplasty (PKP is very rare, the management is a challenge due to both the pattern of antibiotic resistance and the aggressive nature of the infectious process. We report the first delayed-onset case of VRE endophthalmitis after PKP. Materials and Methods: Case report of a 51-year-old female with a 7-week history of PKP who arrived at the emergency room with signs and symptoms of endophthalmitis. Initial visual acuity was light perception, and a posterior pole exam was not possible due to the intense vitreous reaction. Mode B ultrasound was used to assess the posterior pole. The patient underwent pars plana vitrectomy and received intravitreous antibiotics. Results: Vitreous stains and cultures were positive for Enterococcus faecium resistant to vancomycin. Donor rim cultures and viral PCR were negative. Treatment was carried out by repeated intravitreal antibiotics and systemic linezolid. Clinical improvement was seen after the second dose of intravitreous antibiotics and systemic linezolid, but visual acuity remained at light perception consistent with the ischemic changes observed in the posterior pole. Conclusion: VRE endophthalmitis might be associated with positive donor rim cultures. Prompt use of systemic linezolid in addition to intravitreous antibiotics is recommendable, but even with prompt treatment, visual prognosis is guarded.

  18. The treatment of acute corneal hydrops by subtotal penetrating keratoplasty. Clinical case

    Directory of Open Access Journals (Sweden)

    I. A. Loskutov

    2014-07-01

    Full Text Available Clinical case of acute hydrops treatment using subtotal penetrating keratoplasty (PK is presented. The diagnosis of acute hydrops was based on clinical and functional evaluations including optical coherent tomography (OCT. A part of diseased cornea was removed and examined under a light microscope. These studies revealed morphological changes in almost all corneal layers. OCT and histology demonstrated that PK was indicated to this patient. Recent literature data on the epidemiology and pathogenesis of acute hydrops are presented. This rare disease results from tears in the Descemet’s membrane that allow aqueous humor to enter the stroma. Current treatment is aimed to suppress corneal inflammation, restore endothelium and Descemet’s membrane integrity and drain stromal cysts to optimize cornea healing. In this case, subtotal PK was performed due to the significant corneal thinning and a high risk of its melting. «Material for corneal graft» (iLab, Moscow, Russia was used as a donor material.

  19. Correction of High Astigmatism after Penetrating Keratoplasty with Toric Multifocal Intraocular Lens Implantation

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    Raffaele Nuzzi

    2017-07-01

    Full Text Available After penetrating keratoplasty (PK, high astigmatism is often induced, being frequently about 4–6 dpt. According to the entity and typology of astigmatism, different methods of correction can be used. Selective suture removal, relaxing incisions, wedge resections, compression sutures, photorefractive keratectomy, and laser-assisted in situ keratomileusis can reduce corneal astigmatism and ametropia, but meanwhile they can cause a reduction in the corneal integrity and cause an over- or undercorrection. In case of moderate-to-high regular astigmatisms, the authors propose a toric multifocal intraocular lens (IOL implantation to preserve the corneal integrity (especially in PK after herpetic corneal leukoma keratitis. We evaluated a 45-year-old patient who at the age of 30 was subjected to PK in his left eye due to corneal leukoma herpetic keratitis, which led to high astigmatism (7.50 dpt cyl. 5°. The patient was subjected to phacoemulsification and customized toric multifocal IOL implantation in his left eye. The correction of PK-induced residual astigmatism with a toric IOL implantation is an excellent choice but has to be evaluated in relation to patient age, corneal integrity, longevity graft, and surgical risk. It seems to be a well-tolerated therapeutic choice and with good results.

  20. Laser welding in penetrating keratoplasty and cataract surgery of pediatric patients: early results

    Science.gov (United States)

    Rossi, Francesca; Pini, Roberto; Menabuoni, Luca; Malandrini, Alex; Canovetti, Annalisa; Lenzetti, Ivo; Capozzi, Paolo; Valente, Paola; Buzzonetti, Luca

    2013-03-01

    Diode laser welding of ocular tissues is a procedure that enables minimally invasive closure of a corneal wound. This procedure is based on a photothermal effect: a water solution of Indocyanine Green (ICG) is inserted in the surgical wound, in order to stain the corneal tissue walls. The stained tissue is then irradiated with a low power infrared diode laser, delivering laser light through a 300-μm core diameter optical fiber. This procedure enables an immediate closure of the wounds: it is thus possible to reduce or to substitute the use of surgical threads. This is of particular interest in children, because the immediate closure improves refractive outcome and anti-amblyopic effect; moreover this procedure avoids several general anaesthesia for suture management. In this work, we present the first use of diode laser welding procedure in paediatric patients. 5 selected patients underwent cataract surgery (Group 1), while 4 underwent fs-laserassisted penetrating keratoplasty (Group 2). In Group 1 the conventional surgery procedure was performed, while no stitches were used for the closure of the surgical wounds: these were laser welded and immediately closed. In Group 2 the donor button was sutured upon the recipient by 8 single stitches, instead of 16 single stitches or a running suture. The laser welding procedure was performed in order to join the donor tissue to the recipient bed. Objective observations in the follow up study evidenced a perfect adhesion of the laser welded tissues, no collateral effects and an optimal restoration of the treated tissues.

  1. Weighing of risk factors for penetrating keratoplasty graft failure: application of Risk Score System

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    Abdo Karim Tourkmani

    2017-03-01

    Full Text Available AIM: To analyze the relationship between the score obtained in the Risk Score System (RSS proposed by Hicks et al with penetrating keratoplasty (PKP graft failure at 1y postoperatively and among each factor in the RSS with the risk of PKP graft failure using univariate and multivariate analysis. METHODS: The retrospective cohort study had 152 PKPs from 152 patients. Eighteen cases were excluded from our study due to primary failure (10 cases, incomplete medical notes (5 cases and follow-up less than 1y (3 cases. We included 134 PKPs from 134 patients stratified by preoperative risk score. Spearman coefficient was calculated for the relationship between the score obtained and risk of failure at 1y. Univariate and multivariate analysis were calculated for the impact of every single risk factor included in the RSS over graft failure at 1y. RESULTS: Spearman coefficient showed statistically significant correlation between the score in the RSS and graft failure (P0.05 between diagnosis and lens status with graft failure. The relationship between the other risk factors studied and graft failure was significant (P<0.05, although the results for previous grafts and graft failure was unreliable. None of our patients had previous blood transfusion, thus, it had no impact. CONCLUSION: After the application of multivariate analysis techniques, some risk factors do not show the expected impact over graft failure at 1y.

  2. Ahmed glaucoma valve in post-penetrating-keratoplasty glaucoma: A critically evaluated prospective clinical study

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    Anita Panda

    2011-01-01

    Full Text Available Aim: The aim was to evaluate the outcome of Ahmed glaucoma valve (AGV in post-penetrating-keratoplasty glaucoma (PKPG. Materials and Methods: In this prospective study, 20 eyes of 20 adult patients with post-PKPG with intraocular pressure (IOP >21 mmHg, on two or more antiglaucoma medications, underwent AG (model FP7 implantation and were followed up for a minimum of 6 months. Absolute success was defined as 5 < IOP < 21 mmHg and qualified success as 5 < IOP < 21 mmHg with medications or minor procedures. Results: The mean IOP decreased from 42.95 ± 10.24 to 17.69 ± 3.64 mmHg (P < 0.001 and the use of medications dropped from 2.92 to 0.39 (P < 0.001 after AGV implantation. The absolute success was achieved in 11 eyes and qualified success in 9. There was no significant change in best corrected visual acuity, graft clarity, or graft thickness. Six device-related complications occurred after AGV implantations which were successfully managed with medical or minor surgical therapy. Conclusions: Postkeratoplasty refractory glaucoma managed by AGV implantation revealed a satisfactory outcome up to 6 months of follow-up.

  3. Precut cornea for Descemet's stripping endothelial keratoplasty: experience at a single eye bank.

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    Mohamed, Ashik; Chaurasia, Sunita; Chandragiri, Venkataswamy; Kandhibanda, Srinivas; Gunnam, Srinivas; Garg, Prashant

    2017-06-01

    The aim of the study is to describe the experience with precut facility for endothelial keratoplasty at a single eye bank affiliated to a tertiary eye care center in India. Data on precut tissues from Nov 2012 to Dec 2014 were retrospectively reviewed from the electronic database of the eye bank of a tertiary eye care center in South India. Donor characteristic data including donor age, precut and postcut endothelial cell density (ECD), recipient age, and thickness of graft were collected. The number of precuts increased from 42 in 2012 (Nov and Dec) and 422 in 2013 to 584 in 2014. Of the total of 1048 precuts, seven (0.67 %) were miscut and could not be utilized for transplants. The donor age ranged from 2 to 89 years. A mean change of 43.6 ± 325.2 cells/mm 2 in ECD was noted after cut, proportional increase in mean being 1.9 %. The change in ECD after cut was negatively correlated with ECD before cut. The recipient age ranged from 1 to 89 years. The median thickness of donor lenticule after cut was 148 µm (interquartile range 131-166 µm). Analysis of precut donor corneas from a single eye bank shows that the ECD of the processed tissues was excellent for transplantation. The tissue wastage in the hands of eye bank personal was minimal.

  4. Pre-banking microbial contamination of donor conjunctiva and storage medium for penetrating keratoplasty.

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    Inomata, Takenori; Ono, Koichi; Matsuba, Tsuyoshi; Shiang, Tina; Di Zazzo, Antonio; Nakatani, Satoru; Yamaguchi, Masahiro; Ebihara, Nobuyuki; Murakami, Akira

    2017-09-01

    The aims of this study were to investigate the incidence of positive donor tissue cultures before transfer to preservation medium (Optisol™-GS) for penetrating keratoplasty, to verify the efficacy of antibiotics contained in Optisol™-GS by examining the drug susceptibility and to assess the relationship between the results of our microbial assessments as well as donor factors and the incidence of contamination. We conducted a retrospective, cross-sectional study using Juntendo Eye Bank records for all corneal transplantations. Two hundred donor conjunctiva harvestings and storage medium (EP-II ® ) cultures were performed between July 2008 and June 2011. We analyzed the associations between donor factors (age, gender, history of cataract surgery, death-to-preservation interval, cause of death) and contamination rates using multivariate analysis by the generalized estimating equation model. We obtained positive bacterial cultures from 154 of the 200 eyes (77.0%). The isolated bacteria were indigenous, such as coagulase-negative Staphylococci, Corynebacterium sp., and methicillin-resistant Staphylococcus aureus (MRSA). There was significant resistance to levofloxacin (18 eyes, 9.0%) and gentamicin (12 eyes, 6.0%), and no vancomycin-resistant bacteria were detected. The donor factors did not correlate with the prevalence of bacterial contamination in our criteria. Pre-banking microbial assessment allows for microbial detection, bacterial susceptibility and resistance testing. This is useful for developing preservation mediums containing effective spectrum antibiotic agents for high quality control of corneal banking.

  5. Corneal endothelial rejection after penetrating keratoplasty treated with intravenous and topic corticosteroid: one year follow up

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    Ricardo Yuji Abe

    2013-02-01

    Full Text Available OBJECTIVE: To analyze the recovery of visual acuity (VA and graft survival after first episode of endothelial rejection in penetrating keratoplasty (PKP treated with intravenous (IV and topic corticosteroid. METHODS: Interventional, prospective, non-comparative case series study evolving 32 PKP patients in one year follow up, who presented first episode of corneal endothelial rejection. The patients were submitted to 500 mg IV injection of methylprednisolone in association with topical prednisolone. Main outcome measures included VA recovery and corneal edema regression. Second outcome included new rejections and graft failure. Multivariate analysis techniques were used to estimate rates of graft outcome events and the impact of risk factors. RESULTS: A total of 32 eyes from 32 patients (13 male and 19 female were included in the study. The mean VA (in number of letters before rejection was 48 (22 to 88 letters. Patients treated within 7 days or less of initial symptoms had better VA recovery, corneal edema regression and less graft failure (p<0.001. Patients with previous ocular surgery had worse VA recovery and more graft failure (p<0.047. CONCLUSION: The association between the other risk factors and the outcomes did not reach statistical significance in the multivariate model because of the small numbers of patients. Methylprednisolone in association with topical prednisolone is an alternative treatment for graft rejection. Our study showed that patients treated within 7 days of symptoms and no previous anterior segment surgery had better visual outcome and graft survival after treatment.

  6. Energy Efficient Triple IG Automation EEE (Triple-E)

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    McGlinchy, Timothy B

    2013-02-28

    GED Integrated Solutions collaborated with US window and door manufactures to investigate, design and verify technical and cost feasibility for producing high performance, high volume, low material and labor cost window, utilizing a modified window design containing a triple insulating glass unit (IGU). This window design approach when combined with a high volume IGU manufacturing system, can produce R5 rated windows for an approximate additional consumer cost of only $4 per square foot when compared to conventional Low-E argon dual pane IG windows, resulting in a verify practical, reliable and affordable high performance window for public use.

  7. Young donor-graft assisted endothelial keratoplasty (PDEK/DMEK) with epithelial debridement for chronic pseudophakic bullous keratopathy.

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    Agarwal, Amar; Narang, Priya; Kumar, Dhivya A; Agarwal, Ashvin

    2017-10-01

    The aim of this study was to describe the applicability and report visual outcomes for the treatment of subepithelial fibrosis and anterior stromal scarring in cases of chronic pseudophakic bullous keratopathy (PBK) with epithelial debridement and endothelial keratoplasty (EK) (pre-Descemet endothelial keratoplasty [PDEK]; Descemet membrane endothelial keratoplasty [(DMEK]) using young donor tissue. Prospective, single-centre, interventional study. 6 cases with chronic PBK (> 1 year duration). Case 1 underwent PDEK with glued intraocular lens (IOL) as a single-stage procedure, whereas cases 2 and 3 underwent glued IOL followed by DMEK and PDEK, respectively, as a second-stage procedure. Cases 4 and 6 underwent PDEK, whereas case 5 underwent DMEK. Epithelial debridement was performed in all cases at the time of EK, and young donor grafts were used. The main outcome measures were best spectacle-corrected visual acuity, clearance of corneal scar and haze, central corneal thickness (CCT), specular microscopy, and endothelial cell count (ECC). Postoperatively, all cases demonstrated significant improvement in visual acuity. The mean value of depth of subepithelial haze was 121±71.7 µm and 25.3 ± 19.8 µm in the preoperative and postoperative periods, respectively (p = 0.028). At the 1-month follow-up, the mean preoperative CCT of 676 ± 92.7 µm was reduced to 534.6 ± 21.1µm. At the 6-month follow-up, the mean ECC loss resulting from the procedure was 36.5 ± 10.4%. EK with epithelial debridement performed for the treatment of chronic PBK resulted in significantly improved visual acuity to a functional level, with the clearance of subepithelial fibrosis and anterior stromal scar, in most patients. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  8. Simultaneous topography-guided PRK followed by corneal collagen cross-linking after lamellar keratoplasty for keratoconus

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    Spadea L

    2012-11-01

    Full Text Available Leopoldo Spadea,1 Marino Paroli21University of L’Aquila, Department of Biotechnological and Applied Clinical Sciences, Eye Clinic, L’Aquila, 2La Sapienza University, Department of Biotechnology and Medical-Surgical Sciences, Latina, ItalyBackground: The purpose of this paper is to report the results of using combined treatment of customized excimer laser-assisted photorefractive keratectomy (PRK and prophylactic corneal collagen crosslinking (CXL for residual refractive error in a group of patients who had previously undergone lamellar keratoplasty for keratoconus.Methods: The study included 14 eyes from 14 patients who had originally been treated for keratoconus in one eye by excimer laser-assisted lamellar keratoplasty (ELLK, and subsequently presented with residual ametropia (-6.11 D ± 2.48, range -2.50 to -9.50. After a mean 40.1 ± 12.4 months since ELLK they underwent combined simultaneous corneal regularization treatment with topographically guided transepithelial excimer laser PRK (central corneal regularization and corneal CXL induced by riboflavin-ultraviolet A.Results: After a mean 15 ± 6.5 (range 6–24 months, all eyes gained at least one Snellen line of uncorrected distance visual acuity (range 1–10. No patient lost lines of corrected distance visual acuity, and four patients gained three lines of corrected distance visual acuity. Mean manifest refractive spherical equivalent was -0.79 ± 2.09 (range +1 to -3.0 D, and topographic keratometric astigmatism was 5.02 ± 2.93 (range 0.8–8.9 D. All the corneas remained clear (haze < 1.Conclusion: The combination of customized PRK and corneal CXL provided safe and effective results in the management of corneal regularization for refractive purposes after ELLK for keratoconus.Keywords: corneal collagen crosslinking, excimer laser-assisted lamellar keratoplasty, photorefractive keratectomy

  9. In situ ultrahigh-resolution optical coherence tomography characterization of eye bank corneal tissue processed for lamellar keratoplasty.

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    Brown, Jamin S; Wang, Danling; Li, Xiaoli; Baluyot, Florence; Iliakis, Bernie; Lindquist, Thomas D; Shirakawa, Rika; Shen, Tueng T; Li, Xingde

    2008-08-01

    To use optical coherence tomography (OCT) as a noninvasive tool to perform in situ characterization of eye bank corneal tissue processed for lamellar keratoplasty. A custom-built ultrahigh-resolution OCT (UHR-OCT) was used to characterize donor corneal tissue that had been processed for lamellar keratoplasty. Twenty-seven donor corneas were analyzed. Four donor corneas were used as controls, whereas the rest were processed into donor corneal buttons for lamellar transplantation by using hand dissection, a microkeratome, or a femtosecond laser. UHR-OCT was also used to noninvasively characterize and monitor the viable corneal tissue immersed in storage medium over 3 weeks. The UHR-OCT captured high-resolution images of the donor corneal tissue in situ. This noninvasive technique showed the changes in donor corneal tissue morphology with time while in storage medium. The characteristics of the lamellar corneal tissue with each processing modality were clearly visible by UHR-OCT. The in situ characterization of the femtosecond laser-cut corneal tissue was noted to have more interface debris than shown by routine histology. The effects of the femtosecond laser microcavitation bubbles on the corneal tissue were well visualized at the edges of the lamellar flap while in storage medium. The results of our feasibility study show that UHR-OCT can provide superb, in situ microstructural characterization of eye bank corneal tissue noninvasively. The UHR-OCT interface findings and corneal endothelial disc thickness uniformity analysis are valuable information that may be used to optimize the modalities and parameters for lamellar tissue processing. The UHR-OCT is a powerful approach that will allow us to further evaluate the tissue response to different processing techniques for posterior lamellar keratoplasty. It may also provide information that can be used to correlate with postoperative clinical outcomes. UHR-OCT has the potential to become a routine part of tissue

  10. Recurrent progressive anterior segment fibrosis syndrome following a descemet-stripping endothelial keratoplasty in an infant with congenital aniridia

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    Mihir Kothari

    2014-01-01

    Full Text Available Progressive anterior segment fibrosis syndrome (ASFS, after intraocular surgery in older children (≥9 years and adults with congenital aniridia, is described in the literature. In this report, we describe an unique case of ASFS in an infant with congenital aniridia following a combined trabeculotomy-ectomy and its recurrence after a descemet stripping endothelial keratoplasty. The ophthalmologists should be well aware of this entity and warn the parents about its possibilities. Use of immunomodulators or prolonged anti-inflammatory therapy may be considered to prevent its occurrence.

  11. A case of recipient bed melt and wound dehiscence after penetrating keratoplasty and subconjunctival injection of bevacizumab.

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    Bhasin, Purendra; Gujar, Prateek; Bhasin, Priyamvada

    2012-11-01

    We describe a case of recipient bed melt and wound dehiscence after uneventful penetrating keratoplasty and subconjunctival injection of bevacizumab. Three weeks postoperatively, the patient presented with limbal ischemia, recipient bed melt, and wound dehiscence corresponding to the area of bevacizumab injection. The melt was managed by application of cyanoacrylate glue along with bandage contact lens. Although the graft survived, there was a problem in re-epithelization. This case highlights the need for further studies to elucidate the therapeutic dose, side effects, and correct timing of using bevacizumab with respect to corneal transplant surgery.

  12. Geodynamical simulation of the RRF triple junction

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    Wang, Z.; Wei, D.; Liu, M.; Shi, Y.; Wang, S.

    2017-12-01

    Triple junction is the point at which three plate boundaries meet. Three plates at the triple junction form a complex geological tectonics, which is a natural laboratory to study the interactions of plates. This work studies a special triple junction, the oceanic transform fault intersects the collinear ridges with different-spreading rates, which is free of influence of ridge-transform faults and nearby hotspots. First, we build 3-D numerical model of this triple junction used to calculate the stead-state velocity and temperature fields resulting from advective and conductive heat transfer. We discuss in detail the influence of the velocity and temperature fields of the triple junction from viscosity, spreading rate of the ridge. The two sides of the oceanic transform fault are different sensitivities to the two factors. And, the influence of the velocity mainly occurs within 200km of the triple junction. Then, we modify the model by adding a ridge-transform fault to above model and directly use the velocity structure of the Macquarie triple junction. The simulation results show that the temperature at both sides of the oceanic transform fault decreases gradually from the triple junction, but the temperature difference between the two sides is a constant about 200°. And, there is little effect of upwelling velocity away from the triple junction 100km. The model results are compared with observational data. The heat flux and thermal topography along the oceanic transform fault of this model are consistent with the observed data of the Macquarie triple junction. The earthquakes are strike slip distributed along the oceanic transform fault. Their depths are also consistent with the zone of maximum shear stress. This work can help us to understand the interactions of plates of triple junctions and help us with the foundation for the future study of triple junctions.

  13. Electrospun nanofibrous SF/P(LLA-CL membrane: a potential substratum for endothelial keratoplasty

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    Chen JZ

    2015-05-01

    Full Text Available Junzhao Chen,1,* Chenxi Yan,1,* Mengyu Zhu,1,* Qinke Yao,1 Chunyi Shao,1 Wenjuan Lu,1 Jing Wang,2 Xiumei Mo,2 Ping Gu,1 Yao Fu,1 Xianqun Fan1 1Department of Ophthalmology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 2Biomaterials and Tissue Engineering Laboratory, College of Chemistry and Chemical Engineering and Biotechnology, Donghua University, Shanghai, People’s Republic of China *These authors contributed equally to this work Background: Cornea transplant technology has progressed markedly in recent decades, allowing surgeons to replace diseased corneal endothelium by a thin lamellar structure. A thin, transparent, biocompatible, tissue-engineered substratum with corneal endothelial cells for endothelial keratoplasty is currently of interest. Electrospinning a nanofibrous structure can simulate the extracellular matrix and have beneficial effects for cell culture. Silk fibroin (SF has good biocompatibility but poor mechanical properties, while poly(L-lactic acid-co-Ɛ-caprolactone (P(LLA-CL has good mechanical properties but poor biocompatibility. Blending SF with P(LLA-CL can maintain the advantages of both these materials and overcome their disadvantages. Blended electrospun nanofibrous membranes may be suitable for regeneration of the corneal endothelium. The aim of this study was to produce a tissue-engineered construct suitable for endothelial keratoplasty.Methods: Five scaffolds containing different SF:P(LLA-CL blended ratios (100:0, 75:25, 50:50, 25:75, 0:100 were manufactured. A human corneal endothelial (B4G12 cell line was cultured on the membranes. Light transmission, speed of cell adherence, cell viability (live-dead test, cell proliferation (Ki-67, BrdU staining, and cell monolayer formation were detected on membranes with the different blended ratios, and expression of some functional genes was also detected by real-time polymerase chain reaction.Results: Different blended ratios of scaffolds

  14. Quantitative Analysis of Endothelial Cell Loss in Preloaded Descemet Membrane Endothelial Keratoplasty Grafts.

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    Wolle, Meraf A; DeMill, David L; Johnson, Lauren; Lentz, Stephen I; Woodward, Maria A; Mian, Shahzad I

    2017-11-01

    Availability of preloaded Descemet membrane endothelial keratoplasty (pDMEK) tissue may increase acceptance of DMEK in surgical management of endothelial disease. The goal of this study was to determine the safety of pDMEK grafts for 24 hours before surgery by analyzing endothelial cell loss (ECL) using 2 image analysis software programs. A total of 18 cadaveric corneas were prepared for DMEK using a standardized technique and loaded in a modified Jones tube injector. Nine of the corneas were injected into Calcein AM vital dye after 1 minute (controls), and the remaining 9 corneas were left preloaded for 24 hours before injection into vital dye for staining. The stained corneas were imaged using an inverted confocal microscope. ECL was then analyzed and quantified by 2 different graders using 2 image analysis software programs. The control DMEK tissue resulted in 22.0% ± 4.0% ECL compared with pDMEK tissue, which resulted in 19.2% ± 7.2% ECL (P = 0.31). Interobserver agreement was 0.93 for MetaMorph and 0.92 for Fiji. The average time required to process images with MetaMorph was 2 ± 1 minutes and with Fiji was 20 ± 10 minutes. Intraobserver agreement was 0.97 for MetaMorph and 0.93 for Fiji. Preloading DMEK tissue is safe and may provide an alternative technique for tissue distribution and surgery for DMEK. The use of MetaMorph software for quantifying ECL is a novel and accurate imaging method with increased efficiency and reproducibility compared with the previously validated Fiji.

  15. Safety of prophylactic intracameral moxifloxacin ophthalmic solution after cataract surgery in patients with penetrating keratoplasty

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    Osman Sevki Arslan

    2014-10-01

    Full Text Available AIM:To determine the safety of prophylactic intracameral moxifloxacin after cataract surgery in patients with penetrating keratoplasty (PKP.METHODS:In this retrospective study of consecutive patients who had phacoemulsification cataract surgery after PKP, were treated with intracameral moxifloxacin 0.5% ophthalmic solution (0.5 mg/0.1 mL. The main outcome measures were anterior chamber reaction, best corrected visual acuity (BCVA, corneal endothelial cell count (ECC, and central corneal thickness (CCT.RESULTS:Fifty-five patients were recruited (26 males, 29 females. The mean age was 54.36±4.97y (range 45-64y. All eyes had improved postoperative BCVA. The mean BCVA was 0.25 preoperatively and 0.57 postoperatively, which was statistically significant (P<0.001. One eye had 3+, 7 eyes had 2+, 12 eyes had 1+ and 8 eyes had trace amount of aqueous cells on the first day after surgery. All eyes had no anterior chamber cells at subsequent follow up examinations. Effective phacoemulsification time was 4.33±1.01s. The mean ECC was 2340.20 cells/mm2 preoperatively and 1948.75 cells/mm2 1mo postoperatively (P<0.001. The increase of 21.09 µm in postoperative pachymetry 1mo after surgery was statistically significant (P<0.001.CONCLUSION: No untoward effects were observed after intracameral injection of moxifloxacin (0.5 mg/0.1 mL in terms of anterior chamber reaction, CCT, ECC, and visual rehabilitation at the conclusion of cataract surgery in patients with PKP.

  16. Penetrating keratoplasty in eThekwini Health District 2011–2014

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    Monawwar Khan

    2015-07-01

    Full Text Available Background: Penetrating keratoplasty (PK – corneal transplantation or full-thickness corneal graft remains the primary sight-restoring procedure for corneal blindness. South Africa is experiencing a shortage of donor corneas, resulting in long waiting times for a corneal transplant. A corneal graft protocol has been drawn up in the eThekwini Health District to triage prospective corneal graft recipients. Aim: To describe the clinical and demographic profiles of patients on the elective corneal graft waiting list, the waiting time for PK and the scoring system prioritisation process of corneal graft allocation. Setting: All patients on the elective corneal graft waiting list in the eThekwini Health District. Methods: An observational, descriptive cross-sectional study was conducted for a 3-year period between April 2011 and March 2014. Results: A total of 104 patients were on the elective corneal graft waiting list for PK during the study period. Only 20% (n = 21 of patients received a corneal graft during the 3-year period. Amongst those that received a corneal graft, the median waiting period was 280 days (interquartile range 143–520 days. The majority of patients on the waiting list (67% were younger than 41 years of age. The commonest indication for PK was keratoconus (64%. Patients with higher pro forma scores are more likely to receive a corneal graft when a donor cornea becomes available. Conclusion: With a shortage of donor corneas, very few patients receive a corneal graft. Educational programmes are vital to increase awareness of corneal blindness and the value of corneal donations.

  17. Complications and management in Descemet′s stripping endothelial keratoplasty: Analysis of consecutive 430 cases

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    Samar K Basak

    2014-01-01

    Full Text Available Purpose: To analyze the complications and their managements in Descemet′s stripping endothelial keratoplasty (DSEK in consecutive 430 cases by single surgeon in a tertiary eye hospital. Materials and Methods: 430 eyes of 366 patients with endothelial dysfunctions scheduled for DSEK, were analyzed retrospectively. In all cases donor dissection was performed manually, and ′Taco′ insertion and unfolding technique was used. Intra-operative and postoperative complications with their managements and outcomes were reviewed retrospectively. Periodic endothelial cell density was analyzed for each patient till the last visit. Follow-up period was between 3 to 60 months (mean 18.7 months. Results: 13 (3.0% eyes had operative complications during donor dissection and 16 (3.7% had during recipient procedure. In 7 (1.6% eyes, donor lenticule was replaced with a new one during the surgery. In early postoperative period, 21 (4.9% eyes had donor dislocation and 12 (2.8% eyes had air-induced pupillary block; and they were managed immediately. 2 cases had primary graft failure and in 1 case had postoperative bacterial endophthalmitis requiring evisceration. In late postoperative period, 48 (11.3% eyes had secondary glaucoma and 14 (3.3% eyes had late secondary graft failure. Endothelial rejection occurred in 5 (1.2% cases. Mean endothelial cell loss was 19.7% after 3 months and 54.2% after 5 years. Total graft failure in this series was 31 (7.2% and in 17 cases re-DSEK was performed successfully. Conclusions: Both operative and postoperative complications do occur in DSEK. Most of these complications can be managed by medical or appropriate surgical means. Some of the complications can be avoided and reduced with experience.

  18. Comparison of Sulfur Hexafluoride (SF6) and Air Tamponade in Noniridectomized Descemet Membrane Endothelial Keratoplasty.

    Science.gov (United States)

    Einan-Lifshitz, Adi; Sorkin, Nir; Boutin, Tanguy; Showail, Mahmood; Borovik, Armand; Jamshidi, Farzad; Chan, Clara C; Rootman, David S

    2018-03-01

    To compare the efficacy and safety of 20% sulfur hexafluoride gas (SF6) and air tamponade in patients who underwent noniridectomized Descemet membrane endothelial keratoplasty (DMEK). A retrospective chart review of patients who underwent DMEK with either air or SF6 tamponade: 41 eyes received air tamponade (group 1) and 41 received SF6 tamponade (group 2). Best spectacle-corrected visual acuity, endothelial cell density, and complications including graft detachment and elevated intraocular pressure were compared. The mean follow-up time was 8 ± 4 months in group 1 and 3 ± 2 months in group 2. Mean best spectacle-corrected visual acuity improved from 1.12 ± 0.88 to 0.64 ± 0.78 logarithm of the minimum angle of resolution (logMAR) in group 1 (P = 0.009) and from 1.00 ± 0.78 to 0.62 ± 0.53 logMAR in group 2 (P = 0.006). The graft detachment rate was 39% (16 eyes) in group 1 and 42% (17 eyes) in group 2 (P = 0.822). The rate of graft detachment larger than one third of the graft area was 17% in group 1 and 20% in group 2 (P = 0.775). Rebubbling was performed in 26.8% and 20% of eyes in group 1 and 2, respectively (P = 0.43). Average endothelial cell loss was 32% in group 1 and 33% in group 2 (P = 0.83). In the immediate postoperative period, elevated intraocular pressure was observed in 2 eyes (5%) in group 1 and in 4 eyes (10%) in group 2 (P = 0.4). There was 1 primary graft failure in each group. Use of air with it being readily available and short acting is a good method of Descemet membrane tamponade in noniridectomized DMEK.

  19. Air Versus Sulfur Hexafluoride Gas Tamponade in Descemet Membrane Endothelial Keratoplasty: A Fellow Eye Comparison.

    Science.gov (United States)

    von Marchtaler, Philipp V; Weller, Julia M; Kruse, Friedrich E; Tourtas, Theofilos

    2018-01-01

    To perform a fellow eye comparison of outcomes and complications when using air or sulfur hexafluoride (SF6) gas as a tamponade in Descemet membrane endothelial keratoplasty (DMEK). One hundred thirty-six eyes of 68 consecutive patients who underwent uneventful DMEK in both eyes for Fuchs endothelial corneal dystrophy were included in this retrospective study. Inclusion criteria were air tamponade (80% of the anterior chamber volume) in the first eye and 20% SF6 gas tamponade (80% of the anterior chamber volume) in the second eye; and same donor tissue culture condition in both eyes. All eyes received laser iridotomy on the day before DMEK. Main outcome measures included preoperative and postoperative best-corrected visual acuity, endothelial cell density, corneal volume, rebubbling rate, and rate of postoperative pupillary block caused by the air/gas bubble. Thirteen of 68 eyes (19.1%) with an air tamponade needed rebubbling compared with 4 of 68 eyes (5.9%) with an SF6 gas tamponade (P = 0.036). Postoperative pupillary block necessitating partial release of air/gas occurred in 1 eye (1.5%) with an air tamponade and 3 eyes (4.4%) with an SF6 gas tamponade (P = 0.301). There were no significant differences in preoperative and postoperative best-corrected visual acuity, endothelial cell density, and corneal volume within 3-month follow-up. Our results confirm the previously reported better graft adhesion when using an SF6 gas tamponade in DMEK without increased endothelial cell toxicity. The rate of pupillary block in eyes with an SF6 gas tamponade was comparable to that with an air tamponade. As a consequence, we recommend using SF6 gas as the tamponade in DMEK.

  20. Rebubbling in Descemet Membrane Endothelial Keratoplasty: Influence of Pressure and Duration of the Intracameral Air Tamponade.

    Science.gov (United States)

    Pilger, Daniel; Wilkemeyer, Ina; Schroeter, Jan; Maier, Anna-Karina B; Torun, Necip

    2017-06-01

    To explore the impact of intracameral air tamponade pressure and duration on graft attachment and rebubbling rates. A prospective, interventional, nonrandomized study. setting: Department of Ophthalmology, Charité - Universitätsmedizin Berlin. One hundred seventeen patients who underwent Descemet membrane endothelial keratoplasty (DMEK). Intraocular pressure (IOP) at the end of the surgery, immediately after filling the anterior chamber with air, categorized into low (20 mm Hg), and the time until partial removal of the air. Rebubbling rates and endothelial cell density over a 3-month follow-up period analyzed by a multivariable Cox regression model and an analysis of covariance model. Thirty-two patients required a rebubbling (27% [95% CI 19%-35%]). Nine patients required more than 1 rebubbling (7% [95% CI 3%-12%]). Compared with normal IOP, lower (HR 8.98 [95% CI 1.07-75.41]) and higher IOP (HR 10.63 [95% CI 1.44-78.27]) increased the risk of requiring a rebubbling (P = .006). Independent of the IOP, an air tamponade duration beyond 2 hours reduced the risk of rebubbling (HR 0.36 [95% CI 0.18-0.71, P = .003]). One month after surgery, the mean endothelial cell loss was 13% (95% CI 2%-25%) and 23% (95% CI 17%-29%) in the group with air tamponade duration of below and above 2 hours, respectively (P = .126). At 3 months after surgery, it was 31% (95% CI 17%-42%) and 42% (95% CI 32%-52%) in the respective groups (P = .229). A postsurgical air tamponade of at least 2 hours with an IOP within the physiological range could help to reduce rebubbling rates. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Diamond knife-assisted deep anterior lamellar keratoplasty to manage keratoconus.

    Science.gov (United States)

    Vajpayee, Rasik B; Maharana, Prafulla K; Sharma, Namrata; Agarwal, Tushar; Jhanji, Vishal

    2014-02-01

    To evaluate the outcomes of a new surgical technique, diamond knife-assisted deep anterior lamellar keratoplasty (DALK), and compare its visual and refractive results with big-bubble DALK in cases of keratoconus. Tertiary eyecare hospital. Comparative case series. The visual and surgical outcomes of diamond knife-assisted DALK were compared with those of successful big-bubble DALK. Diamond knife-assisted DALK was performed in 19 eyes and big-bubble DALK, in 11 eyes. All surgeries were completed successfully. No intraoperative or postoperative complications occurred with diamond knife-assisted DALK. Six months after diamond knife-assisted DALK, the mean corrected distance visual acuity (CDVA) improved significantly from 1.87 logMAR ± 0.22 (SD) to 0.23 ± 0.06 logMAR, the mean keratometry improved from 65.99 ± 8.86 diopters (D) to 45.13 ± 1.16 D, and the mean keratometric cylinder improved from 7.99 ± 3.81 D to 2.87 ± 0.59 D (all P=.005). Postoperatively, the mean refractive astigmatism was 2.55 ± 0.49 D and the mean spherical equivalent was -1.97 ± 0.56 D. The mean logMAR CDVA (P = .06), postoperative keratometry (P=.64), refractive cylinder (P=.63), and endothelial cell loss (P=.11) were comparable between diamond knife-assisted DALK and big-bubble DALK. Diamond knife-assisted DALK was effective and predictable as a surgical technique for management of keratoconus cases. This technique has the potential to offer visual and refractive outcomes comparable to those of big-bubble DALK. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  2. Impact of 10% SF6 Gas Compared to 100% Air Tamponade in Descemet's Membrane Endothelial Keratoplasty.

    Science.gov (United States)

    Rickmann, Annekatrin; Szurman, Peter; Jung, Sacha; Boden, Karl Thomas; Wahl, Silke; Haus, Arno; Boden, Katrin; Januschowski, Kai

    2018-04-01

    To compare the clinical outcomes following Descemet's membrane endothelial keratoplasty (DMEK) with 100% air tamponade versus 10% sulfur hexafluoride (SF 6 ) tamponade. Retrospective analysis of 108 consecutive DMEK cases subdivided by anterior chamber tamponade with 54 eyes receiving 10% SF 6 and 54 eyes receiving 100% air injection. A post-hoc matched analysis revealed no statistically significant differences between the groups. The main outcome measurements were the complication rate, including intra- and postoperative complications and graft detachment rate requiring re-bubbling. Clinical outcome included best-corrected visual acuity (BCVA), endothelial cell count (ECC), and central corneal thickness (CCT) measured 1, 3, and 6 months after DMEK surgery. The graft detachment rate with consecutive re-bubbling was 18.5% in the air group and 22.2% in the SF 6 group (p = 0.2). Remaining small peripheral graft detachments with a clear cornea occurred more often in the 100% air group (air: 22.2%; 12/54, 6/12 inferior compared to SF 6 : 7.4%; 4/54, 2/4 inferior; p = 0.06). The primary graft failure rate was comparable between the two groups. No complete graft detachment occurred. Outcome results for BCVA, ECC, and CCT at all follow-up time points were comparable between the two groups. The clinical outcomes (including re-bubbling rate, primary graft failure rate, and endothelial cell loss) were comparable with 100% air versus 10% SF 6 tamponade, whereas other studies suggest that a higher SF 6 concentration (20%) may result in a lower re-bubbling rate.

  3. [Transpalpebral tonometry with a digital tonometer in healthy eyes and after penetrating keratoplasty].

    Science.gov (United States)

    Amm, M; Hedderich, J

    2005-01-01

    The Goldmann applanation technique established itself as gold standard for clinical intraocular pressure (IOP) measurement. But the device measures by corneal touch and presupposes corneal conditions within a normal range. So precise determination of IOP is crucial in corneal disorders and after corneal surgery. This pilot study presents tonometry data of normal and postkeratoplasty eyes measured transpalpebrally with a digital tonometer in comparison to Goldmann tonometry. The TGDc-01 tonometer is based on a ballistic principle of measurement. IOP was measured in 50 healthy eyes (group 1) and 40 eyes after penetrating keratoplasty (group 2) first by the TGDc-01 and after 3 minutes by Goldmann tonometry (Haag-Streit). Subjective refraction, keratometry and ultrasonic pachymetry were performed in all eyes. The IOP measurements in the postkeratoplasty eyes were done when corneal epithelium was fully closed and only a medium suture edema could be observed. The Pearson's product-moment correlation was r=0,46 for group 1 and 0,65 for group 2. Using the concordance correlation coefficient the value showed a reproducibility index of r(c)=0,44 in group 1 and r(c)=0,60 in group 2. Following the Bland-Altman-analysis 58% of the cases in group 1 had a difference between the two instruments of maximum 3 mmHg. In group 2, 53,5% of the eyes showed an absolute difference between Goldmann and TDGc-01 of 3 mmHg or less. A transpalpebral measurement technique-avoiding corneal contact-seems to be an alternative choice in patients with corneal pathologies and after corneal surgery. The TGDc-01 tonometer provided mostly similar results compared to the Goldmann device, but with fluctuations. Keeping the deviations between the two methods in mind we recommend, however, the use of the transpalpebral approach only in combination with other techniques (palpation, indentation) to obtain enough reliability of IOP information in problem eyes.

  4. Standardization of the Descemet membrane endothelial keratoplasty technique: Outcomes of the first 450 consecutive cases.

    Science.gov (United States)

    Satué, M; Rodríguez-Calvo-de-Mora, M; Naveiras, M; Cabrerizo, J; Dapena, I; Melles, G R J

    2015-08-01

    To evaluate the clinical outcome of the first 450 consecutive cases after Descemet membrane endothelial keratoplasty (DMEK), as well as the effect of standardization of the technique. Comparison between 3 groups: Group I: (cases 1-125), as the extended learning curve; Group II: (cases 126-250), transition to technique standardization; Group III: (cases 251-450), surgery with standardized technique. Best corrected visual acuity, endothelial cell density, pachymetry and intra- and postoperative complications were evaluated before, and 1, 3 and 6 months after DMEK. At 6 months after surgery, 79% of eyes reached a best corrected visual acuity of≥0.8 and 43%≥1.0. Mean preoperative endothelial cell density was 2,530±220 cells/mm2 and 1,613±495 at 6 months after surgery. Mean pachymetry measured 668±92 μm and 526±46 μm pre- and (6 months) postoperatively, respectively. There were no significant differences in best corrected visual acuity, endothelial cell density and pachymetry between the 3 groups (P > .05). Graft detachment presented in 17.3% of the eyes. The detachment rate declined from 24% to 12%, and the rate of secondary surgeries from 9.6% to 3.5%, from group I to III respectively. Visual outcomes and endothelial cell density after DMEK are independent of the technique standardization. However, technique standardization may have contributed to a lower graft detachment rate and a relatively low number of secondary interventions required. As such, DMEK may become the first choice of treatment in corneal endothelial disease. Copyright © 2014 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  5. Organ culture storage of pre-prepared corneal donor material for Descemet's membrane endothelial keratoplasty.

    Science.gov (United States)

    Bhogal, Maninder; Matter, Karl; Balda, Maria S; Allan, Bruce D

    2016-11-01

    To evaluate the effect of media composition and storage method on pre-prepared Descemet's membrane endothelial keratoplasty (DMEK) grafts. 50 corneas were used. Endothelial wound healing and proliferation in different media were assessed using a standard injury model. DMEK grafts were stored using three methods: peeling with free scroll storage; partial peeling with storage on the stroma and fluid bubble separation with storage on the stroma. Endothelial cell (EC) phenotype and the extent of endothelial overgrowth were examined. Global cell viability was assessed for storage methods that maintained a normal cell phenotype. 1 mm wounds healed within 4 days. Enhanced media did not increase EC proliferation but may have increased EC migration into the wounded area. Grafts that had been trephined showed evidence of EC overgrowth, whereas preservation of a physical barrier in the bubble group prevented this. In grafts stored in enhanced media or reapposed to the stroma after trephination, endothelial migration occurred sooner and cells underwent endothelial-mesenchymal transformation. Ongoing cell loss, with new patterns of cell death, was observed after returning grafts to storage. Grafts stored as free scrolls retained more viable ECs than grafts prepared with the fluid bubble method (74.2± 3% vs 60.3±6%, p=0.04 (n=8). Free scroll storage is superior to liquid bubble and partial peeling techniques. Free scrolls only showed overgrowth of ECs after 4 days in organ culture, indicating a viable time window for the clinical use of pre-prepared DMEK donor material using this method. Methods for tissue preparation and storage media developed for whole corneas should not be used in pre-prepared DMEK grafts without prior evaluation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  6. Black diaphragm intraocular lens implantation and penetrating keratoplasty in aphakic eyes with traumatic aniridia

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    Xiao-Guang Dong

    2013-04-01

    Full Text Available AIM: To evaluate the long-term outcome of implantation of black diaphragm intraocular (BDI lens combined with penetrating keratoplasty (PKP for managing aphakic eyes with traumatic aniridia and corneal damage. METHODS: Six aphakic eyes of six patients with traumatic aniridia and corneal damage had BDI lens implantation at Qingdao Eye Hospital, Shandong Eye Institute from June 2008 to November 2011. Medical records of the patients were reviewed. Three patients received PKP and after 12-18months were implanted with BDI lens. The other three patients completed PKP and BDI lens implantation at the same time. The corrected visual acuity, intraocular pressure and number of corneal endothelial cells were monitored. RESULTS: The patients were followed up for an average of 24.3±12.1months (range 14-48 months. All BDI lenses were located well. The best corrected visual acuity got improved in 5 patients (0.1-1.0 and decreased in 1 patient from 0.4 to 0.2. Three patients had normal intraocular pressure (IOP after implantation. Two patients required antiglaucoma medications to control IOP within the normal range and 1 patient implanted Ahmed glaucoma valve to control IOP. The corneal grafts kept transparent in all eyes and the corneal endothelial counting >1 000/mm2, although two patients experienced acute graft rejection and loss more than 30% corneal endothelial cells. CONCLUSION: Implantation of BDI lens combined with PKP is an effective option for managing aphakic eyes with traumatic aniridia and corneal damage. Although the results in our study are encouraging, additional studies of the long-term safety and efficacy are required. A larger study population and longer follow-up may be beneficial.

  7. Clinical outcomes after combined Ahmed glaucoma valve implantation and penetrating keratoplasty or pars plana vitrectomy.

    Science.gov (United States)

    Lee, Jin Young; Sung, Kyung Rim; Tchah, Hung Won; Yoon, Young Hee; Kim, June Gone; Kim, Myoung Joon; Kim, Jae Yong; Yun, Sung-Cheol; Lee, Joo Yong

    2012-12-01

    To evaluate whether a combination of penetrating keratoplasty (PKP) or pars plana vitrectomy (PPV) and Ahmed glaucoma valve (AGV) implantation affords a level of success similar to that of AGV implantation alone. Eighteen eyes underwent simultaneous PPV and AGV, 14 eyes with PKP and AGV and 30 eyes with AGV implantation alone were evaluated. Success was defined as attainment of an intraocular pressure (IOP) >5 and glaucoma medication. Kaplan-Meier survival analysis was performed to compare cumulative survival between the combined surgery groups and the AGV implantation-alone group. Cox proportional hazard regression analysis was conducted to identify factors predictive of success in each of the three groups. Mean (±standard deviation) preoperative IOP was 30.2 ± 10.2 mmHg in the PKP + AGV, 35.2 ± 9.8 mmHg in the PPV + AGV, and 36.2 ± 10.1 mmHg in the AGV implantation-alone group. The cumulative success rate at 18 months was 66.9%, 73.2%, and 70.8% in the three groups, respectively. Neither combined surgery group differed significantly in terms of cumulative success rate compared with the AGV implantation-alone group (p = 0.556, p = 0.487, respectively). The mean number of preoperative anti-glaucoma medications prescribed was significantly associated with success in the PKP + AGV implantation group (hazard ratio, 2.942; p = 0.024). Either PKP or PPV performed in conjunction with AGV implantation afforded similar success rates compared to patients treated with AGV implantation alone. Therefore, in patients with refractory glaucoma who have underlying corneal or retinal pathology requiring treatment with PKP or PPV, AGV implantation can be performed simultaneously.

  8. Intrastromal Corneal Ring Segments for Astigmatism Correction after Deep Anterior Lamellar Keratoplasty

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    Júlio C. D. Arantes

    2017-01-01

    Full Text Available Background. To evaluate the change in corneal astigmatism after intrastromal corneal ring segment (ICRS implantation in keratoconus patients with previous deep anterior lamellar keratoplasty (DALK. Design was a longitudinal, retrospective, interventional study. The study included 25 eyes of 24 patients with keratoconus who had DALK performed at least two years prior to ICRS implantation. All patients had a clear corneal graft with up to 8.00 D of corneal astigmatism and intolerance to contact lenses. The studied parameters were age, sex, corrected distance visual acuity (CDVA, maximum keratometry (K1, minimum keratometry (K2, spherical equivalent, and astigmatism. There was a statistically significant decrease in the postintervention analysis as follows: 3.5 D reduction in K1 (p<0.001; 1.53 D in K2 (p=0.005; and 2.52 D (p<0.001 in the average K. The spherical equivalent reduced from −3.67 D (±2.74 to −0.71 D (±2.35 (p<0.001. The topographic astigmatism reduced from 3.87 D preoperatively to 1.90 D postoperatively (p<0.001. The CDVA improved from 0.33 (±0.10 to 0.20 (±0.09, p<0.001. ICRS implantation is a useful option for the correction of astigmatism after DALK as it yields significant visual, topographic, and refractive results.

  9. Guided search for triple conjunctions.

    Science.gov (United States)

    Nordfang, Maria; Wolfe, Jeremy M

    2014-08-01

    A key tenet of feature integration theory and of related theories such as guided search (GS) is that the binding of basic features requires attention. This would seem to predict that conjunctions of features of objects that have not been attended should not influence search. However, Found (1998) reported that an irrelevant feature (size) improved the efficiency of search for a Color × Orientation conjunction if it was correlated with the other two features across the display, as compared to the case in which size was not correlated with color and orientation features. We examined this issue with somewhat different stimuli. We used triple conjunctions of color, orientation, and shape (e.g., search for a red, vertical, oval-shaped item). This allowed us to manipulate the number of features that each distractor shared with the target (sharing) and it allowed us to vary the total number of distractor types (and, thus, the number of groups of identical items: grouping). We found that these triple conjunction searches were generally very efficient--producing very shallow Reaction Time × Set Size slopes, consistent with strong guidance by basic features. Nevertheless, both of the variables, sharing and grouping, modulated performance. These influences were not predicted by previous accounts of GS; however, both can be accommodated in a GS framework. Alternatively, it is possible, though not necessary, to see these effects as evidence for "preattentive binding" of conjunctions.

  10. Pseudomonas aeruginosa endophthalmitis after penetrating keratoplasty transmitted from the same donor to two recipients confirmed by pulsed-field gel electrophoresis.

    Science.gov (United States)

    Oguido, Ana Paula Miyagusko Taba; Casella, Antonio Marcelo Barbante; Hofling-Lima, Ana Luisa; Pacheco, Sergio Arruda; Bispo, Paulo José Martins; Marques, Fernanda

    2011-09-01

    Two devastating cases of multidrug-resistant Pseudomonas aeruginosa endophthalmitis after keratoplasty as the result of transmission from the same donor were confirmed by pulsed-field gel electrophoresis. Strategies for preventing donor-to-host transmission, such as the use of antimicrobial agents of greater efficacy and better methods for detecting microorganisms in preservation medium, could minimize this type of transmission.

  11. Atypical Presentation of Iridocorneal Endothelial Syndrome With Band Keratopathy but No Corneal Edema Managed With Descemet Membrane Endothelial Keratoplasty.

    Science.gov (United States)

    Zygoura, Vasiliki; Lavy, Itay; Verdijk, Robert M; Santander-García, Diana; Baydoun, Lamis; Dapena, Isabel; Melles, Gerrit R J

    2018-04-17

    To report an unusual presentation of iridocorneal endothelial (ICE) syndrome associated with band keratopathy and its management with ethylenediamine-tetraacetic acid (EDTA) chelation and Descemet membrane endothelial keratoplasty (DMEK). A 57-year-old female patient presented with unilateral progressive painless visual impairment, corneal band keratopathy, and morphological corneal endothelial changes without corneal edema or any previous ophthalmic, medical, or family history. Routine specular and confocal microscopy imaging, as well as biomicroscopy, best-corrected visual acuity, and pachymetry measurements were performed before and after the surgical procedures. Histopathologic and immunohistochemical evaluations of the surgically excised diseased DM-endothelium were performed. Superficial epithelial keratectomy with EDTA chelation was performed. After an initial period of a few months of corneal clearance, the patient presented with recurrence of visually significant band keratopathy. After 1 year, she underwent retreatment with superficial epithelial keratectomy and EDTA chelation, followed by DMEK. Histopathologic and immunohistochemical analysis showed ICE syndrome. Two years after DMEK surgery, the cornea was still clear and band keratopathy had not recurred. To the best of our knowledge, this is the first case in the literature that reports the association of ICE syndrome with band keratopathy. As band keratopathy recurred shortly after EDTA chelation, endothelial keratoplasty (DMEK) may be indicated to successfully treat such cases.

  12. Simultaneous topography-guided PRK followed by corneal collagen cross-linking after lamellar keratoplasty for keratoconus.

    Science.gov (United States)

    Spadea, Leopoldo; Paroli, Marino

    2012-01-01

    The purpose of this paper is to report the results of using combined treatment of customized excimer laser-assisted photorefractive keratectomy (PRK) and prophylactic corneal collagen crosslinking (CXL) for residual refractive error in a group of patients who had previously undergone lamellar keratoplasty for keratoconus. The study included 14 eyes from 14 patients who had originally been treated for keratoconus in one eye by excimer laser-assisted lamellar keratoplasty (ELLK), and subsequently presented with residual ametropia (-6.11 D ± 2.48, range -2.50 to -9.50). After a mean 40.1 ± 12.4 months since ELLK they underwent combined simultaneous corneal regularization treatment with topographically guided transepithelial excimer laser PRK (central corneal regularization) and corneal CXL induced by riboflavin-ultraviolet A. After a mean 15 ± 6.5 (range 6-24) months, all eyes gained at least one Snellen line of uncorrected distance visual acuity (range 1-10). No patient lost lines of corrected distance visual acuity, and four patients gained three lines of corrected distance visual acuity. Mean manifest refractive spherical equivalent was -0.79 ± 2.09 (range +1 to -3.0) D, and topographic keratometric astigmatism was 5.02 ± 2.93 (range 0.8-8.9) D. All the corneas remained clear (haze PRK and corneal CXL provided safe and effective results in the management of corneal regularization for refractive purposes after ELLK for keratoconus.

  13. A clinical comparison of the Xpert non-contact tonometer with the Goldmann applanation tonometer after penetrating keratoplasty.

    Science.gov (United States)

    Lisle, C; Ehlers, N

    2000-04-01

    To assess the agreement between the Xpert non-contact tonometer (NCT) and the Goldmann applanation tonometer in patients who have undergone penetrating keratoplasty. The study material consisted of 42 consecutive patients (43 eyes) who had undergone penetrating keratoplasty within the previous 13 months. The slope of the linear relationship between the two measurement methods did not differ significantly from 1.0. The mean difference between the methods of 0.96 mmHg was not statistically significant. The range of intraindividual differences between the methods was from -9.8 to 22.8 mmHg. The standard deviation of differences was 6.62 mmHg. The 95% limits of agreement were -12.00 to 13.94 mmHg. There was no significant correlation between the central corneal thickness, astigmatism or transplant size and the difference between the methods The Xpert NCT shows considerable variation from the Goldmann values The degree of agreement with the true IOP value remains to be shown.

  14. MMSC-LIKE LIMBAL CELLS COTRANSPLANTATION PROMOTES LOCAL IMMUNOCORRECTION AND CORNEAL GRAFT TRANSPARENT RETENTION IN HIGH RISK KERATOPLASTY

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    S. A. Borzenok

    2014-01-01

    Full Text Available Aim was to evaluate clinical results of donor corneal graft survival in high-risk recipients in co-transplantation of preserved allogenic limbal grafts. Materials and methods. Two types of penetrative keratoplasties were carried out in patients with corneal graft opacities and high risk of rejection (n = 69. Co-transplantation of donor cornea and allogenic MMSC-like limbal cells in the form of limbal transplants was carried out in the 1st group (n = 36; in the 2nd group (n = 33 only the cornea was transplanted. Results. Observation of the patients during one year after surgery showed that the rate of transparent cornea engraftment increased in the 1st group (86,1 against 69,7% in the 2nd group. The density of endothelial cells was also higher in the 1st group (85,9 against 76,2% in the 2nd group. At the same time, progressive decreasing of pro-inflammatory cytokines (IL-6, IFNγ, TNFα and increasing of anti-inflammatory cytokines (IL-10, IL-1RA, TGFβ along with higher level of HLA-G5 were revealed in the recipients’ tear fluid in the 1st group in comparison to the 2nd group. Conclusion. Simultaneous transplantation of preserved limbal grafts with corneal graft in high-risk keratoplasty favors the transparent cornea engraftment, obviously, this is due to immunoregulatory activity of the MMSC-like limbal cells. 

  15. Quantitative & qualitative analysis of endothelial cells of donor cornea before & after penetrating keratoplasty in different pathological conditions

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    Aruna K.R. Gupta

    2016-01-01

    Full Text Available Background & objectives: Endothelial cells of the donor cornea are known to be affected quantitatively and qualitatively in different pathological conditions after penetrating keratoplasty (PK and this has direct effect on the clarity of vision obtained after PK. This study was undertaken to analyze the qualitative and quantitative changes in donor endothelial cells before and after PK in different pathological conditions. Methods: A prospective investigational analysis of 100 consecutive donor corneas used for penetrating keratoplasty between June 2006 and June 2008, was conducted. The patients were evaluated on the first day, at the end of first week, first month, third and six months and one year. Results: A decrease was observed in endothelial cell count in all pathological conditions. After one year of follow up the loss was 33.1 per cent in corneal opacity, 45.9 per cent in acute infective keratitis (AIK, 58.5 per cent in regrafts, 28.5 per cent in pseudophakic bullous keratopathy (PBK, 37 per cent in descemetocele, 27 per cent in keratoconus and 35.5 per cent in aphakic bullous keratopathy (ABK cases. Interpretation & conclusions: The endothelial cell loss was highest in regraft cases which was significant (P<0.05, while the least endothelial cell loss was seen in keratoconus cases. The cell loss was associated with increase in coefficient of variation (CV, i.e. polymegathism and pleomorphism. Inspite of this polymegathism and pleomorphism, the clarity of the graft was maintained.

  16. [Posterior lamellar keratoplasty with DSEK technique and use of the Tan EndoGlide - short-term results].

    Science.gov (United States)

    Kałuiny, Bartłomiej J; Piotrowiak, Ilona; Sołdańska, Beata; Grzybek, Katarzyna; Czajkowska, Monika; Galas, Małgorzata; Malukiewicz, Grazyna

    2013-01-01

    To present the differences in surgical technique of DSEK (Descemet's Stripping Endothelial Keratoplasty) with the use of Tan EndoGlide (Coronet, UK) and Busin Glide (Moria, FR). Short-term results will also be presented, DSEK was performed in 24 eyes, in 8 cases the surgery was combined with cataract phacoemulsification and lOL implantation. Surgery course and 6 months postoperative results of first 12 eyes performed with the use of Tan EndoGlide were compared with 12 consecutive eyes preformed with Busin Glide. Tan EndoGlide provided much more stable anterior chamber, donor tissue unfolding process was better controlled but the incision was wider incision. Surgically induced mean refractory cylinder 6. months after the surgery was 1.56 - 1.15 Dsph in Tan EndoGlide group and 1.18 +/- 1.10 Dsph in Busin Glide group (P 0.05). Mean CDVA was 0.65+/- 0.27 and 0.63 +/- 0.25, respectively (P>0,05). Statistically significant differences in intra- and post-operative complications between both groups were not found. The Tan EndoGlide used during posterior lamellar keratoplasty with DSEK technique is a good alternative to currently used methods. It provides better stabilization of the anterior chamber, however its use is linked with higher postoperative astigmatism in comparison with Busin Glide. The visual outcomes and endothelial cell loss 6 months after the surgery were similar in both groups.

  17. Visual outcomes after deep anterior lamellar keratoplasty using donor corneas without removal of Descemet membrane and endothelium

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    Tatiana Moura Bastos Prazeres

    Full Text Available ABSTRACT Purpose: The optical quality of the interface after deep anterior lamellar keratoplasty (DALK using the big-bubble technique has been shown to be excellent, leading to results comparable to penetrating keratoplasty. However, there is little in the literature with respect to the controversy surrounding the preparation of the donor cornea. The purpose of this study was to evaluate visual acuity (VA in patients with keratoconus who underwent DALK without removal of the donor graft endothelium. Methods: The records of 90 patients who underwent DALK without the removal of the Descemet membrane (DM and endothelium were retrospectively reviewed. Data collected included uncorrected VA (UCVA and spectacle-corrected VA (SCVA at 7, 30, 180 days, and 1 year postoperatively. Contact lens-corrected visual acuity (CLVA was evaluated after 1 year of the procedure. Results: UCVA was significantly better than preoperative values at 7 days (p<0.001, 30 days (p<0.001, 180 days (p<0.001, and 1 year (p<0.001 after surgery. The 1-year postoperative mean SCVA and CLVA also improved when compared with preoperative SCVA (p<0.001 for both. Conclusions: DALK utilizing donor corneas with attached Descemet membrane and endothelium results in satisfactory VA in patients with keratoconus.

  18. A simple rescue maneuver for unfolding and centering a tightly rolled graft in Descemet membrane endothelial keratoplasty

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    Droutsas K

    2014-10-01

    Full Text Available Konstantinos Droutsas,1,2 Thomas Bertelmann,1 Frank M Schroeder,1 Dimitrios Papaconstantinou,2 Walter Sekundo1 1Department of Ophthalmology, Philipps University, Marburg, Germany; 2First Department of Ophthalmology, University of Athens, Medical School of Athens, Athens, Greece Abstract: A 74-year-old man underwent Descemet membrane endothelial keratoplasty (DMEK for endothelial decompensation due to Fuchs endothelial dystrophy. After descemetorhexis, the DMEK graft was inserted into the anterior chamber. However, unfolding of the graft was not possible as the graft was very tightly rolled together and the anterior chamber deep. After placing a 30G-cannula connected to an air-filled syringe inside the roll's lumen, a small air bubble was injected, which allowed the roll to open up, until it assumed a “taco” configuration around the bubble. Then, the graft was centered by pressing the posterior part of the roll against, and sweeping it over the iris. In the present case a “tight” DMEK roll was successfully unfolded by injection of a single air bubble into the roll’s lumen and centered by a “sweeping” the partialy unfolded graft over the iris. This technique allowed a controlled unfolding and centering of the DMEK graft with limited trauma to the donor endothelium and may be applied in cases where other less traumatic maneuvers are not successful. Keywords: Fuchs endothelial dystrophy, surgical technique, endothelial keratoplasty

  19. Fluorescent in situ hybridization (FISH) on corneal impression cytology specimens (CICS): study of epithelial cell survival after keratoplasty.

    Science.gov (United States)

    Catanese, Muriel; Popovici, Cornel; Proust, Hélène; Hoffart, Louis; Matonti, Frédéric; Cochereau, Isabelle; Conrath, John; Gabison, Eric E

    2011-02-22

    To assess corneal epithelial cell survival after keratoplasty. Corneal impression cytology (CIC) was performed on sex-mismatched corneal transplants. Fluorescent in situ hybridization (FISH) with sex chromosome-specific probes was performed to identify epithelial cell mosaicism and therefore allocate the donor or recipient origin of the cells. Twenty-four samples of corneal epithelial cells derived from 21 transplanted patients were analyzed. All patients received post-operative treatment using dexamethasone eye drops, with progressive tapering over 18 months, and nine patients also received 2% cyclosporine eye drops. Out of the 24 samples reaching quality criteria, sex mosaicism was found in 13, demonstrating the presence of donor-derived cells at the center of the graft for at least 211 days post keratoplasty. Kaplan-Meier analysis established a median survival of donor corneal epithelial cells of 385 days. Although not statistically significant, the disappearance of donor cells seemed to be delayed and the average number of persistent cells appeared to be greater when 2% cyclosporine was used topically as an additional immunosuppressive therapy. The combination of corneal impressions and FISH analysis is a valuable tool with negligible side effects to investigate the presence of epithelial cell mosaicism in sex-mismatched donor transplants. Epithelial cells survived at the center of the graft with a median survival of more than one year, suggesting slower epithelial turnover than previously described.

  20. Holonomy loops, spectral triples and quantum gravity

    DEFF Research Database (Denmark)

    Johannes, Aastrup; Grimstrup, Jesper Møller; Nest, Ryszard

    2009-01-01

    We review the motivation, construction and physical interpretation of a semi-finite spectral triple obtained through a rearrangement of central elements of loop quantum gravity. The triple is based on a countable set of oriented graphs and the algebra consists of generalized holonomy loops...

  1. Spectral triples and the geometry of fractals

    DEFF Research Database (Denmark)

    Christensen, Erik; Ivan, Cristina; Schroe, Elmar

    2012-01-01

    It is shown that one can construct a spectral triple for the Sierpinski gasket such that it represents any given K-homology class, On the other hand if the geodesic distance and the dimension has to be part of the data from the triple, there are certain restriction....

  2. Triple Test in Carcinoma Breast

    Science.gov (United States)

    Sameer; Mukherjee, Arindam

    2014-01-01

    Introduction: The commonest clinical presentation in majority of breast pathology is a lump. A definite diagnosis of breast lump is very important for the surgeon to decide on the final course of treatment and also saves the patient from unnecessary physical, emotional and psychological trauma if there is a definite preoperative diagnosis of benign lesion. The present study was done to evaluate the effectiveness and relevance of “TRIPLE TEST”in diagnosis of carcinoma breast in rural labour class population. Materials and Methods: The present study was a prospective study conducted on patients over 35 years of age having palpable breast lumps presenting in the out patient department of general surgery, ESI Hospital Basaidarapur New Delhi, India. The duration of study was from May 2007 to June 2009 and a total of 100 cases were studied. Each patient was subjected to a detailed history, clinical breast examination ,diagnostic mammography and FNAC. In this study, the results of each modality was divided in three groups: benign, suspicious and malignant. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of each test was calculated individually and as combined. Result: Out of 100 patients enrolled in this study, 60 cases were benign and 40 cases were of malignant breast disease. The age of patients with carcinoma breast in the series varied from 35 years to 70 years. The highest incidence of malignancy noted was 30% in 41-50 years age group (4th decade) followed by 27.5% in 51-60 years age group (5th decade). The sensitivity of clinical examination was found to be 75%, specificity was 83.3%, positive predictive value (PPV) of 75% and diagnostic accuracy of 80%. The sensitivity, specificity, positive predictive value and diagnostic accuracy of mammography was calculated and was found to be 94.9% , 90% , 86% and 92% respectively. The sensitivity, specificity, positive predictive value and diagnostic accuracy of

  3. NIM Realization of the Gallium Triple Point

    Science.gov (United States)

    Xiaoke, Yan; Ping, Qiu; Yuning, Duan; Yongmei, Qu

    2003-09-01

    In the last three years (1999 to 2001), the gallium triple-point cell has been successfully developed, and much corresponding research has been carried out at the National Institute of Metrology (NIM), Beijing, China. This paper presents the cell design, apparatus and procedure for realizing the gallium triple point, and presents studies on the different freezing methods. The reproducibility is 0.03 mK, and the expanded uncertainty of realization of the gallium triple point is evaluated to be 0.17 mK (p=0.99, k=2.9). Also, the reproducibility of the gallium triple point was compared with that of the triple point of water.

  4. Simulation of triple coincidences in PET

    International Nuclear Information System (INIS)

    Cal-González, J; Herranz, E; Vicente, E; Udias, J M; Lage, E; Dave, S R; Parot, V; Herraiz, J L; Moore, S C; Park, M-A

    2015-01-01

    Although current PET scanners are designed and optimized to detect double coincidence events, there is a significant amount of triple coincidences in any PET acquisition. Triple coincidences may arise from causes such as: inter-detector scatter (IDS), random triple interactions (R T ), or the detection of prompt gamma rays in coincidence with annihilation photons when non-pure positron-emitting radionuclides are used (β + γ events). Depending on the data acquisition settings of the PET scanner, these triple events are discarded or processed as a set of double coincidences if the energy of the three detected events is within the scanner’s energy window. This latter option introduces noise in the data, as at most, only one of the possible lines-of-response defined by triple interactions corresponds to the line along which the decay occurred. Several novel works have pointed out the possibility of using triple events to increase the sensitivity of PET scanners or to expand PET imaging capabilities by allowing differentiation between radiotracers labeled with non-pure and pure positron-emitting radionuclides. In this work, we extended the Monte Carlo simulator PeneloPET to assess the proportion of triple coincidences in PET acquisitions and to evaluate their possible applications. We validated the results of the simulator against experimental data acquired with a modified version of a commercial preclinical PET/CT scanner, which was enabled to acquire and process triple-coincidence events. We used as figures of merit the energy spectra for double and triple coincidences and the triples-to-doubles ratio for different energy windows and radionuclides. After validation, the simulator was used to predict the relative quantity of triple-coincidence events in two clinical scanners assuming different acquisition settings. Good agreement between simulations and preclinical experiments was found, with differences below 10% for most of the observables considered. For

  5. Theoretical investigation of compounds with triple bonds

    International Nuclear Information System (INIS)

    Devarajan, Deepa

    2011-01-01

    In this thesis, compounds with potential triple-bonding character involving the heavier main-group elements, Group 4 transition metals, and the actinides uranium and thorium were studied by using molecular quantum mechanics. The triple bonds are described in terms of the individual orbital contributions (σ, π parallel , and π perpendicular to ), involving electron-sharing covalent or donor-acceptor interactions between the orbitals of two atoms or fragments. Energy decomposition, natural bond orbital, and atoms in molecules analyses were used for the bonding analysis of the triple bonds. The results of this thesis suggest that the triple-bonding character between the heavier elements of the periodic table is important and worth further study and exploration.

  6. The time domain triple probe method

    International Nuclear Information System (INIS)

    Meier, M.A.; Hallock, G.A.; Tsui, H.Y.W.; Bengtson, R.D.

    1994-01-01

    A new Langmuir probe technique based on the triple probe method is being developed to provide simultaneous measurement of plasma temperature, potential, and density with the temporal and spatial resolution required to accurately characterize plasma turbulence. When the conventional triple probe method is used in an inhomogeneous plasma, local differences in the plasma measured at each probe introduce significant error in the estimation of turbulence parameters. The Time Domain Triple Probe method (TDTP) uses high speed switching of Langmuir probe potential, rather than spatially separated probes, to gather the triple probe information thus avoiding these errors. Analysis indicates that plasma response times and recent electronics technology meet the requirements to implement the TDTP method. Data reduction techniques of TDTP data are to include linear and higher order correlation analysis to estimate fluctuation induced particle and thermal transport, as well as energy relationships between temperature, density, and potential fluctuations

  7. Descemet Membrane Endothelial Keratoplasty Learning Curve for Graft Preparation in an Eye Bank Using 645 Donor Corneas.

    Science.gov (United States)

    Parekh, Mohit; Ruzza, Alessandro; Romano, Vito; Favaro, Elisa; Baruzzo, Mattia; Salvalaio, Gianni; Grassetto, Andrea; Ferrari, Stefano; Ponzin, Diego

    2018-03-01

    To investigate the learning curve of Descemet membrane endothelial keratoplasty (DMEK) graft preparation in an eye bank. Four operators prepared 645 DMEK grafts using the stripping technique between 2014 and 2017 at the Veneto Eye Bank Foundation, Italy. Endothelial cell loss (ECL) and tissue wastage were recorded retrospectively after DMEK preparation and correlated with the number of tissues prepared each year by each operator. On average, our operators performed 1 donor preparation a week over the course of this study. Only donors older than 60 years were used in this study, and approximately 10% of donors had diabetes. The Wilcoxon test for paired data and 1-way ANOVA were used for checking statistical significance with the Tukey test as post hoc analysis. P 0.05). There is a learning curve for DMEK graft preparation. ECL and tissue wastage can be reduced with practice and skills. However, each operator may be limited to his or her own learning capability.

  8. Moorfields technique of donor cornea mounting for femtosecond-assisted keratoplasty: use of viscoelastic in the artificial anterior chamber.

    Science.gov (United States)

    Iovieno, Alfonso; Chowdhury, Vivek; Stevens, Julian D; Maurino, Vincenzo

    2012-07-01

    Appropriate mounting and cutting of the donor sclero-corneal cap is often cumbersome during femtosecond laser-assisted keratoplasty. The authors describe a technique for donor cornea femtosecond laser cutting using ophthalmic viscoelastic devices. The donor sclero-corneal cap is mounted on the artificial anterior chamber using a dispersive ophthalmic viscoelastic device instead of saline solution. The chances of artificial anterior chamber pressure loss, inadequate applanation, and fluid leaks are consistently reduced with the use of dispersive ophthalmic viscoelastic devices. The speed of donor femtosecond laser cutting is increased. The viscosity and elasticity of dispersive ophthalmic viscoelastic devices greatly assist the procedure with regard to ease of applanation, corneal endothelium protection, and decreased distortion of the applanated cornea. Copyright 2012, SLACK Incorporated.

  9. About the Triple A. Argentina 1973 - 1976

    OpenAIRE

    Rostica, Julieta

    2011-01-01

    On May 25, 1973, Peronism returned to govern Argentina after about two decades of prohibition and political persecution. After its establishment, certain crimes began to be signed with “AAA”. The Triple A adopted the particularity of disappearing with the coup on March 24 1976. Why could this organization only exist in a democracy erected in the middle of two military dictatorships? Why did it exist during the very wished Peronist government? The article offers an approach to the Triple A, th...

  10. Evaluation of the Role of Umbilical Cord Serum and Autologous Serum Therapy in Reepithelialization After Keratoplasty: A Randomized Controlled Clinical Trial.

    Science.gov (United States)

    Kamble, Neha; Sharma, Namrata; Maharana, Prafulla K; Bandivadekar, Pooja; Nagpal, Ritu; Agarwal, Tushar; Velpandian, Thirumurthy; Mittal, Suneeta; Vajpayee, Rasik B

    2017-09-01

    To evaluate the role of umbilical cord serum (UCS) and autologous serum (AS) therapy in reepithelialization of corneal graft after keratoplasty in a randomized controlled trial. A total of 105 eyes with epithelial defect (ED) after keratoplasty (penetrating keratoplasty-67 and anterior lamellar keratoplasty-38) on the first postoperative day were included in the study. The eyes were randomized into three groups: UCS (n=35), AS (n=35), and artificial tears (AT) (n=35). All patients received standard postoperative medical therapy. The primary outcome measure was time to epithelialization, and secondary outcome measures were best-corrected visual acuity and graft clarity. The ED healed completely in 103 eyes. The mean time for complete reepithelialization was 2.5±2.1, 3.1±2.2, and 4.5±1.4 days in UCS, AS, and AT groups, respectively. The mean percentage decrease in the size of the ED was significantly better in the UCS and AS groups as compared with the AT group (P=0.001). The rate of reepithelialization was comparable between the AS and UCS groups (P=0.3). On bivariate analysis, significant correlation was found between the mean size of postoperative ED, grade of the donor cornea (P=0.001), and the presence of preoperative ED (P=0.001). No complications were associated with the use of serum therapy. Most of the cases of postkeratoplasty corneal ED can be managed with AT only. The serum therapy (AS/UCS) helps in the faster reepithelialization of postkeratoplasty ED as compared with AT and may be considered as a treatment option for early epithelial healing.

  11. Drop evaporation and triple line dynamics

    Science.gov (United States)

    Sobac, Benjamin; Brutin, David; Gavillet, Jerome; Université de Provence Team; Cea Liten Team

    2011-03-01

    Sessile drop evaporation is a phenomenon commonly came across in nature or in industry with cooling, paintings or DNA mapping. However, the evaporation of a drop deposited on a substrate is not completely understood due to the complexity of the problem. Here we investigate, with several nano-coating of the substrate (PTFE, SiOx, SiOc and CF), the influence of the dynamic of the triple line on the evaporation process. The experiment consists in analyzing simultaneously the motion of the triple line, the kinetics of evaporation, the internal thermal motion and the heat and mass transfer. Measurements of temperature, heat-flux and visualizations with visible and infrared cameras are performed. The dynamics of the evaporative heat flux appears clearly different depending of the motion of the triple line

  12. Normalization for triple-target microarray experiments

    Directory of Open Access Journals (Sweden)

    Magniette Frederic

    2008-04-01

    Full Text Available Abstract Background Most microarray studies are made using labelling with one or two dyes which allows the hybridization of one or two samples on the same slide. In such experiments, the most frequently used dyes are Cy3 and Cy5. Recent improvements in the technology (dye-labelling, scanner and, image analysis allow hybridization up to four samples simultaneously. The two additional dyes are Alexa488 and Alexa494. The triple-target or four-target technology is very promising, since it allows more flexibility in the design of experiments, an increase in the statistical power when comparing gene expressions induced by different conditions and a scaled down number of slides. However, there have been few methods proposed for statistical analysis of such data. Moreover the lowess correction of the global dye effect is available for only two-color experiments, and even if its application can be derived, it does not allow simultaneous correction of the raw data. Results We propose a two-step normalization procedure for triple-target experiments. First the dye bleeding is evaluated and corrected if necessary. Then the signal in each channel is normalized using a generalized lowess procedure to correct a global dye bias. The normalization procedure is validated using triple-self experiments and by comparing the results of triple-target and two-color experiments. Although the focus is on triple-target microarrays, the proposed method can be used to normalize p differently labelled targets co-hybridized on a same array, for any value of p greater than 2. Conclusion The proposed normalization procedure is effective: the technical biases are reduced, the number of false positives is under control in the analysis of differentially expressed genes, and the triple-target experiments are more powerful than the corresponding two-color experiments. There is room for improving the microarray experiments by simultaneously hybridizing more than two samples.

  13. Ceratoplastia endotelial lamelar profunda em distrofia de Fuchs: relato de caso Deep lamellar endothelial keratoplasty in Fuchs' dystrophy: case report

    Directory of Open Access Journals (Sweden)

    Fernando Trench de Oliveira Komatsu

    2004-08-01

    Full Text Available Descrever o caso de paciente portador de distrofia de Fuchs submetido a ceratoplastia endotelial lamelar profunda. O procedimento cirúrgico foi realizado no olho direito em um caso de distrofia de Fuchs com falência endotelial. Realizou-se incisão límbica superior, o estroma corneano foi delaminado e um disco lamelar de 8,5 mm com 0,150 mm de espessura, contendo estroma, membrana de Descemet e endotélio, foi transplantado sem sutura corneana. Foram avaliados: acuidade visual sem e com correção, biomicroscopia, topografia, paquimetria ultra-sônica e densidade endotelial. A paciente apresentava na avaliação pré-operatória acuidade visual com correção de 20/100 (+4,00 DE -3,25 DC x 60º, astigmatismo de 6,6 dioptrias (37,5 a 12º x 44,1 a 102º, espessura paquimétrica de 0,625 mm e contagem endotelial de 720 cel/mm². Após três meses da cirurgia, apresentava-se com acuidade visual com correção de 20/30 (-1,25 DE -0,50 DC x 45º, astigmatismo regular de 1,0 dioptria (37,2 a 75º x 38,2 a 165º, espessura paquimétrica de 0,503 mm e contagem endotelial de 2447 cel/mm². Observaram-se como complicações: corte inadvertido da íris, má coaptação de bordas, dobras do disco doador e nébula na interface. Os resultados preliminares sugerem que a ceratoplastia endotelial lamelar posterior é uma alternativa para o tratamento cirúrgico da distrofia de Fuchs com falência endotelial. Seguimento mais prolongado e maior número de casos são necessários para melhor entendimento e caracterização desta técnica e de suas repercussões.To report a case of deep lamellar endothelial keratoplasty (DLEK technique applied to a patient with Fuchs' dystrophy. The surgical procedure was performed on the right eye for a case of Fuchs' dystrophy with endothelial failure. Through a 9 mm self-sealing scleral tunnel incision, a stromal pocket was dissected at 0.35 mm depth. A 8.5 mm lamellar donor disc with 0.150 mm thickness, containing posterior

  14. Krein Spectral Triples and the Fermionic Action

    International Nuclear Information System (INIS)

    Dungen, Koen van den

    2016-01-01

    Motivated by the space of spinors on a Lorentzian manifold, we define Krein spectral triples, which generalise spectral triples from Hilbert spaces to Krein spaces. This Krein space approach allows for an improved formulation of the fermionic action for almost-commutative manifolds. We show by explicit calculation that this action functional recovers the correct Lagrangians for the cases of electrodynamics, the electro-weak theory, and the Standard Model. The description of these examples does not require a real structure, unless one includes Majorana masses, in which case the internal spaces also exhibit a Krein space structure.

  15. RITA: The reinvented triple axis spectrometer

    Energy Technology Data Exchange (ETDEWEB)

    Mason, T.E. [Toronto Univ., ON (Canada). Dept. of Physics; Clausen, K.N.; Aeppli, G.; McMorrow, D.R.; Kjems, J.K. [Risoe National Lab., Roskilde (Denmark)

    1995-11-01

    Risoe National Laboratory was reported to be in the process of developing a new spectrometer design, RITA, based on the triple axis design. The spectrometer will attempt to incorporate more recent innovations such as multilayer supermirrors and microstrip proportional counters into a rethinking of the triple-axis spectrometer. By optimizing the beam optics, using supermirrors and extending the analyser to map regions of (Q, {omega}) space using an array of independently controllable pyrolytic graphite crystals focussed on an area detector, it was hoped that the efficiency of single-crystal inelastic experiments could be increased by as much as a factor of 20. 7 figs., 20 refs.

  16. Triple helix interactions for eco-innovation

    DEFF Research Database (Denmark)

    Hermann, Roberto Rivas; Riisgaard, Henrik; Remmen, Arne

    the role of science parks in promoting eco-innovation. This study uses qualitative data gathered in two units of analysis: Panama Canal Authority and City of Knowledge Science Park. The study examines how Triple Helix interactions have built the regional system of eco-innovation at the Panama Canal...

  17. Triple-axis spectrometer DruechaL

    International Nuclear Information System (INIS)

    Buehrer, W.; Keller, P.

    1996-01-01

    DruechaL is a triple-axis spectrometer located at a cold guide. The characteristics of guide and instrument allow the use of a broad spectral range of neutrons. The resolution in momentum and energy transfer can be tuned to match the experimental requirements by using either collimators or focusing systems (monochromator, antitrumpet, analyser). (author) figs., tabs., refs

  18. A Biatrial Myxoma with Triple Ripples.

    Science.gov (United States)

    Barik, Ramachandra

    2018-01-01

    Cardiac myxoma is a benign tumor, but it is known for its space-occupying effect at the site of origin and frequent systemic embolization. This case report highlights a biatrial myxoma of interatrial septum who presented with significant tricuspid valve regurgitation, atrial fibrillation, and cardioembolic stroke of the left parietal lobe, i.e., a biatrial myxoma with triple ripples.

  19. Revised Reynolds Stress and Triple Product Models

    Science.gov (United States)

    Olsen, Michael E.; Lillard, Randolph P.

    2017-01-01

    Revised versions of Lag methodology Reynolds-stress and triple product models are applied to accepted test cases to assess the improvement, or lack thereof, in the prediction capability of the models. The Bachalo-Johnson bump flow is shown as an example for this abstract submission.

  20. Minimal representations and Freudenthal triple systems

    International Nuclear Information System (INIS)

    Olive, D.

    2004-01-01

    Unitary representations of noncompact Lie groups have long been sought in physics. The first nice concrete construction was found by Dirac in connection with the anti-de Sitter group. Some subsequent generalizations will be described, in particular the minimal representation thought to be relevant to realising duality in supergravity superstring theories. A relation to Freudenthal triple systems will be described. (author)

  1. Triple-axis spectrometer DruechaL

    Energy Technology Data Exchange (ETDEWEB)

    Buehrer, W; Keller, P [Lab. for Neutron Scattering ETH Zurich, Zurich (Switzerland) and Paul Scherrer Institute, Villigen (Switzerland)

    1996-11-01

    DruechaL is a triple-axis spectrometer located at a cold guide. The characteristics of guide and instrument allow the use of a broad spectral range of neutrons. The resolution in momentum and energy transfer can be tuned to match the experimental requirements by using either collimators or focusing systems (monochromator, antitrumpet, analyser). (author) figs., tabs., refs.

  2. Discovering Steiner Triple Systems through Problem Solving

    Science.gov (United States)

    Sriraman, Bharath

    2004-01-01

    An attempt to implement problem solving as a teacher of ninth grade algebra is described. The problems selected were not general ones, they involved combinations and represented various situations and were more complex which lead to the discovery of Steiner triple systems.

  3. Graft rejection episodes after Descemet stripping with endothelial keratoplasty: part two: the statistical analysis of probability and risk factors.

    Science.gov (United States)

    Price, M O; Jordan, C S; Moore, G; Price, F W

    2009-03-01

    To investigate risk factors and probability of initial immunological graft rejection episodes after Descemet stripping with endothelial keratoplasty (DSEK). Outcomes of 598 DSEK cases from a single tertiary referral centre were reviewed. Risk factors and probability of rejection were assessed by multivariate Cox proportional hazards modelling. Rejection episodes occurred in 54 eyes of 48 patients. Estimated probability of a rejection episode was 7.6% by 1 year and 12% by 2 years after grafting. Relative risk of rejection was five times higher for African-American patients compared with Caucasians (p = 0.0002). Eyes with pre-existing glaucoma (9%) or steroid-responsive ocular hypertension (27%) had twice the relative risk of rejection (p = 0.045) compared with eyes that did not have those problems. Patient age, sex and corneal diagnosis did not significantly influence rejection risk. Risk of rejection was not increased when fellow eyes were grafted within 1 year of the first eye (p = 0.62). Pre-existing glaucoma or steroid-responsive ocular hypertension and race were the two factors that independently influenced relative risk of rejection after DSEK. Rejection risk was not increased if the fellow eye was grafted within the prior year with DSEK.

  4. Management of Extreme Ametropia after Penetrating Keratoplasty: A Series of Surgical Procedures for High Myopia and Astigmatism

    Directory of Open Access Journals (Sweden)

    Jorge E. Valdez-Garcia

    2014-08-01

    Full Text Available A series of surgical interventions - relaxing corneal incisions, intraocular lens, and intrastromal rings - were used to correct a case of extreme ametropia in a thin cornea after a penetrating keratoplasty in an 18-year-old patient who presented with a -10.25 -8.50 × 120 preoperative refraction and 20/200 best-corrected visual acuity (BCVA. After a series of surgical procedures, the patient's BCVA in his left eye improved to 20/30 with +0.50 -1.00 × 170, the slit lamp examination showed no significant findings, and the patient's visual complaints disappeared. At the 1-year follow-up, the BCVA was 20/25, without visual complaints. The process of individualizing the surgical procedure in the present case was employed in an outcome-based approach, that is, the next surgical procedure was defined after the surgery and postoperative evaluation. The patient did not present complications during the follow-up period of 2.5 years.

  5. Late occurrence of granular dystrophy in bilateral keratoconus: Penetrating keratoplasty and long-term follow-up

    Directory of Open Access Journals (Sweden)

    Varsha M Rathi

    2011-01-01

    Full Text Available We report a rare case of keratoconus with granular dystrophy with a follow-up of two decades, documenting the sequential presentation of two diseases confirmed by histology and genetic studies. A 13-year-old boy was diagnosed in 1988 with keratoconus in both eyes (BE based on slit-lamp biomicroscopy findings of corneal ectasia in BE accompanied by Fleischer′s ring, Vogt′s striae, a small, old, healed hydrops. The left eye (LE had central corneal thinning and scar in the central area involving the mid and posterior stroma secondary to healed hydrops. Penetrating keratoplasty (PKP was advised. The boy was lost to follow-up till 1991 and presented with white, dot-like opacities in the central cornea in the RE only, suggestive of granular corneal dystrophy. Similar findings of white, dot-like opacities were noted in the LE in 1995 and the patient subsequently underwent PKP in BE. Histopathology of corneal buttons confirmed the presence of patchy, crystal-like orange deposits, which stained bright red with Masson′s trichrome. Mutational analysis of the TGFBI gene in patient′s DNA revealed a heterozygous mutation corresponding to a change in Arg555Trp in the keratoepithelin protein. Granular dystrophy recurred after 8 years in the RE.

  6. HERPES VIRUS CONTAMINATION OF DONOR’S TISSUE AS A POTENTIAL ETIOLOGY OF CORNEAL GRAFT DISEASE AFTER PENETRATING KERATOPLASTY

    Directory of Open Access Journals (Sweden)

    E. A. Mironkova

    2012-01-01

    Full Text Available We present the study of outcomes of PCR-diagnostics directed on detection of DNA of herpes-family viruses in donor’s corneal tissues taken during penetrating keratoplasty (PK. In total, there were 46 patients, who under- went PKs. They were followed up from 14 days till 12 months. PCR-research of fragments of a donor cornea re- vealed existence of DNA in 21.7%. The retrospective analysis showed that in the presence of herpes-virus DNA in donor’s cornea is the risk factor of postoperative complications development and increases the rejection rate 2–3 times, reaching 100% – 70%. Thus the high risk of graft failures remains associated not only with the system immunosupressive therapy which is usually considered as the precondition of activization of chronic infections, but also in the absence of that. It gives the ground to conclude that preoperative preparation of a donor material, especially «fresh» corneas, should include expanded PCR-diagnostics on herpes-viruses and its obligatory dis- carding in cases of positive tests. 

  7. Early Ahmed glaucoma valve implantation after penetrating keratoplasty leads to better outcomes in an Asian population with preexisting glaucoma.

    Directory of Open Access Journals (Sweden)

    Ming-Cheng Tai

    Full Text Available BACKGROUND: To evaluate the efficacy of Ahmed Glaucoma Valve (AGV surgery and the optimal interval between penetrating keratoplasty (PKP and AGV implantation in a population of Asian patients with preexisting glaucoma who underwent PKP. METHODOLOGY/PRINCIPAL FINDINGS: In total, 45 eyes of 45 patients were included in this retrospective chart review. The final intraocular pressures (IOPs, graft survival rate, and changes in visual acuity were assessed to evaluate the outcomes of AGV implantations in eyes in which AGV implantation occurred within 1 month of post-PKP IOP elevation (Group 1 and in eyes in which AGV implantation took place more than 1 month after the post-PKP IOP evaluation (Group 2. Factors that were associated with graft failure were analyzed, and the overall patterns of complications were reviewed. By their final follow-up visits, 58% of the patients had been successfully treated for glaucoma. After the operation, there were no statistically significant differences between the groups with respect to graft survival (p = 0.98, but significant differences for IOP control (p = 0.049 and the maintenance of visual acuity (VA (p21 mm Hg. The most common surgical complication, aside from graft failure, was hyphema. CONCLUSIONS/SIGNIFICANCE: Early AGV implantation results in a higher probability of AGV survival and a better VA outcome without increasing the risk of corneal graft failure as a result of post-PKP glaucoma drainage tube implantation.

  8. Early Ahmed Glaucoma Valve Implantation after Penetrating Keratoplasty Leads to Better Outcomes in an Asian Population with Preexisting Glaucoma

    Science.gov (United States)

    Tai, Ming-Cheng; Chen, Yi-Hao; Cheng, Jen-Hao; Liang, Chang-Min; Chen, Jiann-Torng; Chen, Ching-Long; Lu, Da-Wen

    2012-01-01

    Background To evaluate the efficacy of Ahmed Glaucoma Valve (AGV) surgery and the optimal interval between penetrating keratoplasty (PKP) and AGV implantation in a population of Asian patients with preexisting glaucoma who underwent PKP. Methodology/Principal Findings In total, 45 eyes of 45 patients were included in this retrospective chart review. The final intraocular pressures (IOPs), graft survival rate, and changes in visual acuity were assessed to evaluate the outcomes of AGV implantations in eyes in which AGV implantation occurred within 1 month of post-PKP IOP elevation (Group 1) and in eyes in which AGV implantation took place more than 1 month after the post-PKP IOP evaluation (Group 2). Factors that were associated with graft failure were analyzed, and the overall patterns of complications were reviewed. By their final follow-up visits, 58% of the patients had been successfully treated for glaucoma. After the operation, there were no statistically significant differences between the groups with respect to graft survival (p = 0.98), but significant differences for IOP control (p = 0.049) and the maintenance of visual acuity (VA) (pglaucoma, a history of previous PKP, and a preoperative IOP that was >21 mm Hg. The most common surgical complication, aside from graft failure, was hyphema. Conclusions/Significance Early AGV implantation results in a higher probability of AGV survival and a better VA outcome without increasing the risk of corneal graft failure as a result of post-PKP glaucoma drainage tube implantation. PMID:22629464

  9. Subluxation of iris-sutured intraocular lenses and results of a closed chamber technique for repositioning after penetrating keratoplasty.

    Science.gov (United States)

    Jabbur, Nada S; Akpek, Esen Karamursel; Stark, Walter J

    2005-05-01

    To describe subluxation of iris-fixated intraocular lenses (IOLs) after penetrating keratoplasty (PK) as a postoperative complication and report the long-term outcomes of a closed-chamber refixation technique used in the management. This was a retrospective, noncomparative interventional case series in which 19 consecutive patient charts with a subluxated iris-fixated IOL after PK were retrospectively reviewed. Fourteen of the patients underwent surgery using a closed-chamber refixation technique. These patients were evaluated for visual outcome and surgical complications associated with the procedure. In 13 patients, postoperative follow-up was available. In all 13 cases, the fixated IOL appeared stable and remained well positioned during a follow-up period of 56 months (range, 6-122). All patients (100%) achieved improved uncorrected visual acuity. The postoperative visual acuity ranged from 20/20 to 20/100 with a mean of 20/40. Vitreous hemorrhage occurred in 1 patient, and an additional patient required a second surgery using the same technique. Both of these patients did well with a final visual acuity of 20/40 and 20/50, respectively. Subluxation of iris-fixated IOL after PK can occur as a postoperative complication. The technique that we herein describe enables secure refixation of subluxated IOLs and yields favorable long-term results.

  10. Endophthalmitis after descemet stripping endothelial keratoplasty with concave-oriented dislocation on slit-lamp optical coherence topography.

    Science.gov (United States)

    Kaiura, Terry L; Ritterband, David C; Koplin, Richard S; Shih, Carolyn; Palmierto, Pat M; Seedor, John A

    2010-02-01

    To present the first reported case of Descemet membrane stripping endothelial keratoplasty (DSEK)-associated endophthalmitis with concave dislocation on slit-lamp optical coherence topography (SL-OCT). An 86-year-old man underwent DSEK for corneal decompensation secondary to prior surgery. On all postoperative visits, a slit-lamp examination and SL-OCT were performed. On the first postoperative day, the lenticle was dislocated in a concave configuration as imaged with the SL-OCT. On the second postoperative day, the patient had eye pain, nausea, and increased intraocular pressure. On SL-OCT imaging, the concave configuration and fibrin stranding were imaged. With intraocular pressure lowering, the patient's pain subsided, and he was scheduled for a lenticle refloat the following day. The next day, endophthalmitis was diagnosed secondary to exuberant purulent inflammation. At surgery, the lenticle was removed, cultures were obtained, and pars plana vitrectomy and intravitreal injections were administered. Intraoperative cultures were positive for heavy growth of Streptococcus pneumoniae. Endophthalmitis is a potential complication for any intraocular procedure including DSEK. SL-OCT imaging postoperatively may reveal concave lenticle configuration and subtle anterior chamber fibrin stranding may be early sign of endophthalmitis.

  11. Indicações para ceratoplastia penetrante no Hospital das Clínicas-UNICAMP Penetrating keratoplasty indications in "Hospital das Clínicas-UNICAMP"

    Directory of Open Access Journals (Sweden)

    Vanessa Gonçalves Crespi Flores

    2007-06-01

    Full Text Available OBJETIVO: Determinar as principais causas de indicação de transplante penetrante no Hospital das Clínicas-UNICAMP no período de janeiro de 1999 a dezembro de 2003. MÉTODOS: Estudo de série de casos, retrospectivo, não comparativo. Os autores revisaram os prontuários de 857 pacientes submetidos à ceratoplastia penetrante no Hospital das Clínicas-UNICAMP entre 1999-2003 e os classificaram em categorias diagnósticas de indicação para cirurgia. RESULTADOS: Dentre os 857 prontuários revisados a idade variou de 0-88 anos (média 44 anos±1,2. Dentre as principais causas de indicação de transplante de córnea encontramos: ceratocone em 427 casos (49,82%; úlcera de córnea infecciosa perfurada ou não, 152 casos (17,74%; falência de transplante prévio, 87 casos (10,15%; ceratopatia bolhosa, 72 casos (8,40%; distrofia de Fuchs, 59 casos (6,88%; seqüela de tracoma, 28 casos (3,27%; outras causas, 32 casos (3,74%. Entre as crianças até 10 anos a principal causa de indicação de transplante foram as úlceras infecciosas (77,78% e entre 11-50 anos o ceratocone foi a principal causa (71,65%. CONCLUSÕES: Este estudo foi composto por uma população jovem e as principais causas de indicação de transplante foram o ceratocone e os transplantes tectônicos.PURPOSE: To determine the main causes of penetrating keratoplasty indications at "Hospital das Clínicas-UNICAMP" (January, 1999 to December, 2003. METHODS: A non-comparative, retrospective series of case studies. The authors reviewed the files of 857 patients who underwent penetrating keratoplasty at "Hospital das Clínicas-UNICAMP" between 1999-2003 and classified them into different categories according to diagnostic indication for surgery. RESULTS: The age range was between 0-88 years (average 44 years ±1.2. The main causes of penetrating keratoplasty were: keratoconus in 427 cases (49.82%; 152 cases (17.74% of corneal ulceration (perforated or not; corneal graft failure in 87

  12. On Spectral Triples in Quantum Gravity I

    DEFF Research Database (Denmark)

    Aastrup, Johannes; M. Grimstrup, Jesper; Nest, Ryszard

    2009-01-01

    This paper establishes a link between Noncommutative Geometry and canonical quantum gravity. A semi-finite spectral triple over a space of connections is presented. The triple involves an algebra of holonomy loops and a Dirac type operator which resembles a global functional derivation operator....... The interaction between the Dirac operator and the algebra reproduces the Poisson structure of General Relativity. Moreover, the associated Hilbert space corresponds, up to a discrete symmetry group, to the Hilbert space of diffeomorphism invariant states known from Loop Quantum Gravity. Correspondingly......, the square of the Dirac operator has, in terms of canonical quantum gravity, the form of a global area-squared operator. Furthermore, the spectral action resembles a partition function of Quantum Gravity. The construction is background independent and is based on an inductive system of triangulations...

  13. Triple Achilles Tendon Rupture: Case Report.

    Science.gov (United States)

    Saxena, Amol; Hofer, Deann

    We present a case report with 1-year follow-up data of a 57-year-old male soccer referee who had sustained an acute triple Achilles tendon rupture injury during a game. His triple Achilles tendon rupture consisted of a rupture of the proximal watershed region, a rupture of the main body (mid-watershed area), and an avulsion-type rupture of insertional calcific tendinosis. The patient was treated surgically with primary repair of the tendon, including tenodesis with anchors. Postoperative treatment included non-weightbearing for 4 weeks and protected weightbearing until 10 weeks postoperative, followed by formal physical therapy, which incorporated an "antigravity" treadmill. The patient was able to return to full activity after 26 weeks, including running and refereeing, without limitations. Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  14. WDVV equation and triple-product relation

    International Nuclear Information System (INIS)

    Shigechi, Keiichi; Wadati, Miki; Wang Ning

    2005-01-01

    We study the relation between the WDVV equations and the τ-function of the noncommutative KP (NCKP) hierarchy. WDVV-like equations (Hirota triple-product relation) in the noncommutative context appear as a consequence of the nontrivial equation for τ-function of the NC KP hierarchy, while the prepotential in the Seiberg-Witten (SW) theory has been identified to the τ-function of the Whitham hierarchy. We show that the spectral curve for the SW theory is the same as the Toda-chain hierarchy. We also show explicitly that Whitham hierarchy includes commutative Toda/KP hierarchy. Further, we comment on the origin of the Hirota triple-product relation in the context of the SW theory

  15. Triple Giant Resonance Excitations: A Microscopic Approach

    International Nuclear Information System (INIS)

    Lanza, E.G.; Andres, M.V.; Catara, F.; Chomaz, Ph.; Fallot, M.; Scarpaci, J.A.

    2007-01-01

    We present, for the first time, microscopic calculations of inelastic cross sections of the triple excitation of giant resonances induced by heavy ion probes. We start from a microscopic approach based on RPA. The mixing of three-phonon states among themselves and with two- and one-phonon states is considered within a boson expansion with Pauli corrections. In this way we go beyond the standard harmonic approximations and get anharmonic excitation spectra. At the same time we also introduce non-linearities in the external field. The calculations are done by solving semiclassical coupled channel equations, the channels being superpositions of one-, two- and three-phonon states. Previous calculations for the Double Giant Resonance excitation show good agreement with experimental cross sections. The inclusion of the three phonon components confirms the previous results for the DGR and produces a strong increase in the Triple GR energy region

  16. Resolution of a triple axis spectrometer

    DEFF Research Database (Denmark)

    Nielsen, Mourits; Bjerrum Møller, Hans

    1969-01-01

    A new method for obtaining the resolution function for a triple-axis neutron spectrometer is described, involving a combination of direct measurement and analytical calculation. All factors which contribute to the finite resolution of the instrument may be taken into account, and Gaussian...... or experimentally determined probability distributions may be used. The application to the study of the dispersion relation for excitations in a crystal is outlined...

  17. Frequency tripling with multimode-lasers

    International Nuclear Information System (INIS)

    Langer, H.; Roehr, H.; Wrobel, W.G.

    1978-10-01

    The presence of different modes with random phases in a laser beam leads to fluctuations in nonlinear optical interactions. This paper describes the influence of the linewidth of a dye laser on the generation of intensive Lyman-alpha radiation by frequency tripling. Using this Lyman-alpha source for resonance scattering on strongly doppler-broadened lines in fusion plasmas the detection limit of neutral hydrogen is nearly two orders higher with the multimode than the singlemode dye laser. (orig.) [de

  18. Triple collinear emissions in parton showers

    Energy Technology Data Exchange (ETDEWEB)

    Höche, Stefan; Prestel, Stefan

    2017-10-01

    A framework to include triple collinear splitting functions into parton showers is presented, and the implementation of flavor-changing NLO splitting kernels is discussed as a first application. The correspondence between the Monte-Carlo integration and the analytic computation of NLO DGLAP evolution kernels is made explicit for both timelike and spacelike parton evolution. Numerical simulation results are obtained with two independent implementations of the new algorithm, using the two independent event generation frameworks Pythia and Sherpa.

  19. A Tulczyjew triple for classical fields

    International Nuclear Information System (INIS)

    Grabowska, Katarzyna

    2012-01-01

    The geometrical structure known as the Tulczyjew triple has proved to be very useful in describing mechanical systems, even those with singular Lagrangians or subject to constraints. Starting from basic concepts of the variational calculus, we construct the Tulczyjew triple for first-order field theory. The important feature of our approach is that we do not postulate ad hoc the ingredients of the theory, but obtain them as unavoidable consequences of the variational calculus. This picture of field theory is covariant and complete, containing not only the Lagrangian formalism and Euler–Lagrange equations but also the phase space, the phase dynamics and the Hamiltonian formalism. Since the configuration space turns out to be an affine bundle, we have to use affine geometry, in particular the notion of the affine duality. In our formulation, the two maps α and β which constitute the Tulczyjew triple are morphisms of double structures of affine-vector bundles. We also discuss the Legendre transformation, i.e. the transition between the Lagrangian and the Hamiltonian formulation of the first-order field theory. (paper)

  20. Modified big-bubble technique compared to manual dissection deep anterior lamellar keratoplasty in the treatment of keratoconus.

    Science.gov (United States)

    Knutsson, Karl Anders; Rama, Paolo; Paganoni, Giorgio

    2015-08-01

    To evaluate the clinical findings and results of manual dissection deep anterior lamellar keratoplasty (DALK) compared to a modified big-bubble DALK technique in eyes affected by keratoconus. Sixty eyes of 60 patients with keratoconus were treated with one of the two surgical techniques manual DALK (n = 30); big-bubble DALK (n = 30). The main outcomes measured were visual acuity, corneal topographic parameters, thickness of residual stroma and endothelial cell density (ECD). Patients were examined postoperatively at 1 month, 6 months, 1 year and 1 month after suture removal. Final best spectacle-corrected visual acuity (BSCVA) measured 1 month after suture removal was 0.11 ± 0.08 LogMAR in the big-bubble group compared to 0.13 ± 0.08 in the manual DALK group (p = 0.227). In patients treated with the big-bubble technique without complications (Descemet's membrane completely bared), the stromal residue was not measureable. Mean stromal residual thickness in the manual DALK group was 30.50 ± 27.60 μm. Data analysis of the manual DALK group demonstrated a significant correlation between BSCVA and residual stromal thickness; lower residual stromal thickness correlated with better BSCVA values (Spearman ρ = 0.509, p = 0.018). Postoperative ECD was similar in both groups at all intervals, with no statistically significant differences. In both groups, ECD loss was only significant during the 1- to 6-month interval (p = 0.001 and p big-bubble DALK and manual DALK groups, respectively). Manual DALK provides comparable results to big-bubble DALK. Big-bubble DALK permits faster visual recovery and is a surgical technique, which can be easily converted to manual DALK in cases of unsuccessful 'big-bubble' formation. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  1. Femtosecond laser-assisted deep anterior lamellar keratoplasty in phototherapeutic keratectomy versus the big-bubble technique in keratoconus

    Directory of Open Access Journals (Sweden)

    Jarbas Pereira de Macedo

    2018-05-01

    Full Text Available AIM: To compare the functional and anatomic results of femtosecond laser (FSL-assisted deep anterior lamellar keratoplasty (DALK associated with phototherapeutic keratectomy (PTK and FSL-assisted DALK performed using the big-bubble technique in keratoconus. METHODS: During the first phase of the study, an electron microscopy histopathology pilot study was conducted that included four unsuitable donor corneas divided into two groups: in FSL group, FSL lamellar cuts were performed on two corneas and in FSL+PTK group, PTK was performed at the stromal beds of two corneas after FSL lamellar cuts were made. During the second phase of the study, a randomized clinical trial was conducted that included two treatment groups of patients with keratoconus: group 1 (n=14 eyes underwent FSL-assisted DALK associated with PTK and group 2 (n=12 eyes underwent FSL-assisted DALK associated with the big-bubble technique. The main outcome measures were the postoperative visual acuity (VA and optical coherence tomography (OCT measurements, confocal microscopic findings, and contrast sensitivity. RESULTS: In the pilot study, histopathology showed a more regular stromal bed in the FSL+PTK group. In the clinical trial, group 1 had significantly worse best spectacle-corrected VA and contrast sensitivity (P<0.05 for both comparisons. The residual stromal bed measured by OCT was significantly (P<0.05 thicker in group 1. Confocal microscopy detected opacities only at the donor-receptor interface in group 1. CONCLUSION: Patients with keratoconus treated with FSL-assisted DALK performed using the big-bubble technique fare better than treated with FSL-assisted DALK associated with PTK.

  2. Ocular penetration and pharmacokinetics of topical gatifloxacin 0.3% and moxifloxacin 0.5% ophthalmic solutions after keratoplasty.

    Science.gov (United States)

    Holland, Edward J; Lane, Stephen S; Kim, Terry; Raizman, Michael; Dunn, Steven

    2008-04-01

    To compare the corneal and aqueous penetration and pharmacokinetics of gatifloxacin 0.3% and moxifloxacin 0.5% ophthalmic solutions and their effect on corneal reepithelialization after penetrating keratoplasty. In this randomized, open-label, parallel-controlled study, corneal and aqueous penetration and the pharmacokinetic parameters of topically applied gatifloxacin 0.3% and moxifloxacin 0.5% (2 preoperative doses of 1 drop given 5 minutes apart) were estimated by using a sparse sampling method. Corneal and aqueous samples were collected 0.25, 0.5, 1, or 2 hours after the final dose. The concentration was determined by a high-performance liquid chromatography method. Stromal Cmax:MBC50 (maximum drug concentration in serum to 50% minimum bactericidal concentration) ratios for selected ocular pathogens were also assessed. Postoperative corneal reepithelialization at days 1, 3, and 7 was evaluated and compared between groups. The calculated pharmacokinetic parameters were higher with moxifloxacin 0.5% than with gatifloxacin 0.3%. The stromal Cmax was 48.5 versus 15.7 microg/g (P = 0.04), and the stromal AUC0-2 (area under the concentration-time curve from 0 to 2 hours) was 30.9 versus 13.6 mug.h/g (P 0.05), and the endothelial AUC0-2 was 43.9 versus 9.8 microg.h/g (P 0.05), and the aqueous AUC0-2 was 1.2 versus 0.4 microg.h/mL (P < 0.05). Stromal Cmax:MBC50 ratios were higher in the moxifloxacin 0.5% group for each pathogen tested. The corneal reepithelialization rates were comparable between groups. Topical preoperative moxifloxacin 0.5% achieved greater corneal and aqueous penetration than did gatifloxacin 0.3%. The clinical significance of this difference is not known. Postoperative use of these agents had similar effects on corneal reepithelialization.

  3. Long-term outcomes of penetrating keratoplasty in keratoconus:analysis of the factors associated with final visual acuities

    Directory of Open Access Journals (Sweden)

    Jin A Choi

    2014-06-01

    Full Text Available AIM: To investigate the long-term results of penetrating keratoplasty (PK in patients with keratoconus (KC and to evaluate factors that might influence the final visual outcome.METHODS:We retrospectively reviewed the data of all patients with clinical KC who had undergone PK by a single corneal surgeon in a single center from May 1980 to December 2005. The age of the patients, preoperative best-corrected visual acuity (BCVA, corneal thickness, death to preservation time, and preservation to transplantation time were recorded. Additionally, postoperative complications such as graft rejection, development of glaucoma and specular microscopy were checked during the follow-up.RESULTS:Sixty-nine eyes from 69 patients were finally included. The follow-up period was 8.64±6.13y. Graft rejection occurred in 4 eyes of 69 cases (5.8%, and the time to graft rejection was 2.1±1.3y. A Kaplan–Meier survival analysis showed that the estimated cumulative probability of graft rejection at 6, 13, and 17y after PK were 95.6%, 90.0%, and 78.8%, respectively. When we evaluated factors that might influence final BCVA in eyes, no disparity donor-host trephine size (same graft size as well as higher spherical equivalent, and average K-value were associated with higher final BCVA. (P=0.006, 0.051, 0.092, and 0.021 in eyes with follow-up <8y; P=0.068, 0.065, and 0.030 in eyes with follow-up ≥8y, respectively.CONCLUSION: The long-term results of PK in patients with KC were favorable with a high percentage of good BCVA. Less myopic change and low average K-reading, as well as a surgical technique using the same size donor-recipient button may provide better visual outcomes particularly in patients with KC.

  4. Pars Plana-Modified versus Conventional Ahmed Glaucoma Valve in Patients Undergoing Penetrating Keratoplasty: A Prospective Comparative Randomized Study.

    Science.gov (United States)

    Parihar, Jitendra Kumar Singh; Jain, Vaibhav Kumar; Kaushik, Jaya; Mishra, Avinash

    2017-03-01

    To compare the outcome of pars-plana-modified Ahmed glaucoma valve (AGV) versus limbal-based conventional AGV into the anterior chamber, in patients undergoing penetrating keratoplasty (PK) for glaucoma with coexisting corneal diseases. In this prospective randomized clinical trial, 58 eyes of 58 patients with glaucoma and coexisting corneal disease were divided into two groups. Group 1 (29 eyes of 29 patients) included patients undergoing limbal-based conventional AGV into the anterior chamber (AC) along-with PK and group 2 (29 eyes of 29 patients) included those undergoing pars-plana-modified AGV along-with PK. Outcome measures included corneal graft clarity, intraocular pressure (IOP), number of antiglaucoma medications, and postoperative complications. Patients were followed up for a minimum period of 2 years. Out of 58 eyes (58 patients), 50 eyes (50 patients: 25 eyes of 25 patients each in group 1 and group 2) completed the study and were analyzed. Complete success rate for AGV (group 1: 76%; group 2: 72%; p = 0.842) and corneal graft clarity (group 1: 68%; group 2: 76%; p = 0.081) were comparable between the two groups at 2 years. Graft failure was more in conventional AGV (32%) as compared to pars plana-modified AGV (24%) but not statistically significant (p = 0.078) at 2 years. Though both procedures were comparable in various outcome measures, pars-plana-modified AGV is a viable option for patients undergoing PK, as it provides a relatively better corneal graft survival rate and lesser complications that were associated with conventional AGV.

  5. On Pythagoras Theorem for Products of Spectral Triples

    OpenAIRE

    D'Andrea, Francesco; Martinetti, Pierre

    2013-01-01

    We discuss a version of Pythagoras theorem in noncommutative geometry. Usual Pythagoras theorem can be formulated in terms of Connes' distance, between pure states, in the product of commutative spectral triples. We investigate the generalization to both non pure states and arbitrary spectral triples. We show that Pythagoras theorem is replaced by some Pythagoras inequalities, that we prove for the product of arbitrary (i.e. non-necessarily commutative) spectral triples, assuming only some un...

  6. Targeting Histone Abnormality in Triple Negative Breast Cancer

    Science.gov (United States)

    2015-08-01

    κB pathway in triple negative breast cancer . 8th International Nitric Oxide Conference & 6th International Nitrite/ Nitrate Conference, Cleveland, OH...1 AWARD NUMBER: W81XWH-14-1-0237 TITLE: Targeting Histone Abnormality in Triple-Negative Breast Cancer PRINCIPAL INVESTIGATOR: Yi...TITLE AND SUBTITLE 5a. CONTRACT NUMBER Targeting Histone Abnormality in Triple-Negative Breast Cancer 5b. GRANT NUMBER W81XWH-14-1-0237 5c

  7. Natural triple beta-stranded fibrous folds.

    Science.gov (United States)

    Mitraki, Anna; Papanikolopoulou, Katerina; Van Raaij, Mark J

    2006-01-01

    A distinctive family of beta-structured folds has recently been described for fibrous proteins from viruses. Virus fibers are usually involved in specific host-cell recognition. They are asymmetric homotrimeric proteins consisting of an N-terminal virus-binding tail, a central shaft or stalk domain, and a C-terminal globular receptor-binding domain. Often they are entirely or nearly entirely composed of beta-structure. Apart from their biological relevance and possible gene therapy applications, their shape, stability, and rigidity suggest they may be useful as blueprints for biomechanical design. Folding and unfolding studies suggest their globular C-terminal domain may fold first, followed by a "zipping-up" of the shaft domains. The C-terminal domains appear to be important for registration because peptides corresponding to shaft domains alone aggregate into nonnative fibers and/or amyloid structures. C-terminal domains can be exchanged between different fibers and the resulting chimeric proteins are useful as a way to solve structures of unknown parts of the shaft domains. The following natural triple beta-stranded fibrous folds have been discovered by X-ray crystallography: the triple beta-spiral, triple beta-helix, and T4 short tail fiber fold. All have a central longitudinal hydrophobic core and extensive intermonomer polar and nonpolar interactions. Now that a reasonable body of structural and folding knowledge has been assembled about these fibrous proteins, the next challenge and opportunity is to start using this information in medical and industrial applications such as gene therapy and nanotechnology.

  8. The Triple Axis and SPINS Spectrometers.

    Science.gov (United States)

    Trevino, S F

    1993-01-01

    In this paper are described the triple axis and spin polarized inelastic neutron scattering (SPINS) spectrometers which are installed at the NIST Cold Neutron Research Facility (CNRF). The general principle of operation of these two instruments is described in sufficient detail to allow the reader to make an informed decision as to their usefulness for his needs. However, it is the intention of the staff at the CNRF to provide the expert resources for their efficient use in any given situation. Thus, this work is not intended as a user manual but rather as a guide into the range of applicability of the two instruments.

  9. Binaries and triples among asteroid pairs

    Science.gov (United States)

    Pravec, Petr; Scheirich, Peter; Kušnirák, Peter; Hornoch, Kamil; Galád, Adrián

    2015-08-01

    Despite major achievements obtained during the past two decades, our knowledge of the population and properties of small binary and multiple asteroid systems is still far from advanced. There is a numerous indirect evidence for that most small asteroid systems were formed by rotational fission of cohesionless parent asteroids that were spun up to the critical frequency presumably by YORP, but details of the process are lacking. Furthermore, as we proceed with observations of more and more binary and paired asteroids, we reveal new facts that substantially refine and sometimes change our understanding of the asteroid systems. One significant new finding we have recently obtained is that primaries of many asteroid pairs are actually binary or triple systems. The first such case found is (3749) Balam (Vokrouhlický, ApJL 706, L37, 2009). We have found 9 more binary systems among asteroid pairs within our ongoing NEOSource photometric project since October 2012. They are (6369) 1983 UC, (8306) Shoko, (9783) Tensho-kan, (10123) Fideoja, (21436) Chaoyichi, (43008) 1999 UD31, (44620) 1999 RS43, (46829) 1998 OS14 and (80218) 1999 VO123. We will review their characteristics. These paired binaries as we call them are mostly similar to binaries in the general ("background") population (of unpaired asteroids), but there are a few trends. The paired binaries tend to have larger secondaries with D_2/D_1 = 0.3 to 0.5 and they also tend to be wider systems with 8 of the 10 having orbital periods between 30 and 81 hours, than average among binaries in the general population. There may be also a larger fraction of triples; (3749) Balam is a confirmed triple, having a larger close and a smaller distant satellite, and (8306) Shoko and (10123) Fideoja are suspect triples as they show additional rotational lightcurve components with periods of 61 and 38.8 h that differ from the orbital period of 36.2 and 56.5 h, respectively. The unbound secondaries tend to be of the same size or

  10. Designing Broadband Access Networks with Triple Redundancy

    DEFF Research Database (Denmark)

    Pedersen, Jens Myrup; Riaz, Muhammad Tahir; Knudsen, Thomas Phillip

    2005-01-01

    An architecture is proposed for designing broadband access networks, which offer triple redundancy to the end users, resulting in networks providing connectivity even in case of any two independent node or line failures. Two physically independent connections are offered by fiber, and the last...... provided by some wireless solution. Based on experience with planning Fiber To The Home, the architecture is designed to meet a number of demands, making it practicable and useful in realworld network planning. The proposed wired topology is planar, and suitable for being fitted onto the road network...

  11. Experimental observation of triple correlations in fluids

    Directory of Open Access Journals (Sweden)

    M.Ya. Sushko

    2013-03-01

    Full Text Available We present arguments for the hypothesis that under some conditions, triple correlations of density fluctuations in fluids can be detected experimentally by the method of molecular spectroscopy. These correlations manifest themselves in the form of so-called 1.5-(or sesquialteral scattering. The latter is of most significance in the pre-asymptotic vicinity of the critical point and can be registered along certain thermodynamic paths. Its presence in the overall scattering pattern is demonstrated by our processing available experimental data for the depolarization factor. Some consequences of these results are discussed.

  12. Dispersion cancellation in a triple Laue interferometer

    International Nuclear Information System (INIS)

    Lemmel, Hartmut

    2014-01-01

    The concept of dispersion cancellation has been established in light optics to improve the resolution of interferometric measurements on dispersive media. Odd order dispersion cancellation allows to measure phase shifts without defocusing the interferometer due to wave packet displacements, while even order dispersion cancellation allows to measure time lags without losing resolution due to wave packet spreading. We report that either type of dispersion cancellation can be realized very easily in a triple Laue interferometer. Such interferometers are Mach–Zehnder interferometers based on Bragg diffraction, and are commonly used for neutrons and x-rays. Although the first x-ray interferometer was built nearly five decades ago, the feature of dispersion cancellation hasn't been recognized so far because the concept was hardly known in the neutron and x-ray community. However, it explains right away the surprising decoupling of phase shift and spatial displacement that we have discovered recently in neutron interferometry (Lemmel and Wagh 2010 Phys. Rev. A 82 033626). Furthermore, this article might inspire the light optics community to consider whether a triple Laue interferometer for laser light would be useful and feasible. We explain how dispersion cancellation works in neutron interferometry, and we describe the setup rigorously by solving the Schrödinger equation and by calculating the path integral. We point out, that the latter has to be evaluated with special care since in our setup the beam trajectory moves with respect to the crystal lattice of the interferometer. (paper)

  13. Robust Modeling of Stellar Triples in PHOEBE

    Science.gov (United States)

    Conroy, Kyle E.; Prsa, Andrej; Horvat, Martin; Stassun, Keivan G.

    2017-01-01

    The number of known mutually-eclipsing stellar triple and multiple systems has increased greatly during the Kepler era. These systems provide significant opportunities to both determine fundamental stellar parameters of benchmark systems to unprecedented precision as well as to study the dynamical interaction and formation mechanisms of stellar and planetary systems. Modeling these systems to their full potential, however, has not been feasible until recently. Most existing available codes are restricted to the two-body binary case and those that do provide N-body support for more components make sacrifices in precision by assuming no stellar surface distortion. We have completely redesigned and rewritten the PHOEBE binary modeling code to incorporate support for triple and higher-order systems while also robustly modeling data with Kepler precision. Here we present our approach, demonstrate several test cases based on real data, and discuss the current status of PHOEBE's support for modeling these types of systems. PHOEBE is funded in part by NSF grant #1517474.

  14. VERITAS: Versatile Triple-Axis Spectrometer

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sung Il

    2006-04-15

    Korea Atomic Energy Research Institute is planning to build a cold neutron triple-axis spectrometer at HANARO, the 30 MW research reactor. The spectrometer is expected to be completed in 2008 with the following configuration from the upstream to the downstream. Guide Supermirror m = 2, In-pile Straight Section, {approx} 5 m Curved Guide, {approx} 26 m w/ R 1500 m Straight Guide before the Instrument, {approx} 40 m Filters PG and Be Neutron Velocity Selector (Future) Monochromators Vertically Focusing Monochromators PG(002) and Heusler(111) Doubly Focusing Monochromators (Future) Monochromator-Sample Distance 2 m Collimation C1 Soller Collimators, 20', 40' 80'Beam Height at the Sample Table 1.5 m Sample-Analyzer Distance 1.0 m Collimation C2 Soller Collimators, 20', 40', 80' Radial Collimator Analyzers Horizontally Focusing Analyzers w/ Fixed Vertical Focusing PG(002) and Heusler(111) Analyzer-Detector Distance 0.5 m Detectors 5 cm Tube Detector 25 cm wide Position Sensitive Detector Once completed, the neutron flux at sample is expected to surpass that of SPINS at NCNR, making this instrument one of the most powerful 2nd generation cold neutron triple-axis spectrometers in the world.

  15. VERITAS: Versatile Triple-Axis Spectrometer

    International Nuclear Information System (INIS)

    Park, Sung Il

    2006-04-01

    Korea Atomic Energy Research Institute is planning to build a cold neutron triple-axis spectrometer at HANARO, the 30 MW research reactor. The spectrometer is expected to be completed in 2008 with the following configuration from the upstream to the downstream. Guide Supermirror m = 2, In-pile Straight Section, ∼ 5 m Curved Guide, ∼ 26 m w/ R 1500 m Straight Guide before the Instrument, ∼ 40 m Filters PG and Be Neutron Velocity Selector (Future) Monochromators Vertically Focusing Monochromators PG(002) and Heusler(111) Doubly Focusing Monochromators (Future) Monochromator-Sample Distance 2 m Collimation C1 Soller Collimators, 20', 40' 80'Beam Height at the Sample Table 1.5 m Sample-Analyzer Distance 1.0 m Collimation C2 Soller Collimators, 20', 40', 80' Radial Collimator Analyzers Horizontally Focusing Analyzers w/ Fixed Vertical Focusing PG(002) and Heusler(111) Analyzer-Detector Distance 0.5 m Detectors 5 cm Tube Detector 25 cm wide Position Sensitive Detector Once completed, the neutron flux at sample is expected to surpass that of SPINS at NCNR, making this instrument one of the most powerful 2nd generation cold neutron triple-axis spectrometers in the world

  16. BROWN DWARF BINARIES FROM DISINTEGRATING TRIPLE SYSTEMS

    International Nuclear Information System (INIS)

    Reipurth, Bo; Mikkola, Seppo

    2015-01-01

    Binaries in which both components are brown dwarfs (BDs) are being discovered at an increasing rate, and their properties may hold clues to their origin. We have carried out 200,000 N-body simulations of three identical stellar embryos with masses drawn from a Chabrier IMF and embedded in a molecular core. The bodies are initially non-hierarchical and undergo chaotic motions within the cloud core, while accreting using Bondi–Hoyle accretion. The coupling of dynamics and accretion often leads to one or two dominant bodies controlling the center of the cloud core, while banishing the other(s) to the lower-density outskirts, leading to stunted growth. Eventually each system transforms either to a bound hierarchical configuration or breaks apart into separate single and binary components. The orbital motion is followed for 100 Myr. In order to illustrate 200,000 end-states of such dynamical evolution with accretion, we introduce the “triple diagnostic diagram,” which plots two dimensionless numbers against each other, representing the binary mass ratio and the mass ratio of the third body to the total system mass. Numerous freefloating BD binaries are formed in these simulations, and statistical properties are derived. The separation distribution function is in good correspondence with observations, showing a steep rise at close separations, peaking around 13 AU and declining more gently, reaching zero at separations greater than 200 AU. Unresolved BD triple systems may appear as wider BD binaries. Mass ratios are strongly peaked toward unity, as observed, but this is partially due to the initial assumptions. Eccentricities gradually increase toward higher values, due to the lack of viscous interactions in the simulations, which would both shrink the orbits and decrease their eccentricities. Most newborn triple systems are unstable and while there are 9209 ejected BD binaries at 1 Myr, corresponding to about 4% of the 200,000 simulations, this number has grown to

  17. BROWN DWARF BINARIES FROM DISINTEGRATING TRIPLE SYSTEMS

    Energy Technology Data Exchange (ETDEWEB)

    Reipurth, Bo [Institute for Astronomy and NASA Astrobiology Institute University of Hawaii, 640 N. Aohoku Place, Hilo, HI 96720 (United States); Mikkola, Seppo, E-mail: reipurth@ifa.hawaii.edu, E-mail: Seppo.Mikkola@utu.fi [Tuorla Observatory, University of Turku, Väisäläntie 20, Piikkiö (Finland)

    2015-04-15

    Binaries in which both components are brown dwarfs (BDs) are being discovered at an increasing rate, and their properties may hold clues to their origin. We have carried out 200,000 N-body simulations of three identical stellar embryos with masses drawn from a Chabrier IMF and embedded in a molecular core. The bodies are initially non-hierarchical and undergo chaotic motions within the cloud core, while accreting using Bondi–Hoyle accretion. The coupling of dynamics and accretion often leads to one or two dominant bodies controlling the center of the cloud core, while banishing the other(s) to the lower-density outskirts, leading to stunted growth. Eventually each system transforms either to a bound hierarchical configuration or breaks apart into separate single and binary components. The orbital motion is followed for 100 Myr. In order to illustrate 200,000 end-states of such dynamical evolution with accretion, we introduce the “triple diagnostic diagram,” which plots two dimensionless numbers against each other, representing the binary mass ratio and the mass ratio of the third body to the total system mass. Numerous freefloating BD binaries are formed in these simulations, and statistical properties are derived. The separation distribution function is in good correspondence with observations, showing a steep rise at close separations, peaking around 13 AU and declining more gently, reaching zero at separations greater than 200 AU. Unresolved BD triple systems may appear as wider BD binaries. Mass ratios are strongly peaked toward unity, as observed, but this is partially due to the initial assumptions. Eccentricities gradually increase toward higher values, due to the lack of viscous interactions in the simulations, which would both shrink the orbits and decrease their eccentricities. Most newborn triple systems are unstable and while there are 9209 ejected BD binaries at 1 Myr, corresponding to about 4% of the 200,000 simulations, this number has grown to

  18. Recovery and normalization of triple coincidences in PET

    Energy Technology Data Exchange (ETDEWEB)

    Lage, Eduardo, E-mail: elage@mit.edu; Parot, Vicente; Dave, Shivang R.; Herraiz, Joaquin L. [Madrid-MIT M+Visión Consortium, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139 (United States); Moore, Stephen C.; Sitek, Arkadiusz; Park, Mi-Ae [Division of Nuclear Medicine, Department of Radiology, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts 02115 (United States); Udías, Jose M. [Grupo de Física Nuclear, Departamento de Física Atómica Molecular y Nuclear, Universidad Complutense de Madrid, CEI Moncloa, Madrid 28040 (Spain); Vaquero, Juan J. [Departamento de Ingeniería Biomédica e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Leganés 28911 (Spain)

    2015-03-15

    Purpose: Triple coincidences in positron emission tomography (PET) are events in which three γ-rays are detected simultaneously. These events, though potentially useful for enhancing the sensitivity of PET scanners, are discarded or processed without special consideration in current systems, because there is not a clear criterion for assigning them to a unique line-of-response (LOR). Methods proposed for recovering such events usually rely on the use of highly specialized detection systems, hampering general adoption, and/or are based on Compton-scatter kinematics and, consequently, are limited in accuracy by the energy resolution of standard PET detectors. In this work, the authors propose a simple and general solution for recovering triple coincidences, which does not require specialized detectors or additional energy resolution requirements. Methods: To recover triple coincidences, the authors’ method distributes such events among their possible LORs using the relative proportions of double coincidences in these LORs. The authors show analytically that this assignment scheme represents the maximum-likelihood solution for the triple-coincidence distribution problem. The PET component of a preclinical PET/CT scanner was adapted to enable the acquisition and processing of triple coincidences. Since the efficiencies for detecting double and triple events were found to be different throughout the scanner field-of-view, a normalization procedure specific for triple coincidences was also developed. The effect of including triple coincidences using their method was compared against the cases of equally weighting the triples among their possible LORs and discarding all the triple events. The authors used as figures of merit for this comparison sensitivity, noise-equivalent count (NEC) rates and image quality calculated as described in the NEMA NU-4 protocol for the assessment of preclinical PET scanners. Results: The addition of triple-coincidence events with the

  19. Recovery and normalization of triple coincidences in PET.

    Science.gov (United States)

    Lage, Eduardo; Parot, Vicente; Moore, Stephen C; Sitek, Arkadiusz; Udías, Jose M; Dave, Shivang R; Park, Mi-Ae; Vaquero, Juan J; Herraiz, Joaquin L

    2015-03-01

    Triple coincidences in positron emission tomography (PET) are events in which three γ-rays are detected simultaneously. These events, though potentially useful for enhancing the sensitivity of PET scanners, are discarded or processed without special consideration in current systems, because there is not a clear criterion for assigning them to a unique line-of-response (LOR). Methods proposed for recovering such events usually rely on the use of highly specialized detection systems, hampering general adoption, and/or are based on Compton-scatter kinematics and, consequently, are limited in accuracy by the energy resolution of standard PET detectors. In this work, the authors propose a simple and general solution for recovering triple coincidences, which does not require specialized detectors or additional energy resolution requirements. To recover triple coincidences, the authors' method distributes such events among their possible LORs using the relative proportions of double coincidences in these LORs. The authors show analytically that this assignment scheme represents the maximum-likelihood solution for the triple-coincidence distribution problem. The PET component of a preclinical PET/CT scanner was adapted to enable the acquisition and processing of triple coincidences. Since the efficiencies for detecting double and triple events were found to be different throughout the scanner field-of-view, a normalization procedure specific for triple coincidences was also developed. The effect of including triple coincidences using their method was compared against the cases of equally weighting the triples among their possible LORs and discarding all the triple events. The authors used as figures of merit for this comparison sensitivity, noise-equivalent count (NEC) rates and image quality calculated as described in the NEMA NU-4 protocol for the assessment of preclinical PET scanners. The addition of triple-coincidence events with the authors' method increased peak

  20. Triple Play Service and IPTV Services Offered within it

    Directory of Open Access Journals (Sweden)

    Dagmar Pajdusakova

    2008-01-01

    Full Text Available This paper deals with Triple Play multimedia service and figures its architecture. Triple Play offers voice, video and data services together in one customer connection. There is offered IPTV (Internet Protocol Television service within this service, where we can include also Video on Demand service and other different additional services. In the paper is described classification of Video on Demand services.

  1. Absolute migration and the evolution of the Rodriguez triple junction ...

    African Journals Online (AJOL)

    The Rodriguez Triple Junction (RTJ) is a junction connecting three mid-ocean ridges in the Indian Ocean: the Southwest Indian Ridge (SWIR), the Central Indian Ridge (CIR) and the Southeast Indian Ridge (SEIR). The evolution of the RTJ has been studied extensively for the past 10 Ma and the triple junction is believed to ...

  2. Government and Governance of Regional Triple Helix Interactions

    Science.gov (United States)

    Danson, Mike; Todeva, Emanuela

    2016-01-01

    This conceptual paper contributes to the discussion of the role of regional government and regional Triple Helix constellations driving economic development and growth within regional boundaries. The impact of regionalism and subsidiarity on regional Triple Helix constellations, and the questions of governmentality, governance and institutional…

  3. Unexpected Hydration of a Triple Bond During DNA Synthesis

    DEFF Research Database (Denmark)

    Fatthalla, Maha I.; Pedersen, Erik B.

    2016-01-01

    acidic conditions, polarizes the triple bond in the intercalator and this makes hydration of the triple bond possible during the DNA synthesis and an oligonucleotide with 1-(indol-3-yl)-2-(pyren-1-yl)ethanone as the intercalator is formed. Insertion of the unhydrated and hydrated linker systems gave...

  4. Triple junction polymer solar cells for photoelectrochemical water splitting

    NARCIS (Netherlands)

    Esiner, S.; Eersel, van H.; Wienk, M.M.; Janssen, R.A.J.

    2013-01-01

    A triple junction polymer solar cell in a novel 1 + 2 type configuration provides photoelectrochemical water splitting in its maximum power point at V ˜ 1.70 V with an estimated solar to hydrogen energy conversion efficiency of 3.1%. The triple junction cell consists of a wide bandgap front cell and

  5. Regional Dimensions of the Triple Helix Model: Setting the Context

    Science.gov (United States)

    Todeva, Emanuela; Danson, Mike

    2016-01-01

    This paper introduces the rationale for the special issue and its contributions, which bridge the literature on regional development and the Triple Helix model. The concept of the Triple Helix at the sub-national, and specifically regional, level is established and examined, with special regard to regional economic development founded on…

  6. "Special Issue": Regional Dimensions of the Triple Helix Model

    Science.gov (United States)

    Todeva, Emanuela; Danson, Mike

    2016-01-01

    This paper introduces the rationale for the special issue and its contributions, which bridge the literature on regional development and the Triple Helix model. The concept of the Triple Helix at the sub-national, and specifically regional, level is established and examined, with special regard to regional economic development founded on…

  7. Rooted triple consensus and anomalous gene trees

    Directory of Open Access Journals (Sweden)

    Schmidt Heiko A

    2008-04-01

    Full Text Available Abstract Background Anomalous gene trees (AGTs are gene trees with a topology different from a species tree that are more probable to observe than congruent gene trees. In this paper we propose a rooted triple approach to finding the correct species tree in the presence of AGTs. Results Based on simulated data we show that our method outperforms the extended majority rule consensus strategy, while still resolving the species tree. Applying both methods to a metazoan data set of 216 genes, we tested whether AGTs substantially interfere with the reconstruction of the metazoan phylogeny. Conclusion Evidence of AGTs was not found in this data set, suggesting that erroneously reconstructed gene trees are the most significant challenge in the reconstruction of phylogenetic relationships among species with current data. The new method does however rule out the erroneous reconstruction of deep or poorly resolved splits in the presence of lineage sorting.

  8. Radiation sterilization of triple sugar iron agar

    International Nuclear Information System (INIS)

    Altmann, G.; Eisenberg, E.; Bogokowsky, B.

    1979-01-01

    Triple sugar iron agar (TSI), a medium used for the identification of enteric bacteria, was sterilized by gamma radiation using radiation doses of 750-2000 krad. The radio-sterilized medium, slightly modified by increasing its Phenol Red content, performed well when tested with different enterobacteriaceae and other gram negative bacteria. Growth, change of indicator reaction in slant and butt and formation of gas and H 2 S were equal in irradiated and autoclaved TSI. Slants of irradiated TSI in stoppered plastic tubes kept their diagnostic properties during storage for at least 4 months. Gamma irradiation appears to be an attractive and economical method of sterilising nutrient media in sealed tubes or other containers, avoiding the risk of contamination during processing. (author)

  9. Triple-layer smart grid business model

    DEFF Research Database (Denmark)

    Ma, Zheng; Lundgaard, Morten; Jørgensen, Bo Nørregaard

    2016-01-01

    Viewing the smart grid with the theory of business models may open opportunities in understanding and capturing values in new markets. This study tries to discover and map the smart grid ecosystem-based business model framework with two different environments (sub-Saharan Africa and Denmark......), and identifies the parameters for the smart grid solutions to the emerging markets. This study develops a triple-layer business model including the organizational (Niche), environmental (Intermediate), and global (Dominators) factors. The result uncovers an interface of market factors and stakeholders...... in a generic smart grid constellation. The findings contribute the transferability potential of the smart grid solutions between countries, and indicate the potential to export and import smart grid solutions based on the business modeling....

  10. Polarized triple-axis spectrometer TASP

    Energy Technology Data Exchange (ETDEWEB)

    Boeni, P; Keller, P [Lab. for Neutron Scattering ETH Zurich, Zurich (Switzerland) and Paul Scherrer Institute, Villigen (Switzerland)

    1996-11-01

    The polarized triple-axis spectrometer TASP at SINQ has been optimized for measuring magnetic cross sections in condensed matter. The neutrons are polarized or analyzed either by means of benders or Heusler monochromators. The beam divergence, i.e. the intensity, and the spectral range of the neutrons is rather large because of the supermirror coatings of the feeding neutron guide. The intensity can be further increased at the sample position by means of a focussing monochromator and a focussing anti-trumpet. The end position of TASP allows the tailoring of the neutron beam already before the monochromator and to scatter neutrons over very wide ranges of angles. (author) 6 figs., 1 tab., 8 refs.

  11. RITA-type triple axis spectrometers

    International Nuclear Information System (INIS)

    Roennow, H.M.

    2001-01-01

    The RITA spectrometer at Risoe National Laboratory was the first to incorporate a complete re-thinking of the neutron-path from source, through detector to analysis. Since then, other RITA-type spectrometers such as SPINS at NIST, RITA-II at PSI have been built, and several new spectrometers around the world are adapting the same philosophy. The main novelty of RITA was the introduction of a single back-end tank featuring both an analyser block with multiple individually turnable analyser blades and a 2D position sensitive detector. Several new triple-axis spectrometers are presently being built at existing and future sources, and almost all of them have learnt from the experience with RITA. (R.P.)

  12. About the Triple A. Argentina 1973 - 1976

    OpenAIRE

    Rostica, Julieta

    2011-01-01

    El 25 de mayo de 1973 el peronismo volvió a gobernar la Argentina tras aproximadamente dos décadas de proscripción y persecución política. Tras su establecimiento, ciertos crímenes comenzaron a ser firmados con “AAA”. La Triple A tuvo la particularidad de desaparecer con el golpe de Estado del 24 de marzo de 1976. ¿Por qué esta organización sólo pudo existir en una democracia erigida en medio de dos dictaduras militares? ¿Por qué existió durante el tan anhelado gobierno peronista? El artículo...

  13. Triple negative breast cancer: an Indian perspective

    Directory of Open Access Journals (Sweden)

    Akhtar M

    2015-08-01

    Full Text Available Murtaza Akhtar, Subhrajit Dasgupta, Murtuza Rangwala Department of Surgery, NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, Maharashtra, India Introduction: Breast cancer is the most common female cancer in the world. Triple negative breast cancer (TNBC is a recently identified biological variant with aggressive tumor behavior and poor prognosis. Data of hormonal status from the Indian population is scarce due to financial constraints in performing immunohistochemistry evaluation. The present study aims to prospectively analyze receptor status of all breast cancer patients and identify TNBC and compare their clinical profile and short term survival with other non-TNBC group. Materials and methods: All cytologically and histopathologically confirmed cases of carcinoma breast were prospectively enrolled. In a longitudinal study at tertiary care hospital in central India based on the hormonal status, they were further divided into TNBC and other groups. Comparison of risk factors, clinical profile and short-term survival was carried out. Results: A total 85 patients were enrolled and of them 37 (43.7% were TNBC. On comparing risk factors ie, age, age at menarche, total reproductive age, age at first child birth, and menopausal status – no statistical significance was observed between the TNBC and non-TNBC groups. But on comparison of clinical profile TNBC tumors were significantly large with majority of patients presenting as locally advanced breast cancer (83%. No statistical difference was observed in axillary lymph node status between two groups. TNBC tumors were histologically more aggressive (grade 3 compared to other groups. No statistically significant difference was observed in short term overall survival but all three deaths were observed in the TNBC group only and two local recurrences after surgery were observed in the TNBC group. Conclusion: TNBC forms a large proportion of carcinoma breast patients in a central

  14. Fractura triple del complejo suspensorio del hombro

    Directory of Open Access Journals (Sweden)

    Eraclio Delgado Rifá

    2015-06-01

    Full Text Available El complejo suspensorio del hombro es una estructura sumamente importante, compuesta por un anillo de huesos y tejidos blandos. Las lesiones aisladas de este complejo anatómico son frecuentes y no afectan su estabilidad. La interrupción doble conduce a la inestabilidad de esta estructura y usualmente requiere tratamiento quirúrgico. La triple interrupción, por su parte, es sumamente rara y es encontrada en casos de trauma de alta energía a menudo en asociación con otras lesiones. Se presenta una triple lesión del complejo suspensorio del hombro en un paciente de 46 años de edad, con una fractura de la glenoides, del acromion tipo III de Kuhn y de la coracoides tipo II de Ogawa. En este caso, la fractura del acromion fue tratada con fijación percutánea con alambres de Kirschner, por tener asociado lesiones de partes blandas que contraindicaron la reducción abierta. La fractura de la glenoides y de la apófisis coracoides fueron tratadas conservadoramente. Después de 6 meses de evolución, el paciente tuvo un resultado funcional aceptable, con una abducción de 90 grados, los 30 grados de rotación externa y 70 de rotación interna, además asintomático y consolidación de todas las fracturas. A pesar de ser catalogada de una lesión grave del cinturón escapular y estar asociada a otras lesiones se obtuvo un resultado satisfactorio al final del tratamiento.

  15. Combined HLA matched limbal stem cells allograft with amniotic membrane transplantation as a prophylactic surgical procedure to prevent corneal graft rejection after penetrating keratoplasty: case report

    Directory of Open Access Journals (Sweden)

    Paolo Capozzi

    2014-09-01

    Full Text Available Purpose. To determine if the use of combined HLA matched limbal stem cells allograft with amniotic membrane transplantation (AMT is a safe and effective prophylactic surgical procedure to prevent corneal graft after penetrating keratoplasty (PK. Methods. We report the case of a 17 years old patient with a history of congenital glaucoma, trabeculectomy and multiple corneal graft rejections, presenting total limbal cell deficiency. To reduce the possibility of graft rejection in the left eye after a new PK, a two step procedure was performed. At first the patient underwent a combined HLA matched limbal stem cells allograft (LAT and AMT and then, 10 months later, a new PK. Results. During 12 months of follow-up, the corneal graft remained stable and smooth, with no sign of graft rejection. Conclusions. In our patient, the prophylactic use of LAT from HLA-matched donors and AMT before PK, may result in a better prognosis of corneal graft survival.

  16. Interface Fluid Syndrome After Laser In Situ Keratomileusis (LASIK) Because of Fuchs Endothelial Dystrophy Reversed by Descemet Membrane Endothelial Keratoplasty (DMEK).

    Science.gov (United States)

    Luceri, Salvatore; Baksoellah, Zainab; Ilyas, Abbas; Baydoun, Lamis; Melles, Gerrit R J

    2016-12-01

    To describe a case that developed "interface fluid syndrome" after previous laser in situ keratomileusis (LASIK) because of Fuchs endothelial dystrophy (FED), which was reversed by Descemet membrane endothelial keratoplasty (DMEK). A 58-year-old male patient presented with bilateral visual impairment owing to FED and visually significant cataract. Cataract surgery was carried out in both eyes followed by DMEK in his left eye. After cataract surgery, visual acuity did not improve sufficiently because corneal thickness increased and a fine cleft with interface fluid developed between the LASIK-flap and the residual stromal bed. After uneventful DMEK in his left eye, the fluid resolved within a week and visual acuity improved rapidly. This case demonstrates that "interface fluid syndrome" after LASIK caused by concomitant endothelial dysfunction may be reversed by DMEK allowing fast visual recovery.

  17. Measurements of intraocular pressure by Goldmann tonometry, Tonopen XL, and the transpalpebral tonometer, TGDc-01, after penetrating keratoplasty: a comparativye study.

    Science.gov (United States)

    Shemesh, Gabi; Waisbourd, Michael; Varssano, David; Michaeli, Adi; Lazar, Moshe; Kurtz, Shimon

    2009-08-01

    The aim of this study was to compare intraocular pressure (IOP) measurements obtained by Goldmann tonometry (GT), the Tonopen XL, and a new transpalpebral tonometer, TGDc-01, in eyes that had undergone penetrating keratoplasty (PKP). IOP was measured in post-PKP eyes by means of GT, Tonopen XL, and TGDc-01. Central corneal thickness measurements were also obtained for all eyes. Forty-five eyes of 43 patients were enrolled in the study. The mean IOP difference (+/-SD) was -0.42 +/- 5.83 mm Hg between GT and Tonopen and 3.20 +/- 7.55 mm Hg between GT and TGDc-01. The correlation coefficient was 0.84 between GT and Tonopen XL (P tonometer is simply inaccurate or whether avoiding contact with the corneal graft by measuring IOP through the eyelid enables it to provide more accurate IOP readings than those obtained by transcorneal techniques.

  18. 'Blue bubble' technique: an ab interno approach for Descemet separation in deep anterior lamellar keratoplasty using trypan blue stained viscoelastic device.

    Science.gov (United States)

    Livny, Eitan; Bahar, Irit; Hammel, Naama; Nahum, Yoav

    2018-04-01

    In this study, we examined a novel variant of 'big-bubble' deep anterior lamellar keratoplasty using trypan-blue-stained viscoelastic device for the creation of a pre-descemetic bubble. Ten corneoscleral rims were mounted on an artificial anterior chamber (AC). The AC was filled with air through a limbal paracentesis. A Melles' triangulated spatula was inserted through the paracentesis, with its tip penetrating the AC, was then slightly retracted and pushed into the deep stroma above the roof of the paracentesis. A mixture of trypan blue and viscoelastic device (Healon, Abbott Medical Optics, Abbott Park, Illinois) was injected into this intra-stromal pocket using a 27-G cannula to create a pre-descemetic separation bubble. Bubble type and visualization of dyed viscoelastic device were noted. The method was later employed in three cases. In all 10 corneoscleral rims, the technique successfully created a visible pre-descemetic (type 1) bubble that could be expanded up to the predicted diameter of trephination. Subsequent trephination and the removal of corneal stroma were uneventful. In two out of four clinical cases, a type 1 bubble was created, while in two others, visco-dissection failed and dyed viscoelastic was seen in the AC. The presented technique holds promise of being a relatively easy to perform, predictable and well-controlled alternative for achieving a type 1 bubble during deep anterior lamellar keratoplasty surgery. The trypan-blue-stained viscoelastic device facilitates proper visualization and control of the separation bubble and assists in identifying the penetrance to the separation bubble prior to removal of the stromal cap. © 2017 Royal Australian and New Zealand College of Ophthalmologists.

  19. Estudo retrospectivo dos transplantes penetrantes de córnea da Santa Casa de Porto Alegre Retrospective study of penetrating keratoplasty at the Santa Casa of Porto Alegre

    Directory of Open Access Journals (Sweden)

    Caroline Fabris

    2001-10-01

    Full Text Available Objetivos: Traçar o perfil clínico e social dos pacientes submetidos a transplante de córnea e avaliar as principais indicações desses transplantes, tempo de espera para doação e os índices de sucesso, rejeição e falência dos transplantes penetrantes de córnea. Métodos: Foram analisados retrospectivamente os prontuários de 87 pacientes submetidos a transplante penetrante de córnea no Serviço de Oftalmologia da Santa Casa de Porto Alegre entre janeiro de 1990 e dezembro de 1998, totalizando 91 olhos. Destes, 56 pacientes foram chamados para avaliação clínica do enxerto durante o levantamento de dados para este estudo. Resultados: Considerando-se os 91 transplantes (87 pacientes, 53 (60,9% foram realizados em pacientes do sexo masculino e 34 (39%, do sexo feminino. A idade variou de 3 a 89 anos, com média de 42,3 ± 19,8 anos. As principais indicações para transplante de córnea foram ceratocone em 32 (35% olhos, ceratopatia bolhosa (pós-facectomia, distrofia de Fuchs e outros em 24 (26,4%, trauma mecânico em 9 (9,9%, causas infecciosas em 9 (9,9%, queimadura química em 2 (2,2%, queimadura térmica em 1 (1,1% e outras causas em 14 (15,4% olhos. O tempo médio de espera por doação de córnea foi de 17,3 ± 9,9 meses. Do total de 91 olhos transplantados, 25 (27,5% apresentaram rejeição e 12 (13,2% olhos apresentaram falência do transplante. Conclusões: Este estudo mostrou a epidemiologia dos pacientes transplantados. A falta de dados seriados devido à alta precoce e perda de acompanhamento dos pacientes tornou impossível a análise e a comparação dos resultados pós-operatórios com outros estudos.Purpose: To describe the clinical and social profile of recipient patients of transplanted corneas, and to evaluate main indications for corneal transplants, waiting time for donor tissue, and percentages of success, rejection and failure of penetrating keratoplasty. Methods: Retrospective chart review of 87 patients

  20. On Pythagoras Theorem for Products of Spectral Triples

    Science.gov (United States)

    D'Andrea, Francesco; Martinetti, Pierre

    2013-05-01

    We discuss a version of Pythagoras theorem in noncommutative geometry. Usual Pythagoras theorem can be formulated in terms of Connes' distance, between pure states, in the product of commutative spectral triples. We investigate the generalization to both non-pure states and arbitrary spectral triples. We show that Pythagoras theorem is replaced by some Pythagoras inequalities, that we prove for the product of arbitrary (i.e. non-necessarily commutative) spectral triples, assuming only some unitality condition. We show that these inequalities are optimal, and we provide non-unital counter-examples inspired by K-homology.

  1. Hermitian (ϵ,δ)-Freudenthal-Kantor Triple Systems and Certain Applications of *-Generalized Jordan Triple Systems to Field Theory

    International Nuclear Information System (INIS)

    Kamiya, Noriaki; Sato, Matsuo

    2014-01-01

    We define Hermitian (ϵ,δ)-Freudenthal-Kantor triple systems and prove a structure theorem. We also give some examples of triple systems that are generalizations of the u(N)⊕u(M) and sp(2N)⊕u(1) Hermitian 3-algebras. We apply a *-generalized Jordan triple system to a field theory and obtain a Chern-Simons gauge theory. We find that the novel Higgs mechanism works, where the Chern-Simons gauge theory reduces to a Yang-Mills theory in a certain limit

  2. Applications of tripled chaotic maps in cryptography

    International Nuclear Information System (INIS)

    Behnia, S.; Akhshani, A.; Akhavan, A.; Mahmodi, H.

    2009-01-01

    Security of information has become a major issue during the last decades. New algorithms based on chaotic maps were suggested for protection of different types of multimedia data, especially digital images and videos in this period. However, many of them fundamentally were flawed by a lack of robustness and security. For getting higher security and higher complexity, in the current paper, we introduce a new kind of symmetric key block cipher algorithm that is based on tripled chaotic maps. In this algorithm, the utilization of two coupling parameters, as well as the increased complexity of the cryptosystem, make a contribution to the development of cryptosystem with higher security. In order to increase the security of the proposed algorithm, the size of key space and the computational complexity of the coupling parameters should be increased as well. Both the theoretical and experimental results state that the proposed algorithm has many capabilities such as acceptable speed and complexity in the algorithm due to the existence of two coupling parameters and high security. Note that the ciphertext has a flat distribution and has the same size as the plaintext. Therefore, it is suitable for practical use in secure communications.

  3. Triple echo steady-state (TESS) relaxometry.

    Science.gov (United States)

    Heule, Rahel; Ganter, Carl; Bieri, Oliver

    2014-01-01

    Rapid imaging techniques have attracted increased interest for relaxometry, but none are perfect: they are prone to static (B0 ) and transmit (B1 ) field heterogeneities, and commonly biased by T2 /T1 . The purpose of this study is the development of a rapid T1 and T2 relaxometry method that is completely (T2 ) or partly (T1 ) bias-free. A new method is introduced to simultaneously quantify T1 and T2 within one single scan based on a triple echo steady-state (TESS) approach in combination with an iterative golden section search. TESS relaxometry is optimized and evaluated from simulations, in vitro studies, and in vivo experiments. It is found that relaxometry with TESS is not biased by T2 /T1 , insensitive to B0 heterogeneities, and, surprisingly, that TESS-T2 is not affected by B1 field errors. Consequently, excellent correspondence between TESS and reference spin echo data is observed for T2 in vitro at 1.5 T and in vivo at 3 T. TESS offers rapid T1 and T2 quantification within one single scan, and in particular B1 -insensitive T2 estimation. As a result, the new proposed method is of high interest for fast and reliable high-resolution T2 mapping, especially of the musculoskeletal system at high to ultra-high fields. Copyright © 2013 Wiley Periodicals, Inc.

  4. Triple Isotope Water Analyzer for Extraplanetary Studies, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — Los Gatos Research (LGR) proposes to employ Off-Axis ICOS to develop triple-isotope water analyzers for lunar and other extraplanetary exploration. This instrument...

  5. Uncovering the triple omeron vertex from Wilson line formalism

    International Nuclear Information System (INIS)

    Chirilli, G. A.; Szymanowski, L.; Wallon, S.

    2011-01-01

    We compute the triple omeron vertex from the Wilson line formalism, including both planar and nonplanar contributions, and get perfect agreement with the result obtained in the Extended Generalized Logarithmic Approximation based on Reggeon calculus.

  6. Tripled Fixed Point in Ordered Multiplicative Metric Spaces

    Directory of Open Access Journals (Sweden)

    Laishram Shanjit

    2017-06-01

    Full Text Available In this paper, we present some triple fixed point theorems in partially ordered multiplicative metric spaces depended on another function. Our results generalise the results of [6] and [5].

  7. Triple-membrane reduces need for ion exchange regeneration

    International Nuclear Information System (INIS)

    Valcour, H.

    1989-01-01

    Triple-membrane water treatment systems are comprised of ultrafiltration units for pretreatment, electrodialysis reversal primary demineralizers, reverse osmosis secondary demineralizers, portable ion exchange unit polishing demineralizers, and ultraviolet sterilizers. The triple-membrane process is designed to provide an unprecedented degree of pretreatment to maximize efficiency, durability and reliability of the reverse osmosis, whilst reducing the required regeneration frequency of the ion exchange demineralizer by one to two orders of magnitude. (author)

  8. Modified Genta triple stain for identifying Helicobacter pylori.

    OpenAIRE

    el-Zimaity, H M; Wu, J; Graham, D Y

    1999-01-01

    AIM: To evaluate whether lead nitrate could replace uranyl nitrate in the Genta stain for H pylori without sacrificing the advantages of the triple stain (Steiner silver impregnation combined with Alcian blue and haematoxylin/eosin (H&E)). METHODS: A comparison was made in 16 specimens between the original triple stain and the revised version. One pathologist evaluated all sections. RESULTS: Direct substitution of lead nitrate for uranium nitrate produced well stained organisms without interf...

  9. Immunohistochemical Characteristics of Triple Negative/Basal-like Breast Cancer

    OpenAIRE

    Emel Ebru PALA; Ümit BAYOL; Süheyla CUMURCU; Elif KESKİN

    2012-01-01

    Objective: Triple-negative-breast-cancer that accounts for 10-20% of all breast carcinomas is defined by the lack of estrogen receptor, progesterone receptor, HER2 expression, and agressive clinical behavior. Triple-negative-breast-cancer is categorized into basal like and other types. The basal-like subtype is characterized by the expression of myoepithelial/basal markers.Material and Method: We studied 41 immunohistochemically triplenegative- breast-cancer patients to determine EGFR, Cytoke...

  10. Targeting Prolyl Peptidases in Triple-Negative Breast Cancer

    Science.gov (United States)

    2017-02-01

    ABSTRACT Triple negative breast cancer (TNBC) is an aggressive sub-type with limited treatment options and poor prognosis. The most life -threatening... negative feedback loops within the pathway limit their effectiveness . For example, AKT inhibitors cause increased expression of IGF1R/ErbB3 and, as a...AWARD NUMBER: W81XWH-16-1-0025 TITLE: Targeting Prolyl Peptidases in Triple- Negative Breast Cancer PRINCIPAL INVESTIGATOR: Carl G. Maki, PhD

  11. Warps, grids and curvature in triple vector bundles

    Science.gov (United States)

    Flari, Magdalini K.; Mackenzie, Kirill

    2018-06-01

    A triple vector bundle is a cube of vector bundle structures which commute in the (strict) categorical sense. A grid in a triple vector bundle is a collection of sections of each bundle structure with certain linearity properties. A grid provides two routes around each face of the triple vector bundle, and six routes from the base manifold to the total manifold; the warps measure the lack of commutativity of these routes. In this paper we first prove that the sum of the warps in a triple vector bundle is zero. The proof we give is intrinsic and, we believe, clearer than the proof using decompositions given earlier by one of us. We apply this result to the triple tangent bundle T^3M of a manifold and deduce (as earlier) the Jacobi identity. We further apply the result to the triple vector bundle T^2A for a vector bundle A using a connection in A to define a grid in T^2A . In this case the curvature emerges from the warp theorem.

  12. The triple-A supply chain.

    Science.gov (United States)

    Lee, Hau L

    2004-10-01

    Building a strong supply chain is essential for business success. But when it comes to improving their supply chains, few companies take the right approach. Many businesses work to make their chains faster or more cost-effective, assuming that those steps are the keys to competitive advantage. To the contrary: Supply chains that focus on speed and costs tend to deteriorate over time. The author has spent 15 years studying more than 60 companies to gain insight into this and other supply chain dilemmas. His conclusion: Only companies that build supply chains that are agile, adaptable, and aligned get ahead of their rivals. All three components are essential; without any one of them, supply chains break down. Great companies create supply chains that respond to abrupt changes in markets. Agility is critical because in most industries, both demand and supply fluctuate rapidly and widely. Supply chains typically cope by playing speed against costs, but agile ones respond both quickly and cost-efficiently. Great companies also adapt their supply networks when markets or strategies change. The best supply chains allow managers to identify structural shifts early by recording the latest data, filtering out noise, and tracking key patterns. Finally, great companies align the interests of the partners in their supply chains with their own. That's important because every firm is concerned solely with its own interests. If its goals are out of alignment with those of other partners in the supply chain, performance will suffer. When companies hear about the triple-A supply chain, they assume that building one will require increased technology and investment. But most firms already have the infrastructure in place to create one. A fresh attitude alone can go a long way toward making it happen.

  13. Collagenolytic Matrix Metalloproteinase Activities toward Peptomeric Triple-Helical Substrates.

    Science.gov (United States)

    Stawikowski, Maciej J; Stawikowska, Roma; Fields, Gregg B

    2015-05-19

    Although collagenolytic matrix metalloproteinases (MMPs) possess common domain organizations, there are subtle differences in their processing of collagenous triple-helical substrates. In this study, we have incorporated peptoid residues into collagen model triple-helical peptides and examined MMP activities toward these peptomeric chimeras. Several different peptoid residues were incorporated into triple-helical substrates at subsites P3, P1, P1', and P10' individually or in combination, and the effects of the peptoid residues were evaluated on the activities of full-length MMP-1, MMP-8, MMP-13, and MMP-14/MT1-MMP. Most peptomers showed little discrimination between MMPs. However, a peptomer containing N-methyl Gly (sarcosine) in the P1' subsite and N-isobutyl Gly (NLeu) in the P10' subsite was hydrolyzed efficiently only by MMP-13 [nomenclature relative to the α1(I)772-786 sequence]. Cleavage site analysis showed hydrolysis at the Gly-Gln bond, indicating a shifted binding of the triple helix compared to the parent sequence. Favorable hydrolysis by MMP-13 was not due to sequence specificity or instability of the substrate triple helix but rather was based on the specific interactions of the P7' peptoid residue with the MMP-13 hemopexin-like domain. A fluorescence resonance energy transfer triple-helical peptomer was constructed and found to be readily processed by MMP-13, not cleaved by MMP-1 and MMP-8, and weakly hydrolyzed by MT1-MMP. The influence of the triple-helical structure containing peptoid residues on the interaction between MMP subsites and individual substrate residues may provide additional information about the mechanism of collagenolysis, the understanding of collagen specificity, and the design of selective MMP probes.

  14. Comparative study on mammography between triple negative and triple positive breast cancer

    International Nuclear Information System (INIS)

    Cui Chunxiao; Lin Qing; Yang Qing; Zhang Chuanyu; Wang Shaohua; Yu Hualong; Duan Feng; Liu Shihe

    2012-01-01

    Objective: To analyze the mammographic findings of triple-negative breast cancer [TNBC, which is estrogen receptor (ER) negative, progesterone receptor (PR) negative, and human epidermal growth factor receptor 2 (HER2) negative] and triple-positive breast cancer (TPBC, which is ER positive, PR positive, and HER2 positive), and to evaluate the relationship of immunohistochemologic receptor status and mammographic findings. Methods: The immunohistochemistry results of 631 cases with breast cancers were reviewed, including 117 cases of TNBC and 44 cases of TPBC. All of the patients took mammography at initial diagnosis. We retrospectively evaluated the visibility, morphology, distribution and size of the lesion (masses and calcifications) and breast density on mammography of TNBC, and compared them with those of TPBC. The age onset and tumor sizes of TNBC and TPBC were compared by using Chi-square test and t test. Results: The visibility rate of TNBC and TPBC on mammography were 88.0%(103/117) and 90.9% (40/44), and the difference between them was insignificant (χ 2 =0.055, P >0.05). TNBC was more frequently associated with merely a mass (56/103) than TPBC (12/40) (χ 2 =6.860, P<0.01), and the mean diameter of the mass of TNBC [(2.6 ± 1.4) cm] was larger than that of TPBC [(2.0 ± 0.6) cm] (t=2.087, P<0.05). TNBC were less frequently associated with microcalcifications (37/103) than TPBC (24/40) (χ 2 =7.423, P<0.01). Mammographic density and lesion visibility were similar between the two different immunophenotypes of breast cancers. The mean age of TNBC (52±9) was more than that of TPBC (48 ±8) (t=2.759, P<0.01). Infiltrating ductal carcinoma was the main pathologic type of both groups. Basal-like breast cancer accounted for 49% (57/117) of TNBC while none happened in TPBC. Conclusions: TNBC shows merely a mass with indistinct margins,lager size and is less associated with microcalcifications. These mammographic features might be useful in diagnosing triple

  15. The interface of mental health and human rights in Indigenous peoples: triple jeopardy and triple opportunity.

    Science.gov (United States)

    Tarantola, Daniel

    2007-01-01

    Insufficient understanding of the reciprocal interactions between health and human rights, mental health and human rights and the realization of all human rights by Indigenous peoples constitute a triple jeopardy in how these topics are currently being addressed and/or openly antagonized. This paper will attempt to show how a combined health and human rights approach to mental health in Indigenous peoples can transform a triple jeopardy into a triple opportunity. The vast and growing body of literature on mental health, health as a whole, and human rights as these relate to health and to Indigenous peoples will be used to frame the discussion. Attention to the complex interactions of health and human rights can guide policy formulation and action by offering a method of analysis, a process of participatory decision and a framework for accountability. In addition, mental health can find its rightful place in the health and human rights discourse through efforts to help policymakers and practitioners broaden their vision of mental illness to holistically encompass aspects of physical, social, emotional and cultural wellbeing. Finally, connecting the role that rights realization plays in determining health and wellbeing will add power to the rightful claims by Indigenous peoples to the promotion and protection of all their human rights--civil, political, economic, social and cultural. Broadening the research agenda by applying systematically a health and human rights analytical framework to the understanding of social determinants of health would minimize the risk of assigning health outcome merely to behaviours, practices and lifestyles, uncovering structural determinants of holistic health entrenched in policies and governmental conduct. Building the evidence of the negative impact of human rights violation on health and the negative impact of ill-health on the fulfilment of other human rights can help in designing comprehensive interventions, building on the

  16. Ocular Problems in Triple-A Syndrome and Their Management

    Directory of Open Access Journals (Sweden)

    Seydi Okumuş

    2012-12-01

    Full Text Available Triple-A syndrome (Allgrove syndrome, is a rare autosomal recessive syndrome that is characterized by adrenal insufficiency, alacrimia and achalasia. In this report, we present a case of triple-A syndrome and discuss the ocular manifestations of the diseases along with evaluation of the therapeutic options. In addition to the classic triad of triple-A syndrome, our patient had intermittent exotropia. The patient was receiving oral steroids for adrenal insufficiency and artificial tear drops for eye dryness. Surgery was planned for exotropia. Punctum plug insertion was made simultaneously with bilateral lateral rectus recessions. Postoperative follow-up revealed near and distant horizontal deviation at the interval of ±10 PD. The patient’s complaints about eyes regressed significantly as well. Triple-A syndrome is a life threatening and rare disorder that could be fatal when undiagnosed. Punctum plugs are convenient therapy option for the treatment of xerophthalmia encountered in triple-A syndrome. With strabismus surgery including punctum plug insertion, any other surgery can be simultaneously carried out during a single session of general anesthesia. (Turk J Ophthalmol 2012; 42: 492-4

  17. Development of 600 kV triple resonance pulse transformer.

    Science.gov (United States)

    Li, Mingjia; Zhang, Faqiang; Liang, Chuan; Xu, Zhou

    2015-06-01

    In this paper, a triple-resonance pulse transformer based on an air-core transformer is introduced. The voltage across the high-voltage winding of the air-core transformer is significantly less than the output voltage; instead, the full output voltage appears across the tuning inductor. The maximum ratio of peak load voltage to peak transformer voltage is 2.77 in theory. By analyzing pulse transformer's lossless circuit, the analytical expression for the output voltage and the characteristic equation of the triple-resonance circuit are presented. Design method for the triple-resonance pulse transformer (iterated simulation method) is presented, and a triple-resonance pulse transformer is developed based on the existing air-core transformer. The experimental results indicate that the maximum ratio of peak voltage across the load to peak voltage across the high-voltage winding of the air-core transformer is approximately 2.0 and the peak output voltage of the triple-resonance pulse transformer is approximately 600 kV.

  18. Longitudinal Neuropsychological Profile in a Patient with Triple A Syndrome

    Directory of Open Access Journals (Sweden)

    Luigi Mazzone

    2013-01-01

    Full Text Available Triple A syndrome is an autosomal recessive disorder characterized by the triad of adrenocorticotropic hormone resistant adrenal insufficiency, achalasia, and alacrima. Our aim was to describe the neuropsychological characteristics and the cooccurring psychopathological and neurological disorders in an Italian male child suffering from Triple A syndrome at the time of admission (T0 and after one year of follow-up (T1. Many difficulties were observed in the motor domain, as well as in manual dexterity and static/dynamic balance domains of the motor task over time. In sharp contrast with previous literature reports on frequent mild cognitive dysfunction in patients with Triple A syndrome, our child did not show any mental retardation. By contrast, he showed an average IQ at T0 with a slight improvement at T1. To our knowledge, this report is the first describing neuropsychological profile and co-occurring psychopathological problems in a child with Triple A syndrome. Considering that the Triple A syndrome is a progressive disorder which can take years to develop the full-blown clinical picture, these patients require periodical medical controls. Moreover, assessment of neuropsychological and psychopathological features should be performed in patients with this disease, in order to underline the variability of this syndrome.

  19. Air Pump-Assisted Graft Centration, Graft Edge Unfolding, and Graft Uncreasing in Young Donor Graft Pre-Descemet Endothelial Keratoplasty.

    Science.gov (United States)

    Jacob, Soosan; Narasimhan, Smita; Agarwal, Amar; Agarwal, Athiya; A I, Saijimol

    2017-08-01

    To assess an air pump-assisted technique for graft centration, graft edge unfolding, and graft uncreasing while performing pre-Descemet endothelial keratoplasty (PDEK) using young donor grafts. Continuous pressurized air infusion was used for graft centration, graft edge unfolding, and graft unwrinkling. Ten eyes of 10 patients underwent PDEK with donors aged below 40 years. In all eyes, the donor scrolled into tight scrolls. In all cases, the air pump-assisted technique was effective in positioning and centering the graft accurately and in straightening infolded graft edges and smoothing out graft creases and wrinkles. Endothelial cell loss was 38.6%. Postoperative best-corrected visual acuity at 6 months was 0.66 ± 0.25 in decimal equivalent. Continuous pressurized air infusion acted as a third hand providing a continuous pressure head that supported the graft and prevented graft dislocation as well as anterior chamber collapse during intraocular maneuvering. Adequate maneuvering space was available in all cases, and bleeding, if any, was tamponaded successfully in all cases. Although very young donor grafts may be used for PDEK, they are difficult to center and unroll completely before floating against host stroma. An air pump-assisted technique using continuous pressurized air infusion allows successful final graft positioning even with very young donor corneas. It thus makes surgery easier as several key steps are made easier to handle. It additionally helps in tamponading hemorrhage during peripheral iridectomy, increasing surgical space, preventing fluctuations in the anterior chamber depth, and promoting graft adherence.

  20. The influence of triple bottom line on international operations management

    Directory of Open Access Journals (Sweden)

    Francisco Sperotto Flores

    2017-12-01

    Full Text Available This paper takes a triple bottom line perspective to analyze how the international operations literature integrates economic, social, and environmental issues. Additionally, it shows the main drivers of and barriers to the adoption of triple bottom line practices by companies in an international context. We conducted a literature review in English language journals which publish research of production and operations management and sustainability, resulting in a final sample of 29 papers. Results show that social and legal pressure for companies to adopt a responsible behavior prompts an isomorphic process that leads them to conduct their operations on behalf of triple bottom line goals. Behavioral differences between spin-offs in various countries caused institutions to create mechanisms that can press and change private standards through regulation and enforcement. There is room for progress in studies that seek to analyze the company’s relationships in its international experience and its multi-institutional relations.

  1. BPS dynamics of the triple (p,q) string junction

    International Nuclear Information System (INIS)

    Rey, S.-J.; Yee, J.-T.

    1998-01-01

    We study the dynamics of the triple junction of (p,q) strings in type IIB string theory. We probe the tension and mass density of (p,q) strings by studying harmonic fluctuations of the triple junction. We show that they agree perfectly with the BPS formula provided a suitable geometric interpretation of the junction is given. We provide a precise statement of the BPS limit and force-balance property. At weak coupling and sufficiently dense limit, we argue that a (p,q) string embedded in the string network is a 'wiggly string', whose low-energy dynamics can be described via a renormalization group evolved, smooth effective non-relativistic string. We also suggest the possibility that, upon type IIB strings being promoted to the M-theory membrane, there can exist 'evanescent' bound-states at the triple junction in the continuum. (orig.)

  2. Triple shape memory polymers by 4D printing

    Science.gov (United States)

    Bodaghi, M.; Damanpack, A. R.; Liao, W. H.

    2018-06-01

    This article aims at introducing triple shape memory polymers (SMPs) by four-dimensional (4D) printing technology and shaping adaptive structures for mechanical/bio-medical devices. The main approach is based on arranging hot–cold programming of SMPs with fused decomposition modeling technology to engineer adaptive structures with triple shape memory effect (SME). Experiments are conducted to characterize elasto-plastic and hyper-elastic thermo-mechanical material properties of SMPs in low and high temperatures at large deformation regime. The feasibility of the dual and triple SMPs with self-bending features is demonstrated experimentally. It is advantageous in situations either where it is desired to perform mechanical manipulations on the 4D printed objects for specific purposes or when they experience cold programming inevitably before activation. A phenomenological 3D constitutive model is developed for quantitative understanding of dual/triple SME of SMPs fabricated by 4D printing in the large deformation range. Governing equations of equilibrium are established for adaptive structures on the basis of the nonlinear Green–Lagrange strains. They are then solved by developing a finite element approach along with an elastic-predictor plastic-corrector return map procedure accomplished by the Newton–Raphson method. The computational tool is applied to simulate dual/triple SMP structures enabled by 4D printing and explore hot–cold programming mechanisms behind material tailoring. It is shown that the 4D printed dual/triple SMPs have great potential in mechanical/bio-medical applications such as self-bending gripers/stents and self-shrinking/tightening staples.

  3. Tunable Hybrid Qubit in a Triple Quantum Dot

    Science.gov (United States)

    Wang, Bao-Chuan; Cao, Gang; Li, Hai-Ou; Xiao, Ming; Guo, Guang-Can; Hu, Xuedong; Jiang, Hong-Wen; Guo, Guo-Ping

    2017-12-01

    We experimentally demonstrate quantum-coherent dynamics of a triple-dot-based multielectron hybrid qubit. Pulsed experiments show that this system can be conveniently initialized, controlled, measured electrically, and has a good ratio Q ˜29 between the coherence time and gate time. Furthermore, the current multielectron hybrid qubit has an operation frequency that is tunable in a wide range, from 2 to about 15 GHz. We also provide a qualitative understanding of the experimental observations by mapping them onto a three-electron system. The demonstration of the high tunability in a triple dot system could be potentially useful for future quantum control.

  4. Triple pelvic osteotomy in the treatment of hip dysplasia

    Directory of Open Access Journals (Sweden)

    Vukašinović Zoran

    2009-01-01

    Full Text Available Introduction. Insufficient femoral head coverage is found in a variety of diseases, with acetabular dysplasia as the most frequent disorder and triple pelvic osteotomy as the most recently introduced surgical treatment. Objective. This study analyses pre- and postoperative pathoanatomic characteristics of triple in comparison to Salter and Chiari osteotomies, with a logistic regression analysis of outcome predictor and effect explanator factors in relation to the chosen type of operation. Methods. The study involved 136 adolescents treated with Salter and Chiari osteotomies or a triple pelvic osteotomy at the Institute of Orthopaedic Surgery 'Banjica' in Belgrade. The patients were between 10-20 years old at the time of operation. We collected and analyzed data from all the patients: illness history, operative parameters, preoperative and postoperative pathoanatomic data. The data was statistically processed using the statistical software SPSS, defining standard descriptive values, and by using the appropriate tests of analytic statistics: t-test for dependent and independent variables, χ2-test, Fisher's exact test, Wilcoxon's test, parameter correlation, one-way ANOVA, multi-factorial ANOVA and logistic regression, according to the type of the analyzed data and the conditions under which the statistical methods were applied. Results. The average CE angle after triple pelvic osteotomy was 43.5°, more improved than after the Salter osteotomy (33.0° and Chiari osteotomy (31.4° (F=16.822; p<0.01. Postoperative spherical congruence was also more frequent after the triple osteotomy than after the other two types of operations, and with a high significance. Preoperative painful discomfort was found to be a valid predictor of indications for the triple osteotomy over both Chiari and Salter osteotomies. The valid explanators of effect for the triple osteotomy are: postoperative joint congruence (compared to the Chiari osteotomy and increase in joint

  5. Non-resonant triple alpha reaction rate at low temperature

    Energy Technology Data Exchange (ETDEWEB)

    Itoh, T.; Tamii, A.; Aoi, N.; Fujita, H.; Hashimoto, T.; Miki, K.; Ogata, K. [Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047 (Japan); Carter, J.; Donaldson, L.; Sideras-Haddad, E. [Schools of Physics, University of Witwatersrand, Johannesburg 2050 (South Africa); Furuno, T.; Kawabata, T. [Departments of Physics, Kyoto University, Sakyo, Kyoto, 606-8502 (Japan); Kamimura, M. [RIKEN Nishina Center, Wako, Saitama, 351-0198 (Japan); Nemulodi, F.; Neveling, R.; Smit, F. D.; Swarts, C. [iThemba Laboratory for Accelerator Based Sciences Somerset, West, 7129 (South Africa)

    2014-05-02

    Our experimental goal is to study the non-resonant triple alpha reaction rate at low temperture (T < 10{sup 8} K). The {sup 13}C(p,d) reaction at 66 MeV has been used to probe the alpha-unbound continuum state in {sup 12}C just below the 2{sup nd} 0{sup +} state at 7.65 MeV. The transition strength to the continuum state is predicted to be sensitive to the non-resonant triple alpha reaction rate. The experiment has been performed at iThemba LABS. We report the present status of the experiment.

  6. RDF 1.1 Turtle : terse RDF triple language

    OpenAIRE

    World Wide Web Consortium

    2014-01-01

    RDF es un lenguaje de objetivo general para la representación de la información en la Web. Este documento define una sintaxis textual para RDF llamada Turtle que permite a un grafo RDF ser completamente escrito en un formulario de texto compacto y natural, con las abreviaturas para los patrones y tipos de datos de uso común. Turtle ofrece niveles de compatibilidad con el formato N-Triples, así como la sintaxis de patrón triple de la Recomendación SPARQL del W3C.

  7. Resultados e indicações de ceratoplastias penetrantes realizadas por médicos em treinamento, num país em desenvolvimento Indications and results of penetrating keratoplasty performed by training physicians in a developing country

    Directory of Open Access Journals (Sweden)

    Marta Ferrari Teixeira

    2001-11-01

    Full Text Available Objetivos: Avaliar as indicações mais freqüentes, bem como o resultado da acuidade visual final após a ceratoplastia penetrante, realizadas por residentes em treinamento. Métodos: Avaliaram-se retrospectivamente 159 casos de ceratoplastia penetrante realizadas no período de janeiro de 1991 a outubro de 1998, na Faculdade de Medicina de São José do Rio Preto - Hospital de Base, correlacionando-os em termos de indicação para ceratoplastia penetrante e acuidade visual final. O tempo mínimo de acompanhamento para obtenção da acuidade visual final foi de seis meses. Para comparação e análise estatística da acuidade visual final, os casos de ceratoplastia penetrante foram divididos em seis grupos de diagnóstico pré-operatório: ceratocone, ceratopatia bolhosa pseudofácica, ceratopatia bolhosa afácica, distrofia endotelial de Fuchs, ceratopatia em faixa e leucomas. Todas as cirurgias foram realizadas por residentes em treinamento, sob supervisão docente. Resultados: O ceratocone foi o grupo que atingiu um maior aumento médio de acuidade visual pós-operatória em linhas (7,55 ± 2,83 e a ceratopatia em faixa o menor (0,33 ± 3,20. Constatou-se significativa diferença entre as indicações encontradas nos países desenvolvidos, onde se observa predominância de ceratocone. De acordo com nosso estudo, as principais indicações para ceratoplastia penetrante foram, em ordem decrescente, leucoma, ceratopatia bolhosa pseudofácica, ceratocone, distrofia endotelial de Fuchs, ceratopatia bolhosa afácica e ceratopatia em faixa. Conclusão: O ceratocone apresentou diferença significativa (p Purpose: This study was designed to evaluate the most frequent indications, as well as the results of final visual acuity (VA after penetrating keratoplasty (PK, performed by residents. Methods: A consecutive series of 159 cases of PK was followed during the period from January 1991 to October 1998, at the Medical School of São Jose do Rio Preto

  8. E-cigarette Use Triples Among Middle and High School Students in Just One Year

    Science.gov (United States)

    ... Information Act Office Public Health Image Library (PHIL) E-cigarette use triples among middle and high school students ... ET Contact: Media Relations (404) 639-3286 Current e-cigarette use among middle and high school students tripled ...

  9. Living Labs as boundary-spanners between Triple Helix actors

    NARCIS (Netherlands)

    van Geenhuizen, M.S.

    2016-01-01

    Living labs are an increasingly popular methodology to enhance innovation. Living labs aim to span boundaries between different organizations, among others Triple helix actors, by acting as a network organization typically in a real-life environment to foster co-creation by user-groups. This paper

  10. Targeting histone abnormality in triple negative breast cancer

    Science.gov (United States)

    2017-08-01

    clinical trials for treatment of cancers such as acute myeloid leukemia (AML) and lung cancer (http://clinicaltrials. gov). LSD2 has been linked to...The Cancer Genome Atlas; AML, acute myeloid leukemia ; DNMT, DNA methyltransferase; TNBC, triple-negative breast cancer; BCSC, breast cancer stem cell

  11. Two path transport measurements on a triple quantum dot

    Energy Technology Data Exchange (ETDEWEB)

    Rogge, Maximilian C.; Haug, Rolf J. [Institut fuer Festkoerperphysik, Leibniz Universitaet Hannover, Appelstr. 2, 30167 Hannover (Germany)

    2008-07-01

    We present a novel triple quantum dot device made with local anodic oxidation on a GaAs/AlGaAs heterostructure. The geometry provides two path transport via a three lead setup with each lead connected to one of the three quantum dots. In addition charge detection is implemented via a quantum point contact. One lead is used as a common source contact, the other two are used as two separate drain contacts with independent current measurement. Thus two paths are formed with two dots in each path. Along both paths serial transport is observed at the triple points of the two corresponding dots. With four side gates a wide tunability is given. Thus the system can be tuned in and out of triple dot resonances. When all three dots come into resonance, quadruple points are formed with simultaneous transport along both paths. The data are analysed in combined two colour plots and compared to the charge detection showing sets of three different lines, one for each dot. This way the two path setup allows to investigate the transition from double dot physics to triple dot physics.

  12. Performance of Mercury Triple-Point Cells Made in Brazil

    Science.gov (United States)

    Petkovic, S. G.; Santiago, J. F. N.; Filho, R. R.; Teixeira, R. N.; Santos, P. R. F.

    2003-09-01

    Fixed-points cells are primary standards in ITS-90. They contain reference material with a purity of 99.999 % or more. The gallium in a melting-point cell, for example, can reach a purity of 99.99999 %. This level of purity is not easy to obtain. However, substances like water and mercury can be purified by means of distillation and chemical procedures. This paper presents the results of mercury triple-point cells made in Brazil that were directly compared to a mercury triple-point cell of 99.999% purity. This reference cell, made by Isotech (England), was previously compared to cells from CENAM (Mexico) and NRC (Canada) and the maximum deviation found was approximately 0.4 mK. The purification stage started with a sample of mercury 99.3 % pure, and the repeated use of both mechanical and chemical processes led to a purification grade considered good enough for calibration of standard platinum resistance thermometers. The purification procedures, the method of construction of the cell, the laboratory facilities, the comparison results and the budget of uncertainties are described in this paper. All of the cells tested have a triple-point temperature within 0.25 mK of the triple-point temperature of the Inmetro reference cell.

  13. Nanostructured thin films for multibandgap silicon triple junction solar cells

    NARCIS (Netherlands)

    Schropp, R.E.I.; Li, H. B. T.; Franken, R.H.; Rath, J.K.; van der Werf, C.H.M.; Schuttauf, J.A.; Stolk, R.L.

    2009-01-01

    A considerable improvement in performance has been achieved for multibandgap proto-Si/proto-SiGe/nc-Si:H triple junction n–i–p solar cells in which hot-wire chemical vapor deposition (HWCVD) is used to obtain the absorber layers of the bottom and the top cell. To achieve this, optimized Ag/ZnO

  14. Triple-negative breast cancer: present challenges and new perspectives

    NARCIS (Netherlands)

    Podo, Franca; Buydens, Lutgarde M. C.; Degani, Hadassa; Hilhorst, Riet; Klipp, Edda; Gribbestad, Ingrid S.; van Huffel, Sabine; van Laarhoven, Hanneke W. M.; Luts, Jan; Monleon, Daniel; Postma, Geert J.; Schneiderhan-Marra, Nicole; Santoro, Filippo; Wouters, Hans; Russnes, Hege G.; Sørlie, Therese; Tagliabue, Elda; Børresen-Dale, Anne-Lise

    2010-01-01

    Triple-negative breast cancers (TNBC), characterized by absence of estrogen receptor (ER), progesterone receptor (PR) and lack of overexpression of human epidermal growth factor receptor 2 (HER2), are typically associated with poor prognosis, due to aggressive tumor phenotype(s), only partial

  15. An improved computer controlled triple-axis neutron spectrometer

    International Nuclear Information System (INIS)

    Cooper, M.J.; Hall, J.W.; Hutchings, M.T.

    1975-07-01

    A description is given of the computer-controlled triple-axis neutron spectrometer installed at the PLUTO reactor at Harwell. The reasons for an nature of recent major improvements are discussed. Following a general description of the spectrometer, details are then given of the new computerised control system, including the functions of the various programs which are now available to the user. (author)

  16. Co-innovatie Triple P: integratie van marketingstrategie en personeelsbeleid

    NARCIS (Netherlands)

    Bartels, J.; Hendriks, R.; Ruyter, de P.; Zeelenberg, A.; Engelsman, V.; Eichelsheim, C.; Skoppek, H.; Schmidt, M.

    2008-01-01

    This project focuses on the integration of Triple P in marketing and personnel policy. The aim of the project is as follows: “How can you effectively use the intrinsic values of sustainable agriculture and corporate social responsibility in the marketing of organic fruit and vegetables?” In the

  17. The scalar spectrum of the triple seesaw mechanism

    International Nuclear Information System (INIS)

    Caetano, Wellington; Pires, Carlos

    2011-01-01

    Full text: The Triple seesaw mechanism provides an expression to the neutrino masses which get suppressed by high-scale M 3 in its denominator. Thus, we have a seesaw mechanism which works naturally at TeV scale, presenting, in this way, a great potential of being probed at LHC. In order to generate the small left-handed neutrino masses, the triple seesaw mechanism also requires only heavy right-handed neutrinos as extra fermionic content as the type I seesaw. The minimum Higgs sector required by the mechanism is composed by the standard Higgs doublet plus another Higgs doublet and a Higgs singlet. In this work we obtain the mass spectrum and the eigenvectors of the scalar sector that realizes the Triple seesaw mechanism. As our results, we recover the standard Higgs boson with mass in a region at 116 H < 151 GeV. We analyzed the expression given in the Triple seesaw mechanism for the neutrino mass in a scenario that is consistent with the small mass from the neutrino oscillation data and compatible with the requirements for a WIMP (weakly interacting massive particles) candidate. Finally, we obtain, as our main result, a neutral pseudoscalar with mass around 8-10 GeV which is stable and can be a possible WIMP dark matter candidate. (author)

  18. Triple Pulse Tester - Efficient Power Loss Characterization of Power Modules

    DEFF Research Database (Denmark)

    Trintis, Ionut; Poulsen, Thomas; Beczkowski, Szymon

    2015-01-01

    In this paper the triple pulse testing method and circuit for power loss characterization of power modules is introduced. The proposed test platform is able to accurately characterize both the switching and conduction losses of power modules in a single automated process. A configuration of a half...

  19. The EU must triple its energy saving policy effect

    NARCIS (Netherlands)

    Wesselink, B.; Eichhammer, W.; Harmsen, R.

    2010-01-01

    The impact of EU energy savings policy must triple to achieve the bloc’s 2020 energy savings goal. But such efforts could get a much better foundation if European leaders set a binding energy consumption target, rather than the current indicative savings target. The evidence for such

  20. On intersections of pairs of Steiner triple systems

    NARCIS (Netherlands)

    Hall, J.I.; Udding, J.T.

    1977-01-01

    Numerous articles exist in the literature concerning the intersection properties of collections of Steiner triple systems based on the same point set ([4], [5], [11], [12], [14], [15], [16], [19], [20]). In this paper we discuss several methods, first used by the authors in [7], for treating such

  1. Boundary triples for Schrodinger operators with singular interactions on hypersurfaces

    Czech Academy of Sciences Publication Activity Database

    Behrndt, J.; Langer, M.; Lotoreichik, Vladimir

    2016-01-01

    Roč. 7, č. 2 (2016), s. 290-302 ISSN 2220-8054 R&D Projects: GA ČR(CZ) GA14-06818S Institutional support: RVO:61389005 Keywords : boundary triple * Weyl function * Schrodinger operator * singular potential * delta-interaction * hypersurface Subject RIV: BE - Theoretical Physics

  2. Naval Assistance to Spain and the Triple Entente

    Directory of Open Access Journals (Sweden)

    Nicholas W. Mitiukov

    2015-03-01

    Full Text Available During the World War I Spain rendered military support to the Triple Entente, avoiding the regime of neutrality. Five trawlers, converted into minesweepers were sold to Russia and eight – to Italy. Data, concerning France, vary. There is information about no less than 27 trawlers. But probably 243 watercrafts were sold to France and 14 were contracted to build.

  3. December2004 Results of Triple Arthrodesis in Uganda.

    African Journals Online (AJOL)

    user

    2004-12-02

    Dec 2, 2004 ... Background: In Uganda, foot deformities of various kinds and complexities are common. The aim of this study was to evaluate ... Conclusion: In the developing world triple arthrodesis still has a role to play in treatment of feet deformities. The results ... on flat ground, high stepping gait, moderate deformity ...

  4. Molecular basis of the triple negative breast cancer

    Directory of Open Access Journals (Sweden)

    Ayse Feyda Nursal

    2015-06-01

    Full Text Available Breast cancer is the most common type of cancer in women and more than 1 million breast cancer cases are diagnosed each year all over the world. Breast cancer is a complex and heterogeneous disease in terms of its molecular structure, mutation type, metastase properties, clinical course and therapeutic response. Breast cancer is divided into subtypes based on expression properties of molecular markers as estrogen receptor, progestron receptor, human epidermal growth factor receptor 2. Triple-negative breast cancer is characterized by the lack of tumors that estrogen receptor, progestron receptor, human epidermal growth factor receptor 2 gene expression. These type of tumors lead to agressive clinical course due to unresponsiveness to systemic endocrine therapy and poor prognosis. Triple negative breast cancer constitutes 10-20% of all breast cancers. It affects generally young and African-American women. Triple negative breast cancer have several subtypes based on the gene expression properties. The majority of them are basal-like breast cancers. In this review, current literature is revised and summarized with respect to the molecular basis of triple negative cancers. [Archives Medical Review Journal 2015; 24(2.000: 251-259

  5. The Triple Helix Model and the Knowledge-Based Economy

    NARCIS (Netherlands)

    Leydesdorff, L.; Meyer, M.

    2010-01-01

    The Triple Helix model of university-industry-government relations can be generalized from a neo-institutional model of networks of relations to a neo-evolutionary model of how three selection environments operate upon one another. Two selection mechanisms operating upon each other can mutually

  6. Chemical application of positron annihilation through triple coincidence measurement

    International Nuclear Information System (INIS)

    Yegnasubramanian, S.; Gangadharan, S.

    1982-01-01

    This report summarises the work on the application of triple coincidence measurement of annihilation radiation for providing chemical state information; the observations have been corroborated by angular correlation and Doppler broadening measurements and supplemented by the magnetic quenching in the angular correlation and peak-to-valley ratio in the Ge(Li) singles spectrum for the 511 keV line. (author)

  7. Organizing product innovation: hierarchy, market or triple-helix networks?

    Science.gov (United States)

    Fitjar, Rune Dahl; Gjelsvik, Martin; Rodríguez-Pose, Andrés

    This paper assesses the extent to which the organization of the innovation effort in firms, as well as the geographical scale at which this effort is pursued, affects the capacity to benefit from product innovations. Three alternative modes of organization are studied: hierarchy, market and triple-helix-type networks. Furthermore, we consider triple-helix networks at three geographical scales: local, national and international. These relationships are tested on a random sample of 763 firms located in five urban regions of Norway which reported having introduced new products or services during the preceding 3 years. The analysis shows that firms exploiting internal hierarchy or triple-helix networks with a wide range of partners managed to derive a significantly higher share of their income from new products, compared to those that mainly relied on outsourcing within the market. In addition, the analysis shows that the geographical scale of cooperation in networks, as well as the type of partner used, matters for the capacity of firms to benefit from product innovation. In particular, firms that collaborate in international triple-helix-type networks involving suppliers, customers and R&D institutions extract a higher share of their income from product innovations, regardless of whether they organize the processes internally or through the network.

  8. Questioning triple rice intensification on the Vietnamese mekong delta floodplains

    NARCIS (Netherlands)

    Tran, Dung Duc; Halsema, van Gerardo; Hellegers, Petra J.G.J.; Ludwig, Fulco; Wyatt, Andrew

    2018-01-01

    Large areas of the Vietnamese Mekong Delta floodplains (VMDF) are protected by high dikes to facilitate three rice crops per year. While this has increased rice production, there is evidence that triple rice systems have negative long-term effects, both environmental and economic. Double rice

  9. The principle of relativity and the special relativity triple

    International Nuclear Information System (INIS)

    Guo Hanying; Wu Hongtu; Zhou Bin

    2009-01-01

    Based on the principle of relativity and the postulate on universal invariant constants (c,l) as well as Einstein's isotropy conditions, three kinds of special relativity form a triple with a common Lorentz group as isotropy group under full Umov-Weyl-Fock-Lorentz transformations among inertial motions

  10. Stellar evolution and the triple-α reactions

    International Nuclear Information System (INIS)

    Suda, Takuma

    2014-01-01

    Nuclear reaction rates play a crucial role in the evolution of stars. For low-mass stars, the triple-α reaction controls the helium burning stars in the red giant and asymptotic giant branch (AGB) phase. More importantly, the cross section of the triple-α reaction has a great impact on the helium ignition at the center of the electron degenerate helium core of red giants and on the helium shell flashes of AGB stars. It is to be noted that stellar evolution models are influenced not only by the value of the cross section, but also by the temperature dependence of the reaction rate. In this paper, I present the impact of the triple-α reaction rates on the evolution of low-mass metal-free stars and intermediate-mass AGB stars. According to the previous study, the constraint on the triple-α reaction rate is derived based on stellar evolution theory. It is found that the recent revisions of the rate proposed by nuclear physics calculations satisfy the condition for the ignition of the helium core flash in low-mass stars

  11. Quality of the spare triple-GEM detectors

    CERN Document Server

    Lenci, Rosario; Paoletti, Emiliano; Pasquali, Luigi; Pinci, Davide; Piscitelli, Carmelo; Poli Lener, Marco; Sciubba, Adalberto; Tskhadadze, Edisher

    2017-01-01

    Triple-GEM chambers equip the inner region of the M1 muon station. In order to provide spare detectors in case of problems in the operating ones, new chambers have been assembled at the Frascati National Laboratories of the INFN. This note summarizes the results of the quality tests performed at the end of the production procedure.

  12. Behavior of Triple Langmuir Probes in Non-Equilibrium Plasmas

    Science.gov (United States)

    Polzin, Kurt A.; Ratcliffe, Alicia C.

    2018-01-01

    The triple Langmuir probe is an electrostatic probe in which three probe tips collect current when inserted into a plasma. The triple probe differs from a simple single Langmuir probe in the nature of the voltage applied to the probe tips. In the single probe, a swept voltage is applied to the probe tip to acquire a waveform showing the collected current as a function of applied voltage (I-V curve). In a triple probe three probe tips are electrically coupled to each other with constant voltages applied between each of the tips. The voltages are selected such that they would represent three points on the single Langmuir probe I-V curve. Elimination of the voltage sweep makes it possible to measure time-varying plasma properties in transient plasmas. Under the assumption of a Maxwellian plasma, one can determine the time-varying plasma temperature T(sub e)(t) and number density n(sub e)(t) from the applied voltage levels and the time-histories of the collected currents. In the present paper we examine the theory of triple probe operation, specifically focusing on the assumption of a Maxwellian plasma. Triple probe measurements have been widely employed for a number of pulsed and timevarying plasmas, including pulsed plasma thrusters (PPTs), dense plasma focus devices, plasma flows, and fusion experiments. While the equilibrium assumption may be justified for some applications, it is unlikely that it is fully justifiable for all pulsed and time-varying plasmas or for all times during the pulse of a plasma device. To examine a simple non-equilibrium plasma case, we return to basic governing equations of probe current collection and compute the current to the probes for a distribution function consisting of two Maxwellian distributions with different temperatures (the two-temperature Maxwellian). A variation of this method is also employed, where one of the Maxwellians is offset from zero (in velocity space) to add a suprathermal beam of electrons to the tail of the

  13. Pursuing the Triple Aim: The First 7 Years.

    Science.gov (United States)

    Whittington, John W; Nolan, Kevin; Lewis, Ninon; Torres, Trissa

    2015-06-01

    POLICY POINTS: In 2008, researchers at the Institute for Healthcare Improvement (IHI) proposed the Triple Aim, strategic organizing principles for health care organizations and geographic communities that seek, simultaneously, to improve the individual experience of care and the health of populations and to reduce the per capita costs of care for populations. In 2010, the Triple Aim became part of the US national strategy for tackling health care issues, especially in the implementation of the Patient Protection and Affordable Care Act (ACA) of 2010. Since that time, IHI and others have worked together to determine how the implementation of the Triple Aim has progressed. Drawing on our 7 years of experience, we describe 3 major principles that guided the organizations and communities working on this endeavor: creating the right foundation for population management, managing services at scale for the population, and establishing a learning system to drive and sustain the work over time. In 2008, researchers at the Institute for Healthcare Improvement (IHI) described the Triple Aim as simultaneously "improving the individual experience of care; improving the health of populations; and reducing the per capita costs of care for populations." IHI and its close colleagues had determined that both individual and societal changes were needed. In 2007, IHI began recruiting organizations from around the world to participate in a collaborative to implement what became known as the Triple Aim. The 141 participating organizations included health care systems, hospitals, health care insurance companies, and others closely tied to health care. In addition, key groups outside the health care system were represented, such as public health agencies, social services groups, and community coalitions. This collaborative provided a structure for observational research. By noting the contrasts between the contexts and structures of those sites in the collaborative that progressed and

  14. mTOR in breast cancer: differential expression in triple-negative and non-triple-negative tumors.

    LENUS (Irish Health Repository)

    Walsh, S

    2012-04-01

    Triple-negative breast cancer (TNBC) is defined by the absence of estrogen receptors (ER), progesterone receptors (PR) and overexpression of HER2. Targeted therapy is currently unavailable for this subgroup of breast cancer patients. mTOR controls cancer cell growth, survival and invasion and is thus a potential target for the treatment of patients with TNBC. Using immunohistochemistry, mTOR and p-mTOR were measured in 89 TNBCs and 99 non-TNBCs. While mTOR expression was confined to tumor cell cytoplasm, p-mTOR staining was located in the nucleus, perinuclear area and in the cytoplasm. Potentially important, was our finding that nuclear p-mTOR was found more frequently in triple-negative than non triple-negative cancers (p < 0.001). These results suggest that mTOR may play a more important role in the progression of TNBC compared to non-TNBC. Based on these findings, we conclude that mTOR may be a new target for the treatment of triple-negative breast cancer.

  15. Prevalence of Germline Mutations in Genes Engaged in DNA Damage Repair by Homologous Recombination in Patients with Triple-Negative and Hereditary Non-Triple-Negative Breast Cancers.

    Directory of Open Access Journals (Sweden)

    Pawel Domagala

    Full Text Available This study sought to assess the prevalence of common germline mutations in several genes engaged in the repair of DNA double-strand break by homologous recombination in patients with triple-negative breast cancers and hereditary non-triple-negative breast cancers. Tumors deficient in this type of DNA damage repair are known to be especially sensitive to DNA cross-linking agents (e.g., platinum drugs and to poly(ADP-ribose polymerase (PARP inhibitors.Genetic testing was performed for 36 common germline mutations in genes engaged in the repair of DNA by homologous recombination, i.e., BRCA1, BRCA2, CHEK2, NBN, ATM, PALB2, BARD1, and RAD51D, in 202 consecutive patients with triple-negative breast cancers and hereditary non-triple-negative breast cancers.Thirty five (22.2% of 158 patients in the triple-negative group carried mutations in genes involved in DNA repair by homologous recombination, while 10 (22.7% of the 44 patients in the hereditary non-triple-negative group carried such mutations. Mutations in BRCA1 were most frequent in patients with triple-negative breast cancer (18.4%, and mutations in CHEK2 were most frequent in patients with hereditary non-triple-negative breast cancers (15.9%. In addition, in the triple-negative group, mutations in CHEK2, NBN, and ATM (3.8% combined were found, while mutations in BRCA1, NBN, and PALB2 (6.8% combined were identified in the hereditary non-triple-negative group.Identifying mutations in genes engaged in DNA damage repair by homologous recombination other than BRCA1/2 can substantially increase the proportion of patients with triple-negative breast cancer and hereditary non-triple-negative breast cancer who may be eligible for therapy using PARP inhibitors and platinum drugs.

  16. Development of triple axis neutron spectrometer (Paper No. 24)

    International Nuclear Information System (INIS)

    Pal, B.C.; Wadhwa, N.R.; Goveas, S.H.

    1987-02-01

    The triple axis neutron spectrometers are the basic instruments intended for use with neutron beams from reactors. Various types of spectrometers, each devoted to different kinds of measurement can be designed and manufactured, once a prototype having all the attributes of a versatile instrument is designed and developed. With the view to achieving self reliance in this field, Central Workshops of Bhabha Atomic Research Centre (BARC), Bombay designed and developed a prototype of triple axis spectrometer meeting the specifications prepared by Nuclear Physics Division of BARC . This spectrometer, with a moving wedge system was successfully manufactured and installed at 'DHRUVA'. Another version of this spectrometer, called the 'Polarised Neutron Spectrometer' was also built and exported to South Korea and installed at Korea Advanced Energy Research Institute, Seoul. This paper deals with basic concept, development of design, engineering of mechanical assemblies, the manufacturing approach and problems encountered during manufacture. (author). 3 figs

  17. Grain boundary and triple junction diffusion in nanocrystalline copper

    Energy Technology Data Exchange (ETDEWEB)

    Wegner, M., E-mail: m.wegner@uni-muenster.de; Leuthold, J.; Peterlechner, M.; Divinski, S. V., E-mail: divin@uni-muenster.de [Institut für Materialphysik, Universität Münster, Wilhelm-Klemm-Straße 10, D-48149, Münster (Germany); Song, X., E-mail: xysong@bjut.edu.cn [College of Materials Science and Engineering, Beijing University of Technology, 100124 Beijing (China); Wilde, G. [Institut für Materialphysik, Universität Münster, Wilhelm-Klemm-Straße 10, D-48149, Münster (Germany); Institute of Nanochemistry and Nanobiology, School of Environmental and Chemical Engineering, Shanghai University, 200444 Shanghai (China)

    2014-09-07

    Grain boundary and triple junction diffusion in nanocrystalline Cu samples with grain sizes, 〈d〉, of ∼35 and ∼44 nm produced by spark plasma sintering were investigated by the radiotracer method using the {sup 63}Ni isotope. The measured diffusivities, D{sub eff}, are comparable with those determined previously for Ni grain boundary diffusion in well-annealed, high purity, coarse grained, polycrystalline copper, substantiating the absence of a grain size effect on the kinetic properties of grain boundaries in a nanocrystalline material at grain sizes d ≥ 35 nm. Simultaneously, the analysis predicts that if triple junction diffusion of Ni in Cu is enhanced with respect to the corresponding grain boundary diffusion rate, it is still less than 500⋅D{sub gb} within the temperature interval from 420 K to 470 K.

  18. Triple dividends of water consumption charges in South Africa

    Science.gov (United States)

    Letsoalo, Anthony; Blignaut, James; de Wet, Theuns; de Wit, Martin; Hess, Sebastiaan; Tol, Richard S. J.; van Heerden, Jan

    2007-05-01

    The South African government is exploring ways to address water scarcity problems by introducing a water resource management charge on the quantity of water used in sectors such as irrigated agriculture, mining, and forestry. It is expected that a more efficient water allocation, lower use, and a positive impact on poverty can be achieved. This paper reports on the validity of these claims by applying a computable general equilibrium model to analyze the triple dividend of water consumption charges in South Africa: reduced water use, more rapid economic growth, and a more equal income distribution. It is shown that an appropriate budget-neutral combination of water charges, particularly on irrigated agriculture and coal mining, and reduced indirect taxes, particularly on food, would yield triple dividends, that is, less water use, more growth, and less poverty.

  19. EXTREME AO OBSERVATIONS OF TWO TRIPLE ASTEROID SYSTEMS WITH SPHERE

    International Nuclear Information System (INIS)

    Yang, B.; Wahhaj, Z.; Dumas, C.; Marsset, M.; Beauvalet, L.; Marchis, F.; Nielsen, E. L.; Vachier, F.

    2016-01-01

    We present the discovery of a new satellite of asteroid (130) Elektra—S/2014 (130) 1—in differential imaging and in integral field spectroscopy data over multiple epochs obtained with Spectro-Polarimetric High-contrast Exoplanet Research/Very Large Telescope. This new (second) moonlet of Elektra is about 2 km across, on an eccentric orbit, and about 500 km away from the primary. For a comparative study, we also observed another triple asteroid system, (93) Minerva. For both systems, component-resolved reflectance spectra of the satellites and primary were obtained simultaneously. No significant spectral difference was observed between the satellites and the primary for either triple system. We find that the moonlets in both systems are more likely to have been created by sub-disruptive impacts as opposed to having been captured

  20. EXTREME AO OBSERVATIONS OF TWO TRIPLE ASTEROID SYSTEMS WITH SPHERE

    Energy Technology Data Exchange (ETDEWEB)

    Yang, B.; Wahhaj, Z.; Dumas, C.; Marsset, M. [European Southern Observatory, Santiago (Chile); Beauvalet, L. [National Observatory, Rio de Janeiro (Brazil); Marchis, F.; Nielsen, E. L. [Carl Sagan Center at the SETI Institute, Mountain View, CA (United States); Vachier, F., E-mail: byang@eso.org [Institut de Mécanique Céleste et de Calcul des Éphémérides, Paris (France)

    2016-04-01

    We present the discovery of a new satellite of asteroid (130) Elektra—S/2014 (130) 1—in differential imaging and in integral field spectroscopy data over multiple epochs obtained with Spectro-Polarimetric High-contrast Exoplanet Research/Very Large Telescope. This new (second) moonlet of Elektra is about 2 km across, on an eccentric orbit, and about 500 km away from the primary. For a comparative study, we also observed another triple asteroid system, (93) Minerva. For both systems, component-resolved reflectance spectra of the satellites and primary were obtained simultaneously. No significant spectral difference was observed between the satellites and the primary for either triple system. We find that the moonlets in both systems are more likely to have been created by sub-disruptive impacts as opposed to having been captured.

  1. Assembly of Liposomes Controlled by Triple Helix Formation

    DEFF Research Database (Denmark)

    Vogel, Stefan; Jakobsen, Ulla

    2013-01-01

    Attachment of DNA to the surface of different solid nanoparticles (e.g. gold- and silica nanoparticles) is well established and a number of DNA-modified solid nanoparticle systems have been applied to thermal denaturation analysis of oligonucleotides. We report herein the non-covalent immobilizat...... analysis (NTA) and dynamic light scattering (DLS) show independently from ultraviolet spectroscopy experiments the formation of liposome aggregates.......-covalent immobilization of oligonucleotides on the surface of soft nanoparticles (e.g. liposomes) and the subsequent controlled assembly by DNA triple helix formation. The non-covalent approach avoids tedious surface chemistry and necessary purification procedures and can simplify and extend the available methodology...... sequences (G or C-rich) to explore the applicability of the method for different triple helical assembly modes. We demonstrate advantages and limitations of the approach and proof the reversible and reproducible formation of liposome aggregates during thermal denaturation cycles. Nanoparticle tracking...

  2. Viscoplastic sculpting in stable triple layer heavy oil transport flow

    Science.gov (United States)

    Sarmadi, Parisa; Hormozi, Sarah; A. Frigaard, Ian

    2017-11-01

    In we introduced a novel methodology for efficient transport of heavy oil via a triple layer core-annular flow. Pumping pressures are significantly reduced by concentrating high shear rates to a lubricating layer, while ideas from Visco-Plastic Lubrication are used to eliminate interfacial instabilities. We purposefully position a shaped unyielded skin of a viscoplastic fluid between the transported oil and the lubricating fluid layer to balance the density difference between the fluids. Here we address the sculpting of the shaped skin within a concentric inflow manifold. We use the quasi-steady model to provide inputs to an axisymmetric triple layer computation, showing the development of the streamwise skin profile and establishment of the flow. For this, we use a finite element discretization with the augmented-Lagrangian method to represent the yield surface behaviour accurately and a PLIC method to track the interface motion.

  3. Triple and quartic gauge boson couplings at the LHC

    CERN Document Server

    Kupco, Alexander; The ATLAS collaboration

    2017-01-01

    This report at the conference Physics in Collision 2017 reviews recent results from the ATLAS and CMS experiments on production of gauge boson pairs, triples, and vector boson scattering (VBS) processes. Large datasets from LHC proton-proton collisions at $\\sqrt{s}=8$ and $13\\,\\mathrm{TeV}$ allowed the first observations of rare processes: triboson production in channel $Z\\gamma\\gamma$ at $\\sqrt{s}=8\\,\\mathrm{TeV}$ and VBS of same signed WW at $\\sqrt{s}=13\\,\\mathrm{TeV}$. Both experiments observe good agreement with the Standard model (SM) predictions. The data were used to set new limits on anomalous triple and quartic gauge couplings not present in the SM.

  4. Artificial neural network analysis of triple effect absorption refrigeration systems

    Energy Technology Data Exchange (ETDEWEB)

    Hajizadeh Aghdam, A. [Department of Mechanical Engineering, Islamic Azad University (Iran, Islamic Republic of)], email: a.hajizadeh@iaukashan.ac.ir; Nazmara, H.; Farzaneh, B. [Department of Mechanical Engineering, University of Tabriz (Iran, Islamic Republic of)], email: h.nazmara@nioec.org, email: b_farzaneh_ms@yahoo.com

    2011-07-01

    In this study, artificial neural networks are utilized to predict the performance of triple effect series and parallel flow absorption refrigeration systems, with lithium bromide/water as the working fluid. Important parameters such as high generator and evaporator temperatures were varied and their effects on the performance characteristics of the refrigeration unit were observed. Absorption refrigeration systems make energy savings possible because they can use heat energy to produce cooling, in place of the electricity used for conventional vapour compression chillers. In addition, non-conventional sources of energy (such as solar, waste heat, and geothermal) can be utilized as their primary energy input. Moreover, absorption units use environmentally friendly working fluid pairs instead of CFCs and HCFCs, which affect the ozone layer. Triple effect absorption cycles were analysed. Results apply for both series and parallel flow systems. A relative preference for parallel-flow over series-flow is also shown.

  5. From binary black hole simulation to triple black hole simulation

    International Nuclear Information System (INIS)

    Bai Shan; Cao Zhoujian; Han, Wen-Biao; Lin, Chun-Yu; Yo, Hwei-Jang; Yu, Jui-Ping

    2011-01-01

    Black hole systems are among the most promising sources for a gravitational wave detection project. Now, China is planning to construct a space-based laser interferometric detector as a follow-on mission of LISA in the near future. Aiming to provide some theoretical support to this detection project on the numerical relativity side, we focus on black hole systems simulation in this work. Considering the globular galaxy, multiple black hole systems also likely to exist in our universe and play a role as a source for the gravitational wave detector we are considering. We will give a progress report in this paper on our black hole system simulation. More specifically, we will present triple black hole simulation together with binary black hole simulation. On triple black hole simulations, one novel perturbational method is proposed.

  6. Lifestyle Triple P: a parenting intervention for childhood obesity

    Directory of Open Access Journals (Sweden)

    Gerards Sanne MPL

    2012-04-01

    Full Text Available Abstract Background Reversing the obesity epidemic requires the development and evaluation of childhood obesity intervention programs. Lifestyle Triple P is a parent-focused group program that addresses three topics: nutrition, physical activity, and positive parenting. Australian research has established the efficacy of Lifestyle Triple P, which aims to prevent excessive weight gain in overweight and obese children. The aim of the current randomized controlled trial is to assess the effectiveness of the Lifestyle Triple P intervention when applied to Dutch parents of overweight and obese children aged 4–8 years. This effectiveness study is called GO4fit. Methods/Design Parents of overweight and obese children are being randomized to either the intervention or the control group. Those assigned to the intervention condition receive the 14-week Lifestyle Triple P intervention, in which they learn a range of nutritional, physical activity and positive parenting strategies. Parents in the control group receive two brochures, web-based tailored advice, and suggestions for exercises to increase active playing at home. Measurements are taken at baseline, directly after the intervention, and at one year follow-up. Primary outcome measure is the children’s body composition, operationalized as BMI z-score, waist circumference, and fat mass (biceps and triceps skinfolds. Secondary outcome measures are children’s dietary behavior and physical activity level, parenting practices, parental feeding style, parenting style, parental self-efficacy, and body composition of family members (parents and siblings. Discussion Our intervention is characterized by a focus on changing general parenting styles, in addition to focusing on changing specific parenting practices, as obesity interventions typically do. Strengths of the current study are the randomized design, the long-term follow-up, and the broad range of both self-reported and objectively measured

  7. Trilayered Morphology of an ABC Triple Crystalline Triblock Terpolymer

    KAUST Repository

    Palacios, Jordana K.

    2017-09-07

    Triple crystalline triblock terpolymers are materials with remarkable semicrystalline superstructures. In this work, we report for first time the alternating triple lamellar morphology that self-assembles inside spherulites of a triblock terpolymer composed of poly(ethylene oxide) (PEO), poly(ε-caprolactone) (PCL), and poly(l-lactide) (PLLA). The morphology of the PEO-b-PCL-b-PLLA triblock terpolymer is compared to an analogous PCL-b-PLLA diblock copolymer. Both diblock and triblock form a single phase in the melt. Two crystallization protocols were employed to create particular crystalline morphologies. In both cases, the isothermal crystallization of the PLA block is induced first (at 81 °C, a temperature above the melting points of both PCL and PEO blocks) and PLLA spherulites form a template, whereupon cooling the other two blocks can crystallize within the PLLA interlamellar spaces. WAXS analysis demonstrated the double crystalline and triple crystalline nature of the materials. The lamellar structure was evaluated by AFM observations and SAXS measurements. Moreover, theoretical SAXS curves of one-dimensional structural models were calculated. AFM micrographs of the triblock terpolymer evidenced the three different lamellae of PLLA, PCL and PEO that coexist together within the same spherulite. Three different lamellar thickness were determined, and their dimensions suggested that all blocks crystallized in chain-folded conformations. The evolution of the triple lamellar morphology during heating of tricrystalline samples was followed by in situ synchrotron SAXS measurements. The theoretical analysis of the SAXS curves of the triblock terpolymer allowed us to propose a stacking morphological model, in which a particular trilayer structure exists, where one lamella of PCL or one lamella of PEO is inserted randomly between two adjacent PLLA lamellae.

  8. Lifestyle Triple P: a parenting intervention for childhood obesity.

    Science.gov (United States)

    Gerards, Sanne M P L; Dagnelie, Pieter C; Jansen, Maria W J; van der Goot, Lidy O H M; de Vries, Nanne K; Sanders, Matthew R; Kremers, Stef P J

    2012-04-03

    Reversing the obesity epidemic requires the development and evaluation of childhood obesity intervention programs. Lifestyle Triple P is a parent-focused group program that addresses three topics: nutrition, physical activity, and positive parenting. Australian research has established the efficacy of Lifestyle Triple P, which aims to prevent excessive weight gain in overweight and obese children. The aim of the current randomized controlled trial is to assess the effectiveness of the Lifestyle Triple P intervention when applied to Dutch parents of overweight and obese children aged 4-8 years. This effectiveness study is called GO4fit. Parents of overweight and obese children are being randomized to either the intervention or the control group. Those assigned to the intervention condition receive the 14-week Lifestyle Triple P intervention, in which they learn a range of nutritional, physical activity and positive parenting strategies. Parents in the control group receive two brochures, web-based tailored advice, and suggestions for exercises to increase active playing at home. Measurements are taken at baseline, directly after the intervention, and at one year follow-up. Primary outcome measure is the children's body composition, operationalized as BMI z-score, waist circumference, and fat mass (biceps and triceps skinfolds). Secondary outcome measures are children's dietary behavior and physical activity level, parenting practices, parental feeding style, parenting style, parental self-efficacy, and body composition of family members (parents and siblings). Our intervention is characterized by a focus on changing general parenting styles, in addition to focusing on changing specific parenting practices, as obesity interventions typically do. Strengths of the current study are the randomized design, the long-term follow-up, and the broad range of both self-reported and objectively measured outcomes. Current Controlled Trials NTR 2555 MEC AZM/UM: NL 31988

  9. Interaction Driven Interband Tunneling of Bosons in the Triple Well

    OpenAIRE

    Cao, Lushuai; Brouzos, Ioannis; Zöllner, Sascha; Schmelcher, Peter

    2010-01-01

    We study the tunneling of a small ensemble of strongly repulsive bosons in a one-dimensional triple-well potential. The usual treatment within the single-band approximation suggests suppression of tunneling in the strong interaction regime. However, we show that several windows of enhanced tunneling are opened in this regime. This enhanced tunneling results from higher band contributions, and has the character of interband tunneling. It can give rise to various tunneling processes, such as si...

  10. Tidal breakup of triple stars in the Galactic Centre

    Science.gov (United States)

    Fragione, Giacomo; Gualandris, Alessia

    2018-04-01

    The last decade has seen the detection of fast moving stars in the Galactic halo, the so-called hypervelocity stars (HVSs). While the bulk of this population is likely the result of a close encounter between a stellar binary and the supermassive black hole (MBH) in the Galactic Centre (GC), other mechanims may contribute fast stars to the sample. Few observed HVSs show apparent ages, which are shorter than the flight time from the GC, thereby making the binary disruption scenario unlikely. These stars may be the result of the breakup of a stellar triple in the GC, which led to the ejection of a hypervelocity binary (HVB). If such binary evolves into a blue straggler star due to internal processes after ejection, a rejuvenation is possible that make the star appear younger once detected in the halo. A triple disruption may also be responsible for the presence of HVBs, of which one candidate has now been observed. We present a numerical study of triple disruptions by the MBH in the GC and find that the most likely outcomes are the production of single HVSs and single/binary stars bound to the MBH, while the production of HVBs has a probability ≲ 1 per cent regardless of the initial parameters. Assuming a triple fraction of ≈ 10 per cent results in an ejection rate of ≲ 1 Gyr - 1, insufficient to explain the sample of HVSs with lifetimes shorter than their flight time. We conclude that alternative mechanisms are responsible for the origin of such objects and HVBs in general.

  11. Kramers Turnover Theory for a Triple Well Potential

    International Nuclear Information System (INIS)

    Pollak, E.; Talkner, P.

    2001-01-01

    Kramers turnover theory is solved for a particle in a symmetric triple well potential for temperatures above the crossover temperature between tunneling and activated barrier crossing. Comparison with the turnover theory for a double well potential shows that the presence of the intermediate well always leads to a decrease of the reaction rate. At most though, the rate is a factor of two smaller than in the case of a double well potential. (author)

  12. Triple-coincidence with automatic chance coincidence correction

    International Nuclear Information System (INIS)

    Chase, R.L.

    1975-05-01

    The chance coincidences in a triple-coincidence circuit are of two types--partially correlated and entirely uncorrelated. Their relative importance depends on source strength and source and detector geometry so that the total chance correction cannot, in general, be calculated. The system described makes use of several delays and straightforward integrated circuit logic to provide independent evaluation of the two components of the chance coincidence rate. (auth)

  13. One-loop triple collinear splitting amplitudes in QCD

    Energy Technology Data Exchange (ETDEWEB)

    Badger, Simon; Buciuni, Francesco; Peraro, Tiziano [Higgs Centre for Theoretical Physics, School of Physics and Astronomy, University of Edinburgh,Edinburgh EH9 3JZ, Scotland (United Kingdom)

    2015-09-28

    We study the factorisation properties of one-loop scattering amplitudes in the triple collinear limit and extract the universal splitting amplitudes for processes initiated by a gluon. The splitting amplitudes are derived from the analytic Higgs plus four partons amplitudes. We present compact results for primitive helicity splitting amplitudes making use of super-symmetric decompositions. The universality of the collinear factorisation is checked numerically against the full colour six parton squared matrix elements.

  14. Realization of the Gallium Triple Point at NMIJ/AIST

    Science.gov (United States)

    Nakano, T.; Tamura, O.; Sakurai, H.

    2008-02-01

    The triple point of gallium has been realized by a calorimetric method using capsule-type standard platinum resistance thermometers (CSPRTs) and a small glass cell containing about 97 mmol (6.8 g) of gallium with a nominal purity of 99.99999%. The melting curve shows a very flat and relatively linear dependence on 1/ F in the region from 1/ F = 1 to 1/ F = 20 with a narrow width of the melting curve within 0.1 mK. Also, a large gallium triple-point cell was fabricated for the calibration of client-owned CSPRTs. The gallium triple-point cell consists of a PTFE crucible and a PTFE cap with a re-entrant well and a small vent. The PTFE cell contains 780 g of gallium from the same source as used for the small glass cell. The PTFE cell is completely covered by a stainless-steel jacket with a valve to enable evacuation of the cell. The melting curve of the large cell shows a flat plateau that remains within 0.03 mK over 10 days and that is reproducible within 0.05 mK over 8 months. The calibrated value of a CSPRT obtained using the large cell agrees with that obtained using the small glass cell within the uncertainties of the calibrations.

  15. GATA3 expression in triple-negative breast cancers.

    Science.gov (United States)

    Byrne, David J; Deb, Siddhartha; Takano, Elena A; Fox, Stephen B

    2017-07-01

    GATA-binding protein 3 (GATA3) is a well-studied transcription factor found to be essential in the development of luminal breast epithelium and has been identified in a variety of tumour types, including breast and urothelial carcinomas, making it a useful immunohistochemistry marker in the diagnosis of both primary and metastatic disease. We investigated GATA3 protein expression in a 106 primary triple-negative breast carcinomas (100 basal-like, six non-basal-like) using Cell Marque mouse monoclonal anti-GATA3 (L50-823). Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was used to quantify mRNA expression in 22 triple-negative breast cancers (TNBCs) (20 primary and two cell lines), four luminal (three primary and one cell line) and five human epidermal growth factor receptor 2 (HER2) (four primary and one cell line) amplified tumours. In 98 TNBCs where IHC was assessable, 47 (48%) had a 1+ or greater staining with 20 (21%) having high GATA3 expression when using a weighted scoring. Our study has demonstrated that GATA3 expression is common in primary triple-negative breast carcinomas. It also suggests that although GATA3 is an oestrogen receptor (ER) regulated gene, it still proves useful in differentiating between primary and metastatic tumours in patients with a history of breast cancer regardless of its molecular subtype. © 2017 John Wiley & Sons Ltd.

  16. Layout compliance for triple patterning lithography: an iterative approach

    Science.gov (United States)

    Yu, Bei; Garreton, Gilda; Pan, David Z.

    2014-10-01

    As the semiconductor process further scales down, the industry encounters many lithography-related issues. In the 14nm logic node and beyond, triple patterning lithography (TPL) is one of the most promising techniques for Metal1 layer and possibly Via0 layer. As one of the most challenging problems in TPL, recently layout decomposition efforts have received more attention from both industry and academia. Ideally the decomposer should point out locations in the layout that are not triple patterning decomposable and therefore manual intervention by designers is required. A traditional decomposition flow would be an iterative process, where each iteration consists of an automatic layout decomposition step and manual layout modification task. However, due to the NP-hardness of triple patterning layout decomposition, automatic full chip level layout decomposition requires long computational time and therefore design closure issues continue to linger around in the traditional flow. Challenged by this issue, we present a novel incremental layout decomposition framework to facilitate accelerated iterative decomposition. In the first iteration, our decomposer not only points out all conflicts, but also provides the suggestions to fix them. After the layout modification, instead of solving the full chip problem from scratch, our decomposer can provide a quick solution for a selected portion of layout. We believe this framework is efficient, in terms of performance and designer friendly.

  17. Prenatal diagnosis and prognosis of triple X syndrome: 47, XXX.

    Science.gov (United States)

    Ben Hamouda, H; Mkacher, N; Elghezal, H; Bannour, H; Kamoun, M; Soua, H; Saad, A; Souissi, M M; Sfar, M T

    2009-11-01

    Triple X syndrome is a relatively common sex chromosomal abnormality occurring in 0,1% of live-born female infants. Most of these infants have a normal phenotype and only a few cases with 47, XXX karyotype have congenital malformations. We report three cases of triple X syndrome that were diagnosed prenatally by genetic amniocentesis for advanced maternal age and have been observed from birth to age of 3 to 12 years. A description of their growth and development is presented. The birth weight was normal in all patients and one of them had facial dysmorphism with right microphtalmia and auricular septal defect. During the first 2 years of life, the neuromotor development of these infants was not distinguishable from chromosomally normal children. By 3 years of age, two patients have a moderate developmental delay in speech and language. One girl 12-year-old had normal schooling. The diagnosis of the triple X syndrome can be never made because clinical demonstrations are not rather important to arouse the demand of a karyotype. Prenatal diagnosis is often made in front of the advanced maternal age. Expectant parents must be counseled as to the significance of this 47, XXX karyotype and prognostic information must be given.

  18. Second Law Of Thermodynamics Analysis Of Triple Cycle Power Plant

    Directory of Open Access Journals (Sweden)

    Matheus M. Dwinanto

    2012-11-01

    Full Text Available Triple cycle power plant with methane as a fuel has been analyzed on the basis of second law of thermodynamics.In this model, ideal Brayton cycle is selected as a topping cycle as it gives higher efficiency at lower pressure ratio comparedintercooler and reheat cycle. In trilple cycle the bottoming cycles are steam Rankine and organic Rankine cycle. Ammoniahas suitable working properties like critical temperature, boiling temperature, etc. Steam cycle consists of a deaerator andreheater. The bottoming ammonia cycle is a ideal Rankine cycle. Single pressure heat recovery steam and ammoniagenerators are selected for simplification of the analysis. The effects of pressure ratio and maximum temperature which aretaken as important parameters regarding the triple cycle are discussed on performance and exergetic losses. On the otherhand, the efficiency of the triple cycle can be raised, especially in the application of recovering low enthalpy content wasteheat. Therefore, by properly combining with a steam Rankine cycle, the ammonia Rankine cycle is expected to efficientlyutilize residual yet available energy to an optimal extent. The arrangement of multiple cycles is compared with combinedcycle having the same sink conditions. The parallel type of arrangement of bottoming cycle is selected due to increasedperformance.

  19. Static analysis of triple-effect adsorption refrigeration with compressor

    Directory of Open Access Journals (Sweden)

    Fumi Watanabe

    2017-03-01

    Full Text Available In order to improve the efficiency of the adsorption refrigeration cycle, this study proposes a triple-effect adsorption refrigeration cycle equipped with a compressor. This cycle can run in order to create a large variation in adsorbent concentration range by the compressor, even if there is little temperature variation in the desorption and adsorption processes. The objective of this study is to clarify the effect that regulating adsorption pressure using a compressor has on the adsorption refrigeration cycle, and to that end cycle efficiency was calculated using a static analysis based on a state of equilibrium. As a results from the simulation, the triple-effect cycles can operate by regulating adsorption pressure. Both COP and exergy efficiency can be improved by a factor of 1.2 if the cycled is regulated the adsorption pressure of each cycle rather than using a shared adsorption pressure. For heat sources in the temperature range of 70–100 °C, this method is superior in terms of COP and exergy efficiency. COP values of approximately 1.7–1.8 can be obtained, which is three times higher than single-effect cycles. The triple-effect cycles have one-third the SCE of single-effect cycles but about the same SCE as double-effect cycles.

  20. Nuclear collective flow from gaussian fits to triple differential distributions

    International Nuclear Information System (INIS)

    Gosset, J.; Babinet, R.; Cavata, C.; Marco, M. de; Demoulins, M.; Fanet, H.; Fodor, Z.; L'Hote, D.; Lucas, B.

    1990-01-01

    A simple characterization of triple differential cross sections is needed for a systematic study of the nuclear matter collective flow in relativistic nucleus-nucleus collisions. Our analysis is based upon a fitting procedure, so that the triple differential distributions need not be measured in the whole momentum space. If the detector acceptance eliminates most spectator particles or if it is artificially restricted for doing so, this method leads to a flow characterization of the participant nuclear matter. The center-of-mass triple-differential momentum distributions are fitted to a simple analytical shape, namely an anisotropic Gaussian distribution. The adjusted parameters (flow angle and aspect ratios) are corrected for uncertainty in the event-by-event determination of the reaction plane azimuth (finite-number effects). Results are presented for neon-nucleus and argon-nucleus collisions at incident energy between 400 and 800 MeV per nucleon. Flow is already significant for light systems, and depends clearly upon the impact parameter

  1. An empirical understanding of triple collocation evaluation measure

    Science.gov (United States)

    Scipal, Klaus; Doubkova, Marcela; Hegyova, Alena; Dorigo, Wouter; Wagner, Wolfgang

    2013-04-01

    Triple collocation method is an advanced evaluation method that has been used in the soil moisture field for only about half a decade. The method requires three datasets with an independent error structure that represent an identical phenomenon. The main advantages of the method are that it a) doesn't require a reference dataset that has to be considered to represent the truth, b) limits the effect of random and systematic errors of other two datasets, and c) simultaneously assesses the error of three datasets. The objective of this presentation is to assess the triple collocation error (Tc) of the ASAR Global Mode Surface Soil Moisture (GM SSM 1) km dataset and highlight problems of the method related to its ability to cancel the effect of error of ancillary datasets. In particular, the goal is to a) investigate trends in Tc related to the change in spatial resolution from 5 to 25 km, b) to investigate trends in Tc related to the choice of a hydrological model, and c) to study the relationship between Tc and other absolute evaluation methods (namely RMSE and Error Propagation EP). The triple collocation method is implemented using ASAR GM, AMSR-E, and a model (either AWRA-L, GLDAS-NOAH, or ERA-Interim). First, the significance of the relationship between the three soil moisture datasets was tested that is a prerequisite for the triple collocation method. Second, the trends in Tc related to the choice of the third reference dataset and scale were assessed. For this purpose the triple collocation is repeated replacing AWRA-L with two different globally available model reanalysis dataset operating at different spatial resolution (ERA-Interim and GLDAS-NOAH). Finally, the retrieved results were compared to the results of the RMSE and EP evaluation measures. Our results demonstrate that the Tc method does not eliminate the random and time-variant systematic errors of the second and the third dataset used in the Tc. The possible reasons include the fact a) that the TC

  2. Integrating Compassionate, Collaborative Care (the "Triple C") Into Health Professional Education to Advance the Triple Aim of Health Care.

    Science.gov (United States)

    Lown, Beth A; McIntosh, Sharrie; Gaines, Martha E; McGuinn, Kathy; Hatem, David S

    2016-03-01

    Empathy and compassion provide an important foundation for effective collaboration in health care. Compassion (the recognition of and response to the distress and suffering of others) should be consistently offered by health care professionals to patients, families, staff, and one another. However, compassion without collaboration may result in uncoordinated care, while collaboration without compassion may result in technically correct but depersonalized care that fails to meet the unique emotional and psychosocial needs of all involved. Providing compassionate, collaborative care (CCC) is critical to achieving the "triple aim" of improving patients' health and experiences of care while reducing costs. Yet, values and skills related to CCC (or the "Triple C") are not routinely taught, modeled, and assessed across the continuum of learning and practice. To change this paradigm, an interprofessional group of experts recently recommended approaches and a framework for integrating CCC into health professional education and postgraduate training as well as clinical care. In this Perspective, the authors describe how the Triple C framework can be integrated and enhance existing competency standards to advance CCC across the learning and practice continuum. They also discuss strategies for partnering with patients and families to improve health professional education and health care design and delivery through quality improvement projects. They emphasize that compassion and collaboration are important sources of professional, patient, and family satisfaction as well as critical aspects of professionalism and person-centered, relationship-based high-quality care.

  3. A biodegradable, sustained-released, prednisolone acetate microfilm drug delivery system effectively prolongs corneal allograft survival in the rat keratoplasty model.

    Directory of Open Access Journals (Sweden)

    Yu-Chi Liu

    Full Text Available Frequent and long-term use of topical corticosteroids after corneal transplantation is necessary to prevent graft rejection. However, it relies heavily on patient compliance, and sustained therapeutic drug levels are often not achieved with administration of topical eye drops. A biodegradable drug delivery system with a controlled and sustained drug release may circumvent these limitations. In this study, we investigated the efficacy of a prednisolone acetate (PA-loaded poly (d,l-lactide-co-ε-caprolactone (PLC microfilm drug delivery system on promoting the survival of allogeneic grafts after penetrating keratoplasty (PK using a rat model. The drug release profiles of the microfilms were characterized (group 1. Subsequently, forty-eight PK were performed in four experimental groups: syngeneic control grafts (group 2, allogeneic control grafts (group 3, allogeneic grafts with subconjunctivally-implanted PA microfilm (group 4, and allogeneic grafts with PA eye drops (group 5; n = 12 in each. PA-loaded microfilm achieved a sustained and steady release at a rate of 0.006-0.009 mg/day, with a consistent aqueous drug concentration of 207-209 ng/ml. The mean survival days was >28 days in group 2, 9.9±0.8 days in group 3, 26.8±2.7 days in group 4, and 26.4±3.4 days in group 5 (P = 0.023 and P = 0.027 compared with group 3. Statistically significant decrease in CD4+, CD163+, CD 25+, and CD54+ cell infiltration was observed in group 4 and group 5 compared with group 3 (P<0.001. There was no significant difference in the mean survival and immunohistochemical analysis between group 4 and group 5. These results showed that sustained PA-loaded microfilm effectively prolongs corneal allograft survival. It is as effective as conventional PA eye drops, providing a promising clinically applicable alternative for patients undergoing corneal transplantation.

  4. Boston Type 1 Keratoprosthesis versus Repeat Donor Keratoplasty for Corneal Graft Failure: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Ahmad, Sumayya; Mathews, Priya M; Lindsley, Kristina; Alkharashi, Majed; Hwang, Frank S; Ng, Sueko M; Aldave, Anthony J; Akpek, Esen Karamursel

    2016-01-01

    To compare repeat penetrating keratoplasty (PK) with Boston type I keratoprosthesis (KPro) implantation for full-thickness donor corneal graft failure. Previous donor graft failure is a common indication for both PK and KPro implantation. Selection of the surgical procedure is entirely dependent on the surgeon because there are no studies available for guidance. Therefore, a systematic review was undertaken to examine vision, device retention, graft clarity, and postoperative glaucoma and infection outcomes after repeat PK versus KPro implantation. Articles with data regarding repeat PK published between 1990 and 2014 were identified in PubMed, EMBASE, the Latin American and Caribbean Health Sciences Literature Database, and the Cochrane Central Register of Controlled Trials and were reviewed. Results were compared with a retrospective review of consecutive, nonrandomized, longitudinal case series of KPro implantations performed at 5 tertiary care centers in the United States. Visual acuity at 2 years was the primary outcome measure. The proportion of clear grafts in the repeat PK group, device retention in the KPro group, and the development of postoperative glaucoma and infection were secondary outcome measures. The search strategy identified 17 128 articles in the PK analysis. After screening, 26 studies (21 case series and 5 cohort studies) were included in the review. Pooled analysis of the 26 unique studies demonstrated a 42% (95% confidence interval [CI], 30%-56%) likelihood of maintaining 20/200 or better at 2 years after repeat PK, compared with an 80% (95% CI, 68%-88%) probability with KPro implantation. The probability of maintaining a clear graft at 5 years was 47% (95% CI, 40%-54%) after repeat PK, whereas the probability of retention of the KPro at 5 years was 75% (95% CI, 64%-84%). The rate of progression of glaucoma at 3 years was 25% (95% CI, 10%-44%) after repeat PK and 30% in the KPro cohort. These results demonstrate favorable outcomes of KPro

  5. Predictors of Corneal Perforation or Need for Therapeutic Keratoplasty in Severe Fungal Keratitis: A Secondary Analysis of the Mycotic Ulcer Treatment Trial II.

    Science.gov (United States)

    Prajna, N Venkatesh; Krishnan, Tiruvengada; Rajaraman, Revathi; Patel, Sushila; Shah, Ranjeet; Srinivasan, Muthiah; Das, Manoranjan; Ray, Kathryn J; Oldenburg, Catherine E; McLeod, Stephen D; Zegans, Michael E; Acharya, Nisha R; Lietman, Thomas M; Rose-Nussbaumer, Jennifer

    2017-09-01

    Identifying patients with infectious keratitis who are at risk of experiencing a poor outcome may be useful to allocate resources toward high-risk patients, particularly in resource-poor settings. To determine baseline patient and ulcer characteristics that predict a high risk of developing corneal perforation and/or the need to undergo therapeutic penetrating keratoplasty (TPK). This is a secondary analysis of Mycotic Ulcer Treatment Trial II, a multicenter, double-masked, placebo-controlled randomized clinical trial that enrolled 240 patients with smear-positive filamentous fungal corneal ulcers who enrolled between May 2010 and August 2015. Participants had a baseline visual acuity of 20/400 or worse and were randomized to receive oral voriconazole or a placebo (all participants received topical voriconazole, 1%). After 39 participants (16.3%) were enrolled, topical natamycin, 5%, was also added. The primary outcome of this secondary analysis was the rate of corneal perforation or the need to undergo TPK. The mean (SD) age at enrollment was 49 (13) years, 104 participants (43.3%) were women, and all were of Southeast Asian descent. The presence of hypopyon at baseline indicated 2.28 times the odds of the patient developing corneal perforation and/or needing TPK (95% CI, 1.18-4.40; P = .01). Study participants whose infiltrate involved the posterior one-third had a 71.4% risk of developing corneal perforation and/or needing TPK. For each 1-mm increase in the geometric mean of the infiltrate, there was 1.37 (95% CI, 1.12-1.67; P = .002) increased odds of developing perforation and/or needing TPK. Other clinical features such as visual acuity, baseline culture positivity, type of filamentous fungal organism and duration of symptoms, and demographic characteristics, such as sex and occupation, were not significant predictors in the multivariable regression analysis. These results suggest that risk stratification from baseline ulcer characteristics can

  6. Coupling characteristics of the spun optical fiber with triple stress elements

    Science.gov (United States)

    Ji, Minning; Shang, Fengtao; Chen, Dandan

    2018-06-01

    An empirical formula related to the stress field distribution in the optical fiber with triple stress elements is proposed and proved. The possible intercoupling between the fundamental modes and the higher order modes is demonstrated. The transmission property of the spun optical fiber with triple stress elements is analyzed. The experimental data from a sample of the spun optical fiber with triple stress elements confirm the theoretical results very well.

  7. Triple oxygen isotope systematics of structurally bonded water in gypsum

    Science.gov (United States)

    Herwartz, Daniel; Surma, Jakub; Voigt, Claudia; Assonov, Sergey; Staubwasser, Michael

    2017-07-01

    The triple oxygen isotopic composition of gypsum mother water (gmw) is recorded in structurally bonded water in gypsum (gsbw). Respective fractionation factors have been determined experimentally for 18O/16O and 17O/16O. By taking previous experiments into account we suggest using 18αgsbw-gmw = 1.0037; 17αgsbw-gmw = 1.00195 and θgsbw-gmw = 0.5285 as fractionation factors in triple oxygen isotope space. Recent gypsum was sampled from a series of 10 ponds located in the Salar de Llamara in the Atacama Desert, Chile. Total dissolved solids (TDS) in these ponds show a gradual increase from 23 g/l to 182 g/l that is accompanied by an increase in pond water 18O/16O. Gsbw falls on a parallel curve to the ambient water from the saline ponds. The offset is mainly due to the equilibrium fractionation between gsbw and gmw. However, gsbw represents a time integrated signal biased towards times of strong evaporation, hence the estimated gmw comprises elevated 18O/16O compositions when compared to pond water samples taken on site. Gypsum precipitation is associated with algae mats in the ponds with lower salinity. No evidence for respective vital effects on the triple oxygen isotopic composition of gypsum hydration water is observed, nor are such effects expected. In principle, the array of δ18Ogsbw vs. 17Oexcess can be used to: (1) provide information on the degree of evaporation during gypsum formation; (2) estimate pristine meteoric water compositions; and (3) estimate local relative humidity which is the controlling parameter of the slope of the array for simple hydrological situations. In our case study, local mining activities may have decreased deep groundwater recharge, causing a recent change of the local hydrology.

  8. Triple vacuum glazing: Heat transfer and basic mechanical design constraints

    Energy Technology Data Exchange (ETDEWEB)

    Manz, H.; Brunner, S.; Wullschleger, L. [Swiss Federal Laboratories for Materials Testing and Research (EMPA), Laboratory for Applied Physics in Building, Ueberlandstrasse 129, CH-8600 Duebendorf (Switzerland)

    2006-12-15

    Given the major role played by windows with regard to energy losses from buildings in cold climates, low thermal transmittance is an indispensable property of glazing in low-energy buildings. Evacuation offers the only means of achieving negligible gaseous conduction in glazing cavities. Application of low-emittance coatings to glass sheet surfaces inside the cavity reduces the radiative heat transfer. The feasibility of double vacuum glazing using arrays of support pillars between the glass sheets has been shown by other authors. This type of glazing is commercially manufactured today. Based on these achievements, our study set out to investigate heat transfer in triple vacuum glazing by means of (i) an analytical thermal network model and (ii) a numerical finite difference model. The study focused on the impact of the following parameters on thermal transmittance: emittances of glass sheet surfaces inside the cavity, support pillar radius, support pillar separation and thermal conductivity of support pillar material. The design procedure for triple vacuum glazing taking into account not only thermal but also mechanical stresses due to atmospheric pressure, i.e., to enable identification of favourable parameter sets, is presented. Our findings suggest that use of the triple vacuum glazing concept can significantly reduce the thermal transmittances achieved by the best insulation glazing units currently on the market. E.g., a centre-of-glazing thermal transmittance of less than 0.2Wm{sup -2}K{sup -1} is achievable using stainless steel support pillars, 6mm/4mm/6mm sheets of untempered soda-lime glass and four low-emittance coatings ({epsilon}=0.03). (author)

  9. Synthesis and crystal structure analysis of uranyl triple acetates

    Energy Technology Data Exchange (ETDEWEB)

    Klepov, Vladislav V., E-mail: vladislavklepov@gmail.com [Institute for Energy and Climate Research (IEK-6), Forschungszentrum Jülich GmbH, 52428 Jülich (Germany); Department of Chemistry, Samara National Research University, 443086 Samara (Russian Federation); Serezhkina, Larisa B.; Serezhkin, Victor N. [Department of Chemistry, Samara National Research University, 443086 Samara (Russian Federation); Alekseev, Evgeny V., E-mail: e.alekseev@fz-juelich.de [Institute for Energy and Climate Research (IEK-6), Forschungszentrum Jülich GmbH, 52428 Jülich (Germany); Institut für Kristallographie, RWTH Aachen University, 52066 Aachen (Germany)

    2016-12-15

    Single crystals of triple acetates NaR[UO{sub 2}(CH{sub 3}COO){sub 3}]{sub 3}·6H{sub 2}O (R=Mg, Co, Ni, Zn), well-known for their use as reagents for sodium determination, were grown from aqueous solutions and their structural and spectroscopic properties were studied. Crystal structures of the mentioned phases are based upon (Na[UO{sub 2}(CH{sub 3}COO){sub 3}]{sub 3}){sup 2–} clusters and [R(H{sub 2}O){sub 6}]{sup 2+} aqua-complexes. The cooling of a single crystal of NaMg[UO{sub 2}(CH{sub 3}COO){sub 3}]{sub 3}·6H{sub 2}O from 300 to 100 K leads to a phase transition from trigonal to monoclinic crystal system. Intermolecular interactions between the structural units and their mutual packing were studied and compared from the point of view of the stereoatomic model of crystal structures based on Voronoi-Dirichlet tessellation. Using this method we compared the crystal structures of the triple acetates with Na[UO{sub 2}(CH{sub 3}COO){sub 3}] and [R(H{sub 2}O){sub 6}][UO{sub 2}(CH{sub 3}COO){sub 3}]{sub 2} and proposed reasons of triple acetates stability. Infrared and Raman spectra were collected and their bands were assigned. - Graphical abstract: Single crystals of uranium based triple acetates, analytical reagents for sodium determination, were synthesized and structurally, spectroscopically and topologically characterized. The structures were compared with the structures of compounds from preceding families [M(H{sub 2}O){sub 6})][UO{sub 2}(CH{sub 3}COO){sub 3}]{sub 2} (M = Mg, Co, Ni, Zn) and Na[UO{sub 2}(CH{sub 3}COO){sub 3}]. Analysis was performed with the method of molecular Voronoi-Dirichlet polyhedra to reveal a large contribution of the hydrogen bonds into intermolecular interactions which can be a reason of low solubility of studied complexes.

  10. Targeting Histone Abnormality in Triple Negative Breast Cancer

    Science.gov (United States)

    2016-08-01

    W81XWH-14-1-0237 Triple-Negative Breast Cancer Davidson, PI U10 CA180844 NCI NCTN-Network Lead 5% 2014- 2019 $11,255 Davidson, Co-PI Academic Site...MD AACR High Tech Strategic Business Meeting, Sunnyvale, CA Medical Oncology Board Review, George Washington University, Washington, DC Great...both ductal car - cinoma in situ and invasive ductal carcinoma of the breast. Oncogene 2003; 22: 2021–2033. 25 Lin T, Ponn A, Hu X, Law BK, Lu J

  11. Efficacy of Neoadjuvant Cisplatin in Triple-Negative Breast Cancer

    DEFF Research Database (Denmark)

    Szallasi, Zoltan Imre; Eklund, Aron Charles; Li, Qiyuan

    2010-01-01

    PURPOSE Cisplatin is a chemotherapeutic agent not used routinely for breast cancer treatment. As a DNA cross-linking agent, cisplatin may be effective treatment for hereditary BRCA1-mutated breast cancers. Because sporadic triple-negative breast cancer (TNBC) and BRCA1-associated breast cancer...... samples were evaluated for selected biomarkers. Results Six (22%) of 28 patients achieved pathologic complete responses, including both patients with BRCA1 germline mutations;18 (64%) patients had a clinical complete or partial response. Fourteen (50%) patients showed good pathologic responses (Miller...

  12. Electrically protected resonant exchange qubits in triple quantum dots.

    Science.gov (United States)

    Taylor, J M; Srinivasa, V; Medford, J

    2013-08-02

    We present a modulated microwave approach for quantum computing with qubits comprising three spins in a triple quantum dot. This approach includes single- and two-qubit gates that are protected against low-frequency electrical noise, due to an operating point with a narrowband response to high frequency electric fields. Furthermore, existing double quantum dot advances, including robust preparation and measurement via spin-to-charge conversion, are immediately applicable to the new qubit. Finally, the electric dipole terms implicit in the high frequency coupling enable strong coupling with superconducting microwave resonators, leading to more robust two-qubit gates.

  13. Hydrothermal Exploration at the Chile Triple Junction - ABE's last adventure?

    Science.gov (United States)

    German, C. R.; Shank, T. M.; Lilley, M. D.; Lupton, J. E.; Blackman, D. K.; Brown, K. M.; Baumberger, T.; Früh-Green, G.; Greene, R.; Saito, M. A.; Sylva, S.; Nakamura, K.; Stanway, J.; Yoerger, D. R.; Levin, L. A.; Thurber, A. R.; Sellanes, J.; Mella, M.; Muñoz, J.; Diaz-Naveas, J. L.; Inspire Science Team

    2010-12-01

    In February and March 2010 we conducted preliminary exploration for hydrothermal plume signals along the East Chile Rise where it intersects the continental margin at the Chile Triple Junction (CTJ). This work was conducted as one component of our larger NOAA-OE funded INSPIRE project (Investigation of South Pacific Reducing Environments) aboard RV Melville cruise MV 1003 (PI: Andrew Thurber, Scripps) with all shiptime funded through an award of the State of California to Andrew Thurber and his co-PI's. Additional support came from the Census of Marine Life (ChEss and CoMarge projects). At sea, we conducted a series of CTD-rosette and ABE autonomous underwater vehicle operations to prospect for and determine the nature of any seafloor venting at, or adjacent to, the point where the the East Chile Rise subducts beneath the continental margin. Evidence from in situ sensing (optical backscatter, Eh) and water column analyses of dissolved CH4, δ3He and TDFe/TDMn concentrations document the presence of two discrete sites of venting, one right at the triple junction and the other a further 10km along axis, north of the Triple Junction, but still within the southernmost segment of the East Chile Rise. From an intercomparison of the abundance of different chemical signals we can intercompare likely characteristics of these differet source sites and also differentiate between them and the high methane concentrations released from cold seep sites further north along the Chile Margin, both with the CTJ region and also at the Concepcion Methane Seep Area (CMSA). This multi-disciplinary and international collaboration - involving scientists from Chile, the USA, Europe and Japan - can serve as an excellent and exciting launchpoint for wide-ranging future investigations of the Chile Triple Junction area - the only place on Earth where an oceanic spreading center is being actively subducted beneath a continent and also the only place on Earth where all known forms of deep

  14. Prisoners of War of the Triple Alliance within Kazakhstan

    OpenAIRE

    Gulzhaukhar K. Kokebayeva; Nurzipa K. Alpysbayeva; Shotbek T. Bulgauov

    2015-01-01

    The work studies the problem of the detention of prisoners of war of the Triple Alliance in the camps, located within Kazakhstan. During the first months of war, the Russian authorities treated the prisoners of war in accordance with ‘Convention on the Treatment of the Prisoners of War’, approved by the Emperor of Russia. The content of this document corresponded to the Hague Convention with Respect to the Laws and Customs of War on Land. The major areas of the detention of prisoners of war w...

  15. Wnt signaling in triple-negative breast cancer

    Science.gov (United States)

    Pohl, SÖ-G; Brook, N; Agostino, M; Arfuso, F; Kumar, A P; Dharmarajan, A

    2017-01-01

    Wnt signaling regulates a variety of cellular processes, including cell fate, differentiation, proliferation and stem cell pluripotency. Aberrant Wnt signaling is a hallmark of many cancers. An aggressive subtype of breast cancer, known as triple-negative breast cancer (TNBC), demonstrates dysregulation in canonical and non-canonical Wnt signaling. In this review, we summarize regulators of canonical and non-canonical Wnt signaling, as well as Wnt signaling dysfunction that mediates the progression of TNBC. We review the complex molecular nature of TNBC and the emerging therapies that are currently under investigation for the treatment of this disease. PMID:28368389

  16. Triple M-brane configurations and preserved supersymmetries

    International Nuclear Information System (INIS)

    Golubtsova, A.A.; Ivashchuk, V.D.

    2013-01-01

    We investigate all standard triple composite M-brane intersections defined on products of Ricci-flat manifolds for preserving supersymmetries in eleven-dimensional N=1 supergravity. The explicit formulae for computing the numbers of preserved supersymmetries are obtained, which generalize the relations for topologically trivial flat factor spaces presented in the classification by Bergshoeff et al. We obtain certain examples of configurations preserving some fractions of supersymmetries, e.g. containing such factor spaces as K3, C ⁎ 2 /Z 2 , a four-dimensional pp-wave manifold and the two-dimensional pseudo-Euclidean manifold R ⁎ 1,1 /Z 2

  17. Nonlinear triple-point problems on time scales

    Directory of Open Access Journals (Sweden)

    Douglas R. Anderson

    2004-04-01

    Full Text Available We establish the existence of multiple positive solutions to the nonlinear second-order triple-point boundary-value problem on time scales, $$displaylines{ u^{Delta abla}(t+h(tf(t,u(t=0, cr u(a=alpha u(b+delta u^Delta(a,quad eta u(c+gamma u^Delta(c=0 }$$ for $tin[a,c]subsetmathbb{T}$, where $mathbb{T}$ is a time scale, $eta, gamma, deltage 0$ with $Beta+gamma>0$, $0

  18. Triple-phase bone image abnormalities in Lyme arthritis

    International Nuclear Information System (INIS)

    Brown, S.J.; Dadparvar, S.; Slizofski, W.J.; Glab, L.B.; Burger, M.

    1989-01-01

    Arthritis is a frequent manifestation of Lyme disease. Limited triple-phase Tc-99m MDP bone imaging of the wrists and hands with delayed whole-body images was performed in a patient with Lyme arthritis. This demonstrated abnormal joint uptake in the wrists and hands in all three phases, with increased activity seen in other affected joints on delayed whole-body images. These findings are nonspecific and have been previously described in a variety of rheumatologic conditions, but not in Lyme disease. Lyme disease should be considered in the differential diagnosis of articular and periarticular bone scan abnormalities

  19. Synchrotron X-ray diffraction using triple-axis spectrometry

    International Nuclear Information System (INIS)

    Als-Nielsen, J.

    1980-12-01

    High resolution X-ray diffraction studies of (i) monolayers of the noble gases Kr and Ar physiosorbed on graphite (ii) smectic A fluctuations in the nematic and the smectic A phases of liquid crystals are described. The apparatus used is a triple axis spectrometer situated at the storage ring DORIS at Hasylab, DESY, Hamburg. A monochromatic, well collimated beam is extracted from the synchrotron radiation spectrum by Bragg reflection from perfect Si or Ge crystals. The direction of the beam scattered from the sample is determined by Bragg reflection from a perfect Si or Ge crystal. High intensities even with resolution extending beyond the wavelength of visible light can be obtained. (Auth.)

  20. Nuclear collective flow from gaussian fits to triple differential distributions

    International Nuclear Information System (INIS)

    Gosset, J.; Demoulins, M.; Babinet, R.; Cavata, C.; Fanet, H.; L'Hote, D.; Lucas, B.; Poitou, J.; Valette, O.; Alard, J.P.; Augerat, J.; Bastid, N.; Charmensat, P.; Dupieux, P.; Fraysse, L.; Marroncle, J.; Montarou, G.; Parizet, M.J.; Qassoud, D.; Rahmani, A.; Brochard, F.; Gorodetzky, P.; Racca, C.

    1990-01-01

    In order to study the nuclear collective flow, the triple differential momentum distributions of charged baryons are fitted to a simple anisotropic gaussian distribution, within an acceptance which removes most of the spectator contribution. The adjusted flow angle and aspect ratios are corrected for systematic errors in the determination of the reaction plane. This method has been tested with Monte Carlo simulations and applied to experimental results and intranuclear cascade simulations of argon-nucleus collisions at 400 MeV per nucleon. (orig.)

  1. Triple-root jump in spacecraft potential due to electron beam emission or impact

    International Nuclear Information System (INIS)

    Lai, S.T.

    1992-01-01

    Triple-root jump in spacecraft potential is well understood in the double Maxwellian model of the natural space environment. In this paper, however, the author points out that triple-root jumps in spacecraft potential may also occur during photoemission or electron beam emission from a spacecraft. Impact of an incoming electron beam on a spacecraft may also cause triple-root jumps provided that the beam, ambient plasma, and surface parameters satisfy certain inequality conditions. The parametric conditions under which such beam induced triple-root jumps may occur are presented

  2. Emission of partial dislocations from triple junctions of grain boundaries in nanocrystalline materials

    International Nuclear Information System (INIS)

    Gutkin, M Yu; Ovid'ko, I A; Skiba, N V

    2005-01-01

    A theoretical model is suggested that describes emission of partial Shockley dislocations from triple junctions of grain boundaries (GBs) in deformed nanocrystalline materials. In the framework of the model, triple junctions accumulate dislocations due to GB sliding along adjacent GBs. The dislocation accumulation at triple junctions causes partial Shockley dislocations to be emitted from the dislocated triple junctions and thus accommodates GB sliding. Ranges of parameters (applied stress, grain size, etc) are calculated in which the emission events are energetically favourable in nanocrystalline Al, Cu and Ni. The model accounts for the corresponding experimental data reported in the literature

  3. Benign metastasizing leiomyoma in triple location: lungs, parametria and appendix

    Directory of Open Access Journals (Sweden)

    Renata Raś

    2016-07-01

    Full Text Available Benign metastasizing leiomyoma (BML usually are situated in one organ, most often in lungs. BML patients typically have a history of uterine leiomyoma treated with hysterectomy, myomectomy or subtotal hysterectomy. The aim of the study was to present the case of a 53-year-old woman with triple location in the lungs, parametria and appendix. She had undergone a myomectomy 26 years earlier. In 2015, she was admitted to the surgical department because of abdominal pain, whereupon a cholecystectomy was performed. CT scans showed pelvic mass with pulmonary metastasis. Upon discharge the patient was referred to the Gynecology Clinic, where a laparotomy was performed. The intraoperative findings were: 1 uterus with multiple leiomyomas, 2 four tumors in the parametria, 3 tumor connected to the appendix. A subtotal hysterectomy, with a bilateral salpingo-oophorectomy, removal of the tumors from the parametria and appendectomy was performed. Pathology confirmed the diagnosis based on morphology and immunohistochemical staining (strongly positive for estrogen receptors and SMA, while Ki67 was very low, below 1%. Upon postoperative recovery, the patient was referred to the Thoracic Surgery Department. During the thoracotomy, multiple nodes, surrounded by lung parenchyma, were revealed. Wedge resection was performed, for localized pulmonary lesions, and sent for pathological examination. The final pathological diagnosis was benign metastasizing leiomyomatosis. In conclusion, the triple location of BML could possibly be a result of a parallel different metastasizing mechanism, although it is impossible to exclude one mechanism, which may be the cause of the metastases in three locations.

  4. Automated realization of the gallium melting and triple points

    Science.gov (United States)

    Yan, X.; Duan, Y.; Zhang, J. T.; Wang, W.

    2013-09-01

    In order to improve the automation and convenience of the process involved in realizing the gallium fixed points, an automated apparatus, based on thermoelectric and heat pipe technologies, was designed and developed. This paper describes the apparatus design and procedures for freezing gallium mantles and realizing gallium melting and triple points. Also, investigations on the melting behavior of a gallium melting point cell and of gallium triple point cells were carried out while controlling the temperature outside the gallium point cells at 30 °C, 30.5 °C, 31 °C, and 31.5 °C. The obtained melting plateau curves show dentate temperature oscillations on the melting plateaus for the gallium point cells when thermal couplings occurred between the outer and inner liquid-solid interfaces. The maximum amplitude of the temperature fluctuations was about 1.5 mK. Therefore, the temperature oscillations can be used to indicate the ending of the equilibrium phase transitions. The duration and amplitude of such temperature oscillations depend on the temperature difference between the setting temperature and the gallium point temperature; the smaller the temperature difference, the longer the duration of both the melting plateaus and the temperature fluctuations.

  5. Shifting to triple value healthcare: Reflections from England.

    Science.gov (United States)

    Jani, Anant; Jungmann, Sven; Gray, Muir

    2018-02-01

    Increasing need and demand because of growing and aging populations combined with stagnant or decreasing resources being invested into healthcare globally mean that a radical shift is needed to ensure that healthcare systems can meet current and future challenges. Quality-, safety- and efficiency-improvement approaches have been used as means to address many problems in healthcare and while they are essential and necessary, they are not sufficient to meet our current challenges. To build resilient and sustainable healthcare systems, we need a shift to focus on triple value healthcare, which will help healthcare professionals improve outcomes at the process, patient and population levels while also optimising resource utilisation. Here we present a brief history of the Quality and Evidence-based Healthcare model and then describe how value emerged as a predominant theme in England. We then highlight the four solutions that we, as part of the RightCare programme, designed and refined in the English NHS to turn theory into practice: We end with a description of how triple value is being introduced into Germany and steps that can be taken to facilitate its adoption. Copyright © 2018. Published by Elsevier GmbH.

  6. Bridging disparate symptoms of schizophrenia: a Triple network dysfunction theory

    Directory of Open Access Journals (Sweden)

    Tereza eNekovarova

    2014-05-01

    Full Text Available Schizophrenia is a complex neuropsychiatric disorder with variable symptomatology, traditionally divided into positive and negative symptoms, and cognitive deficits. Yet, the etiology of this disorder has yet to be fully understood.Recent findings suggest that alteration of the basic sense of self-awareness may be an essential distortion of schizophrenia spectrum disorders. In addition, extensive research of social and mentalizing abilities has stressed the role of distortion of social skills in schizophrenia.This article aims to propose and support a concept of triple brain network model of the dysfunctional switching between default mode and central executive network related to the aberrant activity of salience network. This model could represent a unitary mechanism of a wide array of symptom domains present in schizophrenia including the deficit of SELF (self-awareness and self-representation and theory of mind (ToM dysfunctions along with the traditional positive, negative and cognitive domains. We review previous studies which document the dysfunctions of SELF and ToM in schizophrenia together with neuroimaging data elucidating the triple brain network model as a common neuronal substrate of this dysfunction.

  7. Drying of carrot slices in a triple pass solar dryer

    Directory of Open Access Journals (Sweden)

    Seshachalam Kesavan

    2017-01-01

    Full Text Available An indirect triple pass forced convection solar dryer was developed and its performance was evaluated for drying of carrot slices. The drying experiments were carried out under the meteorological conditions of Coimbatore city in India during the year 2016. The experimental set-up consists of a blower, triple pass packed bed air collector (using sand with wire mesh absorber plate, and a drying chamber. The air mass flow rate was optimized to 0.062 kg/s. The initial moisture content of the carrot slices was reduced from 87.5% (on wet basis to the final moisture content of 10% (wet basis in 6 h duration. The thin layer drying characteristics were analyzed using twelve mathematical models available in open literature. The results showed that the pick-up efficiency of the dryer was varied in the range between 14 and 43% with an average air collector thermal efficiency of 44% during the experimentation. The drying characteristics of carrot slices was predicted with good degree of accuracy using Wang and Singh drying model.

  8. Analysis of the Clinicopathologic Features and Prognosis in Triple-Negative Breast Cancer

    Institute of Scientific and Technical Information of China (English)

    Dehong Yang; Hong Liu; Jing Zhao

    2008-01-01

    OBJECTIVE To investigate the clinical and pathological features,as well as prognosis in triple-negative breast cancer patients.METHODS A total of 509 cases of operable breast cancer from January,2002 to June,2002 treated in the Cancer Hospital of Tianjin Medical University were analyzed.The Her-2,ER and PR status was determined using immunohistochemistry.Of the total cases,one group was identified as triple negative breast cancer,ie defined as ER,PR and Her-2 negative.The other group was nontriple-negative breast cancer.Clinicopathologic features of the groups were compared and 5-year disease-free survival (DFS)analyzed by the Kaplan-Meier method.RESULTS Of the total cases,21.4% (109/509) of cases were found to be triple- negative while 78.6% (400/509) were non-triplenegative.The triple negative group had higher incidence rates than the non-triple-negative group of the medullary type and Grade Ⅲ tumors (P < 0.05).There was no other difference in the clinicopathologic features between the 2 groups.From follow-up to June,2007,21.1% (23/109) of the triple-negative group and 12.7%(51/400) of the non-triple negative group had a local recurrence or distant metastasis,resulting in a significant difference (P < 0.05).In the triple-negative group and non-triple-negative group,5-year DFS were 78.9% and 87.3% respectively.There was a statistically significant difference between the 2 groups (P = 0.031).CONCLUSION Compared with non-triple-negative breast cancer,triple-negative breast cancer patients have an increased likehood of a local recurrence or distant metastasis and a poorer prognosis.

  9. Effectiveness of the triple P positive parenting program on parenting: A meta-analysis

    NARCIS (Netherlands)

    Graaf, I. de; Speetjens, P.; Smit, F.; Wolff, M. de; Tavecchio, L.

    2008-01-01

    Triple P is a parenting program intended to prevent and to provide treatment for severe behavioral, emotional, and developmental problems in children. The aim of this meta-analysis was to assess the effectiveness of Triple P Level 4 interventions on parenting styles and parental competency. Level 4

  10. The effectiveness of lifestyle triple P in the Netherlands : A randomized controlled trial

    NARCIS (Netherlands)

    Gerards, Sanne M P L; Dagnelie, Pieter C.; Gubbels, Jessica S.; Van Buuren, Stef; Hamers, Femke J M; Jansen, Maria W J; Van Der Goot, Odilia H M; De Vries, Nanne K.; Sanders, Matthew R.; Kremers, Stef P J

    2015-01-01

    Introduction Lifestyle Triple P is a general parenting intervention which focuses on preventing further excessive weight gain in overweight and obese children. The objective of the current study was to assess the effectiveness of the Lifestyle Triple P intervention in the Netherlands. Method We used

  11. Triple Value System Dynamics Modeling to Help Stakeholders Engage with Food-Energy-Water Problems

    Science.gov (United States)

    Triple Value (3V) Community scoping projects and Triple Value Simulation (3VS) models help decision makers and stakeholders apply systems-analysis methodology to complex problems related to food production, water quality, and energy use. 3VS models are decision support tools that...

  12. Software-Enabled Project Management Techniques and Their Relationship to the Triple Constraints

    Science.gov (United States)

    Elleh, Festus U.

    2013-01-01

    This study investigated the relationship between software-enabled project management techniques and the triple constraints (time, cost, and scope). There was the dearth of academic literature that focused on the relationship between software-enabled project management techniques and the triple constraints (time, cost, and scope). Based on the gap…

  13. Micro-photoluminescence of GaAs/AlGaAs triple concentric quantum rings.

    Science.gov (United States)

    Abbarchi, Marco; Cavigli, Lucia; Somaschini, Claudio; Bietti, Sergio; Gurioli, Massimo; Vinattieri, Anna; Sanguinetti, Stefano

    2011-10-31

    A systematic optical study, including micro, ensemble and time resolved photoluminescence of GaAs/AlGaAs triple concentric quantum rings, self-assembled via droplet epitaxy, is presented. Clear emission from localized states belonging to the ring structures is reported. The triple rings show a fast decay dynamics, around 40 ps, which is expected to be useful for ultrafast optical switching applications.

  14. Selective intercalation of six ligands molecules in a self-assembled triple helix

    NARCIS (Netherlands)

    Mateos timoneda, Miguel; Kerckhoffs, J.M.C.A.; Reinhoudt, David; Crego Calama, Mercedes

    2007-01-01

    The addition of a ligand molecule to an artificial self-assembled triple helix leads to the selective intercalation of two hydrogen-bonded trimers in specific binding pockets. Furthermore, the triple helix suffers large conformational rearrangements in order to accommodate the ligand molecules in a

  15. The effectiveness of lifestyle triple P in the Netherlands: A randomized controlled trial

    NARCIS (Netherlands)

    Gerards, S.M.P.L.; Dagnelie, P.C.; Gubbels, J.S.; Buuren, S. van; Hamers, F.J.M.; Jansen, M.W.J.; Goot, O.H.M. van der; Vries, N.K. de; Sanders, M.R.; Kremers, S.P.J.

    2015-01-01

    Introduction Lifestyle Triple P is a general parenting intervention which focuses on preventing further excessive weight gain in overweight and obese children. The objective of the current study was to assess the effectiveness of the Lifestyle Triple P intervention in the Netherlands. Method We used

  16. Banach Gelfand Triples for Applications in Physics and Engineering

    Science.gov (United States)

    Feichtinger, Hans G.

    2009-07-01

    The principle of extension is widespread within mathematics. Starting from simple objects one constructs more sophisticated ones, with a kind of natural embedding from the set of old objects to the new, enlarged set. Usually a set of operations on the old set can still be carried out, but maybe also some new ones. Done properly one obtains more completed objects of a similar kind, with additional useful properties. Let us give a simple example: While multiplication and addition can be done exactly and perfectly in the setting of Q, the rational numbers, the field R of real numbers has the advantage of being complete (Cauchy sequences have a limit…) and hence allowing for numbers like π or √2 . Finally the even "more complicated" field C of complex numbers allows to find solutions to equations like z2 = -1. The chain of inclusions of fields, Q⊂R⊂C is a good motivating example in the domain of "numbers." The main subject of the present survey-type article is a new theory of Banach Gelfand triples (BGTs), providing a similar setting in the context of (generalized) functions. Test functions are the simple objects, elements of the Hilbert space L2(Rd) are well suited in order to describe concepts of orthogonality, and they can be approximated to any given precision (in the ‖ṡ‖2-norm) by test functions. Finally one needs an even larger (Banach) space of generalized functions resp. distributions, containing among others pure frequencies and Dirac measures in order to describe various mappings between such Banach Gelfand triples in terms of the most important "elementary building blocks," in a clear analogy to the finite/discrete setting (where Dirac measures correspond to unit vectors). Our concrete Banach Gelfand triple is based on the Segal algebra S0(Rd), which coincides with the modulation space M1(Rd) = M01,1(Rd), and plays a very important and natural role for time-frequency analysis. We will point out that it provides the appropriate setting for a

  17. Common breast cancer susceptibility loci are associated with triple negative breast cancer

    Science.gov (United States)

    Stevens, Kristen N.; Vachon, Celine M.; Lee, Adam M.; Slager, Susan; Lesnick, Timothy; Olswold, Curtis; Fasching, Peter A.; Miron, Penelope; Eccles, Diana; Carpenter, Jane E.; Godwin, Andrew K.; Ambrosone, Christine; Winqvist, Robert; Schmidt, Marjanka K.; Cox, Angela; Cross, Simon S.; Sawyer, Elinor; Hartmann, Arndt; Beckmann, Matthias W.; Schulz-Wendtland, Rüdiger; Ekici, Arif B.; Tapper, William J; Gerty, Susan M; Durcan, Lorraine; Graham, Nikki; Hein, Rebecca; Nickels, Stephan; Flesch-Janys, Dieter; Heinz, Judith; Sinn, Hans-Peter; Konstantopoulou, Irene; Fostira, Florentia; Pectasides, Dimitrios; Dimopoulos, Athanasios M.; Fountzilas, George; Clarke, Christine L.; Balleine, Rosemary; Olson, Janet E.; Fredericksen, Zachary; Diasio, Robert B.; Pathak, Harsh; Ross, Eric; Weaver, JoEllen; Rüdiger, Thomas; Försti, Asta; Dünnebier, Thomas; Ademuyiwa, Foluso; Kulkarni, Swati; Pylkäs, Katri; Jukkola-Vuorinen, Arja; Ko, Yon-Dschun; Van Limbergen, Erik; Janssen, Hilde; Peto, Julian; Fletcher, Olivia; Giles, Graham G.; Baglietto, Laura; Verhoef, Senno; Tomlinson, Ian; Kosma, Veli-Matti; Beesley, Jonathan; Greco, Dario; Blomqvist, Carl; Irwanto, Astrid; Liu, Jianjun; Blows, Fiona M.; Dawson, Sarah-Jane; Margolin, Sara; Mannermaa, Arto; Martin, Nicholas G.; Montgomery, Grant W; Lambrechts, Diether; dos Santos Silva, Isabel; Severi, Gianluca; Hamann, Ute; Pharoah, Paul; Easton, Douglas F.; Chang-Claude, Jenny; Yannoukakos, Drakoulis; Nevanlinna, Heli; Wang, Xianshu; Couch, Fergus J.

    2012-01-01

    Triple negative breast cancers are an aggressive subtype of breast cancer with poor survival, but there remains little known about the etiological factors which promote its initiation and development. Commonly inherited breast cancer risk factors identified through genome wide association studies (GWAS) display heterogeneity of effect among breast cancer subtypes as defined by estrogen receptor (ER) and progesterone receptor (PR) status. In the Triple Negative Breast Cancer Consortium (TNBCC), 22 common breast cancer susceptibility variants were investigated in 2,980 Caucasian women with triple negative breast cancer and 4,978 healthy controls. We identified six single nucleotide polymorphisms (SNPs) significantly associated with risk of triple negative breast cancer, including rs2046210 (ESR1), rs12662670 (ESR1), rs3803662 (TOX3), rs999737 (RAD51L1), rs8170 (19p13.11) and rs8100241 (19p13.11). Together, our results provide convincing evidence of genetic susceptibility for triple negative breast cancer. PMID:21844186

  18. Multilayer Antireflection Coating for Triple Junction Solar Cells

    International Nuclear Information System (INIS)

    Zhan Feng; Wang Hai-Li; He Ji-Fang; Wang Juan; Huang She-Song; Ni Hi-Qiao; Niu Zhi-Chuan

    2011-01-01

    According to the theory of optical films, we simulate the reflectivity of antireflection coatings (ARCs) for solar cells of Ga 0.5 In 0.5 P/GaAs/Ge based on an optical transfer matrix. In order to provide sufficient consideration of the refractive index dispersion effect of multilayer ARCs, we use multi-dimensional matrix data for reliable simulation. After the reflection curves are obtained, the effective average reflectance R e is introduced to optimize the film system by minimizing R e . Optimization of single layer (Al 2 O 3 ), double layer (MgF 2 /ZnS) and triple layer (MgF 2 /Al 2 O 3 /ZnS) ARCs is realized by using this method for space and terrestrial applications. Effects of these ARCs are compared after optimization. These theoretical parameters can be used to guide experiments. (condensed matter: electronic structure, electrical, magnetic, and optical properties)

  19. Double-membrane triple-electrolyte redox flow battery design

    Science.gov (United States)

    Yushan, Yan; Gu, Shuang; Gong, Ke

    2018-03-13

    A redox flow battery is provided having a double-membrane (one cation exchange membrane and one anion exchange membrane), triple-electrolyte (one electrolyte in contact with the negative electrode, one electrolyte in contact with the positive electrode, and one electrolyte positioned between and in contact with the two membranes). The cation exchange membrane is used to separate the negative or positive electrolyte and the middle electrolyte, and the anion exchange membrane is used to separate the middle electrolyte and the positive or negative electrolyte. This design physically isolates, but ionically connects, the negative electrolyte and positive electrolyte. The physical isolation offers great freedom in choosing redox pairs in the negative electrolyte and positive electrolyte, making high voltage of redox flow batteries possible. The ionic conduction drastically reduces the overall ionic crossover between negative electrolyte and positive one, leading to high columbic efficiency.

  20. Application of artificial intelligence to triple quadrupole mass spectrometry (TQMS)

    International Nuclear Information System (INIS)

    Wong, C.M.; Crawford, R.W.; Kehler, T.P.; Kunz, J.C.

    1984-01-01

    At Lawrence Livermore National Laboratory the authors have designed a totally computerized triple quadrupole mass spectrometer with the ultimate goal of using it as a prototype for ''knowledge-based'' instrument control. As an ''intelligent'' instrument, with its computer-based data acquisition and control system, it has the ability to learn and respond quickly. The intelligence is encoded in the system using the representation and rule-based reasoning heuristic techniques of Artificial Intelligence. These techniques are used to encode heuristic knowledge, or the intuition, formal and informal rules, and experiential knowledge that the human expert normally uses to make decisions and arrive at solutions in a specific domain problem. In this specific case, the knowledge the authors are encoding is a tuning procedure for the spectrometer, including heuristics to describe a self-adaptive, feedback control process for real-time optimization or tuning of the data acquisition procedure throughout the entire data collection process

  1. OPTIMIZING THE DYNAMIC APERTURE FOR TRIPLE BEND ACHROMATIC LATTICES

    International Nuclear Information System (INIS)

    KRAMER, S.L.; BENGTSSON, J.

    2006-01-01

    The Triple Bend Achromatic (TBA) lattice has the potential for lower natural emittance per period than the Double Bend Achromatic (DBA) lattice for high brightness light sources. However, the DBA has been chosen for 3rd generation light sources more often due to the higher number of undulator straight section available for a comparable emittance. The TBA has considerable flexibility in linear optics tuning while maintaining this emittance advantage. We have used the tune and chromaticity flexibility of a TBA lattice to minimize the lowest order nonlinearities to implement a 3rd order achromatic tune, while maintaining a constant emittance. This frees the geometric sextupoles to counter the higher order nonlinearities. This procedure is being used to improve the nonlinear dynamics of the TBA as a proposed lattice for NSLS-II facility. The flexibility of the TBA lattice will also provide for future upgrade capabilities of the beam parameters

  2. Prisoners of War of the Triple Alliance within Kazakhstan

    Directory of Open Access Journals (Sweden)

    Gulzhaukhar K. Kokebayeva

    2015-03-01

    Full Text Available The work studies the problem of the detention of prisoners of war of the Triple Alliance in the camps, located within Kazakhstan. During the first months of war, the Russian authorities treated the prisoners of war in accordance with ‘Convention on the Treatment of the Prisoners of War’, approved by the Emperor of Russia. The content of this document corresponded to the Hague Convention with Respect to the Laws and Customs of War on Land. The major areas of the detention of prisoners of war were Turkestan and Omsk Military Okrug, combining all military institutions of the Steppe Governorate General, including the ones of North-Eastern and Central Kazakhstan. The source base of the research is the materials of Kazakhstan and German archives, the recollections of the former prisoners of war and the published collections of documents and materials.

  3. Distinct microbiological signatures associated with triple negative breast cancer.

    Science.gov (United States)

    Banerjee, Sagarika; Wei, Zhi; Tan, Fei; Peck, Kristen N; Shih, Natalie; Feldman, Michael; Rebbeck, Timothy R; Alwine, James C; Robertson, Erle S

    2015-10-15

    Infectious agents are the third highest human cancer risk factor and may have a greater role in the origin and/or progression of cancers, and related pathogenesis. Thus, knowing the specific viruses and microbial agents associated with a cancer type may provide insights into cause, diagnosis and treatment. We utilized a pan-pathogen array technology to identify the microbial signatures associated with triple negative breast cancer (TNBC). This technology detects low copy number and fragmented genomes extracted from formalin-fixed paraffin embedded archival tissues. The results, validated by PCR and sequencing, define a microbial signature present in TNBC tissue which was underrepresented in normal tissue. Hierarchical clustering analysis displayed two broad microbial signatures, one prevalent in bacteria and parasites and one prevalent in viruses. These signatures demonstrate a new paradigm in our understanding of the link between microorganisms and cancer, as causative or commensal in the tumor microenvironment and provide new diagnostic potential.

  4. Triple F - A Comet Nucleus Sample Return Mission

    Science.gov (United States)

    Kueppers, Michael; Keller, Horst Uwe; Kuhrt, Ekkehard; A'Hearn, Michael; Altwegg, Kathrin; Betrand, Regis; Busemann, Henner; Capria, Maria Teresa; Colangeli, Luigi

    2008-01-01

    The Triple F (Fresh From the Fridge) mission, a Comet Nucleus Sample Return, has been proposed to ESA s Cosmic Vision program. A sample return from a comet enables us to reach the ultimate goal of cometary research. Since comets are the least processed bodies in the solar system, the proposal goes far beyond cometary science topics (like the explanation of cometary activity) and delivers invaluable information about the formation of the solar system and the interstellar molecular cloud from which it formed. The proposed mission would extract three samples of the upper 50 cm from three locations on a cometary nucleus and return them cooled to Earth for analysis in the laboratory. The simple mission concept with a touch-and-go sampling by a single spacecraft was proposed as an M-class mission in collaboration with the Russian space agency ROSCOSMOS.

  5. Triple M-brane configurations and preserved supersymmetries

    Energy Technology Data Exchange (ETDEWEB)

    Golubtsova, A.A., E-mail: siedhe@gmail.com [Institute of Gravitation and Cosmology, Peoples' Friendship University of Russia, 6 Miklukho-Maklaya Str., Moscow 117198 (Russian Federation); Laboratoire de Univers et Théories (LUTh), Observatoire de Paris, Place Jules Janssen 5, 92190 Meudon (France); Ivashchuk, V.D., E-mail: ivashchuk@mail.ru [Center for Gravitation and Fundamental Metrology, VNIIMS, 46 Ozyornaya Str., Moscow 119361 (Russian Federation); Institute of Gravitation and Cosmology, Peoples' Friendship University of Russia, 6 Miklukho-Maklaya Str., Moscow 117198 (Russian Federation)

    2013-07-21

    We investigate all standard triple composite M-brane intersections defined on products of Ricci-flat manifolds for preserving supersymmetries in eleven-dimensional N=1 supergravity. The explicit formulae for computing the numbers of preserved supersymmetries are obtained, which generalize the relations for topologically trivial flat factor spaces presented in the classification by Bergshoeff et al. We obtain certain examples of configurations preserving some fractions of supersymmetries, e.g. containing such factor spaces as K3, C{sub ⁎}{sup 2}/Z{sub 2}, a four-dimensional pp-wave manifold and the two-dimensional pseudo-Euclidean manifold R{sub ⁎}{sup 1,1}/Z{sub 2}.

  6. Hybrid Steepest-Descent Methods for Triple Hierarchical Variational Inequalities

    Directory of Open Access Journals (Sweden)

    L. C. Ceng

    2015-01-01

    Full Text Available We introduce and analyze a relaxed iterative algorithm by combining Korpelevich’s extragradient method, hybrid steepest-descent method, and Mann’s iteration method. We prove that, under appropriate assumptions, the proposed algorithm converges strongly to a common element of the fixed point set of infinitely many nonexpansive mappings, the solution set of finitely many generalized mixed equilibrium problems (GMEPs, the solution set of finitely many variational inclusions, and the solution set of general system of variational inequalities (GSVI, which is just a unique solution of a triple hierarchical variational inequality (THVI in a real Hilbert space. In addition, we also consider the application of the proposed algorithm for solving a hierarchical variational inequality problem with constraints of finitely many GMEPs, finitely many variational inclusions, and the GSVI. The results obtained in this paper improve and extend the corresponding results announced by many others.

  7. Triple inverter pierce oscillator circuit suitable for CMOS

    Science.gov (United States)

    Wessendorf,; Kurt, O [Albuquerque, NM

    2007-02-27

    An oscillator circuit is disclosed which can be formed using discrete field-effect transistors (FETs), or as a complementary metal-oxide-semiconductor (CMOS) integrated circuit. The oscillator circuit utilizes a Pierce oscillator design with three inverter stages connected in series. A feedback resistor provided in a feedback loop about a second inverter stage provides an almost ideal inverting transconductance thereby allowing high-Q operation at the resonator-controlled frequency while suppressing a parasitic oscillation frequency that is inherent in a Pierce configuration using a "standard" triple inverter for the sustaining amplifier. The oscillator circuit, which operates in a range of 10 50 MHz, has applications for use as a clock in a microprocessor and can also be used for sensor applications.

  8. Small angle neutron scattering using a triple axis spectrometer

    International Nuclear Information System (INIS)

    Ahmed, F.U.; Goyal, P.S.; Kamal, L.; Yunus, S.M.; Datta, T.K.; Rahman, M.O.; Azad, A.K.; Begum, S.; Zakaria, A.K.

    1994-01-01

    SANS techniques has been developed on a triple axis neutron spectrometer at TRIGA Mark II (3 MW) research reactor, AERE, Savar, Dhaka, Bangladesh. Double crystal (with very small mosaic spread ∼ 1 min.) diffraction known as Bonse and Hart's method has been employed. Such a device is a useful tool for small angle scattering in the Q range between 10 -5 and 10 -1 Angstroms -1 and for real time experiments at short time scales. Therefore, large objects and large distance interparticle correlations can be easily investigated. The results of SANS' measurements using alumina (A1 2 0 3 ) sample are presented. The radius of gyration has been determined and the data has been fitted to the scattering function of a sphere. 9 refs., 6 figs.,

  9. Gastric Metastasis of Triple Negative Invasive Lobular Carcinoma.

    Science.gov (United States)

    Geredeli, Caglayan; Dogru, Osman; Omeroglu, Ethem; Yilmaz, Farise; Cicekci, Faruk

    2015-05-05

    Invasive lobular carcinomas are the second most common type (5% to 15%) of invasive breast carcinomas. The most frequent sites of breast cancer metastasis are the local and distant lymph nodes, brain, lung, liver, and bones; metastasis to the gastrointestinal system, especially to the stomach, is rare. When a mass is detected in an unusual place in a patient with invasive lobular carcinoma, it should be kept in mind that such a mass may be either a second primary carcinoma or the metastasis of an invasive lobular carcinoma. In this report, we present a case of gastric metastasis from triple-negative invasive lobular breast cancer. It is important to make an accurate diagnosis by distinguishing gastric metastasis from breast cancer in order to select the best initial treatment for systemic diseases of breast cancer. Considering our case, healthcare professionals should take into account that cases with invasive lobular breast cancer may experience unusual metastases.

  10. Chaotic dynamics in the (47171) Lempo triple system

    Science.gov (United States)

    Correia, Alexandre C. M.

    2018-05-01

    We investigate the dynamics of the (47171) Lempo triple system, also known by 1999 TC36. We derive a full 3D N-body model that takes into account the orbital and spin evolution of all bodies, which are assumed triaxial ellipsoids. We show that, for reasonable values of the shapes and rotational periods, the present best fitted orbital solution for the Lempo system is chaotic and unstable in short time-scales. The formation mechanism of this system is unknown, but the orbits can be stabilised when tidal dissipation is taken into account. The dynamics of the Lempo system is very rich, but depends on many parameters that are presently unknown. A better understanding of this systems thus requires more observations, which also need to be fitted with a complete model like the one presented here.

  11. Triple-server blind quantum computation using entanglement swapping

    Science.gov (United States)

    Li, Qin; Chan, Wai Hong; Wu, Chunhui; Wen, Zhonghua

    2014-04-01

    Blind quantum computation allows a client who does not have enough quantum resources or technologies to achieve quantum computation on a remote quantum server such that the client's input, output, and algorithm remain unknown to the server. Up to now, single- and double-server blind quantum computation have been considered. In this work, we propose a triple-server blind computation protocol where the client can delegate quantum computation to three quantum servers by the use of entanglement swapping. Furthermore, the three quantum servers can communicate with each other and the client is almost classical since one does not require any quantum computational power, quantum memory, and the ability to prepare any quantum states and only needs to be capable of getting access to quantum channels.

  12. Fractal Based Triple Band High Gain Monopole Antenna

    Science.gov (United States)

    Pandey, Shashi Kant; Pandey, Ganga Prasad; Sarun, P. M.

    2017-10-01

    A novel triple-band microstrip fed planar monopole antenna is proposed and investigated. A fractal antenna is created by iterating a narrow pulse (NP) generator model at upper side of modified ground plane, which has a rhombic patch, for enhancing the bandwidth and gain. Three iterations are carried out to study the effects of fractal geometry on the antenna performance. The proposed antenna can operate over three frequency ranges viz, 3.34-4.8 GHz, 5.5-10.6 GHz and 13-14.96 GHz suitable for WLAN 5.2/5.8 GHz, WiMAX 3.5/5.5 GHz and X band applications respectively. Simulated and measured results are in good agreements with each others. Results show that antenna provides wide/ultra wide bandwidths, monopole like radiation patterns and very high antenna gains over the operating frequency bands.

  13. A triple GEM gamma camera for medical application

    Energy Technology Data Exchange (ETDEWEB)

    Anulli, F. [Laboratori Nazionali di Frascati INFN, Frascati (Italy); Balla, A. [Laboratori Nazionali di Frascati INFN, Frascati (Italy); Bencivenni, G. [Laboratori Nazionali di Frascati INFN, Frascati (Italy); Corradi, G. [Laboratori Nazionali di Frascati INFN, Frascati (Italy); D' Ambrosio, C. [Laboratori Nazionali di Frascati INFN, Frascati (Italy); Domenici, D. [Laboratori Nazionali di Frascati INFN, Frascati (Italy); Felici, G. [Laboratori Nazionali di Frascati INFN, Frascati (Italy); Gatta, M. [Laboratori Nazionali di Frascati INFN, Frascati (Italy); Morone, M.C. [Dipartimento di Biopatologia e Diagnostica per immagini, Universita di Roma Tor Vergata (Italy); INFN - Sezione di Roma Tor Vergata (Italy); Murtas, F. [Laboratori Nazionali di Frascati INFN, Frascati (Italy)]. E-mail: fabrizio.murtas@lnf.infn.it; Schillaci, O. [Dipartimento di Biopatologia e Diagnostica per immagini, Universita di Roma Tor Vergata (Italy)

    2007-03-01

    A Gamma Camera for medical applications 10x10cm{sup 2} has been built using a triple GEM chamber prototype. The photon converters placed in front of the three GEM foils, has been realized with different technologies. The chamber, High Voltage supplied with a new active divider made in Frascati, is readout through 64 pads, 1mm{sup 2} wide, organized in a row of 8cm long, with LHCb ASDQ chip. This Gamma Camera can be used both for X-ray movie and PET-SPECT imaging; this chamber prototype is placed in a scanner system, creating images of 8x8cm{sup 2}. Several measurements have been performed using phantom and radioactive sources of Tc99m(140keV) and Na22(511keV). Results on spatial resolution and image reconstruction are presented.

  14. Multistep Hybrid Extragradient Method for Triple Hierarchical Variational Inequalities

    Directory of Open Access Journals (Sweden)

    Zhao-Rong Kong

    2013-01-01

    Full Text Available We consider a triple hierarchical variational inequality problem (THVIP, that is, a variational inequality problem defined over the set of solutions of another variational inequality problem which is defined over the intersection of the fixed point set of a strict pseudocontractive mapping and the solution set of the classical variational inequality problem. Moreover, we propose a multistep hybrid extragradient method to compute the approximate solutions of the THVIP and present the convergence analysis of the sequence generated by the proposed method. We also derive a solution method for solving a system of hierarchical variational inequalities (SHVI, that is, a system of variational inequalities defined over the intersection of the fixed point set of a strict pseudocontractive mapping and the solution set of the classical variational inequality problem. Under very mild conditions, it is proven that the sequence generated by the proposed method converges strongly to a unique solution of the SHVI.

  15. Triple-Vessel Percutaneous Coronary Revascularization In Situs Inversus Dextrocardia

    Directory of Open Access Journals (Sweden)

    Nikolaos Kakouros

    2010-01-01

    Full Text Available Dextrocardia with situs inversus occurs in approximately one in 10,000 individuals of whom 20% have primary ciliary dyskinesia inherited as an autosomal recessive trait. These patients have a high incidence of congenital cardiac disease but their risk of coronary artery disease is similar to that of the general population. We report what is, to our knowledge, the first case of total triple-vessel coronary revascularization by percutaneous stent implantation in a 79-year-old woman with situs inversus dextrocardia. We describe the successful use of standard diagnostic and interventional guide catheters with counter rotation and transversely inversed image acquisition techniques. The case also highlights that the right precordial pain may represent cardiac ischemia in this population.

  16. Triple A (Allgrove) syndrome: an unusual association with syringomyelia

    Science.gov (United States)

    2013-01-01

    Triple A (Allgrove) syndrome was first described by Allgrove in 1978 in two pairs of siblings. Since then, about 100 cases have been reported, all of them displaying an autosomal recessive pattern of inheritance. Clinical picture is characterized by achalasia, alacrimia and ACTH-resistant adrenal failure. A progressive neurological syndrome including central, peripheral and autonomic nervous system impairment, and mild mental retardation is often associated. The triple A syndrome gene, designated AAAS, is localized on chromosome 12q13. It consists of 16 exons, encoding for a 546 aminoacid protein called ALADIN (Alacrimia-Achalasia-aDrenal Insufficiency Neurologic disorder). We report on a 13 year-old boy presenting with Addison’s disease, dysphagia, muscle weakness, excessive fatigue and recent onset gait ataxia. The analysis of the AAAS gene revealed a homozygous missense mutation in exon 12. It was a T > G transversion at nucleotide position 1224, resulting in a change of leucine at amino acid position 381 into arginine (Leu381Arg or L381R). Brain appearance was found normal at magnetic resonance imaging (MRI) and functional spectroscopy analysis showed normal levels of the main metabolites. Spine MRI showed a cystic cavity within the spinal cord (syringomyelia), localized between the sixth cervical vertebra and the first thoracic vertebra. Cerebellar tonsils descended 7 mm caudal to foramen magnum, consistently with a mild type 1 Chiari malformation. Mild posterior inter-vertebral disk protrusions were evident between T9 and T10 and between L4 and L5. To our knowledge, this is the first report describing type 1 Chiari malformation and multiple spinal cord abnormalities in a patient with Allgrove syndrome. PMID:23800107

  17. Triple-negative breast cancer: new perspectives for targeted therapies

    Directory of Open Access Journals (Sweden)

    Tomao F

    2015-01-01

    Full Text Available Federica Tomao,1 Anselmo Papa,2 Eleonora Zaccarelli,2 Luigi Rossi,2 Davide Caruso,2 Marina Minozzi,2 Patrizia Vici,3 Luigi Frati,4 Silverio Tomao21Department of Gynecology and Obstetrics, “Sapienza” University of Rome, Policlinico “Umberto I”, Rome, 2Department of Medico-Surgical Sciences and Biotechnologies, “Sapienza” University of Rome, Oncology Unit, Istituto Chirurgico Ortopedico Traumatologico, Latina, 3Division of Medical Oncology B, Regina Elena National Cancer Institute, Rome, Italy; 4Department of Molecular Medicine, “Sapienza” University of Rome, Policlinico “Umberto I”, Rome, ItalyAbstract: Breast cancer is a heterogeneous disease, encompassing a large number of entities showing different morphological features and having clinical behaviors. It has became apparent that this diversity may be justified by distinct patterns of genetic, epigenetic, and transcriptomic aberrations. The identification of gene-expression microarray-based characteristics has led to the identification of at least five breast cancer subgroups: luminal A, luminal B, normal breast-like, human epidermal growth factor receptor 2, and basal-like. Triple-negative breast cancer is a complex disease diagnosed by immunohistochemistry, and it is characterized by malignant cells not expressing estrogen receptors or progesterone receptors at all, and human epidermal growth factor receptor 2. Along with this knowledge, recent data show that triple-negative breast cancer has specific molecular features that could be possible targets for new biological targeted drugs. The aim of this article is to explore the use of new drugs in this particular setting, which is still associated with poor prognosis and high risk of distant recurrence and death.Keywords: basal-like breast cancer, estrogen–progesterone receptors, gene-expression microarray, human epidermal growth factor receptor 2, chemotherapy, target therapy

  18. Derivation of a triple mosaic adenovirus for cancer gene therapy.

    Directory of Open Access Journals (Sweden)

    Yizhe Tang

    2009-12-01

    Full Text Available A safe and efficacious cancer medicine is necessary due to the increasing population of cancer patients whose particular diseases cannot be cured by the currently available treatment. Adenoviral (Ad vectors represent a promising therapeutic medicine for human cancer therapy. However, several improvements are needed in order for Ad vectors to be effective cancer therapeutics, which include, but are not limited to, improvement of cellular uptake, enhanced cancer cell killing activity, and the capability of vector visualization and tracking once injected into the patients. To this end, we attempted to develop an Ad as a multifunctional platform incorporating targeting, imaging, and therapeutic motifs. In this study, we explored the utility of this proposed platform by generating an Ad vector containing the poly-lysine (pK, the herpes simplex virus type 1 (HSV-1 thymidine kinase (TK, and the monomeric red fluorescent protein (mRFP1 as targeting, tumor cell killing, and imaging motifs, respectively. Our study herein demonstrates the generation of the triple mosaic Ad vector with pK, HSV-1 TK, and mRFP1 at the carboxyl termini of Ad minor capsid protein IX (pIX. In addition, the functionalities of pK, HSV-1 TK, and mRFP1 proteins on the Ad vector were retained as confirmed by corresponding functional assays, indicating the potential multifunctional application of this new Ad vector for cancer gene therapy. The validation of the triple mosaic Ad vectors also argues for the ability of pIX modification as a base for the development of multifunctional Ad vectors.

  19. The TWA 3 Young Triple System: Orbits, Disks, Evolution

    Energy Technology Data Exchange (ETDEWEB)

    Kellogg, Kendra [Department of Physics and Astronomy, The University of Western Ontario, London, ON N6A 3K7 (Canada); Prato, L.; Avilez, I.; Wasserman, L. H.; Levine, S. E.; Bosh, A. S. [Lowell Observatory, 1400 West Mars Hill Road, Flagstaff, AZ 86001 (United States); Torres, Guillermo [Harvard-Smithsonian Center for Astrophysics, Cambridge, MA 02138 (United States); Schaefer, G. H. [The CHARA Array of Georgia State University, Mount Wilson Observatory, Mount Wilson, CA 91023 (United States); Ruíz-Rodríguez, D. [Research School of Astronomy and Astrophysics, Australian National University, Canberra, ACT 2611 (Australia); Bonanos, Alceste Z. [IAASARS, National Observatory of Athens, 15236 Penteli (Greece); Guenther, E. W. [Thüringer Landessternwarte Tautenburg, D-07778 Tautenburg (Germany); Neuhäuser, R. [Astrophysikalisches Institut und Universitäts-Sternwarte, FSU Jena, Schillergäßchen 2-3, D-07745 Jena (Germany); Morzinski, Katie M.; Close, Laird; Hinz, Phil; Males, Jared R. [Steward Observatory, University of Arizona, 933 N. Cherry Ave, Tucson, AZ 85721 (United States); Bailey, Vanessa, E-mail: kkellogg@uwo.ca, E-mail: lprato@lowell.edu [Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, Stanford University, Stanford, CA, 94305 (United States)

    2017-08-01

    We have characterized the spectroscopic orbit of the TWA 3A binary and provide preliminary families of probable solutions for the TWA 3A visual orbit, as well as for the wide TWA 3A–B orbit. TWA 3 is a hierarchical triple located at 34 pc in the ∼10 Myr old TW Hya association. The wide component separation is 1.″55; the close pair was first identified as a possible binary almost 20 years ago. We initially identified the 35-day period orbital solution using high-resolution infrared spectroscopy that angularly resolved the A and B components. We then refined the preliminary orbit by combining the infrared data with a reanalysis of our high-resolution optical spectroscopy. The orbital period from the combined spectroscopic solution is ∼35 days, the eccentricity is ∼0.63, and the mass ratio is ∼0.84; although this high mass ratio would suggest that optical spectroscopy alone should be sufficient to identify the orbital solution, the presence of the tertiary B component likely introduced confusion in the blended optical spectra. Using millimeter imaging from the literature, we also estimate the inclinations of the stellar orbital planes with respect to the TWA 3A circumbinary disk inclination and find that all three planes are likely misaligned by at least ∼30°. The TWA 3A spectroscopic binary components have spectral types of M4.0 and M4.5; TWA 3B is an M3. We speculate that the system formed as a triple, is bound, and that its properties were shaped by dynamical interactions between the inclined orbits and disk.

  20. [Immunohistochemical characteristics of triple negative/basal-like breast cancer].

    Science.gov (United States)

    Pala, Emel Ebru; Bayol, Ümit; Cumurcu, Süheyla; Keskın, Elif

    2012-01-01

    Triple-negative-breast-cancer that accounts for 10-20% of all breast carcinomas is defined by the lack of estrogen receptor, progesterone receptor, HER2 expression, and agressive clinical behavior. Triple-negative-breast-cancer is categorized into basal like and other types. The basal-like subtype is characterized by the expression of myoepithelial/basal markers. We studied 41 immunohistochemically triplenegative- breast-cancer patients to determine EGFR, Cytokeratine 5/6, p53, Ki67, GCDFP-15 expression profiles, HER2 and Chromosome 17 centromere gene status by fluorescence-in-situ-hybridization method. Histological type was invasive ductal carcinoma in 90.2% of the tumors. p53, Ki67, GCDFP-15 mean positivity rates were 55.6%, 51.7%, and 3.2%, respectively. GCDFP-15 positivity was noted in 8 cases of which 6 were Cytokeratine 5/6 negative. The cut-off value for Cytokeratine 5/6 positivity was 5%. EGFR immunoreactivity was grouped into 0, 1+ as negative; 2+, 3+ as positive categories. Cytokeratine 5/6 was positive in 56,1%, EGFR was positive in 51.2% of the patients. The relation between Cytokeratine 5/6 and EGFR expression was statistically significant (p < 0.01). None of the cases showed HER2 amplification by fluorescence-in-situ-hybridization method. GCDFP-15 alone is not a useful marker to detect the metastasis of basaloid type breast cancers. Cytokeratine 5/6 and EGFR expressions showed correlation so these markers are reliable to diagnose basaloid type tumors with a 5% cut-off value.

  1. A millisecond pulsar in a stellar triple system.

    Science.gov (United States)

    Ransom, S M; Stairs, I H; Archibald, A M; Hessels, J W T; Kaplan, D L; van Kerkwijk, M H; Boyles, J; Deller, A T; Chatterjee, S; Schechtman-Rook, A; Berndsen, A; Lynch, R S; Lorimer, D R; Karako-Argaman, C; Kaspi, V M; Kondratiev, V I; McLaughlin, M A; van Leeuwen, J; Rosen, R; Roberts, M S E; Stovall, K

    2014-01-23

    Gravitationally bound three-body systems have been studied for hundreds of years and are common in our Galaxy. They show complex orbital interactions, which can constrain the compositions, masses and interior structures of the bodies and test theories of gravity, if sufficiently precise measurements are available. A triple system containing a radio pulsar could provide such measurements, but the only previously known such system, PSR B1620-26 (refs 7, 8; with a millisecond pulsar, a white dwarf, and a planetary-mass object in an orbit of several decades), shows only weak interactions. Here we report precision timing and multiwavelength observations of PSR J0337+1715, a millisecond pulsar in a hierarchical triple system with two other stars. Strong gravitational interactions are apparent and provide the masses of the pulsar M[Symbol: see text](1.4378(13), where M[Symbol: see text]is the solar mass and the parentheses contain the uncertainty in the final decimal places) and the two white dwarf companions (0.19751(15)M[Symbol: see text] and 0.4101(3))M[Symbol: see text], as well as the inclinations of the orbits (both about 39.2°). The unexpectedly coplanar and nearly circular orbits indicate a complex and exotic evolutionary past that differs from those of known stellar systems. The gravitational field of the outer white dwarf strongly accelerates the inner binary containing the neutron star, and the system will thus provide an ideal laboratory in which to test the strong equivalence principle of general relativity.

  2. Topological regularizations of the triple collision singularity in the 3-vortex problem

    International Nuclear Information System (INIS)

    Hiraoka, Yasuaki

    2008-01-01

    The triple collision singularity in the 3-vortex problem is studied in this paper. Under the necessary condition k 1 -1 +k 2 -1 +k 3 -1 =0 for vorticities to have the triple collision, the main results are summarized as follows: (i) For k 1 = k 2 , the triple collision singularity is topologically regularizable. (ii) For 0 1 − k 2 | < ε with a sufficiently small ε, the triple collision singularity is not topologically regularizable. First of all, in order to prove these statements, all singularities in the 3-vortex problem are classified. Then, we introduce a dynamical system by blowing up the triple collision singularity with an appropriate time scaling. Roughly speaking, it corresponds to pasting an invariant manifold at the triple collision singularity on the original phase space. This technique is well known as McGehee's collision manifold (1974 Inventions Math. 27 191–227) in the N-body problem of celestial mechanics. Finally, by adopting the viewpoint of Easton (1971 J. Diff. Eqns 10 92–9), topological regularizations of the triple collision singularity are studied in detail

  3. Reliability of twin-dependent triple junction distributions measured from a section plane

    International Nuclear Information System (INIS)

    Hardy, Graden B.; Field, David P.

    2016-01-01

    Numerous studies indicate polycrystalline triple junctions are independent microstructural features with distinct properties from their constituent grain boundaries. Despite the influence of triple junctions on material properties, it is impractical to characterize triple junctions on a large scale using current three-dimensional methods. This work demonstrates the ability to characterize twin-dependent triple junction distributions from a section plane by adopting a grain boundary plane stereology. The technique is validated through simulated distributions and simulated electron back-scatter diffraction (EBSD) data. Measures of validation and convergence are adopted to demonstrate the quantitative reliability of the technique as well as the convergence behavior of twin-dependent triple junction distributions. This technique expands the characterization power of EBSD and prepares the way for characterizing general triple junction distributions from a section plane. - Graphical abstract: The distribution of planes forming a triple junction with a given twin boundary is shown partially in the stereographic projections below from a given projection. The plot on the left shows the ideal/measured distribution and the plot on the right shows the distribution obtained from the stereological method presented here.

  4. Interspecies and intraspecies transmission of triple reassortant H3N2 influenza A viruses

    OpenAIRE

    Lee Chang-Won; Al-Natour Mohammad Q; Yassine Hadi M; Saif Yehia M

    2007-01-01

    1. Abstract The triple reassortant H3N2 viruses were isolated for the first time from pigs in 1998 and are known to be endemic in swine and turkey populations in the United States. In 2004, we isolated two H3N2 triple reassortant viruses from two turkey breeder flocks in Ohio and Illinois. Infected hens showed no clinical signs, but experienced a complete cessation of egg production. In this study, we evaluated three triple reassortant H3N2 isolates of turkey origin and one isolate of swine o...

  5. Dirac operators and spectral triples for some fractal sets built on curves

    DEFF Research Database (Denmark)

    Christensen, Erik; Ivan, Cristina; Lapidus, Michel L.

    2008-01-01

    A spectral triple is an object which is described using an algebra of operators on a Hilbert space and an unbounded self-adjoint operator, called a Dirac operator. This model may be applied to the study of classical geometrical objects .The article contains a construction of a spectral triple ass...... associated to some classical fractal subsets of the plane, and it is demonstrated that you can read of many classical geometrical structures, such as distance, measure and Hausdorff dimension from the spectral triple....

  6. EURAMET.T-K7 Key Comparison of Water Triple-Point Cells

    Science.gov (United States)

    Peruzzi, A.; Bosma, R.; Kerkhof, O.; Rosenkranz, P.; Del Campo Maldonado, M. D.; Strnad, R.; Nielsen, J.; Anagnostou, M.; Veliki, T.; Zvizdic, D.; Grudnewicz, E.; Nedea, M.; Neagu, D. M.; Steur, P.; Filipe, E.; Lobo, I.; Antonsen, I.; Renaot, E.; Heinonen, M.; Weckstrom, T.; Bojkovski, J.; Turzo-Andras, E.; Nemeth, S.; White, M.; Tegeler, E.; Dobre, M.; Duris, S.; Kartal Dogan, A.; Uytun, A.; Augevicius, V.; Pauzha, A.; Pokhodun, A.; Simic, S.

    2011-12-01

    The results of a EURAMET key comparison of water triple-point cells (EURAMET.T-K7) are reported. The equipment used, the measuring conditions applied, and the procedures adopted for the water triple-point measurement at the participating laboratories are synthetically presented. The definitions of the national reference for the water triple-point temperature adopted by each laboratory are disclosed. The multiplicity of degrees of equivalence arising for the linking laboratories with respect to the "mother" comparison CCT-K7 is discussed in detail.

  7. Recovery by triple junction motion in aluminium deformed to ultrahigh strains

    DEFF Research Database (Denmark)

    Yu, Tianbo; Hansen, Niels; Huang, Xiaoxu

    2011-01-01

    during plastic deformation and decreases during isochronal and isothermal annealing. Based on TEM and EBSD observations, thermally activated triple junction motion is identified as the key process during the recovery of highly strained aluminium, leading to the removal of thin lamellae with small...... dihedral angles at the ends and structural coarsening. A mechanism for recovery by triple junction motion is proposed, which can underpin the general observation that a lamellar structure formed by plastic deformation during annealing can evolve into an equiaxed structure, preceding further structural...... coarsening and recrystallization. Within this framework, the grain boundary surface tension on triple junctions is discussed based on the structural parameters characterizing the deformed and annealed microstructure....

  8. ACA and the Triple Aim: Musings of a Health Care Actuary.

    Science.gov (United States)

    McCarthy, Mac

    2015-01-01

    In 2008, the Institute for Healthcare Improvement (IHI) promulgated the Triple Aim, which advocates simultaneous improvements in patient experiences, improved population health and lower cost per capita. In 2010, the Patient Protection and Affordable Care Act (ACA) promised quality, affordable health care for all Americans. It's fair to assume that the framers of ACA were aware of the Triple Aim, and it is likely that much of ACA was heavily influenced by IHI's positions. So it is reasonable, from time to time, to assess ACA's impact on health care against the Triple Aim principles.

  9. Triple-phase enhanced MSCT in evaluating solitary pulmonary nodules

    International Nuclear Information System (INIS)

    Zhang Jin'e; Zhao Zhenjun; Liang Changhong; He Hui; Zhang Jia; Ru Guangteng

    2005-01-01

    Objective: An evaluation of the triple-phase enhanced MSCT in the assessment of solitary pulmonary nodules (SPN). Methods: Prospective study was made on 102 SPN using triple-phase enhanced MSCT, and the net elevation of the CT value of nodules as well as the neoplastic blood vessels were assessed. In total 102 patients were enrolled, including 63 males and 39 females, aged from 17 to 87 years (57.2 years in average). The nodules sized from 2.1 to 4.0 cm (3.3cm in average). Pulmonary carcinoma was proved in 71 cases and benign SPN in 31 cases(including 11 inflammatory pseudo tumors, 6 tuberculosis, 3 inflammatory granulomas, 3 lesions of acute nonspecific inflammation, 3 hamartomas, 3 mycosis and 2 abscesses). The spiral scan was performed on an 8-row detector spiral CT (GE/light speed Qx/I Extra) with 5mm/4 slices. The scan time was 1 second per circle. The 5mm sliced imaging was done for CT value measurement and 1.25mm sliced imaging was for MPR(multiplanar reconstruction) or VR(volume rendering), 20ml Ultravist(300 mg/I) was administered at first at a rate of 4ml/s via forearm superficial vein by a power injector. The peak CT values in pulmonary artery and aorta were to determine the delay time for the acquisition in pulmonary phase and aortal phase. Then Ultravist in a volume of lml/ body kilogram was injected, followed by 50 ml of sodium chloride. Delay phase was 3 minutes. Results: The differences of net increased CT value in three phases were statistically significant respectively between lung cancer and benign nodules (F=30.668, 4.495 and 56.141, respectively, P=0.000, 0.036 and 0. 000, respectively). When the net increased CT value≥20 HU was set as a diagnostic threshold, the sensitivity, specificity, positive predict value, negative predict value and veracity were 93%, 29%, 75%, 64.3% and 73.5%. When net increased CT value ≥20 HU in aortal phase while net increased CT value < 20 HU in pulmonary phase was set as a di- agnostic threshold, those values

  10. Experimental lamellar keratoplasty in rabbits using microfibrilar cellulose membrane: clinical, morphological and immunohistochemical findings Ceratoplastia lamelar experimental em coelhos usando membrana microfibrilar de celulose: achados clínicos, morfológicos e imunoistoquímicos

    Directory of Open Access Journals (Sweden)

    Luciana Riacciardi Macedo

    2010-02-01

    Full Text Available The clinical, histopathological and immunohistochemical features of the cornea were investigated in adult male New Zealand rabbits submitted to lamellar keratoplasty with microfibrillar cellulose membrane. Thirty animals were divided into five groups (n=6 and evaluated up to 60 days after surgery. Clinical examination revealed moderate manifestations of edema, blepharospasm and photophobia on the second day, which became mild or disappeared after the seventh day. This period was characterized clinically by repair of the corneal defect. Histopathological analysis showed the presence of a thin layer of squamous cells covering the damaged area as early as 7th day, accompanied by a mild infiltrate of polymorphonuclear cells. Blood vessels were observed in the epithelium after the 15th day, which had regressed by day 48. Ki67 antibody labeling showed an increase of proliferating cells in the epithelium by the 15th day and in the stroma by day 30. Remodeling and epithelial adhesion were observed during this period. Microfibrillar cellulose membrane (Bionext® used for lamellar keratoplasty was found to yield good results considering the good integration of the implant.Avaliaram-se aspectos clínicos, histopatógicos e imunoistoquímicos da córnes de coelhos da raça Nova Zelândia adultos e machos em ceratoplastias lamelares com membrana de celulose microfibrilar. Trinta animais distribuídos em cinco grupos (n=6 foram estudados por até 60 dias de pós-operatório. A avaliação clínica revelou manifestações moderadas de edema, blefaroespasmo e fotofobia ao segundo dia, evoluindo para formas discretas ou ausentes a partir do sétimo dia, período em que se observou, clinicamente, reparo do defeito corneal. A histopatologia revelou uma fina camada de células escamosas, recobrindo a área lesada já aos sete dias, com discreto infiltrado de células polimorfonucleares. Observaram-se vasos no epitélio a partir do 15o dia, com regressão ao 48o dia

  11. New - Nucleus - NucNet. The ENS triple communication system

    Energy Technology Data Exchange (ETDEWEB)

    Feuz, Peter [ENS and NucNet (Belgium); Holt, Peter [Nuclear Europe Worldscan and Nucleus (Belgium)

    1993-07-01

    The ENS triple communication system was built up as a step-by-step response to practical needs. In fact the triple communication system has the fourth issue, namely WINFO. Nuclear Europe was started in 1981 with three pilot issues. Now, Nuclear Europe Worldscan has become an integrator, between over 20 000 members of ENS Member Societies, from the Atlantic to the Urals and beyond; an integrator between Europe and the rest-of-the world nuclear community; between industry and science and engineering; between the bosses and the staff; and finally, an integrator between the nuclear community and those outsiders who take an interest in nuclear issues. Nucleus started in 1987, selected by the ENS Steering Committee for as the most worthwhile for transferring messages from nuclear community to the politicians and opinion-leaders, i.e. to non-technical outsiders. It is a briefing sheet for people who work with key policy principles, politicians and journalists. It is designed and written for people having no time to read. The keys to each two-page Nucleus are headlines. Nucleus appears in English, French, Croatian, Russian, Dutch, Hungarian, Romanian and Finnish. When the need grew really urgent for Europe, the ENS Information Committee proposed a feasibility study, which the European nuclear community entrusted to ENS in 1989. NucNet was launched in January 1991 - first as a European, and later as a truly worldwide, communications system. NucNet is the worldwide network which circulates nuclear news and information that the public should be informed of, written in a language that the public can easily understand. NucNet is highly appreciated, for instance, by NPP managers because they are informed about incidents faster than by any other means. But, NucNet is not merely an incident reporting system. (As a general rule, the network only reports on incidents in nuclear plants if they are rated at level 2 or above on the IAEA's International Nuclear Event Scale). The more

  12. New - Nucleus - NucNet. The ENS triple communication system

    International Nuclear Information System (INIS)

    Feuz, Peter; Holt, Peter

    1993-01-01

    The ENS triple communication system was built up as a step-by-step response to practical needs. In fact the triple communication system has the fourth issue, namely WINFO. Nuclear Europe was started in 1981 with three pilot issues. Now, Nuclear Europe Worldscan has become an integrator, between over 20 000 members of ENS Member Societies, from the Atlantic to the Urals and beyond; an integrator between Europe and the rest-of-the world nuclear community; between industry and science and engineering; between the bosses and the staff; and finally, an integrator between the nuclear community and those outsiders who take an interest in nuclear issues. Nucleus started in 1987, selected by the ENS Steering Committee for as the most worthwhile for transferring messages from nuclear community to the politicians and opinion-leaders, i.e. to non-technical outsiders. It is a briefing sheet for people who work with key policy principles, politicians and journalists. It is designed and written for people having no time to read. The keys to each two-page Nucleus are headlines. Nucleus appears in English, French, Croatian, Russian, Dutch, Hungarian, Romanian and Finnish. When the need grew really urgent for Europe, the ENS Information Committee proposed a feasibility study, which the European nuclear community entrusted to ENS in 1989. NucNet was launched in January 1991 - first as a European, and later as a truly worldwide, communications system. NucNet is the worldwide network which circulates nuclear news and information that the public should be informed of, written in a language that the public can easily understand. NucNet is highly appreciated, for instance, by NPP managers because they are informed about incidents faster than by any other means. But, NucNet is not merely an incident reporting system. (As a general rule, the network only reports on incidents in nuclear plants if they are rated at level 2 or above on the IAEA's International Nuclear Event Scale). The more

  13. Two-week, high-dose proton pump inhibitor, moxifloxacin triple Helicobacter pylori therapy after failure of standard triple or non-bismuth quadruple treatments.

    Science.gov (United States)

    Gisbert, Javier P; Romano, Marco; Molina-Infante, Javier; Lucendo, Alfredo J; Medina, Enrique; Modolell, Inés; Rodríguez-Tellez, Manuel; Gomez, Blas; Barrio, Jesús; Perona, Monica; Ortuño, Juan; Ariño, Inés; Domínguez-Muñoz, Juan Enrique; Perez-Aisa, Ángeles; Bermejo, Fernando; Domínguez, Jose Luis; Almela, Pedro; Gomez-Camarero, Judith; Millastre, Judith; Martin-Noguerol, Elisa; Gravina, Antonietta G; Martorano, Marco; Miranda, Agnese; Federico, Alessandro; Fernandez-Bermejo, Miguel; Angueira, Teresa; Ferrer-Barcelo, Luis; Fernández, Nuria; Marín, Alicia C; McNicholl, Adrián G

    2015-02-01

    Aim was to evaluate the efficacy and tolerability of a moxifloxacin-containing second-line triple regimen in patients whose previous Helicobacter pylori eradication treatment failed. Prospective multicentre study including patients in whom a triple therapy or a non-bismuth-quadruple-therapy failed. Moxifloxacin (400mg qd), amoxicillin (1g bid), and esomeprazole (40 mg bid) were prescribed for 14 days. Eradication was confirmed by (13)C-urea-breath-test. Compliance was determined through questioning and recovery of empty medication envelopes. 250 patients were consecutively included (mean age 48 ± 15 years, 11% with ulcer). Previous (failed) therapy included: standard triple (n = 179), sequential (n = 27), and concomitant (n = 44); 97% of patients took all medications, 4 were lost to follow-up. Intention-to-treat and per-protocol eradication rates were 82.4% (95% CI, 77-87%) and 85.7% (95% CI, 81-90%). Cure rates were similar independently of diagnosis (ulcer, 77%; dyspepsia, 82%) and previous treatment (standard triple, 83%; sequential, 89%; concomitant, 77%). At multivariate analysis, only age was associated with eradication (OR = 0.957; 95% CI, 0.933-0.981). Adverse events were reported in 25.2% of patients: diarrhoea (9.6%), abdominal pain (9.6%), and nausea (9.2%). 14-day moxifloxacin-containing triple therapy is an effective and safe second-line strategy in patients whose previous standard triple therapy or non-bismuth quadruple (sequential or concomitant) therapy has failed, providing a simple alternative to bismuth quadruple regimen. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  14. Optimization of elliptic neutron guides for triple-axis spectroscopy

    International Nuclear Information System (INIS)

    Janoschek, M.; Boeni, P.; Braden, M.

    2010-01-01

    In the last decade the performance of neutron guides for the transport of neutrons has been significantly increased. The most recent developments have shown that elliptic guide systems can be used to focus neutron beams while simultaneously reducing the number of neutron reflections, hence, leading to considerable gains in neutron flux. We have carried out Monte-Carlo simulations for a new triple-axis spectrometer that will be built at the end position of the conventional cold guide NL-1 in the neutron guide hall of the research reactor FRM-II in Munich, Germany. Our results demonstrate that an elliptic guide section at the end of a conventional guide can be used to at least maintain the total neutron flux onto the sample, while significantly improving the energy resolution of the spectrometer. The simulation further allows detailed insight how the defining parameters of an elliptic guide have to be chosen to obtain optimum results. Finally, we show that the elliptic guide limits losses in the neutron flux that generally arise at the gaps, where the monochromator system of the upstream instrument is situated.

  15. Triple synchronous cancers. A medical and ethical problem

    International Nuclear Information System (INIS)

    Debevec, L.; Cesar, R.; Kern, I.

    2007-01-01

    In a patient with suspicious synchronous multiple tumours, there are limited possibilities for effective therapy. Therefore, the decision for invasive diagnostics and precise staging of tumours is questionable, especially in elderly patients suitable only for symptomatic therapy. A 78-year-old man with hypertension and angina pectoris was admitted to the hospital due to syncope. Two primary lung tumours and a kidney tumour were detected by imaging investigation. The patient refused invasive diagnostics and left the hospital. After 19 months he was readmitted in an impaired clinical condition and subsequently died of bronchopneumonia. The autopsy revealed squamous cell carcinoma of the right upper lobe with metastases to regional lymph nodes and to the brain, small-cell carcinoma of the left upper lobe with metastases to regional lymph nodes and to the spleen, and clear-cell kidney carcinoma with multiple metastases to the lungs. All tumours were necrotizing, and therefore we assumed that any attempt at specific therapy would have been ineffective. In an elderly patient with advanced lung tumors and suspicious synchronous triple cancers, the ''wait and see'' option can be suitable. (author)

  16. Performance of a Horizontal Triple Cylinder Type Pulping Machine

    Directory of Open Access Journals (Sweden)

    Sukrisno Widyotomo

    2011-05-01

    Full Text Available Pulping is one important step in wet coffee processing method. Pulping process usually uses a machine which constructed by wood or metal materials. A horizontal single cylinder type of fresh coffee cherries pulping machine is the most popular machine in coffee processing. One of the weaknesses of a horizontal single cylinder type of fresh coffee cherries pulping machine is higher in broken beans. Broken bean is one of mayor aspects in defect system that contribute to low quality. Indonesian Coffee and Cocoa Research Institute has designed and tested a horizontal double cylinder type of fresh coffee cherries pulping machine which resulted in 12.6—21.4% of broken beans. To reduce percentage of broken beans, Indonesian Coffee and Cocoa Research Institute has developed and tested a horizontal triple cylinder type of fresh coffee cherries pulping machine. Material tested was fresh mature Robusta coffee cherries, 60—65% (wet basis moisture content; has classified on 3 levels i.e. unsorted, small and medium, and clean from metal and foreign materials. The result showed that the machine produced 6,340 kg/h in optimal capacity for operational conditions, 1400 rpm rotor rotation speed for unsorted coffee cherries with composition 55.5% whole parchment coffee, 3.66% broken beans, and 1% beans in wet skin.Key words : coffee, pulp, pulper, cylinder, quality.

  17. BIPM project: Intercomparison of water triple-point cells

    Science.gov (United States)

    Chattle, M. V.; Butler, J.

    1994-12-01

    The paper presents the results of an intercomparison between 3 triple point of water cells circulated by the Bureau International des Poids et Measures (BIPM), and a cell which is one of those used as a reference cell at the National Physical Laboratory (NPL). All 4 cells were prepared, stored and measured in the manner normally adopted at NPL. The results of the intercomparison show that over the course of about 6 weeks the temperatures of the 3 circulated cells generally agreed within 0.20 mK, with a maximum difference of 0.27(7) mK. Over the same period, the total variations of temperature measured in the 3 individual cells were 0.04 mK, 0.08 mK and 0.18 mK, respectively; the NPL cell varied by 0.10 mK. Gallium point measurements made over a similar period confirmed that these differences were partly due to small drifts in the thermometer resistance or in the measuring system.

  18. Triple Bioluminescence Imaging for In Vivo Monitoring of Cellular Processes

    Directory of Open Access Journals (Sweden)

    Casey A Maguire

    2013-01-01

    Full Text Available Bioluminescence imaging (BLI has shown to be crucial for monitoring in vivo biological processes. So far, only dual bioluminescence imaging using firefly (Fluc and Renilla or Gaussia (Gluc luciferase has been achieved due to the lack of availability of other efficiently expressed luciferases using different substrates. Here, we characterized a codon-optimized luciferase from Vargula hilgendorfii (Vluc as a reporter for mammalian gene expression. We showed that Vluc can be multiplexed with Gluc and Fluc for sequential imaging of three distinct cellular phenomena in the same biological system using vargulin, coelenterazine, and D-luciferin substrates, respectively. We applied this triple imaging system to monitor the effect of soluble tumor necrosis factor-related apoptosis-inducing ligand (sTRAIL delivered using an adeno-associated viral vector (AAV on brain tumors in mice. Vluc imaging showed efficient sTRAIL gene delivery to the brain, while Fluc imaging revealed a robust antiglioma therapy. Further, nuclear factor-κB (NF-κB activation in response to sTRAIL binding to glioma cells death receptors was monitored by Gluc imaging. This work is the first demonstration of trimodal in vivo bioluminescence imaging and will have a broad applicability in many different fields including immunology, oncology, virology, and neuroscience.

  19. Temozolomide Enhances Triple-Negative Breast Cancer Virotherapy In Vitro

    Directory of Open Access Journals (Sweden)

    Rodolfo Garza-Morales

    2018-05-01

    Full Text Available Triple-negative breast cancer (TNBC is one of the most aggressive types of cancer, and treatment is limited to chemotherapy and radiation. Oncolytic virotherapy may be a promising approach to treat TNBC. However, oncolytic adenovirus (OAd-based mono-therapeutic clinical trials have resulted in modest outcomes. The OAd potency could be increased by chemotherapy-induced autophagy, an intracellular degradation system that delivers cytoplasmic constituents to the lysosome. In this study, the ability of alkylating agent temozolomide (TMZ-induced autophagy to increase OAd replication and oncolysis in TNBC cells was evaluated. Human TNBC MDA-MB-231 and HCC1937 cells and mouse 4T1 cells were infected with an OAd expressing the red fluorescent protein mCherry on the virus capsid (OAdmCherry alone or in combination with TMZ. TNBC cells treated with OAdmCherry/TMZ displayed greater mCherry and adenovirus (Ad early region 1A (E1A expression and enhanced cancer-cell killing compared to OAdmCherry or TMZ alone. The combined therapy-mediated cell death was associated with virus replication and accumulation of the autophagy marker light chain 3 (LC3-II. Overall, this study provides experimental evidence of TMZ’s ability to increase oncolytic virotherapy in both human and murine TNBC cells.

  20. Triple negative breast cancer: new therapeutic approaches and BRCA status.

    Science.gov (United States)

    Guney Eskiler, Gamze; Cecener, Gulsah; Egeli, Unal; Tunca, Berrin

    2018-05-01

    Treatment of triple negative breast cancer (TNBC) is a clinically challenging problem due to intriguing clinical and pathologic features of TNBC and natural or induced resistance to existing therapies. However, a great understanding of features of TNBC particularly associated with BRCA mutations has led to the development of different therapeutic approaches. Besides, identification of TNBC subtypes contribute to investigation of the underlying molecular differences and development of new strategies for the treatment of TNBC patients. In this review, we discussed the definition and characteristic properties of TNBC. We summarized an up-to-date description of the reported clinical trials of novel targeted strategies especially PARP inhibitors (PARPi) due to novel and highly potent for the treatment of TNBC. Additionally, we reviewed published studies which investigated the prevalence and types of BRCA1/2 mutation in breast cancer patients to assess and draw attention of association of BRCA status with TNBC. Consequently, the definition subtype of TNBC has important predictive value for the development of new therapeutic agents in the treatment of TNBC. Additionally, the incidence and types of mutations in BRCA-related pathways may be affected by ethnic origin and contribute to the risk of developing TNBC. © 2018 APMIS. Published by John Wiley & Sons Ltd.

  1. 12 loops and triple wrapping in ABJM theory from integrability

    International Nuclear Information System (INIS)

    Anselmetti, Lorenzo; Bombardelli, Diego; Cavaglià, Andrea; Tateo, Roberto

    2015-01-01

    Adapting a method recently proposed by C. Marboe and D. Volin for N=4 super-Yang-Mills, we develop an algorithm for a systematic weak coupling expansion of the spectrum of anomalous dimensions in the sl(2)-like sector of planar N=6 super-Chern-Simons. The method relies on the Quantum Spectral Curve formulation of the problem and the expansion is written in terms of the interpolating function h(λ), with coefficients expressible as combinations of Euler-Zagier sums with alternating signs. We present explicit results up to 12 loops (six nontrivial orders) for various twist-1 and twist-2 operators, corresponding to triple and double wrapping terms, respectively, which are beyond the reach of the Asymptotic Bethe Ansatz as well as Lüscher’s corrections. The algorithm works for generic states in this sector and in principle can be used to compute arbitrary orders of the weak coupling expansion. For the simplest operator with L=1 and spin S=1, the Padé extrapolation of the 12-loop result nicely agrees with the available Thermodynamic Bethe Ansatz data in a relatively wide range of values of the coupling. A Mathematica notebook with a selection of results is attached.

  2. Numerical simulation of triple concentric-tube heat exchangers

    Energy Technology Data Exchange (ETDEWEB)

    Garcia-Valladares, O. [Centro de Investigacion en Energia (CIE), Universidad Nacional Autonoma de Mexico (UNAM), Privada Xochicalco S/N, Temixco, 62580, Morelos (Mexico)

    2004-10-01

    A detailed one-dimensional steady and transient numerical simulation of the thermal and fluid-dynamic behaviour of triple concentric-tube heat exchangers has been developed. The governing equations (continuity, momentum and energy) inside the inner tube and the annulus (inner and outer), together with the energy equations in the inner, intermediate and outermost tube wall and insulation, are solved iteratively in a segregated manner. The discretized governing equations in the zones with fluid flow are coupled using an implicit step by step method. This formulation requires the use of empirical information for the evaluation of convective heat transfer, shear stress and void fraction. An implicit central difference numerical scheme and a line-by-line solver was used in the inner and intermediate tube walls and the outermost tube wall with insulation. All the flow variables (enthalpies, temperatures, pressures, mass fractions, velocities, heat fluxes, etc.) together with the thermophysical properties are evaluated at each point of the grid in which the domain is discretized. Different numerical aspects and comparisons with results obtained from the technical literature are presented in order to verify and validate the model. (authors)

  3. Clinical Characteristics in Patients with Triple Negative Breast Cancer

    Directory of Open Access Journals (Sweden)

    Janet Yeh

    2017-01-01

    Full Text Available Purpose. The purpose of this study was to compare and contrast the clinical characteristics of the triple negative breast cancer (TNBC and non-TNBC patients, with a particular focus on genetic susceptibility and risk factors prior to diagnosis. Methods. Our institutional database was queried for all patients diagnosed with invasive breast cancer between January 2010 and May 2016. Results. Out of a total of 1964 patients, 190 (10% patients had TNBC. The median age for both TNBC and non-TNBC was 59 years. There was a significantly higher proportion of African American and Asian patients with TNBC (p=0.0003 compared to patients with non-TNBC. BRCA1 and BRCA2 were significantly associated with TNBC (p<0.0001, p=0.0007. A prior history of breast cancer was significantly associated with TNBC (p=0.0003. There was no relationship observed between TNBC and a history of chemoprevention or patients who had a history of AH or LCIS. Conclusions. We found that having Asian ancestry, a prior history of breast cancer, and a BRCA1 or BRCA2 mutation all appear to be positively associated with TNBC. In order to develop more effective treatments, better surveillance, and improved prevention strategies, it is necessary to improve our understanding of the population at risk for TNBC.

  4. Triple valve endocarditis by mycobacterium tuberculosis. A case report

    Directory of Open Access Journals (Sweden)

    Shaikh Quratulain

    2012-09-01

    Full Text Available Abstract Background Granulomas caused by Mycobacterium Tuberculosis have been observed at autopsy in the heart, pre-dominantly in the myocardium and endocardium, but rarely involving the coronary vessels and valvular structures. Mycobacterium tuberculosis valvular endocarditis is extremely rare, with most reports coming from autopsy series. Case presentation We report the case of a 17 year old immunocompetent girl who presented with history of fever, malaise, foot gangrene and a left sided hemiparesis. On investigation she was found to have infective endocarditis involving the aortic, mitral and tricuspid valves. She had developed a right middle cerebral artery stroke. She underwent dual valve replacement and tricuspid repair. The vegetations showed granulomatous inflammation but blood cultures and other biological specimen cultures were negative for any organisms. She was started on antituberculous treatment and anticoagulation. Conclusion This is the first reported case of triple valve endocarditis by Mycobacterium Tuberculosis in an immunocompetent host. Especially important is the fact that the right heart is involved which has been historically described in the setting of intravenous drug abuse. This implies that Tuberculosis should be considered in cases of culture negative endocarditis in endemic areas like Pakistan even in immunocompetent hosts.

  5. MCNP analysis and optimization of a triple crystal phoswich detector

    CERN Document Server

    Childress, N L

    2002-01-01

    Researchers at the University of Missouri-Columbia have designed a triple crystal phoswich detector that allows for simultaneous detection of alpha, beta, and gamma radiation. A ZnS:Ag layer detects alpha particles, a CaF sub 2 :Eu scintillator preferentially interacts with beta particles, and a NaI:Tl cell is used for gamma detection. The detector output is digitally collected, processed, and analyzed by a personal computer using custom software. Monte Carlo N-Particle version 4C simulations of this detector found that the phoswich design has inherent minimum energy limits of 250 keV E sub m sub a sub x for beta particles and 50 keV for gamma-rays. For a 2.54 cm thick NaI:Tl crystal, intrinsic gamma efficiency for photons ranges from a maximum of 80% at 100 keV to 26% for 2 MeV photons. Mischaracterized gamma events in the CaF sub 2 :Eu crystal above 175 keV can be corrected by subtracting 26+-4% of the total number of counts in the NaI:Tl crystal from the CaF sub 2 :Eu response. Beta induced events in the N...

  6. Motifs in triadic random graphs based on Steiner triple systems

    Science.gov (United States)

    Winkler, Marco; Reichardt, Jörg

    2013-08-01

    Conventionally, pairwise relationships between nodes are considered to be the fundamental building blocks of complex networks. However, over the last decade, the overabundance of certain subnetwork patterns, i.e., the so-called motifs, has attracted much attention. It has been hypothesized that these motifs, instead of links, serve as the building blocks of network structures. Although the relation between a network's topology and the general properties of the system, such as its function, its robustness against perturbations, or its efficiency in spreading information, is the central theme of network science, there is still a lack of sound generative models needed for testing the functional role of subgraph motifs. Our work aims to overcome this limitation. We employ the framework of exponential random graph models (ERGMs) to define models based on triadic substructures. The fact that only a small portion of triads can actually be set independently poses a challenge for the formulation of such models. To overcome this obstacle, we use Steiner triple systems (STSs). These are partitions of sets of nodes into pair-disjoint triads, which thus can be specified independently. Combining the concepts of ERGMs and STSs, we suggest generative models capable of generating ensembles of networks with nontrivial triadic Z-score profiles. Further, we discover inevitable correlations between the abundance of triad patterns, which occur solely for statistical reasons and need to be taken into account when discussing the functional implications of motif statistics. Moreover, we calculate the degree distributions of our triadic random graphs analytically.

  7. Triple Modular Redundancy verification via heuristic netlist analysis

    Directory of Open Access Journals (Sweden)

    Giovanni Beltrame

    2015-08-01

    Full Text Available Triple Modular Redundancy (TMR is a common technique to protect memory elements for digital processing systems subject to radiation effects (such as in space, high-altitude, or near nuclear sources. This paper presents an approach to verify the correct implementation of TMR for the memory elements of a given netlist (i.e., a digital circuit specification using heuristic analysis. The purpose is detecting any issues that might incur during the use of automatic tools for TMR insertion, optimization, place and route, etc. Our analysis does not require a testbench and can perform full, exhaustive coverage within less than an hour even for large designs. This is achieved by applying a divide et impera approach, splitting the circuit into smaller submodules without loss of generality, instead of applying formal verification to the whole netlist at once. The methodology has been applied to a production netlist of the LEON2-FT processor that had reported errors during radiation testing, successfully showing a number of unprotected memory elements, namely 351 flip-flops.

  8. Triple test cross analysis for salinity tolerance in wheat

    International Nuclear Information System (INIS)

    Zafar, M.; Khan, A.S.; Chowdhry, M.A.

    2008-01-01

    Triple test cross analysis applied to study additive, dominance and epistatic components of genetic variation for five seedling traits namely shoot length, fresh shoot weight, root length, fresh root weight and root shoot ratio at two salinity levels 0 (control) and 10 dSm/sup -1/ in wheat. The results revealed that the epistatic component is an important element for salinity tolerance at seedling stage in wheat. Both additive and dominance gene effects were involved in the inheritance of shoot length, fresh shoot weight, root length fresh root weight and root shoot ratio Complete dominance was indicated for shoot length, fresh root weight and root/shoot ratio and partial dominance was observed for other traits at control and over dominance was observed for shoot length, fresh shoot weight and root/shoot ratio, complete dominance for fresh root weight and partial dominance for root length at 10 dSm/sup -1/ salinity level. Significant epitasis was observed for all the traits except shoot length at both the salinity treatments. (author)

  9. Optimization of the triple-pressure combined cycle power plant

    Directory of Open Access Journals (Sweden)

    Alus Muammer

    2012-01-01

    Full Text Available The aim of this work was to develop a new system for optimization of parameters for combined cycle power plants (CCGTs with triple-pressure heat recovery steam generator (HRSG. Thermodynamic and thermoeconomic optimizations were carried out. The objective of the thermodynamic optimization is to enhance the efficiency of the CCGTs and to maximize the power production in the steam cycle (steam turbine gross power. Improvement of the efficiency of the CCGT plants is achieved through optimization of the operating parameters: temperature difference between the gas and steam (pinch point P.P. and the steam pressure in the HRSG. The objective of the thermoeconomic optimization is to minimize the production costs per unit of the generated electricity. Defining the optimal P.P. was the first step in the optimization procedure. Then, through the developed optimization process, other optimal operating parameters (steam pressure and condenser pressure were identified. The developed system was demonstrated for the case of a 282 MW CCGT power plant with a typical design for commercial combined cycle power plants. The optimized combined cycle was compared with the regular CCGT plant.

  10. Integrating health impact assessment into the triple bottom line concept

    International Nuclear Information System (INIS)

    Mahoney, Mary; Potter, Jenny-Lynn

    2004-01-01

    This theoretical study explores the links between the Triple Bottom Line (TBL) concept and the principles of HIA and considers the potential role of HIA to provide a mechanism for integrating health concerns within a broader agenda of government and business. TBL is a framework linked to the broader sustainability agenda that underpins and reviews environmental, economic and social performance of organizations. In its simplest form, TBL acts as a tool for reporting to stakeholders/shareholders organizational performance and the nature of the impacts on the community. The links to HIA are clear as both seek to determine the impact (potential and actual) on the health and well-being of the population. The study found that TBL can operate at four levels within organizations ranging from reporting through to full integration with the organization's goals and practices. Health is narrowly defined and there are tensions about how to undertake the social accountability functions. The study shows the potential role for HIA within the broader policy and accountability agenda. As health is one of the main outcomes of an organization's activities it needs to be taken into account at all levels of activity

  11. Triple Halo Coil: Development and Comparison with Other TMS Coils

    Science.gov (United States)

    Rastogi, Priyam; Hadimani, Ravi; Jiles, David

    Transcranial Magnetic Stimulation (TMS) is a non-invasive stimulation technique that can be used for the treatment of various neurological disorders such as Parkinson's Disease, PTSD, TBI and anxiety by regulating synaptic activity. TMS is FDA approved for the treatment of major depressive disorder. There is a critical need to develop deep TMS coils that can stimulate deeper regions of the brain without excessively stimulating the cortex in order to provide an alternative to surgical methods. We have developed a novel multi-coil configuration called ``Triple Halo Coil'' (THC) that can stimulate deep brain regions. Investigation of induced electric and magnetic field in these regions have been achieved by computer modelling. Comparison of the results due to THC configuration have been conducted with other TMS coils such as ``Halo Coil'', circular coil and ``Figure of Eight'' coil. There was an improvement of more than 15 times in the strength of magnetic field, induced by THC configuration at 10 cm below the vertex of the head when compared with the ``Figure of Eight'' coil alone. Carver Charitable Trust.

  12. W mass and Triple Gauge Couplings at Tevatron

    Directory of Open Access Journals (Sweden)

    Pétroff Pierre

    2013-05-01

    Full Text Available The W mass is a crucial parameter in the Standard Model (SM of particle physics, providing constraints on the mass of the Higgs boson as well as on new physics models via quantum loop corrections. On the other hand, any deviation of the triple gauge boson couplings (TGC from their values predicted by the SM would be also an indication for new physics. We present recent measurements on W boson mass and searches for anomalous TGC (aTGC in Wγ, Zγ, WW, WZ and ZZ at Fermilab Tevatron both by CDF and DØ Collaborations. The CDF Collaboration has measured the W boson mass using data corresponding to 2.2 fb−1 of integrated luminosity. The measurement, performed using electron and muon decays of W boson, yields a mass of MW = 80387 ± 19 MeV. The DØ Collaboration has measured MW = 80367 ± 26 MeV with data corresponding to 4.3 fb−1 of integrated luminosity in the channel W → ev. The combination with an earlier DØ result, using independant data sample at 1 fb−1 of integrated luminosity, yields MW = 80375 ± 23 MeV. The limits on anomalous TGCs parameters are consistent with the SM expectations.

  13. Amending triple superphosphate with chicken litter biochar improves phosphorus availability

    Directory of Open Access Journals (Sweden)

    Audrey Asap

    2018-04-01

    Full Text Available The reaction of H2PO42- and HPO4- with Al and Fe in acid soils to form a precipitate reduces P availability. Chicken litter biochar has been used to improve soil P availability for maize production but with limited information on optimum rates of biochar and Triple Superphosphate (TSP to increase P availability. This study determined the optimum amount of chicken litter biochar and TSP that could increase P availability. Different rates of chicken litter biochar and TSP were evaluated in an incubation study for 30, 60, and 90 days. Selected soil chemical properties before and after incubation were determined using standard procedures. Soil pH, total P, available P, and water soluble P increased in treatments with 75% and 50% biochar. Total acidity, exchangeable Al3+, and Fe2+ were significantly reduced by the chicken litter biochar. The chicken litter biochar also increased soil CEC and exchangeable cations (K, Ca, Mg and Na. The use of 75% and 50% of 5 t ha-1 biochar with 25% TSP of the existing recommendation can be used to increase P availability whilst minimizing soil Al and Fe content. This rates can be used to optimize chicken litter biochar and TSP use in acid soils for crop production especially maize and short term vegetables.

  14. Comparing Relational and Ontological Triple Stores in Healthcare Domain

    Directory of Open Access Journals (Sweden)

    Ozgu Can

    2017-01-01

    Full Text Available Today’s technological improvements have made ubiquitous healthcare systems that converge into smart healthcare applications in order to solve patients’ problems, to communicate effectively with patients, and to improve healthcare service quality. The first step of building a smart healthcare information system is representing the healthcare data as connected, reachable, and sharable. In order to achieve this representation, ontologies are used to describe the healthcare data. Combining ontological healthcare data with the used and obtained data can be maintained by storing the entire health domain data inside big data stores that support both relational and graph-based ontological data. There are several big data stores and different types of big data sets in the healthcare domain. The goal of this paper is to determine the most applicable ontology data store for storing the big healthcare data. For this purpose, AllegroGraph and Oracle 12c data stores are compared based on their infrastructural capacity, loading time, and query response times. Hence, healthcare ontologies (GENE Ontology, Gene Expression Ontology (GEXO, Regulation of Transcription Ontology (RETO, Regulation of Gene Expression Ontology (REXO are used to measure the ontology loading time. Thereafter, various queries are constructed and executed for GENE ontology in order to measure the capacity and query response times for the performance comparison between AllegroGraph and Oracle 12c triple stores.

  15. [Triple synchronous primary gynaecological tumours. A case report].

    Science.gov (United States)

    Gutiérrez-Palomino, Laura; Romo-de Los Reyes, José María; Pareja-Megía, María Jesús; García-Mejido, José Antonio

    2016-01-01

    Synchronous multiple primary malignancies in the female genital tract are infrequent. From 50 to 70% of them corresponds to synchronous cancers of the endometrium and ovary. To our knowledge, this is only the third case report in the international literature of three concurrent gynaecological cancers of epithelial origin. A case is presented, as well as a literature review due to the infrequency of its diagnosis and the lack of information on the subject. A 49-year-old woman, with previous gynaecological history of ovarian endometriosis. She underwent a hysterectomy and bilateral oophorectomy, as she had been diagnosed with endometrial hyperplasia with atypia. The final histopathology reported synchronous ovarian, Fallopian tube, and endometrial cancer. An extension study and complete surgical staging was performed, both being negative. She received adjuvant treatment of chemotherapy and radiotherapy. She is currently free of disease. The aetiology is uncertain. There is controversy relating to increased susceptibility of synchronous neoplasms to pelvic endometriosis and inherited genetic syndromes. Its diagnosis needs to differentiate them from metastatic disease. Additionally, they are problematical from a clinical, diagnostic, therapeutic, and prognostic point of view. The presentation of more cases of triple synchronous cancers is necessary for a complete adjuvant and surgical treatment. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  16. Behaviors of tribrachial edge flames and their interactions in a triple-port burner

    KAUST Repository

    Yamamoto, Kazuhiro; Isobe, Yusuke; Hayashi, Naoki; Yamashita, Hiroshi; Chung, Suk-Ho

    2015-01-01

    In a triple-port burner, various non-premixed flames have been observed previously. Especially for the case with two lifted flames, such configuration could be suitable in studying interaction between two tribrachial flames. In the present study

  17. A Study of Triple Negative Breast Cancer at a Tertiary Cancer Care ...

    African Journals Online (AJOL)

    cause of cancer deaths worldwide. It is the ... Background: Triple negative breast cancers (TNBCs) are a diverse and heterogeneous group .... nonHispanic black patients with breast cancer, at 24.6%. ... chance of breast conservation rates.

  18. Reynolds-Stress and Triple-Product Models Applied to Flows with Rotation and Curvature

    Science.gov (United States)

    Olsen, Michael E.

    2016-01-01

    Predictions for Reynolds-stress and triple product turbulence models are compared for flows with significant rotational effects. Driver spinning cylinder flowfield and Zaets rotating pipe case are to be investigated at a minimum.

  19. Surgical experience of laparoscopic retroperitoneal triple neurectomy for a patient with chronic neuropathic inguinodynia

    Directory of Open Access Journals (Sweden)

    Masato Narita

    2017-01-01

    Conclusions: Laparoscopic retroperitoneal triple neurectomy is useful for treating refractory neuropathic pain. The diagnosis of neuropathic pain via thorough preoperative assessment is vital for procedure success because the procedure would not be effective for other types of pain.

  20. Revisions to Conventional Clock Domain Crossing Methodologies in Triple Modular Redundant Circuits

    Science.gov (United States)

    Berg, Melanie D.; LaBel, Kenneth A.

    2018-01-01

    We present updates to the conventional methodology of triple modular redundancy (TMR) insertion as it pertains to clock domain crossings (CDCs). Three types of TMR schemes and their suggested corresponding CDC revisions are discussed.

  1. Evaluation of Triple Containment Method for Air Transport of Contaminated Human

    National Research Council Canada - National Science Library

    Neville, J

    2003-01-01

    A triple containment system intended for transport of biologically contaminated human remains was tested for its ability to maintain integrity during exposure to altitude changes representative of air transport...

  2. Mometasone-based triple combination therapy in melasma: Is it really safe?

    Directory of Open Access Journals (Sweden)

    Majid Imran

    2010-01-01

    Full Text Available Background: Kligman′s triple combination formula has been one of the most popular treatment options in melasma over the last three decades. The original Kligman′s formula has been modified in many ways over the years and the most recent modification that has been introduced is a triple combination of 2% hydroquinone, 0.025% tretinoin, and 1% mometasone. The use of this triple combination in patients with melasma has seen a sharp rise over the last few years and with this rampant use the side-effect profile of this triple combination has also come to the fore. Aim : The aim of the present study was to assess the overall safety of the mometasone-based triple combination treatment in the management of melasma. Materials and Methods: This retrospective study was performed on 60 patients of melasma who had used a mometasone-based triple combination treatment for at least 3 weeks anytime in the previous 1 year. The patients were given a preformed questionnaire wherein they assessed the overall effect of the triple combination treatment on their melasma during its use as well as after its withdrawal. The patients were specifically asked about the status of their disease as well as the sun sensitivity of their skin before and after the use of triple combination treatment. In addition, the patients were assessed by a single trained dermatologist for the presence of any adverse effects arising out of the triple combination treatment in the form of telangiectasia, hypertrichosis, acne, skin atrophy, etc. Results: Majority of patients (51.7% had used the combination treatment well beyond the recommended duration. About one-third (36.7% of the patients rated their melasma as worse at the time of filling the questionnaire as compared with their disease before the use of triple combination treatment. On clinical examination, the evidence of steroid side effects was seen in 26 patients (43.3%. Steroid-induced telangiectasia was the commonest finding, seen

  3. Magnitude of regge cut contributions in the triple-regge region

    International Nuclear Information System (INIS)

    Bartels, J.; Kramer, G.

    1976-09-01

    Starting from the reggeon calculus, the various possibilities of absorptive Pomeron cut corrections in the triple-Regge region are considered. For the case of pp→pX, we estimate their importance at present day energies. We conclude that at highest ISR energies Pomeron cuts of the eikonal type are not enough, and enhanced diagrams with at least one additional triple Pomeron coupling need to be included. (orig.) [de

  4. Clinical effect of calcium hydroxide paste combined with triple antibiotic paste on root canal disinfection

    Directory of Open Access Journals (Sweden)

    Chen QU

    2014-03-01

    Full Text Available Objective To compare the efficacy in disinfection and pain control of calcium hydroxide paste and triple antibiotic paste (ornidazole, ciprofloxacin and minocycline used individually or jointly for root canal disinfection. Methods Two hundred and thirty-five patients with chronic apical periodontitis (235 teeth were involved in the present study and divided into 2 groups: fistula group (n=118 and no fistula group (n=117. Each group was then randomly divided into 4 subgroups: calcium hydroxide paste group, triple antibiotic paste group, calcium hydroxide + triple antibiotic paste group, and camphor phenol group. After regular root canal preparation, root canals of patients in 4 groups were filled with tiny paper ends impregnated with fore 4 different drugs respectively. Visual analogue scales (VAS of pain were given to the patients with a guide for filling the scale. One week later, both the data of the scales and the effects of root canal disinfection were recorded and analyzed. Results Seven days after treatment, the clinical efficacy of calcium hydroxide paste, triple antibiotic paste and calcium hydroxide + triple antibiotic paste was similar (P>0.05 either in fistula group or in no fistula group, but all better than that of camphor phenol (P<0.05. VAS score analysis showed that, at least on the first 3 days after sealing medicine in the root canal, calcium hydroxide + triple antibiotic paste achieved better result of pain control than the other three groups (P<0.05 no matter with or without fistula. Conclusions  Calcium hydroxide paste, triple antibiotic paste, calcium hydroxide + triple antibiotic paste are effective in treatment of chronic apical periodontitis whether with or without fistula. However, the combined use of calcium hydroxide and three antibiotic pastes is better for controlling the pain after root canal preparation than other treatments, which is therefore worthy of clinical application. DOI: 10.11855/j.issn.0577-7402.2014.02.12

  5. Sound transmission through triple-panel structures lined with poroelastic materials

    OpenAIRE

    Liu, Y

    2015-01-01

    In this paper, previous theories on the prediction of sound transmission loss for a double-panel structure lined with poroelastic materials are extended to address the problem of a triple-panel structure. Six typical configurations are considered for a triple-panel structure based on the method of coupling the porous layers to the facing panels which determines critically the sound insulation performance of the system. The transfer matrix method is employed to solve the system by applying app...

  6. Measurement of triple gauge-boson couplings at 172 GeV

    CERN Document Server

    Barate, R; Décamp, D; Ghez, P; Goy, C; Lees, J P; Lucotte, A; Minard, M N; Nief, J Y; Pietrzyk, B; Boix, G; Casado, M P; Chmeissani, M; Crespo, J M; Delfino, M C; Fernández, E; Fernández-Bosman, M; Garrido, L; Graugès-Pous, E; Juste, A; Martínez, M; Merino, G; Miquel, R; Mir, L M; Morawitz, P; Park, I C; Pascual, A; Perlas, J A; Riu, I; Sánchez, F; Colaleo, A; Creanza, D; De Palma, M; Gelao, G; Iaselli, Giuseppe; Maggi, G; Maggi, M; Nuzzo, S; Ranieri, A; Raso, G; Ruggieri, F; Selvaggi, G; Silvestris, L; Tempesta, P; Tricomi, A; Zito, G; Huang, X; Lin, J; Ouyang, Q; Wang, T; Xie, Y; Xu, R; Xue, S; Zhang, J; Zhang, L; Zhao, W; Abbaneo, D; Alemany, R; Becker, U; Bright-Thomas, P G; Casper, David William; Cattaneo, M; Cerutti, F; Ciulli, V; Dissertori, G; Drevermann, H; Forty, Roger W; Frank, M; Gianotti, F; Hagelberg, R; Hansen, J B; Harvey, J; Janot, P; Jost, B; Lehraus, Ivan; Mato, P; Minten, Adolf G; Moneta, L; Pacheco, A; Pusztaszeri, J F; Ranjard, F; Rolandi, Luigi; Rousseau, D; Schlatter, W D; Schmitt, M; Schneider, O; Tejessy, W; Teubert, F; Tomalin, I R; Vreeswijk, M; Wachsmuth, H W; Wagner, A; Ajaltouni, Ziad J; Badaud, F; Chazelle, G; Deschamps, O; Falvard, A; Ferdi, C; Gay, P; Guicheney, C; Henrard, P; Jousset, J; Michel, B; Monteil, S; Montret, J C; Pallin, D; Perret, P; Podlyski, F; Proriol, J; Rosnet, P; Fearnley, Tom; Hansen, J D; Hansen, J R; Hansen, P H; Nilsson, B S; Rensch, B; Wäänänen, A; Daskalakis, G; Kyriakis, A; Markou, C; Simopoulou, Errietta; Vayaki, Anna; Blondel, A; Brient, J C; Machefert, F P; Rougé, A; Rumpf, M; Valassi, Andrea; Videau, H L; Boccali, T; Focardi, E; Parrini, G; Zachariadou, K; Cavanaugh, R J; Corden, M; Georgiopoulos, C H; Hühn, T; Jaffe, D E; Antonelli, A; Bencivenni, G; Bologna, G; Bossi, F; Campana, P; Capon, G; Chiarella, V; Felici, G; Laurelli, P; Mannocchi, G; Murtas, F; Murtas, G P; Passalacqua, L; Pepé-Altarelli, M; Curtis, L; Dorris, S J; Halley, A W; Lynch, J G; Negus, P; O'Shea, V; Raine, C; Scarr, J M; Smith, K; Teixeira-Dias, P; Thompson, A S; Thomson, E; Thomson, F; Ward, J J; Buchmüller, O L; Dhamotharan, S; Geweniger, C; Graefe, G; Hanke, P; Hansper, G; Hepp, V; Kluge, E E; Putzer, A; Sommer, J; Tittel, K; Werner, S; Wunsch, M; Beuselinck, R; Binnie, David M; Cameron, W; Dornan, Peter J; Girone, M; Goodsir, S M; Martin, E B; Marinelli, N; Moutoussi, A; Nash, J; Sedgbeer, J K; Spagnolo, P; Williams, M D; Ghete, V M; Girtler, P; Kneringer, E; Kuhn, D; Rudolph, G; Betteridge, A P; Bowdery, C K; Buck, P G; Colrain, P; Crawford, G; Finch, A J; Foster, F; Hughes, G; Jones, R W L; Whelan, E P; Williams, M I; Giehl, I; Hoffmann, C; Jakobs, K; Kleinknecht, K; Quast, G; Renk, B; Rohne, E; Sander, H G; Van Gemmeren, P; Zeitnitz, C; Aubert, Jean-Jacques; Benchouk, C; Bonissent, A; Bujosa, G; Carr, J; Coyle, P; Ealet, A; Fouchez, D; Leroy, O; Motsch, F; Payre, P; Talby, M; Sadouki, A; Thulasidas, M; Tilquin, A; Trabelsi, K; Aleppo, M; Antonelli, M; Ragusa, F; Berlich, R; Blum, Walter; Büscher, V; Dietl, H; Ganis, G; Gotzhein, C; Kroha, H; Lütjens, G; Lutz, Gerhard; Mannert, C; Männer, W; Moser, H G; Richter, R H; Rosado-Schlosser, A; Schael, S; Settles, Ronald; Seywerd, H C J; Stenzel, H; Wiedenmann, W; Wolf, G; Boucrot, J; Callot, O; Chen, S; Davier, M; Duflot, L; Grivaz, J F; Heusse, P; Höcker, A; Jacholkowska, A; Kado, M; Kim, D W; Le Diberder, F R; Lefrançois, J; Lutz, A M; Schune, M H; Serin, L; Tournefier, E; Veillet, J J; Videau, I; Zerwas, D; Azzurri, P; Bagliesi, G; Bettarini, S; Bozzi, C; Calderini, G; Dell'Orso, R; Fantechi, R; Ferrante, I; Giassi, A; Gregorio, A; Ligabue, F; Lusiani, A; Marrocchesi, P S; Messineo, A; Palla, Fabrizio; Rizzo, G; Sanguinetti, G; Sciabà, A; Sguazzoni, G; Steinberger, Jack; Tenchini, Roberto; Vannini, C; Venturi, A; Verdini, P G; Blair, G A; Bryant, L M; Chambers, J T; Coles, J; Green, M G; Medcalf, T; Perrodo, P; Strong, J A; Von Wimmersperg-Töller, J H; Botterill, David R; Clifft, R W; Edgecock, T R; Haywood, S; Maley, P; Norton, P R; Thompson, J C; Wright, A E; Bloch-Devaux, B; Colas, P; Fabbro, B; Faïf, G; Lançon, E; Lemaire, M C; Locci, E; Pérez, P; Przysiezniak, H; Rander, J; Renardy, J F; Rosowsky, A; Roussarie, A; Trabelsi, A; Vallage, B; Black, S N; Dann, J H; Kim, H Y; Konstantinidis, N P; Litke, A M; McNeil, M A; Taylor, G; Booth, C N; Brew, C A J; Cartwright, S L; Combley, F; Kelly, M S; Lehto, M H; Reeve, J; Thompson, L F; Affholderbach, K; Böhrer, A; Brandt, S; Cowan, G D; Foss, J; Grupen, Claus; Smolik, L; Stephan, F; Apollonio, M; Bosisio, L; Della Marina, R; Giannini, G; Gobbo, B; Musolino, G; Pütz, J; Rothberg, J E; Wasserbaech, S R; Williams, R W; Armstrong, S R; Charles, E; Elmer, P; Ferguson, D P S; Gao, Y; González, S; Greening, T C; Hayes, O J; Hu, H; Jin, S; McNamara, P A; Nachtman, J M; Nielsen, J; Orejudos, W; Pan, Y B; Saadi, Y; Scott, I J; Walsh, J; Wu Sau Lan; Wu, X; Yamartino, J M; Zobernig, G

    1998-01-01

    The triple gauge-boson couplings, Awp, Aw and Abp, have been measured using 34 semileptonically and 54 hadronically decaying WW candidate events. The events were selected in the data recorded during 1996 with the ALEPH detector at 172 GeV, corresponding to an integrated luminosity of 10.65 pb^-1. The triple gauge-boson couplings have been measured using optimal observables constructed from kinematic information of WW events. The results are in agreement with the Standard Model expectation.

  7. TNK2 Tyrosine Kinase as a Novel Therapeutic Target in Triple-Negative Breast Cancer

    Science.gov (United States)

    2017-10-01

    Award Number: W81XWH-15-1-0311 TITLE: TNK2 Tyrosine Kinase as a Novel Therapeutic Target in Triple- Negative Breast Cancer PRINCIPAL...Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Triple-negative breast cancers (TNBCs) represent only 10%-15% of all breast cancers ; however... cancers (TNBC) represent 10-15% of all breast cancers . While significant advances have been made for targeted therapy of ER and HER2-positive breast

  8. Determination of the solid-liquid-vapor triple point pressure of carbon

    International Nuclear Information System (INIS)

    Haaland, D.M.

    1976-01-01

    A detailed experimental study of the triple point pressure of carbon using laser heating techniques has been completed. Uncertainties and conflict in previous investigations have been addressed and substantial data presented which places the solid-liquid-vapor carbon triple point at 107 +- 2 atmospheres. This is in agreement with most investigations which have located the triple point pressure between 100 and 120 atmospheres, but is in disagreement with recent low pressure carbon experiments. The absence of any significant polymorphs of carbon other than graphite suggests that the graphite-liquid-vapor triple point has been measured. Graphite samples were melted in a pressure vessel using a 400 W Nd:YAG continuous-wave laser focused to a maximum power density of approximately 80 kW/cm 2 . Melt was confirmed by detailed microstructure analysis and x-ray diffraction of the recrystallized graphite. Experiments to determine the minimum melt pressure of carbon were completed as a function of sample size, type of inert gas, and laser power density to asure that laser power densities were sufficient to produce melt at the triple point pressure of carbon, and the pressure of carbon at the surface of the sample was identical to the measured pressure of the inert gas in the pressure vessel. High-speed color cinematography of the carbon heating revealed the presence of a laser-generated vapor or particle plume in front of the sample. The existence of this bright plume pevented the measurement of the carbon triple point temperature

  9. Measurement uncertainty in single, double and triple isotope dilution mass spectrometry.

    Science.gov (United States)

    Vogl, Jochen

    2012-02-15

    Triple IDMS has been applied for the first time to the quantification of element concentrations. It has been compared with single and double IDMS obtained on the same sample set in order to evaluate the advantages and disadvantages of triple IDMS over single and double IDMS as an analytical reference procedure. The measurement results of single, double and triple IDMS are indistinguishable, considering rounding due to the individual measurement uncertainties. As expected, the relative expanded uncertainties (k = 2) achieved with double IDMS (0.08%) are dramatically smaller than those obtained with single IDMS (1.4%). Triple IDMS yields the smallest relative expanded uncertainties (k = 2, 0.077%) unfortunately at the expense of a much higher workload. Nevertheless triple IDMS has the huge advantage that the isotope ratio of the spike does not need to be determined. Elements with high memory effects, highly enriched spikes or highest metrological requirements may be typical applications for triple IDMS. Copyright © 2011 John Wiley & Sons, Ltd.

  10. Accuracy of Triple Diagnostic Test in Patients with Thyroid Nodule at Dr. Cipto Mangunkusumo General Hospital

    Directory of Open Access Journals (Sweden)

    Diani Kartini

    2017-04-01

    Full Text Available The aim of the study is to evaluate the accuracy of triple diagnostic test on thyroid nodules. The data from patients’ medical records who came to Cipto Mangunkusumo General Hospital for the first time or for evaluation of thyroid nodule and patients who underwent thyroidectomy during 2010 to 2011. Clinical examination was scored by McGill Thyroid Nodule Score. ROC procedure was performed to obtain clinical cut-off scores of diagnosis of malignant. Ultrasonography (USG result was considered malignant for TIRADS 4, 5, and 6. If clinical, USG and histopathology examinations of triple diagnostic give positive results, it will be classified as concordant malignant whereas if all those three show benign results, the classification is benign. Thyroid carcinoma was found in 134 out of 161 patients with thyroid nodule. There were 84 patients with concordant results for all three elements of the triple test. Out of 84 patients with concordant triple diagnostic results, there were 53 malignant cases (32.9% and 31 benign cases (19.3%. Main histopathological findings among patients with thyroid carcinoma was papillary (90.3%, follicular (3%, medullary (0.7%, and anaplastic (6%. The sensitivity and specificity of triple diagnostic was 77% and 94%, with positive predictive value of 98%, negative predictive value of 51,6% and accuracy of 80.9%. Combination of clinical findings, USG, and FNAB gave malignant probability of 92%, better than combination of clinical findings and USG (81.6% or clinical findings and FNAB (87%. Triple diagnostic cannot be used as an ideal test to replace frozen section examination in managing thyroid nodule. However, in cases with concordant results of each triple diagnostic’s element, the positive predictive value (98% and malignant probability (92% is high. Keywords: thyroid nodule, triple diagnostic, accuracy.   Akurasi Metode Triple Diagnostic pada Pasien Nodul Tiroid  di RSUPN Dr. Cipto Mangunkusumo   Abstrak Tujuan

  11. Lysine methyltransferase SMYD2 promotes triple negative breast cancer progression.

    Science.gov (United States)

    Li, Linda Xiaoyan; Zhou, Julie Xia; Calvet, James P; Godwin, Andrew K; Jensen, Roy A; Li, Xiaogang

    2018-02-27

    We identified SMYD2, a SMYD (SET and MYND domain) family protein with lysine methyltransferase activity, as a novel breast cancer oncogene. SMYD2 was expressed at significantly higher levels in breast cancer cell lines and in breast tumor tissues. Silencing of SMYD2 by RNAi in triple-negative breast cancer (TNBC) cell lines or inhibition of SMYD2 with its specific inhibitor, AZ505, significantly reduced tumor growth in vivo. SMYD2 executes this activity via methylation and activation of its novel non-histone substrates, including STAT3 and the p65 subunit of NF-κB, leading to increased TNBC cell proliferation and survival. There are cross-talk and synergistic effects among SMYD2, STAT3, and NF-κB in TNBC cells, in that STAT3 can contribute to the modification of NF-κB p65 subunit post-translationally by recruitment of SMYD2, whereas the p65 subunit of NF-κB can also contribute to the modification of STAT3 post-translationally by recruitment of SMYD2, leading to methylation and activation of STAT3 and p65 in these cells. The expression of SMYD2 can be upregulated by IL-6-STAT3 and TNFα-NF-κB signaling, which integrates epigenetic regulation to inflammation in TNBC development. In addition, we have identified a novel SMYD2 transcriptional target gene, PTPN13, which links SMYD2 to other known breast cancer associated signaling pathways, including ERK, mTOR, and Akt signaling via PTPN13 mediated phosphorylation.

  12. Triple Higgs boson production in the linear collider

    International Nuclear Information System (INIS)

    Ferrera, Giancarlo; Guasch, Jaume; Lopez-Val, David; Sola, Joan

    2008-01-01

    Triple Higgs boson production (3H) may provide essential information to reconstruct the Higgs potential. We consider 3H-production in the International Linear Collider (ILC) both in the Minimal Supersymmetric Standard Model (MSSM) and in the general Two-Higgs-Doublet Model (2HDM). We compute the total cross-section for the various 3H final states, such as H + H - h 0 , H 0 A 0 h 0 , etc., and compare with the more traditional double Higgs (2H) boson production processes. While the cross-sections for the 2H final states lie within the same order of magnitude in both the MSSM and 2HDM, we find that for the 3H states the maximum 2HDM cross-sections, being of order 0.1 pb, are much larger than the MSSM ones which, in most cases, are of order 10 -6 pb or less. Actually, the 3H processes could be the dominant mechanism for Higgs boson production in the 2HDM. Ultimately, the origin of the remarkable enhancement of the 3H channels in the 2HDM case (for both type I and type II models) originates in the structure of the trilinear Higgs boson couplings. The extremely clean environment of the ILC should allow a relatively comfortable tagging of the three Higgs boson events. In view of the fact that the MSSM contribution is negligible, these events should manifest themselves mainly in the form of 6 heavy-quark jet final states. Some of these signatures could be spectacular, and in case of being detected would constitute strong evidence of an extended Higgs sector of non-supersymmetric origin

  13. TMEPAI genome editing in triple negative breast cancer cells

    Directory of Open Access Journals (Sweden)

    Bantari W.K. Wardhani

    2017-05-01

    Full Text Available Background: Clustered regularly interspaced short palindromic repeats/CRISPR-associated 9 (CRISPR/Cas9 is a powerful genome editing technique. It consists of RNA-guided DNA endonuclease Cas9 and single guide RNA (gRNA. By combining their expressions, high efficiency cleavage of the target gene can be achieved, leading to the formation of DNA double-strand break (DSB at the genomic locus of interest which will be repaired via NHEJ (non-homologous end joining or HDR (homology-directed repair and mediate DNA alteration. We aimed to apply the CRISPR/Cas9 technique to knock-out the transmembrane prostate androgen-induced protein (TMEPAI gene in the triple negative breast cancer cell line.Methods: Designed gRNA which targets the TMEPAI gene was synthesized, annealed, and cloned into gRNA expression vector. It was co-transfected into the TNBC cell line using polyethylenimine (PEI together with Cas9-GFP and puromycin resistant gene vector. At 24-hours post-transfection, cells were selected by puromycin for 3 days before they were cloned. Selected knock-out clones were subsequently checked on their protein levels by western blotting.Results: CRISPR/Cas9, a genome engineering technique successfully knocked-out TMEPAI in the Hs578T TNBC cell line. Sequencing shows a frameshift mutation in TMEPAI. Western blot shows the absence of TMEPAI band on Hs578T KO cells.Conclusion: TMEPAI gene was deleted in the TNBC cell line using the genomic editing technique CRISPR/Cas9. The deletion was confirmed by genome and protein analysis.

  14. [Premature immunosenescence in triple-transgenic mice for Alzheimer's disease].

    Science.gov (United States)

    Mate, Ianire; Cruces, Julia; Vida, Carmen; Sanfeliu, Coral; Manassra, Rashed; Giménez-Llort, Lydia; De la Fuente, Mónica

    2014-01-01

    A deterioration of the neuroimmunoendocrine network has been observed in Alzheimer's disease (AD). However, the peripheral immune response has hardly been investigated in this pathology. Since some immune function parameters have been established as good markers of the rate of ageing, and can predict longevity, the aim of the present work was to study some of these functions in splenic leucocytes in transgenic mice for AD of different ages. Young female (4 ± 1 months), adult (9 ± 1 months), and mature (12 ± 1 months) triple-transgenic mice for AD (3 xTgAD) and non-transgenic (NTg) control mice of the same ages were used. The chemotaxis, the anti-tumour activity of « natural killer » (NK) cells and the lymphoproliferative response in the presence of the mitogens concanavalin A and lipopolysaccharide, functions that decrease with age, were determined in splenic leucocytes. In addition, the differences in lifespan between 3 xTgAD and NTg were studied in parallel using other animals, until their death through natural causes. In 3 xTgAD, with respect to NTg, chemotaxis decreased at all ages studied, whereas in lymphoproliferative response this reduction was shown at 4 months and 9 months. NK activity was diminished only in young 3 xTgAD with respect to NTg. The 3 xTgAD showed a shorter lifespan than the NTg control group. The 3 xTgAD mice show a premature immunosenescence, which could explain their early mortality. The determination of these immune functions at peripheral level could serve as a marker of the progression of the Alzheimer's disease. Copyright © 2013 SEGG. Published by Elsevier Espana. All rights reserved.

  15. Triple therapy in type 2 diabetes; a systematic review and network meta-analysis

    Directory of Open Access Journals (Sweden)

    Martin J. Downes

    2015-12-01

    Full Text Available Aims. The purpose was to evaluate the evidence for triple therapy regimen using medicines available in Australia for type 2 diabetes.Methods. A systematic literature review was performed to update the relevant evidence from 2002 to 2014 on triple therapy for type 2 diabetes. A multiple-treatments network meta-analysis was undertaken to summarise the comparative efficacy and harms of different triple therapies.Results. Twenty seven trials were identified, most were six months of duration. The following combinations were included in the network meta-analysis: metformin (MET + sulfonylureas (SU (used as reference combination; MET + SU+ dipeptidyl peptidase 4 inhibitors (DPP-4-i; MET + SU+ thiazolidinediones (TZD; MET + SU+ glucagon-like peptide-1 receptor agonists (GLP-1-RA; MET + SU+ insulins; MET + TZD + DPP-4-i; and MET + SU+ sodium/glucose cotransporter 2 inhibitors (SGLT2-i. For HbA1c reduction, all triple therapies were statistically superior to MET+SU dual therapy, except for MET + TZD + DPP-4-i. None of the triple therapy combinations demonstrated differences in HbA1c compared with other triple therapies. MET + SU + SGLT2-i and MET + SU + GLP-1-RA resulted in significantly lower body weight than MET + SU + DPP-4-i, MET+SU+insulin and MET + SU + TZDs; MET + SU + DPP-4-i resulted in significantly lower body weight than MET + SU + insulin and MET + SU + TZD. MET + SU + insulin, MET + SU + TZD and MET + SU + DPP-4-i increased the odds of hypoglycaemia when compared to MET + SU. MET + SU + GLP-1-RA reduced the odds of hypoglycaemia compared to MET + SU + insulin.Conclusion. Care when choosing a triple therapy combination is needed as there is often a risk of increased hypoglycaemia events associated with this regimen and there are very limited data surrounding the long-term effectiveness and safety of combined therapies.

  16. Sound transmission through triple-panel structures lined with poroelastic materials

    Science.gov (United States)

    Liu, Yu

    2015-03-01

    In this paper, previous theories on the prediction of sound transmission loss for a double-panel structure lined with poroelastic materials are extended to address the problem of a triple-panel structure. Six typical configurations are considered for a triple-panel structure based on the method of coupling the porous layers to the facing panels which determines critically the sound insulation performance of the system. The transfer matrix method is employed to solve the system by applying appropriate types of boundary conditions for these configurations. The transmission loss of the triple-panel structures in a diffuse sound field is calculated as a function of frequency and compared with that of corresponding double-panel structures. Generally, the triple-panel structure with poroelastic linings has superior acoustic performance to the double-panel counterpart, remarkably in the mid-high frequency range and possibly at low frequencies, by selecting appropriate configurations in which those with two air gaps in the structure exhibit the best overall performance over the entire frequency range. The poroelastic lining significantly lowers the cut-on frequency above which the triple-panel structure exhibits noticeably higher transmission loss. Compared with a double-panel structure, the wider range of system parameters for a triple-panel structure due to the additional partition provides more design space for tuning the sound insulation performance. Despite the increased structural complexity, the triple-panel structure lined with poroelastic materials has the obvious advantages in sound transmission loss while without the penalties in weight and volume, and is hence a promising replacement for the widely used double-panel sandwich structure.

  17. Triple X syndrome and puberty: focus on the hypothalamus-hypophysis-gonad axis.

    Science.gov (United States)

    Stagi, Stefano; di Tommaso, Mariarosaria; Scalini, Perla; Lapi, Elisabetta; Losi, Stefania; Bencini, Erica; Masoni, Fabrizio; Dosa, Laura; Becciani, Sabrina; de Martino, Maurizio

    2016-06-01

    To evaluate the hypothalamus-hypophysis-gonad axis in a cohort of children and adolescents with nonmosaic triple X syndrome. Cross-sectional study with retrospective analysis. University pediatric hospital. Fifteen prepubertal subjects (median age 9.0 years, range 6.9-11.9 years) with nonmosaic triple X syndrome and age- and pubertal-matched control group (30 girls, median age 9.1 y, range 6.9-11.6 years). None. We evaluated FSH, LH, and E2 levels and performed an autoimmunity screening as well as a pelvic ultrasonography and an LH-releasing hormone stimulation test. All triple X patients (with and without pubertal signs) showed a pubertal LH peak level that was significantly different from controls. Triple X patients showed increased basal and peak FSH and LH values compared with control subjects. However, the mean E2 level was significantly lower than control subjects. However, triple X patients showed reduced DHEAS levels and reduced inhibin levels compared with control subjects. Finally, triple X patients had a significantly reduced ovarian volume compared with control subjects, in both prepubertal and pubertal patients. Triple X patients showed premature activation of the GnRH pulse generator, even without puberty signs. Both basal and peak LH and FSH levels were higher than in control subjects, and E2 and inhibin levels and ovarian volume were reduced, which led to a reduced gonadal function. Other studies and a longitudinal evaluation is necessary to better understand the endocrinologic features of these subjects. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  18. Binary Black Hole Mergers from Field Triples: Properties, Rates, and the Impact of Stellar Evolution

    Energy Technology Data Exchange (ETDEWEB)

    Antonini, Fabio [Center for Interdisciplinary Exploration and Research in Astrophysics (CIERA) and Department of Physics and Astrophysics, Northwestern University, Evanston, IL 60208 (United States); Toonen, Silvia [Astronomical Institute Anton Pannekoek, University of Amsterdam, P.O. Box 94249, 1090 GE, Amsterdam (Netherlands); Hamers, Adrian S. [Institute for Advanced Study, School of Natural Sciences, Einstein Drive, Princeton, NJ 08540 (United States)

    2017-06-01

    We consider the formation of binary black hole (BH) mergers through the evolution of field massive triple stars. In this scenario, favorable conditions for the inspiral of a BH binary are initiated by its gravitational interaction with a distant companion, rather than by a common-envelope phase invoked in standard binary evolution models. We use a code that follows self-consistently the evolution of massive triple stars, combining the secular triple dynamics (Lidov–Kozai cycles) with stellar evolution. After a BH triple is formed, its dynamical evolution is computed using either the orbit-averaged equations of motion, or a high-precision direct integrator for triples with weaker hierarchies for which the secular perturbation theory breaks down. Most BH mergers in our models are produced in the latter non-secular dynamical regime. We derive the properties of the merging binaries and compute a BH merger rate in the range (0.3–1.3) Gpc{sup −3} yr{sup −1}, or up to ≈2.5 Gpc{sup −3} yr{sup −1} if the BH orbital planes have initially random orientation. Finally, we show that BH mergers from the triple channel have significantly higher eccentricities than those formed through the evolution of massive binaries or in dense star clusters. Measured eccentricities could therefore be used to uniquely identify binary mergers formed through the evolution of triple stars. While our results suggest up to ≈10 detections per year with Advanced-LIGO, the high eccentricities could render the merging binaries harder to detect with planned space based interferometers such as LISA.

  19. Triple dose of gadolinium-DTPA and delayed MRI in patients with benign multiple sclerosis.

    Science.gov (United States)

    Filippi, M; Capra, R; Campi, A; Colombo, B; Prandini, F; Marcianò, N; Gasparotti, R; Comi, G

    1996-01-01

    OBJECTIVES--To evaluate whether a triple dose of gadolinium-DTPA (Gd-DTPA) or delayed MRI increase the number, size, and conspicuousness of enhancing lesions in patients with benign multiple sclerosis. METHODS--T1 weighted brain MRI was carried out on 20 patients with benign multiple sclerosis (expanded disability status scale 10 years) in two sessions. In the first session, one scan was obtained before and two scans five to seven minutes and 20-30 minutes after the injection of 0.1 mmol/kg Gd-DTPA (standard dose). In the second session, six to 24 hours later, the same procedure was repeated with 0.3 mmol/kg Gd-DTPA (triple dose). RESULTS--Nine enhancing lesions were found in seven patients (35%) using the standard dose of Gd-DTPA. The numbers of enhancing lesions increased to 13 (P = 0.03) and the number of patients with such lesions to eight (40%) on the delayed standard dose scans. On the early triple dose scans, we found 19 enhancing lesions in 10 patients (50%). The number of enhancing lesions was significantly higher (P = 0.01) than that obtained with the early standard dose. The number of enhancing lesions was 18 and the number of "active" patients 11 (55%) on the delayed triple dose scans. The enhancing areas increased progressively from the early standard dose scans to the delayed triple dose scans. The contrast ratios of the lesions detected in early standard dose scans was lower than those of lesions present in the early (P = 0.01) and delayed (P = 0.04) triple dose scans. CONCLUSIONS--More enhancing lesions were detected in patients with benign multiple sclerosis with both delay of MRI and the use of triple dose of Gd-DTPA suggesting that the amount of inflammation in the lesions of such patients is mild and heterogeneous. Images PMID:8778257

  20. La Triple Hélice de las TIC en Ecuador

    Directory of Open Access Journals (Sweden)

    Yolanda Esperanza Ledesma Silva

    2018-03-01

    Full Text Available Las tecnologías de la información y la comunicación (TIC contribuyen al crecimiento económico global de un país. El uso de las TIC puede ser una oportunidad para modernizar tanto la gestión de la información como la administración del sistema en los tres sectores de la economía: Gobierno, Universidad y Empresa. El problema identificado es la ausencia de literatura sobre este tema. El presente artículo tiene como objetivo contribuir a resolver este problema y responder a la pregunta: ¿Cuáles son las interrelaciones entre el gobierno, las universidades y las empresas en el uso de las TIC en Ecuador? La metodología utilizada es el modelo de la Triple Hélice, con el fin de analizar las interacciones entre los tres sectores mencionados. Entre las principales conclusiones están: La primera hélice, Gobierno-Universidad, incluye la planificación pública en materia de TIC que se caracteriza por ser vertical, centralizada y excluyente, lo cual se puede observar por la falta de participación de los actores que intervienen en la formulación de proyectos y políticas relacionadas con las TIC y su aplicación.  En la segunda hélice, Gobierno-Empresa, existe la necesidad de invertir en las TIC, especialmente en el sector rural, con el fin de motivar la participación respectiva de la empresa privada y el gobierno. La tercera hélice, Empresa-Universidad, se expresa en la necesidad de conformar una comunidad 2.0 en las universidades que contribuya a la mejora del proceso de enseñanza-aprendizaje a través de la compartición e intercambio de información relevante entre los docentes, estudiantes y su entorno.

  1. Triple oxygen isotopes in biogenic and sedimentary carbonates

    Science.gov (United States)

    Passey, Benjamin H.; Hu, Huanting; Ji, Haoyuan; Montanari, Shaena; Li, Shuning; Henkes, Gregory A.; Levin, Naomi E.

    2014-09-01

    The 17O anomaly (Δ17O) of natural waters has been shown to be sensitive to evaporation in a way analogous to deuterium excess, with evaporated bodies of water (e.g., leaf waters, lake waters, animal body waters) tending to have lower Δ17O than primary meteoric waters. In animal body water, Δ17O relates to the intake of evaporated waters, evaporative effluxes of water, and the Δ17O value of atmospheric O2, which itself carries signatures of global carbon cycling and photochemical reactions in the stratosphere. Carbonates have the potential to record the triple oxygen isotope compositions of parent waters, allowing reconstruction of past water compositions, but such investigations have awaited development of methods for high-precision measurement of Δ17O of carbonate. We describe optimized methods based on a sequential acid digestion/reduction/fluorination approach that yield Δ17O data with the high precision (∼0.010‰, 1σ) needed to resolve subtle environmental signals. We report the first high-precision Δ17O dataset for terrestrial carbonates, focusing on vertebrate biogenic carbonates and soil carbonates, but also including marine invertebrates and high-temperature carbonates. We determine apparent three-isotope fractionation factors between the O2 analyte derived from carbonate and the parent waters of the carbonate. These in combination with appropriate temperature estimates (from clumped isotope thermometry, or known or estimated body temperatures) are used to calculate the δ18O and Δ17O of parent waters. The clearest pattern to emerge is the strong 17O-depletion in avian, dinosaurian, and mammalian body water (from analyses of eggshell and tooth enamel) relative to meteoric waters, following expected influences of evaporated water (e.g., leaf water) and atmospheric O2 on vertebrate body water. Parent waters of the soil carbonates studied here have Δ17O values that are similar to or slightly lower than global precipitation. Our results suggest

  2. Fabrication of read-only type triple-layered disc

    Science.gov (United States)

    Yang, Huei Wen; Jeng, Tzuan Ren; Yen, Wen Hsin; Chan, Rong Po; Shin, Kuo Ding; Huang, Der Ray

    2003-06-01

    The approach to increase optical recording density has become very popular research subject in these years. One direct and effective method is to increase the recording layer stack number. That is to say, to add one more recording layer can get one more recording capacity. In this paper, we will propose a new method for manufacturing read only type multi-layered disc. The process is described in the following. This first recorded data layer (called L0) still follows the traditional DVD disc manufacturing process. We obtain the polycarbonate substrate by replicating from Ni stamper. Then polycarbonate substrate is sputtered thin silicon film for semi-reflection layer. As for second layer (L1) and even more layer (Ln-1) producing, one special kind of duplication (called SKD) method is proposed. The duplication (or replication) source of second or nth recorded data is not only limited from Ni stamper. Even polycarbonate or PMMA substrate has recording data are also acceptable sources. At next step, the duplication source is deposited by thin gold film. Then we apply spin coating to bond the first layer (L0) substrate and second layer (L1) duplication source by choosing suitable UV curing glue. After being emitted by UV lamp for several seconds, we can easily separate the duplication source of second layer (L1) from (L0) substrate. Then we find the thin second data layer (L1) is replicated and stacks upon the first layer. On the same way, we sputter thin AgTi layer on the thin second data layer for another semi- reflective layer. By following the above manufacture step, we can produce more layers. In our experimental, we prepare triple layered read-only type disc. The total capacity is almost 12GB for one side of disc, and 24GB for two side of disc. The read-out intensity of laser from each data layer is expected to be similar. Thus we have designed particular reflectance and transmittance for each data layer by controlling the thickness of thin silicon film. We can

  3. BioBenchmark Toyama 2012: an evaluation of the performance of triple stores on biological data

    Science.gov (United States)

    2014-01-01

    Background Biological databases vary enormously in size and data complexity, from small databases that contain a few million Resource Description Framework (RDF) triples to large databases that contain billions of triples. In this paper, we evaluate whether RDF native stores can be used to meet the needs of a biological database provider. Prior evaluations have used synthetic data with a limited database size. For example, the largest BSBM benchmark uses 1 billion synthetic e-commerce knowledge RDF triples on a single node. However, real world biological data differs from the simple synthetic data much. It is difficult to determine whether the synthetic e-commerce data is efficient enough to represent biological databases. Therefore, for this evaluation, we used five real data sets from biological databases. Results We evaluated five triple stores, 4store, Bigdata, Mulgara, Virtuoso, and OWLIM-SE, with five biological data sets, Cell Cycle Ontology, Allie, PDBj, UniProt, and DDBJ, ranging in size from approximately 10 million to 8 billion triples. For each database, we loaded all the data into our single node and prepared the database for use in a classical data warehouse scenario. Then, we ran a series of SPARQL queries against each endpoint and recorded the execution time and the accuracy of the query response. Conclusions Our paper shows that with appropriate configuration Virtuoso and OWLIM-SE can satisfy the basic requirements to load and query biological data less than 8 billion or so on a single node, for the simultaneous access of 64 clients. OWLIM-SE performs best for databases with approximately 11 million triples; For data sets that contain 94 million and 590 million triples, OWLIM-SE and Virtuoso perform best. They do not show overwhelming advantage over each other; For data over 4 billion Virtuoso works best. 4store performs well on small data sets with limited features when the number of triples is less than 100 million, and our test shows its

  4. BioBenchmark Toyama 2012: an evaluation of the performance of triple stores on biological data.

    Science.gov (United States)

    Wu, Hongyan; Fujiwara, Toyofumi; Yamamoto, Yasunori; Bolleman, Jerven; Yamaguchi, Atsuko

    2014-01-01

    Biological databases vary enormously in size and data complexity, from small databases that contain a few million Resource Description Framework (RDF) triples to large databases that contain billions of triples. In this paper, we evaluate whether RDF native stores can be used to meet the needs of a biological database provider. Prior evaluations have used synthetic data with a limited database size. For example, the largest BSBM benchmark uses 1 billion synthetic e-commerce knowledge RDF triples on a single node. However, real world biological data differs from the simple synthetic data much. It is difficult to determine whether the synthetic e-commerce data is efficient enough to represent biological databases. Therefore, for this evaluation, we used five real data sets from biological databases. We evaluated five triple stores, 4store, Bigdata, Mulgara, Virtuoso, and OWLIM-SE, with five biological data sets, Cell Cycle Ontology, Allie, PDBj, UniProt, and DDBJ, ranging in size from approximately 10 million to 8 billion triples. For each database, we loaded all the data into our single node and prepared the database for use in a classical data warehouse scenario. Then, we ran a series of SPARQL queries against each endpoint and recorded the execution time and the accuracy of the query response. Our paper shows that with appropriate configuration Virtuoso and OWLIM-SE can satisfy the basic requirements to load and query biological data less than 8 billion or so on a single node, for the simultaneous access of 64 clients. OWLIM-SE performs best for databases with approximately 11 million triples; For data sets that contain 94 million and 590 million triples, OWLIM-SE and Virtuoso perform best. They do not show overwhelming advantage over each other; For data over 4 billion Virtuoso works best. 4store performs well on small data sets with limited features when the number of triples is less than 100 million, and our test shows its scalability is poor; Bigdata

  5. The effect of increasing strength and approach velocity on triple jump performance.

    Science.gov (United States)

    Allen, Sam J; Yeadon, M R Fred; King, Mark A

    2016-12-08

    The triple jump is an athletic event comprising three phases in which the optimal phase ratio (the proportion of each phase to the total distance jumped) is unknown. This study used a planar whole body torque-driven computer simulation model of the ground contact parts of all three phases of the triple jump to investigate the effect of strength and approach velocity on optimal performance. The strength and approach velocity of the simulation model were each increased by up to 30% in 10% increments from baseline data collected from a national standard triple jumper. Increasing strength always resulted in an increased overall jump distance. Increasing approach velocity also typically resulted in an increased overall jump distance but there was a point past which increasing approach velocity without increasing strength did not lead to an increase in overall jump distance. Increasing both strength and approach velocity by 10%, 20%, and 30% led to roughly equivalent increases in overall jump distances. Distances ranged from 14.05m with baseline strength and approach velocity, up to 18.49m with 30% increases in both. Optimal phase ratios were either hop-dominated or balanced, and typically became more balanced when the strength of the model was increased by a greater percentage than its approach velocity. The range of triple jump distances that resulted from the optimisation process suggests that strength and approach velocity are of great importance for triple jump performance. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Role of intertube interactions in double- and triple-walled carbon nanotubes.

    Science.gov (United States)

    Hirschmann, Thomas Ch; Araujo, Paulo T; Muramatsu, Hiroyuki; Rodriguez-Nieva, Joaquin F; Seifert, Max; Nielsch, Kornelius; Kim, Yoong Ahm; Dresselhaus, Mildred S

    2014-02-25

    Resonant Raman spectroscopy studies are performed to access information about the intertube interactions and wall-to-wall distances in double- and triple-walled carbon nanotubes. Here, we explain how the surroundings of the nanotubes in a multiwalled system influence their radial breathing modes. Of particular interest, the innermost tubes in double- and triple-walled carbon nanotube systems are shown to be significantly shielded from environmental interactions, except for those coming from the intertube interaction with their own respective host tubes. From a comparison of the Raman results for bundled as well as individual fullerene-peapod-derived double- and triple-walled carbon nanotubes, we observe that metallic innermost tubes, when compared to their semiconducting counterparts, clearly show weaker intertube interactions. Additionally, we discuss a correlation between the wall-to-wall distances and the frequency upshifts of the radial breathing modes observed for the innermost tubes in individual double- and triple-walled carbon nanotubes. All results allow us to contemplate fundamental properties related to DWNTs and TWNTs, as for example diameter- and chirality-dependent intertube interactions. We also discuss differences in fullerene-peapod-derived and chemical vapor deposition grown double- and triple-walled systems with the focus on mechanical coupling and interference effects.

  7. An overview of triple infection with hepatitis B, C and D viruses.

    Science.gov (United States)

    Riaz, Mehwish; Idrees, Muhamad; Kanwal, Hifza; Kabir, Firoz

    2011-07-27

    Viral hepatitis is one of the major health problems worldwide, particularly in South East Asian countries including Pakistan where hepatitis C virus (HCV) and hepatitis B virus (HBV) infections are highly endemic. Hepatitis delta virus (HDV) is also not uncommon world-wide. HCV, HBV, and HDV share parallel routes of transmission due to which dual or triple viral infection can occur in a proportion of patients at the same time. HBV and HCV are important factors in the development of liver cirrhosis (LC) and hepatocellular carcinoma (HCC). In addition to LC and HCC, chronic HDV infection also plays an important role in liver damage with oncogenic potential.The current article reviews the available literature about the epidemiology, pathogenesis, transmission, symptoms, diagnosis, replication, disease outcome, treatment and preventive measures of triple hepatitis infection by using key words; epidemiology of triple infection, risk factors, awareness status, treatment and replication cycle in PubMed, PakMediNet, Directory of Open Access Journals (DOAJ) and Google Scholar. Total data from 74 different studies published from 1983 to 2010 on triple hepatitis infections were reviewed and included in this study. The present article briefly describes triple infection with HCV, HBV and HDV.

  8. Test results for triple-modulation radar electronics with improved range disambiguation

    Energy Technology Data Exchange (ETDEWEB)

    Pollastrone, Fabio, E-mail: fabio.pollastrone@enea.it; Neri, Carlo

    2015-10-15

    Highlights: • A new digital radar electronic system based on triple-modulation has been developed. • The triple-modulation system uses an improved algorithm for the range-disambiguation. • The new radar electronics has been applied in the IVVS optical radar prototype for ITER. • The performances obtained with IVVS double and triple-modulation were compared. - Abstract: The In Vessel Viewing System (IVVS) is an optical radar with sub milimetrical resolution that will be used for imaging and metrology pourposes in ITER. The electronics of the system is based on a Digital Radar Electronics developed in ENEA Frascati laboratories during the past years. Until the present study, the system was based on amplitude modulation technique having double-modulation frequency. The power of the laser is sinusoidally modulated and the distance of the points scanned by the laser beam is obtained measuring the phase difference between outgoing and echo signals. Recently a triple-modulation radar electronics version and an algorithm able to solve the range disambiguation were developed. The aim of the upgrade was the increase of the robustness in the range disambiguation. The paper briefly describes the updates carried out on the Digital Radar Electronics and extensively the test results obtained by comparing the performance of the triple modulation versus the double modulation techniques.

  9. MDP-based resource allocation for triple-play transmission on xDSL systems

    Science.gov (United States)

    de Souza, Lamartine V.; de Carvalho, Glaucio H. S.; Cardoso, Diego L.; de Carvalho, Solon V.; Frances, Carlos R. L.; Costa, João C. W. A.; Riu, Jaume Rius i.

    2007-09-01

    Many broadband services are based on multimedia applications, such as voice over internet protocol (VoIP), video conferencing, video on demand (VoD), and internet protocol television (IPTV). The combination "triple-play" is often used with IPTV. It simply means offering voice, video and data. IPTV and others services uses digital broadband networks such as ADSL2+ (Asymmetric Digital Subscriber Line) and VDSL (Very High Rate DSL) to transmit the data. We have formulated a MDP (Markov Decision Process) for a triple-play transmission on DSL environment. In this paper, we establish the relationship between DSL transmission characteristics and its finite-state Markov model for a triple-play transmission system. This relationship can be used for a resource management for multimedia applications delivered through a broadband infrastructure. The solution to our optimization problem can be found using dynamic programming (DP) techniques, such as value iteration and its variants. Our study results in a transmission strategy that chooses the optimal resource allocation according the triple-play traffic requirements, defined in technical report TR-126 (Triple-Play Services Quality of Experience Requirements) from DSL Forum, minimizing quality of service (QoS) violations with respect to bandwidth. Three traffic classes (video, audio, and best effort internet data) are defined and analyzed. Our simulation results show parameters like as blocking probability for each class, link utilization and optimal control policies. The MDP-based approach provides a satisfactory way of resource management for a DSL system.

  10. Studies of the Triple Pomeron Vertex in perturbative QCD and its applications in phenomenology

    International Nuclear Information System (INIS)

    Kutak, K.

    2006-12-01

    We study the properties of the Triple Pomeron Vertex in the perturbative QCD using the twist expansion method. Such analysis allows us to find the momenta configurations preferred by the vertex. When the momentum transfer is zero, the dominant contribution in the limit when N c →∞ comes from anticollinear pole. This is in agreement with result obtained without expanding, but by direct averaging of the Triple Pomeron Vertex over angles. Resulting theta functions show that the anticollinear configuration is optimal for the vertex. In the finite N c case the collinear term also contributes. Using the Triple Pomeron Vertex we construct a pomeron loop and we also consider four gluon propagation between two Triple Pomeron Vertices. We apply the Triple Pomeron Vertex to construct the Hamiltonian from which we derive the Balitsky-Kovchegov equation for an unintegrated gluon density. In order to apply this equation to phenomenology, we apply the Kwiecinski-Martin-Stasto model for higher order corrections to a linear part of the Balitsky-Kovchegov equation. We introduce the definition of the saturation scale which reflects properties of this equation. Finally, we use it for computation of observables, such as the F 2 structure function and diffractive Higgs boson production cross section. The impact of screening corrections on F 2 is negligible, but those effects turn out to be significant for diffractive Higgs boson production at LHC

  11. Studies of the Triple PomeronVertex in perturbative QCD and its applications in phenomenology

    Energy Technology Data Exchange (ETDEWEB)

    Kutak, K.

    2006-12-15

    We study the properties of the Triple Pomeron Vertex in the perturbative QCD using the twist expansion method. Such analysis allows us to find the momenta configurations preferred by the vertex. When the momentum transfer is zero, the dominant contribution in the limit when N{sub c}{yields}{infinity} comes from anticollinear pole. This is in agreement with result obtained without expanding, but by direct averaging of the Triple Pomeron Vertex over angles. Resulting theta functions show that the anticollinear configuration is optimal for the vertex. In the finite N{sub c} case the collinear term also contributes. Using the Triple Pomeron Vertex we construct a pomeron loop and we also consider four gluon propagation between two Triple Pomeron Vertices. We apply the Triple Pomeron Vertex to construct the Hamiltonian from which we derive the Balitsky-Kovchegov equation for an unintegrated gluon density. In order to apply this equation to phenomenology, we apply the Kwiecinski-Martin-Stasto model for higher order corrections to a linear part of the Balitsky-Kovchegov equation. We introduce the definition of the saturation scale which reflects properties of this equation. Finally, we use it for computation of observables, such as the F{sub 2} structure function and diffractive Higgs boson production cross section. The impact of screening corrections on F{sub 2} is negligible, but those effects turn out to be significant for diffractive Higgs boson production at LHC.

  12. Triple p-positive parenting program for mothers of ADHD children.

    Science.gov (United States)

    Aghebati, Asma; Gharraee, Banafsheh; Hakim Shoshtari, Mitra; Gohari, Mahmood Reza

    2014-01-01

    Attention deficit hyperactivity disorder (ADHD) is a chronic, highly prevalent neurodevelopmental disorder which affects 9% of school-age children. Triple P-Positive Parenting Program is an evidence-based parenting program reported to be useful in the management of this disorder. The aim of this randomized controlled trial was to evaluate the effectiveness of Triple P in mothers of ADHD children. In this study, 30 mothers with ADHD children aged between 6 to 10 were randomly assigned to two groups (15 participants in each group). Parenting style, mother-child relationship, maternal depression, anxiety and stress, and children's behavioral problems were evaluated. The intervention group received 120 minute sessions for 5 weeks and 15-30 minute telephone contacts for 3 weeks while no intervention was done for the control group. Analysis of covariance revealed that mothers of the Triple P group showed significant (p parenting style, mother-child relationship, and considerable decrease in depression, anxiety and stress. Women trained in the Triple P group also reported significantly lower rates of child misbehavior than women of the control group. Triple P-Positive Parenting intervention is effective and acceptable for mothers of ADHD children. None. Clinical Trial Registration-URL: http://www.irct.ir. Unique identifier: IRCT201111288234N1.

  13. Triple Negative Breast Cancer in Pregnancy and Postpartum: Two Case Reports in Hispanic Women

    Directory of Open Access Journals (Sweden)

    Ruchi Upadhyay

    2015-01-01

    Full Text Available Objective. Despite studies suggesting that triple negative breast cancer is more often seen in women of African ancestry, we report here two cases of pregnancy associated triple negative breast cancer in Hispanic women. Cases. Case one is a 37-year-old female para 2-0-0-2, who presented with a left breast mass, at 19 weeks of gestation, the biopsy of which reported an invasive ductal carcinoma, found to be triple receptor negative. The patient underwent chemotherapy during the pregnancy and was delivered with a cesarean at 37 weeks for obstetric indication. After delivery, the patient completed her chemotherapy that was followed by radical mastectomy and radiotherapy. Case two is a 28-year-old female para 6-0-1-5, who presented while breast-feeding with signs and symptoms of mastitis, and an engorged and tender right breast, five months postpartum. However, the sonogram revealed a fluid filled cavity. Aspiration and cytology did not reflect an infection and were negative for malignancy. High suspicion and lack of improvement led to biopsy that identified an invasive ductal carcinoma, found to be triple negative. The patient underwent chemotherapy followed by modified radical mastectomy. Conclusions. Triple negative breast cancer, during pregnancy or postpartum, poses a unique challenge and requires a multidisciplinary team to optimize treatment for these women.

  14. Comparison of split double and triple twists in pair figure skating.

    Science.gov (United States)

    King, Deborah L; Smith, Sarah L; Brown, Michele R; McCrory, Jean L; Munkasy, Barry A; Scheirman, Gary I

    2008-05-01

    In this study, we compared the kinematic variables of the split triple twist with those of the split double twist to help coaches and scientists understand these landmark pair skating skills. High-speed video was taken during the pair short and free programmes at the 2002 Salt Lake City Winter Olympics and the 2003 International Skating Union Grand Prix Finals. Three-dimensional analyses of 14 split double twists and 15 split triple twists from eleven pairs were completed. In spite of considerable variability in the performance variables among the pairs, the main difference between the split double twists and split triple twists was an increase in rotational rate. While eight of the eleven pairs relied primarily on an increased rotational rate to complete the split triple twist, three pairs employed a combined strategy of increased rotational rate and increased flight time due predominantly to delayed or lower catches. These results were similar to observations of jumps in singles skating for which the extra rotation is typically due to an increase in rotational velocity; increases in flight time come primarily from delayed landings as opposed to additional height during flight. Combining an increase in flight time and rotational rate may be a good strategy for completing the split triple twist in pair skating.

  15. Characterization of bundled and individual triple-walled carbon nanotubes by resonant Raman spectroscopy.

    Science.gov (United States)

    Hirschmann, Thomas Ch; Araujo, Paulo T; Muramatsu, Hiroyuki; Zhang, Xu; Nielsch, Kornelius; Kim, Yoong Ahm; Dresselhaus, Mildred S

    2013-03-26

    The optical characterization of bundled and individual triple-walled carbon nanotubes was studied for the first time in detail by using resonant Raman spectroscopy. In our approach, the outer tube of a triple-walled carbon nanotube system protects the two inner tubes (or equivalently the inner double-walled carbon nanotube) from external environment interactions making them a partially isolated system. Following the spectral changes and line-widths of the radial breathing modes and G-band by performing laser energy dependent Raman spectroscopy, it is possible to extract important information as regards to the electronic and vibrational properties, tube diameters, wall-to-wall distances, radial breathing mode, and G-band resonance evolutions as well as high-curvature intertube interactions in isolated double- and triple-walled carbon nanotube systems.

  16. Wavelets and triple difference as a mathematical method for filtering and mitigation of DGPS errors

    Directory of Open Access Journals (Sweden)

    Aly M. El-naggar

    2015-12-01

    Wavelet spectral techniques can separate GPS signals into sub-bands where different errors can be separated and mitigated. The main goal of this paper was the development and implementation of DGPS error mitigation techniques using triple difference and wavelet. This paper studies, analyzes and provides new techniques that will help mitigate these errors in the frequency domain. The proposed technique applied to smooth noise for GPS receiver positioning data is based upon the analysis of wavelet transform (WT. The technique is applied using wavelet as a de-noising tool to tackle the high-frequency errors in the triple difference domain and to obtain a de-noised triple difference signal that can be used in a positioning calculation.

  17. Triple photonic band-gap structure dynamically induced in the presence of spontaneously generated coherence

    International Nuclear Information System (INIS)

    Gao Jinwei; Bao Qianqian; Wan Rengang; Cui Cuili; Wu Jinhui

    2011-01-01

    We study a cold atomic sample coherently driven into the five-level triple-Λ configuration for attaining a dynamically controlled triple photonic band-gap structure. Our numerical calculations show that three photonic band gaps with homogeneous reflectivities up to 92% can be induced on demand around the probe resonance by a standing-wave driving field in the presence of spontaneously generated coherence. All these photonic band gaps are severely malformed with probe reflectivities declining rapidly to very low values when spontaneously generated coherence is gradually weakened. The triple photonic band-gap structure can also be attained in a five-level chain-Λ system of cold atoms in the absence of spontaneously generated coherence, which however requires two additional traveling-wave fields to couple relevant levels.

  18. Transport and interaction blockade of cold bosonic atoms in a triple-well potential

    International Nuclear Information System (INIS)

    Schlagheck, P; Malet, F; Cremon, J C; Reimann, S M

    2010-01-01

    We theoretically investigate the transport properties of cold bosonic atoms in a quasi-one-dimensional (1D) triple-well potential that consists of two large outer wells, which act as microscopic source and drain reservoirs, and a small inner well, which represents a quantum-dot-like scattering region. Bias and gate 'voltages' introduce a time-dependent tilt of the triple-well configuration, and are used to shift the energetic level of the inner well with respect to the outer ones. By means of exact diagonalization considering a total number of six atoms in the triple-well potential, we find diamond-like structures for the occurrence of single-atom transport in the parameter space spanned by the bias and gate voltages. We discuss the analogy with Coulomb blockade in electronic quantum dots, and point out how one can infer the interaction energy in the central well from the distance between the diamonds.

  19. From double Chooz to triple Chooz - neutrino physics at the Chooz reactor complex

    International Nuclear Information System (INIS)

    Huber, Patrick; Kopp, Joachim; Lindner, Manfred; Rolinec, Mark; Winter, Walter

    2006-01-01

    We discuss the potential of the proposed Double Chooz reactor experiment to measure the neutrino mixing angle sin 2 2θ 13 . We especially consider systematical uncertainties and their partial cancellation in a near and far detector operation, and we discuss implications of a delayed near detector startup. Furthermore, we introduce Triple Chooz, which is a possible upgrade scenario assuming a second, larger far detector, which could start data taking in an existing cavern five years after the first far detector. We review the role of the Chooz reactor experiments in the global context of future neutrino beam experiments. We find that both Double Chooz and Triple Chooz can play a leading role in the search for a finite value of sin 2 2θ 13 . Double Chooz could achieve a sensitivity limit of ∼ 2.10 -2 at the 90% confidence level after 5 years while the Triple Chooz setup could give a sensitivity below 10 -2

  20. Aligning emergency care with the triple aim: Opportunities and future directions after healthcare reform.

    Science.gov (United States)

    Agrawal, Shantanu; Conway, Patrick H

    2014-09-01

    The Triple Aim of better health, better care, and lower costs has become a fundamental framework for understanding the need for broad health care reform and describing health care value. While the framework is not specific to any clinical setting, this article focuses on the alignment between the framework and Emergency Department (ED) care. The paper explores where emergency care is naturally aligned with each Aim, as well as current barriers which must be addressed to meet the full vision of the Triple Aim. We propose a vision of EDs serving as a nexus for care coordination optimally consistent with the Triple Aim and the requirements for such a role. These requirements include: (1) substantial integration in coordinated care models; (2) development of reliable and actionable data on ED quality, population health, and cost outcomes; (3) specific initiatives to control and optimize ED utilization; and (4) payment models which preserve surge and disaster response capacity. Published by Elsevier Inc.

  1. How To Design A Triple Bottom Line Organization: A Start-Up Case Study

    Directory of Open Access Journals (Sweden)

    Bernhard Schroeder

    2014-05-01

    Full Text Available In today’s business environment, where success for a start-up company is measured by early revenue and profit, it can be quite challenging to design a triple bottom line organization (people/planet/profit from the very beginning. We present a case study of a U.S.-based start-up firm and discuss its early challenges, developmental processes, and current success as a triple bottom line firm. The company’s founder and CEO, with no initial product, distribution, or revenue strategy, sought to develop a company that could provide the marketplace with a valuable product while also staying true to a corporate vision of positively affecting less fortunate people. Our analysis of the case suggests that the founder’s vision, passion, transparent communication, and leveraging of partners’ resources were key elements in building the firm. We draw implications of our case study for the designers of future triple bottom line organizations.

  2. Gain uniformity experimental study performed on triple-GEM gas detector

    International Nuclear Information System (INIS)

    Dong Liyuan; Qi Huirong; Lu Xinyu; Ouyang Qun; Chen Yuanbo; Li Yuhong

    2012-01-01

    With the application of the two-dimensional GEM gaseous detector in X-ray imaging, the correction method of gain uniformity caused by triple-GEM avalanche structures and electric field uniformity should be studied. The paper reported the study of the triple-GEM detector with effective area 100 mm × 100 mm used the Pad's size of 9.5 mm × 9.5 mm. In the test, 100 readout channels were designed. Results showed that gain remained stable over time; at air flow increases, gain from increases obviously to changes very little. Particularly, triple-GEM's gain uniformity was very good (more than 80%) and the range of energy resolution was from 0.18 to 0.2. To improve gain consistency of results, the difference value revised was obtained to be about 0.1 by the least square method. It provided a better method to improve gain uniformity of GEM detector. (authors)

  3. Design and Analysis of a Triple Stop-band Filter Using Ratioed Periodical Defected Microstrip Structure

    Science.gov (United States)

    Jiang, Tao; Wang, Yanyan; Li, Yingsong

    2017-07-01

    In this paper, a triple stop-band filter with a ratioed periodical defected microstrip structure is proposed for wireless communication applications. The proposed ratioed periodical defected microstrip structures are spiral slots, which are embedded into a 50 Ω microstrip line to obtain multiple stop-bands. The performance of the proposed triple stop-band filter is investigated numerically and experimentally. Moreover, the equivalent circuit model of the proposed filter is also established and discussed. The results are given to verify that the proposed triple stop-band filter has three stop bands at 3.3 GHz, 5.2 GHz, 6.8 GHz to reject the unwanted signals, which is promising for integrating into UWB communication systems to efficiently prevent the potential interferences from unexpected narrowband signals such as WiMAX, WLAN and RFID communication systems.

  4. High flux polarized neutrons triple-axis spectrometer: 2T (LLB-Saclay)

    International Nuclear Information System (INIS)

    Bourges, Ph.; Hennion, B.; Sidis, Y.; Boutrouille, Ph.; Baroni, P.

    1999-01-01

    A description of the performance of the newly designed thermal beam triple-axis spectrometer, 2T at LLB (Saclay) is given. The beam tube will be increased to 50 x 120 mm 2 (HxV) before the monochromator. A gain of about a factor 2 on the neutron flux at the monitor position is expected after this operation, scheduled on April/May 1999. Polarized neutrons beam option will be installed on this triple axis. The polarization is obtained using high quality heusler crystals recently grown at ILL. The size of both heusler monochromator and analyzer have been chosen to fully cover the beam size. The monochromator (analyzer) will be equipped with a vertical (horizontal) curvature. The flux of the polarized beam on the detector is then expected to be 5 times better than IN20 at ILL (best existing polarized neutrons triple-axis on thermal beam) with incident energy upto 75 MeV. (author)

  5. Gender differences in triple jump phase ratios and arm swing motion of international level athletes

    Directory of Open Access Journals (Sweden)

    Vassilios Panoutsakopoulos

    2016-12-01

    Full Text Available Background: Female triple jumping is a relatively new athletics event. A limited number of researchers have focused on comparing male and female jumpers competing in international events, resulting in scarce findings in the literature regarding gender differences of the determinants of triple jump performance. Objective: The aim of the study was to examine the possible gender differences in the approach step characteristics, the spatiotemporal parameters of the separate phases of the triple jump as performed by athletes participating in sub-elite international events. Methods: The male and female participants of the 2015 European Team Championships triple jump event were recorded with a panning video camera. Approach speed was measured using photocells. Kinematical parameters were extracted using the APAS WIZARD 13.3.0.3 software. The relationships between the examined parameters and the actual triple jump performance were examined with Pearson's correlation analysis. Repeated measures ANOVA and chi-square statistical tests were run to examine the significance of the differences between genders. Results: Approach speed significantly correlated with the actual jumping distance in both males and females (p < .05. Significant gender differences (p < .05 existed concerning basic kinematical parameters. Men were found to have larger average horizontal speed of the 11 m to 1 m segment of the final approach, step length of the final six steps of the approach, step frequency of the final two steps, actual phase distances and percentage distribution of the step. Women, unlike men, used solely single arm swing techniques. No athlete executed the jump using a jump dominated technique. Conclusions: Gender differences in triple jump performance lies upon the kinematical parameters of the final two steps of the approach, the length of the step phase and the support time for the jump. The technique elements of the penultimate step are suggested to

  6. Thermochemistry of uranium(VI), arsenic, and alkali metal triple oxides

    International Nuclear Information System (INIS)

    Karyakin, N.V.; Chernorukov, G.N.

    1994-01-01

    The standard enthalpies of reactions of stoichiometric mixtures of potassium dyhydrogen orthoarsenate, uranium(VI) oxide, alkali metal nitrates, and of mixtures of triple oxides with the general formula M I AsUO 6 (M I =Li, Na, K, Rb, and Cs) and potassium nitrate with aqueous solution of hydrofluoric acid were determined an an adiabatic calorimeter at 298.15 K. The standard enthalpies of formation of uranium(VI), arsenic, and alkali metal triple oxides at 298.15 K were calculated form the data obtained. 8 refs., 1 tab

  7. Structure of 12C and the triple-α process

    DEFF Research Database (Denmark)

    Fynbo, H.O.U.; Diget, C.Aa.

    2014-01-01

    We review experiments at IGISOL and associated work at ISOLDE and KVI on the use of the β-decays of 12N and 12B for the study of the structure of 12C and the consequences for the rate of the triple-α reaction in stars.......We review experiments at IGISOL and associated work at ISOLDE and KVI on the use of the β-decays of 12N and 12B for the study of the structure of 12C and the consequences for the rate of the triple-α reaction in stars....

  8. A Modified Triple Pelvic Osteotomy for the Treatment of Hip Hypoplasia

    Directory of Open Access Journals (Sweden)

    Hassan Rahimi

    2013-09-01

    Full Text Available Background: The prevalence of hip dysplasia is 1 in 1000. Several pelvic osteotomy methods have been developed to prevent early osteoarthritis, such as triple osteotomy. In this study we are going to introduce our new technique that was done on 4 patients with favorable short-term results.   Methods: Four patients underwent triple osteotomy and fixation using a reconstruction plate and early weight bearing was started. Results: The Harris Hip Score, limb length, center-edge angle, and acetabular inclination showed improvement. Conclusion: This modified technique is suggested for corrective surgery on adult dysplastic hips.

  9. Two-loop corrections to the triple Higgs boson production cross section

    Energy Technology Data Exchange (ETDEWEB)

    Florian, Daniel de [International Center for Advanced Studies (ICAS), ECyT-UNSAM, Campus Miguelete, 25 de Mayo y Francia (1650) Buenos Aires (Argentina); Mazzitelli, Javier [International Center for Advanced Studies (ICAS), ECyT-UNSAM, Campus Miguelete, 25 de Mayo y Francia (1650) Buenos Aires (Argentina); Physik-Institut, Universität Zürich, Winterthurerstrasse 190, CH-8057 Zürich (Switzerland)

    2017-02-22

    In this paper we compute the QCD corrections for the triple Higgs boson production cross section via gluon fusion, within the heavy-top approximation. We present, for the first time, analytical results for the next-to-leading order corrections, and also compute the soft and virtual contributions of the next-to-next-to-leading order cross section. We provide predictions for the total cross section and the triple Higgs invariant mass distribution. We find that the QCD corrections are large at both perturbative orders, and that the scale uncertainty is substantially reduced when the second order perturbative corrections are included.

  10. Physics of lateral triple quantum-dot molecules with controlled electron numbers.

    Science.gov (United States)

    Hsieh, Chang-Yu; Shim, Yun-Pil; Korkusinski, Marek; Hawrylak, Pawel

    2012-11-01

    We review the recent progress in theory and experiments with lateral triple quantum dots with controlled electron numbers down to one electron in each dot. The theory covers electronic and spin properties as a function of topology, number of electrons, gate voltage and external magnetic field. The orbital Hund's rules and Nagaoka ferromagnetism, magnetic frustration and chirality, interplay of quantum interference and electron-electron interactions and geometrical phases are described and related to charging and transport spectroscopy. Fabrication techniques and recent experiments are covered, as well as potential applications of triple quantum-dot molecule in coherent control, spin manipulation and quantum computation.

  11. Modeling Radiation Effects on a Triple Junction Solar Cell using Silvaco ATLAS

    OpenAIRE

    Schiavo, Daniel

    2012-01-01

    In this research, Silvaco ATLAS, an advanced virtual wafer fabrication tool, was used to model the effects of radiation on a triple junction InGaP/GaAs/Ge solar cell. A Silvaco ATLAS model of a triple junction InGaP/GaAs/Ge cell was created by first creating individual models for solar cells composed of each material. Realistic doping levels were used and thicknesses were varied to produce the design parameters and create reasonably efficient solar cell models for testing. After the individua...

  12. Nottingham Prognostic Index in Triple-Negative Breast Cancer: a reliable prognostic tool?

    International Nuclear Information System (INIS)

    Albergaria, André; Ricardo, Sara; Milanezi, Fernanda; Carneiro, Vítor; Amendoeira, Isabel; Vieira, Daniella; Cameselle-Teijeiro, Jorge; Schmitt, Fernando

    2011-01-01

    A breast cancer prognostic tool should ideally be applicable to all types of invasive breast lesions. A number of studies have shown histopathological grade to be an independent prognostic factor in breast cancer, adding prognostic power to nodal stage and tumour size. The Nottingham Prognostic Index has been shown to accurately predict patient outcome in stratified groups with a follow-up period of 15 years after primary diagnosis of breast cancer. Clinically, breast tumours that lack the expression of Oestrogen Receptor, Progesterone Receptor and Human Epidermal growth factor Receptor 2 (HER2) are identified as presenting a 'triple-negative' phenotype or as triple-negative breast cancers. These poor outcome tumours represent an easily recognisable prognostic group of breast cancer with aggressive behaviour that currently lack the benefit of available systemic therapy. There are conflicting results on the prevalence of lymph node metastasis at the time of diagnosis in triple-negative breast cancer patients but it is currently accepted that triple-negative breast cancer does not metastasize to axillary nodes and bones as frequently as the non-triple-negative carcinomas, favouring instead, a preferentially haematogenous spread. Hypothetically, this particular tumour dissemination pattern would impair the reliability of using Nottingham Prognostic Index as a tool for triple-negative breast cancer prognostication. The present study tested the effectiveness of the Nottingham Prognostic Index in stratifying breast cancer patients of different subtypes with special emphasis in a triple-negative breast cancer patient subset versus non- triple-negative breast cancer. We demonstrated that besides the fact that TNBC disseminate to axillary lymph nodes as frequently as luminal or HER2 tumours, we also showed that TNBC are larger in size compared with other subtypes and almost all grade 3. Additionally, survival curves demonstrated that these prognostic factors are

  13. Optical Interference Coatings Design Contest 2007: triple bandpass filter and nonpolarizing beam splitter.

    Science.gov (United States)

    Tilsch, Markus; Hendrix, Karen

    2008-05-01

    A triple bandpass filter (28 solutions received) and a nonpolarizing beam splitter (23 solutions received) were the subjects of the design contest held in conjunction with the 2007 Optical Interference Coatings topical meeting of the Optical Society of America. Fifteen designers participated using a wide spectrum of design approaches and optimization strategies to create the submissions. The results differ significantly, but all meet the contest requirements. Fabien Lemarchand wins both contests by submitting the thinnest (6254 nm) triple bandpass design and the widest (61.7 nm) nonpolarizing beam-splitter design. Michael Trubetskov is in second place, followed by Vladimir Pervak in both contests. The submitted designs are described and evaluated.

  14. Triple superphosphate obtaining from Bayovar phosphoric rock and labelling with P-32

    International Nuclear Information System (INIS)

    Rodriguez, J.

    1983-01-01

    In view of the fact that in Peru the triple superphosphate utilized is an imported product and that, on the other hand, the phospherous rocks of Bayovar contain an average of 18% of P 2 O 5 , a process of enrichment was carried out in order to obtain at an experimental level the triple superphosphate having the necessary requirements for agricultural use. At a later stage the product obtained was labelled with P-32. To verify the experiment, phosphor was extracted in continuous fractionated form and at the same time colorimetric determinations with the method of the Vanado-Molibdo-Phosphor were carried out

  15. Physics of lateral triple quantum-dot molecules with controlled electron numbers

    International Nuclear Information System (INIS)

    Hsieh, Chang-Yu; Shim, Yun-Pil; Korkusinski, Marek; Hawrylak, Pawel

    2012-01-01

    We review the recent progress in theory and experiments with lateral triple quantum dots with controlled electron numbers down to one electron in each dot. The theory covers electronic and spin properties as a function of topology, number of electrons, gate voltage and external magnetic field. The orbital Hund's rules and Nagaoka ferromagnetism, magnetic frustration and chirality, interplay of quantum interference and electron–electron interactions and geometrical phases are described and related to charging and transport spectroscopy. Fabrication techniques and recent experiments are covered, as well as potential applications of triple quantum-dot molecule in coherent control, spin manipulation and quantum computation. (review article)

  16. Triple-effect absorption refrigeration system with double-condenser coupling

    Science.gov (United States)

    DeVault, Robert C.; Biermann, Wendell J.

    1993-01-01

    A triple effect absorption refrigeration system is provided with a double-condenser coupling and a parallel or series circuit for feeding the refrigerant-containing absorbent solution through the high, medium, and low temperature generators utilized in the triple-effect system. The high temperature condenser receiving vaporous refrigerant from the high temperature generator is double coupled to both the medium temperature generator and the low temperature generator to enhance the internal recovery of heat within the system and thereby increase the thermal efficiency thereof.

  17. Recovering the triple coincidence of non-pure positron emitters in preclinical PET

    Science.gov (United States)

    Lin, Hsin-Hon; Chuang, Keh-Shih; Chen, Szu-Yu; Jan, Meei-Ling

    2016-03-01

    Non-pure positron emitters, with their long half-lives, allow for the tracing of slow biochemical processes which cannot be adequately examined by the commonly used short-lived positron emitters. Most of these isotopes emit high-energy cascade gamma rays in addition to positron decay that can be detected and create a triple coincidence with annihilation photons. Triple coincidence is discarded in most scanners, however, the majority of the triple coincidence contains true photon pairs that can be recovered. In this study, we propose a strategy for recovering triple coincidence events to raise the sensitivity of PET imaging for non-pure positron emitters. To identify the true line of response (LOR) from a triple coincidence, a framework utilizing geometrical, energy and temporal information is proposed. The geometrical criterion is based on the assumption that the LOR with the largest radial offset among the three sub pairs of triple coincidences is least likely to be a true LOR. Then, a confidence time window is used to test the valid LOR among those within triple coincidence. Finally, a likelihood ratio discriminant rule based on the energy probability density distribution of cascade and annihilation gammas is established to identify the true LOR. An Inveon preclinical PET scanner was modeled with GATE (GEANT4 application for tomographic emission) Monte Carlo software. We evaluated the performance of the proposed method in terms of identification fraction, noise equivalent count rates (NECR), and image quality on various phantoms. With the inclusion of triple coincidence events using the proposed method, the NECR was found to increase from 11% to 26% and 19% to 29% for I-124 and Br-76, respectively, when 7.4-185 MBq of activity was used. Compared to the reconstructed images using double coincidence, this technique increased the SNR by 5.1-7.3% for I-124 and 9.3-10.3% for Br-76 within the activity range of 9.25-74 MBq, without compromising the spatial resolution or

  18. Evaluation of a novel triple-channel radiochromic film analysis procedure using EBT2.

    Science.gov (United States)

    van Hoof, Stefan J; Granton, Patrick V; Landry, Guillaume; Podesta, Mark; Verhaegen, Frank

    2012-07-07

    A novel approach to read out radiochromic film was introduced recently by the manufacturer of GafChromic film. In this study, the performance of this triple-channel film dosimetry method was compared against the conventional single-red-channel film dosimetry procedure, with and without inclusion of a pre-irradiation (pre-IR) film scan, using EBT2 film and kilo- and megavoltage photon beams up to 10 Gy. When considering regions of interest averaged doses, the triple-channel method and both single-channel methods produced equivalent results. Absolute dose discrepancies between the triple-channel method, both single-channel methods and the treatment planning system calculated dose values, were no larger than 5 cGy for dose levels up to 2.2 Gy. Signal to noise in triple-channel dose images was found to be similar to signal to noise in single-channel dose images. The accuracy of resulting dose images from the triple- and single-channel methods with inclusion of pre-IR film scan was found to be similar. Results of a comparison of EBT2 data from a kilovoltage depth dose experiment to corresponding Monte Carlo depth dose data produced dose discrepancies of 9.5 ± 12 cGy and 7.6 ± 6 cGy for the single-channel method with inclusion of a pre-IR film scan and the triple-channel method, respectively. EBT2 showed to be energy sensitive at low kilovoltage energies with response differences of 11.9% and 15.6% in the red channel at 2 Gy between 50-225 kVp and 80-225 kVp photon spectra, respectively. We observed that the triple-channel method resulted in non-uniformity corrections of ±1% and consistency values of 0-3 cGy for the batches and dose levels studied. Results of this study indicate that the triple-channel radiochromic film read-out method performs at least as well as the single-channel method with inclusion of a pre-IR film scan, reduces film non-uniformity and saves time with elimination of a pre-IR film scan.

  19. Added flexibility in triple axis spectrometers: The two RITAs at Risø

    DEFF Research Database (Denmark)

    Lefmann, K.; McMorrow, D.F.; Rønnow, H.M.

    2000-01-01

    The cold-neutron triple-axis spectrometer RITA-I at Rise has been operational for about three years, and in the near future an improved version, RITA-2 will replace the existing triple-axis instrument TAS7. We review the performance of RITA-1 and the operation modes of its flexible secondary...... spectrometer, giving examples of a few key experiments, and describe the software developed for running it. Further, the design of the new RITA-2 instrument is presented. The two RITA spectrometers are compared with their sister instrument SPINS at NIST and with similar instruments planned elsewhere. (C) 2000...

  20. Phantom studies of triple photon absorptiometry and bone mineral measurement at a hip prosthesis

    International Nuclear Information System (INIS)

    Farrell, T.J.; Webber, C.E.

    1992-01-01

    The feasibility of using triple photon absorptiometry (TPA) for the measurement of bone mineral mass about a hip prosthesis was examined. A theoretical expression describing the variance of TPA measurements was verified using a triple photon source and phantom materials which simulate the soft tissue-bone mineral-metal prosthesis system. The expression for the variance was used to determine an optimized set of photon energies. It was shown that a precision of 3% could be obtained for reasonable measurement times using this optimized set of energies and that TPA should be a feasible approach for measurement of bone mineral about a hip prosthesis. (orig.)

  1. Measurement of triple gauge-boson couplings at 172 GeV

    Science.gov (United States)

    ALEPH Collaboration; Barate, R.; Buskulic, D.; Decamp, D.; Ghez, P.; Goy, C.; Jezequel, S.; Lees, J.-P.; Lucotte, A.; Minard, M.-N.; Nief, J.-Y.; Pietrzyk, B.; Boix, G.; Casado, M. P.; Chmeissani, M.; Crespo, J. M.; Delfino, M.; Fernandez, E.; Fernandez-Bosman, M.; Garrido, Ll.; Graugès, E.; Juste, A.; Martinez, M.; Merino, G.; Miquel, R.; Mir, Ll. M.; Morawitz, P.; Park, I. C.; Pascual, A.; Perlas, J. A.; Riu, I.; Sanchez, F.; Colaleo, A.; Creanza, D.; de Palma, M.; Gelao, G.; Iaselli, G.; Maggi, G.; Maggi, M.; Nuzzo, S.; Ranieri, A.; Raso, G.; Ruggieri, F.; Selvaggi, G.; Silvestris, L.; Tempesta, P.; Tricomi, A.; Zito, G.; Huang, X.; Lin, J.; Ouyang, Q.; Wang, T.; Xie, Y.; Xu, R.; Xue, S.; Zhang, J.; Zhang, L.; Zhao, W.; Abbaneo, D.; Alemany, R.; Becker, U.; Bright-Thomas, P.; Casper, D.; Cattaneo, M.; Cerutti, F.; Ciulli, V.; Dissertori, G.; Drevermann, H.; Forty, R. W.; Frank, M.; Gianotti, F.; Hagelberg, R.; Hansen, J. B.; Harvey, J.; Janot, P.; Jost, B.; Lehraus, I.; Mato, P.; Minten, A.; Moneta, L.; Pacheco, A.; Pusztaszeri, J.-F.; Ranjard, F.; Rolandi, L.; Rousseau, D.; Schlatter, D.; Schmitt, M.; Schneider, O.; Tejessy, W.; Teubert, F.; Tomalin, I. R.; Vreeswijk, M.; Wachsmuth, H.; Wagner, A.; Ajaltouni, Z.; Badaud, F.; Chazelle, G.; Deschamps, O.; Falvard, A.; Ferdi, C.; Gay, P.; Guicheney, C.; Henrard, P.; Jousset, J.; Michel, B.; Monteil, S.; Montret, J.-C.; Pallin, D.; Perret, P.; Podlyski, F.; Proriol, J.; Rosnet, P.; Fearnley, T.; Hansen, J. D.; Hansen, J. R.; Hansen, P. H.; Nilsson, B. S.; Rensch, B.; Wäänänen, A.; Daskalakis, G.; Kyriakis, A.; Markou, C.; Simopoulou, E.; Vayaki, A.; Blondel, A.; Brient, J.-C.; Machefert, F.; Rougé, A.; Rumpf, M.; Valassi, A.; Videau, H.; Boccali, T.; Focardi, E.; Parrini, G.; Zachariadou, K.; Cavanaugh, R.; Corden, M.; Georgiopoulos, C.; Huehn, T.; Jaffe, D. E.; Antonelli, A.; Bencivenni, G.; Bologna, G.; Bossi, F.; Campana, P.; Capon, G.; Chiarella, V.; Felici, G.; Laurelli, P.; Mannocchi, G.; Murtas, F.; Murtas, G. P.; Passalacqua, L.; Pepe-Altarelli, M.; Curtis, L.; Dorris, S. J.; Halley, A. W.; Lynch, J. G.; Negus, P.; O'Shea, V.; Raine, C.; Scarr, J. M.; Smith, K.; Teixeira-Dias, P.; Thompson, A. S.; Thomson, E.; Thomson, F.; Ward, J. J.; Buchmüller, O.; Dhamotharan, S.; Geweniger, C.; Graefe, G.; Hanke, P.; Hansper, G.; Hepp, V.; Kluge, E. E.; Putzer, A.; Sommer, J.; Tittel, K.; Werner, S.; Wunsch, M.; Beuselinck, R.; Binnie, D. M.; Cameron, W.; Dornan, P. J.; Girone, M.; Goodsir, S.; Martin, E. B.; Marinelli, N.; Moutoussi, A.; Nash, J.; Sedgbeer, J. K.; Spagnolo, P.; Williams, M. D.; Ghete, V. M.; Girtler, P.; Kneringer, E.; Kuhn, D.; Rudolph, G.; Betteridge, A. P.; Bowdery, C. K.; Buck, P. G.; Colrain, P.; Crawford, G.; Finch, A. J.; Foster, F.; Hughes, G.; Jones, R. W. L.; Whelan, E. P.; Williams, M. I.; Giehl, I.; Hoffmann, C.; Jakobs, K.; Kleinknecht, K.; Quast, G.; Renk, B.; Rohne, E.; Sander, H.-G.; van Gemmeren, P.; Zeitnitz, C.; Aubert, J. J.; Benchouk, C.; Bonissent, A.; Bujosa, G.; Carr, J.; Coyle, P.; Ealet, A.; Fouchez, D.; Leroy, O.; Motsch, F.; Payre, P.; Talby, M.; Sadouki, A.; Thulasidas, M.; Tilquin, A.; Trabelsi, K.; Aleppo, M.; Antonelli, M.; Ragusa, F.; Berlich, R.; Blum, W.; Büscher, V.; Dietl, H.; Ganis, G.; Gotzhein, C.; Kroha, H.; Lütjens, G.; Lutz, G.; Mannert, C.; Männer, W.; Moser, H.-G.; Richter, R.; Rosado-Schlosser, A.; Schael, S.; Settles, R.; Seywerd, H.; Stenzel, H.; Wiedenmann, W.; Wolf, G.; Boucrot, J.; Callot, O.; Chen, S.; Davier, M.; Duflot, L.; Grivaz, J.-F.; Heusse, Ph.; Höcker, A.; Jacholkowska, A.; Kado, M. M.; Kim, D. W.; Le Diberder, F.; Lefrançois, J.; Lutz, A.-M.; Schune, M.-H.; Serin, L.; Tournefier, E.; Veillet, J.-J.; Videau, I.; Zerwas, D.; Azzurri, P.; Bagliesi, G.; Bettarini, S.; Bozzi, C.; Calderini, G.; dell'Orso, R.; Fantechi, R.; Ferrante, I.; Giassi, A.; Gregorio, A.; Ligabue, F.; Lusiani, A.; Marrocchesi, P. S.; Messineo, A.; Palla, F.; Rizzo, G.; Sanguinetti, G.; Sciabà, A.; Sguazzoni, G.; Steinberger, J.; Tenchini, R.; Vannini, C.; Venturi, A.; Verdini, P. G.; Blair, G. A.; Bryant, L. M.; Chambers, J. T.; Coles, J.; Green, M. G.; Medcalf, T.; Perrodo, P.; Strong, J. A.; von Wimmersperg-Toeller, J. H.; Botterill, D. R.; Clifft, R. W.; Edgecock, T. R.; Haywood, S.; Maley, P.; Norton, P. R.; Thompson, J. C.; Wright, A. E.; Bloch-Devaux, B.; Colas, P.; Fabbro, B.; Faïf, G.; Lançon, E.; Lemaire, M.-C.; Locci, E.; Perez, P.; Przysiezniak, H.; Rander, J.; Renardy, J.-F.; Rosowsky, A.; Roussarie, A.; Trabelsi, A.; Vallage, B.; Black, S. N.; Dann, J. H.; Kim, H. Y.; Konstantinidis, N.; Litke, A. M.; McNeil, M. A.; Taylor, G.; Booth, C. N.; Brew, C. A. J.; Cartwright, S.; Combley, F.; Kelly, M. S.; Lehto, M.; Reeve, J.; Thompson, L. F.; Affholderbach, K.; Böhrer, A.; Brandt, S.; Cowan, G.; Foss, J.; Grupen, C.; Smolik, L.; Stephan, F.; Apollonio, M.; Bosisio, L.; della Marina, R.; Giannini, G.; Gobbo, B.; Musolino, G.; Putz, J.; Rothberg, J.; Wasserbaech, S.; Williams, R. W.; Armstrong, S. R.; Charles, E.; Elmer, P.; Ferguson, D. P. S.; Gao, Y.; González, S.; Greening, T. C.; Hayes, O. J.; Hu, H.; Jin, S.; McNamara, P. A., III; Nachtman, J. M.; Nielsen, J.; Orejudos, W.; Pan, Y. B.; Saadi, Y.; Scott, I. J.; Walsh, J.; Wu, Sau Lan; Wu, X.; Yamartino, J. M.; Zobernig, G.

    1998-03-01

    The triple gauge-boson couplings, αWΦ, αW and αBΦ, have been measured using 34 semileptonically and 54 hadronically decaying W+W- candidate events. The events were selected in the data recorded during 1996 with the ALEPH detector at 172 GeV, corresponding to an integrated luminosity of 10.65 pb-1. The triple gauge-boson couplings have been measured using optimal observables constructed from kinematic information of W+W- events. The results are in agreement with the Standard Model expectation.

  2. Evaluation of a novel triple-channel radiochromic film analysis procedure using EBT2

    International Nuclear Information System (INIS)

    Van Hoof, Stefan J; Granton, Patrick V; Landry, Guillaume; Podesta, Mark; Verhaegen, Frank

    2012-01-01

    A novel approach to read out radiochromic film was introduced recently by the manufacturer of GafChromic film. In this study, the performance of this triple-channel film dosimetry method was compared against the conventional single-red-channel film dosimetry procedure, with and without inclusion of a pre-irradiation (pre-IR) film scan, using EBT2 film and kilo- and megavoltage photon beams up to 10 Gy. When considering regions of interest averaged doses, the triple-channel method and both single-channel methods produced equivalent results. Absolute dose discrepancies between the triple-channel method, both single-channel methods and the treatment planning system calculated dose values, were no larger than 5 cGy for dose levels up to 2.2 Gy. Signal to noise in triple-channel dose images was found to be similar to signal to noise in single-channel dose images. The accuracy of resulting dose images from the triple- and single-channel methods with inclusion of pre-IR film scan was found to be similar. Results of a comparison of EBT2 data from a kilovoltage depth dose experiment to corresponding Monte Carlo depth dose data produced dose discrepancies of 9.5 ± 12 cGy and 7.6 ± 6 cGy for the single-channel method with inclusion of a pre-IR film scan and the triple-channel method, respectively. EBT2 showed to be energy sensitive at low kilovoltage energies with response differences of 11.9% and 15.6% in the red channel at 2 Gy between 50–225 kVp and 80–225 kVp photon spectra, respectively. We observed that the triple-channel method resulted in non-uniformity corrections of ±1% and consistency values of 0–3 cGy for the batches and dose levels studied. Results of this study indicate that the triple-channel radiochromic film read-out method performs at least as well as the single-channel method with inclusion of a pre-IR film scan, reduces film non-uniformity and saves time with elimination of a pre-IR film scan. (paper)

  3. Building integration photovoltaic module with reference to Ghana: using triple junction amorphous silicon

    OpenAIRE

    Essah, Emmanuel Adu

    2010-01-01

    This paper assesses the potential for using building integrated photovoltaic (BIPV) \\ud roof shingles made from triple-junction amorphous silicon (3a-Si) for electrification \\ud and as a roofing material in tropical countries, such as Accra, Ghana. A model roof \\ud was constructed using triple-junction amorphous (3a-Si) PV on one section and \\ud conventional roofing tiles on the other. The performance of the PV module and tiles \\ud were measured, over a range of ambient temperatures and solar...

  4. A Lagrangian framework for deriving triples and quadruples corrections to the CCSD energy

    DEFF Research Database (Denmark)

    Eriksen, Janus Juul; Kristensen, Kasper; Kjærgaard, Thomas

    2014-01-01

    Using the coupled cluster Lagrangian technique, we have determined perturbative corrections to the coupled cluster singles and doubles (CCSD) energy that converge towards the coupled cluster singles, doubles, and triples (CCSDT) and coupled cluster singles, doubles, triples, and quadruples (CCSDTQ......) energies, considering the CCSD state as the unperturbed reference state and the fluctua- tion potential as the perturbation. Since the Lagrangian technique is utilized, the energy corrections satisfy Wigner’s 2n + 1 rule for the cluster amplitudes and the 2n + 2 rule for the Lagrange multi- pliers...

  5. [Opacification of an intraocular lens: calcification of hydrophilic intraocular lenses after gas tamponade of the anterior chamber].

    Science.gov (United States)

    Schmidinger, G; Pemp, B; Werner, L

    2013-11-01

    A patient with endothelial dystrophy was treated with Descemet stripping automated endothelial keratoplasty (DSAEK) combined with cataract extraction and implantation of a hydrophilic intraocular lens (IOL, Lentis-L312, Oculentis) but visual acuity dropped from 0.15 logMAR to 0.52 logMAR 18 months later due to calcification of the IOL. With new methods of lamellar corneal transplantation being used more frequently the number of necessary anterior chamber tamponades with air/gas are increasing. In cataract cases in which a gas tamponade and transplantation might be necessary later on (cornea guttata), hydrophilic IOLs should be avoided.

  6. Effectiveness of the Triple P Positive Parenting Program on behavioral problems in children: A meta-analysis

    NARCIS (Netherlands)

    de Graaf, I.; Speetjens, P.; Smit, F.; de Wolff, M.; Tavecchio, L.

    2008-01-01

    The Triple P Positive Parenting Program is a multilevel parenting program to prevent and offer treatment for severe behavioral, emotional, and developmental problems in children. The aim of this meta-analysis is to assess the effectiveness of Triple P Level 4 interventions in the management of

  7. CCR 20th Anniversary Commentary: Triple-Negative Breast Cancer in 2015—Still in the Ballpark.

    Science.gov (United States)

    Narod, Steven A; Dent, Rebecca A; Foulkes, William D

    2015-09-01

    The research article by Dent and colleagues, which was published in the August 1, 2007, issue of Clinical Cancer Research, provided a clinical description of metastatic progression of triple-negative breast cancers. Finding successful treatment strategies for women with triple-negative breast cancer remains a challenge. ©2015 American Association for Cancer Research.

  8. Isolated orbital mass as the primary presentation of a triple-hit lymphoma transformed from a systemic follicular lymphoma.

    Science.gov (United States)

    Zhou, Xiao Yi; Lu, Xinyan; Raparia, Kirtee; Chen, Yi-Hua

    2018-06-01

    Triple-hit lymphoma is a highly aggressive B-cell lymphoma. We report a case of triple-hit lymphoma transformed from systemic follicular lymphoma (FL) after 9-year remission and presented primarily as an isolated orbital mass without systemic symptoms or lymphadenopathy. A 58-year-old female presented with intermittent vertical binocular diplopia, left upper eyelid swelling and pain and was found to have a 2.9 cm orbital mass. Histological section revealed a CD10-positive large B-cell lymphoma, consistent with transformation of FL. Fluorescent in situ hybridization (FISH) analysis demonstrated rearrangements involving C-MYC, BCL-2 and BCL-6 genes, indicating a high grade, triple-hit lymphoma. Triple-hit lymphoma transformed from a low-grade lymphoma may initially present as an isolated orbital mass without systemic evidence of transformation. Early recognition of double or triple-hit lymphomas is important since these patients require aggressive chemotherapy.

  9. Effectiveness of the Triple P Positive Parenting Program on behavioral problems in children: a meta-analysis.

    Science.gov (United States)

    de Graaf, Ireen; Speetjens, Paula; Smit, Filip; de Wolff, Marianne; Tavecchio, Louis

    2008-09-01

    The Triple P Positive Parenting Program is a multilevel parenting program to prevent and offer treatment for severe behavioral, emotional, and developmental problems in children. The aim of this meta-analysis is to assess the effectiveness of Triple P Level 4 interventions in the management of behavioral problems in children by pooling the evidence from relevant literature that included Level 4 Triple P interventions. Level 4 intervention is indicated if the child has multiple behavior problems in a variety of settings and there are clear deficits in parenting skills. Results indicate that Level 4 of Triple P interventions reduced disruptive behaviors in children. These improvements were maintained well over time, with further improvements in long-term follow-up. These effects support the widespread adoption and implementation of Triple P that is taking place in an increasing number of countries in quite diverse cultural contexts around the world.

  10. Establishment of a New National Reference Ensemble of Water Triple Point Cells

    Science.gov (United States)

    Senn, Remo

    2017-10-01

    The results of the Bilateral Comparison EURAMET.T-K3.5 (w/VSL, The Netherlands) with the goal to link Switzerland's ITS-90 realization (Ar to Al) to the latest key comparisons gave strong indications for a discrepancy in the realization of the triple point of water. Due to the age of the cells of about twenty years, it was decided to replace the complete reference ensemble with new "state-of-the-art" cells. Three new water triple point cells from three different suppliers were purchased, as well as a new maintenance bath for an additional improvement of the realization. In several loops measurements were taken, each cell of both ensembles intercompared, and the deviations and characteristics determined. The measurements show a significant lower average value of the old ensemble of 0.59 ± 0.25 mK (k=2) in comparison with the new one. Likewise, the behavior of the old cells is very unstable with a drift downward during the realization of the triple point. Based on these results the impact of the new ensemble on the ITS-90 realization from Ar to Al was calculated and set in the context to performed calibrations and their related uncertainties in the past. This paper presents the instrumentation, cells, measurement procedure, results, uncertainties and impact of the new national reference ensemble of water triple point cells on the current ITS-90 realization in Switzerland.

  11. Triple-A: the political economy of the blockbuster video game

    NARCIS (Netherlands)

    Nieborg, D.B.

    2011-01-01

    David Nieborg onderzocht blockbuster of Triple A games voor spelcomputers. Hij bekeek hoe de game-industrie aan het veranderen is door de druk van voortdurende innovatie en welke weerslag dit heeft op zowel de games zelf (de verscheidenheid) als op hun distributiewijze. Nieborg vindt dat er steeds

  12. Rendezvous of the "Third Kind": Triple Helix Origins and Future Possibilities

    Science.gov (United States)

    Etzkowitz, Henry

    2015-01-01

    The Triple Helix, representing university-industry-government interactions, was rooted in a 1993 International Workshop on University-Industry Relations at UNAM's Centro Para la Innovacion Technologica in Mexico City. Impelled by Mexican reality, where university-industry interactions and the institutions themselves operated within a governmental…

  13. Triple P business development in the Dutch agro-food sector : 9 cases of strategic innovation

    NARCIS (Netherlands)

    Someren, van T.C.R.; Nijhof, A.H.J.

    2010-01-01

    The 21st Century will be dominated by innovations in order to realize sustainable development. Innovative entrepreneurs will search for and create Triple P business cases and thereby transform industries. The Dutch agro-food sector innovation programme TransForum has stimulated and supported a wide

  14. The triple helix of collagens - an ancient protein structure that enabled animal multicellularity and tissue evolution.

    Science.gov (United States)

    Fidler, Aaron L; Boudko, Sergei P; Rokas, Antonis; Hudson, Billy G

    2018-04-09

    The cellular microenvironment, characterized by an extracellular matrix (ECM), played an essential role in the transition from unicellularity to multicellularity in animals (metazoans), and in the subsequent evolution of diverse animal tissues and organs. A major ECM component are members of the collagen superfamily -comprising 28 types in vertebrates - that exist in diverse supramolecular assemblies ranging from networks to fibrils. Each assembly is characterized by a hallmark feature, a protein structure called a triple helix. A current gap in knowledge is understanding the mechanisms of how the triple helix encodes and utilizes information in building scaffolds on the outside of cells. Type IV collagen, recently revealed as the evolutionarily most ancient member of the collagen superfamily, serves as an archetype for a fresh view of fundamental structural features of a triple helix that underlie the diversity of biological activities of collagens. In this Opinion, we argue that the triple helix is a protein structure of fundamental importance in building the extracellular matrix, which enabled animal multicellularity and tissue evolution. © 2018. Published by The Company of Biologists Ltd.

  15. ADAM-17: a novel therapeutic target for triple negative breast cancer.

    LENUS (Irish Health Repository)

    McGowan, P M

    2013-02-01

    Validated targeted therapy is currently unavailable for patients with invasive breast cancer negative for oestrogen receptors, progesterone receptors and HER2 [i.e., those with triple-negative (TN) disease]. ADAM-17 is a protease involved in the activations of several ligands that bind to and promotes intracellular signalling from the EGFR\\/HER family of receptors.

  16. Triple helical DNA in a duplex context and base pair opening

    Science.gov (United States)

    Esguerra, Mauricio; Nilsson, Lennart; Villa, Alessandra

    2014-01-01

    It is fundamental to explore in atomic detail the behavior of DNA triple helices as a means to understand the role they might play in vivo and to better engineer their use in genetic technologies, such as antigene therapy. To this aim we have performed atomistic simulations of a purine-rich antiparallel triple helix stretch of 10 base triplets flanked by canonical Watson–Crick double helices. At the same time we have explored the thermodynamic behavior of a flipping Watson–Crick base pair in the context of the triple and double helix. The third strand can be accommodated in a B-like duplex conformation. Upon binding, the double helix changes shape, and becomes more rigid. The triple-helical region increases its major groove width mainly by oversliding in the negative direction. The resulting conformations are somewhere between the A and B conformations with base pairs remaining almost perpendicular to the helical axis. The neighboring duplex regions maintain a B DNA conformation. Base pair opening in the duplex regions is more probable than in the triplex and binding of the Hoogsteen strand does not influence base pair breathing in the neighboring duplex region. PMID:25228466

  17. Electrode alignment of transverse tripoles using a percutaneous triple-lead approach in spinal cord stimulation

    NARCIS (Netherlands)

    Sankarasubramanian, V.; Buitenweg, Jan R.; Holsheimer, J.; Veltink, Petrus H.

    The aim of this modeling study is to determine the influence of electrode alignment of transverse tripoles on the paresthesia coverage of the pain area in spinal cord stimulation, using a percutaneous triple-lead approach. Transverse tripoles, comprising a central cathode and two lateral anodes,

  18. The effects of gastrocnemius-soleus muscle forces on ankle biomechanics during triple arthrodesis

    DEFF Research Database (Denmark)

    Hejazi, Shima; Rouhi, Gholamreza; Rasmussen, John

    2017-01-01

    This paper presents a finite element model of the ankle, taking into account the effects of muscle forces, determined by a musculoskeletal analysis, to investigate the contact stress distribution in the tibio-talar joint in patients with triple arthrodesis and in normal subjects. Forces of major a...

  19. Influences of triple junctions on stress-assisted grain boundary motion in nanocrystalline materials

    International Nuclear Information System (INIS)

    Aramfard, Mohammad; Deng, Chuang

    2014-01-01

    Stress-assisted grain boundary motion is among the most studied modes of microstructural evolution in crystalline materials. In this study, molecular dynamics simulations were used to systematically investigate the influences of triple junctions on the stress-assisted motion of symmetric tilt grain boundaries in Cu by considering a honeycomb nanocrystalline model. It was found that the grain boundary motion in nanocrystalline models was highly sensitive to the loading mode, and a strong coupling effect which was prevalent in bicrystal models was only observed when simple shear was applied. In addition, the coupling factor extracted from the honeycomb model was found to be larger and more sensitive to temperature change than that from bicrystal models for the same type of grain boundary under the same loading conditions. Furthermore, the triple junctions seemed to exhibit unusual asymmetric pinning effects to the migrating grain boundary and the constraints by the triple junctions and neighboring grains led to remarkable non-linear grain boundary motion in directions both parallel and normal to the applied shear, which was in stark contrast to that observed in bicrystal models. In addition, dislocation nucleation and propagation, which were absent in the bicrystal model, were found to play an important role on shear-induced grain boundary motion when triple junctions were present. In the end, a generalized model for shear-assisted grain boundary motion was proposed based on the findings from this research. (paper)

  20. Analytic reconstruction algorithms for triple-source CT with horizontal data truncation

    International Nuclear Information System (INIS)

    Chen, Ming; Yu, Hengyong

    2015-01-01

    Purpose: This paper explores a triple-source imaging method with horizontal data truncation to enlarge the field of view (FOV) for big objects. Methods: The study is conducted by using theoretical analysis, mathematical deduction, and numerical simulations. The proposed algorithms are implemented in c + + and MATLAB. While the basic platform is constructed in MATLAB, the computationally intensive segments are coded in c + +, which are linked via a MEX interface. Results: A triple-source circular scanning configuration with horizontal data truncation is developed, where three pairs of x-ray sources and detectors are unevenly distributed on the same circle to cover the whole imaging object. For this triple-source configuration, a fan-beam filtered backprojection-type algorithm is derived for truncated full-scan projections without data rebinning. The algorithm is also extended for horizontally truncated half-scan projections and cone-beam projections in a Feldkamp-type framework. Using their method, the FOV is enlarged twofold to threefold to scan bigger objects with high speed and quality. The numerical simulation results confirm the correctness and effectiveness of the developed algorithms. Conclusions: The triple-source scanning configuration with horizontal data truncation cannot only keep most of the advantages of a traditional multisource system but also cover a larger FOV for big imaging objects. In addition, because the filtering is shift-invariant, the proposed algorithms are very fast and easily parallelized on graphic processing units