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Sample records for lens diaphragm patient

  1. [Visual rehabilitation of patients with large post-traumatic defects of the anterior eye segment through iris-lens diaphragm implantation].

    Science.gov (United States)

    Khodzhaev, N S; Sobolev, N P; Mushkova, I A; Izmaylova, S B; Karimova, A N

    The diversity of methodological approaches and lack of pathogenetically reasonable tactics for patients with combined ocular injuries became the basis for the development and systematization of surgical rehabilitation stages of patients, in whom post-traumatic cataract is combined with post-traumatic aniridia and corneal scarring. to construct a visual rehabilitation approach to patients with post-traumatic defects of the anterior eye segment following optical-reconstructive surgery that involved implantation of an iris-lens diaphragm (ILD). We have analyzed 80 reconstructive cases with ILD implantation in patients with post-traumatic aniridia and corneal damage. These patients constituted the first study group (Group 1). We have also investigated 58 eyes with residual ametropy and stable visual function 1 year after ILD implantation before and after conducting a laser keratorefractive surgery. These patients were assigned to the second study group (Group 2). Rehabilitation approach to patients after anterior segment injuries that has been proposed allows to achieve high clinical and functional results and reduce the risk of intra- and postoperative complications. The proposed approach to patients after optical-reconstructive surgery with iris-lens diaphragm implantation followed by keratorefractive surgery is an effective method of visual rehabilitation of anterior eye segment post-traumatic defects.

  2. Diaphragm adaptations in patients with COPD.

    NARCIS (Netherlands)

    Ottenheijm, C.A.C.; Heunks, L.M.A.; Dekhuijzen, P.N.R.

    2008-01-01

    Inspiratory muscle weakness in patients with COPD is of major clinical relevance. For instance, maximum inspiratory pressure generation is an independent determinant of survival in severe COPD. Traditionally, inspiratory muscle weakness has been ascribed to hyperinflation-induced diaphragm

  3. 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.

  4. Diaphragm pacing improves sleep in patients with amyotrophic lateral sclerosis.

    Science.gov (United States)

    Gonzalez-Bermejo, Jesus; Morélot-Panzini, Capucine; Salachas, François; Redolfi, Stefania; Straus, Christian; Becquemin, Marie-Hélène; Arnulf, Isabelle; Pradat, Pierre-François; Bruneteau, Gaëlle; Ignagni, Anthony R; Diop, Moustapha; Onders, Raymond; Nelson, Teresa; Menegaux, Fabrice; Meininger, Vincent; Similowski, Thomas

    2012-01-01

    In amyotrophic lateral sclerosis (ALS) patients, respiratory insufficiency is a major burden. Diaphragm conditioning by electrical stimulation could interfere with lung function decline by promoting the development of type 1 muscle fibres. We describe an ancillary study to a prospective, non-randomized trial (NCT00420719) assessing the effects of diaphragm pacing on forced vital capacity (FVC). Sleep-related disturbances being early clues to diaphragmatic dysfunction, we postulated that they would provide a sensitive marker. Stimulators were implanted laparoscopically in the diaphragm close to the phrenic motor point in 18 ALS patients for daily conditioning. ALS functioning score (ALSFRS), FVC, sniff nasal inspiratory pressure (SNIP), and polysomnographic recordings (PSG, performed with the stimulator turned off) were assessed before implantation and after four months of conditioning (n = 14). Sleep efficiency improved (69 ± 15% to 75 ± 11%, p = 0.0394) with fewer arousals and micro-arousals. This occurred against a background of deterioration as ALSFRS-R, FVC, and SNIP declined. There was, however, no change in NIV status or the ALSFRS respiratory subscore, and the FVC decline was mostly due to impaired expiration. Supporting a better diaphragm function, apnoeas and hypopnoeas during REM sleep decreased. In conclusion, in these severe patients not expected to experience spontaneous improvements, diaphragm conditioning improved sleep and there were hints at diaphragm function changes.

  5. A novel technique for diaphragm biopsies in human patients.

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    Noullet, Séverine; Romero, Norma; Menegaux, Fabrice; Chapart, Maud; Demoule, Alexandre; Morelot-Panzini, Capucine; Similowski, Thomas; Gonzalez-Bermejo, Jésus

    2015-06-15

    The diaphragm is difficult to biopsy because of its anatomic location. We describe a new laparoscopic diaphragm biopsy technique. Fifty one patients with amyotrophic lateral sclerosis gave their consent to diaphragm biopsy in the context of an implanted phrenic nerve stimulation protocol (NCT01583088). The biopsy was taken from the costal diaphragm, after opening the parietal peritoneum with scissors, and by grasping the diaphragmatic muscle over the rib with toothed laparoscopy forceps. The first four electrocoagulation biopsies were unsuitable for morphologic examination. The following 47 biopsies were therefore performed without electrocoagulation. The mean size of the biopsy fragments obtained after preparation was 3 ± 1 × 2 ± 1 × 1 ± 1 mm (maximum: 4 × 3 × 2 mm). A diaphragmatic injury occurred during the section in three cases requiring immediate suture without causing pneumothorax. A small pleural effusion was observed on the postoperative chest x-ray in one patient with a spontaneously favorable outcome. Numerous stains were able to be performed on the fragments obtained. Diaphragm biopsy can be safely performed by laparoscopy and yields tissue suitable for our future histologic evaluation. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Fabrication of polymer micro-lens array with pneumatically diaphragm-driven drop-on-demand inkjet technology.

    Science.gov (United States)

    Xie, Dan; Zhang, Honghai; Shu, Xiayun; Xiao, Junfeng

    2012-07-02

    The paper reports an effective method to fabricate micro-lens arrays with the ultraviolet-curable polymer, using an original pneumatically diaphragm-driven drop-on-demand inkjet system. An array of plano convex micro-lenses can be formed on the glass substrate due to surface tension and hydrophobic effect. The micro-lens arrays have uniform focusing function, smooth and real planar surface. The fabrication process showed good repeatability as well, fifty micro-lenses randomly selected form 9 × 9 miro-lens array with an average diameter of 333.28μm showed 1.1% variations. Also, the focal length, the surface roughness and optical property of the fabricated micro-lenses are measured, analyzed and proved satisfactory. The technique shows great potential for fabricating polymer micro-lens arrays with high flexibility, simple technological process and low production cost.

  7. Diaphragm Muscle Fiber Weakness and Ubiquitin-Proteasome Activation in Critically Ill Patients

    NARCIS (Netherlands)

    Hooijman, P.E.; Beishuizen, A.; Witt, C.C.; de Waard, M.C.; Girbes, A.R.J.; Spoelstra-de Man, A.M.E.; Niessen, H.W.; Manders, E.; van Hees, H.W.H.; van den Brom, C.E.; Silderhuis, V.; Lawlor, M.W.; Labeit, S.; Stienen, G.J.M.; Hartemink, K.J.; Paul, M.A.; Heunks, L.M.A.; Ottenheijm, C.A.C.

    2015-01-01

    RATIONALE: The clinical significance of diaphragm weakness in critically ill patients is evident: it prolongs ventilator dependency, and increases morbidity and duration of hospital stay. To date, the nature of diaphragm weakness and its underlying pathophysiologic mechanisms are poorly understood.

  8. Rectal diaphragm in a patient with imperforate anus and rectoprostatic fistula

    Directory of Open Access Journals (Sweden)

    Thakur Ashokanand

    2009-01-01

    Full Text Available The association of rectal diaphragm in an imperforate anus has not been reported until now. A 1-year-old male presented with right transverse colostomy for high anorectal malformation. The patient had imperforate anus and a recto-prostatic fistula with rectal diaphragm. We managed the case by an ano-rectal pull through with excision of the diaphragm.

  9. Generalized free-space diffuse photon transport model based on the influence analysis of a camera lens diaphragm.

    Science.gov (United States)

    Chen, Xueli; Gao, Xinbo; Qu, Xiaochao; Chen, Duofang; Ma, Xiaopeng; Liang, Jimin; Tian, Jie

    2010-10-10

    The camera lens diaphragm is an important component in a noncontact optical imaging system and has a crucial influence on the images registered on the CCD camera. However, this influence has not been taken into account in the existing free-space photon transport models. To model the photon transport process more accurately, a generalized free-space photon transport model is proposed. It combines Lambertian source theory with analysis of the influence of the camera lens diaphragm to simulate photon transport process in free space. In addition, the radiance theorem is also adopted to establish the energy relationship between the virtual detector and the CCD camera. The accuracy and feasibility of the proposed model is validated with a Monte-Carlo-based free-space photon transport model and physical phantom experiment. A comparison study with our previous hybrid radiosity-radiance theorem based model demonstrates the improvement performance and potential of the proposed model for simulating photon transport process in free space.

  10. Estimation of diaphragm length in patients with severe chronic obstructive pulmonary disease.

    Science.gov (United States)

    McKenzie, D K; Gorman, R B; Tolman, J; Pride, N B; Gandevia, S C

    2000-11-01

    In patients with advanced chronic obstructive pulmonary disease (COPD) diaphragm function may be compromised because of reduced muscle fibre length. Diaphragm length (L(Di)) can be estimated from measurements of transverse diameter of the rib cage (D(Rc)) and the length of the zone of apposition (L(Zapp)) in healthy subjects, but this method has not been validated in patients with COPD. Postero-anterior chest radiographs were obtained at total lung capacity (TLC), functional residual capacity (FRC) and residual volume (RV) in nine male patients with severe COPD (mean [S.D.]; FEV(1), 23 [6] %pred.; FRC, 199 [15] %pred.). Radiographs taken at TLC were used to identify the lateral costal insertions of the diaphragm (L(Zapp) assumed to approach zero at TLC). L(Di) was measured directly and also estimated from measurements of L(Zapp) and D(Rc) using a prediction equation derived from healthy subjects. The estimation of L(Di) was highly accurate with an intraclass correlation coefficient of 0.93 and 95% CI of approximately +/-8% of the true value. L(Di) decreased from 426 (64) mm at RV to 305 (31) mm at TLC. As there were only small and variable changes in D(Rc) across the lung volume range, most of the L(Di) changes occurred in the zone of apposition. Additional studies showed that measurements of L(Di) from PA and lateral radiographs performed at different lung volumes were tightly correlated. These results suggest that non-invasive measurements of L(Zapp) in the coronal plane (e.g. using ultrasonography) and D(Rc) (e.g. using magnetometers) can be used to provide an accurate estimate of L(Di) in COPD patients.

  11. Therapeutic effects of diaphragmatic plication for acquired unilateral non-malignant diaphragm paralysis in twenty patients

    Directory of Open Access Journals (Sweden)

    Reza Bagheri

    2013-12-01

    Full Text Available Background: Acquired paralysis of the diaphragm is a condition caused by trauma, surgical injuries, (lung cancer surgery, esophageal surgery, cardiac surgery, thoracic surgery, and is sometimes of an unknown etiology. It can lead to dyspnea and can affect ventilatory function and patients activity. Diaphragmatic plication is a treatment method which decreases inconsistent function of diaphragm. The aim of this study is to evaluate the outcome of diaphragmatic plication in patients with acquired unilateral non-malignant diaphragmatic paralysis. Methods: From 1991 to 2011, 20 patients with acquired unilateral diaphragmatic paralysis who underwent surgery enrolled in our study in Ghaem Hospital Mashhad University of Medical Science. Patients were evaluated in terms of age, sex, BMI, clinical symptoms, dyspnea score (DS, etiology of paralysis, diagnostic methods, respiratory function tests and complication of surgery. Some tests including dyspnea score were carried out again six months after surgery. We evaluated patients with SPSS version 11.5 and Paired t-test or nonparametric equivalent. Results: Twenty patients enrolled in our study. 14 were male and 6 were female. The mean age was 58 years and the average time interval between diagnosis to surgical treatment was 38.3 months. Acquired diaphragmatic paralysis was mostly caused by trauma (in 11 patients and almost occurred on the left side (in 15 patients. Diagnostic methods included chest x-ray, CT scan, ultrasonography and sniff. Test prior to surgery the average FVC was 41.4±7 percent and the average FEV1 was 52.4±6 percent and after surgery they were 80.1±8.6 percent and 74.4±1 percent respectively. The average increase in FEV1 and FVC 63.4±4, 61.1±7.8. Performing surgery also leads to a noticeable improvement in dyspnea score in our study. Conclusion: In patients with acquired unilateral non-malignant diaphragm paralysis diaphragmatic plication is highly recommended due to the

  12. [Diaphragm pacing for the ventilatory support of the quadriplegic patients with respiratory paralysis].

    Science.gov (United States)

    Cheng, H; Wang, L S; Pan, H C; Shoung, H M; Lee, L S

    1992-02-01

    Electrical stimulation of the phrenic nerve to pace the diaphragm in patients with chronic ventilatory insufficiency has been an established therapeutic modality since William W.L. Glenn first described using radiofrequency signals in 1978 to stimulate the phrenic nerves. Before this event, patients who were ventilator-dependent and thus bedridden because of respiratory paralysis associated with quadriplegia usually anticipated little chance for physical or psychosocial rehabilitation. Two cases of C1-C2 subluxtion with cord injury and chronic ventilatory insufficiency were implanted at VGH-Taipei with diaphragm pacemaker in 1988. Postoperative phrenic nerve stimulation was given according to individual training schedule. One case with total phrenic paralysis received bilateral phrenic nerve stimulation and became weaned from the ventilator 6 months later. The other case with partially active ventilatory function received unilateral phrenic nerve stimulation to compensate the ventilation. However, its final outcome still showed the necessity of a bilateral mode to achieve adequate ventilation irrespective of strenuous training for 2 years.

  13. In patients with a tumour invading the phrenic nerve does prophylactic diaphragm plication improve postoperative lung function?

    Science.gov (United States)

    Beattie, Gwyn W; Dunn, William G; Asif, Mohammed

    2016-09-01

    A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was 'In patients with tumours involving the phrenic nerve, does prophylactic diaphragm plication improve lung function following tumour resection?' Using the reported search, 258 papers were found of which 6 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Three case reports and one case series represent 37 patients in the literature along with two relevant animal studies. Patients treated with prophylactic plication at the time of injury or sacrifice of the phrenic nerve had reduced radiological evidence of diaphragm paralysis, lower reported shortness of breath and reduced requirement for ventilatory support. In patients with prophylactic diaphragm plication and a concurrent pulmonary resection, the predicted postoperative lung function correlated closely with the postoperative measured FEV1, FVC and gas transfer. The postoperative measured FEV1 was reported as 86-98%, the FVC 82-89% and gas transfer 97% of the predicted values. Two animal models investigate the mechanics of respiration, spirometry and gas exchange following diaphragmatic plication. A randomized control study in four dogs measured a 50% reduction in tidal volume and respiratory rate, a 40% decrease in arterial PO2 and a 43% increase in arterial CO2 when the phrenic nerve was crushed in animals with a pneumonectomy but without prophylactic diaphragm plication. A further randomized control animal study with 28 dogs found that plicating the diaphragm after unilateral phrenic nerve transection resulted in a significant increase in tidal volume and lung compliance and a significant decrease in respiratory frequency and the work of breathing. Prophylactic diaphragm plication may preserve lung function, reduce the risk of

  14. DiPALS: Diaphragm Pacing in patients with Amyotrophic Lateral Sclerosis - a randomised controlled trial.

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    McDermott, Christopher J; Bradburn, Mike J; Maguire, Chin; Cooper, Cindy L; Baird, Wendy O; Baxter, Susan K; Cohen, Judith; Cantrill, Hannah; Dixon, Simon; Ackroyd, Roger; Baudouin, Simon; Bentley, Andrew; Berrisford, Richard; Bianchi, Stephen; Bourke, Stephen C; Darlison, Roy; Ealing, John; Elliott, Mark; Fitzgerald, Patrick; Galloway, Simon; Hamdalla, Hisham; Hanemann, C Oliver; Hughes, Philip; Imam, Ibrahim; Karat, Dayalan; Leek, Roger; Maynard, Nick; Orrell, Richard W; Sarela, Abeezar; Stradling, John; Talbot, Kevin; Taylor, Lyn; Turner, Martin; Simonds, Anita K; Williams, Tim; Wedzicha, Wisia; Young, Carolyn; Shaw, Pamela J

    2016-06-01

    Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease resulting in death, usually from respiratory failure, within 2-3 years of symptom onset. Non-invasive ventilation (NIV) is a treatment that when given to patients in respiratory failure leads to improved survival and quality of life. Diaphragm pacing (DP), using the NeuRx/4(®) diaphragm pacing system (DPS)™ (Synapse Biomedical, Oberlin, OH, USA), is a new technique that may offer additional or alternative benefits to patients with ALS who are in respiratory failure. The Diaphragm Pacing in patients with Amyotrophic Lateral Sclerosis (DiPALS) trial evaluated the effect of DP on survival over the study duration in patients with ALS with respiratory failure. The DiPALS trial was a multicentre, parallel-group, open-label, randomised controlled trial incorporating health economic analyses and a qualitative longitudinal substudy. Eligible participants had a diagnosis of ALS (ALS laboratory-supported probable, clinically probable or clinically definite according to the World Federation of Neurology revised El Escorial criteria), had been stabilised on riluzole for 30 days, were aged ≥ 18 years and were in respiratory failure. We planned to recruit 108 patients from seven UK-based specialist ALS or respiratory centres. Allocation was performed using 1 : 1 non-deterministic minimisation. Participants were randomised to either standard care (NIV alone) or standard care (NIV) plus DP using the NeuRX/4 DPS. The primary outcome was overall survival, defined as the time from randomisation to death from any cause. Secondary outcomes were patient quality of life [assessed by European Quality of Life-5 Dimensions, three levels (EQ-5D-3L), Short Form questionnaire-36 items and Sleep Apnoea Quality of Life Index questionnaire]; carer quality of life (EQ-5D-3L and Caregiver Burden Inventory); cost-utility analysis and health-care resource use; tolerability and adverse events. Acceptability and attitudes to

  15. Traumatic rupture of the diaphragm: CT findings

    International Nuclear Information System (INIS)

    Cho, Sung Tae; Kim, Sung Jin; Cha, Sang Hoon; Park, Kil Sun; Kim, Jin Hee; Yim, Se Hwan

    1995-01-01

    The aim of this study was to assess the clinical utility of the known CT signs of the traumatic rupture of the diaphragm. CT scans and chest radiographs were retrospectively reviewed in 13 patients who had diaphragmatic rupture confirmed by surgery. On chest radiographs the elevation of the diaphragm was evaluated. On CT, 1) discontinuity of the diaphragm, 2) lack of depiction of the diaphragm surrounding the herniated intraabdominal organs (absent diaphragm sign), and 3) fat seen lateral to the diaphragm (fat sign) were evaluated. Chest radiographs showed the elevation of the diaphragm in 11 patients (85%). CT scan showed absent diaphragm sign in 11 patients (85%), discontinuity of the diaphragm in 8 (62%), and fat sign in 7 (54%). All of 12 patients who had the left diaphragmatic rupture had one or more of the above findings. Discontinuity of the diaphragm, absent diaphragm sign, and fat sign may be helpful CT findings in the diagnosis of the traumatic rupture of the left diaphragm

  16. High Dk piggyback contact lens system for contact lens-intolerant keratoconus patients.

    Science.gov (United States)

    Sengor, Tomris; Kurna, Sevda Aydin; Aki, Suat; Ozkurt, Yelda

    2011-01-01

    The aim of the study was to examine the clinical success of high Dk (oxygen permeability) piggyback contact lens (PBCL) systems for the correction of contact lens intolerant keratoconus patients. Sixteen patients (29 eyes) who were not able to wear gas-permeable rigid lenses were included in this study. Hyper Dk silicone hydrogel (oxygen transmissibility or Dk/t = 150 units) and fluorosilicone methacrylate copolymer (Dk/t = 100 units) lenses were chosen as the PBCL systems. The clinical examinations included visual acuity and corneal observation by biomicroscopy, keratometer reading, and fluorescein staining before and after fitting the PBCL system. INDICATIONS FOR USING PBCL SYSTEM WERE: lens stabilization and comfort, improving comfort, and adding protection to the cone. Visual acuities increased significantly in all of the patients compared with spectacles (P = 0). Improvement in visual acuity compared with rigid lenses alone was recorded in 89.7% of eyes and no alteration of the visual acuity was observed in 10.3% of the eyes. Wearing time of PBCL systems for most of the patients was limited time (mean 6 months, range 3-12 months); thereafter they tolerated rigid lenses alone except for 2 patients. The PBCL system is a safe and effective method to provide centering and corneal protection against mechanical trauma by the rigid lenses for keratoconus patients and may increase contact lens tolerance.

  17. Diaphragm Dysfunction in Critical Illness.

    Science.gov (United States)

    Supinski, Gerald S; Morris, Peter E; Dhar, Sanjay; Callahan, Leigh Ann

    2018-04-01

    The diaphragm is the major muscle of inspiration, and its function is critical for optimal respiration. Diaphragmatic failure has long been recognized as a major contributor to death in a variety of systemic neuromuscular disorders. More recently, it is increasingly apparent that diaphragm dysfunction is present in a high percentage of critically ill patients and is associated with increased morbidity and mortality. In these patients, diaphragm weakness is thought to develop from disuse secondary to ventilator-induced diaphragm inactivity and as a consequence of the effects of systemic inflammation, including sepsis. This form of critical illness-acquired diaphragm dysfunction impairs the ability of the respiratory pump to compensate for an increased respiratory workload due to lung injury and fluid overload, leading to sustained respiratory failure and death. This review examines the presentation, causes, consequences, diagnosis, and treatment of disorders that result in acquired diaphragm dysfunction during critical illness. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  18. Three-dimensional quadratic modeling and quantitative evaluation of the diaphragm on a volumetric CT scan in patients with chronic obstructive pulmonary disease

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Yongjun [School of Electrical Engineering, Korea Advanced Institute of Science and Technology, 291 Daehak-ro, Yuseong-gu, Daejeon 34138 (Korea, Republic of); Bae, Jangpyo [Interdisciplinary Program, Bioengineering Major, Graduate School, Seoul National University, Seoul 08826 (Korea, Republic of); Kim, Namkug, E-mail: namkugkim@gmail.com [Department of Convergence Medicine, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505 (Korea, Republic of); Park, Joo-Young; Lee, Sang Min; Seo, Joon Beom [Department of Radiology, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505 (Korea, Republic of)

    2016-07-15

    Purpose: In patients with chronic obstructive pulmonary disease (COPD), diaphragm function may deteriorate due to reduced muscle fiber length. Quantitative analysis of the morphology of the diaphragm is therefore important. In the authors current study, they propose a diaphragm segmentation method for COPD patients that uses volumetric chest computed tomography (CT) data, and they provide a quantitative analysis of the diaphragmatic dimensions. Methods: Volumetric CT data were obtained from 30 COPD patients and 10 normal control patients using a 16-row multidetector CT scanner (Siemens Sensation 16) with 0.75-mm collimation. Diaphragm segmentation using 3D ray projections on the lower surface of the lungs was performed to identify the draft diaphragmatic lung surface, which was modeled using quadratic 3D surface fitting and robust regression in order to minimize the effects of segmentation error and parameterize diaphragm morphology. This result was visually evaluated by an expert thoracic radiologist. To take into consideration the shape features of the diaphragm, several quantification parameters—including the shape index on the apex (SIA) (which was computed using gradient set to 0), principal curvatures on the apex on the fitted diaphragm surface (CA), the height between the apex and the base plane (H), the diaphragm lengths along the x-, y-, and z-axes (XL, YL, ZL), quadratic-fitted diaphragm lengths on the z-axis (FZL), average curvature (C), and surface area (SA)—were measured using in-house software and compared with the pulmonary function test (PFT) results. Results: The overall accuracy of the combined segmentation method was 97.22% ± 4.44% while the visual accuracy of the models for the segmented diaphragms was 95.28% ± 2.52% (mean ± SD). The quantitative parameters, including SIA, CA, H, XL, YL, ZL, FZL, C, and SA were 0.85 ± 0.05 (mm{sup −1}), 0.01 ± 0.00 (mm{sup −1}), 17.93 ± 10.78 (mm), 129.80 ± 11.66 (mm), 163.19 ± 13.45 (mm), 71

  19. Simple and effective solution for diaphragm pacing by that uses the transvenous femoral approach in a patient treated with cardiac resynchronization-defibrillator therapy: The wrapping method

    Directory of Open Access Journals (Sweden)

    Ahmet Taha Alper, Prof.

    2017-08-01

    Full Text Available The use of cardiac resynchronization therapy (CRT has become widespread in patients with heart failure who meet the criteria for implantation. Coronary sinus lead positioning is important to provide the intended biventricular stimulation. Diaphragm pacing is a lead-related complication which occurs secondary to phrenic nerve stimulation. We present the case of a 58-year-old male patient who had diaphragm pacing after CRT with defibrillator implantation. The complication was resolved by using the transvenous femoral approach with the wrapping method.

  20. Successful Reinnervation of the Diaphragm After Intercostal to Phrenic Nerve Neurotization in Patients With High Spinal Cord Injury.

    Science.gov (United States)

    Nandra, Kulvir S; Harari, Martin; Price, Thea P; Greaney, Patrick J; Weinstein, Michael S

    2017-08-01

    Our objective in this study was to extend diaphragmatic pacing therapy to include paraplegic patients with high cervical spinal cord injuries between C3 and C5. Diaphragmatic pacing has been used in patients experiencing ventilator-dependent respiratory failure due to spinal cord injury as a means to reduce or eliminate the need for mechanical ventilation. However, this technique relies on intact phrenic nerve function. Recently, phrenic nerve reconstruction with intercostal nerve grafting has expanded the indications for diaphragmatic pacing. Our study aimed to evaluate early outcomes and efficacy of intercostal nerve transfer in diaphragmatic pacing. Four ventilator-dependent patients with high cervical spinal cord injuries were selected for this study. Each patient demonstrated absence of phrenic nerve function via external neck stimulation and laparoscopic diaphragm mapping. Each patient underwent intercostal to phrenic nerve grafting with implantation of a phrenic nerve pacer. The patients were followed, and ventilator dependence was reassessed at 1 year postoperatively. Our primary outcome was measured by the amount of time our patients tolerated off the ventilator per day. We found that all 4 patients have tolerated paced breathing independent of mechanical ventilation, with 1 patient achieving 24 hours of tracheostomy collar. From this study, intercostal to phrenic nerve transfer seems to be a promising approach in reducing or eliminating ventilator support in patients with C3 to C5 high spinal cord injury.

  1. Iris reconstruction combined with iris-claw intraocular lens implantation for the management of iris-lens injured patients.

    Science.gov (United States)

    Hu, Shufang; Wang, Mingling; Xiao, Tianlin; Zhao, Zhenquan

    2016-03-01

    To study the efficiency and safety of iris reconstruction combined with iris-claw intraocular lens (IOL) implantation in the patients with iris-lens injuries. Retrospective, noncomparable consecutive case series study. Eleven patients (11 eyes) following iris-lens injuries underwent iris reconstructions combined with iris-claw IOL implantations. Clinical data, such as cause and time of injury, visual acuity (VA), iris and lens injuries, surgical intervention, follow-up period, corneal endothelial cell count, and optical coherence tomography, were collected. Uncorrected VA (UCVA) in all injured eyes before combined surgery was equal to or iris returned to its natural round shape or smaller pupil, and the iris-claw IOLs in the 11 eyes were well-positioned on the anterior surface of reconstructed iris. No complications occurred in those patients. Iris reconstruction combined with iris-claw IOL implantation is a safe and efficient procedure for an eye with iris-lens injury in the absence of capsular support.

  2. Phacoemulsification and intraocular lens implantation in patients with oculocutaneous albinism.

    Science.gov (United States)

    Dávila, Pedro J; Ulloa-Padilla, Jan P; Izquierdo, Natalio J

    2017-01-01

    To evaluate the benefits of phacoemulsification and intraocular lens implantation in patients with oculocutaneous albinism (OCA). The charts of 195 patients with OCA who visited a local eye clinic were reviewed. All of these patients had genetic linkage analysis to establish OCA type. Frequencies and Paired t-test analysis were determined. Of the 195 patients, nine (4.6%) underwent clear cornea phacoemulsification with intraocular lens implantation. Seven of the nine patients with OCA had the Hermansky-Pudlak (HPS) type 1; two had OCA type 1. Pre-operative BCVA of all eyes ranged from 1.0 to 2.3 logMAR with a mean of 1.42 logMAR and a standard deviation of 0.41 logMAR. Post-operative BCVA of all eyes ranged from 1.0 to 1.30 logMAR with a mean of 1.04 logMAR and a standard deviation of 0.10 logMAR. BCVA improved after phacoemulsification surgery and intraocular lens implantation (p = 0.002). Pre-operative astigmatism of all eyes ranged from +0.50 to +5.75 with a mean of +2.25 and a standard deviation of +2.40. Post-operative astigmatism of all eyes ranged from +0.50 to +2.00 with a mean of +1.23 and a standard deviation of +0.42. Astigmatism improved after phacoemulsification surgery and intraocular lens implantation (p = 0.05). Nine patients with OCA who underwent phacoemulsification and intraocular lens implant experienced improved visual acuity and reduced astigmatism post-operatively. These results suggest cataract surgery may improve vision and refractive errors, and thus quality of life, in patients with albinism.

  3. Transient anterior subcapsular vacuolar change of the crystalline lens in patients after posterior chamber phakic intraocular lens implantation.

    Science.gov (United States)

    Chung, Jin Kwon; Shin, Jin Hee; Lee, Sung Jin

    2013-10-25

    We present two cases of transient vacuolar changes in the anterior subcapsular space of the crystalline lens in patients after posterior chamber phakic intraocular lens implantation. Implantable collamer lenses (ICL) were implanted in healthy myopic patients. Vacuolar changes developed just after the irrigating procedure through the narrow space between the ICL and the crystalline lens. Slit-lamp examinations and spectral domain optical coherence tomography showed bleb-like lesions in the anterior subcapsular space of one eye in each case, though the lesions gradually improved without visual deterioration. Consequently, the lesions turned into a few anterior subcapsular small faint opacities. Direct irrigation of the narrow space confined by the ICL and the crystalline lens is at risk for the development of vacuolar changes in the crystalline lens. The observed spontaneous reversal indicates that surgeons should not rush to surgical intervention but rather opt for close follow over several weeks.

  4. Phacoemulsification using iris hooks and scleral fixation of the intraocular lens in patients with secondary glaucoma associated with lens subluxation.

    Science.gov (United States)

    Ma, K T; Lee, H K; Seong, G J; Kim, C Y

    2008-09-01

    We described the techniques and results of phacoemulsification using iris hook and scleral fixation of intraocular lens (IOL) in patients with secondary glaucoma associated with lens subluxation. Eight eyes of seven patients with secondary glaucoma associated with lens dislocation, who had undergone the surgery, were retrospectively reviewed. At a mean of 23.5 months+/-13.6 (SD) after the surgery, the mean best-corrected visual acuity improved from 0.24+/-0.21 to 0.83+/-0.3, and mean intraocular pressure (IOP) was changed from 38.4+/-11.4 to 15.5+/-1.8 mmHg at the final examination. There were no vitreoretinal complications except cystoid macular oedema in one eye. The technique appears to be safe and effective in terms of visual rehabilitation and controlling IOP in patients with secondary glaucoma associated with lens subluxation.

  5. Eventration of diaphragm with a rare association

    Directory of Open Access Journals (Sweden)

    Syed Shafiq

    2014-01-01

    Full Text Available Eventration of the diaphragm is a rare anomaly of unknown origin characterized by a permanent high position of one or rarely both the leaflets of the diaphragm, providing a potential space for the displacement of abdominal viscera on the affected side(s. The etiology, diagnosis, and management of this condition remains a controversial subject. We report a rare case of infiltrating squamous cell carcinoma of the esophagus in a patient with eventration of the diaphragm and gastric volvulus who presented to us with retrosternal discomfort. To the best of our knowledge, this rare association has not been reported in the literature, although one case of esophageal adenocarcinoma arising from Barrett′s esophagus in association with eventration of the diaphragm has been reported previously. This case again emphasis the varied associations of an eventration of the diaphragm.

  6. DiapHRaGM: A mnemonic to describe the work of breathing in patients with respiratory failure.

    Directory of Open Access Journals (Sweden)

    Aiman Tulaimat

    Full Text Available The assessment of the work of breathing in the definitions of respiratory failure is vague and variable.Identify a parsimonious set of signs to describe the work of breathing in hypoxemic, acutely ill patients.We examined consecutive medical ICU patients receiving oxygen with a mask, non-invasive ventilation, or T-piece. A physician inspected each patient for 10 seconds, rated the level of respiratory distress, and then examined the patient for vital signs and 17 other physical signs. We used the rating of distress as a surrogate for measuring the work of breathing, constructed three multivariate models to identify the one with the smallest number of signs and largest explained variance, and validated it with bootstrap analysis.We performed 402 observations on 240 patients. Respiratory distress was absent in 78, mild in 157, moderate in 107, and severe in 60. Respiratory rate, hypoxia, heart rate, and frequency of most signs increased as distress increased. Respiratory rate and hypoxia explained 43% of the variance in respiratory distress. Diaphoresis, gasping, and contraction of the sternomastoid explained an additional 28%. Heart rate, blood pressure, alertness, agitation, body posture, nasal flaring, audible breathing, cyanosis, tracheal tug, retractions, paradox, scalene or abdominal muscles contraction did not increase the explained variance in respiratory distress.Most of the variance is respiratory distress can be explained by five signs summarized by the mnemonic DiapHRaGM (diaphoresis, hypoxia, respiratory rate, gasping, accessory muscle. This set of signs may allow for efficient, standardized assessments of the work of breathing of hypoxic patients.

  7. Diaphragm users should follow 13 tips for best effectiveness.

    Science.gov (United States)

    Reese, M; Hatcher, R A

    1984-11-01

    The following 13 tips should be presented by family planning practitioners to diaphragm users: 1) the client must be able to feel her cervix; 2) the diaphragm should be checked for tears or holes before each use; 3) it should always be used with contraceptive jelly or cream; 4) petroleum products should not be used with the diaphragm; 5) the device should be inserted in plentyof time before intercourse; 6) it should be used at every intercourse; 7) to insert the diaphragm, use 1 hand to hold the cup down and the dome up, fold the diaphragm in half, push it toward the back of the vagina, and tuck the front rim behind the pubic bone; 8) check placement of the diaphragm by ensuring that the soft rubber dome covers the cervix and the front rim is firmly behind the pubic bone; 9) be aware that the diaphragm is probably not in the correct position if it causes discomfort; 10) do not douche with the diaphragm in place; 11) leave the device in place for a least 6 hours after intercourse; 12) remove the diaphragm by hooking the index finger behind the front rim and pulling down and out, being careful not to puncture the diaphragm; and 13) wash the diaphragm with mild soap and water and store it in a platic container away from heat. If patients gain or lose more than 10 pounds, have a pregnancy or pelvic surgery, suspect that their diaphragm is too large or too small, or are experiencing discomfort or pain, they should have the fit checked. Finally, since several cases of toxic shock syndrome have occured in diaphragm users, patients should avoid leaving the diaphragm in place more than 24 hours and avoid its use during menstruation.

  8. Ultrasonographic Assessment of Diaphragm Function in Critically Ill Subjects.

    Science.gov (United States)

    Umbrello, Michele; Formenti, Paolo

    2016-04-01

    The majority of patients admitted to the ICU require mechanical ventilation as a part of their process of care. However, mechanical ventilation itself or the underlying disease can lead to dysfunction of the diaphragm, a condition that may contribute to the failure of weaning from mechanical ventilation. However, extended time on the ventilator increases health-care costs and greatly increases patient morbidity and mortality. Nevertheless, symptoms and signs of muscle disease in a bedridden (or bed rest-only) ICU patient are often difficult to assess because of concomitant confounding factors. Conventional assessment of diaphragm function lacks specific, noninvasive, time-saving, and easily performed bedside tools or requires patient cooperation. Recently, the use of ultrasound has raised great interest as a simple, noninvasive method of quantification of diaphragm contractile activity. In this review, we discuss the physiology and the relevant pathophysiology of diaphragm function, and we summarize the recent findings concerning the evaluation of its (dys)function in critically ill patients, with a special focus on the role of ultrasounds. We describe how to assess diaphragm excursion and diaphragm thickening during breathing and the meaning of these measurements under spontaneous or mechanical ventilation as well as the reference values in health and disease. The spread of ultrasonographic assessment of diaphragm function may possibly result in timely identification of patients with diaphragm dysfunction and to a potential improvement in the assessment of recovery from diaphragm weakness. Copyright © 2016 by Daedalus Enterprises.

  9. Ultrasonographic assessment of the diaphragm in chronic obstructive pulmonary disease patients: relationships with pulmonary function and the influence of body composition - a pilot study.

    Science.gov (United States)

    Smargiassi, Andrea; Inchingolo, Riccardo; Tagliaboschi, Linda; Di Marco Berardino, Alessandro; Valente, Salvatore; Corbo, Giuseppe Maria

    2014-01-01

    Skeletal muscle weakness with loss of fat-free mass (FFM) is one of the main systemic effects of chronic obstructive pulmonary disease (COPD). The diaphragm is also involved, leading to disadvantageous conditions and poor contractile capacities. We measured the thickness of the diaphragm (TD) by ultrasonography to evaluate the relationships between echographic measurements, parameters of respiratory function and body composition data. Thirty-two patients (23 males) underwent (1) pulmonary function tests, (2) echographic assessment of TD in the zone of apposition at various lung volumes, i.e. TD at residual volume (TDRV), TD at functional residual capacity (TDFRC) and TD at total lung capacity (TDTLC), and (3) bioelectrical body impedance analysis. The BMI and the BODE (BMI-Obstruction-Dyspnea-Exercise) index values were reported. TDRV, TDFRC and TDTLC measured 3.3, 3.6 and 6 mm, respectively, with good intraobserver reproducibility (0.97, 0.97 and 0.96, respectively). All the TDs were found to be related to FFM, with the relationship being greater for TDFRC (r(2) = 0.39 and p = 0.0002). With regard to lung volumes, inspiratory capacity (IC) was found to be closely related to TDTLC (r(2) = 0.42 and p = 0.0001). The difference between TDTLC and TDRV, as a thickening value (TDTLCRV), was closely related to FVC (r(2) = 0.34 and p = 0.0004) and to air-trapping indices (RV/TLC, FRC/TLC and IC/TLC): the degree of lung hyperinflation was greater and the TDTLCRV was less. Finally, we found a progressive reduction of both thicknesses and thickenings as the severity of IC/TLC increased, with a significant p value for the trend in both analyses (p = 0.02). Ultrasonographic assessment of the diaphragm could be a useful tool for studying disease progression in COPD patients, in terms of lung hyperinflation and the loss of FFM. © 2014 S. Karger AG, Basel.

  10. Safety and efficacy of diaphragm pacing in patients with respiratory insufficiency due to amyotrophic lateral sclerosis (DiPALS): a multicentre, open-label, randomised controlled trial.

    Science.gov (United States)

    2015-09-01

    Non-invasive ventilation is part of the standard of care for treatment of respiratory failure in patients with amyotrophic lateral sclerosis (ALS). The NeuRx RA/4 Diaphragm Pacing System has received Humanitarian Device Exemption approval from the US Food and Drug Administration for treatment of respiratory failure in patients with ALS. We aimed to establish the safety and efficacy of diaphragm pacing with this system in patients with respiratory muscle weakness due to ALS. We undertook a multicentre, open-label, randomised controlled trial at seven specialist ALS and respiratory centres in the UK. Eligible participants were aged 18 years or older with laboratory supported probable, clinically probable, or clinically definite ALS; stable riluzole treatment for at least 30 days; and respiratory insufficiency. We randomly assigned participants (1:1), via a centralised web-based randomisation system with minimisation that balanced patients for age, sex, forced vital capacity, and bulbar function, to receive either non-invasive ventilation plus pacing with the NeuRx RA/4 Diaphragm Pacing System or non-invasive ventilation alone. Patients, carers, and outcome assessors were not masked to treatment allocation. The primary outcome was overall survival, defined as the time from randomisation to death from any cause. Analysis was by intention to treat. This trial is registered, ISRCTN number 53817913. Between Dec 5, 2011, and Dec 18, 2013, we randomly assigned 74 participants to receive either non-invasive ventilation alone (n=37) or non-invasive ventilation plus diaphragm pacing (n=37). On Dec 18, 2013, the Data Monitoring and Ethics Committee (DMEC) recommended suspension of recruitment on the basis of overall survival figures. Randomly assigned participants continued as per the study protocol until June 23, 2014, when the DMEC advised discontinuation of pacing in all patients. Follow-up assessments continued until the planned end of the study in December, 2014. Survival

  11. Toric Intraocular Lens Outcomes in Patients With Glaucoma.

    Science.gov (United States)

    Brown, Reay H; Zhong, Le; Bozeman, Caroline W; Lynch, Mary G

    2015-06-01

    To report the outcomes of toric intraocular lens implantation in patients with glaucoma and corneal astigmatism. One hundred twenty-six eyes of 87 patients with glaucoma and corneal astigmatism that underwent cataract surgery with an AcrySof toric intraocular lens (Alcon Laboratories, Inc., Fort Worth, TX) implant were selected for this single-center, retrospective case series. Corrected distance visual acuity, intraocular pressure, and refractive astigmatism were measured in each eye preoperatively and postoperatively. Uncorrected distance visual acuity and toric alignment were measured postoperatively. The uncorrected distance visual acuity was 0.04 ± 0.08 logMAR (20/22 Snellen) for all eyes. Ninety-eight percent of all eyes achieved an uncorrected distance visual acuity of 20/40 or better, with 76% achieving 20/25 or better and 47% achieving 20/20. The corrected distance visual acuity for all eyes was 0.01 ± 0.03 logMAR (20/20.5 Snellen) postoperatively. The refractive cylinder improved from 1.47 ± 1.10 diopters preoperatively to 0.31 ± 0.37 diopters postoperatively. The residual refractive cylinder was 1.00 diopter or less in 97% of eyes, 0.75 diopters or less in 90% of eyes, and 0.50 diopters or less in 83% of eyes. Mean misalignment was 4.4° ± 5.1°. Intraocular pressure decreased by a mean of 2.3 ± 3.3 mm Hg following the surgery. Toric intraocular lenses can reliably reduce astigmatism and improve uncorrected vision in eyes with cataract and glaucoma. Copyright 2015, SLACK Incorporated.

  12. Materials for Slack Diaphragms

    Science.gov (United States)

    Puschmann, Traute

    1940-01-01

    This report deals with systematic experiments carried out on five diaphragm materials with different pretreatment, for the purpose of ascertaining the suitability of such materials for slack diaphragms. The relationship of deflection and load, temperature and moisture, was recorded. Of the explored materials, synthetic leather, balloon cloth, goldbeaters skin, Igelit and Buna, synthetic leather treated with castor oil is the most suitable material for the small pressure range required. Balloon cloth is nearly as good, while goldbeaters skin, Igelit and Buna were found to be below the required standards.

  13. Congenital duodenal diaphragm in eight children

    International Nuclear Information System (INIS)

    Nawaz, Akhtar; Matta, Hilal; Jacobsz, Alic; Al-Salem, Ahmad H.; Trad, Omar

    2004-01-01

    Congenital duodenal obstruction (CDO) is common and usually easy to diagnose cause of intestinal obstruction in the newborn, except when the cause of the obstruction is duodenal diaphragm. We describe our experience with eight children who had intrinsic duodenal obstruction secondary to a duodenal diaphragm. The medical record of 22 children with the diagnosis of congenital intrinsic duodenal were reviewed for age, sex, gestation, birth weight, clinical features, associated anomalies, method of diagnosis, treatment and outcome. Operative findings and procedures were obtained from the operative notes. Eight of 22 children (36.4%) had congenital duodenal diaphragm (CDD). In all children, the diagnosis was made from the plain abdominal X-ray, which showed the classic double-bubble appearence, and barium meal, which showed duodenal obstruction. Four patients had associated anomalies, including two with Down's syndrome intraoperatively, five patients were found to have duodenal diaphragm with a central hole, while the other three had complete duodenal diaphragms. Postoperatively, all patients did well. Six required total parenteral nutrition. The 100% survival rate among these children is comparable to that in Western countries, and can be attributed to the lack of major associated abnormalities, good perioperative management, and the availability of total parenteral nutrition. (author)

  14. Barrier Methods of Birth Control: Spermicide, Condom, Sponge, Diaphragm, and Cervical Cap

    Science.gov (United States)

    ... ACOG Barrier Methods of Birth Control: Spermicide, Condom, Sponge, Diaphragm, and Cervical Cap Home For Patients Search ... Format Barrier Methods of Birth Control: Spermicide, Condom, Sponge, Diaphragm, and Cervical Cap Contraception What are barrier ...

  15. Diaphragm atrophy and weakness in the absence of mitochondrial dysfunction in the critically Ill

    NARCIS (Netherlands)

    Van den Berg, Marloes; Hooijman, Pleuni E.; Beishuizen, Albertus; De Waard, Monique C.; Paul, Marinus A.; Hartemink, Koen J.; Van Hees, Hieronymus W.H.; Lawlor, Michael W.; Brocca, Lorenza; Bottinelli, Roberto; Pellegrino, Maria A.; Stienen, Ger J.M.; Heunks, Leo M.A.; Wüst, Rob C.I.; Ottenheijm, Coen A.C.

    2017-01-01

    Rationale: The clinical significance of diaphragm weakness in critically ill patients is evident: it prolongs ventilator dependency and increases morbidity, duration of hospital stay, and health care costs. The mechanisms underlying diaphragm weakness are unknown, but might include mitochondrial

  16. MDCT diagnosis of penetrating diaphragm injury

    Energy Technology Data Exchange (ETDEWEB)

    Bodanapally, Uttam K.; Shanmuganathan, Kathirkamanathan; Mirvis, Stuart E.; Sliker, Clint W.; Fleiter, Thorsten R.; Sarada, Kamal; Miller, Lisa A. [University of Maryland School of Medicine, Department of Diagnostic Radiology, Baltimore, MD (United States); Stein, Deborah M. [University of Maryland, Department of Surgery, Shock Trauma Center, Baltimore, MD (United States); Alexander, Melvin [National Study Center for Trauma and Emergency Medical Systems, Baltimore, MD (United States)

    2009-08-15

    The purpose of the study was to determine the diagnostic sensitivity and specificity of multidetector CT (MDCT) in detection of diaphragmatic injury following penetrating trauma. Chest and abdominal CT examinations performed preoperatively in 136 patients after penetrating trauma to the torso with injury trajectory in close proximity to the diaphragm were reviewed by radiologists unaware of surgical findings. Signs associated with diaphragmatic injuries in penetrating trauma were noted. These signs were correlated with surgical diagnoses, and their sensitivity and specificity in assisting the diagnosis were calculated. CT confirmed diaphragmatic injury in 41 of 47 injuries (sensitivity, 87.2%), and an intact diaphragm in 71 of 98 patients (specificity, 72.4%). The overall accuracy of MDCT was 77%. The most accurate sign helping the diagnosis was contiguous injury on either side of the diaphragm in single-entry penetrating trauma (sensitivity, 88%; specificity, 82%). Thus MDCT has high sensitivity and good specificity in detecting penetrating diaphragmatic injuries. (orig.)

  17. MDCT diagnosis of penetrating diaphragm injury

    International Nuclear Information System (INIS)

    Bodanapally, Uttam K.; Shanmuganathan, Kathirkamanathan; Mirvis, Stuart E.; Sliker, Clint W.; Fleiter, Thorsten R.; Sarada, Kamal; Miller, Lisa A.; Stein, Deborah M.; Alexander, Melvin

    2009-01-01

    The purpose of the study was to determine the diagnostic sensitivity and specificity of multidetector CT (MDCT) in detection of diaphragmatic injury following penetrating trauma. Chest and abdominal CT examinations performed preoperatively in 136 patients after penetrating trauma to the torso with injury trajectory in close proximity to the diaphragm were reviewed by radiologists unaware of surgical findings. Signs associated with diaphragmatic injuries in penetrating trauma were noted. These signs were correlated with surgical diagnoses, and their sensitivity and specificity in assisting the diagnosis were calculated. CT confirmed diaphragmatic injury in 41 of 47 injuries (sensitivity, 87.2%), and an intact diaphragm in 71 of 98 patients (specificity, 72.4%). The overall accuracy of MDCT was 77%. The most accurate sign helping the diagnosis was contiguous injury on either side of the diaphragm in single-entry penetrating trauma (sensitivity, 88%; specificity, 82%). Thus MDCT has high sensitivity and good specificity in detecting penetrating diaphragmatic injuries. (orig.)

  18. Efficient generation of lens progenitor cells from cataract patient-specific induced pluripotent stem cells.

    Directory of Open Access Journals (Sweden)

    Xiaodi Qiu

    Full Text Available The development of a technique to induce the transformation of somatic cells to a pluripotent state via the ectopic expression of defined transcription factors was a transformational event in the field of regenerative medicine. The development of this technique also impacted ophthalmology, as patient-specific induced pluripotent stemcells (iPSCs may be useful resources for some ophthalmological diseases. The lens is a key refractive element in the eye that focuses images of the visual world onto the retina. To establish a new model for drug screening to treat lens diseases and investigating lens aging and development, we examined whether human lens epithelial cells (HLECs could be induced into iPSCs and if lens-specific differentiation of these cells could be achieved under defined chemical conditions. We first efficiently reprogrammed HLECs from age-related cataract patients to iPSCs with OCT-4, SOX-2, and KLF-4. The resulting HLEC-derived iPS (HLE-iPS colonies were indistinguishable from human ES cells with respect to morphology, gene expression, pluripotent marker expression and their ability to generate all embryonic germ-cell layers. Next, we performed a 3-step induction procedure: HLE-iPS cells were differentiated into large numbers of lens progenitor-like cells with defined factors (Noggin, BMP and FGF2, and we determined that these cells expressed lens-specific markers (PAX6, SOX2, SIX3, CRYAB, CRYAA, BFSP1, and MIP. In addition, HLE-iPS-derived lens cells exhibited reduced expression of epithelial mesenchymal transition (EMT markers compared with human embryonic stem cells (hESCs and fibroblast-derived iPSCs. Our study describes a highly efficient procedure for generating lens progenitor cells from cataract patient HLEC-derived iPSCs. These patient-derived pluripotent cells provide a valuable model for studying the developmental and molecular biological mechanisms that underlie cell determination in lens development and cataract

  19. Four-Dimensional CT of the Diaphragm in Children: Initial Experience

    Science.gov (United States)

    2018-01-01

    Objective To evaluate the technical feasibility of four-dimensional (4D) CT for the functional evaluation of the pediatric diaphragm. Materials and Methods In 22 consecutive children (median age 3.5 months, age range 3 days–3 years), 4D CT was performed to assess diaphragm motion. Diaphragm abnormalities were qualitatively evaluated and diaphragm motion was quantitatively measured on 4D CT. Lung density changes between peak inspiration and expiration were measured in the basal lung parenchyma. The diaphragm motions and lung density changes measured on 4D CT were compared between various diaphragm conditions. In 11 of the 22 children, chest sonography was available for comparison. Results Four-dimensional CT demonstrated normal diaphragm (n = 8), paralysis (n = 10), eventration (n = 3), and diffusely decreased motion (n = 1). Chest sonography demonstrated normal diaphragm (n = 2), paralysis (n = 6), eventration (n = 2), and right pleural effusion (n = 1). The sonographic findings were concordant with the 4D CT findings in 90.9% (10/11) of the patients. In diaphragm paralysis, the affected diaphragm motion was significantly decreased compared with the contralateral normal diaphragm motion (−1.1 ± 2.2 mm vs. 7.6 ± 3.8 mm, p = 0.005). The normal diaphragms showed significantly greater motion than the paralyzed diaphragms (4.5 ± 2.1 mm vs. −1.1 ± 2.2 mm, p Hounsfield units [HU] vs. 180 ± 71 HU, p = 0.03), while no significant differences were found between the normal diaphragms and the paralyzed diaphragms (136 ± 66 HU vs. 89 ± 73 HU, p = 0.1) or between the normal diaphragms and the contralateral normal diaphragms in paralysis (136 ± 66 HU vs. 180 ± 71 HU, p = 0.1). Conclusion The functional evaluation of the pediatric diaphragm is feasible with 4D CT in select children. PMID:29354007

  20. TU-E-201-00: Eye Lens Dosimetry for Patients and Staff

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-06-15

    Madan M. Rehani, Massachusetts General Hospital and Harvard Medical School, Boston Methods for Eye Lens Dosimetry and Studies On Lens Opacities with Interventionalists Radiation induced cataract is a major threat among staff working in interventional suites. Nearly 16 million interventional procedures are performed annually in USA. Recent studies by the principal investigator’s group, primarily among interventional cardiologists, on behalf of the International Atomic Energy Agency, show posterior subcapsular (PSC) changes in the eye lens in 38–53% of main operators and 21–45% of support staff. These changes have potential to lead to cataract in future years, as per information from A-Bomb survivors. The International Commission on Radiological Protection has reduced dose limit for staff by a factor of 7.5 (from 150 mSv/y to 20 mSv/y). With increasing emphasis on radiation induced cataracts and reduction in threshold dose for eye lens, there is a need to implement strategies for estimating eye lens dose. Unfortunately eye lens dosimetry is at infancy when it comes to routine application. Various approaches are being tried namely direct measurement using active or passive dosimeters kept close to eyes, retrospective estimations and lastly correlating patient dose in interventional procedures with staff eye dose. The talk will review all approaches available and ongoing active research in this area, as well as data from surveys done in Europe on status of eye dose monitoring in interventional radiology and nuclear medicine. The talk will provide update on how good is Hp(10) against Hp(3), estimations from CTDI values, Monte Carlo based simulations and current status of eye lens dosimetry in USA and Europe. The cataract risk among patients is in CT examinations of the head. Since radiation induced cataract predominantly occurs in posterior sub-capsular (PSC) region and is thus distinguishable from age or drug related cataracts and is also preventable, actions on

  1. TU-E-201-00: Eye Lens Dosimetry for Patients and Staff

    International Nuclear Information System (INIS)

    2015-01-01

    Madan M. Rehani, Massachusetts General Hospital and Harvard Medical School, Boston Methods for Eye Lens Dosimetry and Studies On Lens Opacities with Interventionalists Radiation induced cataract is a major threat among staff working in interventional suites. Nearly 16 million interventional procedures are performed annually in USA. Recent studies by the principal investigator’s group, primarily among interventional cardiologists, on behalf of the International Atomic Energy Agency, show posterior subcapsular (PSC) changes in the eye lens in 38–53% of main operators and 21–45% of support staff. These changes have potential to lead to cataract in future years, as per information from A-Bomb survivors. The International Commission on Radiological Protection has reduced dose limit for staff by a factor of 7.5 (from 150 mSv/y to 20 mSv/y). With increasing emphasis on radiation induced cataracts and reduction in threshold dose for eye lens, there is a need to implement strategies for estimating eye lens dose. Unfortunately eye lens dosimetry is at infancy when it comes to routine application. Various approaches are being tried namely direct measurement using active or passive dosimeters kept close to eyes, retrospective estimations and lastly correlating patient dose in interventional procedures with staff eye dose. The talk will review all approaches available and ongoing active research in this area, as well as data from surveys done in Europe on status of eye dose monitoring in interventional radiology and nuclear medicine. The talk will provide update on how good is Hp(10) against Hp(3), estimations from CTDI values, Monte Carlo based simulations and current status of eye lens dosimetry in USA and Europe. The cataract risk among patients is in CT examinations of the head. Since radiation induced cataract predominantly occurs in posterior sub-capsular (PSC) region and is thus distinguishable from age or drug related cataracts and is also preventable, actions on

  2. Radial Field Piezoelectric Diaphragms

    Science.gov (United States)

    Bryant, R. G.; Effinger, R. T., IV; Copeland, B. M., Jr.

    2002-01-01

    A series of active piezoelectric diaphragms were fabricated and patterned with several geometrically defined Inter-Circulating Electrodes "ICE" and Interdigitated Ring Electrodes "ICE". When a voltage potential is applied to the electrodes, the result is a radially distributed electric field that mechanically strains the piezoceramic along the Z-axis (perpendicular to the applied electric field). Unlike other piezoelectric bender actuators, these Radial Field Diaphragms (RFDs) strain concentrically yet afford high displacements (several times that of the equivalent Unimorph) while maintaining a constant circumference. One of the more intriguing aspects is that the radial strain field reverses itself along the radius of the RFD while the tangential strain remains relatively constant. The result is a Z-deflection that has a conical profile. This paper covers the fabrication and characterization of the 5 cm. (2 in.) diaphragms as a function of poling field strength, ceramic thickness, electrode type and line spacing, as well as the surface topography, the resulting strain field and displacement as a function of applied voltage at low frequencies. The unique features of these RFDs include the ability to be clamped about their perimeter with little or no change in displacement, the environmentally insulated packaging, and a highly repeatable fabrication process that uses commodity materials.

  3. Bilateral spontaneous dislocation of posterior chamber intraocular lens in a patient with gyrate atrophy

    Directory of Open Access Journals (Sweden)

    Michael Kinori

    2012-01-01

    Full Text Available We report a patient with gyrate atrophy, a rare metabolic disease, who had bilateral late spontaneous posterior dislocation of in-the-bag posterior chamber intraocular lens (PCIOL. He underwent pars plana vitrectomy, PCIOL retrieval and anterior chamber intraocular lens implantation in both eyes. This report may imply that patients with gyrate atrophy are at risk for spontaneous dislocation of intraocular lenses.

  4. Corneal confocal microscopy and dry eye findings in contact lens discomfort patients.

    Science.gov (United States)

    Dogan, Aysun Sanal; Gurdal, Canan; Arslan, Nese

    2018-02-01

    To evaluate the corneal confocal microscopy and dry eye findings in patients with contact lens discomfort. The study included 3 groups of participants: Contact lens wearers using silicone hydrogel soft contact lenses who are symptomatic (CLD, n=15) or asymptomatic (ACL, n=11) and non-wearers as controls (n=14). Duration of contact lens wear, Ocular Surface Disease Index (OSDI) questionnaire responses, fluorescein tear break-uptime (FBUT), and corneal confocal microscopy findings were recorded. Mean age was 25.7±8.2 years and male/female ratio was 7/33. Demographic findings were similar regarding the groups. CLD patients had a longer lens use history than ACL (median 5 vs 2 years, pCLD group than ACL or controls (pCLD group, compared to controls and ACL (pCLD group compared to controls but similar to ACL (pCLD group than the ACL (p=0.014). Patients with CLD had been wearing contact lenses for longer than those without symptoms. OSDI and FBUT scores were worse in CLD patients. In contact lens discomfort patients, there were increased dendritiform cells, indicating intensified inflammatory status of the cornea. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  5. Treatment, material, care, and patient-related factors in contact lens-related dry eye.

    Science.gov (United States)

    Ramamoorthy, Padmapriya; Sinnott, Loraine T; Nichols, Jason J

    2008-08-01

    To examine the effect of general contact lens and material characteristics, care solutions, treatment, and patient-related factors on contact lens-related dry eye. The data were derived from the Contact Lens and Dry Eye Study, designed as a cross-sectional and nested case-control study including 360 subjects. In separate statistical models, logistic regression was used to examine general contact lens characteristics, specific hydrogel lens materials, care solutions, and patient-related factors associated with dry eye status (controlled for age, gender, and current treatments). Several factors were significantly associated with dry eye, including treatment factors such as a recent contact lens refitting (odds ratios [OR] = 5.75, 95% confidence intervals [CI] = 2.14 to 15.46) and use of artificial tears/rewetting drops (OR = 1.09, 95% CI = 1.02 to 1.16), in addition, currently worn materials including Food and Drug Administration (FDA) group II (OR = 2.98, 95% CI = 1.14 to 6.19) and IV (OR = 1.87, 95% CI = 1.08 to 3.24). Significant patient-related factors included decreased overall satisfaction (OR = 3.57, 95% CI = 2.08 to 5.88,), dry eye in the absence of contact lens wear (OR = 6.54, 95% CI = 2.57 to 16.62), reduced daily lens wear duration (OR = 1.16, 95% CI = 1.06 to 1.26), and reduced ability to wear lenses as long as desired (OR = 2.44, 95% CI = 1.30 to 4.54). Care solutions were not associated with contact lens-related dry eye. The strong association of common treatment factors with dry eye status in contact lens wearers suggests that these treatments are not entirely effective. The use of high water content materials was strongly related to dry eye in lens wearers, whereas care solutions were not. Contact lens-related dry eye was also associated with several patient-related factors such as greater ocular discomfort (without lenses), dissatisfaction, and inability to wear lenses for desired durations.

  6. Percutaneous radiofrequency ablation of hepatocellular carcinoma abutting the diaphragm and gastrointestinal tracts with the use of artificial ascites: safety and technical efficacy in 143 patients

    International Nuclear Information System (INIS)

    Song, Inyoung; Rhim, Hyunchul; Lim, Hyo K.; Kim, Young-sun; Choi, Dongil

    2009-01-01

    The purpose of this study was to assess the feasibility, safety and efficacy of radiofrequency ablation (RFA) with the use of artificial ascites for hepatocellular carcinoma (HCC) adjacent to the diaphragm and gastrointestinal tract. One hundred forty-three patients with 181 HCCs who underwent US-guided percutaneous RFA with the use of artificial ascites were retrospectively reviewed. Among the 181 HCCs, 148 HCCs were defined as problematic nodules for two major reasons: poor sonic window or possible thermal injury. We artificially induced ascites before performing RFA by dripping 5% dextrose in a water solution. We assessed the technical success of introducing artificial ascites, technical feasibility of the use of artificial ascites and complications. The technical success rate, as well as the primary and secondary technique success rate, was assessed by regular follow-up CT examinations. RFA with artificial ascites was successfully achieved in 130 of 143 patients. The primary technique effectiveness was 85.3%. During follow-up (mean, 20.4 months), remote intrahepatic recurrence occurred in 49 patients and local tumor progression occurred in 15 patients. Three (2.1%) of the 143 patients experienced major complications (hemoperitoneum, lobar infarction and biloma) related to the RFA procedure. The use of artificial ascites is a simple and useful technique to minimize collateral thermal injury and to improve the sonic window. (orig.)

  7. Association Between Carotid Bulb Diaphragm and Ischemic Stroke in Young Afro-Caribbean Patients: A Population-Based Case-Control Study.

    Science.gov (United States)

    Joux, Julien; Boulanger, Marion; Jeannin, Severine; Chausson, Nicolas; Hennequin, Jean-Luc; Molinié, Vincent; Smadja, Didier; Touzé, Emmanuel; Olindo, Stephane

    2016-10-01

    Carotid bulb diaphragm (CBD) has been described in young carotid ischemic stroke (CIS) patients, especially in blacks. However, the prevalence of CBD in CIS patients is unknown, and whether CBD is a risk factor for CIS remains unclear. We assessed the association between CBD and incident CIS in a population-based study. We selected all young (young (stroke-free patients admitted for a road crash who routinely had computed tomographic angiography. Odds ratio (ORs) were calculated by conditional logistic regression adjusted for hypertension, dyslipidemia, diabetes and smoking. CIS associated with ipsilateral CBD incidence was 3.8 per 100 000 person-years (95% confidence interval, 1.4-6.1). Prevalence of ipsilateral CBD was 23% in all CIS and 37% in undetermined CIS patients. When restricted to undetermined CIS, CBD prevalence was 24 times higher than that in controls (adjusted OR, 24.1; 95% confidence interval, 1.8-325.6). CBD is associated with an increased risk of ipsilateral CIS in young Afro-Caribbean population. © 2016 American Heart Association, Inc.

  8. Intraocular lens subluxation in a patient with facial atopic dermatitis.

    Science.gov (United States)

    Yamazaki, S; Nakamura, K; Kurosaka, D

    2001-02-01

    A 66-year-old Japanese man presented with subluxation of a posterior chamber intraocular lens (IOL) caused by a rupture of part of Zinn's zonule but no retinal break 2 years after phacoemulsification with IOL implantation. He had a history of atopic dermatitis since infancy. This case presents a rare ocular complication of scratching and rubbing the face and eyelids because of itching related to atopic dermatitis.

  9. Comparison of Bigbag and Rayner620H intraocular lens in cataract surgeries in high myopia patients

    Directory of Open Access Journals (Sweden)

    Zhan-Jiang Liu

    2016-01-01

    Full Text Available AIM:To investigate the effects of Bigbag and Rayner620H intraocular lens in cataract surgeries in high myopia patients. METHODS:Seventy-seven patients(128 eyeswere treated by phacoemulsification combined with intraocular lens implantation from January 2014 to March 2015 in our hospital. Thirty-nine patients(65 eyeswere treated with Bigbag intraocular lens, 38 cases(63 eyeswere treated with Rayner620H. The best corrected visual acuity(BCVAdistribution, the actual refractive value, the difference between predictive refractive value and actual refractive value and complications were measured and recorded in the two groups at 1mo after surgeries. RESULTS:The difference between the two groups on BCVA are statistically significant(PWilcoxon rank sum test. The differences between predictive refractive value and actual refractive value of the two groups were statistically significant(PPCONCLUSION:The effect of Bigbag intraocular lens for patients with phacoemulsification and intraocular lens implantation is good, and it can reduce the risk of complications.

  10. Ocular Surface Temperature During Scleral Lens Wearing in Patients With Keratoconus.

    Science.gov (United States)

    Carracedo, Gonzalo; Wang, Zicheng; Serramito-Blanco, Maria; Martin-Gil, Alba; Carballo-Alvarez, Jesús; Pintor, Jesús

    2017-11-01

    To evaluate the ocular surface temperature using an infrared thermography camera before and after wearing scleral lens in patients with keratoconus and correlate these results with the tear production and stability. A pilot, experimental, short-term study has been performed. Twenty-six patients with keratoconus (36.95±8.95 years) participated voluntarily in the study. The sample was divided into two groups: patients with intrastromal corneal ring (KC-ICRS group) and patients without ICRS (KC group). Schirmer test, tear breakup time (TBUT), and ocular surface temperature in the conjunctiva, limbus, and cornea were evaluated before and after wearing a scleral lens. The patients wore the scleral lenses from 6 to 9 hours with average of 7.59±0.73 hours. No significant changes in Schirmer test and TBUT were found for both groups. No temperature differences were found between the KC-ICRS and the KC groups for all zones evaluated. There was a slight, but statistically significant, increase in the inferior cornea, temporal limbus, and nasal conjunctival temperature for KC-ICRS group and temporal limbus temperature decreasing for the KC group after wearing scleral lens (Ptemperature was statistically higher than the central cornea for both groups before and after scleral lenses wearing (Pperipheral cornea was found. No statistically significant differences in the central corneal temperature were found between the groups after scleral lens wearing (P>0.05). Scleral contact lens seems not to modify the ocular surface temperature despite the presence of the tear film stagnation under the lens.

  11. New Stethoscope With Extensible Diaphragm.

    Science.gov (United States)

    Takashina, Tsunekazu; Shimizu, Masashi; Muratake, Torakazu; Mayuzumi, Syuichi

    2016-08-25

    This study compared the diagnostic efficacy of the common suspended diaphragm stethoscope (SDS) with a new extensible diaphragm stethoscope (EDS) for low-frequency heart sounds. The EDS was developed by using an ethylene propylene diene monomer diaphragm. The results showed that the EDS enhanced both the volume and quality of low-frequency heart sounds, and improved the ability of examiners to auscultate such heart sounds. Based on the results of the sound analysis, the EDS is more efficient than the SDS. (Circ J 2016; 80: 2047-2049).

  12. Visual outcomes after lensectomy and iris claw artisan intraocular lens implantation in patients with Marfan syndrome.

    Science.gov (United States)

    Rabie, Hossein Mohammad; Malekifar, Parviz; Javadi, Mohammad Ali; Roshandel, Danial; Esfandiari, Hamed

    2017-08-01

    To review our experience with crystalline lens extraction and iris claw Artisan IOL implantation in patients with lens subluxation secondary to Marfan syndrome. A retrospective analysis of 12 eyes of 9 patients with lens subluxation due to Marfan syndrome who underwent crystalline lens removal and Artisan IOL (Ophtec, Groningen, Netherlands) implantation. A questionnaire of pre- and post-operative data, including demographics, pre- and postoperative comorbidities and complications was completed. Patients were evaluated for visual outcome and occurrence of complications. Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), and spherical equivalents (SE) were compared before and after lens extraction and IOL insertion. The mean age of the participants was 30.03 ± 15.02 years, and mean post-operative follow-up time was 44.5 ± 16.4 months. Mean BCVA also showed a significant improvement from 0.5 ± 0.3 at the baseline to 0.2 ± 0.2 post-operatively (P = 0.006). SE changed significantly from -11.38 ± 1.99 preoperatively to -0.45 ± 1.65 post-operatively (P = 0.003). All eyes had the IOL implanted at desired position. Post-operative complications were retinal detachment in one case and IOL dislocation in another patient. No other complication such as ocular hypertension, angle abnormalities, clinical cystoids macular edema, and corneal decompensation was observed during the follow-up period. Artisan IOL implantation after lens extraction appears to be an attractive alternative for optical correction in cases of Marfan syndrome with ectopia lentis. It confers a significant improvement in visual acuity with reasonable risk profile.

  13. Paper-thinned diaphragm: CT sign of diaphragmatic eventration

    International Nuclear Information System (INIS)

    Im, Jung Gi; Han, Man Chung; Kim, Chu Wan; Shim, Young Soo

    1990-01-01

    CT findings of total left hemidiaphragmatic eventration in two adult patients are described. Chest radiograph showed elevated left hemidiaphragm and left hilum. Paper-thinned muscular portion of the diseased diaphragm was clearly demonstrated with CT scan. With demonstration of paper-thinned diaphragm by CT scan, differentiation of the diaphragmatic eventration from recent onset phrenic nerve paralysis by tumor invasion or from post-traumatic diaphragmatic hernia can be made

  14. Paper-thinned diaphragm: CT sign of diaphragmatic eventration

    Energy Technology Data Exchange (ETDEWEB)

    Im, Jung Gi; Han, Man Chung; Kim, Chu Wan; Shim, Young Soo [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    1990-10-15

    CT findings of total left hemidiaphragmatic eventration in two adult patients are described. Chest radiograph showed elevated left hemidiaphragm and left hilum. Paper-thinned muscular portion of the diseased diaphragm was clearly demonstrated with CT scan. With demonstration of paper-thinned diaphragm by CT scan, differentiation of the diaphragmatic eventration from recent onset phrenic nerve paralysis by tumor invasion or from post-traumatic diaphragmatic hernia can be made.

  15. Diaphragm myoclonus followed by generalised atonia in a patient with trisomy 4p: unusual semiology in an unusual condition.

    Science.gov (United States)

    Varley, James; Wehner, Tim; Sisodiya, Sanjay

    2015-12-01

    In this report, we describe a female patient with trisomy 4p, a rare genetic condition, with unusual seizure semiology. The patient is one of the oldest reported survivors with this condition. This semiology was noted while she was being monitored by inpatient video telemetry. We observed a series of myoclonic shoulder jerks, followed by hiccup-like episodes, and finally an atonic head drop. Corresponding ictal EEG showed semi-rhythmic high-amplitude slow waves with spikes superimposed over the frontotemporal areas. This semiology was confirmed as habitual by her parents. Subsequent hiccup-like episodes had no EEG correlate, and the head drop was again associated with semi-rhythmic high-amplitude slow waves and superimposed spikes, more prominent over the right hemisphere. In addition, we review the several cases in which hiccups have been associated with seizures and how this may relate to the neural pathways involved in the pathophysiology of hiccups. We believe the ictal hiccup-like episodes followed by atonia to be a seizure semiology that has not previously been documented. [Published with video sequence].

  16. [Iris hooks and modified capsular tension ring for subluxation lens in patients with Marfan's syndrome].

    Science.gov (United States)

    Wu, Wen-Jie; Zheng, Dan-ying; Zheng, Ying-feng; Cai, Xiao-yu

    2007-02-01

    To evaluate clinical efficiency and safety of the iris hooks and modified capsular tension ring (MCTR) for the treatment of subluxation lens in patients with Marfan's syndrome. This study comprised 5 patients (7 eyes) with Marfan's syndrome and subluxation lens. After 3.2 mm clear cornea incision and continuous curvilinear capsulorhexis (CCC), 2 - 4 disposable nylon iris hooks were inserted through the stab incisions and placed in the capsulorhexis to support the capsule and enlarged the CCC. Following irrigation/aspiration, a MCTR with suture in its eyelet was placed in the capsule bag. After tightening and tying the suture of MCTR, the capsular bag was centered and fixed. A foldable AcrySof one-piece intraocular lens (IOL) was then placed in the capsule bag. Twelve months after the operation, the best corrected visual acuity was >/= 0.8 in six eyes and 0.7 in one eye. The scheimpflug images obtained from the Pentacam demonstrated that the IOL were well centered. UBM showed that all the MCTR and the haptics of the IOL were in the capsule bag, the eyelet of the MCTR was rested stably between the capsulorhexis margin and the iris. The retroillumination photograph indicated that only one eye had obvious posterior capsular opacification. No intraoperative and postoperative complications such as prolapse of vitreous and retina detachment was occurred. The iris hooks can provide excellent intraoperative capsule-lens stability and facilitate the manipulation during operation. MCTR allows additional suture fixation to the eye wall without damaging the capsular bag and maintains the long-term stability of the intraocular lens. Furthermore, MCTR is helpful for avoiding dislocation of the IOL due to progressive weakening of the zonular fibers in some patients and provides long-term safety.

  17. Long-term follow-up after scleral lens fixation in patients with Marfan syndrome.

    Science.gov (United States)

    Luebke, Jan; Reinhard, Thomas; Agostini, Hansjuergen; Boehringer, Daniel; Eberwein, Philipp

    2017-12-06

    The dislocation of the crystalline lens is a common finding in patients with Marfan syndrome (MFS). Scleral intraocular lens (IOL) fixation is an accepted treatment method of this complication. To now, no long-term data on scleral IOL fixation in MFS exist. We present a retrospective study of 27 eyes of 17 MFS patients that underwent scleral lens fixation at our clinic between 1999 and 2012. These patients are compared to an age- and surgeon-matched group of 31 eyes of 27 patients who underwent the same procedure for reasons other than MFS. The median age in the MFS group was 35.4 years versus 35.6 years in the non-MFS group. The median follow-up was 4 years for MFS and 3 years for non-MFS. In the MFS group, significantly more IOL-dislocations occurred than compared to the non-MFS group (30% vs. 6.5%, p = 0.02). Retinal detachment occurred in four MFS-eyes compared to three eyes in the non-MFS group. Biometry prediction error was 1.11 diopters (D) for MFS and 1.33 D for non-MFS (p = 0.11). Median BCVA (best-corrected visual acuity, logMAR) was 0.1 in the MFS group versus 0.3 in non-MFS patients. Scleral lens fixation in MFS patients achieves satisfying visual and refractive outcomes. Our data shows a significantly higher rate of IOL dislocations in patients with MFS. We therefore recommend addressing this complication preoperatively.

  18. DNA damage in lens epithelium of cataract patients in vivo and ex vivo.

    Science.gov (United States)

    Øsnes-Ringen, Oyvind; Azqueta, Amaia O; Moe, Morten C; Zetterström, Charlotta; Røger, Magnus; Nicolaissen, Bjørn; Collins, Andrew R

    2013-11-01

    DNA damage has been described in the human cataractous lens epithelium, and oxidative stress generated by UV radiation and endogenous metabolic processes has been suggested to play a significant role in the pathogenesis of cataract. In this study, the aim was to explore the quality and relative quantity of DNA damage in lens epithelium of cataract patients in vivo and after incubation in a cell culture system. Capsulotomy specimens were analysed, before and after 1 week of ex vivo cultivation, using the comet assay to measure DNA strand breaks, oxidized purine and pyrimidine bases and UV-induced cyclobutane pyrimidine dimers. DNA strand breaks were barely detectable, oxidized pyrimidines and pyrimidine dimers were present at low levels, whereas there was a relatively high level of oxidized purines, which further increased after cultivation. The observed levels of oxidized purines in cataractous lens epithelium may support a theory consistent with light damage and oxidative stress as mediators of molecular damage to the human lens epithelium. Damage commonly associated with UV-B irradiation was relatively low. The levels of oxidized purines increased further in a commonly used culture system. This is of interest considering the importance and versatility of ex vivo systems in studies exploring the pathogenesis of cataract. © 2012 The Authors. Acta Ophthalmologica © 2012 Acta Ophthalmologica Scandinavica Foundation.

  19. Patient characteristics, diagnosis, and treatment of non-contact lens related Acanthamoeba keratitis.

    Science.gov (United States)

    Sharma, S; Garg, P; Rao, G N

    2000-10-01

    To review the clinical characteristics, diagnosis, and visual outcome in patients with non-contact lens related Acanthamoeba keratitis and compare the findings with reported series of contact lens associated Acanthamoeba keratitis. Medical and microbiology records of 39 consecutive patients with a diagnosis of Acanthamoeba keratitis, at a tertiary eyecare centre in India between January 1996 and June 1998, were analysed retrospectively. A majority of the patients presented with poor visual acuity and large corneal stromal infiltrates (mean size 38.20 (SD 26. 18) mm). A predisposing factor was elicited in 19/39 (48.7%) patients (trauma 15, dirty water splash three, leaf juice one). None of the patients had worn contact lenses. Most patients (26/39 (66. 6%)) came from a low socioeconomic background. Complaint of severe pain was not a significant feature and radial keratoneuritis was seen in 1/39 (2.5%) patients. A ring infiltrate was present in 41.1% of cases. A clinical diagnosis of fungal keratitis was made in 45% of the patients before they were seen by us. However, all patients were diagnosed microbiologically at our institute based on demonstration of Acanthamoeba cysts in corneal scrapings (34/39) and/or culture of Acanthamoeba (34/39). Treatment with biguanides (PHMB, 15/38 (39.4%), PHMB with CHx, 23/38 (60.5%), one patient did not return for treatment) resulted in healing with scar formation in 27 out of 31(87.0%) followed up patients (mean time to healing 106.9 days). Overall visual outcome was poor with no statistical difference between cases diagnosed within 30 days (early) or 30 days after (late) start of symptoms. The visual outcome in cases requiring tissue adhesive (five) and keratoplasty (three) was also poor. This is thought to be the largest series of cases of Acanthamoeba keratitis in non-contact lens wearers. In such cases, the disease is advanced at presentation in most patients, pathognomonic clinical features are often not seen, disease

  20. Idiopathic diaphragmatic paralysis: Bell's palsy of the diaphragm?

    Science.gov (United States)

    Crausman, Robert S; Summerhill, Eleanor M; McCool, F Dennis

    2009-01-01

    Idiopathic diaphragm paralysis is probably more common and responsible for more morbidity than generally appreciated. Bell's palsy, or idiopathic paralysis of the seventh cranial nerve, may be seen as an analogous condition. The roles of zoster sine herpete and herpes simplex have increasingly been recognized in Bell's palsy, and there are some data to suggest that antiviral therapy is a useful adjunct to steroid therapy. Thus, we postulated that antiviral therapy might have a positive impact on the course of acute idiopathic diaphragm paralysis which is likely related to viral infection. Three consecutive patients with subacute onset of symptomatic idiopathic hemidiaphragm paralysis were empirically treated with valacyclovir, 1,000 mg twice daily for 1 week. Prior to therapy, diaphragmatic function was assessed via pulmonary function testing and two-dimensional B-mode ultrasound, with testing repeated 1 month later. Diaphragmatic function pre- and post-treatment was compared to that of a historical control group of 16 untreated patients. All three subjects demonstrated ultrasound recovery of diaphragm function 4-6 weeks following treatment with valacyclovir. This recovery was accompanied by improvements in maximum inspiratory pressure (PI(max)) and vital capacity (VC). In contrast, in the untreated cohort, diaphragm recovery occurred in only 11 subjects, taking an average of 14.9 +/- 6.1 months (mean +/- SD). The results of this small, preliminary study suggest that antiviral therapy with valacyclovir may be helpful in the treatment of idiopathic diaphragm paralysis induced by a viral infection.

  1. Determination of ventilatory liver movement via radiographic evaluation of diaphragm position

    International Nuclear Information System (INIS)

    Balter, James M.; Dawson, Laura A.; Kazanjian, Sahira; McGinn, Cornelius; Brock, Kristy K.; Lawrence, Theodore; Haken, Randall ten

    2001-01-01

    Purpose: To determine the accuracy of estimation of liver movement inferred by observing diaphragm excursion on radiographic images. Methods and Materials: Eight patients with focal liver cancer had platinum embolization microcoils implanted in their livers during catheterization of the hepatic artery for delivery of regional chemotherapy. These patients underwent fluoroscopy, during which normal breathing movement was recorded on videotape. Movies of breathing movement were digitized, and the relative projected positions of the diaphragm and coils were recorded. For 6 patients, daily radiographs were also acquired during treatment. Retrospective measurements of coil position were taken after the diaphragm was aligned with the superior portion of the liver on digitally reconstructed radiographs. Results: Coil movement of 4.9 to 30.4 mm was observed during normal breathing. Diaphragm position tracked inferior-superior coil displacement accurately (population σ 1.04 mm) throughout the breathing cycle. The range of coil movement was predicted by the range of diaphragm movement with an accuracy of 2.09 mm (σ). The maximum error observed measuring coil movement using diaphragm position was 3.8 mm for a coil 9.8 cm inferior to the diaphragm. However, the distance of the coil from the top of the diaphragm did not correlate significantly with the error in predicting liver excursion. Analysis of daily radiographs showed that the error in predicting coil position using the diaphragm as an alignment landmark was 1.8 mm (σ) in the inferior-superior direction and 2.2 mm in the left-right direction, similar in magnitude to the inherent uncertainty in alignment. Conclusions: This study demonstrated that the range of ventilatory movement of different locations within the liver is predicted by diaphragm position to an accuracy that matches or exceeds existing systems for ventilatory tracking. This suggests that the diaphragm is an acceptable anatomic landmark for radiographic

  2. Movement of the diaphragm during radiation treatment

    International Nuclear Information System (INIS)

    Nishioka, Masayuki; Fujioka, Tomio; Sakurai, Makoto; Nakajima, Toshifumi; Onoyama, Yasuto.

    1991-01-01

    Movement of the target volume during the exposure to radiation results in decreased accuracy in radiotherapy. We carried out the quantitative evaluation of the movement of the diaphragm during the radiation therapy. Seventy seven patients, who received radiation therapy for lung cancer from December 1988 to February 1990 at the Osaka-prefectural Habikino Hospital, were studied. The movement was recorded with a sonoprinter at the time of treatment planning for radiotherapy, and the length of movement was evaluated at 6 points on the diaphragm. In a study of 402 points in 77 patients, the average movement was 12 mm, and the maximum movement was 40 mm. At the 17% of the points, the movement exceeded 20 mm. The largest movement was observed at the outer point of the right lung. Movement was greater in men than in women. Performance status was not related to the degree of movement. We concluded that in chest and abdominal irradiation, movement caused by respiration is not negligible, and synchronized radiotherapy should be developed in the future. (author)

  3. Radiofrequency ablation of pulmonary tumors near the diaphragm.

    Science.gov (United States)

    Iguchi, T; Hiraki, T; Gobara, H; Fujiwara, H; Sakurai, J; Matsui, Y; Mitsuhashi, T; Toyooka, S; Kanazawa, S

    To retrospectively evaluate the feasibility, safety, and efficacy of radiofrequency ablation (RFA) of lung tumors located near the diaphragm. A total of 26 patients (15 men, 11 women; mean age, 61.5 years±13.0 [SD]) with a total of 29 lung tumors near the diaphragm (i.e., distance<10mm) were included. Mean tumor diameter was 11.0mm±5.3 (SD) (range, 2-23mm). Efficacy of RFA, number of adverse events and number of adverse events with a grade≥3, based on the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0, were compared between patients with lung tumors near the diaphragm and a control group of patients with more distally located lung tumors (i.e., distance≥10mm). RFA was technically feasible for all tumors near the diaphragm. Four grade 3 adverse events (1 pneumothorax requiring pleurodesis and 3 phrenic nerve injuries) were observed. No grade≥4 adverse events were reported. The median follow-up period for tumors near the diaphragm was 18.3 months. Local progression was observed 3.3 months after RFA in 1 tumor. The technique efficacy rates were 96.2% at 1 year and 96.2% at 2 years and were not different, from those observed in control subjects (186 tumors; P=0.839). Shoulder pain (P<0.001) and grade 1 pleural effusion (P<0.001) were more frequently observed in patients with lung tumor near the diaphragm. The rates of grade≥3 adverse events did not significantly differ between tumors near the diaphragm (4/26 sessions) and the controls (7/133 sessions) (P=0.083). RFA is a feasible and effective therapeutic option for lung tumors located near the diaphragm. However, it conveys a higher rate of shoulder pain and asymptomatic pleural effusion by comparison with more distant lung tumors. Copyright © 2017 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

  4. Is Diaphragm Motion a Good Surrogate for Liver Tumor Motion?

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Juan [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); School of Information Science and Engineering, Shandong University, Jinan, Shandong (China); Cai, Jing [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Wang, Hongjun [School of Information Science and Engineering, Shandong University, Jinan, Shandong (China); Chang, Zheng; Czito, Brian G. [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Bashir, Mustafa R. [Department of Radiology, Duke University Medical Center, Durham, North Carolina (United States); Palta, Manisha [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Yin, Fang-Fang, E-mail: fangfang.yin@duke.edu [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States)

    2014-11-15

    Purpose: To evaluate the relationship between liver tumor motion and diaphragm motion. Methods and Materials: Fourteen patients with hepatocellular carcinoma (10 of 14) or liver metastases (4 of 14) undergoing radiation therapy were included in this study. All patients underwent single-slice cine–magnetic resonance imaging simulations across the center of the tumor in 3 orthogonal planes. Tumor and diaphragm motion trajectories in the superior–inferior (SI), anterior–posterior (AP), and medial–lateral (ML) directions were obtained using an in-house-developed normalized cross-correlation–based tracking technique. Agreement between the tumor and diaphragm motion was assessed by calculating phase difference percentage, intraclass correlation coefficient, and Bland-Altman analysis (Diff). The distance between the tumor and tracked diaphragm area was analyzed to understand its impact on the correlation between the 2 motions. Results: Of all patients, the mean (±standard deviation) phase difference percentage values were 7.1% ± 1.1%, 4.5% ± 0.5%, and 17.5% ± 4.5% in the SI, AP, and ML directions, respectively. The mean intraclass correlation coefficient values were 0.98 ± 0.02, 0.97 ± 0.02, and 0.08 ± 0.06 in the SI, AP, and ML directions, respectively. The mean Diff values were 2.8 ± 1.4 mm, 2.4 ± 1.1 mm, and 2.2 ± 0.5 mm in the SI, AP, and ML directions, respectively. Tumor and diaphragm motions had high concordance when the distance between the tumor and tracked diaphragm area was small. Conclusions: This study showed that liver tumor motion had good correlation with diaphragm motion in the SI and AP directions, indicating diaphragm motion in the SI and AP directions could potentially be used as a reliable surrogate for liver tumor motion.

  5. Traumatic rupture of the diaphragm | Jamabo | Sahel Medical Journal

    African Journals Online (AJOL)

    Those treated for traumatic rupture of the diaphragm were selected and analyzed for age, gender, cause of injury, associated injuries sustained and mode of treatment. They were all treated at the University of Port Harcourt Teaching Hospital and a private clinic in Port Harcourt. Results: 12 patients had traumatic rupture of ...

  6. First reported experience with intramuscular diaphragm pacing in replacing positive pressure mechanical ventilators in children.

    Science.gov (United States)

    Onders, Raymond P; Ponsky, Todd A; Elmo, MaryJo; Lidsky, Karen; Barksdale, Edward

    2011-01-01

    Diaphragm pacing (DP) has been shown to successfully replace mechanical ventilators for adult tetraplegic patients with chronic respiratory insufficiency. This is the first report of DP in ventilator-dependent children. This was a prospective interventional experience under institutional review board approval. Diaphragm pacing involves outpatient laparoscopic diaphragm motor point mapping to identify the site where stimulation causes maximum diaphragm contraction with implantation of 4 percutaneous intramuscular electrodes. Diaphragm conditioning ensues to wean the child from the ventilator. Six children were successfully implanted ranging from 5 to 17 years old with the smallest 15 kg in weight. Length of time on mechanical ventilation ranged from 11 days to 7.6 years with an average of 3.2 years. In all patients, DP provided tidal volumes above basal needs. Five of the patients underwent a home-based weaning program, whereas one patient who was implanted only 11 days post spinal cord injury never returned to the ventilator with DP use. Another patient was weaned from the ventilator full time but died of complications of his underlying brain stem tumor. The remaining patients weaned from the ventilator for over 14 hours a day and/or are actively conditioning their diaphragms. Diaphragm pacing successfully replaced mechanical ventilators, which improves quality of life. Copyright © 2011 Elsevier Inc. All rights reserved.

  7. Can the accuracy of multifocal intraocular lens power calculation be improved to make patients spectacle free?

    Science.gov (United States)

    Ramji, Hasnain; Moore, Johnny; Moore, C B Tara; Shah, Sunil

    2016-04-01

    To optimise intraocular lens (IOL) power calculation techniques for a segmental multifocal IOL, LENTIS™ MPlus(®) (Oculentis GmbH, Berlin, Germany) and assess outcomes. A retrospective consecutive non-randomised case series of patients receiving the MPlus(®) IOL following cataract surgery or clear lens extraction was performed at a privately owned ophthalmic hospital, Midland Eye, Solihull, UK. Analysis was undertaken of 116 eyes, with uncomplicated lens replacement surgery using the LENTIS™ MPlus(®) lenses. Pre-operative biometry data were stratified into short (<22.00 mm) and long axial lengths (ALs) (≥22.00 mm). IOL power predictions were calculated with SRK/T, Holladay I, Hoffer Q, Holladay II and Haigis formulae and compared to the final manifest refraction. These were compared with the OKULIX ray tracing method and the stratification technique suggested by the Royal College of Ophthalmologists (RCOphth). Using SRK/T for long eyes and Hoffer Q for short eyes, 64% achieved postoperative subjective refractions of ≤±0.25 D, 83%≤±0.50 D and 93%≤±0.75 D, with a maximum predictive error of 1.25D. No specific calculation method performed best across all ALs; however for ALs under 22 mm Hoffer Q and Holliday I methods performed best. Excellent but equivalent overall refractive results were found between all biometry methods used in this multifocal IOL study. For eyes with ALs under 22 mm Hoffer Q and Holliday I performed best. Current techniques mean that patients are still likely to need top up glasses for certain situations. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. A Randomized Controlled Trial of Tong Len Meditation Practice in Cancer Patients: Evaluation of a Distant Psychological Healing Effect.

    Science.gov (United States)

    Pagliaro, Gioacchino; Pandolfi, Paolo; Collina, Natalina; Frezza, Giovanni; Brandes, Alba; Galli, Margherita; Avventuroso, Federica Marzocchi; De Lisio, Sara; Musti, Muriel Assunta; Franceschi, Enrico; Esposti, Roberta Degli; Lombardo, Laura; Cavallo, Giovanna; Di Battista, Monica; Rimondini, Simonetta; Poggi, Rosalba; Susini, Cinzia; Renzi, Rina; Marconi, Linda

    2016-01-01

    Tong Len meditation is an important therapeutic tool in the Tibetan medicine, and it can be used for self-healing and/or to heal others. Currently, in the West, there is no scientific study concerning the efficacy of a Tong Len distant healing effect on psychological disorders in cancer patients. To evaluate a distant healing effect of Tong Len meditation on stress, anxiety, depression, fatigue, and self-perceived quality of life in cancer patients. These psychological objectives were chosen as a consequence of the limited scientific literature of present day. We performed a double-blind randomized controlled trial on 103 cancer patients with tumors. Overall, 12 meditators used Tong Len in aid of 52 patients randomly selected as experimental group, while the remaining 51 patients constituted the control group. Patients and meditators did not know each other. All patients completed profile of mood states (POMS) and European Quality of Life-5 dimensions (EQ-5D) questionnaires before treatment (T0), after two (T1) and three months of treatment (T2), and one month after treatment cessation (T3). With regard to the parameters related to depression, a statistically significant improvement (P = .003) was observed in the treatment group compared to controls. On the other hand, the vigor/activity parameter saw significant improvements in the control group (P = .009). Both groups exhibited significant improvements in the other factors assessed in the POMS and EQ-5D questionnaires. This study did not provide sufficient evidence supporting an efficacy of Tong Len meditation in distant psychological healing as compared to a control condition. The research highlighted some psychological improvements through Tong Len distant meditation in a group of patients unknown to meditators. Therefore, the enhancement detected in most parameters in both treatment and control groups raises interest on in-depth analysis and evaluation of distant meditation on cancer patients to mitigate

  9. Subacute presentation of spontaneous diaphragmal rupture: case report

    Directory of Open Access Journals (Sweden)

    Dejan Hermann

    2005-07-01

    Full Text Available Background: Diaphragmatic injuries are relatively rare and present with non specific symptoms and signs. Late discoveries are almost a rule in all but the most evident cases. Many patients are observed or even treated for suspected other conditions, most often musculosceletal disorders.Patients and methods: We report a case of a 14-year-old boy who presented with left lumbar pain and developed peritonitis six days after strenuous training. A chest X-ray revealed abdominal viscera in the left hemithorax. A large posterolateral rupture of the left diaphragm was found at laparotomy together with herniation of the stomach, spleen and colon. The stomach was perforated and partialy necrotic. Afer partial gastrectomy, repositioning and diaphragmal repair the patient recovered well.Conclusions: If pain in toracoabdominal region is a predominant sign after trauma or endogenous strain, one should consider the posibility of ruptured diaphragm and make a chest X-ray. Operation of diaphragmal hernia is necessary and garanties good results when treated on time.

  10. Lens densitometry after corneal cross-linking in patients with keratoconus using a Scheimpflug camera

    Directory of Open Access Journals (Sweden)

    Alireza Baradaran-Rafii

    2015-01-01

    Conclusion: In this short term study with six months' follow-up, we observed no significant impact on lens density following exposure of the crystalline lens to ultraviolet A and riboflavin free radicals in the CXL procedure.

  11. Anatomic connections of the diaphragm influence of respiration on the body system

    Directory of Open Access Journals (Sweden)

    Bordoni B

    2013-07-01

    Full Text Available Bruno Bordoni,1 Emiliano Zanier2 1Rehabilitation Cardiology Institute of Hospitalization and Care with Scientific Address, S Maria Nascente Don Carlo Gnocchi Foundation, 2EdiAcademy, Milano, Italy Abstract: The article explains the scientific reasons for the diaphragm muscle being an important crossroads for information involving the entire body. The diaphragm muscle extends from the trigeminal system to the pelvic floor, passing from the thoracic diaphragm to the floor of the mouth. Like many structures in the human body, the diaphragm muscle has more than one function, and has links throughout the body, and provides the network necessary for breathing. To assess and treat this muscle effectively, it is necessary to be aware of its anatomic, fascial, and neurologic complexity in the control of breathing. The patient is never a symptom localized, but a system that adapts to a corporeal dysfunction. Keywords: diaphragm, fascia, phrenic nerve, vagus nerve, pelvis

  12. Quantification of Diaphragm Mechanics in Pompe Disease Using Dynamic 3D MRI.

    Directory of Open Access Journals (Sweden)

    Katja Mogalle

    Full Text Available Diaphragm weakness is the main reason for respiratory dysfunction in patients with Pompe disease, a progressive metabolic myopathy affecting respiratory and limb-girdle muscles. Since respiratory failure is the major cause of death among adult patients, early identification of respiratory muscle involvement is necessary to initiate treatment in time and possibly prevent irreversible damage. In this paper we investigate the suitability of dynamic MR imaging in combination with state-of-the-art image analysis methods to assess respiratory muscle weakness.The proposed methodology relies on image registration and lung surface extraction to quantify lung kinematics during breathing. This allows for the extraction of geometry and motion features of the lung that characterize the independent contribution of the diaphragm and the thoracic muscles to the respiratory cycle.Results in 16 3D+t MRI scans (10 Pompe patients and 6 controls of a slow expiratory maneuver show that kinematic analysis from dynamic 3D images reveals important additional information about diaphragm mechanics and respiratory muscle involvement when compared to conventional pulmonary function tests. Pompe patients with severely reduced pulmonary function showed severe diaphragm weakness presented by minimal motion of the diaphragm. In patients with moderately reduced pulmonary function, cranial displacement of posterior diaphragm parts was reduced and the diaphragm dome was oriented more horizontally at full inspiration compared to healthy controls.Dynamic 3D MRI provides data for analyzing the contribution of both diaphragm and thoracic muscles independently. The proposed image analysis method has the potential to detect less severe diaphragm weakness and could thus be used to determine the optimal start of treatment in adult patients with Pompe disease in prospect of increased treatment response.

  13. Multiple methods of surgical treatment combined with primary IOL implantation on traumatic lens subluxation/dislocation in patients with secondary glaucoma

    OpenAIRE

    Wang, Rui; Bi, Chun-Chao; Lei, Chun-Ling; Sun, Wen-Tao; Wang, Shan-Shan; Dong, Xiao-Juan

    2014-01-01

    AIM:To describe clinical findings and complications from cases of traumatic lens subluxation/dislocation in patients with secondary glaucoma, and discuss the multiple treating methods of operation combined with primary intraocular lens (IOL) implantation.METHODS:Non-comparative retrospective observational case series. Participants:30 cases (30 eyes) of lens subluxation/dislocation in patients with secondary glaucoma were investigated which accepted the surgical treatment by author in the Opht...

  14. Associated depression in pseudophakic patients with intraocular lens with and without chromophore

    Directory of Open Access Journals (Sweden)

    Mendoza-Mendieta ME

    2016-03-01

    Full Text Available María Elena Mendoza-Mendieta, Ana Aurora Lorenzo-Mejía Association to Prevent Blindness in Mexico (APEC, Hospital “Dr Luis Sánchez Bulnes”, Mexico City, Mexico Background: With aging, the crystalline lens turns yellowish, which increases the absorption of wavelengths in the blue electromagnetic spectrum, reducing their photoreception in the retina. Since these wavelengths are the main stimulus in the regulation of the circadian rhythm, progressive reduction in their transmission is associated with chronic sleep disturbances and depression in elderly patients. Cataract extraction improves circadian photoreception at any age. However, lenses that block blue waves have 27% to 38% less melatonin suppression than lenses that block only ultraviolet (UV rays. Purpose: To assess the depression symptoms in subjects who have had bilateral phacoemulsification and intraocular lens (IOL implants, one group with yellow chromophore IOLs and the other group with transparent IOLs were compared. Setting: Association to Prevent Blindness in Mexico (APEC, Hospital “Dr Luis Sánchez Bulnes”. Design: This was an observational, cross-sectional, and single-center study. Materials and methods: Twenty-six subjects between 60 and 80 years of age, with a history of bilateral phacoemulsification and placement of the same type of IOL in both eyes from 4 to 12 months prior to the study, who attended the follow-up visits and agreed to participate in this study, and provided signed informed consent were included in the study. They were asked to answer the short version of the 15-item Geriatric Depression Scale. Results: The average age of the study participants was 72.5±5.94 years. The group without chromophore included 46.1% (n=12 of the patients and the group with chromophore included 53.9% (n=14 of the patients (P=0.088. Conclusion: In the group of patients with IOLs that block the passage of blue light, the depression rate was 21.4%, a rate similar to that

  15. Fully automatic algorithm for segmenting full human diaphragm in non-contrast CT Images

    Science.gov (United States)

    Karami, Elham; Gaede, Stewart; Lee, Ting-Yim; Samani, Abbas

    2015-03-01

    The diaphragm is a sheet of muscle which separates the thorax from the abdomen and it acts as the most important muscle of the respiratory system. As such, an accurate segmentation of the diaphragm, not only provides key information for functional analysis of the respiratory system, but also can be used for locating other abdominal organs such as the liver. However, diaphragm segmentation is extremely challenging in non-contrast CT images due to the diaphragm's similar appearance to other abdominal organs. In this paper, we present a fully automatic algorithm for diaphragm segmentation in non-contrast CT images. The method is mainly based on a priori knowledge about the human diaphragm anatomy. The diaphragm domes are in contact with the lungs and the heart while its circumference runs along the lumbar vertebrae of the spine as well as the inferior border of the ribs and sternum. As such, the diaphragm can be delineated by segmentation of these organs followed by connecting relevant parts of their outline properly. More specifically, the bottom surface of the lungs and heart, the spine borders and the ribs are delineated, leading to a set of scattered points which represent the diaphragm's geometry. Next, a B-spline filter is used to find the smoothest surface which pass through these points. This algorithm was tested on a noncontrast CT image of a lung cancer patient. The results indicate that there is an average Hausdorff distance of 2.96 mm between the automatic and manually segmented diaphragms which implies a favourable accuracy.

  16. Fluid structure interaction in piston diaphragm pumps

    NARCIS (Netherlands)

    Van Rijswick, R.; Van Rhee, C.

    2013-01-01

    Piston diaphragm pumps are used world-wide for the transport of aggressive and/or abrasive fluids in the chemical, mining and mineral processing industries. Figure 1 shows a cross section of a piston diaphragm pump as is used in the mining and mineral processing industries for the transport of

  17. Fluid structure interaction in piston diaphragm pumps

    NARCIS (Netherlands)

    van Rijswick, R.J.A.

    2017-01-01

    Piston diaphragm pumps are used world-wide to transport abrasive and/or aggressive slurries against high discharge pressures in the mining, mineral processing and power industries. Limitation of excessive deformation of the diaphragm is of utmost importance for eliminating fatigue failures of the

  18. To detect anomalies in diaphragm walls

    NARCIS (Netherlands)

    Spruit, R.

    2015-01-01

    Diaphragm walls are potentially ideal retaining walls for deep excavations in densely built-up areas, as they cause no vibrations during their construction and provide structural elements with high strength and stiffness. In the recent past, however, several projects using diaphragm walls as soil

  19. The effect of contact lens usage on corneal biomechanical parameters in myopic patients.

    Science.gov (United States)

    Cankaya, Ali B; Beyazyildiz, Emrullah; Ileri, Dilek; Ozturk, Faruk

    2012-07-01

    To determine and compare the corneal biomechanical properties in myopic patients who use contact lenses and those who do not use contact lenses. The study consisted of 56 myopic patients who used contact lenses (study group) and 123 myopic patients who did not use contact lenses (control group). Intraocular pressure (IOP) was measured with an ocular response analyzer (ORA) and a Goldmann applanation tonometer. Central corneal thickness was measured with an ultrasonic pachymeter. Axial length and anterior chamber depth measurements were acquired with contact ultrasound A-scan biometry. The differences in ORA parameters between study and control group participants were analyzed. The mean corneal hysteresis in study and control groups was 10.1 ± 1.6 mm Hg (6.5-15.9 mm Hg) and 9.7 ± 1.5 mm Hg (6.3-14.2 mm Hg), respectively (P = 0.16). The mean corneal resistance factor was 10.4 ± 1.9 mm Hg (4.6-15.5 mm Hg) in the study group compared with 9.6 ± 1.9 mm Hg (5.1-15.0 mm Hg) in the control group. The difference for corneal resistance factor was statistically significant (P = 0.014). There was no significant difference in corneal-compensated IOP (P = 0.24). Mean Goldmann-correlated IOP was significantly higher in the study group than in control subjects (15.8 ± 3.2 vs. 14.7 ± 3.7 mm Hg) (P = 0.044). None of the corneal biomechanical parameters was significantly correlated to duration of contact lens usage in the study group. Our results suggest that ORA-generated parameters may be different in subjects with and without contact lens usage. Further longitudinal studies need to be performed to establish the relevance of our results.

  20. Radial-Electric-Field Piezoelectric Diaphragm Pumps

    Science.gov (United States)

    Bryant, Robert G.; Working, Dennis C.; Mossi, Karla; Castro, Nicholas D.; Mane, Pooma

    2009-01-01

    In a recently invented class of piezoelectric diaphragm pumps, the electrode patterns on the piezoelectric diaphragms are configured so that the electric fields in the diaphragms have symmetrical radial (along-the-surface) components in addition to through-the-thickness components. Previously, it was accepted in the piezoelectric-transducer art that in order to produce the out-of-plane bending displacement of a diaphragm needed for pumping, one must make the electric field asymmetrical through the thickness, typically by means of electrodes placed on only one side of the piezoelectric material. In the present invention, electrodes are placed on both sides and patterned so as to produce substantial radial as well as through-the-thickness components. Moreover, unlike in the prior art, the electric field can be symmetrical through the thickness. Tests have shown in a given diaphragm that an electrode configuration according to this invention produces more displacement than does a conventional one-sided electrode pattern. The invention admits of numerous variations characterized by various degrees of complexity. Figure 1 is a simplified depiction of a basic version. As in other piezoelectric diaphragm pumps of similar basic design, the prime mover is a piezoelectric diaphragm. Application of a suitable voltage to the electrodes on the diaphragm causes it to undergo out-of-plane bending. The bending displacement pushes a fluid out of, or pulls the fluid into, a chamber bounded partly by the diaphragm. Also as in other diaphragm pumps in general, check valves ensure that the fluid flows only in through one port and only out through another port.

  1. A method to reduce patient's eye lens dose in neuro-interventional radiology procedures

    International Nuclear Information System (INIS)

    Safari, M.J.; Wong, J.H.D.; Kadir, K.A.A.; Sani, F.M.; Ng, K.H.

    2016-01-01

    Complex and prolonged neuro-interventional radiology procedures using the biplane angiography system increase the patient's risk of radiation-induced cataract. Physical collimation is the most effective way of reducing the radiation dose to the patient's eye lens, but in instances where collimation is not possible, an attenuator may be useful in protecting the eyes. In this study, an eye lens protector was designed and fabricated to reduce the radiation dose to the patients’ eye lens during neuro-interventional procedures. The eye protector was characterised before being tested on its effectiveness in a simulated aneurysm procedure on an anthropomorphic phantom. Effects on the automatic dose rate control (ADRC) and image quality are also evaluated. The eye protector reduced the radiation dose by up to 62.1% at the eye lens. The eye protector is faintly visible in the fluoroscopy images and increased the tube current by a maximum of 3.7%. It is completely invisible in the acquisition mode and does not interfere with the clinical procedure. The eye protector placed within the radiation field of view was able to reduce the radiation dose to the eye lens by direct radiation beam of the lateral x-ray tube with minimal effect on the ADRC system. - Highlights: • The eye protector can considerably reduce the patient's eye lens dose during neuro-interventional procedures. • This protector does not significantly perturb the fluoroscopy image and was completely invisible on the acquisition image due to image subtraction. • The eye protector does not significantly change the exposure parameters (kV and mAs).

  2. Comparison on the visual quality after different multifocal lens implantation in cataract patients

    Directory of Open Access Journals (Sweden)

    Si-Meng Qu

    2018-02-01

    Full Text Available AIM: To compare the visual quality after different multifocal lens(MIOLimplantation in cataract patients. METHODS:Totally 78 cases(78 eyesof cataract patients who receiving phacoemulsification and implantation of different MIOL were enrolled from February 2016 to June 2017 in our hospital. According to the different type of implanted MIOL, the 78 cases(78 eyeswere divided Group A, B and C, each group was 26 cases(26 eyes. Patients in the Group A were implanted regional refraction MIOL SBL-3; patients in the Group B implanted step progressive diffraction MIOL SN6AD1; patients in the Group C implanted all-optical plane diffraction MIOL Tecnis ZMB00. The visual acuity, contrast sensitivity, defocus testing, contrast visual acuity and satisfaction of visual quality were compared in 3 groups at postoperative 3mo. RESULTS: There was no statistically significant difference in postoperative adverse reactions between the three groups(P>0.05. There was statistical difference in uncorrected intermediate visual acuity, uncorrected near visual acuity, distance-corrected intermediate visual acuity and distance-corrected near visual acuity in 3 groups(PPPPPPPPPCONCLUSION:The region refraction MIOL SBL-3 not only could provide better distant, intermediate and near visual acuity, but also could provide better contrast sensitivity and contrast visual acuity, thereby greatly increase visual quality satisfaction.

  3. A Conjunctival Mass in the Deep Superior Fornix After a Long Retained Hard Contact Lens in a Patient With Keloids

    NARCIS (Netherlands)

    Zola, Enrica; van der Meulen, Ivanka J. E.; Lapid-Gortzak, Ruth; van Vliet, J. Mj; Nieuwendaal, Carla P.

    2008-01-01

    Purpose: To report a case of an upper eyelid mass induced by a rigid contact lens retained for more than 3 years in the eye of a patient with a general history of keloids and to provide a review of the literature on retained contact lenses. Methods: Case report. Results: A 45-year-old woman with an

  4. Cough induced rib fracture, rupture of the diaphragm and abdominal herniation

    Directory of Open Access Journals (Sweden)

    Wurl Peter

    2006-11-01

    Full Text Available Abstract Cough can be associated with many complications. In this article, we present a 59 year old male patient with a very rare combination of a cough related stress fracture of the ninth rib, a traumatic rupture of the diaphragm, and an abdominal wall herniation. The hernia was repaired through surgical treatment without bowel resection, the diaphragm and the internal and oblique abdominal muscle were adapted, and the abdomen was reinforced with a prolene net. Although each individual injury is well documented in the literature, the combination of rib fracture, abdominal herniation and diaphragm rupture has not been reported.

  5. Late in-the-bag intraocular lens dislocation in patients with uveitis.

    Science.gov (United States)

    Steeples, Laura R; Jones, Nicholas P

    2015-09-01

    Late in-the-bag intraocular lens (IOL) dislocation is an unusual complication of cataract surgery, being strongly associated with pseudoexfoliation, less so with previous vitreoretinal surgery, myopia and uveitis. We present the clinical features, management and outcomes of late spontaneous IOL dislocation in a series of patients with uveitis. A retrospective case series of IOL dislocation affecting patients in the Manchester Uveitis Clinic, UK. The uveitis diagnosis, IOL type, presentation and management are discussed. Six patients from out of 1056 undergoing cataract surgery (0.57%) were affected. Uveitis was the only identified risk factor for IOL dislocation, which occurred a mean 10.3 years following uncomplicated cataract surgery by phakoemulsification with endocapsular IOL implantation. The dislocation was in-the-bag in all six cases. Two patients presented with the IOL in the anterior chamber, and required removal of the IOL-bag complex, and are using aphakic refractive correction. Two patients with inferior IOL subluxation have been managed conservatively. Two patients underwent pars plana vitrectomy with sutureless scleral fixation of the existing IOL in one case, and IOL exchange with a scleral sutured IOL in the other. IOL dislocation is an uncommon late complication in patients with uveitis. Conservative management is appropriate in patients with tolerable symptoms, or in those with difficult uveitis. Otherwise, fixation of the existing IOL, or removal and implantation of a secondary IOL, may be necessary. Angle-supported, or iris-enclaved IOLs, are not of proven safety in this patient group; scleral-fixated posterior chamber IOLs are the favoured approach in our service. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  6. Diaphragms obtained by radiochemical grafting in PTFE

    International Nuclear Information System (INIS)

    Nenner, T.; Fahrasmane, A.

    1984-01-01

    Diaphragms for alkaline water electrolysis are prepared by radiochemical grafting of PTFE fabric with styrene, which is later on sulfonated, or with acrylic acid. The diaphragms obtained are mechanically resistant to potash at temperatures up to 200 0 C, but show some degrafting, which limits the lifetime. The sulfonated styrene group has been found to be more stable in electrolysis than the acrylic acid. In both cases, the incorporation of a cross-linking agent like divinyl benzene improves the lifetime of the diaphragms. Electrolysis during 500 hours at 120 0 C and 10 kAm 2 could be performed. (author)

  7. The Stress and Stiffness Analysis of Diaphragm

    Directory of Open Access Journals (Sweden)

    Qu Dongyue

    2017-01-01

    Full Text Available Diaphragm coupling with its simple structure, small size, high reliability, which can compensate for its input and output displacement deviation by its elastic deformation, is widely used in aerospace, marine, and chemical etc. This paper uses the ANSYS software and its APDL language to analysis the stress distribution when the diaphragm under the load of torque, axial deviation, centrifugal force, angular deviation and multiple loads. We find that the value of maximum stress usually appears in the outer or inner transition region and the axial deviation has a greater influence to the distribution of the stress. Based on above, we got three kinds of stiffness for axial, angular and torque, which the stiffness of diaphragm is nearly invariable. The results can be regard as an important reference for design and optimization of diaphragm coupling.

  8. Right Diaphragm Spontaneous Rupture: A Surgical Approach

    Directory of Open Access Journals (Sweden)

    Duilio Divisi

    2011-01-01

    Full Text Available We present a case of spontaneous rupture of the diaphragm, characterized by nonspecific symptoms. The rapid diagnosis and appropriate surgical approach led to a positive resolution of the pathology.

  9. Changes in stereoacuity following implantable Collamer lens implantation in patients with myopia

    Directory of Open Access Journals (Sweden)

    Sudarshan Khokhar

    2015-01-01

    Full Text Available The study evaluated the impact of implantable Collamer lens (ICL implantation on stereoacuity in myopes in a retrospective case series. Ninety-five eyes of 48 patients were recruited. Distance and near stereoacuity were measured using distance Randot stereotest and TNO test, respectively, before surgery and at 4 weeks postoperatively. Mean age of the patients was 23.67 ± 3.7 years. Mean uncorrected distance visual acuity (UDVA was 1.28 ± 0.37 logarithm of the minimum angle of resolution (logMAR (median: 1.3; range: 0.3-1.8, and median best-corrected distance visual acuity (BDVA was 0.18 logMAR (range: 0-0.6. There was a significant improvement in both UDVA and BDVA postsurgery (P < 0.001; Wilcoxon signed rank test. The overall improvement in stereopsis was observed in 15/48 (31.25% and 13/48 (27.10% subjects for near and distance, respectively, with no significant difference between the two (P = 0.82; Fisher′s exact test. Among stereoblind individuals, the odd′s ratio for near stereoacuity to improve in comparison to distance stereoacuity was 8.85 (95% confidence interval: 1.68-46.70; P = 0.01. ICL implantation for refractive correction aided stereoacuity improvement in myopes more so for near.

  10. Phrenic Nerve Reconstruction and Bilateral Diaphragm Plication After Lobectomy.

    Science.gov (United States)

    Shinohara, Shuichi; Yamada, Tetsu; Ueda, Mitsuhiro; Ishinagi, Hiroyoshi; Matsuoka, Takahisa; Nagai, Shinjiro; Matsuoka, Katsunari; Miyamoto, Yoshihiro

    2017-07-01

    A 49-year-old man with left phrenic nerve paralysis caused by mediastinal tumor resection 28 years earlier was found to have a nodule in the right upper lobe. The right phrenic nerve was severed during right upper lobectomy but was reconstructed along with bilateral plication of the diaphragm. The patient was weaned from the ventilator during the daytime on postoperative day 13 and was discharged home on postoperative day 48. Three months postoperatively, chest fluoroscopic imaging showed recovery of movement of the right diaphragm. Nerve conduction studies showed improvement of function of the reconstructed right phrenic nerve. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  11. β-hydroxy-β-methylbutyrate (HMB) prevents sepsis-induced diaphragm dysfunction in mice.

    Science.gov (United States)

    Supinski, Gerald S; Callahan, Leigh A

    2014-06-01

    Infections induce severe respiratory muscle weakness. Currently there are no treatments for this important clinical problem. We tested the hypothesis that β-hydroxy-β-methylbutyrate (HMB) would prevent sepsis-induced diaphragm weakness. Four groups of adult male mice were studied: controls (saline-injected), sepsis (intraperitoneal lipopolysaccharide), sepsis+HMB (injected intravenously), and HMB. Diaphragm force generation and indices of caspase 3, calpain, 20S proteasomal subunit, and double-stranded RNA-dependent protein kinase (PKR) activation were assessed after 24h. Sepsis elicited large reductions in diaphragm specific force generation at all stimulation frequencies. Endotoxin also activated caspase 3, calpain, the 20S proteasomal subunit and PKR in the diaphragm. HMB blocked sepsis-induced caspase 3, 20S proteasomal and PKR activation, but did not prevent calpain activation. Most importantly, HMB administration significantly attenuated sepsis-induced diaphragm weakness, preserving muscle force generation at all stimulation frequencies (pHMB may prove to be an important therapy in infected patients, with the potential to increase diaphragm strength, to reduce the duration of mechanical ventilation and to decrease mortality in this patient population. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. Epidemiological assessment of lens opacifications that impaired vision in patients injected with radium-224

    International Nuclear Information System (INIS)

    Chmelevsky, D.; Mays, C.W.; Spiess, H.; Stefani, F.H.; Kellerer, A.M.

    1988-01-01

    The incidence of lens opacifications that impaired vision (cataract) was analyzed among 831 patients who were injected with known dosages of 224 Ra in Germany shortly after World War II. The dependence of the incidence on dosage, i.e., injected activity per unit body weight, and on time after treatment was determined. The observations are equally consistent with proportionality of the incidence of cataract to the square of dosage or with a linear dependence beyond a threshold of 0.5 MBq/kg. The possibility of a linear dependence without threshold was strongly rejected (P less than 0.001). The analysis of temporal dependences yielded a component that was correlated with the injected amount of 224 Ra and a component that was uncorrelated. The former was inferred by a maximum likelihood analysis to increase approximately as the square of the time after treatment. The component unrelated to the treatment was found to increase steeply with age and to become dominant within the collective of patients between age 50 and 60. The relative magnitudes of the two components were such that a fraction of 55 to 60% of the total of 58 cataracts had to be ascribed to the dose-related incidence. Impaired vision due to cataract was diagnosed before age 54 in 25 cases. In terms of injected activity per unit body weight no dependence of the sensitivity on age was found; specifically there was no indication of a faster occurrence of the treatment-related cataracts in patients treated at older ages

  13. Computerized videokeratoscopy contact lens software for RGP fitting in a bilateral postkeratoplasty patient: a clinical case report.

    Science.gov (United States)

    Szczotka, L B; Reinhart, W

    1995-01-01

    Computerized videokeratoscopy systems now allow interactive rigid gas permeable (RGP) fitting evaluation using fluorescein pattern simulations through updated software programs. We used Computed Anatomy's Topographic Modeling System-1 (TMS-1) Custom Design Contact Lens Program successfully to refit a symptomatic bilateral post-penetrating keratoplasty patient. No trial lenses were used. For each eye the base curve, optic zone size, and edge lift were chosen from the optimal fluorescein pattern designed and titrated on the TMS-1 unit. Lens powers were based on the patient's previous lenses and overrefraction. Dispensed lenses provided a clinically acceptable fit, good comfort, and maximal visual acuity, and no adjustments were necessary. Corneal videokeratoscopy can be successfully employed to titrate an RGP fit, even on irregular corneas.

  14. Multiple methods of surgical treatment combined with primary IOL implantation on traumatic lens subluxation/dislocation in patients with secondary glaucoma.

    Science.gov (United States)

    Wang, Rui; Bi, Chun-Chao; Lei, Chun-Ling; Sun, Wen-Tao; Wang, Shan-Shan; Dong, Xiao-Juan

    2014-01-01

    To describe clinical findings and complications from cases of traumatic lens subluxation/dislocation in patients with secondary glaucoma, and discuss the multiple treating methods of operation combined with primary intraocular lens (IOL) implantation. Non-comparative retrospective observational case series. 30 cases (30 eyes) of lens subluxation/dislocation in patients with secondary glaucoma were investigated which accepted the surgical treatment by author in the Ophthalmology of Xi'an No.4 Hospital from 2007 to 2011. According to the different situations of lens subluxation/dislocation, various surgical procedures were performed such as crystalline lens phacoemulsification, crystalline lens phacoemulsification combined anterior vitrectomy, intracapsular cataract extraction combined anterior vitrectomy, lensectomy combined anterior vitrectomy though peripheral transparent cornea incision, pars plana lensectomy combined pars plana vitrectomy, and intravitreal cavity crystalline lens phacofragmentation combined pars plana vitrectomy. And whether to implement trabeculectomy depended on the different situations of secondary glaucoma. The posterior chamber intraocular lenses (PC-IOLs) were implanted in the capsular-bag or trassclerally sutured in the sulus decided by whether the capsular were present. visual acuity, intraocular pressure, the situation of intraocular lens and complications after the operations. The follow-up time was 11-36mo (21.4±7.13). Postoperative visual acuity of all eyes were improved; 28 cases maintained IOP below 21 mm Hg; 2 cases had slightly IOL subluxation, 4 cases had slightly tilted lens optical area; 1 case had postoperative choroidal detachment; 4 cases had postoperative corneal edema more than 1wk, but eventually recovered transparent; 2 cases had mild postoperative vitreous hemorrhage, and absorbed 4wk later. There was no postoperative retinal detachment, IOL dislocation, and endophthalmitis. To take early treatment of traumatic lens

  15. Compliance among soft contact lens wearers.

    Science.gov (United States)

    Kuzman, Tomislav; Kutija, Marija Barisić; Masnec, Sanja; Jandroković, Sonja; Mrazovac, Danijela; Jurisić, Darija; Skegro, Ivan; Kalauz, Miro; Kordić, Rajko

    2014-12-01

    Contact lens compliance is proven to be crucial for preventing lens wear-related complications because of the interdependence of the steps in lens care regime and their influence on lens system microbial contamination. Awareness of the patients' lens handling compliance as well as correct recognition of non-compliant behaviours is the basis for creating more targeted strategies for patient education. The aim of this study was to investigate compliance among soft contact lens (SCL) wearers in different aspects of lens care handling and wearing habits. In our research 50 asymptomatic lens wearers filled out a questionnaire containing demographic data, lens type, hygiene and wearing habits, lenses and lens care system replacement schedule and self-evaluation of contact lens handling hygiene. We established criteria of compliance according to available manufacturer's recommendations, prior literature and our clinical experience. Only 2 (4%) of patients were fully compliant SCL wearers. The most common non-compliant behaviours were insufficient lens solution soaking time (62%), followed by failure to daily exchange lens case solution and showering while wearing lenses. 44% of patients reported storing lenses in saline solution. Mean lens storage case replacement was 3.6 months, with up to 78% patients replacing lens case at least once in 3 months. Average grade in self evaluating level of compliance was very good (4 +/- 0.78) (from 1-poor level of hygiene to 5-great level of hygiene). Lens wearers who reported excessive daily lens wear and more than 10 years of lens wearing experience were also found to be less compliant with other lens system care procedures. (t = -2.99, df=47, p rate, self grading was relatively high. Therefore, these results indicate the need for patient education and encouragement of better lens wearing habits and all of the lens maintenance steps at each patient visit.

  16. Design of pressure-sensing diaphragm for MEMS capacitance diaphragm gauge considering size effect

    Science.gov (United States)

    Li, Gang; Li, Detian; Cheng, Yongjun; Sun, Wenjun; Han, Xiaodong; Wang, Chengxiang

    2018-03-01

    MEMS capacitance diaphragm gauge with a full range of (1˜1000) Pa is considered for its wide application prospect. The design of pressure-sensing diaphragm is the key to achieve balanced performance for this kind of gauges. The optimization process of the pressure-sensing diaphragm with island design of a capacitance diaphragm gauge based on MEMS technique has been reported in this work. For micro-components in micro scale range, mechanical properties are very different from that in the macro scale range, so the size effect should not be ignored. The modified strain gradient elasticity theory considering size effect has been applied to determine the bending rigidity of the pressure-sensing diaphragm, which is then used in the numerical model to calculate the deflection-pressure relation of the diaphragm. According to the deflection curves, capacitance variation can be determined by integrating over the radius of the diaphragm. At last, the design of the diaphragm has been optimized based on three parameters: sensitivity, linearity and ground capacitance. With this design, a full range of (1˜1000) Pa can be achieved, meanwhile, balanced sensitivity, resolution and linearity can be kept.

  17. Outcomes of excimer laser enhancements in pseudophakic patients with multifocal intraocular lens

    Directory of Open Access Journals (Sweden)

    Schallhorn SC

    2016-04-01

    Full Text Available Steven C Schallhorn,1–3 Jan A Venter,2 David Teenan,2 Julie M Schallhorn,3 Keith A Hettinger,2 Stephen J Hannan,2 Martina Pelouskova2 1Department of Ophthalmology, University of California, San Francisco, CA, USA; 2Optical Express, Glasgow, UK; 3Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA Purpose: The aim of this study was to assess visual and refractive outcomes of laser vision correction (LVC to correct residual refraction after multifocal intraocular lens (IOL implantation. Patients and methods: In this retrospective study, 782 eyes that underwent LVC to correct unintended ametropia after multifocal IOL implantation were evaluated. Of all multifocal lenses implanted during primary procedure, 98.7% were refractive and 1.3% had a diffractive design. All eyes were treated with VISX STAR S4 IR excimer laser using a convectional ablation profile. Refractive outcomes, visual acuities, patient satisfaction, and quality of life were evaluated at the last available visit. Results: The mean time between enhancement and last visit was 6.3±4.4 months. Manifest spherical equivalent changed from -0.02±0.83 D (-3.38 D to +2.25 D pre-enhancement to 0.00±0.34 D (-1.38 D to +1.25 D post-enhancement. At the last follow-up, the percentage of eyes within 0.50 D and 1.00 D of emmetropia was 90.4% and 99.5%, respectively. Of all eyes, 74.9% achieved monocular uncorrected distance visual acuity 20/20 or better. The mean corrected distance visual acuity remained the same before (-0.04±0.06 logMAR [logarithm of the minimum angle of resolution] and after LVC procedure (-0.04±0.07 logMAR; P=0.70. There was a slight improvement in visual phenomena (starburst, halo, glare, ghosting/double vision following the enhancement. No sight-threatening complications related to LVC occurred in this study. Conclusion: LVC in pseudophakic patients with multifocal IOL was safe, effective, and predictable in a large cohort of

  18. Unpacking the Complexity of Patient Handoffs Through the Lens of Cognitive Load Theory.

    Science.gov (United States)

    Young, John Q; Ten Cate, Olle; O'Sullivan, Patricia S; Irby, David M

    2016-01-01

    The transfer of a patient from one clinician to another is a high-risk event. Errors are common and lead to patient harm. More effective methods for learning how to give and receive sign-out is an important public health priority. Performing a handoff is a complex task. Trainees must simultaneously apply and integrate clinical, communication, and systems skills into one time-limited and highly constrained activity. The task demands can easily exceed the information-processing capacity of the trainee, resulting in impaired learning and performance. Appreciating the limits of working memory can help identify the challenges that instructional techniques and research must then address. Cognitive load theory (CLT) identifies three types of load that impact working memory: intrinsic (task-essential), extraneous (not essential to task), and germane (learning related). The authors generated a list of factors that affect a trainee's learning and performance of a handoff based on CLT. The list was revised based on feedback from experts in medical education and in handoffs. By consensus, the authors associated each factor with the type of cognitive load it primarily effects. The authors used this analysis to build a conceptual model of handoffs through the lens of CLT. The resulting conceptual model unpacks the complexity of handoffs and identifies testable hypotheses for educational research and instructional design. The model identifies features of a handoff that drive extraneous, intrinsic, and germane load for both the sender and the receiver. The model highlights the importance of reducing extraneous load, matching intrinsic load to the developmental stage of the learner and optimizing germane load. Specific CLT-informed instructional techniques for handoffs are explored. Intrinsic and germane load are especially important to address and include factors such as knowledge of the learner, number of patients, time constraints, clinical uncertainties, overall patient

  19. Verification on reliability of diaphragm seal

    International Nuclear Information System (INIS)

    Ide, Hiroshi; Sakuta, Yoshiyuki; Hanawa, Yoshio; Tsuji, Tomoyuki; Tsuboi, Kazuaki; Nagao, Yoshiharu; Miyazawa, Masataka

    2009-06-01

    The main body of the JMTR is composed of reactor pressure vessel, core and reactor pool. At the bottom of the reactor pool, the Diaphragm-seal (2.6m outer diameter, 2m inner diameter, thickness 1.5mm) of the JMTR made of stainless steel is installed to prevent the water leak of the reactor pool and to absorb the expansion of the reactor pressure vessel due to pressure and temperature changes. In the long-term maintenance plans drawn up in 2004, it is required that the visual inspection for the diaphragm-seal should be carried out in 2007 and that the inspection should be carried out every around five-year. Therefore, prior to the refurbishment of the JMTR, the inspection device which is a deposition-collection apparatus with underwater-camera was developed, and the visual inspection was carried out to confirm the soundness of the diaphragm-seal. As a result, harmful flaws and/or corrosions were not inspected in the visual inspection, and the soundness of the diaphragm seal was confirmed. In future, the long-term integrity of the diaphragm-seal will could be achieved by conducting the periodic inspection. (author)

  20. Quantifying the predictability of diaphragm motion during respiration with a noninvasive external marker

    International Nuclear Information System (INIS)

    Vedam, S.S.; Kini, V.R.; Keall, P.J.; Ramakrishnan, V.; Mostafavi, H.; Mohan, R.

    2003-01-01

    The aim of this work was to quantify the ability to predict intrafraction diaphragm motion from an external respiration signal during a course of radiotherapy. The data obtained included diaphragm motion traces from 63 fluoroscopic lung procedures for 5 patients, acquired simultaneously with respiratory motion signals (an infrared camera-based system was used to track abdominal wall motion). During these sessions, the patients were asked to breathe either (i) without instruction, (ii) with audio prompting, or (iii) using visual feedback. A statistical general linear model was formulated to describe the relationship between the respiration signal and diaphragm motion over all sessions and for all breathing training types. The model parameters derived from the first session for each patient were then used to predict the diaphragm motion for subsequent sessions based on the respiration signal. Quantification of the difference between the predicted and actual motion during each session determined our ability to predict diaphragm motion during a course of radiotherapy. This measure of diaphragm motion was also used to estimate clinical target volume (CTV) to planning target volume (PTV) margins for conventional, gated, and proposed four-dimensional (4D) radiotherapy. Results from statistical analysis indicated a strong linear relationship between the respiration signal and diaphragm motion (p<0.001) over all sessions, irrespective of session number (p=0.98) and breathing training type (p=0.19). Using model parameters obtained from the first session, diaphragm motion was predicted in subsequent sessions to within 0.1 cm (1 σ) for gated and 4D radiotherapy. Assuming a 0.4 cm setup error, superior-inferior CTV-PTV margins of 1.1 cm for conventional radiotherapy could be reduced to 0.8 cm for gated and 4D radiotherapy. The diaphragm motion is strongly correlated with the respiration signal obtained from the abdominal wall. This correlation can be used to predict diaphragm

  1. Microfluidic Pumps Containing Teflon [Trademark] AF Diaphragms

    Science.gov (United States)

    Willis, Peter; White, Victor; Grunthaner, Frank; Ikeda, Mike; Mathies, Richard A.

    2009-01-01

    Microfluidic pumps and valves based on pneumatically actuated diaphragms made of Teflon AF polymers are being developed for incorporation into laboratory-on-a-chip devices that must perform well over temperature ranges wider than those of prior diaphragm-based microfluidic pumps and valves. Other potential applications include implanted biomedical microfluidic devices, wherein the biocompatability of Teflon AF polymers would be highly advantageous. These pumps and valves have been demonstrated to function stably after cycling through temperatures from -125 to 120 C. These pumps and valves are intended to be successors to similar prior pumps and valves containing diaphragms made of polydimethylsiloxane (PDMS) [commonly known as silicone rubber]. The PDMS-containing valves ae designed to function stably only within the temperature range from 5 to 80 C. Undesirably, PDMS membranes are somwehat porous and retain water. PDMS is especially unsuitable for use at temperatures below 0 C because the formation of ice crystals increases porosity and introduces microshear.

  2. Diaphragm walling for Sizewell B sets records

    International Nuclear Information System (INIS)

    Anon.

    1988-01-01

    The first phase of construction of the Sizewell-B nuclear reactor has been completed. This was the building of a diaphragm wall around the site. It is one of the largest and deepest diaphragm walls to be installed in Europe. The site can be pumped dry of groundwater and the foundations constructed in the dry. The specifications of the wall and its construction, using two Hydrofraise excavation rigs, are described. The excavated material is brought up as a slurry and the (bentonite) slurry is cleaned and desanded. Most of the wall has been formed using a plastic concrete but reinforced concrete has been used for some stretches. The diaphragm wall, which is 1258m long and 55m deep on average, was built in 19 weeks. (U.K.)

  3. Reinnervation of the diaphragm by the inferior laryngeal nerve to the phrenic nerve in ventilator-dependent tetraplegic patients with C3-5 damage.

    Science.gov (United States)

    Verin, Eric; Morelot-Panzini, Capucine; Gonzalez-Bermejo, Jesus; Veber, Benoit; Perrouin Verbe, Brigitte; Soudrie, Brigitte; Leroi, Anne Marie; Marie, Jean Paul; Similowski, Thomas

    2017-10-01

    The aim of this study was to evaluate the feasibility of unilateral diaphragmatic reinnervation in humans by the inferior laryngeal nerve. This pilot study included chronically ventilated tetraplegic patients with destruction of phrenic nerve motoneurons. Five patients were included. They all had a high level of tetraplegia, with phrenic nerve motor neuron destruction. They were highly dependent on ventilation, without any possibility of weaning. They did not have other chronic pathologies, especially laryngeal disease. They all had diaphragmatic explorations to diagnose the destruction of the motoneurons of the phrenic nerves and nasoendoscopy to be sure that they did not have laryngeal or pharyngeal disease. Then, surgical anastomosis of the right phrenic nerve was performed with the inferior laryngeal nerve, by a cervical approach. A laryngeal reinnervation was performed at the same time, using the ansa hypoglossi. One patient was excluded because of a functional phrenic nerve and one patient died 6 months after the surgery of a cardiac arrest. The remaining three patients were evaluated after the anastomosis every 6 months. They did not present any swallowing or vocal alterations. In these three patients, the diaphragmatic explorations showed that there was a recovery of the diaphragmatic electromyogram of the right and left hemidiaphragms after 1 year. Two patients had surgical diaphragmatic explorations for diaphragmatic pacing 18-24 months after the reinnervation with excellent results. At 36 months, none of the patients could restore their automatic ventilation. In conclusion, this study demonstrated that diaphragmatic reinnervation by the inferior laryngeal nerve is effective, without any vocal or swallowing complications.

  4. Parametric study of roof diaphragm stiffness requirements

    International Nuclear Information System (INIS)

    Jones, W.D.; Tenbus, M.A.

    1991-01-01

    A common assumption made in performing a dynamic seismic analysis for a building is that the roof/floor system is open-quotes rigidclose quotes. This assumption would appear to be reasonable for many of the structures found in nuclear power plants, since many of these structures are constructed of heavily reinforced concrete having floor/roof slabs at least two feet in thickness, and meet the code requirements for structural detailing for seismic design. The roofs of many Department of Energy (DOE) buildings at the Oak Ridge Y-12 Plant in Oak Ridge, Tennessee, have roofs constructed of either metal, precast concrete or gypsum plank deck overlaid with rigid insulation, tar and gravel. In performing natural phenomena hazard assessments for one such facility, it was assumed that the existing roof performed first as a flexible diaphragm (zero stiffness) and then, rigid (infinitely stiff). For the flexible diaphragm model it was determined that the building began to experience significant damage around 0.09 g's. For the rigid diaphragm model it was determined that no significant damage was observed below 0.20 g's. A Conceptual Design Report has been prepared for upgrading/replacing the roof of this building. The question that needed to be answered here was, open-quotes How stiff should the new roof diaphragm be in order to satisfy the rigid diaphragm assumption and, yet, be cost effective?close quotes. This paper presents a parametric study of a very simple structural system to show that the design of roof diaphragms needs to consider both strength and stiffness (frequency) requirements. This paper shows how the stiffness of a roof system affects the seismically induced loads in the lateral, vertical load resisting elements of a building and provides guidance in determining how open-quotes rigidclose quotes a roof system should be in order to accomplish a cost effective design

  5. Free Piston Double Diaphragm Shock Tube

    OpenAIRE

    OGURA, Eiji; FUNABIKI, Katsushi; SATO, Shunichi; ABE, Takashi; 小倉, 栄二; 船曳, 勝之; 佐藤, 俊逸; 安部, 隆士

    1997-01-01

    A free piston double diaphragm shock tube was newly developed for generation of high Mach number shock wave. Its characteristics was investigated for various operation parameters; such as a strength of the diaphragm at the end of the comparession tube, an initial pressure of low pressure tube, an initial pressure of medium pressure tube and the volume of compression tube. Under the restriction of fixed pressures for the driver high pressure tube (32×10^5Pa) and the low pressure tube (40Pa) in...

  6. Treating traumatic injuries of the diaphragm

    Directory of Open Access Journals (Sweden)

    Dwivedi Sankalp

    2010-01-01

    Full Text Available Traumatic diaphragmatic injury (DI is a unique clinical entity that is usually occult and can easily be missed. Their delayed presentation can be due to the delayed rupture of the diaphragm or delayed detection of diaphragmatic rupture, making the accurate diagnosis of DI challenging to the trauma surgeons. An emergency laparotomy and thorough exploration followed by the repair of the defect is the gold standard for the management of these cases. We report a case of blunt DI in an elderly gentleman and present a comprehensive overview for the management of traumatic injuries of the diaphragm.

  7. Mathematical Modeling of Diaphragm Pneumatic Motors

    Directory of Open Access Journals (Sweden)

    Fojtášek Kamil

    2014-03-01

    Full Text Available Pneumatic diaphragm motors belong to the group of motors with elastic working parts. This part is usually made of rubber with a textile insert and it is deformed under the pressure of a compressed air or from the external mass load. This is resulting in a final working effect. In this type of motors are in contact two different elastic environments – the compressed air and the esaltic part. These motors are mainly the low-stroke and working with relatively large forces. This paper presents mathematical modeling static properties of diaphragm motors.

  8. Progressive Diaphragm Atrophy in Pediatric Acute Respiratory Failure.

    Science.gov (United States)

    Glau, Christie L; Conlon, Thomas W; Himebauch, Adam S; Yehya, Nadir; Weiss, Scott L; Berg, Robert A; Nishisaki, Akira

    2018-02-05

    Diaphragm atrophy is associated with delayed weaning from mechanical ventilation and increased mortality in critically ill adults. We sought to test for the presence of diaphragm atrophy in children with acute respiratory failure. Prospective, observational study. Single-center tertiary noncardiac PICU in a children's hospital. Invasively ventilated children with acute respiratory failure. Diaphragm thickness at end-expiration and end-inspiration were serially measured by ultrasound in 56 patients (median age, 17 mo; interquartile range, 5.5-52), first within 36 hours of intubation and last preceding extubation. The median duration of mechanical ventilation was 140 hours (interquartile range, 83-201). At initial measurement, thickness at end-expiration was 2.0 mm (interquartile range, 1.8-2.5) and thickness at end-inspiration was 2.5 mm (interquartile range, 2-2.8). The change in thickness at end-expiration during mechanical ventilation between first and last measurement was -13.8% (interquartile range, -27.4% to 0%), with a -3.4% daily atrophy rate (interquartile range, -5.6 to 0%). Thickening fraction = ([thickness at end-inspiration - thickness at end-expiration]/thickness at end-inspiration) throughout the course of mechanical ventilation was linearly correlated with spontaneous breathing fraction (beta coefficient, 9.4; 95% CI, 4.2-14.7; p = 0.001). For children with a period of spontaneous breathing fraction less than 0.5 during mechanical ventilation, those with exposure to a continuous neuromuscular blockade infusion (n = 15) had a significantly larger decrease in thickness at end-expiration compared with children with low spontaneous breathing fraction who were not exposed to a neuromuscular blockade infusion (n = 18) (-16.4%, [interquartile range, -28.4% to -7.0%] vs -7.3%; [interquartile range, -10.9% to -0%]; p = 0.036). Diaphragm atrophy is present in children on mechanical ventilation for acute respiratory failure. Diaphragm contractility, measured as

  9. Quantification of the variability of diaphragm motion and implications for treatment margin construction

    NARCIS (Netherlands)

    Rit, Simon; van Herk, Marcel; Zijp, Lambert; Sonke, Jan-Jakob

    2012-01-01

    To quantify the variability of diaphragm motion during free-breathing radiotherapy of lung patients and its effect on treatment margins to account for geometric uncertainties. Thirty-three lung cancer patients were analyzed. Each patient had 5-19 cone-beam scans acquired during different treatment

  10. Eye lens dosimetry in interventional cardiology: Results of staff dose measurements and link to patient dose levels

    International Nuclear Information System (INIS)

    Antic, V.; Ciraj-Bjelac, O.; Rehani, M.; Aleksandric, S.; Arandjic, D.; Ostojic, M.

    2013-01-01

    Workers involved in interventional cardiology procedures receive high eye lens dose if protection is not used. Currently, there is no suitable method for routine use for the measurement of eye dose. Since most angiography machines are equipped with suitable patient dosemeters, deriving factors linking staff eye doses to the patient doses can be helpful. In this study the patient kerma-area product, cumulative dose at an interventional reference point and eye dose in terms of Hp(3) of the cardiologists, nurses and radiographers for interventional cardiology procedures have been measured. Correlations between the patient dose and the staff eye dose were obtained. The mean eye dose was 121 mSv for the first operator, 33 mSv for the second operator/nurse and 12 mSv for radiographer. Normalised eye lens doses per unit kerma-area product were 0.94 mSv Gy -1 cm -2 for the first operator, 0.33 mSv Gy -1 cm -2 for the second operator/nurse and 0.16 mSv Gy -1 cm -2 for radiographers. Statistical analysis indicated that there is a weak but significant (p < 0.01) correlation between the eye dose and the kerma-area product for all three staff categories. These values are based on a local practice and may provide useful reference for other studies for validation and for wider utilisation in assessing the eye dose using patient dose values. (authors)

  11. Visualization of the diaphragm muscle with ultrasound improves diagnostic accuracy of phrenic nerve conduction studies.

    Science.gov (United States)

    Johnson, Nicholas E; Utz, Michael; Patrick, Erica; Rheinwald, Nicole; Downs, Marlene; Dilek, Nuran; Dogra, Vikram; Logigian, Eric L

    2014-05-01

    Evaluation of phrenic neuropathy (PN) with phrenic nerve conduction studies (PNCS) is associated with false negatives. Visualization of diaphragmatic muscle twitch with diaphragm ultrasound (DUS) when performing PNCS may help to solve this problem. We performed bilateral, simultaneous DUS-PNCS in 10 healthy adults and 12 patients with PN. The amplitude of the diaphragm compound muscle action potential (CMAP) (on PNCS) and twitch (on DUS) was calculated. Control subjects had phrenic CMAP (on PCNS). In the 12 patients with PN, 12 phrenic neuropathies were detected. Three of these patients had either significant side-to-side asymmetry or absolute reduction in diaphragm movement that was not detected with PNCS. There were no cases in which the PNCS showed an abnormality but the DUS did not. The addition of DUS to PNCS enhances diagnostic accuracy in PN. Copyright © 2013 Wiley Periodicals, Inc.

  12. Secondary Angle Closure due to Crystalline Lens Dislocation in a Patient with Atopic Dermatitis and Chronic Eye Rubbing

    Directory of Open Access Journals (Sweden)

    Justin Kuiper

    2018-03-01

    Full Text Available Purpose: To report an unusual case of ectopia lentis and angle closure in a patient with chronic eye rubbing. Methods: A 57-year-old male with a history of poorly controlled atopic dermatitis presented with right eye pain, decreased vision, and an intraocular pressure (IOP of 55 mm Hg. He had no past history of ocular disease and no reported history of trauma. He did report a history of chronic eye rubbing. Results: Best corrected visual acuity was hand motions. The examination revealed severe atopic keratoconjunctivitis in both eyes, microcystic corneal edema of the right eye, and 2+ nuclear sclerosis in both eyes. Gonioscopy showed no visible angle structures OD and an open angle OS. Topical and oral IOP-lowering medications and a laser iridotomy were unsuccessful at lowering IOP. He was taken to the operating room for a lensectomy and was found to have 9 clock hours of zonular dehiscence and a dislocated lens. After lensectomy, the IOP improved to 9 mm Hg on postoperative day 1. A follow-up examination at 2 weeks showed improved acuity to 20/150 with a pinhole and an IOP of 10 mm Hg. A dilated examination OS did not reveal significant phacodonesis, and the patient was referred for a possible sutured sulcus lens or anterior chamber intraocular lens. Conclusions: It is important for the provider to consider ectopia lentis in the differential for patients with pupillary block angle closure. For patients with atopic disease, one should be aware that eye rubbing may be a cause of zonular dehiscence, even in the absence of reported trauma or prior intraocular surgery.

  13. Early development of the human pelvic diaphragm

    NARCIS (Netherlands)

    Koch, Wijnandus Franciscus Robertus Maria

    2006-01-01

    The last decade an increasing interest in the pelvic floor can be observed in medical sciences. The lack of data on the development of the human pelvic floor is striking. The early development of the human pelvic diaphragm was studied. Materials and methodsUse was made of 38 human embryos and

  14. The earliest history of diaphragm physiology.

    Science.gov (United States)

    Derenne, J P; Debru, A; Grassino, A E; Whitelaw, W A

    1994-12-01

    The diaphragm was recognized as a distinct anatomical structure in the earliest Greek writings. However, the precise description of wounds suffered by warriors during the Trojan war by Homer was not tied to any particular function. The diaphragm was assimilated to the region that harbours thought. The first physiologic explanations of respiration by Empedocles in the 5th century BC and the concepts introduced by Plato and Hippocrates did not include a significant participation of the diaphragm. Aristole was the first to link respiration to a particular organ and a specific movement of the thorax. However, he considered that it was the heart which caused the lungs to expand by heating them, and the lungs in turn forced the thorax to dilate, a concept which was to survive until the 17th century. As in Aristole's theory the diaphragm played no role in respiration and was just a fence separating the thorax from the abdomen. A major break through occurred in Alexandria in the 4th and 3rd century BC: Herophilus was the first to recognize that muscles were the agents of movement and Erasistratus performed animal experiments which showed that the respiratory muscles were the agents of respiratory movements, thus opening the way to the later discoveries of Galen.

  15. Objective lens

    Science.gov (United States)

    Olczak, Eugene G. (Inventor)

    2011-01-01

    An objective lens and a method for using same. The objective lens has a first end, a second end, and a plurality of optical elements. The optical elements are positioned between the first end and the second end and are at least substantially symmetric about a plane centered between the first end and the second end.

  16. Large Epiphrenic Diverticulum with Perforation and Leakage below the Diaphragm

    DEFF Research Database (Denmark)

    Brønserud, Majken Munk; Brenøe, Anne-Sofie; Eckardt, Jens

    2015-01-01

    contrast revealed contrast leakage near the minor curvature of the stomach. The following esophagogastroduodenoscopy demonstrated a giant dilatation of the esophagus, as well as a second esophageal lumen originating 25 cm from the incisors. The “false” lumen of the esophagus was located parallel...... to esophagus, ending blindly in a perforation below the diaphragm. The clinical presentation and the patient’s age make it most likely, that it was a long epiphrenic diverticulum of pulsion type. The patient was treated conservatively, discharged after 10 days and has been followed in our outpatient clinic...... for 8 months, until he died of aggressive pulmonary cancer....

  17. Scharioth Macula Lens: A new intraocular implant for low-vision patients with stabilized maculopathy- first experience.

    Science.gov (United States)

    Nekolova, Jana; Rozsival, Pavel; Sin, Martin; Jiraskova, Nada

    2017-06-01

    To present the initial results of Scharioth Macula Lens (SML) implantation. The SML is a new add-on intraocular lens designed to increase uncorrected near visual acuity (UCVA) in patients with stabilized maculopathy. Eight patients were included in the study. All met the indication criteria before SML implantation. An SML was implanted in the better seeing eye. Near and distance visual acuity were tested. Possible complications and patient complaints were recorded and patients were asked about their quality of vision after SML implantation. The examination was carried out on day 1, 1 week, 1, 3 and 6 months after surgery. Six-month-results are presented. Apart from one, all patients with the SML had good near visual acuity at a recommended reading distance of 15 cm. Preoperatively, the mean (min-max) near UCVA was J13 (J8-J16), mean distance BCVA was 0.27. Postoperatively, the best results were after 1 month - near UCVA was J2.5 (J1-J7), distance BCVA was 0.26. Three months after surgery, this decreased to J4.5 (J1-J8); distance VA remained 0.25. Six months postoperatively - near vision was J4 (J1-J8) and distance VA was unchanged. Patients reported problems with reading speed and reading distance. Daily exercise improved their reading ability. One patient converted to wet AMD 3 months post-implantation. The SML is a new hope for low-vision patients. It acts as a magnifier in the eye. It is a suitable method for increasing near visual acuity in patients with inactive maculopathy.

  18. Refractive lens exchange in younger and older presbyopes: comparison of complication rates, 3 months clinical and patient-reported outcomes.

    Science.gov (United States)

    Schallhorn, Steven C; Schallhorn, Julie M; Pelouskova, Martina; Venter, Jan A; Hettinger, Keith A; Hannan, Stephen J; Teenan, David

    2017-01-01

    To compare refractive and visual outcomes, patient satisfaction, and complication rates among different age categories of patients who underwent refractive lens exchange (RLE). A stratified, simple random sample of patients matched on preoperative sphere and cylinder was selected for four age categories: 45-49 years (group A), 50-54 years (group B), 55-59 years (group C), and 60-65 years (group D). Each group contained 320 patients. All patients underwent RLE with a multifocal intraocular lens at least in one eye. Three months postoperative refractive/visual and patient-reported outcomes are presented. The percentage of patients that achieved binocular uncorrected distance visual acuity 20/20 or better was 91.6% (group A), 93.8% (group B), 91.6% (group C), 88.8% (group D), P =0.16. Binocularly, 80.0% of patients in group A, 84.7% in group B, 78.9% in group C, and 77.8% in group D achieved 20/30 or better uncorrected near visual acuity ( P =0.13). The proportion of eyes within 0.50 D of emmetropia was 84.4% in group A, 86.8% in group B, 85.7% in group C, and 85.8% in group D ( P =0.67). There was no statistically significant difference in postoperative satisfaction, visual phenomena, dry eye symptoms, distance or near vision activities. Apart from higher rate of iritis in the age group 50-55 years, there was no statistically significant difference in postoperative complication rates. RLE can be safely performed in younger as well as older presbyopes. No significant difference was found in clinical or patient-reported outcomes.

  19. Identifying decreased diaphragmatic mobility and diaphragm thickening in interstitial lung disease: the utility of ultrasound imaging

    Science.gov (United States)

    Santana, Pauliane Vieira; Prina, Elena; Albuquerque, André Luis Pereira; Carvalho, Carlos Roberto Ribeiro; Caruso, Pedro

    2016-01-01

    Objective: To investigate the applicability of ultrasound imaging of the diaphragm in interstitial lung disease (ILD). Methods: Using ultrasound, we compared ILD patients and healthy volunteers (controls) in terms of diaphragmatic mobility during quiet and deep breathing; diaphragm thickness at functional residual capacity (FRC) and at total lung capacity (TLC); and the thickening fraction (TF, proportional diaphragm thickening from FRC to TLC). We also evaluated correlations between diaphragmatic dysfunction and lung function variables. Results: Between the ILD patients (n = 40) and the controls (n = 16), mean diaphragmatic mobility was comparable during quiet breathing, although it was significantly lower in the patients during deep breathing (4.5 ± 1.7 cm vs. 7.6 ± 1.4 cm; p < 0.01). The patients showed greater diaphragm thickness at FRC (p = 0.05), although, due to lower diaphragm thickness at TLC, they also showed a lower TF (p < 0.01). The FVC as a percentage of the predicted value (FVC%) correlated with diaphragmatic mobility (r = 0.73; p < 0.01), and an FVC% cut-off value of < 60% presented high sensitivity (92%) and specificity (81%) for indentifying decreased diaphragmatic mobility. Conclusions: Using ultrasound, we were able to show that diaphragmatic mobility and the TF were lower in ILD patients than in healthy controls, despite the greater diaphragm thickness at FRC in the former. Diaphragmatic mobility correlated with ILD functional severity, and an FVC% cut-off value of < 60% was found to be highly accurate for indentifying diaphragmatic dysfunction on ultrasound. PMID:27167428

  20. Refractive lens exchange in younger and older presbyopes: comparison of complication rates, 3 months clinical and patient-reported outcomes

    Directory of Open Access Journals (Sweden)

    Schallhorn SC

    2017-08-01

    Full Text Available Steven C Schallhorn,1–3 Julie M Schallhorn,1 Martina Pelouskova,3 Jan A Venter,3 Keith A Hettinger,3 Stephen J Hannan,3 David Teenan3 1Department of Ophthalmology, University of California, San Francisco, CA, USA; 2Roski Eye Institute, University of Southern California, Los Angeles, CA, USA; 3Optical Express, Glasgow UK Purpose: To compare refractive and visual outcomes, patient satisfaction, and complication rates among different age categories of patients who underwent refractive lens exchange (RLE. Methods: A stratified, simple random sample of patients matched on preoperative sphere and cylinder was selected for four age categories: 45–49 years (group A, 50–54 years (group B, 55–59 years (group C, and 60–65 years (group D. Each group contained 320 patients. All patients underwent RLE with a multifocal intraocular lens at least in one eye. Three months postoperative refractive/visual and patient-reported outcomes are presented. Results: The percentage of patients that achieved binocular uncorrected distance visual acuity 20/20 or better was 91.6% (group A, 93.8% (group B, 91.6% (group C, 88.8% (group D, P=0.16. Binocularly, 80.0% of patients in group A, 84.7% in group B, 78.9% in group C, and 77.8% in group D achieved 20/30 or better uncorrected near visual acuity (P=0.13. The proportion of eyes within 0.50 D of emmetropia was 84.4% in group A, 86.8% in group B, 85.7% in group C, and 85.8% in group D (P=0.67. There was no statistically significant difference in postoperative satisfaction, visual phenomena, dry eye symptoms, distance or near vision activities. Apart from higher rate of iritis in the age group 50–55 years, there was no statistically significant difference in postoperative complication rates. Conclusion: RLE can be safely performed in younger as well as older presbyopes. No significant difference was found in clinical or patient-reported outcomes. Keywords: refractive lens exchange, multifocal IOLs, younger

  1. Functional restoration of the paralyzed diaphragm in high cervical quadriplegia via phrenic nerve neurotization utilizing the functional spinal accessory nerve.

    Science.gov (United States)

    Yang, Ming-liang; Li, Jian-jun; Zhang, Shao-cheng; Du, Liang-jie; Gao, Feng; Li, Jun; Wang, Yu-ming; Gong, Hui-ming; Cheng, Liang

    2011-08-01

    The authors report a case of functional improvement of the paralyzed diaphragm in high cervical quadriplegia via phrenic nerve neurotization using a functional spinal accessory nerve. Complete spinal cord injury at the C-2 level was diagnosed in a 44-year-old man. Left diaphragm activity was decreased, and the right diaphragm was completely paralyzed. When the level of metabolism or activity (for example, fever, sitting, or speech) slightly increased, dyspnea occurred. The patient underwent neurotization of the right phrenic nerve with the trapezius branch of the right spinal accessory nerve at 11 months postinjury. Four weeks after surgery, training of the synchronous activities of the trapezius muscle and inspiration was conducted. Six months after surgery, motion was observed in the previously paralyzed right diaphragm. The lung function evaluation indicated improvements in vital capacity and tidal volume. This patient was able to sit in a wheelchair and conduct outdoor activities without assisted ventilation 12 months after surgery.

  2. Changes in blood pressure and sleep duration in patients with blue light-blocking/yellow-tinted intraocular lens (CHUKYO study).

    Science.gov (United States)

    Ichikawa, Kazuo

    2014-07-01

    Blood pressure and sleep duration may be influenced by retinal light exposure. Cataracts may exert such an influence by decreasing the transparency of the crystalline lens. A large-scale clinical study was conducted to examine changes in blood pressure and sleep duration after intraocular lens (IOL) implantation during cataract surgery and to investigate how different types of IOL influence the degree of these effects. Using a questionnaire, we collected information, including blood pressure measurement and sleep duration, from 1367 patients (1367 eyes) before IOL implantation, 1 week after IOL implantation and 1 month after IOL implantation. Systolic and diastolic blood pressures were significantly decreased in the total patient group after implantation. The decrease in systolic blood pressure 1 month after implantation was significantly more in patients who received a yellow-tinted IOL than it was in those who received an ultraviolet (UV) light-filtering IOL. The post-implantation sleep duration, including naps, became shorter in patients who had slept too much and became longer in those who had slept too little before IOL implantation. Our observations suggest that a yellow-tinted IOL is better for patients with high blood pressure than a UV light-filtering IOL. Furthermore, the yellow-tinted IOL is as good as the UV light-filtering IOL for improving sleep duration. A pale yellow-tinted IOL is likely to be superior to a moderate yellow-tinted IOL in terms of allowing patients to discriminate different colors. Thus, the pale yellow-tinted IOL appears to be better for patients than the UV light-filtering IOL and the moderate yellow-tinted IOL.

  3. Food and Drug Administration study update. One-year results from 671 patients with the 3M multifocal intraocular lens.

    Science.gov (United States)

    Lindstrom, R L

    1993-01-01

    The clinical evaluation of the Food and Drug Administration study of the 3M diffractive multifocal intraocular lens (IOL) is presented here to demonstrate the results of 1-year postoperative data accumulated for 671 patients, the first of whom received the implant in 1987. Patients were selected for study if they had absence of preoperative pathology, were at least 60 years of age, and had a reasonable postoperative prognosis. Extensive evaluations took place at 4 to 6 months and 12 to 14 months after surgery, including five different visual acuity measurements and contrast sensitivity. All testing was completed on both eyes. Data from the fellow eye served as a control when implanted with a monofocal IOL. Overall uncorrected distance visual acuity at 1 year after surgery shows 57% patients with 20/40 or better acuity. In this same group, 78% achieved J3 or better near vision, which improved to 82% in the best case group. Uncorrected visual acuity of 20/40 or better and J3 or better was achieved by 50% of best case multifocal IOL patients, compared with 26% of the monofocal best case comparison group. Measurements of contrast sensitivity consistently document a small loss, which is considered clinically insignificant. Statistical analysis of satisfaction ratings shows that predictors of satisfaction include uncorrected distance acuity, final near acuity, and fellow eye spherical equivalent. This multifocal lens appears to work very well for most patients, with more than half having functional uncorrected distance and near vision. The study showed several considerations that are important for optimizing clinical performance and patient satisfaction: patient selection, realistic expectations, accurate biometry, and adequate control of surgical procedures.

  4. [The effect of yellow filter intraocular lens on the macula after cataract phacoemulsification in patients with age macular degeneration].

    Science.gov (United States)

    Shpak, A A; Maliugin, B É; Fadeeva, T V

    2012-01-01

    Macula changes diagnosed with optical coherence tomography (OCT) within a year after cataract phacoemulsification (PE) with intraocular lens implantation with and without yellow filter are presented. 32 patients (36 eyes) with early stages of age macular degeneration (AMD) were included into the experimental group and 35 patients (36 eyes) served as controls. IOLs with yellow filter were implanted in 21 eyes, and in 15 cases IOLs without filter were used in each group. According to OCT data thickening of fovea and increasing of macula volume developed within 6 months after cataract PE. Implantation of yellow filter IOLs reduced the intensity of these changes after surgery in patients with AMD. The progression of early AMD into advanced stages within a year after PE was not observed.

  5. Multiple methods of surgical treatment combined with primary IOL implantation on traumatic lens subluxation/dislocation in patients with secondary glaucoma

    Directory of Open Access Journals (Sweden)

    Rui Wang

    2014-04-01

    Full Text Available AIM:To describe clinical findings and complications from cases of traumatic lens subluxation/dislocation in patients with secondary glaucoma, and discuss the multiple treating methods of operation combined with primary intraocular lens (IOL implantation.METHODS:Non-comparative retrospective observational case series. Participants:30 cases (30 eyes of lens subluxation/dislocation in patients with secondary glaucoma were investigated which accepted the surgical treatment by author in the Ophthalmology of Xi''an No.4 Hospital from 2007 to 2011. According to the different situations of lens subluxation/dislocation, various surgical procedures were performed such as crystalline lens phacoemulsification, crystalline lens phacoemulsification combined anterior vitrectomy, intracapsular cataract extraction combined anterior vitrectomy, lensectomy combined anterior vitrectomy though peripheral transparent cornea incision, pars plana lensectomy combined pars plana vitrectomy, and intravitreal cavity crystalline lens phacofragmentation combined pars plana vitrectomy. And whether to implement trabeculectomy depended on the different situations of secondary glaucoma. The posterior chamber intraocular lenses (PC-IOLs were implanted in the capsular-bag or trassclerally sutured in the sulus decided by whether the capsular were present. Main outcome measures:visual acuity, intraocular pressure, the situation of intraocular lens and complications after the operations.RESULTS: The follow-up time was 11-36mo (21.4±7.13. Postoperative visual acuity of all eyes were improved; 28 cases maintained IOP below 21 mm Hg; 2 cases had slightly IOL subluxation, 4 cases had slightly tilted lens optical area; 1 case had postoperative choroidal detachment; 4 cases had postoperative corneal edema more than 1wk, but eventually recovered transparent; 2 cases had mild postoperative vitreous hemorrhage, and absorbed 4wk later. There was no postoperative retinal detachment, IOL

  6. Novel diaphragm for electrolytic cells. Final report

    International Nuclear Information System (INIS)

    The basic intent of these studies is to produce a diaphragm permeable to two types of ions, which have properties which are similar to those of asbestos. PTFE in the form of fabric is rendered hydrophilic by grafting monomer acrylic acid by a radio-chemical technique; two methods were utilized to do this: - Direct radio-chemical method under radiation - Pre-irradiation method in air under radiation and accelerated electronic radiation. The monomer acrylic acid was grafted in the presence or non-presence of cross-linking agents, the latter before developing a resistance derived from the diaphragms obtained at the agressivity of the medium in which they would be utilized

  7. Fungal endophthalmitis caused by Paecilomyces variotii, in an immunocompetent patient, following intraocular lens implantation

    Directory of Open Access Journals (Sweden)

    Anita K

    2010-01-01

    Full Text Available We report the case of a 70-year-old man who was admitted for anterior endophthalmitis following an intraocular lens implantation. He had developed a fluffy growth resembling a fungal mass on the iris of the right eye. The mass was removed and sent for fungal studies to our department. Direct microscopy revealed hyphae. Further studies helped identify the fungus to belong to genus Paecilomyces. This is a rare case of fungal endophthalmitis caused by Paecilomyces variotii in an immunocompetent person.

  8. Clinical and patient-reported outcomes of bilateral implantation of a +2.5 diopter multifocal intraocular lens.

    Science.gov (United States)

    Maxwell, Andrew; Holland, Edward; Cibik, Lisa; Fakadej, Anna; Foster, Gary; Grosinger, Les; Moyes, Andrew; Nielsen, Stephen; Silverstein, Steven; Toyos, Melissa; Weinstein, Arthur; Hartzell, Scott

    2017-01-01

    To assess the effectiveness and safety of a multifocal intraocular lens (IOL) with +2.5 diopter (D) additional power compared with a monofocal IOL. Fifteen sites in the United States. Prospective randomized patient- and observer-masked clinical trial. Randomized patients received multifocal or monofocal IOLs bilaterally. Visual acuity (33 cm, 40 cm, 53 cm, 60 cm, 4 m) was measured; safety was assessed through adverse event rates. Patient-reported visual outcomes were evaluated using the Visual Tasks questionnaire. The frequency and severity of visual disturbances were evaluated using the Assessment of Photic Phenomena and Lens EffectS questionnaire. The multifocal IOL (n = 155) provided better corrected distance visual acuity at 53 cm than the monofocal IOL (n = 165) (0.322 versus 0.512 logMAR; between-group difference, -0.190 logMAR; P < .0001) and 40 cm but not at 4 m. Ocular adverse event rates were less than 3.84% in both groups. Serious adverse event rates were comparable between the 2 IOL types. Patients with multifocal IOLs reported less difficulty with near tasks (with and without correction) and intermediate tasks (without correction). Difficulty with extended-intermediate and distance tasks was similar between groups. The most frequently reported self-rated severe phenomena were halos, starbursts, and glare. Most patients (monofocal ≥72%; multifocal ≥73%) reported never experiencing blurred, distorted, or double vision. The +2.5 D multifocal IOL provided better vision at 40 cm and 53 cm and similar vision at 4 m compared with the monofocal IOL. Safety profiles and visual phenomena were comparable between groups. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  9. Quantification of diaphragm mechanics in Pompe disease using dynamic 3D MRI

    DEFF Research Database (Denmark)

    Mogalle, Katja; Perez-Rovira, Adria; Ciet, Pierluigi

    2016-01-01

    BACKGROUND: Diaphragm weakness is the main reason for respiratory dysfunction in patients with Pompe disease, a progressive metabolic myopathy affecting respiratory and limb-girdle muscles. Since respiratory failure is the major cause of death among adult patients, early identification of respira......BACKGROUND: Diaphragm weakness is the main reason for respiratory dysfunction in patients with Pompe disease, a progressive metabolic myopathy affecting respiratory and limb-girdle muscles. Since respiratory failure is the major cause of death among adult patients, early identification...... methodology relies on image registration and lung surface extraction to quantify lung kinematics during breathing. This allows for the extraction of geometry and motion features of the lung that characterize the independent contribution of the diaphragm and the thoracic muscles to the respiratory cycle....... RESULTS: Results in 16 3D+t MRI scans (10 Pompe patients and 6 controls) of a slow expiratory maneuver show that kinematic analysis from dynamic 3D images reveals important additional information about diaphragm mechanics and respiratory muscle involvement when compared to conventional pulmonary function...

  10. WE-G-18C-06: Is Diaphragm Motion a Good Surrogate for Liver Tumor Motion?

    Energy Technology Data Exchange (ETDEWEB)

    Yang, J [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); School of Information Science and Engineering, Shandong University, Jinan, Shandong (China); Cai, J; Zheng, C; Czito, B; Palta, M; Yin, F [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Wang, H [School of Information Science and Engineering, Shandong University, Jinan, Shandong (China); Bashir, M [Department of Radiology, Duke University Medical Center, Durham, NC (United States)

    2014-06-15

    Purpose: To investigate whether diaphragm motion is a good surrogate for liver tumor motion by comparing their motion trajectories obtained from cine-MRI. Methods: Fourteen patients with hepatocellular carcinoma (10/14) or liver metastases (4/14) undergoing radiation therapy were included in this study. All patients underwent single-slice 2D cine-MRI simulations across the center of the tumor in three orthogonal planes. Tumor and diaphragm motion trajectories in the superior-inferior (SI), anteriorposterior (AP), and medial-lateral (ML) directions were obtained using the normalized cross-correlation based tracking technique. Agreement between tumor and diaphragm motions was assessed by calculating the phase difference percentage (PDP), intra-class correlation coefficient (ICC), Bland-Altman analysis (Diffs) and paired t-test. The distance (D) between tumor and tracked diaphragm area was analyzed to understand its impact on the correlation between tumor and diaphragm motions. Results: Of all patients, the means (±standard deviations) of PDP were 7.1 (±1.1)%, 4.5 (±0.5)% and 17.5 (±4.5)% in the SI, AP and ML directions, respectively. The means of ICC were 0.98 (±0.02), 0.97 (±0.02), and 0.08 (±0.06) in the SI, AP and ML directions, respectively. The Diffs were 2.8 (±1.4) mm, 2.4 (±1.1) mm, and 2.2 (±0.5) mm in the SI, AP and ML directions, respectively. The p-values derived from the paired t-test were < 0.02 in SI and AP directions, whereas were > 0.58 in ML direction primarily due to the small motion in ML direction. Tumor and diaphragmatic motion had high concordance when the distance between the tumor and tracked diaphragm areas was small. Conclusion: Preliminary results showed that liver tumor motion had good correlations with diaphragm motion in the SI and AP directions, indicating diaphragm motion in the SI and AP directions could potentially be a reliable surrogate for liver tumor motion. NIH (1R21CA165384-01A1), Golfers Against Cancer (GAC

  11. Functional assessment of the diaphragm by speckle tracking ultrasound during inspiratory loading

    NARCIS (Netherlands)

    Mos-Oppersma, Eline; Hatam, Nima; Doorduin, Jonne; van der Hoeven, Johannes G.; Marx, Gernot; Goetzenich, Andreas; Fritsch, Sebastian; Heunks, Leo M.A.; Bruells, Christian S.

    2017-01-01

    Assessment of diaphragmatic effort is challenging, especially in critically ill patients in the phase of weaning. Fractional thickening during inspiration assessed by ultrasound has been used to estimate diaphragm effort. It is unknown whether more sophisticated ultrasound techniques such as speckle

  12. Comparison of clinical utility between diaphragm excursion and thickening change using ultrasonography to predict extubation success

    Science.gov (United States)

    Yoo, Jung-Wan; Lee, Seung Jun; Lee, Jong Deog; Kim, Ho Cheol

    2018-01-01

    Background/Aims Both diaphragmatic excursion and change in muscle thickening are measured using ultrasonography (US) to assess diaphragm function and mechanical ventilation weaning outcomes. However, which parameter can better predict successful extubation remains to be determined. The aim of this study was to compare the clinical utility of these two diaphragmatic parameters to predict extubation success. Methods This study included patients subjected to extubation trial in the medical or surgical intensive care unit of a university-affiliated hospital from May 2015 through February 2016. Diaphragm excursion and percent of thickening change (Δtdi%) were measured using US within 24 hours before extubation. Results Sixty patients were included, and 78.3% (47/60) of these patients were successfully extubated, whereas 21.7% (13/60) were not. The median degree of excursion was greater in patients with extubation success than in those with extubation failure (1.65 cm vs. 0.8 cm, p success had a greater Δtdi% than those with extubation failure (42.1% vs. 22.5%, p = 0.03). The areas under the receiver operating curve for excursion and Δtdi% were 0.836 (95% confidence interval [CI], 0.717 to 0.919) and 0.698 (95% CI, 0.566 to 0.810), respectively (p = 0.017). Conclusions Diaphragm excursion seems more accurate than a change in the diaphragm thickness to predict extubation success. PMID:29050461

  13. Diaphragm Pump With Resonant Piezoelectric Drive

    Science.gov (United States)

    Izenson, Michael G.; Kline-Schoder, Robert J.; Shimko, Martin A.

    2007-01-01

    A diaphragm pump driven by a piezoelectric actuator is undergoing development. This pump is intended to be a prototype of lightweight, highly reliable pumps for circulating cooling liquids in protective garments and high-power electronic circuits, and perhaps for some medical applications. The pump would be highly reliable because it would contain no sliding seals or bearings that could wear, the only parts subject to wear would be two check valves, and the diaphragm and other flexing parts could be designed, by use of proven methods, for extremely long life. Because the pump would be capable of a large volumetric flow rate and would have only a small dead volume, its operation would not be disrupted by ingestion of gas, and it could be started reliably under all conditions. The prior art includes a number piezoelectrically actuated diaphragm pumps. Because of the smallness of the motions of piezoelectric actuators (typical maximum strains only about 0.001), the volumetric flow rates of those pumps are much too small for typical cooling applications. In the pump now undergoing development, mechanical resonance would be utilized to amplify the motion generated by the piezoelectric actuator and thereby multiply the volumetric flow rate. The prime mover in this pump would be a stack of piezoelectric ceramic actuators, one end of which would be connected to a spring that would be part of a spring-and-mass resonator structure. The mass part of the resonator structure would include the pump diaphragm (see Figure 1). Contraction of the spring would draw the diaphragm to the left, causing the volume of the fluid chamber to increase and thereby causing fluid to flow into the chamber. Subsequent expansion of the spring would push the diaphragm to the right, causing the volume of the fluid chamber to decrease, and thereby expelling fluid from the chamber. The fluid would enter and leave the chamber through check valves. The piezoelectric stack would be driven electrically to

  14. Morphological and ultrastructural evaluation of the golden retriever muscular dystrophy trachea, lungs, and diaphragm muscle.

    Science.gov (United States)

    Lessa, Thais Borges; de Abreu, Dilayla Kelly; Rodrigues, Márcio Nogueira; Brólio, Marina Pandolphi; Miglino, Maria Angélica; Ambrósio, Carlos Eduardo

    2014-11-01

    Duchenne muscular dystrophy (DMD) is a genetic disease, characterized by atrophy and muscle weakness. The respiratory failure is a common cause of early death in patients with DMD. Golden retriever muscular dystrophy (GRMD) is a canine model which has been extensively used for many advances in therapeutics applications. As the patients with DMD, the GRMD frequently died from cardiac and respiratory failure. Observing the respiratory failure in DMD is one of the major causes of mortality we aimed to describe the morphological and ultrastructural data of trachea, lungs (conductive and respiratory portion of the system), and diaphragm muscle using histological and ultrastructural analysis. The diaphragm muscle showed discontinuous fibers architecture, with different diameter; a robust perimysium inflammatory infiltrate and some muscle cells displayed central nuclei. GRMD trachea and lungs presented collagen fibers and in addition, the GRMD lungs showed higher of levels collagen fibers that could limit the alveolar ducts and alveoli distension. Therefore, the most features observed were the collagen areas and fibrosis. We suggested in this study that the collagen remodeling in the trachea, lungs, and diaphragm muscle may increase fibrosis and affect the trachea, lungs, and diaphragm muscle function that can be a major cause of respiratory failure that occur in patients with DMD. © 2014 Wiley Periodicals, Inc.

  15. Partial Support Ventilation and Mitochondrial-Targeted Antioxidants Protect against Ventilator-Induced Decreases in Diaphragm Muscle Protein Synthesis.

    Directory of Open Access Journals (Sweden)

    Matthew B Hudson

    Full Text Available Mechanical ventilation (MV is a life-saving intervention in patients in respiratory failure. Unfortunately, prolonged MV results in the rapid development of diaphragm atrophy and weakness. MV-induced diaphragmatic weakness is significant because inspiratory muscle dysfunction is a risk factor for problematic weaning from MV. Therefore, developing a clinical intervention to prevent MV-induced diaphragm atrophy is important. In this regard, MV-induced diaphragmatic atrophy occurs due to both increased proteolysis and decreased protein synthesis. While efforts to impede MV-induced increased proteolysis in the diaphragm are well-documented, only one study has investigated methods of preserving diaphragmatic protein synthesis during prolonged MV. Therefore, we evaluated the efficacy of two therapeutic interventions that, conceptually, have the potential to sustain protein synthesis in the rat diaphragm during prolonged MV. Specifically, these experiments were designed to: 1 determine if partial-support MV will protect against the decrease in diaphragmatic protein synthesis that occurs during prolonged full-support MV; and 2 establish if treatment with a mitochondrial-targeted antioxidant will maintain diaphragm protein synthesis during full-support MV. Compared to spontaneously breathing animals, full support MV resulted in a significant decline in diaphragmatic protein synthesis during 12 hours of MV. In contrast, diaphragm protein synthesis rates were maintained during partial support MV at levels comparable to spontaneous breathing animals. Further, treatment of animals with a mitochondrial-targeted antioxidant prevented oxidative stress during full support MV and maintained diaphragm protein synthesis at the level of spontaneous breathing animals. We conclude that treatment with mitochondrial-targeted antioxidants or the use of partial-support MV are potential strategies to preserve diaphragm protein synthesis during prolonged MV.

  16. Partial Support Ventilation and Mitochondrial-Targeted Antioxidants Protect against Ventilator-Induced Decreases in Diaphragm Muscle Protein Synthesis.

    Science.gov (United States)

    Hudson, Matthew B; Smuder, Ashley J; Nelson, W Bradley; Wiggs, Michael P; Shimkus, Kevin L; Fluckey, James D; Szeto, Hazel H; Powers, Scott K

    2015-01-01

    Mechanical ventilation (MV) is a life-saving intervention in patients in respiratory failure. Unfortunately, prolonged MV results in the rapid development of diaphragm atrophy and weakness. MV-induced diaphragmatic weakness is significant because inspiratory muscle dysfunction is a risk factor for problematic weaning from MV. Therefore, developing a clinical intervention to prevent MV-induced diaphragm atrophy is important. In this regard, MV-induced diaphragmatic atrophy occurs due to both increased proteolysis and decreased protein synthesis. While efforts to impede MV-induced increased proteolysis in the diaphragm are well-documented, only one study has investigated methods of preserving diaphragmatic protein synthesis during prolonged MV. Therefore, we evaluated the efficacy of two therapeutic interventions that, conceptually, have the potential to sustain protein synthesis in the rat diaphragm during prolonged MV. Specifically, these experiments were designed to: 1) determine if partial-support MV will protect against the decrease in diaphragmatic protein synthesis that occurs during prolonged full-support MV; and 2) establish if treatment with a mitochondrial-targeted antioxidant will maintain diaphragm protein synthesis during full-support MV. Compared to spontaneously breathing animals, full support MV resulted in a significant decline in diaphragmatic protein synthesis during 12 hours of MV. In contrast, diaphragm protein synthesis rates were maintained during partial support MV at levels comparable to spontaneous breathing animals. Further, treatment of animals with a mitochondrial-targeted antioxidant prevented oxidative stress during full support MV and maintained diaphragm protein synthesis at the level of spontaneous breathing animals. We conclude that treatment with mitochondrial-targeted antioxidants or the use of partial-support MV are potential strategies to preserve diaphragm protein synthesis during prolonged MV.

  17. Resultados topográficos en pacientes portadores de lentes de contacto Topographic results achieved patients wearing contact lens

    Directory of Open Access Journals (Sweden)

    Tania Aymeé Díaz Martínez

    2009-06-01

    results achieved in patients wearing contact lens, who were candidates to refractive surgery with Excimer laser at "Carlos J. Finlay" hospital; to determine the behaviour according to age and sex; to find out the type of contact lens used and the length of wear; and to identify the relationship of the induced corneal topographic pattern in contact lens wearers with corneal warpage and ketatoconus. METHODS: A retrospective study of the corneal topography of candidates to refractive surgery in the last 2 years was performed in 80 patients (contact lens wearers. OPTIKON AMF510P and HUMPHREY topographers were the instruments to screen the patients. All of them were performed a complete ophthalmological exam (manifest refraction, biomicroscopy, keratometry, pachymetry and corneal topography. Results and their stability were compared. Also age, sex, type of lenses and length of wear were analyzed. RESULTS: One hundred and fifty eight eyes were treated, 83 of them presented with normal topographic pattern whereas 58 had contact lens-induced corneal warpage and 17 suffered keratoconus. The average age of patients was 27 years. Mean corneal astigmatism in patients with keratoconus was -3.25 D and in patients with corneal warpage -1.12 D. The reading of the most even meridian in patients with keratocomus was 46,75 dioptries and with corneal warpage was 43,25 D. As to keratoconus, the most curved meridian reading was 54,75 dioptres and in corneal warpage was 46 dioptres. CONCLUSIONS: The type of contact lens and the length of wear has an effect on the occurrence of induced corneal warpage and subclinical keratoconus, and both recorded a similar topographic pattern.

  18. Efficacy of different kinds of artificial tears treatment in patients with xerophthalmia after phacoemulsification combined with intraocular lens implantation

    Directory of Open Access Journals (Sweden)

    Yu-Xia Ruan

    2017-09-01

    Full Text Available AIM: To explore efficacy of the different kinds of artificial tears treatment in patients with xerophthalmia after phacoemulsification combined with intraocular lens implantation.METHODS: Totally 280 patients(280 eyeswith xerophthalmia after operation in our hospital from January 2015 to June 2016 were selected. According to the different treatment methods, they were divided into control group(n=70; treated with tobramycin and dexamethasone eye ointment 3 times per day for 1wk, levofloxacin eye drops 3 times per day for 1wk, pranoprofen eye drops 4 times per day for 1mo, polyacrylic acid group(n=70; besides the treatment of control group, polyacrylic acid was used 4 times per for 1mo, polyethylene glycol group(n=70; besides the treatment of control group, polyethylene glycol was used 4 times per for 1moand sodium hyaluronate group(n=70; besides the treatment of control group, sodium hyaluronate was used 4 times per for 1mo. The tear film break up time(BUT, Schirmer Ⅰ test(SⅠt, symptoms of dry eye and corneal staining in four groups were observed. RESULTS:(1BUT: The BUT of the four groups significantly increased after treatment(PPPPPPPPPPP>0.05; sodium hyaluronate group was significant lower than other groups in corneal staining score at 3wk and 1mo after treatment(PCONCLUSION: Artificial tears in the treatment of xerophthalmia after cataract phacoemulsification combined with intraocular lens implantation has better clinical efficacy, which contains sodium hyaluronate may be the better than others.

  19. Development of diaphragm automatic homing equipment

    International Nuclear Information System (INIS)

    Kobayashi, Hidetoshi; Yamada, Koji; Moriya, Shinichi; Koike, Jiro; Okabe, Masao; Oyama, Akihiro.

    1996-01-01

    In steam-turbine overhaul inspection, one of the most important processes is to remove rust and deposited contaminants on the surface of turbine parts, while the turbine is in operation, to recover thermal efficiency and prepare good surface conditions for color penetrant inspection. These processes generally are done by dry honing, but this generates dust. To protect laborers against these conditions, Hitachi, Ltd. has developed automatic honing equipment for the diaphragms of the nuclear steam turbine. This equipment was first used in the first annual inspection and overhaul of Hamaoka Nuclear Power Plant No.4 of Chubu Electric Power Inc. (author)

  20. Lens Model

    DEFF Research Database (Denmark)

    Nash, Ulrik William

    2014-01-01

    Firms consist of people who make decisions to achieve goals. How do these people develop the expectations which underpin the choices they make? The lens model provides one answer to this question. It was developed by cognitive psychologist Egon Brunswik (1952) to illustrate his theory of probabil...

  1. Evaluation of Effective Diaphragm Area for Pneumatic Actuator

    International Nuclear Information System (INIS)

    Ryu, Hogeun; Han, Bongsub; Seon, Juhyoung

    2016-01-01

    The purpose of this study is to develop a methodology to calculate the exact effective diaphragm area using the results of diagnostic test to be performed in the evaluation of air operated valve performance. By using this developed methodology in pneumatic actuator performance evaluation, it can be reduce the possible errors arising from effective diaphragm area in the evaluation of performance of air operated valves. The performance assessment for the operability and structural integrity of air operated valves for the domestic nuclear power plant is in progress. One of the important parameters that determine the performance of the air operated valves is the effective diaphragm area of diaphragm type actuator. The effective diaphragm area is the actual area which the air pressure acting on the diaphragm. In general, the effective diaphragm area used for the performance evaluation of pneumatic actuator is provided by the manufacture or the actuator drawing. Flat type diaphragm was showed the difference between the measured value of EDA and the manufacture’s value, in the case of convoluted type diaphragm has showed that the measured value of EDA and manufacture’s value is almost the same. When evaluate a performance of a diaphragm actuator, accurate EDA is to be used because it is an important variable affecting the actuator performance. Particularly in the case of flat type diaphragm which EDA is changed in accordance with the stroke position, by using the EDA evaluation methodology developed in this study to minimize a possible error due to EDA when evaluating the performance of the air actuator

  2. Evaluation of Effective Diaphragm Area for Pneumatic Actuator

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Hogeun; Han, Bongsub; Seon, Juhyoung [SOOSAN INDUSTRIES, Seoul (Korea, Republic of)

    2016-10-15

    The purpose of this study is to develop a methodology to calculate the exact effective diaphragm area using the results of diagnostic test to be performed in the evaluation of air operated valve performance. By using this developed methodology in pneumatic actuator performance evaluation, it can be reduce the possible errors arising from effective diaphragm area in the evaluation of performance of air operated valves. The performance assessment for the operability and structural integrity of air operated valves for the domestic nuclear power plant is in progress. One of the important parameters that determine the performance of the air operated valves is the effective diaphragm area of diaphragm type actuator. The effective diaphragm area is the actual area which the air pressure acting on the diaphragm. In general, the effective diaphragm area used for the performance evaluation of pneumatic actuator is provided by the manufacture or the actuator drawing. Flat type diaphragm was showed the difference between the measured value of EDA and the manufacture’s value, in the case of convoluted type diaphragm has showed that the measured value of EDA and manufacture’s value is almost the same. When evaluate a performance of a diaphragm actuator, accurate EDA is to be used because it is an important variable affecting the actuator performance. Particularly in the case of flat type diaphragm which EDA is changed in accordance with the stroke position, by using the EDA evaluation methodology developed in this study to minimize a possible error due to EDA when evaluating the performance of the air actuator.

  3. SU-G-BRA-08: Diaphragm Motion Tracking Based On KV CBCT Projections with a Constrained Linear Regression Optimization

    Energy Technology Data Exchange (ETDEWEB)

    Wei, J [City College of New York, New York, NY (United States); Chao, M [The Mount Sinai Medical Center, New York, NY (United States)

    2016-06-15

    Purpose: To develop a novel strategy to extract the respiratory motion of the thoracic diaphragm from kilovoltage cone beam computed tomography (CBCT) projections by a constrained linear regression optimization technique. Methods: A parabolic function was identified as the geometric model and was employed to fit the shape of the diaphragm on the CBCT projections. The search was initialized by five manually placed seeds on a pre-selected projection image. Temporal redundancies, the enabling phenomenology in video compression and encoding techniques, inherent in the dynamic properties of the diaphragm motion together with the geometrical shape of the diaphragm boundary and the associated algebraic constraint that significantly reduced the searching space of viable parabolic parameters was integrated, which can be effectively optimized by a constrained linear regression approach on the subsequent projections. The innovative algebraic constraints stipulating the kinetic range of the motion and the spatial constraint preventing any unphysical deviations was able to obtain the optimal contour of the diaphragm with minimal initialization. The algorithm was assessed by a fluoroscopic movie acquired at anteriorposterior fixed direction and kilovoltage CBCT projection image sets from four lung and two liver patients. The automatic tracing by the proposed algorithm and manual tracking by a human operator were compared in both space and frequency domains. Results: The error between the estimated and manual detections for the fluoroscopic movie was 0.54mm with standard deviation (SD) of 0.45mm, while the average error for the CBCT projections was 0.79mm with SD of 0.64mm for all enrolled patients. The submillimeter accuracy outcome exhibits the promise of the proposed constrained linear regression approach to track the diaphragm motion on rotational projection images. Conclusion: The new algorithm will provide a potential solution to rendering diaphragm motion and ultimately

  4. SU-G-BRA-08: Diaphragm Motion Tracking Based On KV CBCT Projections with a Constrained Linear Regression Optimization

    International Nuclear Information System (INIS)

    Wei, J; Chao, M

    2016-01-01

    Purpose: To develop a novel strategy to extract the respiratory motion of the thoracic diaphragm from kilovoltage cone beam computed tomography (CBCT) projections by a constrained linear regression optimization technique. Methods: A parabolic function was identified as the geometric model and was employed to fit the shape of the diaphragm on the CBCT projections. The search was initialized by five manually placed seeds on a pre-selected projection image. Temporal redundancies, the enabling phenomenology in video compression and encoding techniques, inherent in the dynamic properties of the diaphragm motion together with the geometrical shape of the diaphragm boundary and the associated algebraic constraint that significantly reduced the searching space of viable parabolic parameters was integrated, which can be effectively optimized by a constrained linear regression approach on the subsequent projections. The innovative algebraic constraints stipulating the kinetic range of the motion and the spatial constraint preventing any unphysical deviations was able to obtain the optimal contour of the diaphragm with minimal initialization. The algorithm was assessed by a fluoroscopic movie acquired at anteriorposterior fixed direction and kilovoltage CBCT projection image sets from four lung and two liver patients. The automatic tracing by the proposed algorithm and manual tracking by a human operator were compared in both space and frequency domains. Results: The error between the estimated and manual detections for the fluoroscopic movie was 0.54mm with standard deviation (SD) of 0.45mm, while the average error for the CBCT projections was 0.79mm with SD of 0.64mm for all enrolled patients. The submillimeter accuracy outcome exhibits the promise of the proposed constrained linear regression approach to track the diaphragm motion on rotational projection images. Conclusion: The new algorithm will provide a potential solution to rendering diaphragm motion and ultimately

  5. Altered DNA Methylation and Expression Profiles of 8-Oxoguanine DNA Glycosylase 1 in Lens Tissue from Age-related Cataract Patients.

    Science.gov (United States)

    Wang, Yong; Li, Fei; Zhang, Guowei; Kang, Lihua; Qin, Bai; Guan, Huaijin

    2015-01-01

    Oxidative stress and DNA damage contribute to the pathogenesis of age-related cataract (ARC). Most oxidative DNA lesions are repaired via the base excision repair (BER) proteins including 8-oxoguanine DNA glycosylase 1 (OGG1). This study examined DNA methylation of CpG islands upstream of OGG1 and their relation to the gene expression in lens cortex from ARC patients. The clinical case-control study consisted of 15 cortical type of ARC patients and 15 age-matched non-ARC controls who received transparent lens extraction due to vitreoretinal diseases. OGG1 expression in lens cortex was analyzed by qRT-PCR and Western blot. The localization and the proportion of cells positive for OGG1 were determined by immunofluorescence. Bisulfite-sequencing PCR (BSP) was performed to evaluate the methylation status of CpG islands near OGG1 in DNA extracted from lens cortex. To test relationship between the methylation and the expression of the gene of interest, 5-Aza-2'-deoxycytidine (5-Aza-dC) was used to induce demethylation of cultured human lens epithelium B-3 (HLE B-3). To test the role of OGG1 in the repair of cellular damage, HLE B-3 was transfected with OGG1 vector, followed by ultraviolet radiation b (UVB) exposure to induce apoptosis. The mRNA and protein levels of OGG1 were significantly reduced in the lens cortex of ARC. Immunofluorescence showed that the proportion of OGG1-positive cells decreased significantly in ARC cortex in comparison with the control. The CpG island in first exon of OGG1 displayed hypermethylation in the DNA extracted from the lens cortex of ARC. Treatment of HLEB-3 cells with 5-Aza-dC upregulated OGG1 expression. UVB-induced apoptosis was attenuated after transfection with OGG1. A reduced OGG1 expression was correlated with hypermethylation of a CpG island of OGG1 in lens cortex of ARC. The role of epigenetic change in OGG1 gene in the susceptibility to oxidative stress induced cortical ARC is warranted to further study.

  6. Dexmedetomidine May Produce Extra Protective Effects on Sepsis-induced Diaphragm Injury

    Directory of Open Access Journals (Sweden)

    Jin Wu

    2015-01-01

    Full Text Available Objective: The objective was to evaluate the protective effects of dexmedetomidine (DEX, a selective agonist of α2-adrenergic receptor, on sepsis-induced diaphragm injury and the underlying molecular mechanisms. Data Sources: The data used in this review were mainly from PubMed articles published in English from 1990 to 2015. Study Selection: Clinical or basic research articles were selected mainly according to their level of relevance to this topic. Results: Sepsis could induce severe diaphragm dysfunction and exacerbate respiratory weakness. The mechanism of sepsis-induced diaphragm injury includes the increased inflammatory cytokines and excessive oxidative stress and superfluous production of nitric oxide (NO. DEX can reduce inflammatory cytokines, inhibit nuclear factor-kappaB signaling pathways, suppress the activation of caspase-3, furthermore decrease oxidative stress and inhibit NO synthase. On the basis of these mechanisms, DEX may result in a shorter period of mechanical ventilation in septic patients in clinical practice. Conclusions: Based on this current available evidence, DEX may produce extra protective effects on sepsis-induced diaphragm injury. Further direct evidence and more specific studies are still required to confirm these beneficial effects.

  7. Inhalation of Budesonide/Formoterol Increases Diaphragm Muscle Contractility

    Directory of Open Access Journals (Sweden)

    Chiyohiko Shindoh

    2012-01-01

    Conclusions: BUD/FORM inhalation has an inotropic effect on diaphragm muscle, protects diaphragm muscle deterioration after endotoxin injection, and inhibits NO production. Increments in muscle contractility with BUD/FORM inhalation are induced through a synergistic effect of an anti-inflammatory agent and 02-agonist.

  8. Hypoxia-induced dysfunction of rat diaphragm: role of peroxynitrite.

    NARCIS (Netherlands)

    Zhu, X.; Heunks, L.M.A.; Versteeg, E.M.M.; Heijden, E. van der; Ennen, L.; Kuppevelt, A.H.M.S.M. van; Vina, J.; Dekhuijzen, P.N.R.

    2005-01-01

    Oxidants may play a role in hypoxia-induced respiratory muscle dysfunction. In the present study we hypothesized that hypoxia-induced impairment in diaphragm contractility is associated with elevated peroxynitrite generation. In addition, we hypothesized that strenuous contractility of the diaphragm

  9. Detecting defects in diaphragm walls prior to excavation

    NARCIS (Netherlands)

    Spruit, R.; Hopman, V.; Van Tol, A.F.; Broere, W.

    2011-01-01

    Recent incidents with leaking diaphragm walls during construction of subway lines in Amsterdam and Rotterdam (Netherlands) have led to reconsideration of the diaphragm wall as a retaining wall construction for deep excavations. In our opinion the joints between the panels are the weak spot. During

  10. Diaphragm disease of the small intestine: an interesting case report.

    Science.gov (United States)

    Ullah, Sana; Ajab, Shereen; Rao, Rajashekhar; Raghunathan, Girish; DaCosta, Philip

    2015-06-01

    Diaphragm disease of small intestine usually presents with nonspecific clinical features. Radiological investigations often fail to differentiate it from small intestinal tumors and inflammatory bowel disease. It is therefore diagnosed on final histology after surgical resection. We hereby report an interesting case of a suspected small bowel tumor later diagnosed as diaphragm disease on histology. © The Author(s) 2014.

  11. Experimental investigation of solar powered diaphragm and helical pumps

    Science.gov (United States)

    For several years, many types of solar powered water pumping systems were evaluated, and in this paper, diaphragm and helical solar photovoltaic (PV) powered water pumping systems are discussed. Data were collected on diaphragm and helical pumps which were powered by different solar PV arrays at mul...

  12. Eye lens dose correlations with personal dose equivalent and patient exposure in paediatric interventional cardiology performed with a fluoroscopic biplane system.

    Science.gov (United States)

    Alejo, L; Koren, C; Corredoira, E; Sánchez, F; Bayón, J; Serrada, A; Guibelalde, E

    2017-04-01

    To analyse the correlations between the eye lens dose estimates performed with dosimeters placed next to the eyes of paediatric interventional cardiologists working with a biplane system, the personal dose equivalent measured on the thorax and the patient dose. The eye lens dose was estimated in terms of H p (0.07) on a monthly basis, placing optically stimulated luminescence dosimeters (OSLDs) on goggles. The H p (0.07) personal dose equivalent was measured over aprons with whole-body OSLDs. Data on patient dose as recorded by the kerma-area product (P KA ) were collected using an automatic dose management system. The 2 paediatric cardiologists working in the facility were involved in the study, and 222 interventions in a 1-year period were evaluated. The ceiling-suspended screen was often disregarded during interventions. The annual eye lens doses estimated on goggles were 4.13±0.93 and 4.98±1.28mSv. Over the aprons, the doses obtained were 10.83±0.99 and 11.97±1.44mSv. The correlation between the goggles and the apron dose was R 2 =0.89, with a ratio of 0.38. The correlation with the patient dose was R 2 =0.40, with a ratio of 1.79μSvGy -1 cm -2 . The dose per procedure obtained over the aprons was 102±16μSv, and on goggles 40±9μSv. The eye lens dose normalized to P KA was 2.21±0.58μSvGy -1 cm -2 . Measurements of personal dose equivalent over the paediatric cardiologist's apron are useful to estimate eye lens dose levels if no radiation protection devices are typically used. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  13. Effect of flexure beam geometry and material on the displacement of piezo actuated diaphragm for micropump

    Science.gov (United States)

    Roopa, R.; Navin Karanth, P.; Kulkarni, S. M.

    2018-02-01

    In this paper, we present a COMSOL analysis of flexure diaphragm for piezo actuated valveless micropump. Diaphragms play an important role in micropumps, till now plane diaphragms are commonly used in micropumps. Use of compliant flexure hinges in diaphragm and other MEMS application is one of the new approach to achieving high deflection in diaphragm at low operating voltage. Flexures hinges in diaphragm acts as simply supported beam. Out-off plane compliance value and stiffness is considered for the selection of proper flexure for diaphragm. Diaphragm material also plays an important role in the diaphragm central deflection. Factor considered for diaphragm material selection is resilience; it is the ratio of yield stress to static modulus. Higher is the resilience will leads to higher deflection generated, it also imparts good compliance. Based on the resilience beryllium copper, stainless steel and brass materials are selected for diaphragm analysis. Simulations have been performed using COMSOL multiphysics. This study reports the effect of flexure hinge geometry and diaphragm material on the central deflection of diaphragms and compared with existing plane diaphragm. Simulation results illustrates that the deflection of three flexure diaphragm with 2mm width and 2mm length flexure is 6.75µm for stainless steel, 10.89 for beryllium copper and 12.10µm for brass, at 140V which is approximately twice that of plane diaphragm deflection. The maximum in both plane and three flexure diaphragm deflection is obtained for brass diaphragm compared to stainless steel and beryllium copper.

  14. Changes in the accommodation-convergence relationship after the Artisan phakic intraocular lens implantation for myopic patients.

    Science.gov (United States)

    Ryu, Ik Hee; Han, Jinu; Lee, Hyung Keun; Kim, Jin Kook; Han, Sueng-Han

    2014-04-01

    To evaluate the change of accommodation-convergence parameters after implantation of Artisan phakic intraocular lens (PIOL). Prospective study for the patients with the Artisan PIOL implantation was performed. A total of 37 patients (3 males and 34 females) enrolled the study. Preoperatively, convergence amplitude, the stimulus accommodative convergence per unit of accommodation (AC/A) ratio and the near point of convergence (NPC) were evaluated. After the Artisan PIOL implantation, the identical evaluations were repeated at 1 week, 1, 3, and 6 months after the surgery. Mean age was 24.3 ± 4.8 years old, and preoperative refractive error was -8.92 ± 4.13 diopters (D). After the implantation, mean refractive errors significantly decreased to within ±1.00 D, and noticeable complications were not found. The convergence amplitude and the stimulus AC/A ratio increased 1 month after the surgery, but progressively stabilized afterward to near preoperative values. NPC didn't show any significant change over follow-up period up to 6 months. These results regarding implantation of the Artisan PIOL revealed the increase of accommodation-convergence relationship within first 1 month after the surgery, but progressive stabilization was noted during follow-up periods.

  15. Global Proteome Changes in the Rat Diaphragm Induced by Endurance Exercise Training.

    Directory of Open Access Journals (Sweden)

    Kurt J Sollanek

    Full Text Available Mechanical ventilation (MV is a life-saving intervention for many critically ill patients. Unfortunately, prolonged MV results in the rapid development of diaphragmatic atrophy and weakness. Importantly, endurance exercise training results in a diaphragmatic phenotype that is protected against ventilator-induced diaphragmatic atrophy and weakness. The mechanisms responsible for this exercise-induced protection against ventilator-induced diaphragmatic atrophy remain unknown. Therefore, to investigate exercise-induced changes in diaphragm muscle proteins, we compared the diaphragmatic proteome from sedentary and exercise-trained rats. Specifically, using label-free liquid chromatography-mass spectrometry, we performed a proteomics analysis of both soluble proteins and mitochondrial proteins isolated from diaphragm muscle. The total number of diaphragm proteins profiled in the soluble protein fraction and mitochondrial protein fraction were 813 and 732, respectively. Endurance exercise training significantly (P<0.05, FDR <10% altered the abundance of 70 proteins in the soluble diaphragm proteome and 25 proteins of the mitochondrial proteome. In particular, key cytoprotective proteins that increased in relative abundance following exercise training included mitochondrial fission process 1 (Mtfp1; MTP18, 3-mercaptopyruvate sulfurtransferase (3MPST, microsomal glutathione S-transferase 3 (Mgst3; GST-III, and heat shock protein 70 kDa protein 1A/1B (HSP70. While these proteins are known to be cytoprotective in several cell types, the cyto-protective roles of these proteins have yet to be fully elucidated in diaphragm muscle fibers. Based upon these important findings, future experiments can now determine which of these diaphragmatic proteins are sufficient and/or required to promote exercise-induced protection against inactivity-induced muscle atrophy.

  16. Feasibility of navigator setting on the left diaphragm for whole-heart coronary MRA. A study in healthy volunteers

    International Nuclear Information System (INIS)

    Watanabe, Kunihiro; Suzuki, Takayoshi; Maruyama, Kazuhiro; Noda, Mayumi; Fujita, Mitsuo; Morita, Satoru; Ohnishi, Takahiro

    2009-01-01

    We prospectively compared the quality of images obtained by navigator setting on the left and right diaphragm on whole-heart coronary magnetic resonance angiography (WHCMRA). In 10 healthy volunteers, we performed free-breathing, 3-dimensional segmented true fast imaging with steady-state precession (trueFISP) WHCMRA by setting the navigator on the left and right diaphragm in random order. For the left diaphragm, we set the navigator outside the scope of the heart to avoid the influence on coronary arteries. We compared image acquisition time and visible length of coronary arteries using paired t-test and subjective image quality on a 4-point scale (1, poor; 4, excellent) using Wilcoxon signed-rank test. Mean overall subjective image quality was significantly better in the left diaphragm than the right (3.3±0.7 versus 2.9±0.9, P=0.02). Mean overall visible length of the coronary arteries was significantly better in the left diaphragm than the right (115.4±31.1 vs. 112.6±29.9 mm, P=0.02). Mean acquisition time between the left and right diaphragm was not significantly different (15.6±5.0 versus 16.0±5.7 min, P=0.79). In this small group of healthy volunteers, navigator setting for WHCMRA was superior on the left diaphragm than the right; however, feasibility of the technique requires additional consideration in a larger group of actual patients. (author)

  17. Recovering from chronic myeloid leukemia: the patients' perspective seen through the lens of narrative medicine.

    Science.gov (United States)

    Graffigna, G; Cecchini, I; Breccia, M; Capochiani, E; Della Seta, R; Galimberti, S; Melosi, A; Simonetti, F; Pizzuti, M; Capalbo, S F; Falzetti, F; Mazza, P; Di Renzo, N; Mastrullo, L; Rapezzi, D; Orlandi, E; Intermesoli, T; Iurlo, A; Pungolino, E; Pacilli, M

    2017-10-01

    The main objective of this study is to gain a deeper understanding of how patients suffering from chronic myeloid leukemia (CML) cope with their illness. The study aims to reconstruct the subjective meaning-making process related to CML in order to gain insights into the impact the disease has on patients' emotions and everyday lives, as well as to explore the psychological impact of their being presented with the chance to suspend their therapy and recover from the disease. Data were gathered from a qualitative study conducted in Italy on 158 Italian CML patients. Basing the study on the narrative inquiry approach, the patients were required to describe their patient journey in a qualitative narrative diary. These contained prompts to elicit the free expression of their needs, expectations, and priorities. A lexicographic analysis was carried out with T-LAB software and in particular a thematic analysis of elementary contexts (TAECs) and a word association analysis (WAA). The TAEC detected four thematic clusters related to two factors (temporal frame and contextual setting) that explained the variance among the narratives. The WAA evidenced a wide variety of emotions, both positive and negative, as patients reacted to the possibility of interrupting their therapy. A better understanding of patients' experiences can offer insights into promoting the development of more sustainable healthcare services and into therapeutic innovation aimed at improving patients' quality of life and at engaging them more in their treatment. The findings of this study can also help make medical professionals more aware of the patient's burden and help them identify potential interactions and emotional levers to improve clinical relationships.

  18. Analytical model for an electrostatically actuated miniature diaphragm compressor

    International Nuclear Information System (INIS)

    Sathe, Abhijit A; Groll, Eckhard A; Garimella, Suresh V

    2008-01-01

    This paper presents a new analytical approach for quasi-static modeling of an electrostatically actuated diaphragm compressor that could be employed in a miniature scale refrigeration system. The compressor consists of a flexible circular diaphragm clamped at its circumference. A conformal chamber encloses the diaphragm completely. The membrane and the chamber surfaces are coated with metallic electrodes. A potential difference applied between the diaphragm and the chamber pulls the diaphragm toward the chamber surface progressively from the outer circumference toward the center. This zipping actuation reduces the volume available to the refrigerant gas, thereby increasing its pressure. A segmentation technique is proposed for analysis of the compressor by which the domain is divided into multiple segments for each of which the forces acting on the diaphragm are estimated. The pull-down voltage to completely zip each individual segment is thus obtained. The required voltage for obtaining a specific pressure rise in the chamber can thus be determined. Predictions from the model compare well with other simulation results from the literature, as well as to experimental measurements of the diaphragm displacement and chamber pressure rise in a custom-built setup

  19. The Effect of the Crystalline Lens on Central Vault After Implantable Collamer Lens Implantation.

    Science.gov (United States)

    Qi, Meng-Ying; Chen, Qian; Zeng, Qing-Yan

    2017-08-01

    To identify associations between crystalline lens-related factors and central vault after Implantable Collamer Lens (ICL) (Staar Surgical, Monrovia, CA) implantation. This retrospective clinical study included 320 eyes from 186 patients who underwent ICL implantation surgery. At 1 year after surgery, the central vault was measured using anterior segment optical coherence tomography. Preoperative anterior chamber depth, lens thickness, lens position (lens position = anterior chamber depth + 1/2 lens thickness), and vault were analyzed to investigate the effects of lens-related factors on postoperative vault. The mean vault was 513 ± 215 µm at 1 year after surgery. Vault was positively correlated with preoperative anterior chamber depth (r = 0.495, P lens position (r = 0.371, P lens thickness (r = -0.262, P lens position than eyes in the other two vault groups (which had vaults ≥ 250 µm) (P lens position less than 5.1 mm had greatly reduced vaults (P lens could have an important influence on postoperative vault. Eyes with a shallower anterior chamber and a forward lens position will have lower vaults. [J Refract Surg. 2017;33(8):519-523.]. Copyright 2017, SLACK Incorporated.

  20. Eye lens exposure to medical staff performing electrophysiology procedures: dose assessment and correlation to patient dose

    International Nuclear Information System (INIS)

    Ciraj-Bjelac, Olivera; Bozovic, Predrag; Arandjic, Danijela; Antic, Vojislav; Selakovic, Jovana; Pavlovic, Sinisa

    2016-01-01

    The purpose of this study was to assess the patient exposure and staff eye dose levels during implantation procedures for all types of pacemaker therapy devices performed under fluoroscopic guidance and to investigate potential correlation between patients and staff dose levels. The mean eye dose during pacemaker/defibrillator implementation was 12 μSv for the first operator, 8.7 μSv for the second operator/nurse and 0.50 μSv for radiographer. Corresponding values for cardiac re-synchronisation therapy procedures were 30, 26 and 2.0 μSv, respectively. Significant (p < 0.01) correlation between the eye dose and the kerma-area product was found for the first operator and radiographers, but not for other staff categories. The study revealed eye dose per procedure and eye dose normalised to patient dose indices for different staff categories and provided an input for radiation protection in electrophysiology procedures. (authors)

  1. Quality of vision in patients implanted with aspherical and spherical intraocular lens: Intraindividual comparison

    Directory of Open Access Journals (Sweden)

    Francesco Semeraro

    2014-01-01

    Full Text Available Aims: To compare the quality of vision in pseudophakic patients implanted with aspherical and spherical intraocular lenses (IOLs. Materials and Methods: Randomized prospective longitudinal intrapatient comparison between aspherical and spherical IOLs performed on 22 patients who underwent bilateral cataract surgery. Best corrected visual acuity, subjective contrast sensitivity, Strehl ratio and spherical aberrations (SA, and higher order wavefront aberrations for a 3.5 mm and a 6.0 mm pupil were measured after 3 months of cataract surgery. Results: SA (Z4,0 decreased significantly in eyes with aspherical IOL implant (P = 0.004. Modulation transfer function (MTF and point spread function (PSF resulted no significant difference between the two groups (P = 0.87; P = 0.32. Conclusion: Although the SA is significantly lower in eyes implanted with aspherical IOL, the quality of vision determined with MTF and PSF does not significantly differ for subjective and objective parameters that were analyzed.

  2. Tumor motion prediction with the diaphragm as a surrogate: a feasibility study

    International Nuclear Information System (INIS)

    Cervino, Laura I; Jiang Yan; Sandhu, Ajay; Jiang, Steve B

    2010-01-01

    We have previously assessed the use of the diaphragm as a surrogate for predicting real-time tumor position with linear models built with training data extracted from the same treatment fraction (Cervino et al 2009 Phys. Med. Biol. 54 3529-41). However, practical use in the clinical setting requires the capability of predicting tumor position throughout the treatment course using a model built at the beginning of the course. We evaluate the inter-fraction applicability of linear models to predict superior-inferior tumor position based on diaphragm position using 21 fluoroscopic sequences from five lung cancer patients. Tumor position is predicted with models built during the first fluoroscopic sequence of each patient. Other fluoroscopic sets are registered to the first set with five different methods. The mean localization prediction error and maximum error at a 95% confidence level averaged over all patients are found to be 1.2 mm and 2.9 mm, respectively, for bony registration and 1.2 mm and 2.8 mm, respectively, for registration based on the mean position of the tumor in the first two breathing cycles. Other registration methods produce larger prediction errors. In the clinical setting, this prediction error could be added as a margin to the target volume. We therefore conclude that it is feasible to predict lung tumor motion with diaphragm with sufficient accuracy in the clinical setting. (note)

  3. Documentation of diaphragmal paralysis with digital subtraction techniques

    International Nuclear Information System (INIS)

    Waggershauser, T.; Muenchen Univ.; Buente, E.; Muenchen Univ.; Kohz, P.; Muenchen Univ.; Fink, U.; Muenchen Univ.

    1992-01-01

    The causative factors for a paresis of the diaphragm are primarily subsequent to operations on lesions of the phrenic nerve or on such mediastinal tumors as lyphomas which result in compression or infiltration of the nerves. (orig.) [de

  4. Acquired relaxation of the right half of the diaphragm

    International Nuclear Information System (INIS)

    Tolmachev, V.V.; Romadanov, A.A.

    1997-01-01

    Case is described of the development of complete relaxation of the right half of diaphragm following inflammatory respiratory disease accompanied by infections neuritis involving right phrenic nerve. Results of biomedical radiography and computerized tomography in dynamics are presented

  5. Assessing the need for intermediate diaphragms in prestressed concrete bridges.

    Science.gov (United States)

    2008-03-01

    Reinforced concrete intermediate diaphragms (IDs) are currently being used in prestressed concrete (PC) girder bridges in Louisiana. Some of the advantages of providing IDs are disputed in the bridge community; the use of IDs increases the cost and t...

  6. Stylus type MEMS texture sensor covered with corrugated diaphragm

    Science.gov (United States)

    Tsukamoto, Takashiro; Asao, Hideaki; Tanaka, Shuji

    2017-09-01

    In this paper, a stylus type MEMS texture sensor covered with a corrugated palylene diaphragm, which prevent debris from jamming into the sensor without significant degradation of sensitivity and bandwidth, was reported. A new fabrication process using a lost-foil method to make the corrugated diaphragm on a 3-axis piezoresistive force sensor at wafer level has been developed. The texture sensor could detect the surface microstructure as small as about 10 \

  7. Hyperglycemia-induced diaphragm weakness is mediated by oxidative stress

    Science.gov (United States)

    2014-01-01

    Introduction A major consequence of ICU-acquired weakness (ICUAW) is diaphragm weakness, which prolongs the duration of mechanical ventilation. Hyperglycemia (HG) is a risk factor for ICUAW. However, the mechanisms underlying HG-induced respiratory muscle weakness are not known. Excessive reactive oxygen species (ROS) injure multiple tissues during HG, but only one study suggests that excessive ROS generation may be linked to HG-induced diaphragm weakness. We hypothesized that HG-induced diaphragm dysfunction is mediated by excessive superoxide generation and that administration of a specific superoxide scavenger, polyethylene glycol superoxide dismutase (PEG-SOD), would ameliorate these effects. Methods HG was induced in rats using streptozotocin (60 mg/kg intravenously) and the following groups assessed at two weeks: controls, HG, HG + PEG-SOD (2,000U/kg/d intraperitoneally for seven days), and HG + denatured (dn)PEG-SOD (2000U/kg/d intraperitoneally for seven days). PEG-SOD and dnPEG-SOD were administered on day 8, we measured diaphragm specific force generation in muscle strips, force-pCa relationships in single permeabilized fibers, contractile protein content and indices of oxidative stress. Results HG reduced diaphragm specific force generation, altered single fiber force-pCa relationships, depleted troponin T, and increased oxidative stress. PEG-SOD prevented HG-induced reductions in diaphragm specific force generation (for example 80 Hz force was 26.4 ± 0.9, 15.4 ± 0.9, 24.0 ± 1.5 and 14.9 ± 0.9 N/cm2 for control, HG, HG + PEG-SOD, and HG + dnPEG-SOD groups, respectively, P hyperglycemia-induced diaphragm dysfunction. This new mechanistic information could explain how HG alters diaphragm function during critical illness. PMID:24886999

  8. Gram negative bacteria and contact lens induced acute red eye

    Directory of Open Access Journals (Sweden)

    Sankaridurg Padmaja

    1996-01-01

    Full Text Available Two patients using hydrogel contact lenses on a daily wear schedule slept overnight with the lenses and woke up with a Contact Lens Induced Acute Red Eye (CLARE. The contact lenses recovered aseptically at the time of the event grew significant colonies of Pseudomonas aeruginosa and Aeromonas hydrophila in patient A and Pseudomonas aeruginosa and Serratia liquefaciens from patient B. Similar organisams from the contact lenses were recovered from the lens case and lens care solutions of patient B. In both the patients the condition resolved on discontinuation of lens wear. Patient compliance as a requirement for successful contact lens wear is highlighted with the illustration of these cases.

  9. Mechanics of the canine diaphragm in pleural effusion.

    Science.gov (United States)

    De Troyer, André; Leduc, Dimitri; Cappello, Matteo; Gevenois, Pierre Alain

    2012-09-01

    Pleural effusion is a complicating feature of many diseases of the lung and pleura, but its effects on the mechanics of the diaphragm have not been assessed. In the present study, radiopaque markers were attached along muscle bundles in the midcostal region of the diaphragm in anesthetized dogs, and the three-dimensional location of the markers during relaxation before and after the stepwise introduction of liquid into the left or right pleural space and during phrenic nerve stimulation in the same conditions was determined using computed tomography. From these data, accurate measurements of diaphragm muscle length and displacement were obtained, and the changes in pleural and abdominal pressure were analyzed as functions of these parameters. The effect of liquid instillation on the axial position of rib 5 was also measured. The data showed that 1) liquid leaked through the dorsal mediastinal sheet behind the pericardium so that effusion was bilateral; 2) effusion caused a caudal displacement of the relaxed diaphragm; 3) this displacement was, compared with passive lung inflation, much larger than the cranial displacement of the ribs; and 4) the capacity of the diaphragm to generate pressure, in particular pleural pressure, decreased markedly as effusion increased, and this decrease was well explained by the decrease in active muscle length. It is concluded that pleural effusion has a major adverse effect on the pressure-generating capacity of the diaphragm and that this is the result of the action of hydrostatic forces on the muscle.

  10. Diaphragm and Lung Ultrasound to Predict Weaning Outcome: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Llamas-Álvarez, Ana M; Tenza-Lozano, Eva M; Latour-Pérez, Jaime

    2017-12-01

    Deciding the optimal timing for extubation in patients who are mechanically ventilated can be challenging, and traditional weaning predictor tools are not very accurate. The aim of this systematic review and meta-analysis was to assess the accuracy of lung and diaphragm ultrasound for predicting weaning outcomes in critically ill adults. MEDLINE, the Cochrane Library, Web of Science, Scopus, LILACS, Teseo, Tesis Doctorales en Red, and OpenGrey were searched, and the bibliographies of relevant studies were reviewed. Two researchers independently selected studies that met the inclusion criteria and assessed study quality in accordance with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. The summary receiver-operating characteristic curve and pooled diagnostic OR (DOR) were estimated by using a bivariate random effects analysis. Sources of heterogeneity were explored by using predefined subgroup analyses and bivariate meta-regression. Nineteen studies involving 1,071 people were included in the study. For diaphragm thickening fraction, the area under the summary receiver-operating characteristic curve was 0.87, and DOR was 21 (95% CI, 11-40). Regarding diaphragmatic excursion, pooled sensitivity was 75% (95% CI, 65-85); pooled specificity, 75% (95% CI, 60-85); and DOR, 10 (95% CI, 4-24). For lung ultrasound, the area under the summary receiver-operating characteristic curve was 0.77, and DOR was 38 (95% CI, 7-198). Based on bivariate meta-regression analysis, a significantly higher specificity for diaphragm thickening fraction and higher sensitivity for diaphragmatic excursion was detected in studies with applicability concerns. Lung and diaphragm ultrasound can help predict weaning outcome, but its accuracy may vary depending on the patient subpopulation. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  11. Converging or Diverging Lens?

    Science.gov (United States)

    Branca, Mario

    2013-01-01

    Why does a lens magnify? Why does it shrink objects? Why does this happen? The activities that we propose here are useful in helping us to understand how lenses work, and they show that the same lens can have different magnification capabilities. A converging lens can also act as a diverging lens. (Contains 4 figures.)

  12. Under - diaphragm irradiation of an osseous stage 4 Hodgkin lymphoma at a patient whose pregnancy was unknown; Irradiation sous-diaphragmatique d'un lymphome hodgkinien de stade 4 osseux chez une patiente dont la grossesse etait meconnue

    Energy Technology Data Exchange (ETDEWEB)

    Moreau, M.V.; Tournier-Rangeard, L.; Brunaud, C.; Marchesi, V.; Peiffert, D. [Centre Alexis-Vautrin, Service de Radiotherapie, 54 - Vandoeuvre-les-Nancy (France); Bologna, S. [Centre Hospitalier Universitaire Brabois, Service d' Hematologie, 54 - Vandoeuvre-les-Nancy (France)

    2007-11-15

    Four years after the irradiation, the patient was in situation of complete forgiveness: the child was normal, there was neither a deformation nor a mental disorder, but the neoplastic risk persists, thus long-term surveillance is imperative. If the pregnancy is known, we have to arrest the foetal risks incurred in order to propose a termination of pregnancy; therefore, are made the measures on phantoms of the dose that he would receive, according to the tumoral localization, to the dose necessary to eradicate the tumor, to the field and the possible masks for an optimal tumoral control. (N.C.)

  13. Dystrophic phenotype improvement in the diaphragm muscle of mdx mice by diacerhein.

    Directory of Open Access Journals (Sweden)

    Rafael Dias Mâncio

    Full Text Available Chronic inflammation and oxidative stress are striking features of Duchenne muscular dystrophy disease. Diacerhein is an anthraquinone, which exhibits anti-inflammatory and antioxidant properties. Based on their actions, the present study evaluated the effects of diacerhein against myonecrosis, oxidative stress and inflammatory response in the diaphragm muscle of mdx mice and compared these results to current treatment widely used in DMD patients, with a main focus on the impact of prednisone. The results demonstrated that diacerhein treatment prevented muscle damage indicated by a decrease in the IgG uptake by muscle fibers, lower CK levels in serum, reduction of fibers with central nuclei with a concomitant increase in fibers with peripheral nuclei. It also had an effect on the inflammatory process, decreasing the inflammatory area, macrophage staining and TNF-α and IL-1β content. Regarding oxidative stress, diacerhein treatment was effective in reducing the ROS and lipid peroxidation in the diaphragm muscle from mdx mice. Compared to prednisone treatment, our findings demonstrated that diacerhein treatment improved the dystrophic phenotype in the diaphragm muscle of mdx mice similar to that of glucocorticoid therapy. In this respect, this work suggests that diacerhein has a potential use as an alternative drug in dystrophinopathy treatment and recommends that its anti-inflammatory and antioxidants properties in the dystrophic muscle should be better understood.

  14. Autophagy-associated atrophy and metabolic remodeling of the mouse diaphragm after short-term intermittent hypoxia.

    Directory of Open Access Journals (Sweden)

    Christian Giordano

    Full Text Available Short-term intermittent hypoxia (IH is common in patients with acute respiratory disorders. Although prolonged exposure to hypoxia induces atrophy and increased fatigability of skeletal muscle, the response to short-term IH is less well known. We hypothesized that the diaphragm and limb muscles would adapt differently to short-term IH given that hypoxia stimulates ventilation and triggers a superimposed exercise stimulus in the diaphragm.We determined the structural, metabolic, and contractile properties of the mouse diaphragm after 4 days of IH (8 hours per day, 30 episodes per hour to a FiO2 nadir=6%, and compared responses in the diaphragm to a commonly studied reference limb muscle, the tibialis anterior. Outcome measures included muscle fiber size, assays of muscle proteolysis (calpain, ubiquitin-proteasome, and autophagy pathways, markers of oxidative stress and mitochondrial function, quantification of intramyocellular lipid and lipid metabolism genes, type I myosin heavy chain (MyHC expression, and in vitro contractile properties.After 4 days of IH, the diaphragm alone demonstrated significant atrophy (30% decrease of myofiber size together with increased LC3B-II protein (2.4-fold and mRNA markers of the autophagy pathway (LC3B, Gabarapl1, Bnip3, whereas active calpain and E3 ubiquitin ligases (MuRF1, atrogin-1 were unaffected in both muscles. Succinate dehydrogenase activity was significantly reduced by IH in both muscles. However, only the diaphragm exhibited increased intramyocellular lipid droplets (2.5-fold after IH, along with upregulation of genes linked to activated lipid metabolism. In addition, although the diaphragm showed evidence for acute fatigue immediately following IH, it underwent an adaptive fiber type switch toward slow type I MyHC-expressing fibers, associated with greater intrinsic endurance of the muscle during repetitive stimulation in vitro.Short-term IH induces preferential atrophy in the mouse diaphragm

  15. Giant flexoelectric polarization in a micromachined ferroelectric diaphragm

    KAUST Repository

    Wang, Zhihong

    2012-08-14

    The coupling between dielectric polarization and strain gradient, known as flexoelectricity, becomes significantly large on the micro- and nanoscale. Here, it is shown that giant flexoelectric polarization can reverse remnant ferroelectric polarization in a bent Pb(Zr0.52Ti0.48) O3 (PZT) diaphragm fabricated by micromachining. The polarization induced by the strain gradient and the switching behaviors of the polarization in response to an external electric field are investigated by observing the electromechanical coupling of the diaphragm. The method allows determination of the absolute zero polarization state in a PZT film, which is impossible using other existing methods. Based on the observation of the absolute zero polarization state and the assumption that bending of the diaphragm is the only source of the self-polarization, the upper bound of flexoelectric coefficient of PZT film is calculated to be as large as 2.0 × 10-4 C m -1. The strain gradient induced by bending the diaphragm is measured to be on the order of 102 m-1, three orders of magnitude larger than that obtained in the bulk material. Because of this large strain gradient, the estimated giant flexoelectric polarization in the bent diaphragm is on the same order of magnitude as the normal remnant ferroelectric polarization of PZT film. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  16. Effect of maternal steroid on developing diaphragm integrity.

    Directory of Open Access Journals (Sweden)

    Yong Song

    Full Text Available Antenatal steroids reduce the severity of initial respiratory distress of premature newborn babies but may have an adverse impact on other body organs. The study aimed to examine the effect of maternal steroids on postnatal respiratory muscle function during development and elucidate the mechanisms underlying the potential myopathy in newborn rats. Pregnant rats were treated with intramuscular injections of 0.5 mg/kg betamethasone 7 d and 3 d before birth. Newborn diaphragms were dissected for assessment of contractile function at 2 d, 7 d or 21 d postnatal age (PNA, compared with age-matched controls. The expression of myosin heavy chain (MHC isoforms and atrophy-related genes and activity of intracellular molecular signalling were measured using quantitative PCR and/or Western blot. With advancing PNA, neonatal MHC gene expression decreased progressively while MHC IIb and IIx isoforms increased. Protein metabolic signalling showed high baseline activity at 2 d PNA, and significantly declined at 7 d and 21 d. Antenatal administration of betamethasone significantly decreased diaphragm force production, fatigue resistance, total fast fibre content and anabolic signalling activity (Akt and 4E-BP1 in 21 d diaphragm. These responses were not observed in 2 d or 7 d postnatal diaphragm. Results demonstrate that maternal betamethasone treatment causes postnatal diaphragmatic dysfunction at 21 d PNA, which is attributed to MHC II protein loss and impairment of the anabolic signalling pathway. Developmental modifications in MHC fibre composition and protein signalling account for the age-specific diaphragm dysfunction.

  17. Bending-Induced Giant Polarization in Ferroelectric MEMS Diaphragm

    KAUST Repository

    Wang, Zhihong

    2016-09-09

    The polarization induced by the strain gradient, i.e. the flexoelectric effect, has been observed in a micromachined Pb(Zr0.52Ti0.48)O3 (PZT) diaphragms. Applying air pressure to bend a flat diaphragm which initially does not exhibit any electromechanical coupling can induce a resonance peak in its impedance spectrum. This result supposes that bending, thus the strain gradient in the diaphragm causes polarization in PZT film. We also investigated the switching behaviors of the polarization in response to an external electric field in a bent diaphragm and further quantified the polarization induced by the strain gradient. The effective flexoelectric coefficient of the PZT film has been calculated as large as 2.0 × 10−4 C/m. A giant flexoelectric polarization of the order of 1 μC/cm2 was characterized which is of the same order of magnitude as the normal remnant ferroelectric polarization of PZT film. The suggested explanation for the giant polarization is the large strain gradient in the diaphragm and the strain gradient induced reorientation of the polar nanodomains.

  18. Spontaneous, late, in-the-bag intraocular lens subluxation in a patient with a previous acute angle-closure glaucoma attack.

    Science.gov (United States)

    Su, Wei-Wen; Chang, Shirley H L

    2004-08-01

    Cataract surgery was performed in a 49-year-old woman 16 months after an acute angle-closure glaucoma attack. Zonular dialysis was observed during surgery, but the intraocular lens (IOL) was implanted in the capsular bag uneventfully. At 4 1/2 months, 1 IOL loop wrapped in the bag herniated into the anterior chamber. The patient had no history of trauma. The IOL loop remained in the anterior chamber for 9 months, until the subluxated IOL spontaneously returned to its original position. Six months later, the IOL again dislocated into the anterior chamber.

  19. Automatic assessment of average diaphragm motion trajectory from 4DCT images through machine learning.

    Science.gov (United States)

    Li, Guang; Wei, Jie; Huang, Hailiang; Gaebler, Carl Philipp; Yuan, Amy; Deasy, Joseph O

    2015-12-01

    To automatically estimate average diaphragm motion trajectory (ADMT) based on four-dimensional computed tomography (4DCT), facilitating clinical assessment of respiratory motion and motion variation and retrospective motion study. We have developed an effective motion extraction approach and a machine-learning-based algorithm to estimate the ADMT. Eleven patients with 22 sets of 4DCT images (4DCT1 at simulation and 4DCT2 at treatment) were studied. After automatically segmenting the lungs, the differential volume-per-slice (dVPS) curves of the left and right lungs were calculated as a function of slice number for each phase with respective to the full-exhalation. After 5-slice moving average was performed, the discrete cosine transform (DCT) was applied to analyze the dVPS curves in frequency domain. The dimensionality of the spectrum data was reduced by using several lowest frequency coefficients ( f v ) to account for most of the spectrum energy (Σ f v 2 ). Multiple linear regression (MLR) method was then applied to determine the weights of these frequencies by fitting the ground truth-the measured ADMT, which are represented by three pivot points of the diaphragm on each side. The 'leave-one-out' cross validation method was employed to analyze the statistical performance of the prediction results in three image sets: 4DCT1, 4DCT2, and 4DCT1 + 4DCT2. Seven lowest frequencies in DCT domain were found to be sufficient to approximate the patient dVPS curves ( R = 91%-96% in MLR fitting). The mean error in the predicted ADMT using leave-one-out method was 0.3 ± 1.9 mm for the left-side diaphragm and 0.0 ± 1.4 mm for the right-side diaphragm. The prediction error is lower in 4DCT2 than 4DCT1, and is the lowest in 4DCT1 and 4DCT2 combined. This frequency-analysis-based machine learning technique was employed to predict the ADMT automatically with an acceptable error (0.2 ± 1.6 mm). This volumetric approach is not affected by the presence of the lung tumors

  20. MO-F-CAMPUS-I-04: Patient Eye-Lens Dose Reduction in Routine Brain CT Examinations Using Organ-Based Tube Current Modulation and In-Plane Bismuth Shielding

    International Nuclear Information System (INIS)

    Tsai, Hui-Yu; Liao, Ying-Lan; Lai, Nan-Ku; Chen, Tou-Rong; Chen, Jun-Rong

    2015-01-01

    Purpose: The purpose of this study is to assess eye-lens dose for patients who underwent brain CT examinations using two dose reduction Methods: organ-based tube current modulation (OBTCM) and in-plane bismuth shielding method. Methods: This study received institutional review board approval; written informed consent to participate was obtained from all patients. Ninety patients who underwent the routine brain CT examination were randomly assigned to three groups, ie. routine, OBTCM, and bismuth shield. The OBTCM technique reduced the tube current when the X-ray tube rotates in front of patients’ eye-lens region. The patients in the bismuth shield group were covered one-ply bismuth shield in the eyes’ region. Eye-lens doses were measured using TLD-100H chips and the total effective doses were calculated using CT-Expo according to the CT scanning parameters. The surface doses for patients at off-center positions were assessed to evaluate the off-centering effect. Results: Phantom measurements indicates that OBTCM technique could reduced by 26% to 28% of the surface dose to the eye lens, and increased by 25% of the surface dose at the opposed incident direction at the angle of 180°. Patients’ eye-lens doses were reduced 16.9% and 30.5% dose of bismuth shield scan and OBTCM scan, respectively compared to the routine scan. The eye-lens doses were apparently increased when the table position was lower than isocenter. Conclusion: Reducing the dose to the radiosensitive organs, such as eye lens, during routine brain CT examinations could lower the radiation risks. The OBTCM technique and in-plane bismuth shielding could be used to reduce the eye-lens dose. The eye-lens dose could be effectively reduced using OBTCM scan without interfering the diagnostic image quality. Patient position relative the CT gantry also affects the dose level of the eye lens. This study was supported by the grants from the Ministry of Science and Technology of Taiwan (MOST103-2314-B-182

  1. Plasma Discharge Process in a Pulsed Diaphragm Discharge System

    Science.gov (United States)

    Duan, Jianjin; Hu, Jue; Zhang, Chao; Wen, Yuanbin; Meng, Yuedong; Zhang, Chengxu

    2014-12-01

    As one of the most important steps in wastewater treatment, limited study on plasma discharge process is a key challenge in the development of plasma applications. In this study, we focus on the plasma discharge process of a pulsed diaphragm discharge system. According to the analysis, the pulsed diaphragm discharge proceeds in seven stages: (1) Joule heating and heat exchange stage; (2) nucleated site formation; (3) plasma generation (initiation of the breakdown stage); (4) avalanche growth and plasma expansion; (5) plasma contraction; (6) termination of the plasma discharge; and (7) heat exchange stage. From this analysis, a critical voltage criterion for breakdown is obtained. We anticipate this finding will provide guidance for a better application of plasma discharges, especially diaphragm plasma discharges.

  2. Single lens to lens duplication: The missing link

    OpenAIRE

    Bhatt, Rupal; Jethani, Jitendra; Saluja, Praveen; Bharti, Vinay

    2008-01-01

    Congenital anomalies of the lens include a wide range from lens coloboma to primary aphakia and doubling of lens. There have been few case reports of double lens; the etiology suggested is metaplastic changes in the surface ectoderm that leads to formation of two lens vesicles and hence resulting in double lens. We report a case with bilobed lens, which raises the possibility of explaining the etiology of double lens.

  3. CFD analysis of a diaphragm free-piston Stirling cryocooler

    Science.gov (United States)

    Caughley, Alan; Sellier, Mathieu; Gschwendtner, Michael; Tucker, Alan

    2016-10-01

    This paper presents a Computational Fluid Dynamics (CFD) analysis of a novel free-piston Stirling cryocooler that uses a pair of metal diaphragms to seal and suspend the displacer. The diaphragms allow the displacer to move without rubbing or moving seals. When coupled to a metal diaphragm pressure wave generator, the system produces a complete Stirling cryocooler with no rubbing parts in the working gas space. Initial modelling of this concept using the Sage modelling tool indicated the potential for a useful cryocooler. A proof-of-concept prototype was constructed and achieved cryogenic temperatures. A second prototype was designed and constructed using the experience gained from the first. The prototype produced 29 W of cooling at 77 K and reached a no-load temperature of 56 K. The diaphragm's large diameter and short stroke produces a significant radial component to the oscillating flow fields inside the cryocooler which were not modelled in the one-dimensional analysis tool Sage that was used to design the prototypes. Compared with standard pistons, the diaphragm geometry increases the gas-to-wall heat transfer due to the higher velocities and smaller hydraulic diameters. A Computational Fluid Dynamics (CFD) model of the cryocooler was constructed to understand the underlying fluid-dynamics and heat transfer mechanisms with the aim of further improving performance. The CFD modelling of the heat transfer in the radial flow fields created by the diaphragms shows the possibility of utilizing the flat geometry for heat transfer, reducing the need for, and the size of, expensive heat exchangers. This paper presents details of a CFD analysis used to model the flow and gas-to-wall heat transfer inside the second prototype cryocooler, including experimental validation of the CFD to produce a robust analysis.

  4. Experimental device for measuring the dynamic properties of diaphragm motors

    Science.gov (United States)

    Fojtášek, Kamil; Dvořák, Lukáš; Mejzlík, Jan

    The subject of this paper is to design and description of the experimental device for the determination dynamic properties of diaphragm pneumatic motors. These motors are structurally quite different from conventional pneumatic linear cylinders. The working fluid is typically compressed air, the piston of motor is replaced by an elastic part and during the working cycle there is a contact of two elastic environments. In the manufacturers catalogs of these motors are not given any working characteristics. Description of the dynamic behavior of diaphragm motor will be used for verification of mathematical models.

  5. Diaphragm electromyographic activity following unilateral midcervical contusion injury in rats

    Science.gov (United States)

    Sieck, Gary C.

    2016-01-01

    Contusion-type injuries to the spinal cord are characterized by tissue loss and disruption of spinal pathways. Midcervical spinal cord injuries impair the function of respiratory muscles and may contribute to significant respiratory complications. This study systematically assessed the impact of a 100-kDy unilateral C4 contusion injury on diaphragm muscle activity across a range of motor behaviors in rats. Chronic diaphragm electromyography (EMG) was recorded before injury and at 1 and 7 days postinjury (DPI). Histological analyses assessed the extent of perineuronal net formation, white-matter sparing, and phrenic motoneuron loss. At 7 DPI, ∼45% of phrenic motoneurons were lost ipsilaterally. Relative diaphragm root mean square (RMS) EMG activity increased bilaterally across a range of motor behaviors by 7 DPI. The increase in diaphragm RMS EMG activity was associated with an increase in neural drive (RMS value at 75 ms after the onset of diaphragm activity) and was more pronounced during higher force, nonventilatory motor behaviors. Animals in the contusion group displayed a transient decrease in respiratory rate and an increase in burst duration at 1 DPI. By 7 days, following midcervical contusion, there was significant perineuronal net formation and white-matter loss that spanned 1 mm around the injury epicenter. Taken together, these findings are consistent with increased recruitment of remaining motor units, including more fatigable, high-threshold motor units, during higher force, nonventilatory behaviors. Changes in diaphragm EMG activity following midcervical contusion injury reflect complex adaptations in neuromotor control that may increase the risk of motor-unit fatigue and compromise the ability to sustain higher force diaphragm efforts. NEW & NOTEWORTHY The present study shows that unilateral contusion injury at C4 results in substantial loss of phrenic motoneurons but increased diaphragm muscle activity across a range of ventilatory and higher

  6. Contact Lens Care

    Science.gov (United States)

    ... Consumers Consumer Information by Audience For Women Contact Lens Care Share Tweet Linkedin Pin it More sharing ... www.fda.gov/medwatch Learn More about Contact Lens Care Other Tips on Contact Lenses Decorative Contact ...

  7. Crura sign: differentiation between traumatic rupture of the diaphragm and nontraumatic diaphragmatic elevation on CT

    International Nuclear Information System (INIS)

    Kim, Sung Jin; Han, Hae Ja; Kim, Wang Jung; Youk, Yong Soo; Han, Gi Seok; Cha, Sang Hoon; Park, Kil Sun; Kim, Dae Young

    1997-01-01

    To evaluate whether in patients with diffuse evaluation of a hemidiaphragm on chest radiographs, the apparence of the crura on CT might be helpful in differentiating between traumatic rupture of the diaphragm (TRD) and nontraumatic causes such as diaphragmatic palsy or diffuse diaphragmatic eventration. Among patients with diffuse elevations of a hemidiaphragm on chest radiograph, 27 who had patients undergone CT scans were retrospectively reviewed. Twelve patients had surgically proven TRD, and 15 had nontraumatic elevation of a hemidiaphragm such as diaphragmatic palsy or diffuse diaphragmatic eventration. Under the hypothesis that the affected crus is markedly thinner than the normal side in nontraumatic elevation but is normal in TRD ('crura sign', we optically assessed without measurement the thickness of both crura. In all patients with TRD, the thickness of the affected crus was similar to that of the contralateral side. In all patients with nontraumatic causes, however, the crus of the elevated hemidiaphragm was markedly thinner than that of the normal side. The 'crura sign' may be useful additional CT finding of traumatic rupture the diaphragm

  8. Bending-induced electromechanical coupling and large piezoelectric response in a micromachined diaphragm

    KAUST Repository

    Wang, Zhihong

    2013-11-04

    We investigated the dependence of electromechanical coupling and the piezoelectric response of a micromachined Pb(Zr 0.52 Ti 0.48)O 3 (PZT) diaphragm on its curvature by observing the impedance spectrum and central deflection responses to a small AC voltage. The curvature of the diaphragm was controlled by applying air pressure to its back. We found that a depolarized flat diaphragm does not initially exhibit electromechanical coupling or the piezoelectric response. However, upon the application of static air pressure to the diaphragm, both electromechanical coupling and the piezoelectric response can be induced in the originally depolarized diaphragm. The piezoelectric response increases as the curvature increases and a giant piezoelectric response can be obtained from a bent diaphragm. The obtained results clearly demonstrate that a high strain gradient in a diaphragm can polarize a PZT film through a flexoelectric effect, and that the induced piezoelectric response of the diaphragm can be controlled by adjusting its curvature.

  9. Continuity diaphragm for skewed continuous span precast prestressed concrete girder bridges.

    Science.gov (United States)

    2004-10-01

    Continuity diaphragms used on skewed bents in prestressed girder bridges cause difficulties in detailing and : construction. Details for bridges with large diaphragm skew angles (>30) have not been a problem for LA DOTD. : However, as the skew angl...

  10. Validation of ultrasonography for non-invasive assessment of diaphragm function in muscular dystrophy.

    Science.gov (United States)

    Whitehead, Nicholas P; Bible, Kenneth L; Kim, Min Jeong; Odom, Guy L; Adams, Marvin E; Froehner, Stanley C

    2016-12-15

    Duchenne muscular dystrophy (DMD) is a severe, degenerative muscle disease that is commonly studied using the mdx mouse. The mdx diaphragm muscle closely mimics the pathophysiological changes in DMD muscles. mdx diaphragm force is commonly assessed ex vivo, precluding time course studies. Here we used ultrasonography to evaluate time-dependent changes in diaphragm function in vivo, by measuring diaphragm movement amplitude. In mdx mice, diaphragm amplitude decreased with age and values were much lower than for wild-type mice. Importantly, diaphragm amplitude strongly correlated with ex vivo specific force values. Micro-dystrophin administration increased mdx diaphragm amplitude by 26% after 4 weeks. Diaphragm amplitude correlated positively with ex vivo force values and negatively with diaphragm fibrosis, a major cause of DMD muscle weakness. These studies validate diaphragm ultrasonography as a reliable technique for assessing time-dependent changes in mdx diaphragm function in vivo. This technique will be valuable for testing potential therapies for DMD. Duchenne muscular dystrophy (DMD) is a severe, degenerative muscle disease caused by dystrophin mutations. The mdx mouse is a widely used animal model of DMD. The mdx diaphragm muscle most closely recapitulates key features of DMD muscles, including progressive fibrosis and considerable force loss. Diaphragm function in mdx mice is commonly evaluated by specific force measurements ex vivo. While useful, this method only measures force from a small muscle sample at one time point. Therefore, accurate assessment of diaphragm function in vivo would provide an important advance to study the time course of functional decline and treatment benefits. Here, we evaluated an ultrasonography technique for measuring time-dependent changes of diaphragm function in mdx mice. Diaphragm movement amplitude values for mdx mice were considerably lower than those for wild-type, decreased from 8 to 18 months of age, and correlated

  11. Evaluation of COPD's diaphragm motion extracted from 4D-MRI

    Science.gov (United States)

    Swastika, Windra; Masuda, Yoshitada; Kawata, Naoko; Matsumoto, Koji; Suzuki, Toshio; Iesato, Ken; Tada, Yuji; Sugiura, Toshihiko; Tanabe, Nobuhiro; Tatsumi, Koichiro; Ohnishi, Takashi; Haneishi, Hideaki

    2015-03-01

    We have developed a method called intersection profile method to construct a 4D-MRI (3D+time) from time-series of 2D-MRI. The basic idea is to find the best matching of the intersection profile from the time series of 2D-MRI in sagittal plane (navigator slice) and time series of 2D-MRI in coronal plane (data slice). In this study, we use 4D-MRI to semiautomatically extract the right diaphragm motion of 16 subjects (8 healthy subjects and 8 COPD patients). The diaphragm motion is then evaluated quantitatively by calculating the displacement of each subjects and normalized it. We also generate phase-length map to view and locate paradoxical motion of the COPD patients. The quantitative results of the normalized displacement shows that COPD patients tend to have smaller displacement compared to healthy subjects. The average normalized displacement of total 8 COPD patients is 9.4mm and the average of normalized displacement of 8 healthy volunteers is 15.3mm. The generated phase-length maps show that not all of the COPD patients have paradoxical motion, however if it has paradoxical motion, the phase-length map is able to locate where does it occur.

  12. Percutaneous Radiofrequency Ablation for the Hepatocellular Carcinoma Abutting the Diaphragm: Assessment of Safety and Therapeutic Efficacy

    International Nuclear Information System (INIS)

    Kang, Tae Wook; Rhim, Hyun Chul; Kim, Eun Young; Kim, Young Sun; Choi, Dong Il; Lee, Won Jae; Lim, Hyo K.

    2009-01-01

    To assess the safety and therapeutic efficacy of a percutaneous radiofrequency (RF) ablation for the hepatocellular carcinoma (HCC) abutting the diaphragm. We retrospectively assessed 80 patients who underwent a percutaneous RF ablation for a single nodular (< 4 cm) HCC over the last four years. Each patient underwent an ultrasound-guided RF ablation using internally cooled electrodes for the first-line treatment. We divided patients into two subgroups based on whether the index tumor was abutting (less than 5 mm) the diaphragm or not: group A (abutting; n = 31) versus group B (non-abutting; n = 49). We compared the two subgroups for complications and therapeutic efficacy using image and the review of medical records. The statistical assessment included an independent t-test, Fisher's exact test, and chi-square test. The assessment of the diaphragmatic swelling at CT immediately following the procedure was more severe in group A than group B (mean thickness change:1.44 vs. 0.46 mm, p = 0.00). Further, right shoulder pain was more common in group A than B (p = 0.01). Although minor complications (hemothorax 1 case, pleural effusion 1 case) were noted only in group A, no major thoracic complication occurred in either group. The technical success rate was lower in group A than group B (84% vs. 98%, p = 0.03). As well, the primary and secondary technique effectiveness rates in group A and group B were 90% versus 98% (p = 0.29) and 79% versus 91% (p = 0.25), respectively. The local tumor progression rate was higher in group A than in group B (29% vs. 6%, p = 0.02). We found that the percutaneous RF ablation for the HCC abutting the diaphragm is a safe procedure without major complications. However, it is less effective with regard to technical success and local tumor control

  13. Diaphragm-Sparing Nerve Blocks for Shoulder Surgery.

    Science.gov (United States)

    Tran, De Q H; Elgueta, Maria Francisca; Aliste, Julian; Finlayson, Roderick J

    Shoulder surgery can result in significant postoperative pain. Interscalene brachial plexus blocks (ISBs) constitute the current criterion standard for analgesia but may be contraindicated in patients with pulmonary pathology due to the inherent risk of phrenic nerve block and symptomatic hemidiaphragmatic paralysis. Although ultrasound-guided ISB with small volumes (5 mL), dilute local anesthetic (LA) concentrations, and LA injection 4 mm lateral to the brachial plexus have been shown to reduce the risk of phrenic nerve block, no single intervention can decrease its incidence below 20%. Ultrasound-guided supraclavicular blocks with LA injection posterolateral to the brachial plexus may anesthetize the shoulder without incidental diaphragmatic dysfunction, but further confirmatory trials are required. Ultrasound-guided C7 root blocks also seem to offer an attractive, diaphragm-sparing alternative to ISB. However, additional large-scale studies are needed to confirm their efficacy and to quantify the risk of periforaminal vascular breach. Combined axillary-suprascapular nerve blocks may provide adequate postoperative analgesia for minor shoulder surgery but do not compare favorably to ISB for major surgical procedures. One intriguing solution lies in the combined use of infraclavicular brachial plexus blocks and suprascapular nerve blocks. Theoretically, the infraclavicular approach targets the posterior and lateral cords, thus anesthetizing the axillary nerve (which supplies the anterior and posterior shoulder joint), as well as the subscapular and lateral pectoral nerves (both of which supply the anterior shoulder joint), whereas the suprascapular nerve block anesthetizes the posterior shoulder. Future randomized trials are required to validate the efficacy of combined infraclavicular-suprascapular blocks for shoulder surgery.

  14. A monitoring device for pressurised-air-driven diaphragm-based artificial heart assist devices

    NARCIS (Netherlands)

    Hoeben, F.P.; Hoeben, F.P.; de Mul, F.F.M.; Stokkink, J.S.D.; Stokkink, H.S.D.; Koelink, M.H.; Koelink, M.H.; Greve, Jan

    1992-01-01

    A non-invasive device has been developed to monitor the diaphragm position and the blood flow in artificial heart assist devices equipped with a pressurised-air-driven diaphragm. Light scattering from the diaphragm is used as a mechanism for measuring. Information about the position of several

  15. Phrenic nerves and diaphragms in sudden infant death syndrome.

    Science.gov (United States)

    Weis, J; Weber, U; Schröder, J M; Lemke, R; Althoff, H

    1998-01-30

    Disturbances of the respiratory system may be an important factor in the cascade of events leading to sudden infant death syndrome (SIDS). Even though the diaphragm is the major respiratory muscle in infants, little is known about alterations of this muscle and of the phrenic nerve in SIDS. In the present study, diaphragms and phrenic nerves of 24 SIDS infants and seven controls were analyzed. Morphometric analysis revealed only slightly larger cross sectional areas of phrenic nerve axons but no increase in myelin sheath thickness in SIDS cases. However, in one SIDS case, myelinated nerve fibre density was severely reduced. Using electron microscopy, several nerve fibres of SIDS infants showed focal accumulations of neurofilaments. Muscle fibre diameters in SIDS diaphragms were significantly larger compared to controls (P fibre ruptures and contracture bands were found. These prominent nonspecific ultrastructural alterations should advise caution in the interpretation of morphometric data. Thus, in some cases exemplified by one case of the present series, decreased density of phrenic nerve myelinated axons might contribute to SIDS. Still, the present results indicate that development of phrenic nerves and diaphragms is not delayed in most SIDS infants.

  16. Potential for Revitalisation of the Diaphragm for Family Planning in ...

    African Journals Online (AJOL)

    This health systems assessment evaluated the feasibility of introducing a new contraceptive device, the SILCS single-size diaphragm, into the existing family planning method mix in Uganda. A total of 26 focus group discussions with 201 female and 77 male potential users and 98 key informant interviews with policymakers ...

  17. Potential for Revitalisation of the Diaphragm for Family Planning in ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    diaphragm, into the existing family planning method mix in Uganda. A total of 26 ... expand women's options for contraceptive protection. ... several countries, and the product was approved in ..... younger clients and may not adequately market ... different stages of their life cycle. .... maternal mortality ratio in Uganda: priority.

  18. A new straight accelerator tube with U diaphragm

    International Nuclear Information System (INIS)

    Liu Jinhong; Lai Weiquan; Deng Yushen; Zhang Jidong

    1994-01-01

    After calculating the potential distribution and the particle trajectories in electrostatic accelerator tubes, a new straight tube with U diaphragm to suppress secondary particles is proposed. It's properties are demonstrated by the high voltage tests and the γ-rays measurements in the accelerator

  19. Design and analysis of diaphragms in dynamic microphones

    Directory of Open Access Journals (Sweden)

    Zi-Gui Huang

    2015-07-01

    Full Text Available Most contemporary high-end microphones are dynamic microphones, adopting the most basic electromagnetic transduction principles. This study investigated the diaphragm structures of dynamic microphones. The diaphragms were composed of polyimide material, and the boundary settings required for actual operation were provided using finite element model analysis software. The characteristic frequencies caused by grooving variations on the three-dimensional diaphragm were analyzed for the various groove shapes and number. The groove angles and width variations were examined based on the optimal groove shape selected in the aforementioned analysis, and the effects of these shapes were determined based on the analytical results. Acoustic waves cause thin films to vibrate, forming the working principle behind dynamic microphones. The thin film drives a coil to vibrate in a magnetic field and cuts the line of magnetic force, subsequently producing a voltage on both ends of the coil. This audio-frequency-inducted voltage represents an acoustic wave message. The finite element model analysis software was used to conduct electromagnetic induction simulations; the sound source was fed to the diaphragm to drive the coil. The coil vibrations caused the line of magnetic force to be cut, and the final voltages produced were examined and compared.

  20. Investigation of PVdF active diaphragms for synthetic jets

    Science.gov (United States)

    Bailo, Kelly C.; Brei, Diann E.; Calkins, Frederick T.

    2000-06-01

    Current research has shown that aircraft can gain significant aerodynamic performance benefits by employing active flow control (AFC). One of the enabling technologies of AFC is the synthetic jet. Synthetic jets, also known as zero-net-mass flux actuators, act as bi-directional pumps injecting high momentum air into the local aerodynamic flow. Previous work has concentrated on high frequency synthetic jets based on piezoelectric active diaphragms such as Thunder actuators. Low frequency synthetic jets present a unique challenge requiring large displacements, which current technology has difficulty meeting. Boeing is investigating novel shaped low frequency synthetic jets that can modify the flow over fixed aircraft wings. This paper present the initial study of two promising active diaphragm concepts: a crescent shape and an opposing bender shape. These active diaphragms were numerically modeled utilizing the general-purpose finite element code ABAQUS. Using the ABAQUS results, the dynamic volume change within each jet was calculated and incorporated into an analytical linear Bernoulli model to predict the velocities and pressures at the nozzle. Simulations were performed to determine trends to assist in selection of prototype configurations. Prototypes of both diaphragm concepts were constructed from polyvinylidene fluoride and experimentally tested at Boeing with promising results.

  1. Effect of hyperinflation on inspiratory function of the diaphragm.

    Science.gov (United States)

    Minh, V D; Dolan, G F; Konopka, R F; Moser, K M

    1976-01-01

    The inspiratory efficiency of the diaphragm during unilateral and bilateral phrenic stimulation (UEPS and BEPS) with constant stimulus was studied in seven dogs from FRC to 120% TLC. Alveolar pressures (PAl) were recorded during relaxation, BEPS and UEPS at each lung volume in the closed respiratory system. From the PAl-lung volume curves, tidal volume (VT), and pressure developed by the diaphragm (Pmus) were derived. Results are summarized below. a) Hyperinflation impaired the inspiratory efficiency of the diaphragm which behaved as an expiratory muscle beyond the lung volume of 103.7% TLC (Vinef). b) The diaphragm during UEPS became expiratory at the same Vinef as during (BEPS. C) The VT-lung volume relationship was linear during BEPS, allowing simple quantitation of VT loss with hyperinflation and prediction of Vinef. d) With only one phrenic nerve stimulated, the functional loss is less pronounced in VT than in Pmus, as compared to BEPS, indicating that the respiratory system was more compliant during UEPS than BEPS. This compliance difference from UEPS to BEPS diminished with severe hyperinflation.

  2. Aberration design of zoom lens systems using thick lens modules.

    Science.gov (United States)

    Zhang, Jinkai; Chen, Xiaobo; Xi, Juntong; Wu, Zhuoqi

    2014-12-20

    A systematic approach for the aberration design of a zoom lens system using a thick lens module is presented. Each component is treated as a thick lens module at the beginning of the design. A thick lens module refers to a thick lens component with a real lens structure, like lens materials, lens curvatures, lens thicknesses, and lens interval distances. All nine third-order aberrations of a thick lens component are considered during the design. The relationship of component aberrations in different zoom positions can be approximated from the aberration shift. After minimizing the aberrations of the zoom lens system, the nine third-order aberrations of every lens component can be determined. Then the thick lens structure of every lens component can be determined after optimization according to their first-order properties and third-order aberration targets. After a third optimization for minimum practical third-order aberrations of a zoom lens system, the aberration design using the thick lens module is complete, which provides a practical zoom lens system with thick lens structures. A double-sided telecentric zoom lens system is designed using the thick lens module in this paper, which shows that this method is practical for zoom lens design.

  3. 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.

  4. Recruitment of rat diaphragm motor units across motor behaviors with different levels of diaphragm activation.

    Science.gov (United States)

    Seven, Yasin B; Mantilla, Carlos B; Sieck, Gary C

    2014-12-01

    Phrenic motor neurons are recruited across a range of motor behaviors to generate varying levels of diaphragm muscle (DIAm) force. We hypothesized that DIAm motor units are recruited in a fixed order across a range of motor behaviors of varying force levels, consistent with the Henneman Size Principle. Single motor unit action potentials and compound DIAm EMG activities were recorded in anesthetized, neurally intact rats across different motor behaviors, i.e., eupnea, hypoxia-hypercapnia (10% O2 and 5% CO2), deep breaths, sustained airway occlusion, and sneezing. Central drive [estimated by root-mean-squared (RMS) EMG value 75 ms after the onset of EMG activity (RMS75)], recruitment delay, and onset discharge frequencies were similar during eupnea and hypoxia-hypercapnia. Compared with eupnea, central drive increased (∼25%) during deep breaths, and motor units were recruited ∼12 ms earlier (P motor units were recruited ∼30 ms earlier (P motor unit onset discharge frequencies were significantly higher (P Recruitment order of motor unit pairs observed during eupnea was maintained for 98%, 87%, and 84% of the same pairs recorded during hypoxia-hypercapnia, deep breaths, and airway occlusion, respectively. Reversals in motor unit recruitment order were observed primarily if motor unit pairs were recruited motor unit recruitment order being determined primarily by the intrinsic size-dependent electrophysiological properties of phrenic motor neurons. Copyright © 2014 the American Physiological Society.

  5. Refractive lens exchange with a multifocal diffractive aspheric intraocular lens

    Directory of Open Access Journals (Sweden)

    Teresa Ferrer-Blasco

    2012-06-01

    Full Text Available PURPOSE: To evaluate the safety, efficacy and predictability after refractive lens exchange with multifocal diffractive aspheric intraocular lens implantation. METHODS: Sixty eyes of 30 patients underwent bilateral implantation with AcrySof® ReSTOR® SN6AD3 intraocular lens with +4.00 D near addition. Patients were divided into myopic and hyperopic groups. Monocular best corrected visual acuity at distance and near and monocular uncorrected visual acuity at distance and near were measured before and 6 months postoperatively. RESULTS: After surgery, uncorrected visual acuity was 0.08 ± 0.15 and 0.11 ± 0.14 logMAR for the myopic and hyperopic groups, respectively (50% and 46.67% of patients had an uncorrected visual acuity of 20/20 or better in the myopic and hyperopic groups, respectively. The safety and efficacy indexes were 1.05 and 0.88 for the myopic and 1.01 and 0.86 for the hyperopic groups at distance vision. Within the myopic group, 20 eyes remained unchanged after the surgery, and 3 gained >2 lines of best corrected visual acuity. For the hyperopic group, 2 eyes lost 2 lines of best corrected visual acuity, 21 did not change, and 3 eyes gained 2 lines. At near vision, the safety and efficacy indexes were 1.23 and 1.17 for the myopic and 1.16 and 1.13 for the hyperopic groups. Best corrected near visual acuity improved after surgery in both groups (from 0.10 logMAR to 0.01 logMAR in the myopic group, and from 0.10 logMAR to 0.04 logMAR in the hyperopic group. CONCLUSIONS: The ReSTOR® SN6AD3 intraocular lens in refractive lens exchange demonstrated good safety, efficacy, and predictability in correcting high ametropia and presbyopia.

  6. Post-lens tear turbidity and visual quality after scleral lens wear.

    Science.gov (United States)

    Carracedo, Gonzalo; Serramito-Blanco, Maria; Martin-Gil, Alba; Wang, Zicheng; Rodriguez-Pomar, Candela; Pintor, Jesús

    2017-11-01

    The aim was to evaluate the turbidity and thickness of the post-lens tear layer and its effect on visual quality in patients with keratoconus after the beginning of lens wear and before lens removal at the end of eight hours. Twenty-six patients with keratoconus (aged 36.95 ± 8.95 years) participated voluntarily in the study. The sample was divided into two groups: patients with intrastromal corneal ring (ICRS group) and patients without ICRS (KC group). Distance visual acuity (VA), contrast sensitivity, pachymetry, post-lens tear layer height and post-lens tear layer turbidity (percentage area occupied and number of particles per mm 2 ) were evaluated with optical coherence tomography before and after wearing a scleral lens. A significant increase of turbidity was found in all groups assessed (p turbidity parameters with distance VA but no correlation between turbidity and post-lens tear layer thickness at the beginning was found (p > 0.05). A strong correlation in all groups between the post-lens tear layer at the beginning and differences of tear layer thickness between two measures was also found (p turbidity. © 2017 Optometry Australia.

  7. Evaluation of phrenic nerve and diaphragm function with peripheral nerve stimulation and M-mode ultrasonography in potential pediatric phrenic nerve or diaphragm pacing candidates.

    Science.gov (United States)

    Skalsky, Andrew J; Lesser, Daniel J; McDonald, Craig M

    2015-02-01

    Assessing phrenic nerve function in the setting of diaphragmatic paralysis in diaphragm pacing candidates can be challenging. Traditional imaging modalities and electrodiagnostic evaluations are technically difficult. Either modality alone is not a direct measure of the function of the phrenic nerve and diaphragm unit. In this article, the authors present their method for evaluating phrenic nerve function and the resulting diaphragm function. Stimulating the phrenic nerve with transcutaneous stimulation and directly observing the resulting movement of the hemidiaphragm with M-mode ultrasonography provides quantitative data for predicting the success of advancing technologies such as phrenic nerve pacing and diaphragm pacing. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Failure analysis of globe control valves with spring-diaphragm actuator for nuclear power plant applications

    International Nuclear Information System (INIS)

    Khan, M.R.; Chen, W.W.H.; Wang, T.Y.

    1997-01-01

    The results of the failure analysis of a globe control valve with spring-diaphragm actuator indicated that the diaphragm failed because the service loading is close to the strength of the diaphragm. The resulting impact force is significantly larger than the plug guide strength and that cause it to bulge out after the impact. To improve the valve performance, proper torque should be used to tighten the actuator diaphragm case fasteners. A stronger actuator diaphragm could be used to provide additional safety margin during operation. Stiffening the plug guide may avoid jamming the bushing

  9. Effects of Silicone Hydrogel Contact Lens Application on Corneal High-order Aberration and Visual Guality in Patients with Corneal Opacities

    Directory of Open Access Journals (Sweden)

    Sevda Aydın Kurna

    2012-03-01

    Full Text Available Pur po se: Evaluation of the corneal high-order aberrations and visual quality changes after application of silicone hydrogel contact lenses in patients with corneal opacities due to various etiologies. Ma te ri al and Met hod: Fifteen eyes of 13 patients with corneal opacities were included in the study. During the ophthalmologic examination before and after contact lens application, visual acuity was measured with Snellen acuity chart and contrast sensitivity - with Bailey-Lowie Charts in letters. Aberrations were measured with corneal aberrometer (NIDEK Magellan Mapper under a naturally dilated pupil. Spherical aberration, coma, trefoil, irregular astigmatism and total high-order root mean square (RMS values were recorded. Measurements were repeated with balafilcon A lenses (PureVision 2 HD, B&L on all patients. Re sults: Patient age varied between 23 and 50 years. Two eyes had subepithelial infiltrates due to adenoviral keratitis, 1 had nebulae due to previous infections or trauma, and 2 had Salzmann’s nodular degeneration. We observed a mean increase of 1 line in visual acuity and 5 letters in contrast sensitivity with contact lenses versus glasses in the patients. Mean RMS values of spherical aberration, irregular astigmatism and total high-order aberrations decreased significantly with contact lenses. Dis cus si on: Silicone hydrogel soft contact lenses may improve visual quality by decreasing the corneal aberrations in patients with corneal opacities. (Turk J Ophthalmol 2012; 42: 97-102

  10. Audiovisual biofeedback improves diaphragm motion reproducibility in MRI

    Science.gov (United States)

    Kim, Taeho; Pollock, Sean; Lee, Danny; O’Brien, Ricky; Keall, Paul

    2012-01-01

    Purpose: In lung radiotherapy, variations in cycle-to-cycle breathing results in four-dimensional computed tomography imaging artifacts, leading to inaccurate beam coverage and tumor targeting. In previous studies, the effect of audiovisual (AV) biofeedback on the external respiratory signal reproducibility has been investigated but the internal anatomy motion has not been fully studied. The aim of this study is to test the hypothesis that AV biofeedback improves diaphragm motion reproducibility of internal anatomy using magnetic resonance imaging (MRI). Methods: To test the hypothesis 15 healthy human subjects were enrolled in an ethics-approved AV biofeedback study consisting of two imaging sessions spaced ∼1 week apart. Within each session MR images were acquired under free breathing and AV biofeedback conditions. The respiratory signal to the AV biofeedback system utilized optical monitoring of an external marker placed on the abdomen. Synchronously, serial thoracic 2D MR images were obtained to measure the diaphragm motion using a fast gradient-recalled-echo MR pulse sequence in both coronal and sagittal planes. The improvement in the diaphragm motion reproducibility using the AV biofeedback system was quantified by comparing cycle-to-cycle variability in displacement, respiratory period, and baseline drift. Additionally, the variation in improvement between the two sessions was also quantified. Results: The average root mean square error (RMSE) of diaphragm cycle-to-cycle displacement was reduced from 2.6 mm with free breathing to 1.6 mm (38% reduction) with the implementation of AV biofeedback (p-value biofeedback (p-value biofeedback (p-value = 0.012). The diaphragm motion reproducibility improvements with AV biofeedback were consistent with the abdominal motion reproducibility that was observed from the external marker motion variation. Conclusions: This study was the first to investigate the potential of AV biofeedback to improve the motion

  11. Corneal Collagen Cross-Linking Combined with an Artiflex Iris-Fixated Anterior Chamber Phakic Intraocular Lens Implantation in a Patient with Progressive Keratoconus

    Directory of Open Access Journals (Sweden)

    Sharif Hashmani

    2017-10-01

    Full Text Available We present here the case of a 24-year-old male who experienced progressive keratoconus and vision loss which adversely affected his ability to carry out everyday tasks. This landed him in the Hashmanis Hospital for consultation. He had a preoperative best corrected visual acuity of 6/12. He underwent multiple Oculus Pentacam examinations, which showed progressive keratoconus. Corneal collagen cross-linking (CXL was performed to stabilize his cornea and, subsequently, an Artiflex anterior chamber iris-fixated phakic intraocular lens (ACIF-PIOL was implanted to alleviate his refractive errors. The patient achieved a postoperative uncorrected visual acuity of 6/12. This report shows that CXL combined with ACIF-PIOL can be safe and effective in those with progressive keratoconus.

  12. [Impact of an Aspherical Aberration Correcting Monofocal Intraocular Lens on Patient Satisfaction for Daily Life Activities: The Heidelberg Daily Task Evaluation (DATE) Questionnaire].

    Science.gov (United States)

    Kretz, F T A; Son, H; Liebing, S; Tandogan, T; Auffarth, G U

    2015-08-01

    A clinical evaluation of the functional results and its impact on daily activities of an aspherical, aberration correcting intraocular lens (IOL) was undertaken. Twenty-one patients aged from 50 to 83 years underwent cataract surgery with implantation of the aspheric IOL (Tecnis ZCB00, Abbott Medical Optics). They were evaluated 2 to 4 months after surgery for their subjective satisfaction of vision quality and its impact on performance of daily activities as well as functional results and refractive outcome. Patients were asked to fill out a questionnaire - the Heidelberg DATE (DAily Tasks Evaluation) questionnaire. Significant changes from pre- to postoperative results were found in refraction (p ≤ 0.03), with a mean prediction error of + 0.21 ± 0.43 D. UDVA and CDVA improved significantly (p < 0.01), with a postoperative CDVA of 0.0 logMAR or better in 97.1 % of eyes. All patients would recommend the procedure to a relative or a friend and 93.8 % of patients reported to be satisfied with the outcome. The implantation of the aspheric IOL Tecnis ZCB00 after cataract surgery allows the restoration of visual function, providing an optimised optical quality and a high level of patient satisfaction. Georg Thieme Verlag KG Stuttgart · New York.

  13. ECTOPIC LENS EXTRACTION IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Vladimir Pfeifer

    2002-12-01

    Full Text Available Background. Ectopia lentis continues to be a therapeutic challenge for ophthalmologists. It can occur as an isolated condition, after ocular trauma, in association with other ocular disorders, as part of a systemic mesodermal disease or a complication of general metabolic disorders. Minimal subluxation of the lens may cause no visual symptoms, but in more advanced cases serious optical disturbances arise. The most important is amblyopia. Surgical treatment options include iris manipulation, lens discission, aspiration, intracapsular or extracapsular extraction, and pars plana lensectomy. The choice of surgical technique remains controversial, in part because of the historically poor visual results and high rate of perioperative complications, including vitreous loss and retinal detachment.Methods. We describe a surgical technique based on the use of the Cionni endocapsular tension ring, dry irrigation aspiration of lens material, centration of the capsular bag and foldable intraocular lens implantation into the bag. With mentioned surgical technique 8 patients were operated; 4 boys and 4 girls, together 11 eyes.Results. The final BCVA after follow up period improved in 9 eyes and it remained the same as before operation in one eye. Statistical comparison of preoperative and postoperative visual acuities showed significant improvement. On the other hand there was no correlation between preoperative and postoperative visual acuity.Conclusions. This surgical procedure is an alternative approach in solving this challenging cases of ectopia lentis with good postoperative visual rehabilitation.

  14. Efficacy evaluation of laparoscopy assisted ultrasound guided radiofrequency ablation in the treatment of hepatocellular carcinoma beneath the diaphragm

    Directory of Open Access Journals (Sweden)

    Song WANG

    2017-06-01

    Full Text Available Objective To explore the feasibility, safety and efficacy of laparoscopy assisted ultrasound guided radiofrequency ablation (RFA in the treatment of hepatocellular carcinoma (HCC beneath the diaphragm. Methods Twenty- three consecutive patients with solitary HCC beneath the diaphragm were treated by laparoscopy assisted ultrasound guided RFA in the Chinese PLA General Hospital from January 2013 to March 2016. We observed the perioperative complications and followed- up long-term effect. Results All the 23 patients successfully underwent laparoscopy assisted ultrasound guided radiofrequency ablation. No serious complications such as massive hemorrhage, biliary fistula and severe pleural effusion, hemopneumothorax occurred in the patients during perioperative period. CT examination 2-3 days after the operation revealed that the tumor was completely covered by the ablation area. Besides, the survival condition was satisfactory during follow-up period of 9-38 months. Conclusion Laparoscopy-assisted ultrasound-guided radiofrequency ablation is effective and safe for HCC beneath the diaphragm. DOI: 10.11855/j.issn.0577-7402.2017.05.16

  15. Diaphragm Effect of Steel Space Roof Systems in Hall Structures

    Directory of Open Access Journals (Sweden)

    Mehmet FENKLİ

    2015-09-01

    Full Text Available Hall structures have been used widely for different purposes. They have are reinforced concrete frames and shear wall with steel space roof systems. Earthquake response of hall structures is different from building type structures. One of the most critical nodes is diaphragm effect of steel space roof on earthquake response of hall structures. Diaphragm effect is depending on lateral stiffness capacity of steel space roof system. Lateral stiffness of steel space roof system is related to modulation geometry, support conditions, selected sections and system geometry. In current paper, three representative models which are commonly used in Turkey were taken in to account for investigation. Results of numerical tests were present comparatively

  16. Refractive neutron lens

    International Nuclear Information System (INIS)

    Petrov, P.V.; Kolchevsky, N.N.

    2013-01-01

    Model of the refractive neutron lens is proposed. System of N lenses acts as one thin lens with a complex refraction index n*. The maximum number N max of individual lenses for 'thick' neutron lens is calculated. Refractive neutron lens properties (resolution, focal depth) as function of resolution factor F 0 =ρbc/μ and depth of field factor dF 0 =λF 0 =λρbc/μ are calculated. It is shown that micro resolution of the refractive neutron optics is far from the wavelength in size and its open possibilities for progress in refractive neutron optics. (authors)

  17. PO2 Cycling Reduces Diaphragm Fatigue by Attenuating ROS Formation

    OpenAIRE

    Zuo, Li; Diaz, Philip T.; Chien, Michael T.; Roberts, William J.; Kishek, Juliana; Best, Thomas M.; Wagner, Peter D.

    2014-01-01

    Prolonged muscle exposure to low PO2 conditions may cause oxidative stress resulting in severe muscular injuries. We hypothesize that PO2 cycling preconditioning, which involves brief cycles of diaphragmatic muscle exposure to a low oxygen level (40 Torr) followed by a high oxygen level (550 Torr), can reduce intracellular reactive oxygen species (ROS) as well as attenuate muscle fatigue in mouse diaphragm under low PO2. Accordingly, dihydrofluorescein (a fluorescent probe) was used to monito...

  18. PO2 cycling reduces diaphragm fatigue by attenuating ROS formation.

    Science.gov (United States)

    Zuo, Li; Diaz, Philip T; Chien, Michael T; Roberts, William J; Kishek, Juliana; Best, Thomas M; Wagner, Peter D

    2014-01-01

    Prolonged muscle exposure to low PO2 conditions may cause oxidative stress resulting in severe muscular injuries. We hypothesize that PO2 cycling preconditioning, which involves brief cycles of diaphragmatic muscle exposure to a low oxygen level (40 Torr) followed by a high oxygen level (550 Torr), can reduce intracellular reactive oxygen species (ROS) as well as attenuate muscle fatigue in mouse diaphragm under low PO2. Accordingly, dihydrofluorescein (a fluorescent probe) was used to monitor muscular ROS production in real time with confocal microscopy during a lower PO2 condition. In the control group with no PO2 cycling, intracellular ROS formation did not appear during the first 15 min of the low PO2 period. However, after 20 min of low PO2, ROS levels increased significantly by ∼30% compared to baseline, and this increase continued until the end of the 30 min low PO2 condition. Conversely, muscles treated with PO2 cycling showed a complete absence of enhanced fluorescence emission throughout the entire low PO2 period. Furthermore, PO2 cycling-treated diaphragm exhibited increased fatigue resistance during prolonged low PO2 period compared to control. Thus, our data suggest that PO2 cycling mitigates diaphragm fatigue during prolonged low PO2. Although the exact mechanism for this protection remains to be elucidated, it is likely that through limiting excessive ROS levels, PO2 cycling initiates ROS-related antioxidant defenses.

  19. A free-piston Stirling cryocooler using metal diaphragms

    Science.gov (United States)

    Caughley, Alan; Sellier, Mathieu; Gschwendtner, Michael; Tucker, Alan

    2016-12-01

    A novel concept for a free-piston Stirling cryocooler has been proposed. The concept uses a pair of metal diaphragms to seal and suspend the displacer of a free-piston Stirling cryocooler. The diaphragms allow the displacer to move without rubbing or moving seals, potentially resulting in a long-life mechanism. When coupled to a metal diaphragm pressure wave generator, the system produces a complete Stirling cryocooler with no rubbing parts in the working gas space. Initial modelling of this concept using the Sage modelling tool indicates the potential for a useful cryocooler. A proof-of-concept prototype was constructed and achieved cryogenic temperatures. A second prototype was designed and constructed using the experience gained from the first. The prototype produced 29 W of cooling at 77 K and reached a no-load temperature of 56 K. Sage predicted the macroscopic behaviour of the prototype well but did not provide sufficient insights to improve performance significantly. This paper presents details of the development, modelling and testing of the proof-of-concept prototype and a second, improved prototype.

  20. Design-based modeling of magnetically actuated soft diaphragm materials

    Science.gov (United States)

    Jayaneththi, V. R.; Aw, K. C.; McDaid, A. J.

    2018-04-01

    Magnetic polymer composites (MPC) have shown promise for emerging biomedical applications such as lab-on-a-chip and implantable drug delivery. These soft material actuators are capable of fast response, large deformation and wireless actuation. Existing MPC modeling approaches are computationally expensive and unsuitable for rapid design prototyping and real-time control applications. This paper proposes a macro-scale 1-DOF model capable of predicting force and displacement of an MPC diaphragm actuator. Model validation confirmed both blocked force and displacement can be accurately predicted in a variety of working conditions i.e. different magnetic field strengths, static/dynamic fields, and gap distances. The contribution of this work includes a comprehensive experimental investigation of a macro-scale diaphragm actuator; the derivation and validation of a new phenomenological model to describe MPC actuation; and insights into the proposed model’s design-based functionality i.e. scalability and generalizability in terms of magnetic filler concentration and diaphragm diameter. Due to the lumped element modeling approach, the proposed model can also be adapted to alternative actuator configurations, and thus presents a useful tool for design, control and simulation of novel MPC applications.

  1. PO2 cycling reduces diaphragm fatigue by attenuating ROS formation.

    Directory of Open Access Journals (Sweden)

    Li Zuo

    Full Text Available Prolonged muscle exposure to low PO2 conditions may cause oxidative stress resulting in severe muscular injuries. We hypothesize that PO2 cycling preconditioning, which involves brief cycles of diaphragmatic muscle exposure to a low oxygen level (40 Torr followed by a high oxygen level (550 Torr, can reduce intracellular reactive oxygen species (ROS as well as attenuate muscle fatigue in mouse diaphragm under low PO2. Accordingly, dihydrofluorescein (a fluorescent probe was used to monitor muscular ROS production in real time with confocal microscopy during a lower PO2 condition. In the control group with no PO2 cycling, intracellular ROS formation did not appear during the first 15 min of the low PO2 period. However, after 20 min of low PO2, ROS levels increased significantly by ∼30% compared to baseline, and this increase continued until the end of the 30 min low PO2 condition. Conversely, muscles treated with PO2 cycling showed a complete absence of enhanced fluorescence emission throughout the entire low PO2 period. Furthermore, PO2 cycling-treated diaphragm exhibited increased fatigue resistance during prolonged low PO2 period compared to control. Thus, our data suggest that PO2 cycling mitigates diaphragm fatigue during prolonged low PO2. Although the exact mechanism for this protection remains to be elucidated, it is likely that through limiting excessive ROS levels, PO2 cycling initiates ROS-related antioxidant defenses.

  2. Influence of double-diaphragm vacuum compaction on deformation during forming of composite prepregs

    Directory of Open Access Journals (Sweden)

    Hassan Alshahrani

    2016-12-01

    Full Text Available During the diaphragm forming process, a vacuum seal is applied between the upper and lower diaphragms to compact and hold the laminate. Therefore, a thorough characterization of the in-plane shear behavior of fabrics under diaphragm forming conditions must take into account the effect of vacuum-sealing and compaction between the two diaphragms during bias extension. The study presented here examined the shear angles of out-of-autoclave 8-harness satin woven carbon/epoxy prepregs under diaphragm compaction. A bias extension test was conducted to study the effect of diaphragm compaction and ply interactions on shear properties. The test was performed at different compaction levels, and changes in shear angle with respect to vacuum levels and diaphragm compaction forces were observed. The contribution of diaphragm material and ply interaction to shear stiffness was evaluated and compared with results from a direct bias extension test. The samples were tested at both room temperature and at elevated temperatures using a radiant heater. The results show that shear angle decreases significantly as vacuum pressure and compaction is applied between the two diaphragms. This finding indicates that vacuum levels and compaction forces have a significant influence on the deformation limit and wrinkling onset during the diaphragm forming process.

  3. GND-PCA-based statistical modeling of diaphragm motion extracted from 4D MRI.

    Science.gov (United States)

    Swastika, Windra; Masuda, Yoshitada; Xu, Rui; Kido, Shoji; Chen, Yen-Wei; Haneishi, Hideaki

    2013-01-01

    We analyzed a statistical model of diaphragm motion using regular principal component analysis (PCA) and generalized N-dimensional PCA (GND-PCA). First, we generate 4D MRI of respiratory motion from 2D MRI using an intersection profile method. We then extract semiautomatically the diaphragm boundary from the 4D-MRI to get subject-specific diaphragm motion. In order to build a general statistical model of diaphragm motion, we normalize the diaphragm motion in time and spatial domains and evaluate the diaphragm motion model of 10 healthy subjects by applying regular PCA and GND-PCA. We also validate the results using the leave-one-out method. The results show that the first three principal components of regular PCA contain more than 98% of the total variation of diaphragm motion. However, validation using leave-one-out method gives up to 5.0 mm mean of error for right diaphragm motion and 3.8 mm mean of error for left diaphragm motion. Model analysis using GND-PCA provides about 1 mm margin of error and is able to reconstruct the diaphragm model by fewer samples.

  4. Primary intraocular lens implantation for penetrating lens trauma in Africa.

    Science.gov (United States)

    Bowman, R J; Yorston, D; Wood, M; Gilbert, C; Foster, A

    1998-09-01

    This study aimed to audit the surgical strategy of primary posterior chamber intraocular lens implantation for cases of recent penetrating trauma involving the lens in an African population. Retrospective, noncomparative case series. Seventy-two cases are reported, including all patients who underwent primary intraocular lens implantation for traumatic cataract extraction performed within 1 month of injury between 1988 and 1996. Demographic characteristics and follow-up attendance rates are analyzed. Surgical technique and the occurrence of intraoperative and postoperative complications are reported. Visual outcomes are reported with detailed analysis for cases of poor visual outcome. Mean age was 14.3 years (standard deviation = 11.1), 57 (79%) were male and 15 (21%) were female (chi-square = 23.66, P capsule had been breached by the trauma in 27 (38%) cases, and 15 of these required anterior vitrectomy. Capsular fixation of the implant was achieved in 49% of patients, the remainder having sulcus fixation. Intraoperative rupture of the posterior capsule occurred in four cases. The only common postoperative complication was acute fibrinous anterior uveitis, which occurred in 29 (40%) patients, and 32% of patients followed up for at least 6 months required secondary posterior capsulotomy. This was more common in younger patients (chi-square = 4.2, P < 0.05). Corrected postoperative visual acuities were available for 51 patients, of which 71% achieved 20/60 or better visual acuity. Patients 6 years of age or younger were less likely to achieve 20/60 (chi-square = 6.61, P = 0.01). This surgical strategy has proved successful, producing good visual results and causing no sight-threatening complications. Primary posterior capsulotomy may be appropriate for younger patients.

  5. Radiation dose to the lens and cataract formation

    International Nuclear Information System (INIS)

    Henk, J.M.; Whitelocke, R.A.F.; Warrington, A.P.; Bessell, E.M.

    1993-01-01

    The purpose of this work was to determine the radiation tolerance of the lens of the eye and the incidence of radiation-induced lens changes in patients treated by fractionated supervoltage radiation therapy for orbital tumors. Forty patients treated for orbital lymphoma and pseudotumor with tumor doses of 20--40 Gy were studied. The lens was partly shielded using lead cylinders in most cases. The dose to the germinative zone of the lens was estimated by measurements in a tissue equivalent phantom using both film densitometry and thermoluminescent dosimetry. Opthalmological examination was performed at 6 monthly intervals after treatment. The lead shield was found to reduce the dose to the germinative zone of the lens to between 36--50% of the tumor dose for Cobalt beam therapy, and to between 11--18% for 5 MeV x-rays. Consequently, the lens doses were in the range 4.5--30 Gy in 10--20 fractions. Lens opacities first appeared from between 3 and 9 years after irradiation. Impairment of visual acuity ensued in 74% of the patients who developed lens opacities. The incidence of lens changes was strongly dose-related. None was seen after doses of 5 Gy or lower, whereas doses of 16.5 Gy or higher were all followed by lens opacities which impaired visual acuity. The largest number of patients received a maximum lens dose of 15 Gy; in this group the actuarial incidence of lens opacities at 8 years was 57% with visual impairment in 38%. The adult lens can tolerate a total dose of 5 Gy during a fractionated course of supervoltage radiation therapy without showing any changes. Doses of 16.5 Gy or higher will almost invariably lead to visual impairment. The dose which causes a 50% probability of visual impairment is approximately 15 Gy. 10 refs., 4 figs., 1 tab

  6. Contribution of oxidative stress to pathology in diaphragm and limb muscles with Duchenne muscular dystrophy.

    Science.gov (United States)

    Kim, Jong-Hee; Kwak, Hyo-Bum; Thompson, LaDora V; Lawler, John M

    2013-02-01

    Duchenne muscular dystrophy (DMD) is a degenerative skeletal muscle disease that makes walking and breathing difficult. DMD is caused by an X-linked (Xp21) mutation in the dystrophin gene. Dystrophin is a scaffolding protein located in the sarcolemmal cytoskeleton, important in maintaining structural integrity and regulating muscle cell (muscle fiber) growth and repair. Dystrophin deficiency in mouse models (e.g., mdx mouse) destabilizes the interface between muscle fibers and the extracellular matrix, resulting in profound damage, inflammation, and weakness in diaphragm and limb muscles. While the link between dystrophin deficiency with inflammation and pathology is multi-factorial, elevated oxidative stress has been proposed as a central mediator. Unfortunately, the use of non-specific antioxidant scavengers in mouse and human studies has led to inconsistent results, obscuring our understanding of the importance of redox signaling in pathology of muscular dystrophy. However, recent studies with more mechanistic approaches in mdx mice suggest that NAD(P)H oxidase and nuclear factor-kappaB are important in amplifying dystrophin-deficient muscle pathology. Therefore, more targeted antioxidant therapeutics may ameliorate damage and weakness in human population, thus promoting better muscle function and quality of life. This review will focus upon the pathobiology of dystrophin deficiency in diaphragm and limb muscle primarily in mouse models, with a rationale for development of targeted therapeutic antioxidants in DMD patients.

  7. Experimental validation of the tuneable diaphragm effect in modern acoustic stethoscopes.

    Science.gov (United States)

    Nowak, Karolina M; Nowak, Lukasz J

    2017-09-01

    The force with which the diaphragm chestpiece of a stethoscope is pressed against the body of a patient during an auscultation examination introduces the initial stress and deformation to the diaphragm and the underlying tissues, thus altering the acoustic parameters of the sound transmission path. If the examination is performed by an experienced physician, he will intuitively adjust the amount of the force in order to achieve the optimal sound quality. However, in case of becoming increasingly popular auto-diagnosis and telemedicine auscultation devices with no such feedback mechanisms, the question arises regarding the influence of the possible force mismatch on the parameters of the recorded signal. The present study describes the results of the experimental investigations on the relation between pressure applied to the chestpiece of a stethoscope and parameters of the transmitted bioacoustic signals. The experiments were carried out using various stethoscopes connected to a force measurement system, which allowed to maintain fixed pressure during auscultation examinations. The signals were recorded during examinations of different volunteers, at various auscultation sites. The obtained results reveal strong individual and auscultation-site variability. It is concluded that the underlying tissue deformation is the primary factor that alters the parameters of the recorded signals. 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/.

  8. Anatomy of pudendal nerve at urogenital diaphragm--new critical site for nerve entrapment.

    Science.gov (United States)

    Hruby, Stephan; Ebmer, Johannes; Dellon, A Lee; Aszmann, Oskar C

    2005-11-01

    To investigate the relations of the pudendal nerve in this complex anatomic region and determine possible entrapment sites that are accessible for surgical decompression. Entrapment neuropathies of the pudendal nerve are an uncommon and, therefore, often overlooked or misdiagnosed clinical entity. The detailed relations of this nerve as it exits the pelvis through the urogenital diaphragm and enters the mobile part of the penis have not yet been studied. Detailed anatomic dissections were performed in 10 formalin preserved hemipelves under 3.5x loupe magnification. The pudendal nerve was dissected from the entrance into the Alcock canal to the dorsum of the penis. The branching pattern of the nerve and its topographic relationship were recorded and photographs taken. The anatomic dissections revealed that the pudendal nerve passes through a tight osteofibrotic canal just distal to the urogenital diaphragm at the entrance to the base of the penis. This canal is, in part, formed by the inferior ramus of the pubic bone, the suspensory ligament of the penis, and the ischiocavernous body. In two specimens, a fusiform pseudoneuromatous thickening was found. The pudendal nerve is susceptible to compression at the passage from the Alcock canal to the dorsum of the penis. Individuals exposed to repetitive mechanical irritation in this region are especially endangered. Diabetic patients with peripheral neuropathy can have additional compression neuropathy with decreased penile sensibility and will benefit from decompression of the pudendal nerve.

  9. Comparison of clear lens extraction and collamer lens implantation in high myopia

    Directory of Open Access Journals (Sweden)

    Ahmed M Emarah

    2010-05-01

    Full Text Available Ahmed M Emarah, Mostafa A El-Helw, Hazem M YassinCairo University, Cairo, EgyptAim: To compare the outcomes of clear lens extraction and collamer lens implantation in high myopia.Patients and methods: Myopic patients younger than 40 years old with more than 12 diopters of myopia or who were not fit for laser-assisted in situ keratomileusis were included. Group 1 comprised patients undergoing clear lens extraction and Group 2 patients received the Visian implantable collamer lens. Outcome and complications were evaluated.Results: Postoperative best corrected visual acuity was -0.61 ± 0.18 in Group 1 and 0.79 ± 0.16 in Group 2. In Group 1, 71.4% achieved a postoperative uncorrected visual acuity better than the preoperative best corrected visual acuity, while only 51.8% patients achieved this in Group 2. Intraocular pressure decreased by 12.55% in Group 1, and increased by 15.11% in Group 2. Corneal endothelial cell density decreased by 4.47% in Group 1 and decreased by 5.67% in Group 2. Posterior capsule opacification occurred in Group 1. In Group 2, lens opacification occurred in 11.11%, significant pigment dispersion in 3.7%, and pupillary block glaucoma in 3.7%.Conclusion: Clear lens extraction presents less of a financial load up front, and less likelihood of the need for a secondary intervention in the future. Clear lens extraction is a more viable solution in developing countries with limited financial resources.Keywords: clear lens extraction, implantable collamer lens, myopia

  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.

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. The Effects of Phacoemulsification and Intraocular Lens Implantation on Anatomical and Functional Parameters in Patients with Primary Angle Closure: A Prospective Study. (An American Ophthalmological Society Thesis).

    Science.gov (United States)

    Traverso, Carlo Enrico; Cutolo, Carlo Alberto

    2017-08-01

    To investigate the clinical, anatomical, and patient-reported outcomes of phacoemulsification (PE) with intraocular lens implantation performed to treat primary angle closure (PAC) and primary angle-closure glaucoma (PACG). Patients were evaluated at baseline and at 6 months after PE. The examination included visual acuity, intraocular pressure (IOP), visual field, optic nerve head, endothelial cell count (ECC), aqueous depth, and ocular biometric parameters. Patient-reported visual function and health status were assessed. Coprimary outcome measures were IOP changes, angle widening, and patient-reported visual function; secondary outcome measures were visual acuity changes, use of IOP-lowering medications, and complications. Univariate and multivariate analyses were performed to determine the predictors of IOP change. Thirty-nine cases were identified, and postoperative data were analyzed for 59 eyes, 39 with PACG and 20 with PAC. Globally, PE resulted in a mean reduction in IOP of -6.33 mm Hg (95% CI, -8.64 to -4.01, P <.001). Aqueous depth and angle measurements improved ( P <.01), whereas ECC significantly decreased ( P <.001). Both corrected and uncorrected visual acuity improved ( P <.01). The EQ visual analog scale did not change ( P =.16), but VFQ-25 improved ( P <.01). The IOP-lowering effect of PE was greater in the PACG compared to the PAC group ( P =.04). In both groups, preoperative IOP was the most significant predictor of IOP change ( P <.01). No sight-threatening complications were recorded. Our data support the usefulness of PE in lowering the IOP in patients with PAC and PACG. Although PE resulted in several anatomical and patient-reported visual improvements, we observe that a marked decrease in ECC should be carefully weighed before surgery.

  13. Facoemulsificación e implante de lente intraocular en cataratas causadas por uveitis Phacoemulsification and intraocular lens implantation in patients with cataract caused by uveitis

    Directory of Open Access Journals (Sweden)

    Dayamí Pérez Gómez

    2008-06-01

    treatment indicated anti-inflammatory drugs. Phacoemulsification with intraocular lens implantation was performed (PMMA, optic 6 mm; during the follow-up period of 24 hours to 6 months, steroidal anti-inflammatory, non-steroids and immunosuppressive drugs were prescribed to patients for 6 weeks. RESULTS: A number of alterations were observed in the anterior segment secondary to uveitis (postsurgical, unspecific, Fuch´s heterochromic cyclitis, postraumatic, Reiter´s syndrome, caused by toxoplasmosis and other infectious choroiditis and by juvenile rheumatoid arthritis. No postsurgical recurrence of uveitis was found in 9 eyes (24.3 %. The complications were related to uveitis, surgery, inflammatory activity and capsular epithelium reaction. Posterior capsular opacity occurred in 11 patients (29.7 % associated to younger age. Individual recovery was satisfactory in 30 (81.1 % patients who improved their vision, that is, 0.8-1.0 in 28 and 0.5-0.6 in 2 (5.4 % patients. CONCLUSIONS: Phacoemulsification with intraocular lens implantation is very useful to treat cataract after uveitis since surgical reaction is low, inflammation is under control and good results are achieved in addition to anatomophysiological rearrangement of the anterior segment.

  14. Capsular 'pits' in the human lens.

    OpenAIRE

    Harris, M. L.; Brown, N. A.; Shun-Shin, G. A.; Smith, G. T.

    1992-01-01

    The lens capsule is an atypical basement membrane surrounding the lens epithelial cells and lens fibres which make up the remainder of the human lens. A seemingly unreported morphological change visible in the lens capsule with the biomicroscope is described.

  15. Assessment of visual function based on IOL-Master comparing with traditional ultrasonic biometry for intraocular lens calculation in high myopia patients

    Directory of Open Access Journals (Sweden)

    Lu Zhang

    2013-10-01

    Full Text Available AIM: To evaluate the clinical feasibility of using a new optical coherence interferometry(IOL-Master, comparing with traditional ultrasonic biometry and manual keratometry in the accuracy and characteristics for intraocular lens calculation of high myopia.METHODS: The measurement of axial length was performed in 60 eyes(30 eyes for each groupwith senile cataract of high myopia(≥-6.00Dusing IOL-Master and ultrasonic biometry. The measurement of corneal power(Kwas also performed in the patient using IOL-Master and manual keratometry preoperatively. Phacoemulsification and foldable lens implantation were done on the patients. IOL power calculation was carried out according to the SRK/T formula on the basis of the group-related data. Best corrected visual acuity, refraction, contrast sensitivity and wave front aberration root mean square(RMSwere re-tested after 3 months postoperatively.RESULTS: Significant difference between the two methods in axial length measurement which was 29.81±1.53mm by ultrasound and 29.63±1.81mm by IOL-Master(P=0.001. And in corneal power measurement which was 43.22±1.67K by manual keratometry and 44.27±1.39K by IOL-Master(P=0.006. There was a significant difference between the two groups(P=0.001. 63.0% vs 31.2% had a mean absolute refractive error(MAREwithin ±0.50 diopter for the IOL-Master and A-scan groups, respectively(χ2=3.1, Pth order aberration, 4th order spherical aberration and total high order aberration in the IOL-Master group were lower than those in the A-scan group at 6mm pupil diameter 3 months later. CONCLUSION: IOL-Master is a non-contact, accurate, safe and reliable tool for calculating IOL power and it is more accurate on the design of the IOL in the cataract surgery on the high myopia patients.

  16. Contact lens rehabilitation following repaired corneal perforations

    Science.gov (United States)

    Titiyal, Jeewan S; Sinha, Rajesh; Sharma, Namrata; Sreenivas, V; Vajpayee, Rasik B

    2006-01-01

    Background Visual outcome following repair of post-traumatic corneal perforation may not be optimal due to presence of irregular keratometric astigmatism. We performed a study to evaluate and compare rigid gas permeable contact lens and spectacles in visual rehabilitation following perforating corneal injuries. Method Eyes that had undergone repair for corneal perforating injuries with or without lens aspiration were fitted rigid gas permeable contact lenses. The fitting pattern and the improvement in visual acuity by contact lens over spectacle correction were noted. Results Forty eyes of 40 patients that had undergone surgical repair of posttraumatic corneal perforations were fitted rigid gas permeable contact lenses for visual rehabilitation. Twenty-four eyes (60%) required aphakic contact lenses. The best corrected visual acuity (BCVA) of ≥ 6/18 in the snellen's acuity chart was seen in 10 (25%) eyes with spectacle correction and 37 (92.5%) eyes with the use of contact lens (p < 0.001). The best-corrected visual acuity with spectacles was 0.20 ± 0.13 while the same with contact lens was 0.58 ± 0.26. All the patients showed an improvement of ≥ 2 lines over spectacles in the snellen's acuity chart with contact lens. Conclusion Rigid gas permeable contact lenses are better means of rehabilitation in eyes that have an irregular cornea due to scars caused by perforating corneal injuries. PMID:16536877

  17. Proof mass effects on spiral electrode d33 mode piezoelectric diaphragm-based energy harvester

    KAUST Repository

    Shen, Zhiyuan; Liu, Shuwei; Miao, Jianmin; Woh, Lye Sun; Wang, Zhihong

    2013-01-01

    This paper presents the characterization of an energy harvester using a piezoelectric diaphragm as the vibration energy conversion microstructure. The diaphragm containing the spiral electrode operates in the d33 mode. The energy harvesting performance of the diaphragm was characterized. The optimal resistance load and the working frequency were characterized. The resonance tuning and the energy harvesting enhancement due to a proof mass were verified. © 2013 IEEE.

  18. Lens subluxation grading system: predictive value for ectopia lentis surgical outcomes

    OpenAIRE

    Mauro Waiswol; Niro Kasahara

    2009-01-01

    Objective: To present a classification system to grade ectopia lentis and to assess its usefulness as a predictor for surgical outcomes. Methods: Fifty-one eyes of 28 patients with either simple (19 patients) or Marfan syndrome-associated ectopia lentis (nine patients) with variable degrees of subluxation were operated on. Lens subluxation intensity was graded according to the lens subluxation grading system (LSGS) from grade 1 (lens on the whole pupillary area) up to grade 4 (lens absent fro...

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Chronic and Intermittent Angle Closure Caused by In-The-Bag Capsular Tension Ring and Intraocular Lens Dislocation in Patients With Pseudoexfoliation Syndrome.

    Science.gov (United States)

    Bochmann, Frank; Strümer, Jörg

    2017-11-01

    A subluxation or dislocation of the intraocular lens (IOL) is a well-known complication after cataract surgery in patients with pseudoexfoliation syndrome (PEX). Capsular tension rings (CTR) are frequently used to prevent postoperative complications caused by zonular weakness. Here we present a series of 7 cases, 2 with intermittent and 5 with acute angle closure caused by a combination of PEX-associated zonular weakness and a resulting unstable capsular bag-CTR-IOL complex. We describe the typical clinical course with elevated intraocular pressure, myopic shift, and shallowing of the anterior chamber in 7 patients with a new type of secondary angle closure. The diagnostic challenges and treatment options are discussed in detail. In all cases, the mechanism of angle closure identified by ultrasound biomicroscopy was an anterior dislocation of the peripheral iris by the capsular bag-CTR-IOL complex. The IOL was removed together with the capsular bag and the CTR and replaced by an iris-fixated IOL in all cases. We present a new type of secondary angle closure caused by an anterior dislocated capsular bag-CTR-IOL complex. The cause of both, this atypical presentation and the ineffectiveness of the laser peripheral iridotomy is the large diameter CTR. Therefore CTR implantation might also be the source of late postoperative complications. If a secondary angle closure associated with PEX and unstable capsular bag-CTR-IOL complex is encountered, IOL explantation and replacement by an iris-fixated IOL is a simple and effective treatment option.

  1. A Study of Free-Piston Double-Diaphragm Drivers for Expansion Tubes. Report 1

    Science.gov (United States)

    Kendall, M. A.

    1997-01-01

    In recent years the free-piston double-diaphragm driver has been used to increase the performance of the XI pilot expansion tube to super-orbital test conditions. However, the actual performance of the double-diaphragm driver was found to be considerably less than ideal. An experimental study of the double-diaphragm driver was carried out on the XI facility over a range of conditions with the objective of determining the effect of. heat losses; and the non-ideal rupture of the 'light' secondary diaphragm on the driver performance. The disparity between the theoretical and measured performance envelope are highlighted. A viscous limit for the experiments vas established. Heat transfer behind the primary shock is shown to be the mechanism behind this limit Incident, reflected and transmitted shock trajectories for the secondary diaphragm were experimentally determined and compared with computed trajectories from a one-dimensional diaphragm inertia model. It was found that the diaphragm did influence the unsteady expansion. A good agreement between experimental and computed shock trajectories was obtained using a diaphragm inertia model assuming that the diaphragm mass became negligible 3 microns after shock impact.

  2. Intraocular lens fabrication

    Energy Technology Data Exchange (ETDEWEB)

    Salazar, Mike A. (Albuquerque, NM); Foreman, Larry R. (Los Alamos, NM)

    1997-01-01

    This invention describes a method for fabricating an intraocular lens made rom clear Teflon.TM., Mylar.TM., or other thermoplastic material having a thickness of about 0.025 millimeters. These plastic materials are thermoformable and biocompatable with the human eye. The two shaped lenses are bonded together with a variety of procedures which may include thermosetting and solvent based adhesives, laser and impulse welding, and ultrasonic bonding. The fill tube, which is used to inject a refractive filling material is formed with the lens so as not to damage the lens shape. A hypodermic tube may be included inside the fill tube.

  3. Intraocular lens fabrication

    Energy Technology Data Exchange (ETDEWEB)

    Salazar, M.A.; Foreman, L.R.

    1997-07-08

    This invention describes a method for fabricating an intraocular lens made from clear Teflon{trademark}, Mylar{trademark}, or other thermoplastic material having a thickness of about 0.025 millimeters. These plastic materials are thermoformable and biocompatable with the human eye. The two shaped lenses are bonded together with a variety of procedures which may include thermosetting and solvent based adhesives, laser and impulse welding, and ultrasonic bonding. The fill tube, which is used to inject a refractive filling material is formed with the lens so as not to damage the lens shape. A hypodermic tube may be included inside the fill tube. 13 figs.

  4. Analysis of phakic before intraocular lens implantation for fundus examination

    OpenAIRE

    Juan Chen; Zhong-Ping Chen; Rui-Ling Zhu

    2014-01-01

    AIM:To investigate the findings of the eyes which were examined preoperatively by three mirror contact lens before the implantation of implantable collamer lens(ICL). To analysis the retinal pathological changes and to explore the clinical analysis of early diagnosis and treatment in retinopathy on fundus examination before operation. METHODS:The retrospective case series study included 127 eyes of 64 patients who underwent phakic intraocular lens implantation were received the fundus examina...

  5. Dynamic performance analysis of diaphragm coupling base on ABAQUS

    Directory of Open Access Journals (Sweden)

    You Wen

    2017-04-01

    Full Text Available Base on the diaphragm coupling of driving system of a rotation testing machine,FEA software ABAQUS is used to simulate the force which the coupling gets when it is working,to obtain the stress and stain during the coupling with axial misalignment and degree misalignment and to find where the maximal stress is as well as its distribution.Then the nature frequency of the coupling is calculated by use of finite element software and rotor dynamics and compared with the date of misalignment and maximum speed from the manufacture,which verifies the correctness of the model and the reliability of the calculation method.

  6. Examination of human diaphragms for trichinosis, Hiroshima and Nagasaki

    Energy Technology Data Exchange (ETDEWEB)

    Gould, S E; Ozaki, Hiroyuki; Kimura, Kazuo

    1961-11-30

    Trichinella spiralis has been found in three species of mammals born in Hokkaido so it possibly infects other species in Japan, including man. Although examination of human diaphragms in a small series of 149 autopsies in Hiroshima and 37 autopsies in Nagasaki (by digestion, compression, and microscopic sections) failed to reveal any instance of trichinous infection, it is felt that the existence or absence of human trichinosis inJapan can be determined only by examination covering a larger series of autopsies, and performed in various parts of the country. 6 references.

  7. [Diaphragm dysfunction in patients with chronic obstructive pulmonary disease

    NARCIS (Netherlands)

    Verheul, A.J.; Dekhuijzen, P.N.R.

    2003-01-01

    Chronic obstructive pulmonary disease (COPD) is characterised by alterations in the airways and lung parenchyma resulting in an increased respiratory workload. Besides an increased load and hyperinflation of the thorax, additional factors, such as systemic inflammation, oxidative stress, hypoxia and

  8. Quality of vision, patient satisfaction and long-term visual function after bilateral implantation of a low addition multifocal intraocular lens.

    Science.gov (United States)

    Pedrotti, Emilio; Mastropasqua, Rodolfo; Bonetto, Jacopo; Demasi, Christian; Aiello, Francesco; Nucci, Carlo; Mariotti, Cesare; Marchini, Giorgio

    2017-07-17

    The aim of the current study was to compare the quality of vision, contrast sensitivity and patient satisfaction with a biaspheric, segmented, rotationally asymmetric IOL (Lentis Comfort LS-313 MF 15-Oculentis GmbH, Berlin, Germany) as opposed to those of a monofocal IOL. This prospective single-blind comparative study included two groups of patients affected by bilateral senile cataract who underwent lens extraction and IOL implantation. The first group received a bilateral implantation of a monofocal IOL, and the second group received a bilateral implantation of the Comfort IOL. Twelve months after surgery uncorrected and corrected visual acuity at different distances (30, 50, 70 cm and 4 m), defocus curve and contrast sensitivity were assessed. Patient's satisfaction and spectacle independence were evaluated by mean of the NEI RQL-42 questionnaire. No significant differences were found between the groups in terms of near vision. The group of patients implanted with a Comfort IOL obtained the best results at intermediate distances (50 and 70 cm P < .001). Both groups showed an excellent uncorrected distance visual acuity (4 m). No statistically significant differences were found in terms of corrected near, intermediate and distance visual acuity. Concerning contrast sensitivity, no statistically significant differences between the groups were observed at any cycles per degree. The NEI RQL-42 questionnaire showed statistically significant differences between the group for "near vision" (P = .015), "dependence on correction" (P = .048) and "suboptimal correction" (P < .001) subscales. Our findings indicated that the Comfort IOL +1.5 D provides a good intermediate spectacle independence together with a high quality of vision, with a low amount of subjective symptoms and a contrast sensitivity similar to those obtained with a monofocal IOL.

  9. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... One Use Facts About Colored Contacts and Halloween Safety Colored Contact Lens Facts Over-the-Counter Costume ... Costume Contact Lenses Can Ruin Vision Eye Makeup Safety In fact, it is illegal to sell colored ...

  10. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... One Use Facts About Colored Contacts and Halloween Safety Colored Contact Lens Facts Over-the-Counter Costume ... new application of artificial intelligence shows whether a patient’s eyes point to high blood pressure or risk ...

  11. The lens and cataracts.

    Science.gov (United States)

    Matthews, Andrew G

    2004-08-01

    It is conservatively estimated that some form of lens opacity is present in 5% to 7% of horses with otherwise clinically normal eyes.These opacities can range from small epicapsular remnants of the fetal vasculature to dense and extensive cataract. A cataract is defined technically as any opacity or alteration in the optical homogeneity of the lens involving one or more of the following: anterior epithelium, capsule, cortex, or nucleus. In the horse, cataracts rarely involve the entire lens structure (ie, complete cataracts) and are more usually localized to one anatomic landmark or sector of the lens. Complete cataracts are invariably associated with overt and significant visual disability. Focal or incomplete cataracts alone seldom cause any apparent visual dysfunction in affected horses,however.

  12. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... One Use Facts About Colored Contacts and Halloween Safety Colored Contact Lens Facts Over-the-Counter Costume ... use of colored contact lenses , from the U.S. Food and Drug Administration (FDA). Are the colored lenses ...

  13. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... sell contacts without a prescription are breaking the law, and may be fined $11,000 per violation. " ... wear any kind of contact lens. In Butler's case, the lenses caused an infection and left her ...

  14. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... contacto de color Sep. 26, 2013 It started as an impulsive buy from a souvenir shop, but ... require the same level of care or consideration as a standard contact lens because they can be ...

  15. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... With Proper Contact Lens Care Apr 23, 2018 Solar Eclipse Inflicts Damage in the Shape of the ... edging closer, thanks to a wave of new technologies aiming to fix failing eye parts with human- ...

  16. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... glow-in-the-dark lizard lenses, costume contacts can certainly add a spooky, eye-popping touch. But ... consideration as a standard contact lens because they can be purchased over-the-counter or on the ...

  17. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... valid prescription that includes the brand name, lens measurements, and expiration date. Purchase the colored contact lenses ... with human-made versions. U.S. News Highlights the Value of Ophthalmologists APR 20, 2018 By Dan T. ...

  18. Vortex gas lens

    Science.gov (United States)

    Bogdanoff, David W.; Berschauer, Andrew; Parker, Timothy W.; Vickers, Jesse E.

    1989-01-01

    A vortex gas lens concept is presented. Such a lens has a potential power density capability of 10 to the 9th - 10 to the 10th w/sq cm. An experimental prototype was constructed, and the divergence half angle of the exiting beam was measured as a function of the lens operating parameters. Reasonably good agreement is found between the experimental results and theoretical calculations. The expanded beam was observed to be steady, and no strong, potentially beam-degrading jets were found to issue from the ends of the lens. Estimates of random beam deflection angles to be expected due to boundary layer noise are presented; these angles are very small.

  19. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... had not been properly fitted by an eye care professional, the lenses stuck to my eye like ... lenses do not require the same level of care or consideration as a standard contact lens because ...

  20. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... not require the same level of care or consideration as a standard contact lens because they can ... sell contacts without a prescription are breaking the law, and may be fined $11,000 per violation. " ...

  1. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... not require the same level of care or consideration as a standard contact lens because they can ... Us About the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms ...

  2. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... be purchased over-the-counter or on the Internet," says Thomas Steinemann, MD, professor of ophthalmology at ... ask for a prescription. There is no such thing as a "one size fits all" contact lens. ...

  3. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... prescription. Follow the contact lens care directions for cleaning, disinfecting, and wearing the lenses. Never share contact ... with Industry Medical Disclaimer Privacy Policy Terms of Service For Advertisers For Media Ophthalmology Job Center © American ...

  4. Extracción de cristalino transparente en pacientes hipermétropes Extraction of transparent crystalline lens in hypermetrope patients

    Directory of Open Access Journals (Sweden)

    Eduardo Rojas Alvarez

    2011-06-01

    Full Text Available OBJETIVOS: Describir los resultados obtenidos en la extracción de cristalino transparente de pacientes hipermétropes. MÉTODOS: Se efectuó un estudio descriptivo, prospectivo y longitudinal, en el período de septiembre de 2009 a febrero de 2010. Fueron estudiados 60 ojos de 30 pacientes con hipermetropía, quienes acudieron al Instituto Cubano de Oftalmología "Ramón Pando Ferrer" y no cumplieron los criterios establecidos para cirugía refractiva corneal. Se aplicó la fórmula Hoffer Q por IOL máster para el cálculo del lente intraocular, técnica quirúrgica estándar, facoemulsificación (facoaspiración, poder ultrasónico: 10 % (pulsado, vacío: 350 mmHg, flujo: 25 cc/min; túnel corneal, capsulorrexis amplia e implante de lente intraocular monofocal en saco capsular. Se realizó el análisis estadístico por promedio asociado a prueba T para datos pareados. RESULTADOS: La edad promedio fue de 39 ± 2,6 años. La longitud axil promedio fue de 21 ± 2 mm. La mejor agudeza visual sin corrección ascendió de 0,08 en el preoperatorio a 0,72 en el posoperatorio. La mejor agudeza visual con corrección varió de 0,92 a 0,98. El valor de la esfera se redujo de 5,25 a - 0,50 y el cilindro de 0,75 a - 0,25 dioptrías; en consecuencia, el equivalente esférico disminuyó de 4,75 en el preoperatorio a -1,00 dioptrías en el período posoperatorio, específicamente en el ojo dominante a 0,46 y en el no dominante a -0,97 dioptrÍas. CONCLUSIONES: La monovisión resulta efectiva en los pacientes. La extracción de cristalino transparente en pacientes hipermétropes es una opción útil cuando estos no son candidatos a cirugía refractiva corneal.OBJECTIVES: To describe the results obtained in the extraction of the transparent crystalline lens in hypermetrope patients. METHODS: A longitudinal, prospective and descriptive study was conducted from September, 2009 to February, 2010. Sixty eyes was studied from 30 patients presenting with

  5. Experimental Characterization of Piezoelectric Radial Field Diaphragms for Fluidic Control

    Science.gov (United States)

    Bryant, R. G.; Kavli, S. E.; Thomas, R. A., Jr.; Darji, K. J.; Mossi, K. M.

    2004-01-01

    NASA has recently developed a new piezoelectric actuator, the Radial Field Diaphragm or RFD. This actuator uses a radially-directed electric field to generate concentric out-of-plane (Z-axis) motion that allows this packaged device to be used as a pump or valve diaphragm. In order to efficiently use this new active device, experimental determination of pressure, flow rate, mechanical work, power consumption and overall efficiency needs to be determined by actually building a pump. However, without an optimized pump design, it is difficult to assess the quality of the data, as these results are inherent to the actual pump. Hence, separate experiments must be conducted in order to generate independent results to help guide the design criteria and pump quality. This paper focuses on the experiments used to generate the RFD's operational parameters and then compares these results to the experimentally determined results of several types of ball pumps. Also discussed are how errors are inherently introduced into the experiments, the pump design, experimental hardware and their effects on the overall system efficiency.

  6. Scattering study at free air ionization chamber diaphragm

    International Nuclear Information System (INIS)

    Santos, Alexandre Lo Bianco dos

    2011-01-01

    The maim of this work consisted in the assessment of the correction factor for air kerma, due to scattered radiation in the diaphragm of the free-air ionization chamber model 481. LNMRl measurements were made to acquire x-ray spectra corresponding to the Qualities RQR-M, described in IEC 61627 standards (2005). These spectra were used as input data in the MC simulations. The operational range of energy spectra provide up to 35 keV. This energy range is typically used in diagnostic radiology, although there is not primary standard for air kerma. The determination of this factor is a fundamental process in the primary standardization of the air kerma. These factors were obtained by computer simulation using the Penelope code. The results are k RQR-M1 =0,9946, k RQR -M2 =0,9932, k RQR-M3 =0,9978 and k RQR-M4 =0,9885; with uncertainties of 0,007 and coverage factor equal to 2. lt can be concluded that, with respect to the diaphragm, the chamber can be used in the primary standard of air kerma. (author)

  7. Clinical study of ultrasound-guided percutaneous radiofrequency ablation for primary hepatic carcinoma adjacent to the diaphragm

    Directory of Open Access Journals (Sweden)

    LI Meng

    2015-04-01

    Full Text Available ObjectiveTo investigate the safety and efficacy of ultrasound (US-guided percutaneous radiofrequency ablation (RFA for primary hepatic carcinoma adjacent to the diaphragm. MethodsThis study included 277 patients with 362 lesions of primary hepatic carcinoma managed with US-guided percutaneous RFA in 302 Hospital of PLA from January 2011 to October 2014. Sixty-six patients with 71 hepatocellular carcinomas (HCCs located less than 5 mm from the diaphragm were in study group, and 95 patients with 114 HCCs located more than 10 mm from the hepatic surface were in control group. The patients′ symptoms and complications were observed after the therapy. The complete ablation rate, local tumor progression rate, and complication rate were compared between the two groups. Comparison of continuous data between the two groups was made by independent-samples t test, while comparison of categorical data was made by chi-square test. ResultsAt one month after operation, 65 (91.5% of 71 tumors in the study group and 107 (93.9% of 114 tumors in the control group achieved complete ablation, according to contrast-enhanced CT and MRI, and there was no significant difference between the two groups (χ2=0.36, P=0.55. The postoperative follow-up showed that the local tumor progression rates in the study group and control group were 16.9% and 13.2%, respectively, without significant difference between the two groups (χ2=0.49, P=0.48. In the study group, 22 patients developed adverse reactions, versus 37 patients in the control group (χ2=2.60, P=0.11. ConclusionUS-guided percutaneous RFA is a safe and effective means for the treatment of primary hepatic carcinoma adjacent to the diaphragm.

  8. Extra Lobes of Liver and Congenital Anomalies of Diaphragm in Children

    Directory of Open Access Journals (Sweden)

    I.P. Zhurylo

    2014-09-01

    Full Text Available The literature data on hepatic congenital anomalies in children are summarized in this article. Three clinical observations of transposition of extra lobe of the liver (ELL into the thoracic cavity in children were analyzed. The true diaphragmatic hernia was found in all cases. Clinical manifestations of this disease depend on the severity of the compression of mediastinum organs. Indications for surgical correction were determined individually. ELL move into the abdominal cavity, excision of the hernia sac and alloplasty of the diaphragmatic defect were performed for one patient. Possible mechanisms for the formation of these complex congenital malformations were discussed based on the comparison of clinical data with the stages of embryogenesis liver, diaphragm and heart.

  9. [Chronic recurrent volvulus of the colonic splenic flexure associated with the eventration of left diaphragm].

    Science.gov (United States)

    Kim, Hee Sun; Yoo, Jeong Seon; Han, Seok Joo; Park, Hyojin

    2007-01-01

    The eventration of diaphragm is usually found incidentally on chest X-ray or sometimes presented as acute gastric volvulus. However, colonic volvulus on splenic flexure area complicated by diaphragmatic eventration is extremely rare. A 25 year old man complained of upper abdominal pain for three days. He had a history of brain injury during infant period, and had epilepsy and mental retardation. Plain chest X-ray showed left diaphragmatic eventration and marked dilatation of colon on splenic flexure area which had not been changed for last three years. Barium enema showed bird beak appearance on distal colon near the splenic flexure. Colonoscopic reduction failed. After decompression with rectal and nasogastric tubes, colonic volvulus was relieved. To prevent the recurrence of volvulus, we performed segmental resection of left colon including splenic flexure area and repaired the left diaphragmatic eventration. After the operation, the patient had no further recurrent episode of volvulus although ileus persisted.

  10. [Phacoemulsification of subluxated lens with capsular tension ring implantation].

    Science.gov (United States)

    Dorecka, Mariola; Rokicki, Wojciech; Nita, Malgorzata; Krysik, Katarzyna; Nita, Ewa; Sikorska, Aleksandra; Romaniuk, Wanda

    2007-01-01

    To evaluate long term results of phacoemulsification with PC IOL and capsular tension ring (CTR) implantation in lens subluxation. The study comprised of 134 patients--146 eyes with subluxated lens. In all cases phacoemulsification with PC IOL and CTR implantation was performed. No intaroperative complications has occured. Postoperative complications included: inflammation in the anterior chamber in 3 eyes (2.1%), retinal detachment in 2 eyes (1.4%). In all cases there was no PC IOL decentration. (1) CTR facilitates phacoemulsification with PC IOL implantation in lens subluxation. (2) Phacoemulsification of subluxated lens with PC IOL and CTR implantation seems to be safe and effective procedure.

  11. Using a Five-Factor Lens to Explore the Relation Between Personality Traits and Violence in Psychiatric Patients

    Science.gov (United States)

    Skeem, Jennifer L.; Miller, Joshua D.; Mulvey, Edward; Tiemann, Jenny; Monahan, John

    2005-01-01

    Recent work suggests that predictors of violence are similar for individuals with and without mental illness. Although psychopathy is among the most potent of such predictors, the nature of its relation to violence is unclear. On the basis of a sample of 769 civil psychiatric patients, the authors explore the possibility that measures of…

  12. One stage resection of spontaneous rupture of hepatocellular carcinoma in the triangular ligament with diaphragm invasion: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Park Kwang-Kuk

    2012-09-01

    Full Text Available Abstract A spontaneous rupture of hepatocellular carcinoma (HCC can lead to extensive hemorrhage and is a rare but life-threatening event. A 58-year-old male patient with no history of trauma presented at our institution with severe epigastric pain and abdominal distension for 6 h. His blood pressure was a 60/40 mmHg, and pulse rate was 132/min. Abdominal contrast enhanced computed tomography (CT imaging revealed a ruptured mass under the left diaphragm and fluid collection in the upper abdomen, flanks and pelvic cavity. Exploratory laparotomy confirmed the presence of an active bleeding tumor in the triangular ligament invading into the diaphragm. The tumor was resected with an appropriate diaphragm margin. The resected tumor was 5 cm in diameter and pathologically identified as hepatocellular carcinoma with a negative surgical margin. This case report shows that ruptured hepatocellular carcinoma should be considered in the differential diagnosis of non-traumatic hemoperitoneum. And it is necessary to set a surgical plan for unpredictable HCC rupture with direct diaphragm invasion.

  13. The influence of tensile forces on the deflection of circular diaphragms in pressure sensors

    NARCIS (Netherlands)

    Voorthuyzen, J.A.; Bergveld, Piet

    1984-01-01

    It is known that the deflection of a diaphragm is determined by two mechanisms, bending moments or bending stress and tensile forces or membrane stress. Usually the influence of tensile forces is not taken into account when calculating the mechanical properties of thin diaphragms. Hence the

  14. Free radicals in hypoxic rat diaphragm contractility: no role for xanthine oxidase.

    NARCIS (Netherlands)

    Heunks, L.M.A.; Machiels, H.A.; Abreu, R.A. de; Zhu, X.; Heijden, E. van der; Dekhuijzen, P.N.R.

    2001-01-01

    Recent evidence indicates that hypoxia enhances the generation of oxidants. Little is known about the role of free radicals in contractility of the rat diaphragm during hypoxia. We hypothesized that antioxidants improve contractility of the hypoxic rat diaphragm and that xanthine oxidase (XO) is an

  15. Diffusivity measurements in some organic solvents by a gas-liquid diaphragm cell

    NARCIS (Netherlands)

    Littel, R.J.; Littel, R.J.; Versteeg, Geert; van Swaaij, Willibrordus Petrus Maria

    1992-01-01

    A diaphragm cell has been developed for the measurement of diffusion coefficients of gases In liquids. The diaphragm cell is operated batchwise with respect to both gas and liquid phases, and the diffusion process Is followed by means of the gas pressure decrease which is recorded by means of a

  16. Diffusivity Measurements in Some Organic Solvents by a Gas-Liquid Diaphragm Cell

    NARCIS (Netherlands)

    Littel, Rob J.; Versteeg, Geert F.; Swaaij, Wim P.M. van

    1992-01-01

    A diaphragm cell has been developed for the measurement of diffusion coefficients of gases in liquids. The diaphragm cell is operated batchwise with respect to both gas and liquid phases, and the diffusion process is followed by means of the gas pressure decrease which is recorded by means of a

  17. Design of calandria-end shield support diaphragm of Narora Atomic Power Project

    Energy Technology Data Exchange (ETDEWEB)

    Srivastava, S K; Nanda Kumar, S; Kakodkar, A

    1975-01-01

    The calandria-end shield diaphragm is one of the important components in Narora Atomic Power Plant. The support diaphragm is designed against elastic and plastic instability failures. Method of analysis for elastic and plastic instability is discussed for normal loading, pipe rupture loading, and earthquake loading.

  18. Design of calandria-end shield support diaphragm of Narora Atomic Power Project

    International Nuclear Information System (INIS)

    Srivastava, S.K.; Nanda Kumar, S.; Kakodkar, A.

    1975-01-01

    The calandria-end shield diaphragm is one of the important components in Narora Atomic Power Plant. The support diaphragm is designed against elastic and plastic instability failures. Method of analysis for elastic and plastic instability is discussed for normal loading, pipe rupture loading and earthquake loading. (author)

  19. Phakic Intraocular Lens Implantation: Refractive Outcome and Safety in Patients with Anterior Chamber Depth between 2.8 and 3.0 versus ≥3.0 mm.

    Science.gov (United States)

    Guerra, Marta G; Silva, Andreia M M; Marques, Sara H M; Melo, Sofia H; Póvoa, João A; Lobo, Conceição; Murta, Joaquim Neto

    2017-01-01

    To compare endothelial cell (EC) variation after anterior chamber phakic intraocular lens (AC-pIOL) implantation in highly myopic patients with a preoperative anterior chamber depth (ACD) between 2.8 and 3.0 versus ≥3.0 mm. A total of 280 eyes submitted to primary AC-pIOL implantation were analyzed. Pre- and postoperative values for uncorrected distance visual acuity, corrected distance visual acuity, spherical equivalent, ACD (endothelial surface), and EC count were collected. The eyes were divided into 2 groups: group A - ACD between 2.8 and 3.0 mm; group B - ACD ≥3.0 mm. Mean global EC loss (ECL) and loss for each ACD group, according to pIOL type, were analyzed. Significant improvement of the spherical equivalent (-11.38 ± 4.57 vs. -0.49 ± 0.79; p = 0.000) and a significant decrease in EC density (2,810.95 ± 343.88 vs. 2,584.09 ± 374.88 cells/mm2; p = 0.000) were noted. The mean annual ECL was -2.19 ± 3.97%. Regarding group A (n = 80), a mean annual ECL of -2.06 ± 3.88% was registered, higher for the Acrysof Cachet® subtype, while group B (n = 200) showed -2.25 ± 4.01% ECL, higher for the Verisyse® subtype. There was no significant difference between the groups (p = 0.96). AC-pIOL implantation significantly improves the spherical equivalent in myopic patients. The mean annual ECL after pIOL implantation was higher in the larger ACD group, but this value was not statistically significant. A 2.8-mm ACD value seems to be a safe cutoff for AC-pIOL implantation. © 2017 S. Karger AG, Basel.

  20. The diaphragms of fenestrated endothelia: gatekeepers of vascular permeability and blood composition.

    Science.gov (United States)

    Stan, Radu V; Tse, Dan; Deharvengt, Sophie J; Smits, Nicole C; Xu, Yan; Luciano, Marcus R; McGarry, Caitlin L; Buitendijk, Maarten; Nemani, Krishnamurthy V; Elgueta, Raul; Kobayashi, Takashi; Shipman, Samantha L; Moodie, Karen L; Daghlian, Charles P; Ernst, Patricia A; Lee, Hong-Kee; Suriawinata, Arief A; Schned, Alan R; Longnecker, Daniel S; Fiering, Steven N; Noelle, Randolph J; Gimi, Barjor; Shworak, Nicholas W; Carrière, Catherine

    2012-12-11

    Fenestral and stomatal diaphragms are endothelial subcellular structures of unknown function that form on organelles implicated in vascular permeability: fenestrae, transendothelial channels, and caveolae. PV1 protein is required for diaphragm formation in vitro. Here, we report that deletion of the PV1-encoding Plvap gene in mice results in the absence of diaphragms and decreased survival. Loss of diaphragms did not affect the fenestrae and transendothelial channels formation but disrupted the barrier function of fenestrated capillaries, causing a major leak of plasma proteins. This disruption results in early death of animals due to severe noninflammatory protein-losing enteropathy. Deletion of PV1 in endothelium, but not in the hematopoietic compartment, recapitulates the phenotype of global PV1 deletion, whereas endothelial reconstitution of PV1 rescues the phenotype. Taken together, these data provide genetic evidence for the critical role of the diaphragms in fenestrated capillaries in the maintenance of blood composition. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. Vitrectorhexis and lens aspiration with posterior chamber intraocular lens implantation in spherophakia.

    Science.gov (United States)

    Al-Haddad, Christiane; Khatib, Lama

    2012-07-01

    We describe a technique that uses the vitrector to perform successful lens aspiration and posterior chamber intraocular lens (IOL) implantation in children with spherophakia and anterior lens subluxation. After an anterior chamber maintainer is placed, the ocutome is introduced through a limbal incision to perform a circular vitrectorhexis to avoid excessive manipulation of the unstable lens followed by gentle cortex aspiration. A foldable IOL is injected into the sulcus (3-piece IOL) or bag (1-piece IOL) if the capsule is sufficiently stable. Through a pars plana incision, the ocutome is then used to perform a posterior capsulotomy to prevent late posterior capsule opacification. In our patient, sulcus IOL placement was more stable than in-the-bag placement. Neither author has a financial or proprietary interest in any material or method mentioned. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  2. Corticosteroid effects on ventilator-induced diaphragm dysfunction in anesthetized rats depend on the dose administered

    Directory of Open Access Journals (Sweden)

    Decramer Marc

    2010-12-01

    Full Text Available Abstract Background High dose of corticosteroids has been previously shown to protect against controlled mechanical ventilation (CMV-induced diaphragmatic dysfunction while inhibiting calpain activation. Because literature suggests that the calpain inhibiting effect of corticosteroid depends on the dose administered, we determined whether lower doses of corticosteroids would also provide protection of the diaphragm during CMV. This may be important for patients undergoing mechanical ventilation and receiving corticosteroids. Methods Rats were assigned to controls or to 24 hours of CMV while being treated at the start of mechanical ventilation with a single intramuscular administration of either saline, or 5 mg/kg (low MP or 30 mg/kg (high MP of methylprednisolone. Results Diaphragmatic force was decreased after CMV and this was exacerbated in the low MP group while high MP rescued this diaphragmatic dysfunction. Atrophy was more severe in the low MP group than after CMV while no atrophy was observed in the high MP group. A significant and similar increase in calpain activity was observed in both the low MP and CMV groups whereas the high dose prevented calpain activation. Expression of calpastatin, the endogenous inhibitor of calpain, was decreased in the CMV and low MP groups but its level was preserved to controls in the high MP group. Caspase-3 activity increased in all CMV groups but to a lesser extent in the low and high MP groups. The 20S proteasome activity was increased in CMV only. Conclusions Administration of 30 mg/kg methylprednisolone during CMV protected against CMV-induced diaphragm dysfunction while 5 mg/kg was more deleterious. The protective effect is due mainly to an inhibition of the calpain system through preservation of calpastatin levels and to a lesser extent to a caspase-3 inhibition.

  3. Diaphragm motion quantification in megavoltage cone-beam CT projection images.

    Science.gov (United States)

    Chen, Mingqing; Siochi, R Alfredo

    2010-05-01

    To quantify diaphragm motion in megavoltage (MV) cone-beam computed tomography (CBCT) projections. User identified ipsilateral hemidiaphragm apex (IHDA) positions in two full exhale and inhale frames were used to create bounding rectangles in all other frames of a CBCT scan. The bounding rectangle was enlarged to create a region of interest (ROI). ROI pixels were associated with a cost function: The product of image gradients and a gradient direction matching function for an ideal hemidiaphragm determined from 40 training sets. A dynamic Hough transform (DHT) models a hemidiaphragm as a contour made of two parabola segments with a common vertex (the IHDA). The images within the ROIs are transformed into Hough space where a contour's Hough value is the sum of the cost function over all contour pixels. Dynamic programming finds the optimal trajectory of the common vertex in Hough space subject to motion constraints between frames, and an active contour model further refines the result. Interpolated ray tracing converts the positions to room coordinates. Root-mean-square (RMS) distances between these positions and those resulting from an expert's identification of the IHDA were determined for 21 Siemens MV CBCT scans. Computation time on a 2.66 GHz CPU was 30 s. The average craniocaudal RMS error was 1.38 +/- 0.67 mm. While much larger errors occurred in a few near-sagittal frames on one patient's scans, adjustments to algorithm constraints corrected them. The DHT based algorithm can compute IHDA trajectories immediately prior to radiation therapy on a daily basis using localization MVCBCT projection data. This has potential for calibrating external motion surrogates against diaphragm motion.

  4. Symmetric lens with extended depth of focus

    OpenAIRE

    Cho, Sung Nae

    2008-01-01

    The lens surface profile is derived based on the instantaneous focal length versus the lens radius data. The lens design based on instantaneous focal length versus the lens radius data has many useful applications in software assisted image focusing technology.

  5. A catoptric lens

    International Nuclear Information System (INIS)

    Rambauske, W.R.

    1973-01-01

    The invention relates to a catoptric lens for combining energies transmitted by several sources such as lasers; said lens comprising mirrors, the reflective surfaces of which have their focuses spaced from a common axis of symmetry. By means of these reflecting surfaces, which are generated by the nutation of portions of quadratic conics about the axis of symmetry, it is possible to focus the energy emmited by several lasers at the focus of the exit-mirror reflecting surface. This can be applied to thermonuclear fusion [fr

  6. Laparoscopic repair of penetrating injury of the diaphragm: an experience from a district hospital

    Directory of Open Access Journals (Sweden)

    Ali Yahya

    2008-01-01

    Full Text Available In this study we review our experience in using laparoscopy as a diagnostic and therapeutic tool in dealing with penetrating diaphragmatic injuries due to stab wounds and look at the feasibility of using this procedure in other similar institutions.Thirty patients, all of whom were males 20-30 years of age, presented to the surgical emergency unit of our hospital with upper abdominal and lower chest wall stab wounds between 01-05-1998 and 30-11-2006. Diagnosis of the diaphragm injury was either obvious with omentum herniating through the chest wall, or occult with confirmation of the injury at laparoscopy.All patients underwent diagnostic laparoscopy, which resulted in identification and efficient treatment of eight patients with diaphragmatic injury, and thereby laparotomy was avoided. The procedure converted to open surgery in one patient because of a small left-sided colonic tear. Laparoscopy is an efficient tool for the diagnosis and management of diaphragmatic injuries. It should be used routinely instead of exploratory laparotomy in haemodynamically stable patients with penetrating lower chest injuries.

  7. DOUBLE BOSS SCULPTURED DIAPHRAGM EMPLOYED PIEZORESISTIVE MEMS PRESSURE SENSOR WITH SILICON-ON-INSULATOR (SOI

    Directory of Open Access Journals (Sweden)

    D. SINDHANAISELVI

    2017-07-01

    Full Text Available This paper presents the detailed study on the measurement of low pressure sensor using double boss sculptured diaphragm of piezoresistive type with MEMS technology in flash flood level measurement. The MEMS based very thin diaphragms to sense the low pressure is analyzed by introducing supports to achieve linearity. The simulation results obtained from Intellisuite MEMS CAD design tool show that very thin diaphragms with rigid centre or boss give acceptable linearity. Further investigations on very thin diaphragms embedded with piezoresistor for low pressure measurement show that it is essential to analyse the piezoresistor placement and size of piezoresistor to achieve good sensitivity. A modified analytical modelling developed in this study for double boss sculptured diaphragm results were compared with simulated results. Further the enhancement of sensitivity is analyzed using non uniform thickness diaphragm and Silicon-On-Insulator (SOI technique. The simulation results indicate that the double boss square sculptured diaphragm with SOI layer using 0.85μm thickness yields the higher voltage sensitivity, acceptable linearity with Small Scale Deflection.

  8. Design of Diaphragm Based MEMS Pressure Sensor with Sensitivity Analysis for Environmental Applications

    Directory of Open Access Journals (Sweden)

    A. Nallathambi

    2015-05-01

    Full Text Available In this paper Micro-electromechanical System (MEMS diaphragm based pressure sensor for environmental applications is discussed. The main focus of this paper is to design, simulate and analyze the sensitivity of MEMS based diaphragm using different structures to measure the low and high pressure values. The simulation is done through the finite element tool and specifications related the maximum convinced stress; deflection and sensitivity of the diaphragms have been analyzed using the software INTELLISUITE 8.7v. The change in pressure is to bending of the diaphragm that modifies the measured displacement between the substrate and the diaphragm. This change in displacement gives the measure of the pressure in that environment. The design of these studies can be used to improve the sensitivity of these devices. Here the diaphragm based pressure sensor produced better displacement, sensitivity and stress output responses are obtained from the square diaphragm. The pressure range from 0.6 MPa to 25 MPa and its maximum displacement is accordingly 59 mm over a pressure range of 0 to 2 MPa. Its sensitivity is therefore 2.35 [10E-12/Pa].

  9. Convergence of pattern generator outputs on a common mechanism of diaphragm motor unit recruitment.

    Science.gov (United States)

    Mantilla, Carlos B; Seven, Yasin B; Sieck, Gary C

    2014-01-01

    Motor units are the final element of neuromotor control. In manner analogous to the organization of neuromotor control in other skeletal muscles, diaphragm motor units comprise phrenic motoneurons located in the cervical spinal cord that innervate the diaphragm muscle, the main inspiratory muscle in mammals. Diaphragm motor units play a primary role in sustaining ventilation but are also active in other nonventilatory behaviors, including coughing, sneezing, vomiting, defecation, and parturition. Diaphragm muscle fibers comprise all fiber types. Thus, diaphragm motor units display substantial differences in contractile and fatigue properties, but importantly, properties of the motoneuron and muscle fibers within a motor unit are matched. As in other skeletal muscles, diaphragm motor units are recruited in order such that motor units that display greater fatigue resistance are recruited earlier and more often than more fatigable motor units. The properties of the motor unit population are critical determinants of the function of a skeletal muscle across the range of possible motor tasks. Accordingly, fatigue-resistant motor units are sufficient to generate the forces necessary for ventilatory behaviors, whereas more fatigable units are only activated during expulsive behaviors important for airway clearance. Neuromotor control of diaphragm motor units may reflect selective inputs from distinct pattern generators distributed according to the motor unit properties necessary to accomplish these different motor tasks. In contrast, widely distributed inputs to phrenic motoneurons from various pattern generators (e.g., for breathing, coughing, or vocalization) would dictate recruitment order based on intrinsic electrophysiological properties. © 2014 Elsevier B.V. All rights reserved.

  10. Analytical investigation of bidirectional ductile diaphragms in multi-span bridges

    Science.gov (United States)

    Wei, Xiaone; Bruneau, Michel

    2018-04-01

    In the AASHTO Guide Specifications for Seismic Bridge Design Provisions, ductile diaphragms are identified as Permissible Earthquake-Resisting Elements (EREs), designed to help resist seismic loads applied in the transverse direction of bridges. When adding longitudinal ductile diaphragms, a bidirectional ductile diaphragm system is created that can address seismic excitations acting along both the bridge's longitudinal and transverse axes. This paper investigates bidirectional ductile diaphragms with Buckling Restrained Braces (BRBs) in straight multi-span bridge with simply supported floating spans. The flexibility of the substructures in the transverse and longitudinal direction of the bridge is considered. Design procedures for the bidirectional ductile diaphragms are first proposed. An analytical model of the example bridge with bidirectional ductile diaphragms, designed based on the proposed methodology, is then built in SAP2000. Pushover and nonlinear time history analyses are performed on the bridge model, and corresponding results are presented. The effect of changing the longitudinal stiffness of the bidirectional ductile diaphragms in the end spans connecting to the abutment is also investigated, in order to better understand the impact on the bridge's dynamic performance.

  11. Investigation of the Durability of a Diaphragm for a Total Artificial Heart.

    Science.gov (United States)

    Gräf, Felix; Rossbroich, Ralf; Finocchiaro, Thomas; Steinseifer, Ulrich

    2016-10-01

    One of the most critical components regarding the durability of the ReinHeart total artificial heart (TAH) is its biocompatible diaphragm, which separates the drive unit from the ventricles. Hence, a durability tester was designed to investigate its required 5-year lifetime. The aim of this study was to prove the validity of accelerated testing of the polyurethane diaphragm. The durability tester allows simultaneous testing of 12 diaphragms and mimics physiological conditions. To accelerate the time of testing, it operates with an increased speed at a frequency of 8 Hz. To prove the correctness of this acceleration, a servo-hydraulic testing machine was used to study the effect of different frequencies and their corresponding loads. Thereby the viscoelastic behavior of the polyurethane was investigated. Additionally, high-speed video measurements were performed. The force against frequency and the high-speed video measurements showed constant behavior. In the range of 1-10 Hz, the maximum resulting forces varied by 3%, and the diaphragm movement was identical. Frequencies below 10 Hz allow a valid statement of the diaphragm's mechanical durability. Viscoelasticity of the polyurethane in the considered frequency-range is negligible. The accelerated durability test is applicable to polyurethane diaphragms, and the results are applicable to TAH use. The reliability of the diaphragm for a lifetime of 5 years was found to be 80% with a confidence of 62%. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  12. Method of production of a diaphragm for instruments in particle optics and diaphragm fabricated by this method

    International Nuclear Information System (INIS)

    Sandrik, J.; Krohne, P.

    1975-01-01

    The production method of, e.g., a circular diaphragm for an electron microscope is based on copper plate as supporting material. A light-sensitive, electrically insulating layer is coated on this. After exposing and freeing the positions of this layer, e.g., the circular interior as well as the cross-piece to the exterior of the diaghragm, a galvanic building-up of a noble metal layer follows, e.g. gold, on these now free positions. After freeing the remaining non-exposed material, an etching-protective lacquer is coated on the positions of the supporting material which are to be maintained. The remaining parts of the supporting material are then removed by positive etching. (DG/LH) [de

  13. Protection of the eye lens

    International Nuclear Information System (INIS)

    2015-01-01

    The limit of radiation exposure for eye lens is going to decrease dramatically from 150 to 20 mSv as a transposition into the French law of a CIPR (International Commission for Radiation Protection) directive. Sanitary studies have shown that radiologists are more likely by a factor of 3.8 to get eye lens opacities than the rest of the population. The wearing of protective glasses is recommended and in order to get a better monitoring of the radiation dose new dosimeters have been designed, they can be worn on the glass frame of directly stuck on the skin near the eyes. A study has shown that veterinary surgeons that are accustomed to stay near animals to keep them quiet during radiological exams are prone to receive high doses as well as physicians that use hypnosis to decrease the level of anxiety of their patients during radiological exams. Radiation exposure of radiologists can be mitigated through: the use of protective shields and equipment and the optimization of the dose delivered to the patient. (A.C.)

  14. [Intraocular lens implantation with one loop haptic amputated: a new propose to the subluxation lens surgical treatment].

    Science.gov (United States)

    Ventura, Marcelo; Endriss, Daniela

    2010-01-01

    To evaluate the postoperative results of congenital lens subluxation corrected by a new technique. Retrospective chart review of 21 eyes of 13 patients with no traumatic lens subluxation who underwent surgery in Altino Ventura Foundation from April, 1999 to April, 2004. The mean age was 8.7 +/- 5.4 years old, and the mean follow-up period was 21.5 +/- 19.3 months. Patients underwent phacoaspiration, endocapsular ring and intraocular lens (IOL) implantation. The implanted IOL had one loop haptic excised and was supported above the ring, inside the capsular bag promoting intraocular lens centralization. Visual acuity improvement was observed in all cases. There was a significant reduction of the spherical equivalent and spherical component comparing the pre and postoperative refraction (psubluxation surgical treatment, promoting lens centralization and postoperative visual acuity improvement.

  15. Effect of Elastase-induced Emphysema on the Force-generating Ability of the Diaphragm

    Science.gov (United States)

    Supinski, Gerald S.; Kelsen, Steven G.

    1982-01-01

    The effect of emphysema on the ability of the diaphragm to generate force was examined in costal diaphragm muscle strips from 10 Golden hamsters killed 18 mo after intratracheal injection of pancreatic elastase in a dose producing hyperinflation (mean total lung capacity [TLC] = 163% of control) and generalized panacinar emphysema. 13 saline-injected normal animals served as controls. The time course of isometric tension and the effect of alterations in muscle fiber and sarcomere length on the isometric tension (T) generated in response to tetanizing electrical stimuli (length-tension [L-T] relationship) were examined. Elastase administration caused an increase in diaphragm muscle thickness and reduction in the length of costal diaphragm muscle fibers measured in situ. Emphysema significantly increased the maximum tetanic tension as a result of hypertrophy. Maximal tension corrected for increases in muscle cross-sectional area (T/cm2), however, was the same in emphysematous (E) and control (C) animals. Emphysema also shifted the muscle fiber L-T curve of the diaphragm but not of a control muscle, the soleus, toward shorter lengths. In contrast to the effects of E on the diaphragm muscle fiber L-T curve, the sarcomere L-T curve was the same in E and C. Since the length at which tension was maximal correlated closely with sarcomere number (r = 0.94; P < 0.001) reduction in the number of sarcomeres in series in muscles from emphysematous animals appeared to explain the shift in the muscle fiber L-T curve. We conclude that in elastase-induced emphysema adaptive changes both in diaphragm cross-sectional area and sarcomere number augment the force-generating ability of the diaphragm. We speculate that changes in sarcomere number compensate for alterations in muscle fiber length resulting from chronic hyperinflation of the thorax, while diaphragmatic muscle hypertrophy represents a response to changes in respiratory load and/or diaphragm configuration (La

  16. A Tribute to Len Barton

    Science.gov (United States)

    Tomlinson, Sally

    2010-01-01

    This article constitutes a short personal tribute to Len Barton in honour of his work and our collegial relationship going back over 30 years. It covers how Len saw his intellectual project of providing critical sociological and political perspectives on special education, disability and inclusion, and his own radical political perspectives. Len's…

  17. Luneburg lens in silicon photonics.

    Science.gov (United States)

    Di Falco, Andrea; Kehr, Susanne C; Leonhardt, Ulf

    2011-03-14

    The Luneburg lens is an aberration-free lens that focuses light from all directions equally well. We fabricated and tested a Luneburg lens in silicon photonics. Such fully-integrated lenses may become the building blocks of compact Fourier optics on chips. Furthermore, our fabrication technique is sufficiently versatile for making perfect imaging devices on silicon platforms.

  18. Internally-cooled centrifugal compressor with cooling jacket formed in the diaphragm

    Science.gov (United States)

    Moore, James J.; Lerche, Andrew H.; Moreland, Brian S.

    2014-08-26

    An internally-cooled centrifugal compressor having a shaped casing and a diaphragm disposed within the shaped casing having a gas side and a coolant side so that heat from a gas flowing though the gas side is extracted via the coolant side. An impeller disposed within the diaphragm has a stage inlet on one side and a stage outlet for delivering a pressurized gas to a downstream connection. The coolant side of the diaphragm includes at least one passageway for directing a coolant in a substantially counter-flow direction from the flow of gas through the gas side.

  19. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... prescription. There is no such thing as a "one size fits all" contact lens. Lenses that are not properly fitted may scratch the eye or cause blood vessels to grow into the cornea. Even if you have perfect vision, you need to get an eye exam and a prescription ...

  20. Contact Lens Risks

    Science.gov (United States)

    ... There is a risk of eye infection from bacteria in swimming pool water, hot tubs, lakes and the ocean Replace your contact lens storage case every 3 months or as directed by your eye care professional. Other Risks of Contact Lenses Other risks of contact lenses include pink eye ( ...

  1. MISSING: BUBBLE CHAMBER LENS

    CERN Multimedia

    2001-01-01

    Would the person who borrowed the large bubble chamber lens from the Microcosm workshops on the ISR please return it. This is a much used piece from our object archives. If anybody has any information about the whereabouts of this object, please contact Emma.Sanders@cern.ch Thank you

  2. The Lens of Chemistry

    Science.gov (United States)

    Thalos, Mariam

    2013-01-01

    Chemistry possesses a distinctive theoretical lens--a distinctive set of theoretical concerns regarding the dynamics and transformations of a perplexing variety of organic and nonorganic substances--to which it must be faithful. Even if it is true that chemical facts bear a special (reductive) relationship to physical facts, nonetheless it will…

  3. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... wear any kind of contact lens. In Butler's case, the lenses caused an infection and left her with a corneal ... A recent article from U.S. News and World Report explains what ophthalmologists are and how they can ...

  4. Quadrupole magnetic lens

    International Nuclear Information System (INIS)

    Piskunov, V.A.

    1981-01-01

    The following connection of windings of electromagnet is suggested for simplification of the design of qUadrupole magnetic lens intended for use in radiotechnical and electron-optical devices. The mentioned windings are connected with each other by a bridge scheme and the variable resistors are switched in its diagonals in the lens containing four electromagnet with windings connected with two variable resistors the mobile contacts of which are connected with a direct current source. Current redistribution between left windings and right windings takes place at shift of mobile contact of variable resistor, and current redistribution between upper and low coils of electromagnets takes place at shifting mobile contact of the other variable resistor. In this case smooth and independent electron-optical misalignment of lens by two mutually perpendicular directions proceeds. Use of the given design of the lens in the oscillograph permits to use printing assembly for alignment plate and to reduce the number of connections at the expense of decreasing the number of resistors

  5. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... can be purchased over-the-counter or on the Internet," says Thomas Steinemann, MD, professor of ophthalmology at ... ask for a prescription. There is no such thing as a "one size fits all" contact lens. Lenses that are not properly fitted may scratch the eye or cause blood vessels to grow into ...

  6. Combined transarterial chemoembolization of the right inferior phrenic artery and radiofrequency ablation for small hepatocellular carcinoma near the diaphragm: its efficacy and safety.

    Science.gov (United States)

    Hyun, Dongho; Cho, Sung Ki; Shin, Sung Wook; Park, Kwang Bo; Lee, Sang Yub; Park, Hong Suk; Choo, Sung Wook; Do, Young Soo

    2018-02-28

    The purpose of the study is to report the efficacy and safety of combined transarterial chemoembolization (TACE) of the right inferior phrenic artery (IPA) and radiofrequency ablation (RFA) for small hepatocellular carcinoma (HCC) near the diaphragm supplied by the right IPA. From July 2009 through April 2015, 11 patients with small (≤ 3 cm) HCC near the diaphragm, which was infeasible for ultrasound-guided RFA and supplied by the right IPA, received TACE of the right IPA and subsequent RFA in one session. The safety and therapeutic efficacy, including technique effectiveness and local tumor progression (LTP), were evaluated. Technique effectiveness was achieved in all the 11 patients (100%). During average follow-up period of 39.2 months (range 13-89 months), LTP occurred in none of the 11 patients. There were twelve minor complications in eight patients, including right shoulder pain (n = 4), right pleural effusion (n = 2), diaphragmatic thickening (n = 2), transient lung change (n = 2), subsegmental intrahepatic bile duct stricture (n = 1), and subsegmental hepatic infarction (n = 1). No major complications were encountered CONCLUSION: Combined TACE of the right IPA and RFA can be a safe and effective treatment for small HCC near the diaphragm that is supplied by the right IPA.

  7. Diaphragm Muscle Weakness Following Acute Sustained Hypoxic Stress in the Mouse Is Prevented by Pretreatment with N-Acetyl Cysteine

    Directory of Open Access Journals (Sweden)

    Andrew J. O’Leary

    2018-01-01

    Full Text Available Oxygen deficit (hypoxia is a major feature of cardiorespiratory diseases characterized by diaphragm dysfunction, yet the putative role of hypoxic stress as a driver of diaphragm dysfunction is understudied. We explored the cellular and functional consequences of sustained hypoxic stress in a mouse model. Adult male mice were exposed to 8 hours of normoxia, or hypoxia (FiO2 = 0.10 with or without antioxidant pretreatment (N-acetyl cysteine, 200 mg/kg i.p.. Ventilation and metabolism were measured. Diaphragm muscle contractile function, myofibre size and distribution, gene expression, protein signalling cascades, and oxidative stress (TBARS were determined. Hypoxia caused pronounced diaphragm muscle weakness, unrelated to increased respiratory muscle work. Hypoxia increased diaphragm HIF-1α protein content and activated MAPK, mTOR, Akt, and FoxO3a signalling pathways, largely favouring protein synthesis. Hypoxia increased diaphragm lipid peroxidation, indicative of oxidative stress. FoxO3 and MuRF-1 gene expression were increased. Diaphragm 20S proteasome activity and muscle fibre size and distribution were unaffected by acute hypoxia. Pretreatment with N-acetyl cysteine substantially enhanced cell survival signalling, prevented hypoxia-induced diaphragm oxidative stress, and prevented hypoxia-induced diaphragm dysfunction. Hypoxia is a potent driver of diaphragm weakness, causing myofibre dysfunction without attendant atrophy. N-acetyl cysteine protects the hypoxic diaphragm and may have application as a potential adjunctive therapy.

  8. Diaphragm flange and method for lowering particle beam impedance at connected beam tubes of a particle accelerator

    Energy Technology Data Exchange (ETDEWEB)

    Biallas, George Herman

    2017-07-04

    A diaphragm flange for connecting the tubes in a particle accelerator while minimizing beamline impedance. The diaphragm flange includes an outer flange and a thin diaphragm integral with the outer flange. Bolt holes in the outer flange provide a means for bolting the diaphragm flange to an adjacent flange or beam tube having a mating bolt-hole pattern. The diaphragm flange includes a first surface for connection to the tube of a particle accelerator beamline and a second surface for connection to a CF flange. The second surface includes a recessed surface therein and a knife-edge on the recessed surface. The diaphragm includes a thickness that enables flexing of the integral diaphragm during assembly of beamline components. The knife-edge enables compression of a soft metal gasket to provide a leak-tight seal.

  9. [Congenital lens subluxation: visual acuity outcomes and intraocular lens postoperative position].

    Science.gov (United States)

    Arraes, Caroline; Endriss, Daniela; Lobato, Francisco; Arraes, João; Ventura, Marcelo

    2010-01-01

    To evaluate the visual acuity outcomes and to investigate the intraocular lens (IOL) and endocapsular ring positions with ultrasound biomicroscopy in 17 eyes of 10 patients with congenital lens subluxation who underwent the same surgical technique, by the same surgeon. The study was performed in the ''Hospital de Olhos de Pernambuco'' and ''Fundação Altino Ventura''. The surgical technique consisted of phacoaspiration with implant of endocapsular ring and intraocular lens with one loop haptic amputated. The age varied from 7 to 22 years. Data on visual acuity (VA) before and after surgery, surgery follow-up period, and complications were analyzed. All patients underwent ultrasound biomicroscopy. The mean follow-up period was 2.8 years. There was a VA improvement in 17 (100%) eyes: in 12 eyes (70.6%) the visual acuity was better than 20/40; 4 (23.5%) ranged from 20/40 to 20/100, and 1 (5.9%) had visual acuity worse than 20/100, however better than the preoperative visual acuity. The posterior capsular opacification occurred in 10 eyes (58.9%). Ultrasound biomicroscopy showed that all IOL were partially decentralized, however without surpassing the pupil border limit. Endocapsular ring position was correct and there was a good capsular support in all cases. The evaluated surgical treatment provided good intraocular lens and endocapsular ring position, with VA improvement Thus, this technique is a viable, effective and safe option for the visual rehabilitation of patients with congenital lens subluxation.

  10. Diaphragm pacing and noninvasive respiratory management of amyotrophic lateral sclerosis/motor neuron disease.

    Science.gov (United States)

    Mahajan, Kedar R; Bach, John Robert; Saporito, Lou; Perez, Nick

    2012-12-01

    Although it is known that continuous noninvasive ventilation (CNIV) can prolong life in amyotrophic lateral sclerosis/motor neuron disease (ALS/MND), in this study we explore similar claims for diaphragm pacing (DP). NIV and DP users' vital capacities (VCs) over time and duration of NIV and CNIV dependence were analyzed for 354 non-DP and 8 DP ALS/MND patients. Patients had a higher rate of monthly VC decline before NIV use (5.1 ± 7.6%) than during NIV use (2.5 ± 3.6%) (P NIV for 19.9 ± 27.6 months until tracheostomy/death, whereas 113 others used it for 10.9 ± 10.5 months until CNIV dependence for another 12.8 ± 16.2 months. After placement, 7 DP users were CNIV dependent in 8.0 ± 7.0 months, whereas 6 underwent tracheostomy/died in 18.2 ± 13.7 months. CNIV prolonged the survival of 113 of the 354 non-DP and 6 DP ALS/MND patients by 12.8 and 10.2 months, respectively. DP provided no benefit on VC or mechanical ventilation-free survival. Copyright © 2012 Wiley Periodicals, Inc.

  11. TU-E-201-01: Methods for Eye Lens Dosimetry and Studies On Lens Opacities with Interventionists

    Energy Technology Data Exchange (ETDEWEB)

    Rehani, M. [Massachusetts General Hospital (United States)

    2015-06-15

    Madan M. Rehani, Massachusetts General Hospital and Harvard Medical School, Boston Methods for Eye Lens Dosimetry and Studies On Lens Opacities with Interventionalists Radiation induced cataract is a major threat among staff working in interventional suites. Nearly 16 million interventional procedures are performed annually in USA. Recent studies by the principal investigator’s group, primarily among interventional cardiologists, on behalf of the International Atomic Energy Agency, show posterior subcapsular (PSC) changes in the eye lens in 38–53% of main operators and 21–45% of support staff. These changes have potential to lead to cataract in future years, as per information from A-Bomb survivors. The International Commission on Radiological Protection has reduced dose limit for staff by a factor of 7.5 (from 150 mSv/y to 20 mSv/y). With increasing emphasis on radiation induced cataracts and reduction in threshold dose for eye lens, there is a need to implement strategies for estimating eye lens dose. Unfortunately eye lens dosimetry is at infancy when it comes to routine application. Various approaches are being tried namely direct measurement using active or passive dosimeters kept close to eyes, retrospective estimations and lastly correlating patient dose in interventional procedures with staff eye dose. The talk will review all approaches available and ongoing active research in this area, as well as data from surveys done in Europe on status of eye dose monitoring in interventional radiology and nuclear medicine. The talk will provide update on how good is Hp(10) against Hp(3), estimations from CTDI values, Monte Carlo based simulations and current status of eye lens dosimetry in USA and Europe. The cataract risk among patients is in CT examinations of the head. Since radiation induced cataract predominantly occurs in posterior sub-capsular (PSC) region and is thus distinguishable from age or drug related cataracts and is also preventable, actions on

  12. TU-E-201-03: Eye Lens Dosimetry in Radiotherapy Using Contact Lens-Shaped Applicator

    Energy Technology Data Exchange (ETDEWEB)

    Park, J. [Seoul National University Hospital (Korea, Republic of)

    2015-06-15

    Madan M. Rehani, Massachusetts General Hospital and Harvard Medical School, Boston Methods for Eye Lens Dosimetry and Studies On Lens Opacities with Interventionalists Radiation induced cataract is a major threat among staff working in interventional suites. Nearly 16 million interventional procedures are performed annually in USA. Recent studies by the principal investigator’s group, primarily among interventional cardiologists, on behalf of the International Atomic Energy Agency, show posterior subcapsular (PSC) changes in the eye lens in 38–53% of main operators and 21–45% of support staff. These changes have potential to lead to cataract in future years, as per information from A-Bomb survivors. The International Commission on Radiological Protection has reduced dose limit for staff by a factor of 7.5 (from 150 mSv/y to 20 mSv/y). With increasing emphasis on radiation induced cataracts and reduction in threshold dose for eye lens, there is a need to implement strategies for estimating eye lens dose. Unfortunately eye lens dosimetry is at infancy when it comes to routine application. Various approaches are being tried namely direct measurement using active or passive dosimeters kept close to eyes, retrospective estimations and lastly correlating patient dose in interventional procedures with staff eye dose. The talk will review all approaches available and ongoing active research in this area, as well as data from surveys done in Europe on status of eye dose monitoring in interventional radiology and nuclear medicine. The talk will provide update on how good is Hp(10) against Hp(3), estimations from CTDI values, Monte Carlo based simulations and current status of eye lens dosimetry in USA and Europe. The cataract risk among patients is in CT examinations of the head. Since radiation induced cataract predominantly occurs in posterior sub-capsular (PSC) region and is thus distinguishable from age or drug related cataracts and is also preventable, actions on

  13. TU-E-201-01: Methods for Eye Lens Dosimetry and Studies On Lens Opacities with Interventionists

    International Nuclear Information System (INIS)

    Rehani, M.

    2015-01-01

    Madan M. Rehani, Massachusetts General Hospital and Harvard Medical School, Boston Methods for Eye Lens Dosimetry and Studies On Lens Opacities with Interventionalists Radiation induced cataract is a major threat among staff working in interventional suites. Nearly 16 million interventional procedures are performed annually in USA. Recent studies by the principal investigator’s group, primarily among interventional cardiologists, on behalf of the International Atomic Energy Agency, show posterior subcapsular (PSC) changes in the eye lens in 38–53% of main operators and 21–45% of support staff. These changes have potential to lead to cataract in future years, as per information from A-Bomb survivors. The International Commission on Radiological Protection has reduced dose limit for staff by a factor of 7.5 (from 150 mSv/y to 20 mSv/y). With increasing emphasis on radiation induced cataracts and reduction in threshold dose for eye lens, there is a need to implement strategies for estimating eye lens dose. Unfortunately eye lens dosimetry is at infancy when it comes to routine application. Various approaches are being tried namely direct measurement using active or passive dosimeters kept close to eyes, retrospective estimations and lastly correlating patient dose in interventional procedures with staff eye dose. The talk will review all approaches available and ongoing active research in this area, as well as data from surveys done in Europe on status of eye dose monitoring in interventional radiology and nuclear medicine. The talk will provide update on how good is Hp(10) against Hp(3), estimations from CTDI values, Monte Carlo based simulations and current status of eye lens dosimetry in USA and Europe. The cataract risk among patients is in CT examinations of the head. Since radiation induced cataract predominantly occurs in posterior sub-capsular (PSC) region and is thus distinguishable from age or drug related cataracts and is also preventable, actions on

  14. TU-E-201-03: Eye Lens Dosimetry in Radiotherapy Using Contact Lens-Shaped Applicator

    International Nuclear Information System (INIS)

    Park, J.

    2015-01-01

    Madan M. Rehani, Massachusetts General Hospital and Harvard Medical School, Boston Methods for Eye Lens Dosimetry and Studies On Lens Opacities with Interventionalists Radiation induced cataract is a major threat among staff working in interventional suites. Nearly 16 million interventional procedures are performed annually in USA. Recent studies by the principal investigator’s group, primarily among interventional cardiologists, on behalf of the International Atomic Energy Agency, show posterior subcapsular (PSC) changes in the eye lens in 38–53% of main operators and 21–45% of support staff. These changes have potential to lead to cataract in future years, as per information from A-Bomb survivors. The International Commission on Radiological Protection has reduced dose limit for staff by a factor of 7.5 (from 150 mSv/y to 20 mSv/y). With increasing emphasis on radiation induced cataracts and reduction in threshold dose for eye lens, there is a need to implement strategies for estimating eye lens dose. Unfortunately eye lens dosimetry is at infancy when it comes to routine application. Various approaches are being tried namely direct measurement using active or passive dosimeters kept close to eyes, retrospective estimations and lastly correlating patient dose in interventional procedures with staff eye dose. The talk will review all approaches available and ongoing active research in this area, as well as data from surveys done in Europe on status of eye dose monitoring in interventional radiology and nuclear medicine. The talk will provide update on how good is Hp(10) against Hp(3), estimations from CTDI values, Monte Carlo based simulations and current status of eye lens dosimetry in USA and Europe. The cataract risk among patients is in CT examinations of the head. Since radiation induced cataract predominantly occurs in posterior sub-capsular (PSC) region and is thus distinguishable from age or drug related cataracts and is also preventable, actions on

  15. Investigation into the behaviour of concrete anchored diaphragm walls under earthquake condition

    International Nuclear Information System (INIS)

    Saba, H. R.; Rahaii, A. R.

    2003-01-01

    Diaphragm walls are frequently used in civil Engineering projects. Considering the variety and important volume of consumed materials (concrete, anchors and soil), one of the important factors for design and construction of these walls, are their behaviour under different executive, and loading conditions. In this paper, various models of concrete diaphragms with different number of anchors and soil parameters under static and dynamic loading have been investigated using finite element method with nonlinear models. Results including the internal forces in diaphragm walls, variation of forces in the anchors, shape of the sliding surface and variation of pressure in soil are obtained and compared. An experimental tool with suitable measurement systems for determining the pressure and internal forces was designed and realised. Also with similitude and dimensional analyses, diaphragms with different number of anchors were built and set on the shaking table test and experimented under different accelograms. Finally results of nonlinear dynamic analysis were compared with experimental results

  16. Development of a Hemispherical Metal Diaphragm for Single-Cycle Liquid-Metal Positive Expulsion Systems

    National Research Council Canada - National Science Library

    Gorland, Sol

    1965-01-01

    This report presents experimental results pertaining to the design and development of a metallic expulsion diaphragm for single-cycle positive expulsion of high-temperature liquid in an agravity condition...

  17. Documentation of diaphragmal paralysis with digital subtraction techniques. Dokumentation von Zwerchfellparesen mit digitaler Subtraktionstechnik

    Energy Technology Data Exchange (ETDEWEB)

    Waggershauser, T. (Muenchen Univ. (Germany). Radiologische Klinik und Poliklinik Muenchen Univ. (Germany). Klinik und Poliklinik fuer Hals-, Nasen- und Ohrenkranke); Buente, E. (Muenchen Univ. (Germany). Radiologische Klinik und Poliklinik Muenchen Univ. (Germany). Klinik und Poliklinik fuer Hals-, Nasen- und Ohrenkranke); Kohz, P. (Muenchen Univ. (Germany). Radiologische Klinik und Poliklinik Muenchen Univ. (Germany). Klinik und Poliklinik fuer Hals-, Nasen- und Ohrenkranke); Fink, U. (Muenchen Univ. (Germany). Radiologische Klinik und Poliklinik Muenchen Univ. (Germany). Klinik und Poliklinik fuer Hals-, Nasen- und Ohrenkranke)

    1992-01-01

    The causative factors for a paresis of the diaphragm are primarily subsequent to operations on lesions of the phrenic nerve or on such mediastinal tumors as lyphomas which result in compression or infiltration of the nerves. (orig.)

  18. Intravitreal Phacoemulsification Using Torsional Handpiece for Retained Lens Fragments

    OpenAIRE

    Kumar, Vinod; Takkar, Brijesh

    2016-01-01

    Purpose: To evaluate the results of intravitreal phacoemulsification with torsional hand piece in eyes with posteriorly dislocated lens fragments. Methods: In this prospective, interventional case series, 15 eyes with retained lens fragments following phacoemulsification were included. All patients underwent standard three-port pars plana vitrectomy and intravitreal phacoemulsification using sleeveless, torsional hand piece (OZiL™, Alcon's Infiniti Vision System). Patients were followed up...

  19. Computer simulation analysis of normal and abnormal development of the mammalian diaphragm

    Directory of Open Access Journals (Sweden)

    Bodenstein Lawrence

    2006-02-01

    Full Text Available Abstract Background Congenital diaphragmatic hernia (CDH is a birth defect with significant morbidity and mortality. Knowledge of diaphragm morphogenesis and the aberrations leading to CDH is limited. Although classical embryologists described the diaphragm as arising from the septum transversum, pleuroperitoneal folds (PPF, esophageal mesentery and body wall, animal studies suggest that the PPF is the major, if not sole, contributor to the muscular diaphragm. Recently, a posterior defect in the PPF has been identified when the teratogen nitrofen is used to induce CDH in fetal rodents. We describe use of a cell-based computer modeling system (Nudge++™ to study diaphragm morphogenesis. Methods and results Key diaphragmatic structures were digitized from transverse serial sections of paraffin-embedded mouse embryos at embryonic days 11.5 and 13. Structure boundaries and simulated cells were combined in the Nudge++™ software. Model cells were assigned putative behavioral programs, and these programs were progressively modified to produce a diaphragm consistent with the observed anatomy in rodents. Homology between our model and recent anatomical observations occurred under the following simulation conditions: (1 cell mitoses are restricted to the edge of growing tissue; (2 cells near the chest wall remain mitotically active; (3 mitotically active non-edge cells migrate toward the chest wall; and (4 movement direction depends on clonal differentiation between anterior and posterior PPF cells. Conclusion With the PPF as the sole source of mitotic cells, an early defect in the PPF evolves into a posteromedial diaphragm defect, similar to that of the rodent nitrofen CDH model. A posterolateral defect, as occurs in human CDH, would be more readily recreated by invoking other cellular contributions. Our results suggest that recent reports of PPF-dominated diaphragm morphogenesis in the rodent may not be strictly applicable to man. The ability to

  20. Computer simulation analysis of normal and abnormal development of the mammalian diaphragm

    Science.gov (United States)

    Fisher, Jason C; Bodenstein, Lawrence

    2006-01-01

    Background Congenital diaphragmatic hernia (CDH) is a birth defect with significant morbidity and mortality. Knowledge of diaphragm morphogenesis and the aberrations leading to CDH is limited. Although classical embryologists described the diaphragm as arising from the septum transversum, pleuroperitoneal folds (PPF), esophageal mesentery and body wall, animal studies suggest that the PPF is the major, if not sole, contributor to the muscular diaphragm. Recently, a posterior defect in the PPF has been identified when the teratogen nitrofen is used to induce CDH in fetal rodents. We describe use of a cell-based computer modeling system (Nudge++™) to study diaphragm morphogenesis. Methods and results Key diaphragmatic structures were digitized from transverse serial sections of paraffin-embedded mouse embryos at embryonic days 11.5 and 13. Structure boundaries and simulated cells were combined in the Nudge++™ software. Model cells were assigned putative behavioral programs, and these programs were progressively modified to produce a diaphragm consistent with the observed anatomy in rodents. Homology between our model and recent anatomical observations occurred under the following simulation conditions: (1) cell mitoses are restricted to the edge of growing tissue; (2) cells near the chest wall remain mitotically active; (3) mitotically active non-edge cells migrate toward the chest wall; and (4) movement direction depends on clonal differentiation between anterior and posterior PPF cells. Conclusion With the PPF as the sole source of mitotic cells, an early defect in the PPF evolves into a posteromedial diaphragm defect, similar to that of the rodent nitrofen CDH model. A posterolateral defect, as occurs in human CDH, would be more readily recreated by invoking other cellular contributions. Our results suggest that recent reports of PPF-dominated diaphragm morphogenesis in the rodent may not be strictly applicable to man. The ability to recreate a CDH defect

  1. Reinforcement of the pelvic diaphragm using a purse-string suture in dogs: description of technique

    Directory of Open Access Journals (Sweden)

    P.C. Moraes

    Full Text Available ABSTRACT Recurrence of perineal hernias is frequent, and is associated to poor identification of anatomical structures during surgery, inadequate suture placement, and failure of physical support of the pelvic diaphragm after surgical reconstruction. The objective of this work is to describe a novel surgical technique for reinforcement of the pelvic diaphragm after performing the internal obturator transposition technique in dogs with perineal hernia.

  2. Surgical treatment of hereditary lens subluxations.

    Science.gov (United States)

    Ozdek, Sengul; Sari, Ayca; Bilgihan, Kamil; Akata, Fikret; Hasanreisoglu, Berati

    2002-01-01

    To evaluate the effectiveness and results of pars plana vitreolensectomy approach with transscleral fixation of intraocular lens in hereditary lens subluxations. Fifteen eyes of 9 consecutive patients with a mean age of 12.8+/-6.2 years (6-26 years) with hereditary lens subluxation were operated on and the results were evaluated in a prospective study. Surgery was considered if best spectacle corrected visual acuity (BSCVA) was less than 20/70. All eyes underwent a 2-port pars plana vitreolensectomy and transscleral fixation of an intraocular lens (IOL). The mean follow-up period was 12.6+/-7.5 months (6-22 months). There was no major intraoperative complication. Preoperatively, 8 eyes (53.3%) had a BSCVA of counting fingers (CF) and 7 eyes (46.6%) had a BSCVA of 20/200 to 20/70. Postoperatively, 14 eyes (93.3%) had a BSCVA of 20/50 or better. None of the patients had IOL decentration or intraocular pressure (IOP) increase during the follow-up period. There was a macular hole formation in 1 eye postoperatively. The early results of pars plana vitreolensectomy with IOL implantation using scleral fixation technique had shown that it not only promises a rapid visual rehabilitation but it is also a relatively safe method. More serious complications, however, may occur in the long term.

  3. Study on the onset of DC diaphragm glow discharge

    International Nuclear Information System (INIS)

    Jin, Xinglong; Wang, Xiaoyan; Zhang, Hongmei; Ren, Hongxia

    2013-01-01

    In this paper, the DC diaphragm glow discharge (DGD) occurred around the small hole on quartz tube between two submersed graphite electrodes and the onset of DGD was systematically investigated. It was found that critical voltage (V D ) decreased with the increasing conductivity, and then maintained at about 620 V. When the hole diameter increased from 1.0 mm to 2.5 mm, H 2 O 2 formation and AO discoloration in anolyte increased with the increase of the hole diameter. In addition, the effect of electrolyte constituents on H 2 O 2 formation and AO discoloration in anolyte induced by DGD was also studied. The concentration of H 2 O 2 and AO discoloration in anolyte was close in inert electrolyte such as Na 2 SO 4 and Na 2 HPO 4 solution. The concentration of H 2 O 2 and AO discoloration rate in Na 2 CO 3 and NaAc solution was lower than those in Na 2 SO 4 and Na 2 HPO 4 solution, due to their capture ability for ·OH. However, NaCl showed enhancing effect on AO discoloration, although it consumed a certain amount of H 2 O 2 . The energy efficiencies of AO discoloration and H 2 O 2 formation were also compared with those of other DGD reactor.

  4. Numerical investigation on vibration characteristics of a micro-speaker diaphragm considering thermoforming effects

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyeong Min; Park, Ke Un [Seoul National University of Science and Technology, Seoul (Korea, Republic of)

    2013-10-15

    Micro-speaker diaphragms play an important role in generating desired sound responses, and are designed to have thin membrane shapes for flexibility in the axial direction. The micro-speaker diaphragms are formed from thin polymer film through the thermoforming process, in which local thickness reductions occur due to strain localization. This thickness reduction results in a change in vibration characteristics of the diaphragm and different sound responses from that of the original design. In this study, the effect of this thickness change in the diaphragm on its vibration characteristics is numerically investigated by coupling thermoforming simulation, structural analysis and modal analysis. Thus, the thickness change in the diaphragm is calculated from the thermoforming simulation, and reflected in the further structural and modal analyses in order to estimate the relevant stiffness and vibration modes. Comparing these simulation results with those from a diaphragm with the uniform thickness, it is found that a local thickness reduction results in the stiffness reduction and the relevant change in the natural frequencies and the corresponding vibration modes.

  5. Numerical investigation on vibration characteristics of a micro-speaker diaphragm considering thermoforming effects

    International Nuclear Information System (INIS)

    Kim, Kyeong Min; Park, Ke Un

    2013-01-01

    Micro-speaker diaphragms play an important role in generating desired sound responses, and are designed to have thin membrane shapes for flexibility in the axial direction. The micro-speaker diaphragms are formed from thin polymer film through the thermoforming process, in which local thickness reductions occur due to strain localization. This thickness reduction results in a change in vibration characteristics of the diaphragm and different sound responses from that of the original design. In this study, the effect of this thickness change in the diaphragm on its vibration characteristics is numerically investigated by coupling thermoforming simulation, structural analysis and modal analysis. Thus, the thickness change in the diaphragm is calculated from the thermoforming simulation, and reflected in the further structural and modal analyses in order to estimate the relevant stiffness and vibration modes. Comparing these simulation results with those from a diaphragm with the uniform thickness, it is found that a local thickness reduction results in the stiffness reduction and the relevant change in the natural frequencies and the corresponding vibration modes.

  6. Measurement of thermal expansion coefficient of graphene diaphragm using optical fiber Fabry–Perot interference

    International Nuclear Information System (INIS)

    Li, Cheng; Liu, Qianwen; Peng, Xiaobin; Fan, Shangchun

    2016-01-01

    Application of the Fabry–Perot (FP) interference method for determining the coefficient of thermal expansion (CTE) of a graphene diaphragm is investigated in this paper. A miniature extrinsic FP interferometric (EFPI) sensor was fabricated by using an approximate 8-layer graphene diaphragm. The extremely thin diaphragm was transferred onto the endface of a ferrule with an inner diameter of 125 μ m, and van der Waals interactions between the graphene diaphragm and its substrate created a low finesse FP interferometer with a cavity length of 36.13 μ m. Double reference FP cavities using two cleaved optical fibers as reflectors were also constructed to differentially cancel the thermal expansion effects of the trapped gas and adhesive material. A temperature test demonstrated an approximate cavity length change of 166.1 nm °C −1 caused by film thermal expansion in the range of 20–60 °C. Then along with the established thermal deformation model of the suspended circular diaphragm, the calculated CTE ranging from  −9.98  ×  10 −6 K −1 to  −2.09  ×  10 −6 K −1 conformed well to the previously measured results. The proposed method would be applicable in other types of elastic materials as the sensitive diaphragm of an EFPI sensor over a wide temperature range. (paper)

  7. High-intensity interval training prevents oxidant-mediated diaphragm muscle weakness in hypertensive mice.

    Science.gov (United States)

    Bowen, T Scott; Eisenkolb, Sophia; Drobner, Juliane; Fischer, Tina; Werner, Sarah; Linke, Axel; Mangner, Norman; Schuler, Gerhard; Adams, Volker

    2017-01-01

    Hypertension is a key risk factor for heart failure, with the latter characterized by diaphragm muscle weakness that is mediated in part by increased oxidative stress. In the present study, we used a deoxycorticosterone acetate (DOCA)-salt mouse model to determine whether hypertension could independently induce diaphragm dysfunction and further investigated the effects of high-intensity interval training (HIIT). Sham-treated (n = 11), DOCA-salt-treated (n = 11), and DOCA-salt+HIIT-treated (n = 15) mice were studied over 4 wk. Diaphragm contractile function, protein expression, enzyme activity, and fiber cross-sectional area and type were subsequently determined. Elevated blood pressure confirmed hypertension in DOCA-salt mice independent of HIIT (P HIIT. Myosin heavy chain (MyHC) protein expression tended to decrease (∼30%; P = 0.06) in DOCA-salt vs. sham- and DOCA-salt+HIIT mice, whereas oxidative stress increased (P HIIT further prevented direct oxidant-mediated diaphragm contractile dysfunction (P hypertension induces diaphragm contractile dysfunction via an oxidant-mediated mechanism that is prevented by HIIT.-Bowen, T. S., Eisenkolb, S., Drobner, J., Fischer, T., Werner, S., Linke, A., Mangner, N., Schuler, G., Adams, V. High-intensity interval training prevents oxidant-mediated diaphragm muscle weakness in hypertensive mice. © FASEB.

  8. A modified SILCS contraceptive diaphragm for long-term controlled release of the HIV microbicide dapivirine.

    Science.gov (United States)

    Major, Ian; Boyd, Peter; Kilbourne-Brook, Maggie; Saxon, Gene; Cohen, Jessica; Malcolm, R Karl

    2013-07-01

    There is considerable interest in developing new multipurpose prevention technologies to address women's reproductive health needs. This study describes an innovative barrier contraceptive device--based on the SILCS diaphragm--that also provides long-term controlled release of the lead candidate anti-HIV microbicide dapivirine. Diaphragm devices comprising various dapivirine-loaded polymer spring cores overmolded with a nonmedicated silicone elastomer sheath were fabricated by injection molding processes. In vitro release testing, thermal analysis and mechanical characterization were performed on the devices. A diaphragm device containing a polyoxymethylene spring core loaded with 10% w/w dapivirine provided continuous and controlled release of dapivirine over a 6-month period, with a mean in vitro daily release rate of 174 mcg/day. The mechanical properties of the new diaphragm were closely matched to the SILCS diaphragm. The study demonstrates proof of concept for a dapivirine-releasing diaphragm with daily release quantities potentially capable of preventing HIV transmission. In discontinuous clinical use, release of dapivirine may be readily extended over 1 or more years. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. A Correlation of Thin Lens Approximation to Thick Lens Design by Using Coddington Factors in Lens Design and Manufacturing

    OpenAIRE

    FARSAKOĞLU, Ö. Faruk

    2014-01-01

    The effect of Coddington factors on aberration functions has been analysed using thin lens approximation. Minimizing spherical aberrations of singlet lenses using Coddington factors in lens design depending on lens manufacturing is discussed. Notation of lens test plate pairs used in lens manufacturing is also presented in terms of Coddington shape factors.

  10. Lens dislocation has a possible relationship with laser iridotomy

    Directory of Open Access Journals (Sweden)

    Mutoh T

    2012-12-01

    Full Text Available Tetsuya Mutoh,1,2 Kevin F Barrette,2 Yukihiro Matsumoto,1 Makoto Chikuda11Department of Ophthalmology, Dokkyo Medical University Koshigaya Hospital, Koshigaya City, Saitama, Japan; 2Department of Ophthalmology, Boston University School of Medicine, Boston, MA, USAAbstract: We report our recent experience of four eyes with spontaneous lens dislocation in four patients with no history of trauma or any systemic disease associated with zonular dialysis. Lens dislocation developed with 0.5 to 6 months following laser iridotomy. All patients were male and two eyes were complicated with acute primary angle closure glaucoma preoperatively. Case 1 showed bilateral lens dislocation, while cases 2 and 3 involved unilateral lens dislocation. Cases 2 and 3 showed lenses completely dislocated into the vitreous cavity. All cases needed lens removal and scleral fixation of intraocular lenses. Final visual acuity was 1.2 in all cases. We suspect that laser iridotomy may induce localized zonular dialysis that results in progressive zonular weakness, leading to lens dislocation.Keywords: lens dislocation, laser iridotomy, primary angle closure glaucoma

  11. Lessons learned: wrong intraocular lens.

    Science.gov (United States)

    Schein, Oliver D; Banta, James T; Chen, Teresa C; Pritzker, Scott; Schachat, Andrew P

    2012-10-01

    To report cases involving the placement of the wrong intraocular lens (IOL) at the time of cataract surgery where human error occurred. Retrospective small case series, convenience sample. Seven surgical cases. Institutional review of errors committed and subsequent improvements to clinical protocols. Lessons learned and changes in procedures adapted. The pathways to a wrong IOL are many but largely reflect some combination of poor surgical team communication, transcription error, lack of preoperative clarity in surgical planning or failure to match the patient, and IOL calculation sheet with 2 unique identifiers. Safety in surgery involving IOLs is enhanced both by strict procedures, such as an IOL-specific "time-out," and the fostering of a surgical team culture in which all members are encouraged to voice questions and concerns. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  12. Ultrastructural effects of silicone oil on the clear crystalline lens of the human eye.

    Science.gov (United States)

    Soliman, Wael; Sharaf, Mohamed; Abdelazeem, Khaled; El-Gamal, Dalia; Nafady, Allam

    2018-03-01

    To evaluate light and electron microscopic changes of the anterior capsule and its epithelium after clear lens extraction of vitrectomized myopic eyes with silicone oil tamponade. This prospective, controlled, non-randomized, interventional study included 20 anterior lens capsular specimens that were excised during combined clear lens extraction and silicone oil removal from previously vitrectomized highly myopic patients with silicone oil tamponade for previous retinal detachment surgeries. The specimens were examined via light microscopy and electron microscopy and compared with 20 anterior capsule specimens removed during clear lens extraction of non-vitrectomized highly myopic eyes. Light microscopic examination of clear lens anterior capsule specimens of vitrectomized myopic eyes filled with silicone oil showed relatively more flat cells with irregular outline of lens' epithelial cells with wide intercellular spaces, deeply stained nuclei, and multiple intracytoplasmic vacuoles. Scanning electron microscopy revealed collagenous surfaces filled with multiple pits, depressions, and abnormal deposits. Transmission electron microscopy revealed lens epithelial cells with apoptotic changes, many cytoplasmic vacuoles, and filopodia-like protrusions between lens epithelial cells and the capsule. Epithelial proliferation and multilayering were also observed. silicone oil may play a role in the development of apoptotic and histopathological changes in clear lens epithelial cells. Clarity of the lens at the time of silicone oil removal does not indicate an absence of cataractous changes. We found justification of combined clear lens extraction and silicone oil removal or combined phacovitrectomy when silicone oil injection is planned, but further long-term studies with larger patient groups are required.

  13. Intravitreal Phacoemulsification Using Torsional Handpiece for Retained Lens Fragments.

    Science.gov (United States)

    Kumar, Vinod; Takkar, Brijesh

    2016-01-01

    To evaluate the results of intravitreal phacoemulsification with torsional hand piece in eyes with posteriorly dislocated lens fragments. In this prospective, interventional case series, 15 eyes with retained lens fragments following phacoemulsification were included. All patients underwent standard three-port pars plana vitrectomy and intravitreal phacoemulsification using sleeveless, torsional hand piece (OZiL™, Alcon's Infiniti Vision System). Patients were followed up for a minimum of six months to evaluate the visual outcomes and complications. The preoperative best-corrected visual acuity (BCVA) ranged from light perception to 0.3. No complications such as thermal burns of the scleral wound, retinal damage due to flying lens fragments, or difficult lens aspiration occurred during intravitreal phacoemulsification. Mean post-operative BCVA at the final follow-up was 0.5. Two eyes developed cystoid macular edema, which was managed medically. No retinal detachment was noted. Intravitreal phacoemulsification using torsional hand piece is a safe and effective alternative to conventional longitudinal phacofragmentation.

  14. Monovisión con lente intraocular monofocal en pacientes présbitas Monovision with monofocal intraocular lens in prebyopic patients

    Directory of Open Access Journals (Sweden)

    Patricia Andújar Coba

    2010-01-01

    the refractive results achieved in presbyopic patients, both hyperopic and myopic, with monovision METHODS: A prospective, longitudinal and descriptive study was carried out in 21 patients, 13 myopic and 8 hyperopic, who underwent lens surgery to correct presbyopia based on the monovision procedure at the Microsurgery Service of the "Ramón Pando Ferrer" Cuban Institute of Ophthalmology from February 2009 to February 2010. The variables were pre and postoperative visual acuity with/without correction, both near and distant, and spheral equivalents. Mean and standard deviation values were used to present all variables. RESULTS: It was found that average visual acuity with correction improved from 0,7 and 0,9 in myopic and hyperopic patients respectively to 0,88 and 0,94 of binocular visual acuity without correction in the postoperative phase, thus correcting their average spheral equivalents of 8,27 diopters (D and +6,26 D in each group. The average visual acuity for near vision for both groups was Jeager (J 2 and the average spheral equivalents reached for distant vision were -0,32 D for myopic and +0,26 D for hyperopic patients. For near vision, i.e. in the non- dominant eye, the spheral equivalent values were 1,6 D for the first group and 1,3 D for the second group. CONCLUSIONS: After surgery there was an undoubted improvement in visual acuity without correction, in near as well as in distant vision. Spherical equivalents were widely modified for both groups in both the dominant and the non-dominant eye, improving vision at both distances. The achieved results corroborate that the benefits brought about by monovision in near vision are more important than the damages it causes in distant vision, making it very successful for certain groups of patients.

  15. Phacoaspiration with a Cionni ring versus pars plana lensectomy, vitrectomy and sutureless transscleral IOL fixation in pediatric patients with a subluxated lens.

    Science.gov (United States)

    Thapa, Bikram Bahadur; Agarwal, Aniruddha; Singh, Ramandeep; Gupta, Parul Chawla; Ram, Jagat

    2016-05-01

    To compare outcomes of phacoaspiration (PA) with Cionni ring-assisted posterior-chamber intraocular lens implantation (PCIOL) versus pars plana lensectomy (PPL) with anterior vitrectomy (AV) and sutureless transscleral fixation of the IOL (TSFIOL) assisted with fibrin glue in the management of a subluxated lens. In this prospective and comparative interventional study, one eye of children with a bilateral subluxated lens was randomized to undergo PA with PCIOL using a Cionni ring (group A: n = 14 eyes), and the other eye underwent PPL + AV with glue-assisted TSFIOL (group B: n = 14 eyes). The outcome measures included best-corrected visual acuity (BCVA) in logMAR units and rates of complications at 12-month follow-up visits. 28 eyes of 14 children (age: 8.06 ± 4.49 years) were included in the study. BCVA improved from preoperative value of 1.21 to 0.4 (p = 0.001) in group A and from 1.53 to 0.31 (p = 0.001) in group B at month 12. There was no significant difference in the BCVA on comparing the two groups at month 12 (p > 0.411). Postoperative complications in group A included corneal edema (two eyes), Cionni hook capture (one eye), elevated IOP (one eye), and posterior capsular opacification (five eyes). In group B, corneal edema was seen in two eyes, hypotony in one eye, vitreous hemorrhage in one eye and pupillary optic capture in four eyes. Head-to-head comparison of the two techniques demonstrates no significant difference in the rates of complications at month 12. The decision to choose either technique may be based on the operating surgeon's skill, experience and preference.

  16. Restoration of diaphragmatic function after diaphragm reinnervation by inferior laryngeal nerve; experimental study in rabbits

    Directory of Open Access Journals (Sweden)

    de Barros Angelique

    2006-01-01

    Full Text Available Abstract Objectives To assess the possibilities of reinnervation in a paralyzed hemidiaphragm via an anastomosis between phrenic nerve and inferior laryngeal nerve in rabbits. Reinnervation of a paralyzed diaphragm could be an alternative to treat patients with ventilatory insufficiency due to upper cervical spine injuries. Material and method Rabbits were divided into five groups of seven rabbits each. Groups I and II were respectively the healthy and the denervated control groups. The 3 other groups were all reinnervated using three different surgical procedures. In groups III and IV, phrenic nerve was respectively anastomosed with the abductor branch of the inferior laryngeal nerve and with the trunk of the inferior laryngeal nerve. In group V, the fifth and fourth cervical roots were respectively anastomosed with the abductor branch of the inferior laryngeal nerve and with the nerve of the sternothyroid muscle (originating from the hypoglossal nerve. Animals were evaluated 4 months later using electromyography, transdiaphragmatic pressure measurements, sonomicrometry and histological examination. Results A poor inspiratory activity was found in quiet breathing in the reinnervated groups, with an increasing pattern of activity during effort. In the reinnervated groups, transdiaphragmatic pressure measurements and sonomicrometry were higher in group III with no significant differencewith groups IV and V. Conclusion Inspiratory contractility of an hemidiaphragm could be restored with immediate anastomosis after phrenic nerve section between phrenic nerve and inferior laryngeal nerve.

  17. Disposable contact lens use as a risk factor for microbial keratitis

    OpenAIRE

    Radford, C.; Minassian, D.; Dart, J.

    1998-01-01

    AIMS—A case-control study was performed to evaluate soft contact lens (SCL) wear modality as a risk factor for microbial keratitis.
METHODS—Contact lens wearers presenting as new patients to Moorfields Eye Hospital accident and emergency department during a 12 month period completed a self administered questionnaire detailing demographic data and contact lens use habits. Cases were patients with a clinical diagnosis of SCL related microbial keratitis. Controls were SCL users attending with di...

  18. Visual outcome with the Oculentis Mplus intraocular lens

    OpenAIRE

    Si-Yuan Liu; Xu Yang

    2017-01-01

    AIM: To evaluate the visual outcome of Oculentis Mplus intraocular lens(IOL).METHODS: Totally 20 eyes in 20 patients received phacoemulsification and Oculentis Mplus intraocular lens implantation were as test group, and 20 eyes(Aspira-aA IOL)were as control group. The following postoperative examinations were performed after operation for 3mo: uncorrected visual acuity of distance and near, refractive results, UBM examination, the rate of wearing spectacles and the complications. RESULTS: At ...

  19. Characteristics of the thick, compound refractive lens

    International Nuclear Information System (INIS)

    Pantell, Richard H.; Feinstein, Joseph; Beguiristain, H. Raul; Piestrup, Melvin A.; Gary, Charles K.; Cremer, Jay T.

    2003-01-01

    A compound refractive lens (CRL), consisting of a series of N closely spaced lens elements each of which contributes a small fraction of the total focusing, can be used to focus x rays or neutrons. The thickness of a CRL can be comparable to its focal length, whereupon a thick-lens analysis must be performed. In contrast with the conventional optical lens, where the ray inside the lens follows a straight line, the ray inside the CRL is continually changing direction because of the multiple refracting surfaces. Thus the matrix representation for the thick CRL is quite different from that for the thick optical lens. Principal planes can be defined such that the thick-lens matrix can be converted to that of a thin lens. For a thick lens the focal length is greater than for a thin lens with the same lens curvature, but this lengthening effect is less for the CRL than for the conventional optical lens

  20. Surgical effect of traumatic lens dislocation with secondary glaucoma

    Directory of Open Access Journals (Sweden)

    Xiao-Dan Zhang

    2014-10-01

    Full Text Available AIM: To retrospectively evaluate the effect of lens extraction combined with vitrectomy to treat traumatic lens dislocation with secondary glaucoma.METHODS:Thirty-one eyes(31 casesof lens dislocation caused by blunt trauma with secondary glaucoma were treated respectively with cataract extraction combined with anterior vitrectomy, trabeculectomy and intraocular lens implantation. The visual acuity and pressure were observed 1wk, 1 and 3mo after operative. RESULTS:Thirty-one eyes were all complete the operation successfully, and 6 eyes were given combined trabeculectomy, 9 eyes were implanted anterior chamber intraocular lens implantation(IOLand 15 eyes were given posterior chamber suture fixation. Sixteen eyes were implanted in one-stage operation, while 8 eyes were implanted in two-stage operation. All intraocular pressure(IOPwere controlled to the normal level after operation and 23 eyes had visual acuity of more than 0.3.CONCLUSION:Lens extraction combined with vitrectomy is an effective method for treatment of lens dislocation with secondary glaucoma. In order to control the IOP and get well visual function, we should choose IOL implantation or trabeculectomy according to the patient's condition.

  1. Displacement and resonance behaviors of a piezoelectric diaphragm driven by a double-sided spiral electrode

    KAUST Repository

    Shen, Zhiyuan

    2012-04-03

    This paper presents the design of a lead zirconate titanate (PZT) diaphragm actuated by double-sided patterned electrodes. Au/Cr electrodes were deposited on bulk PZT wafers by sputtering while patterned by a lift-off process. SU-8 thick film was used to form the structural layer. Double-spiral electrode induced in-plane poling and piezoelectric elongation are converted to an out-of-plane displacement due to the confined boundary condition. The influence of different drive configurations and electrode parameters on deflection has been calculated by finite element methods (FEM) using a uniform field model. Impedance and quasi-static displacement spectra of the diaphragm were measured after poling. Adouble-sided patterned electrode diaphragm can be actuated by more drive configurations than a single-sided one. Compared with a single-sided electrode drive, a double-sided out-of-phase drive configuration increases the coupling coefficient of the fundamental resonance from 7.6% to 11.8%. The displacement response of the diaphragm increases from 2.6 to 8.6nmV 1. Configurations including the electric field component perpendicular to the poling direction can stimulate shear modes of the diaphragm. © 2012 IOP Publishing Ltd.

  2. The role of Sema3–Npn-1 signaling during diaphragm innervation and muscle development

    Science.gov (United States)

    Huettl, Rosa-Eva; Hanuschick, Philipp; Amend, Anna-Lena; Alberton, Paolo; Aszodi, Attila; Huber, Andrea B.

    2016-01-01

    ABSTRACT Correct innervation of the main respiratory muscle in mammals, namely the thoracic diaphragm, is a crucial pre-requisite for the functionality of this muscle and the viability of the entire organism. Systemic impairment of Sema3A–Npn-1 (Npn-1 is also known as NRP1) signaling causes excessive branching of phrenic nerves in the diaphragm and into the central tendon region, where the majority of misguided axons innervate ectopic musculature. To elucidate whether these ectopic muscles are a result of misguidance of myoblast precursors due to the loss of Sema3A–Npn-1 signaling, we conditionally ablated Npn-1 in somatic motor neurons, which led to a similar phenotype of phrenic nerve defasciculation and, intriguingly, also formation of innervated ectopic muscles. We therefore hypothesize that ectopic myocyte fusion is caused by additional factors released by misprojecting growth cones. Slit2 and its Robo receptors are expressed by phrenic motor axons and migrating myoblasts, respectively, during innervation of the diaphragm. In vitro analyses revealed a chemoattractant effect of Slit2 on primary diaphragm myoblasts. Thus, we postulate that factors released by motor neuron growth cones have an influence on the migration properties of myoblasts during establishment of the diaphragm. PMID:27466379

  3. Assessing breathing motion by shape matching of lung and diaphragm surfaces

    Science.gov (United States)

    Urschler, Martin; Bischof, Horst

    2005-04-01

    Studying complex thorax breating motion is an important research topic for accurate fusion of functional and anatomical data, radiotherapy planning or reduction of breathing motion artifacts. We investigate segmented CT lung, airway and diaphragm surfaces at several different breathing states between Functional Residual and Total Lung Capacity. In general, it is hard to robustly derive corresponding shape features like curvature maxima from lung and diaphragm surfaces since diaphragm and rib cage muscles tend to deform the elastic lung tissue such that e.g. ridges might disappear. A novel registration method based on the shape context approach for shape matching is presented where we extend shape context to 3D surfaces. The shape context approach was reported as a promising method for matching 2D shapes without relying on extracted shape features. We use the point correspondences for a non-rigid thin-plate-spline registration to get deformation fields that describe the movement of lung and diaphragm. Our validation consists of experiments on phantom and real sheep thorax data sets. Phantom experiments make use of shapes that are manipulated with known transformations that simulate breathing behaviour. Real thorax data experiments use a data set showing lungs and diaphragm at 5 distinct breathing states, where we compare subsets of the data sets and qualitatively and quantitatively asses the registration performance by using manually identified corresponding landmarks.

  4. Intracapsular lens extraction for the treatment of pupillary block glaucoma associated with anterior subluxation of the crystalline lens.

    Science.gov (United States)

    Kim, Yong Joon; Ha, Seung Joo

    2013-01-01

    To report a case of pupillary block glaucoma associated with spontaneous crystalline lens subluxation into the anterior chamber in a 34-year-old man. Dry vitrectomy was performed for securing enough retrolental space, and an intracapsular lens extraction was then performed via a corneolimbal incision. Additional endothelial cell damage was avoided with an injection of viscoelastics and gentle extraction of the crystalline lens. After deepening of the anterior chamber, scleral fixation of the intraocular lens was performed with an ab externo technique. Two months after the operation, a well-fixated intraocular lens was observed and intraocular pressure was stable. The postoperative corneal astigmatism was -3.5 dpt, and the patient had a best-corrected visual acuity of 20/25. Postoperative complications included decreased endothelial cell count and sector iris paralysis near the incision site. An anteriorly subluxated crystalline lens can cause pupillary block glaucoma in healthy young adults. To prevent intraoperative complications, intracapsular lens extraction with dry vitrectomy can be a good surgical option. The endothelial cell density should be closely monitored after surgery.

  5. Treatment of contact lens related dry eye with antibacterial honey.

    Science.gov (United States)

    Wong, Daniel; Albietz, Julie M; Tran, Huan; Du Toit, Cimonette; Li, Anita Hui; Yun, Tina; Han, Jee; Schmid, Katrina L

    2017-12-01

    Contact lens induced dry eye affects approximately 50% of contact lens wearers. The aim was to assess the effects of Manuka (Leptospermum sp.) honey eye drops (Optimel, Melcare, Australia) on dry eye in contact lens wearers. The safety of the honey eye drops in contact lens wear and contact lens wearers' compliance were also evaluated. Prospective, randomised, cross over study, examiner masked, pilot treatment trial. Twenty-four participants aged 20 to 55 years with contact lens related dry eye were recruited and randomised to two treatment groups; 20 completed the study. One group used Optimel eye drops twice a day for two weeks followed by conventional lubricant (Systane Ultra, Alcon) therapy for two weeks; the other group completed the treatments in the reverse order. Before and after each treatment dry eye symptomology, ocular surface inflammation, and tear quantity and quality were assessed. Participants completed a daily log detailing their usage of treatments and any issues. Dry eye symptoms improved significantly after Optimel treatment. Patients with more severe symptoms at baseline showed a greater improvement in symptoms. No significant differences were observed in the objective signs of dry eye; presumably because of the short treatment duration. Seventy-five% of contact lens wearers reported good adherence to Optimel treatment and 95% reported no issues using this product. Optimel Eye Drops reduce the symptoms of dry eye in contact lens wearers and are safe to use. A longer treatment period to assess the effect on clinical signs of dry eye is required. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  6. ASSESSMENT OF LENS THICKNESS IN ANGLE CLOSURE DISEASE

    Directory of Open Access Journals (Sweden)

    Nishat Sultana Khayoom

    2016-08-01

    Full Text Available BACKGROUND Anterior chamber depth and lens thickness have been considered as important biometric determinants in primary angle-closure glaucoma. Patients with primary narrow angle may be classified as a primary angle closure suspect (PACS, or as having primary angle closure (PAC or primary angle closure glaucoma (PACG. 23.9% of patients with primary angle closure disease are in India, which highlights the importance of understanding the disease, its natural history, and its underlying pathophysiology, so that we may try to establish effective methods of treatment and preventative measures to delay, or even arrest, disease progression, thereby reducing visual morbidity. AIM To determine the lens thickness using A-scan biometry and its significance in various stages of angle closure disease. MATERIALS AND METHODS Patients attending outpatient department at Minto Ophthalmic Hospital between October 2013 to May 2015 were screened for angle closure disease and subsequently evaluated at glaucoma department. In our study, lens thickness showed a direct correlation with shallowing of the anterior chamber by determining the LT/ ACD ratio. A decrease in anterior chamber depth is proportional to the narrowing of the angle which contributes to the progression of the angle closure disease from just apposition to occlusion enhancing the risk for optic nerve damage and visual field loss. Hence, if the lens thickness values are assessed earlier in the disease process, appropriate intervention can be planned. CONCLUSION Determination of lens changes along with anterior chamber depth and axial length morphometrically can aid in early detection of angle closure. The role of lens extraction for PACG is a subject of increased interest. Lens extraction promotes the benefits of anatomical opening of the angle, IOP reduction and improved vision. This potential intervention may be one among the armamentarium of approaches for PACG. Among the current treatment modalities

  7. Avaliação da sensibilidade ao contraste e da estereopsia em pacientes com lente intra-ocular multifocal Contrast sensitivity and stereopsis in pseudophakic patients with multifocal intraocular lens

    Directory of Open Access Journals (Sweden)

    Filipe de Oliveira

    2005-08-01

    Full Text Available OBJETIVO: Avaliar a sensibilidade ao contraste e a acuidade estereoscópica em pacientes pseudofácicos, que receberam implante bilateral de lente intra-ocular multifocal. MÉTODOS: Prospectivamente foram realizados testes de sensibilidade ao contraste com o uso da tabela Pelli-Robson e teste de acuidade estereoscópica com emprego do Titmus Stereo Test, em 20 pacientes com implante bilateral de lente intra-ocular multifocal Acrysof Restor®, no pós-operatório de 1 a 2 meses e sem uso de qualquer correção óptica. RESULTADOS:O teste de sensibilidade ao contraste binocular demonstrou que 6 pacientes (30% apresentaram 1,80 unid. log, 13 (65% 1,65 e 1 (5% 1,50. No teste monocular, ocorreram as seguintes respostas: 17 pacientes (85% 1,65 unid. log e 3 (15% 1,50 para o teste do olho direito. O teste do olho esquerdo mostrou que 16 pacientes (80% apresentaram 1,65 unid. log e 4 (20% 1,50. A média e o desvio-padrão da sensibilidade ao contraste testada binocularmente foi 1,69 (±0,08, ao passo que monocularmente foi 1,63 (±0,05 para OD e 1,62 (±0,06 para OE. O teste de acuidade estereoscópica revelou que 12 pacientes (60% obtiveram 40", 6 (30% 50" e 2 (10% 60", com média de 45" e desvio-padrão de ±6,88". CONCLUSÃO: A lente intra-ocular empregada no estudo, proporcionou resultados de sensibilidade ao contraste e acuidade estereoscópica compatíveis e de acordo com critérios de normalidade estabelecidos anteriormente por outros estudos em grupos de pacientes fácicos e pseudofácicos, e portanto, impacto positivo na funcionalidade visual.PURPOSE: To evaluate the contrast sensitivity and stereopsis tests in patients who underwent bilateral implantation of multifocal intraocular lens. METHODS: Tests of contrast sensitivity using the Pelli-Robson chart and stereopsis evaluation with the Titmus Stereo Test were performed in 20 patients 30-60 days after the bilateral implantation of Acrysof Restor® multifocal intraocular lens. RESULTS: The

  8. D33 mode piezoelectric diaphragm based acoustic transducer with high sensitivity

    KAUST Repository

    Shen, Zhiyuan; Lu, Jingyu; Tan, Cheewee; Miao, Jianmin; Wang, Zhihong

    2013-01-01

    This paper presents the design, fabrication, and characterization of an acoustic transducer using a piezoelectric freestanding bulk diaphragm as the sensing element. The diaphragm bearing the spiral electrode operates in d 33 mode, which allows the in-plane deformation of the diaphragm to be converted to the out-of-plane deformation and generates an acoustic wave in the same direction. A finite element code is developed to reorient the material polarization distribution according to the poling field calculated. The first four resonance modes have been simulated and verified by impedance and velocity spectra. The sensitivity and the sound pressure level of the transducer were characterized. The realized sensitivity of 126.21 μV/Pa at 1 kHz is nearly twenty times of the sensitivity of a sandwich d31 mode transducer. © 2012 Elsevier B.V.

  9. Miniature all-silica optical fiber pressure sensor with an ultrathin uniform diaphragm.

    Science.gov (United States)

    Wang, Wenhui; Wu, Nan; Tian, Ye; Niezrecki, Christopher; Wang, Xingwei

    2010-04-26

    This paper presents an all-silica miniature optical fiber pressure/acoustic sensor based on the Fabry-Perot (FP) interferometric principle. The endface of the etched optical fiber tip and silica thin diaphragm on it form the FP structure. The uniform and thin silica diaphragm was fabricated by etching away the silicon substrate from a commercial silicon wafer that has a thermal oxide layer. The thin film was directly thermally bonded to the endface of the optical fiber thus creating the Fabry-Perot cavity. Thin films with a thickness from 1microm to 3microm have been bonded successfully. The sensor shows good linearity and hysteresis during measurement. A sensor with 0.75 microm-thick diaphragm thinned by post silica etching was demonstrated to have a sensitivity of 11 nm/kPa. The new sensor has great potential to be used as a non-intrusive pressure sensor in a variety of sensing applications.

  10. Action of the isolated canine diaphragm on the lower ribs at high lung volumes.

    Science.gov (United States)

    De Troyer, André; Wilson, Theodore A

    2014-10-15

    The normal diaphragm has an inspiratory action on the lower ribs, but subjects with chronic obstructive pulmonary disease commonly have an inward displacement of the lateral portions of the lower rib cage during inspiration. This paradoxical displacement, conventionally called 'Hoover's sign', has traditionally been attributed to the direct action of radially oriented diaphragmatic muscle fibres. In the present study, the inspiratory intercostal muscles in all interspaces in anaesthetized dogs were severed so that the diaphragm was the only muscle active during inspiration. The displacements of the lower ribs along the craniocaudal and laterolateral axes and the changes in pleural pressure (∆Ppl) and transdiaphragmatic pressure were measured during occluded breaths and mechanical ventilation at different lung volumes between functional residual capacity (FRC) and total lung capacity. From these data, the separate effects on rib displacement of ∆Ppl and of the force exerted by the diaphragm on the ribs were determined. Isolated spontaneous diaphragm contraction at FRC displaced the lower ribs cranially and outward, but this motion was progressively reversed into a caudal and inward motion as lung volume increased. However, although the force exerted by the diaphragm on the ribs decreased with increasing volume, it continued to displace the ribs cranially and outward. These observations suggest that Hoover's sign is usually caused by the decrease in the zone of apposition and, thus, by the dominant effect of ∆Ppl on the lower ribs, rather than an inward pull from the diaphragm. © 2014 The Authors. The Journal of Physiology © 2014 The Physiological Society.

  11. Process engineering and economic evaluations of diaphragm and membrane chlorine cell technologies. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1980-12-01

    The chlor-alkali manufacturing technologies of (1), diaphragm cells (2), current technology membrane cells (3), catalytic cathode membrane cells (4), oxygen-cathode membrane cells and to a lesser extent several other related emerging processes are studied. Comparisons have been made on the two bases of (1) conventional industrial economics, and (2) energy consumption. The current diaphragm cell may have a small economic advantage over the other technologies at the plant size of 544 metric T/D (600 T/D). The three membrane cells all consume less energy, with the oxygen-cathode cell being the lowest. The oxygen-cathode cell appears promising as a low energy chlor-alkali cell where there is no chemical market for hydrogen. Federal funding of the oxygen-cathode cell has been beneficial to the development of the technology, to electrochemical cell research, and may help maintain the US's position in the international chlor-alkali technology marketplace. Tax law changes inducing the installation of additional cells in existing plants would produce the quickest reduction in power consumption by the chlor-alkali industry. Alternative technologies such as the solid polymer electrolyte cell, the coupling of diaphragm cells with fuel cells and the dynamic gel diaphragm have a strong potential for reducing chloralkali industry power consumption. Adding up all the recent and expected improvements that have become cost-effective, the electrical energy required to produce a unit of chlorine by 1990 should be only 50% to 60% of that used in 1970. In the United States the majority of the market does not demand salt-free caustic. About 75% of the electrolytic caustic is produced in diaphragm cells and only a small part of that is purified. This study indicates that unless membrane cell costs are greatly reduced or a stronger demand develops for salt-free caustic, the diaphragm cells will remain competitive. (WHK)

  12. Scleral lens use in dry eye syndrome.

    Science.gov (United States)

    Bavinger, J Clay; DeLoss, Karen; Mian, Shahzad I

    2015-07-01

    Dry eye syndrome can be difficult to manage in severe or refractory cases. In patients in whom traditional treatments have limited efficacy, alternative treatments may be considered for dry eye syndrome, including scleral lenses. The present review summarizes the evidence regarding scleral lens use in dry eye syndrome. Scleral lenses have become a viable option for severe dry eye syndrome, and have been shown to be efficacious and well tolerated, with most reports citing improved visual acuity and relief of symptoms. Currently, there are 18 manufacturers of scleral lenses, although published reports on scleral lenses primarily focus on the BostonSight PROSE and the Jupiter Lens. Scleral lenses are efficacious and well tolerated for use in severe dry eye syndrome. Further research is needed to compare different sizes and types of lenses, and to standardize outcome measures.

  13. Crystalline lens radioprotectors

    International Nuclear Information System (INIS)

    Belkacemi, Y.; Pasquier, D.; Castelain, B.; Lartigau, E.; Warnet, J.M.

    2003-01-01

    During more than a half of century, numerous compounds have been tested in different models against radiation-induced cataract. In this report, we will review the radioprotectors that have been already tested for non-human crystalline lens protection. We will focus on the most important published studies in this topic and the mechanisms of cyto-protection reported in. vitro and in. vivo from animals. The most frequent mechanisms incriminated in the cyto-protective effect are: free radical scavenging, limitation of lipid peroxidation, modulation of cycle progression increase of intracellular reduced glutathione pool, reduction of DNA strand breaks and limitation of apoptotic cell death. Arnifostine (or Ethyol) and anethole dithiolethione (or Sulfarlem), already used clinically as chemo- and radio-protectants, could be further test?r for ocular radioprotection particularly for radiation-induced cataract. (author)

  14. Wedged multilayer Laue lens

    International Nuclear Information System (INIS)

    Conley, Ray; Liu Chian; Qian Jun; Kewish, Cameron M.; Macrander, Albert T.; Yan Hanfei; Maser, Joerg; Kang, Hyon Chol; Stephenson, G. Brian

    2008-01-01

    A multilayer Laue lens (MLL) is an x-ray focusing optic fabricated from a multilayer structure consisting of thousands of layers of two different materials produced by thin-film deposition. The sequence of layer thicknesses is controlled to satisfy the Fresnel zone plate law and the multilayer is sectioned to form the optic. An improved MLL geometry can be created by growing each layer with an in-plane thickness gradient to form a wedge, so that every interface makes the correct angle with the incident beam for symmetric Bragg diffraction. The ultimate hard x-ray focusing performance of a wedged MLL has been predicted to be significantly better than that of a nonwedged MLL, giving subnanometer resolution with high efficiency. Here, we describe a method to deposit the multilayer structure needed for an ideal wedged MLL and report our initial deposition results to produce these structures

  15. Aviation Fuel Gauging Sensor Utilizing Multiple Diaphragm Sensors Incorporating Polymer Optical Fiber Bragg Gratings

    DEFF Research Database (Denmark)

    Marques, C. A. F.; Pospori, A.; Saez-Rodriguez, D.

    2016-01-01

    A high-performance fuel gauging sensor is described that uses five diaphragm-based pressure sensors, which are monitored using a linear array of polymer optical fiber Bragg gratings. The sensors were initially characterized using water, revealing a sensitivity of 98 pm/cm for four of the sensors...... of sensors manufactured with a polyurethane-based diaphragm showed no measurable deterioration over a three month period immersed in fuel. These sensors exhibited a sensitivity of 39 pm/cm, which is less than the silicone rubber devices due to the stiffer nature of the polyurethane material used....

  16. Automated Diaphragm Loading for the LB/TS (Large Blast/Thermal Simulator).

    Science.gov (United States)

    1986-02-28

    103 87 10 925 Q & T 150 126 132 ill 9 775 Q & T 180 151 163 137 7 575 AISI 4140 ANNEALED 90 76 70 59 15 Q & T 125 105 103 87 10 1025 Q & T 150 126 132...carbon steel diaphragm would be 1.9 inches thick, whereas the heat treated alloy steel diaphragm ( AISI 4130) would be 0.44 inches thick. A normalized...EXPOSURE SPEC TREAT @ RT @ 700 F @ RT @ 700 F PERCENT LIMIT ksi ksi ksi ksi in/in F LOW ALLOY STEELS AISI 4130 ANNEALED 90 76 70 59 15 Q & T 125 105

  17. Fabry-Perot Diaphragm Fiber Optic Sensor (DFOS for Acoustic Detection

    Directory of Open Access Journals (Sweden)

    Yan SUN

    2007-10-01

    Full Text Available A diaphragm fiber optic sensor (DFOS solely based on Fabry-Perot multiple beam interference has been designed and fabricated with micro-electric mechanical system (MEMS technology. The silicon diaphragm with an embossed center was designed with an interference gap width kept accurately. The DFOS was verified to be a truly and purely Fabry-Perot device via a critical test. Parallel testing with a Piezoelectric (PZT sensor showed that the DFOS had high sensitivity. The Fabry-Perot DFOS also demonstrated excellent performance in on-line monitoring of Partial Discharge (PD in power transformers.

  18. Effects of cartap on isolated mouse phrenic nerve diaphragm and its related mechanism.

    Science.gov (United States)

    Liao, J W; Kang, J J; Liu, S H; Jeng, C R; Cheng, Y W; Hu, C M; Tsai, S F; Wang, S C; Pang, V F

    2000-06-01

    Cartap, a nereistoxin analogue pesticide, is reported to have no irritation to eyes in rabbits. However, we have demonstrated recently that cartap could actually cause acute death in rabbits via ocular exposure. Our preliminary study with isolated mouse phrenic nerve diaphragms has shown that instead of neuromuscular blockade, cartap caused muscular contracture. The objective of the study was to examine the effect of cartap on the neuromuscular junction in more detail and to investigate its possible underlying mechanism with isolated mouse phrenic nerve diaphragms and sarcoplasmic reticulum (SR) vesicles. Cartap or nereistoxin at various concentrations was added in the organ bath with isolated mouse phrenic nerve diaphragm and both nerve- and muscle-evoked twitches were recorded. Instead of blocking the neuromuscular transmission as nereistoxin did, cartap caused contracture in stimulated or quiescent isolated mouse phrenic nerve diaphragm. Both the cartap-induced muscular contracture force and the time interval to initiate the contracture were dose-dependent. The contracture induced by cartap was not affected by the pretreatment of the diaphragm with the acetylcholine receptor blocker alpha-bungarotoxin; the Na(+) channel blocker tetrodotoxin; or various Ca(2+) channel blockers, NiCl(2), verapamil, and nifedipine. On the contrary, the contracture was significantly inhibited when the diaphragm was pretreated with ryanodine or EGTA containing Ca(2+)-free Krebs solution or in combination. This suggested that both internal and extracellular Ca(2+) might participate in cartap-induced skeletal muscle contracture. Moreover, cartap inhibited the [(3)H]-ryanodine binding to the Ca(2+) release channel of SR in a dose-dependent manner. Additionally, cartap could induce a significant reduction in Ca(2+)-ATPase activity of SR vesicles at a relatively high dose. The results suggested that cartap might cause the influx of extracellular Ca(2+) and the release of internal Ca(2

  19. A pilot study to determine if intraocular lens choice at the time of cataract surgery has an impact on patient-reported driving habits

    Directory of Open Access Journals (Sweden)

    Beiko GHH

    2015-08-01

    Full Text Available George HH Beiko1,2 1Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada; 2Division of Ophthalmology, Department of Surgery, McMaster University, Hamilton, ON, CanadaPurpose: To determine if intraocular lens (IOL choice at the time of cataract surgery affects driving habits.Materials and methods: Pseudophakes who were 28–35 months postbilateral cataract surgery with one of two contemporary one-piece hydrophobic acrylic IOLs (SN60WF or ZCB00 were asked to complete the Driving Habits Questionnaire, a validated instrument for determining self-reported driving status, frequency, and difficulty. To determine if there were any differences in driving habits between the two groups, t-tests and χ2 tests were used.Results: Of 90 respondents, 72 (40 SN60WF and 32 ZCB00 were still active drivers. The SN60WF-implanted subjects were less likely to drive at the same speed or faster than the general flow of traffic, less likely to rate their quality of driving as average/above average, less likely to have traveled beyond their immediate neighborhood, less likely to drive at night, more likely to have moderate-to-severe difficulty driving at night, and more likely to have self-reported road traffic accidents. The differences did not reach statistical significance.Conclusion: Changes in patients’ driving habits 2–3 years after cataract surgery may be associated with the type of IOL implanted. A larger study, powered to demonstrate statistical significance, is needed to verify the trends identified in this pilot study and discover possible contributing factors.Keywords: intraocular lens, cataract surgery, driving habits, disability glare, retinal straylight, accidents

  20. Clinical research on high oxygen permeable contact lens used after photorefractive keratectomy surgery

    Directory of Open Access Journals (Sweden)

    Hao-Jiang Yang

    2013-07-01

    Full Text Available AIM: To evaluate the outcome of high oxygen permeable contact lens used after photorefractive keratectomy(PRKsurgery.METHODS: Totally 95 patients(190 eyesafter PRK were included. Patients were randomly assigned to wear high oxygen permeable contact lens in one eye and normal lens in the fellow eye after surgery. The subjective symptoms and corneal epithelial status after PRK were evaluated. Uncorrected visual acuity(UCVAand haze were assessed at 6 months after PRK.RESULTS: Complaints of blurred vision, pain and photophobia were statistically more among the normal lens group than high oxygen permeable contact lens group(PPP=0.35. There was no difference in UCVA and haze 6 months after surgery(P=0.55. CONCLUSION: High oxygen permeable contact lens can significantly produce less the corneal irritated symptoms, reduce the discomfort feeling and promote healing of corneal epithelium after PRK.

  1. CONSTRUCTIVE ASPECTS INFLUENCE ON STIFFNESS OF DIAPHRAGM WALLS IN FRAME CONSTRUCTIONS WITH (LIGHT STEEL THIN –WALLED STRUCTURES

    Directory of Open Access Journals (Sweden)

    M. V. Savytskyi

    2010-10-01

    Full Text Available The dependences of influence of structural features of diaphragms of lightweight steel framing braced wall structures on their stiffness are determined. On the basis of dependences the procedure for estimation of stiffness of a diaphragm of any configuration that allows making decisions for maintenance of building stiffness is developed.

  2. Improving the Performance of Two-Stage Gas Guns By Adding a Diaphragm in the Pump Tube

    Science.gov (United States)

    Bogdanoff, D. W.; Miller, Robert J.

    1995-01-01

    Herein, we study the technique of improving the gun performance by installing a diaphragm in the pump tube of the gun. A CFD study is carried out for the 0.28 in. gun in the Hypervelocity Free Flight Radiation (HFF RAD) range at the NASA Ames Research Center. The normal, full-length pump tube is studied as well as two pump tubes of reduced length (approximately 75% and approximately 33% of the normal length). Significant improvements in performance are calculated to be gained for the reduced length pump tubes upon the addition of the diaphragm. These improvements are identified as reductions in maximum pressures in the pump tube and at the projectile base of approximately 20%, while maintaining the projectile muzzle velocity or as increases in muzzle velocity of approximately 0.5 km/sec while not increasing the maximum pressures in the gun. Also, it is found that both guns with reduced pump tube length (with diaphragms) could maintain the performance of gun with the full length pump tube without diaphragms, whereas the guns with reduced pump tube lengths without diaphragms could not. A five-shot experimental investigation of the pump tube diaphragm technique is carried out for the gun with a pump tube length of 75% normal. The CFD predictions of increased muzzle velocity are borne out by the experimental data. Modest, but useful muzzle velocity increases (2.5 - 6%) are obtained upon the installation of a diaphragm, compared to a benchmark shot without a diaphragm.

  3. Lente de contato de material híbrido em pacientes com ceratocone e astigmatismo miópico composto Hybrid material contact lens in keratoconus and myopic astigmatism patients

    Directory of Open Access Journals (Sweden)

    Fernando Leal

    2007-03-01

    óculos, exceto para a freqüência B (3 cpg, maior nos usuários de óculos. As aberrações de alta ordem analisadas apresentaram diminuição estatisticamente significante, quando comparados os pacientes sem e com uso de lentes de contato, com exceção da aberração esférica e do coma. CONCLUSÃO: A lente de contato de material híbrido, quando utilizada por portadores de ceratocone e astigmatismo miópico composto, propiciaram desempenho visual e conforto satisfatórios, em níveis que não diferiram, das lentes de contato rígidas-gás-permeáveis nos dois grupos de pacientes.PURPOSE: To evaluate comfort and visual performance in relation to two different used contact lens types: hybrid material (HM and rigid-gas-permeable (RGP, in patients with regular myopic astigmatism and with keratoconus. METHODS: A randomized, double masked, prospective study of 22 patients with the diagnosis of myopic astigmatism (8 with myopic astigmatism and 14 with keratoconus was conducted. Fifteen patients were female and 7 were male, and mean age was: 32.13 ± 8.12 years. In one of the eyes a rigid-gas-permeable contact lens was adapted (DK 30, and in the other a hybrid material contact lens was adapted (DK 23. All patients were submitted to the following tests: measurement of comfort level by means of the analogical visual scale, tear break-up time, best corrected visual acuity with the Bailey-Lovie scale adapted for 4 meters, functional acuity contrast test (FACT and wavefront analysis. RESULTS: In relation to comfort, there was no association with the evaluated contact lens type (p=0.350. There was a variation in comfort level during the first 7 days. The visual acuity increased between the 7th and the 15th day of adaptation. Visual acuity stabilized right after this period. The visual acuity did not show differences in relation to the studied lens type. It was verified that there was no difference in the tear break-up time (p=0.989 in relation to the studied lenses type and

  4. Contact Lens-Related Eye Infections

    Science.gov (United States)

    ... Español Eye Health / Eye Health A-Z Contact Lens-Related Eye Infections Sections Contact Lens-Related Eye ... Six Steps to Avoid Contact Lens Infections Contact Lens-Related Eye Infections Leer en Español: Infecciones relacionadas ...

  5. 21 CFR 886.1375 - Bagolini lens.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Bagolini lens. 886.1375 Section 886.1375 Food and... OPHTHALMIC DEVICES Diagnostic Devices § 886.1375 Bagolini lens. (a) Identification. A Bagolini lens is a device that consists of a plane lens containing almost imperceptible striations that do not obscure...

  6. Straylight Measurements in Contact Lens Wear

    NARCIS (Netherlands)

    van der Meulen, Ivanka J. E.; Engelbrecht, Leonore A.; van Vliet, Johannes M. J.; Lapid-Gortzak, Ruth; Nieuwendaal, Carla P.; Mourits, Maarten P.; Schlingemann, Reinier O.; van den Berg, Thomas J. T. P.

    2010-01-01

    Purpose: (1) To quantify the effect of contact lens wear on straylight in rigid and soft contact lens wearers and (2) to relate findings to morphological changes and subjective complaints. Methods: Straylight was measured using the Oculus C-Quant during contact lens wear and after contact lens

  7. Piggyback intraocular lens implantation to correct pseudophakic refractive error after segmental multifocal intraocular lens implantation.

    Science.gov (United States)

    Venter, Jan A; Oberholster, Andre; Schallhorn, Steven C; Pelouskova, Martina

    2014-04-01

    To evaluate refractive and visual outcomes of secondary piggyback intraocular lens implantation in patients diagnosed as having residual ametropia following segmental multifocal lens implantation. Data of 80 pseudophakic eyes with ametropia that underwent Sulcoflex aspheric 653L intraocular lens implantation (Rayner Intraocular Lenses Ltd., East Sussex, United Kingdom) to correct residual refractive error were analyzed. All eyes previously had in-the-bag zonal refractive multifocal intraocular lens implantation (Lentis Mplus MF30, models LS-312 and LS-313; Oculentis GmbH, Berlin, Germany) and required residual refractive error correction. Outcome measurements included uncorrected distance visual acuity, corrected distance visual acuity, uncorrected near visual acuity, distance-corrected near visual acuity, manifest refraction, and complications. One-year data are presented in this study. The mean spherical equivalent ranged from -1.75 to +3.25 diopters (D) preoperatively (mean: +0.58 ± 1.15 D) and reduced to -1.25 to +0.50 D (mean: -0.14 ± 0.28 D; P < .01). Postoperatively, 93.8% of eyes were within ±0.50 D and 98.8% were within ±1.00 D of emmetropia. The mean uncorrected distance visual acuity improved significantly from 0.28 ± 0.16 to 0.01 ± 0.10 logMAR and 78.8% of eyes achieved 6/6 (Snellen 20/20) or better postoperatively. The mean uncorrected near visual acuity changed from 0.43 ± 0.28 to 0.19 ± 0.15 logMAR. There was no significant change in corrected distance visual acuity or distance-corrected near visual acuity. No serious intraoperative or postoperative complications requiring secondary intraocular lens removal occurred. Sulcoflex lenses proved to be a predictable and safe option for correcting residual refractive error in patients diagnosed as having pseudophakia. Copyright 2014, SLACK Incorporated.

  8. Immunohistochemical studies of lens crystallins in the dysgenetic lens (dyl) mutant mice

    NARCIS (Netherlands)

    Brahma, S.K.; Sanyal, S.

    1984-01-01

    The lens in the dyl mutant mice shows a persistent lens-ectodermal connection as well as degeneration and extrusion of lens materials after the initial differentiation of the fibres. Immunohistochemical investigation of the ontogeny of the lens crystallins in this developing mutant lens has been

  9. Radiation dose to the eye lens

    DEFF Research Database (Denmark)

    Baun, Christina; Falch Braas, Kirsten; D. Nielsen, Kamilla

    2015-01-01

    Radiation Dose to the Eye Lens: Does Positioning Really Matter? C. Baun1, K. Falch1, K.D. Nielsen2, S. Shanmuganathan1, O. Gerke1, P.F. Høilund-Carlsen1 1Department of Nuclear Medicine, Odense University Hospital, Odense C, Denmark. 2University College Lillebaelt, Odense, Denmark. Aim: The scan...... field in oncology patients undergoing eyes-to-thighs PET/CT must always include the base of the scull according to department guidelines. The eye lens is sensitive to radiation exposure and if possible it should be avoided to scan the eye. If the patient’s head is kipped backwards during the scan one...... might avoid including the eye in the CT scan without losing sufficient visualization of the scull base. The aim of this study was to evaluate the possibility of decreasing the radiation dose to the eye lens, simply by changing the head position, when doing the PET/CT scan from the base of the scull...

  10. The safety and efficacy of contact lens wear in the industrial and chemical workplace.

    Science.gov (United States)

    Tyhurst, Keith; McNett, Ryan; Bennett, Edward

    2007-11-01

    The use and safety of contact lenses in the industrial and chemical workplace has often been questioned since the 1960s because of many unconfirmed reports of ocular injury resulting from contact lens wear. Because of these urban legends, contact lens wear has been banned or wearers have been required to wear additional personal protective equipment (PPE) not required of non-contact lens wearers. Literature review via Medline and Google search. Research has shown that contact lenses typically provide protective benefits that decrease the severity of ocular injury and improve worker performance. While contact lens wear contraindications do exist, in most cases, and with proper precautions, contact lens wear is still possible. Industrial and chemical companies need to establish written contact lens use policies based on current studies that have shown the safety of workplace contact lens wear when combined with the same PPE required of non-contact lens wearers. Practitioners need to discuss, with their contact lens patients, the additional responsibilities required to maintain proper lens hygiene and proper PPE in the workplace.

  11. Scleral suspension pars-plana lensectomy for ectopia lentis followed by suture fixation of intraocular lens

    Directory of Open Access Journals (Sweden)

    Mitra Sandip

    2001-01-01

    Full Text Available Purpose: To describe a simple technique of scleral suspension-pars plana lensectomy (SS-PPL in acquired and congenital ectopia lentis and scleral fixation of intraocular lens (IOL. Materials and Methods: Twenty eyes of 16 patients (12 unilateral and 4 bilateral cases of "essential familial lens subluxation" aged 10-40 years (mean 25 years underwent SS-PPL with implantation of scleral fixated IOL. Indications for surgery were best-corrected visual acuity <6/18, bisection of pupil by the lens, and lens-induced glaucoma. Prerequisites for SS-PPL were, visibility of part of the lens in the pupillary area and soft lens. Results: Postoperative visual acuity ranged from 6/6 - 6/36. Lens tilt in 3 cases(15% and small decentration in 2 cases(10% were seen; however these did not seriously compromise the visual result. Scant vitreous bleeding on the first postoperative day was seen in 3 cases (15%. Conclusion: The advantages of the scleral suspension of subluxated lens prior to lensectomy include stabilization; it allows proper viewing of the lens, avoids injury to the iris and cliary body during lensectomy and reduces the possibility of dislocation of the lens.

  12. Effects of acute respiratory and metabolic acidosis on diaphragm muscle obtained from rats.

    Science.gov (United States)

    Michelet, Pierre; Carreira, Serge; Demoule, Alexandre; Amour, Julien; Langeron, Olivier; Riou, Bruno; Coirault, Catherine

    2015-04-01

    Acute respiratory acidosis is associated with alterations in diaphragm performance. The authors compared the effects of respiratory acidosis and metabolic acidosis in the rat diaphragm in vitro. Diaphragmatic strips were stimulated in vitro, and mechanical and energetic variables were measured, cross-bridge kinetics calculated, and the effects of fatigue evaluated. An extracellular pH of 7.00 was obtained by increasing carbon dioxide tension (from 25 to 104 mmHg) in the respiratory acidosis group (n = 12) or lowering bicarbonate concentration (from 24.5 to 5.5 mM) in the metabolic acidosis group (n = 12) and the results compared with a control group (n = 12, pH = 7.40) after 20-min exposure. Respiratory acidosis induced a significant decrease in maximum shortening velocity (-33%, P Respiratory acidosis impaired more relaxation than contraction, as shown by impairment in contraction-relaxation coupling under isotonic (-26%, P acidosis group. In rat diaphragm, acute (20 min) respiratory acidosis induced a marked decrease in the diaphragm contractility, which was not observed in metabolic acidosis.

  13. Bending-induced electromechanical coupling and large piezoelectric response in a micromachined diaphragm

    KAUST Repository

    Wang, Zhihong; Yao, Yingbang; Wang, Xianbin; Yue, Weisheng; Chen, Longqing; Zhang, Xixiang

    2013-01-01

    We investigated the dependence of electromechanical coupling and the piezoelectric response of a micromachined Pb(Zr 0.52 Ti 0.48)O 3 (PZT) diaphragm on its curvature by observing the impedance spectrum and central deflection responses to a small AC

  14. Distinct functions of Crumbs regulating slit diaphragms and endocytosis in Drosophila nephrocytes.

    Science.gov (United States)

    Hochapfel, Florian; Denk, Lucia; Mendl, Gudrun; Schulze, Ulf; Maaßen, Christine; Zaytseva, Yulia; Pavenstädt, Hermann; Weide, Thomas; Rachel, Reinhard; Witzgall, Ralph; Krahn, Michael P

    2017-12-01

    Mammalian podocytes, the key determinants of the kidney's filtration barrier, differentiate from columnar epithelial cells and several key determinants of apical-basal polarity in the conventional epithelia have been shown to regulate podocyte morphogenesis and function. However, little is known about the role of Crumbs, a conserved polarity regulator in many epithelia, for slit-diaphragm formation and podocyte function. In this study, we used Drosophila nephrocytes as model system for mammalian podocytes and identified a conserved function of Crumbs proteins for cellular morphogenesis, nephrocyte diaphragm assembly/maintenance, and endocytosis. Nephrocyte-specific knock-down of Crumbs results in disturbed nephrocyte diaphragm assembly/maintenance and decreased endocytosis, which can be rescued by Drosophila Crumbs as well as human Crumbs2 and Crumbs3, which were both expressed in human podocytes. In contrast to the extracellular domain, which facilitates nephrocyte diaphragm assembly/maintenance, the intracellular FERM-interaction motif of Crumbs is essential for regulating endocytosis. Moreover, Moesin, which binds to the FERM-binding domain of Crumbs, is essential for efficient endocytosis. Thus, we describe here a new mechanism of nephrocyte development and function, which is likely to be conserved in mammalian podocytes.

  15. Concrete Flow in Diaphragm Wall Panels : A Full-Scale In-Situ Test

    NARCIS (Netherlands)

    Van Dalen, J.H.; Bosch, J.W.; Broere, W.

    2015-01-01

    Flow processes, taking place during the concreting of diaphragm wall panels (D-wall panels), are of great importance for the quality of the wall. During this phase, the bentonite, present in the excavated trench, should be completely replaced by concrete in a controlled way. In literature several

  16. Displacement and resonance behaviors of a piezoelectric diaphragm driven by a double-sided spiral electrode

    KAUST Repository

    Shen, Zhiyuan; Olfatnia, Mohammad; Miao, Jianmin; Wang, Zhihong

    2012-01-01

    This paper presents the design of a lead zirconate titanate (PZT) diaphragm actuated by double-sided patterned electrodes. Au/Cr electrodes were deposited on bulk PZT wafers by sputtering while patterned by a lift-off process. SU-8 thick film

  17. Changes in the Diaphragm Lipid Content after Administration of Streptozotocin and High-Fat Diet Regime

    Directory of Open Access Journals (Sweden)

    Bartlomiej Lukaszuk

    2017-01-01

    Full Text Available The diaphragm is a dome-shaped skeletal muscle indispensable for breathing. Its activity contributes up to 70% of the total ventilatory function at rest. In comparison to other skeletal muscles, it is distinguished by an oxidative phenotype and uninterrupted cyclic contraction pattern. Surprisingly, the research regarding diaphragm diabetic phenotype particularly in the light of lipid-induced insulin resistance is virtually nonexistent. Male Wistar rats were randomly allocated into 3 groups: control, streptozotocin-induced (STZ type-1 diabetes, and rodents fed with high-fat diet (HFD. Additionally, half of the animals from each group were administered with myriocin, a robust, selective inhibitor of ceramide synthesis and, therefore, a potent agent ameliorating insulin resistance. Diaphragm lipid contents were evaluated using chromatography. Fatty acid transporter expression was determined by Western blot. The STZ and HFD rats had increased concentration of lipids, namely, ceramides (CER and diacylglycerols (DAG. Interestingly, this coincided with an increased concentration of long-chain (C ≥ 16 saturated fatty acid species present in both the aforementioned lipid fractions. The CER/DAG accumulation was accompanied by an elevated fatty acid transporter expression (FATP-1 in HFD and FATP-4 in STZ. Surprisingly, we observed a significantly decreased triacylglycerol content in the diaphragms of STZ-treated rats.

  18. Midbrain and medullary control of postinspiratory activity of the crural and costal diaphragm in vivo

    NARCIS (Netherlands)

    Subramanian, Hari H.; Holstege, Gert

    Subramanian HH, Holstege G. Midbrain and medullary control of postinspiratory activity of the crural and costal diaphragm in vivo. J Neurophysiol 105: 2852-2862, 2011. First published March 30, 2011; doi:10.1152/jn.00168.2011.-Studies on brain stem respiratory neurons suggest that eupnea consists of

  19. Where Did the Water Go?: Boyle's Law and Pressurized Diaphragm Water Tanks

    Science.gov (United States)

    Brimhall, James; Naga, Sundar

    2007-01-01

    Many homes use pressurized diaphragm tanks for storage of water pumped from an underground well. These tanks are very carefully constructed to have separate internal chambers for the storage of water and for the air that provides the pressure. One might expect that the amount of water available for use from, for example, a 50-gallon tank would be…

  20. CFD Fuel Slosh Modeling of Fluid-Structure Interaction in Spacecraft Propellant Tanks with Diaphragms

    Science.gov (United States)

    Sances, Dillon J.; Gangadharan, Sathya N.; Sudermann, James E.; Marsell, Brandon

    2010-01-01

    Liquid sloshing within spacecraft propellant tanks causes rapid energy dissipation at resonant modes, which can result in attitude destabilization of the vehicle. Identifying resonant slosh modes currently requires experimental testing and mechanical pendulum analogs to characterize the slosh dynamics. Computational Fluid Dynamics (CFD) techniques have recently been validated as an effective tool for simulating fuel slosh within free-surface propellant tanks. Propellant tanks often incorporate an internal flexible diaphragm to separate ullage and propellant which increases modeling complexity. A coupled fluid-structure CFD model is required to capture the damping effects of a flexible diaphragm on the propellant. ANSYS multidisciplinary engineering software employs a coupled solver for analyzing two-way Fluid Structure Interaction (FSI) cases such as the diaphragm propellant tank system. Slosh models generated by ANSYS software are validated by experimental lateral slosh test results. Accurate data correlation would produce an innovative technique for modeling fuel slosh within diaphragm tanks and provide an accurate and efficient tool for identifying resonant modes and the slosh dynamic response.

  1. Temperature Compensation Fiber Bragg Grating Pressure Sensor Based on Plane Diaphragm

    Science.gov (United States)

    Liang, Minfu; Fang, Xinqiu; Ning, Yaosheng

    2018-03-01

    Pressure sensors are the essential equipments in the field of pressure measurement. In this work, we propose a temperature compensation fiber Bragg grating (FBG) pressure sensor based on the plane diaphragm. The plane diaphragm and pressure sensitivity FBG (PS FBG) are used as the pressure sensitive components, and the temperature compensation FBG (TC FBG) is used to improve the temperature cross-sensitivity. Mechanical deformation model and deformation characteristics simulation analysis of the diaphragm are presented. The measurement principle and theoretical analysis of the mathematical relationship between the FBG central wavelength shift and pressure of the sensor are introduced. The sensitivity and measure range can be adjusted by utilizing the different materials and sizes of the diaphragm to accommodate different measure environments. The performance experiments are carried out, and the results indicate that the pressure sensitivity of the sensor is 35.7 pm/MPa in a range from 0 MPa to 50 MPa and has good linearity with a linear fitting correlation coefficient of 99.95%. In addition, the sensor has the advantages of low frequency chirp and high stability, which can be used to measure pressure in mining engineering, civil engineering, or other complex environment.

  2. Diaphragm remodeling and compensatory respiratory mechanics in a canine model of Duchenne muscular dystrophy.

    Science.gov (United States)

    Mead, A F; Petrov, M; Malik, A S; Mitchell, M A; Childers, M K; Bogan, J R; Seidner, G; Kornegay, J N; Stedman, H H

    2014-04-01

    Ventilatory insufficiency remains the leading cause of death and late stage morbidity in Duchenne muscular dystrophy (DMD). To address critical gaps in our knowledge of the pathobiology of respiratory functional decline, we used an integrative approach to study respiratory mechanics in a translational model of DMD. In studies of individual dogs with the Golden Retriever muscular dystrophy (GRMD) mutation, we found evidence of rapidly progressive loss of ventilatory capacity in association with dramatic morphometric remodeling of the diaphragm. Within the first year of life, the mechanics of breathing at rest, and especially during pharmacological stimulation of respiratory control pathways in the carotid bodies, shift such that the primary role of the diaphragm becomes the passive elastic storage of energy transferred from abdominal wall muscles, thereby permitting the expiratory musculature to share in the generation of inspiratory pressure and flow. In the diaphragm, this physiological shift is associated with the loss of sarcomeres in series (∼ 60%) and an increase in muscle stiffness (∼ 900%) compared with those of the nondystrophic diaphragm, as studied during perfusion ex vivo. In addition to providing much needed endpoint measures for assessing the efficacy of therapeutics, we expect these findings to be a starting point for a more precise understanding of respiratory failure in DMD.

  3. Acute gastric volvulus secondary to eventration of the diaphragm in a child

    Directory of Open Access Journals (Sweden)

    Singal A

    2006-01-01

    Full Text Available We report an 18-month-old boy who presented with acute organoaxial volvulus of stomach secondary to eventration of diaphragm. Clinically, the child exhibited classical triad of epigastric distension, unproductive retching and inability to pass a nasogastric tube. Successful operative management is presented and relevant literature is discussed.

  4. Temperature Compensation Fiber Bragg Grating Pressure Sensor Based on Plane Diaphragm

    Science.gov (United States)

    Liang, Minfu; Fang, Xinqiu; Ning, Yaosheng

    2018-06-01

    Pressure sensors are the essential equipments in the field of pressure measurement. In this work, we propose a temperature compensation fiber Bragg grating (FBG) pressure sensor based on the plane diaphragm. The plane diaphragm and pressure sensitivity FBG (PS FBG) are used as the pressure sensitive components, and the temperature compensation FBG (TC FBG) is used to improve the temperature cross-sensitivity. Mechanical deformation model and deformation characteristics simulation analysis of the diaphragm are presented. The measurement principle and theoretical analysis of the mathematical relationship between the FBG central wavelength shift and pressure of the sensor are introduced. The sensitivity and measure range can be adjusted by utilizing the different materials and sizes of the diaphragm to accommodate different measure environments. The performance experiments are carried out, and the results indicate that the pressure sensitivity of the sensor is 35.7 pm/MPa in a range from 0 MPa to 50 MPa and has good linearity with a linear fitting correlation coefficient of 99.95%. In addition, the sensor has the advantages of low frequency chirp and high stability, which can be used to measure pressure in mining engineering, civil engineering, or other complex environment.

  5. Electrical activity of the diaphragm during nCPAP and high flow nasal cannula

    NARCIS (Netherlands)

    de Waal, C. G.; Hutten, G. J.; Kraaijenga, J. V.; de Jongh, F. H.; van Kaam, A. H.

    2017-01-01

    Objective To determine if the electrical activity of the diaphragm, as measure of neural respiratory drive and breathing effort, changes over time in preterm infants transitioned from nasal continuous positive airway pressure (nCPAP) to high flow nasal cannula (HFNC). Design Prospective

  6. Design recommendations for the optimized continuity diaphragm for prestressed concrete bulb-T beams.

    Science.gov (United States)

    2008-01-01

    This research focused on prestressed concrete bulb-T (PCBT) beams made composite with a cast-in-place concrete deck and continuous over several spans through the use of continuity diaphragms. The current design procedure in AASHTO states that a conti...

  7. Contact Lens Related Corneal Ulcer

    OpenAIRE

    Loh, KY; Agarwal, P

    2010-01-01

    A corneal ulcer caused by infection is one of the major causes of blindness worldwide. One of the recent health concerns is the increasing incidence of corneal ulcers associated with contact lens user especially if the users fail to follow specific instruction in using their contact lenses. Risk factors associated with increased risk of contact lens related corneal ulcers are: overnight wear, long duration of continuous wear, lower socio-economic classes, smoking, dry eye and poor hygiene. Th...

  8. Crystalline lens and refractive development.

    Science.gov (United States)

    Iribarren, Rafael

    2015-07-01

    Individual refractive errors usually change along lifespan. Most children are hyperopic in early life. This hyperopia is usually lost during growth years, leading to emmetropia in adults, but myopia also develops in children during school years or during early adult life. Those subjects who remain emmetropic are prone to have hyperopic shifts in middle life. And even later, at older ages, myopic shifts are developed with nuclear cataract. The eye grows from 15 mm in premature newborns to approximately 24 mm in early adult years, but, in most cases, refractions are maintained stable in a clustered distribution. This growth in axial length would represent a refractive change of more than 40 diopters, which is compensated by changes in corneal and lens powers. The process which maintains the balance between the ocular components of refraction during growth is still under study. As the lens power cannot be measured in vivo, but can only be calculated based on the other ocular components, there have not been many studies of lens power in humans. Yet, recent studies have confirmed that the lens loses power during growth in children, and that hyperopic and myopic shifts in adulthood may be also produced by changes in the lens. These studies in children and adults give a picture of the changing power of the lens along lifespan. Other recent studies about the growth of the lens and the complexity of its internal structure give clues about how these changes in lens power are produced along life. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Single lens laser beam shaper

    Science.gov (United States)

    Liu, Chuyu [Newport News, VA; Zhang, Shukui [Yorktown, VA

    2011-10-04

    A single lens bullet-shaped laser beam shaper capable of redistributing an arbitrary beam profile into any desired output profile comprising a unitary lens comprising: a convex front input surface defining a focal point and a flat output portion at the focal point; and b) a cylindrical core portion having a flat input surface coincident with the flat output portion of the first input portion at the focal point and a convex rear output surface remote from the convex front input surface.

  10. A course in lens design

    CERN Document Server

    Velzel, Chris

    2014-01-01

    A Course in Lens Design is an instruction in the design of image-forming optical systems. It teaches how a satisfactory design can be obtained in a straightforward way. Theory is limited to a minimum, and used to support the practical design work. The book introduces geometrical optics, optical instruments and aberrations. It gives a description of the process of lens design and of the strategies used in this process. Half of its content is devoted to the design of sixteen types of lenses, described in detail from beginning to end. This book is different from most other books on lens design because it stresses the importance of the initial phases of the design process: (paraxial) lay-out and (thin-lens) pre-design. The argument for this change of accent is that in these phases much information can be obtained about the properties of the lens to be designed. This information can be used in later phases of the design. This makes A Course in Lens Design a useful self-study book, and a suitable basis for an intro...

  11. Hydrogel based sensor arrays (2 × 2) with perforated piezoresistive diaphragms for metabolic monitoring (in vitro).

    Science.gov (United States)

    Orthner, M P; Lin, G; Avula, M; Buetefisch, S; Magda, J; Rieth, L W; Solzbacher, F

    2010-03-19

    This report details the first experimental results from novel hydrogel sensor array (2 × 2) which incorporates analyte diffusion pores into a piezoresistive diaphragm for the detection of hydrogel swelling pressures and hence chemical concentrations. The sensor assembly was comprised of three components, the active four sensors, HPMA/DMA/TEGDMA (hydroxypropyl methacrylate (HPMA), N,N-dimethylaminoethyl methacrylate (DMA) and crosslinker tetra-ethyleneglycol dimethacrylate (TEGDMA)) hydrogel, and backing plate. Each of the individual sensors of the array can be used with various hydrogels used to measure the presence of a number of stimuli including pH, ionic strength, and glucose concentrations. Ideally, in the future, these sensors will be used for continuous metabolic monitoring applications and implanted subcutaneously. In this paper and to properly characterize the sensor assembly, hydrogels sensitive to changes ionic strength were synthesized using hydroxypropyl methacrylate (HPMA), N,N-dimethylaminoethyl methacrylate (DMA) and crosslinker tetra-ethyleneglycol dimethacrylate (TEGDMA) and inserted into the sensor assembly. This hydrogel quickly and reversibly swells when placed environments of physiological buffer solutions (PBS) with ionic strengths ranging from 0.025 to 0.15 M, making it ideal for proof-of-concept testing and initial characterization. The assembly was wire bonded to a printed circuit board and coated with 3 ± 0.5 μm of Parylene-C using chemical vapor deposition (CVD) to protect the sensor and electrical connections during ionic strength wet testing. Two versions of sensors were fabricated for comparison, the first incorporated diffusion pores into the diaphragm, and the second used a solid diaphragm with perforated backing plate. This new design (perforated diaphragm) was shown to have slightly higher sensitivity than solid diaphragm sensors with separate diffuse backing plates when coupled with the hydrogel. The sensitivities for the 1 mm

  12. Two-Port Pars Plana Anterior and Central Core Vitrectomy (Lam Floaterectomy) in Combination With Phacoemulsification and Intraocular Lens Implantation Under Topical Anesthesia for Patients with Cataract and Significant Floaters: Results of the First 50 Consecutive Cases.

    Science.gov (United States)

    Lam, Dennis S C; Leung, Hiu Ying; Liu, Shu; Radke, Nishant; Yuan, Ye; Lee, Vincent Y W

    2017-01-01

    To study the safety and efficacy of 2-port pars plana anterior and central core vitrectomy (Lam floaterectomy) in combination with phacoemulsification (phaco) and intraocular lens implantation (IOL) for patients with cataract and significant floaters under topical anesthesia. Retrospective review of the first 50 consecutive cases. A standardized treatment protocol was used for patients with cataract and significant (moderate to severe) floaters (duration > 3 months). Data analysis included intraoperative and postoperative complications, floater status, and patient satisfaction. There were 50 eyes (38 patients) with a male-to-female ratio of 1 to 2.3. Twelve patients had bilateral eye surgeries. Mean age was 58.10 ± 9.85 years (range, 39-83). All patients completed the 3-month follow-up. One eye had mild vitreous hemorrhage at the end of surgery arising from sclerotomy wound oozing. No other intraoperative compli-cations were encountered. Postoperatively, there was 1 case of transient hypotony and 1 case of congestion at sclerotomy wound. No cases of retinal break or detachment, or clinically significant macular edema, were reported. There were 5 cases (10%) of mild residual floaters and 1 case (2%) of floater recurrence. Total floater clearance rate was 88%. Patient satisfaction rates were 80%, 14%, 6%, and 0% for very satisfied, satis-fied, acceptable, and unsatisfied, respectively. The 3-month results in terms of safety and efficacy of the Lam floaterectomy in combination with phaco and IOLfor patients with cataract and significant floaters under topical anesthesia are encouraging. Further larger-scale, prospective, multicenter studies seem warranted. Copyright© 2017 Asia-Pacific Academy of Ophthalmology.

  13. Repertoire of free-living protozoa in contact lens solutions.

    Science.gov (United States)

    Bouchoucha, Ibtissem; Aziz, Aurore; Hoffart, Louis; Drancourt, Michel

    2016-10-29

    The repertoire of free-living protozoa in contact lens solutions is poorly known despite the fact that such protozoa may act as direct pathogens and may harbor intra-cellular pathogens. Between 2009 and 2014, the contact lens solutions collected from patients presenting at our Ophthalmology Department for clinically suspected keratitis, were cultured on non-nutrient agar examined by microscope for the presence of free-living protozoa. All protozoa were identified by 18S rRNA gene sequencing. A total of 20 of 233 (8.6 %) contact lens solution specimens collected from 16 patients were cultured. Acanthamoeba amoeba in 16 solutions (80 %) collected from 12 patients and Colpoda steini, Cercozoa sp., Protostelium sp. and a eukaryotic more closely related to Vermamoeba sp., were each isolated in one solution. Cercozoa sp., Colpoda sp., Protostelium sp. and Vermamoeba sp. are reported for the first time as contaminating contact lens solutions. The repertoire of protozoa in contact lens solutions is larger than previously known.

  14. Pigment dispersion syndrome associated with spontaneous subluxation of crystalline lens

    Directory of Open Access Journals (Sweden)

    Vikas Veerwal

    2017-01-01

    Full Text Available Pigment dispersion syndrome (PDS is an ocular condition characterized by a dispersion of iris pigment throughout the eye. This pigment is deposited in a characteristic manner on the corneal endothelium as Krukenberg's spindle, anterior surface of the iris, in the trabecular meshwork, on the lens and zonule and occasionally on the anterior hyaloid face. Even with deposition of pigment on zonular fibers, no zonular weakness, or zonular dehiscence has been reported in these cases. We report a unique case of PDS with bilateral spontaneous subluxation of crystalline lens. With characteristic findings of pigment distribution in both his eyes, the patient had concave iris configuration with heavily pigmented trabecular meshwork confirming the diagnosis of PDS. The patient had bilateral 180° temporal subluxation of crystalline lens in both his eyes. The usual cause of lens subluxation such as Marfan's Syndrome and Ehler's Danlos Syndrome was ruled out. The patient underwent right eye followed by left eye intracapsular cataract extraction with ab-interno technique with postoperative best-corrected visual acuity (BCVA of 6/9 in both eyes. Spontaneous subluxation of crystalline lens in isolated PDS is not known to occur and has been reported by means of this case. We recommend a thorough assessment of zonular status in all cases of PDS.

  15. Pigment dispersion syndrome associated with spontaneous subluxation of crystalline lens.

    Science.gov (United States)

    Veerwal, Vikas; Goyal, Jawahar Lal; Jain, Parul; Arora, Ritu

    2017-01-01

    Pigment dispersion syndrome (PDS) is an ocular condition characterized by a dispersion of iris pigment throughout the eye. This pigment is deposited in a characteristic manner on the corneal endothelium as Krukenberg's spindle, anterior surface of the iris, in the trabecular meshwork, on the lens and zonule and occasionally on the anterior hyaloid face. Even with deposition of pigment on zonular fibers, no zonular weakness, or zonular dehiscence has been reported in these cases. We report a unique case of PDS with bilateral spontaneous subluxation of crystalline lens. With characteristic findings of pigment distribution in both his eyes, the patient had concave iris configuration with heavily pigmented trabecular meshwork confirming the diagnosis of PDS. The patient had bilateral 180° temporal subluxation of crystalline lens in both his eyes. The usual cause of lens subluxation such as Marfan's Syndrome and Ehler's Danlos Syndrome was ruled out. The patient underwent right eye followed by left eye intracapsular cataract extraction with ab-interno technique with postoperative best-corrected visual acuity (BCVA) of 6/9 in both eyes. Spontaneous subluxation of crystalline lens in isolated PDS is not known to occur and has been reported by means of this case. We recommend a thorough assessment of zonular status in all cases of PDS.

  16. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Be More Independent Oct 31, ... scientists in England have given blind patients some functional vision, using human embryonic stem cells. Two blind patients regained enough ...

  17. Free-Standing β-Ga2O3 Thin Diaphragms

    Science.gov (United States)

    Zheng, Xu-Qian; Lee, Jaesung; Rafique, Subrina; Han, Lu; Zorman, Christian A.; Zhao, Hongping; Feng, Philip X.-L.

    2018-02-01

    Free-standing, very thin, single-crystal β-gallium oxide (β-Ga2O3) diaphragms have been constructed and their dynamical mechanical properties characterized by noncontact, noninvasive optical measurements harnessing the multimode nanomechanical resonances of these suspended nanostructures. We synthesized single-crystal β-Ga2O3 using low-pressure chemical vapor deposition (LPCVD) on a 3C-SiC epilayer grown on Si substrate at temperature of 950°C for 1.5 h. The synthesized single-crystal nanoflakes had widths of ˜ 2 μm to 30 μm and thicknesses of ˜ 20 nm to 140 nm, from which we fabricated free-standing circular drumhead β-Ga2O3 diaphragms with thicknesses of ˜ 23 nm to 73 nm and diameters of ˜ 3.2 μm and ˜ 5.2 μm using a dry stamp-transfer technique. Based on measurements of multiple flexural-mode mechanical resonances using ultrasensitive laser interferometric detection and performing thermal annealing at 250°C for 1.5 h, we quantified the effects of annealing and adsorption of atmospheric gas molecules on the resonant characteristics of the diaphragms. Furthermore, we studied the effects of structural nonidealities on these free-standing β-Ga2O3 nanoscale diaphragms. We present extensive characterization of the mechanical and optical properties of free-standing β-Ga2O3 diaphragms, paving the way for realization of resonant transducers using such nanomechanical structures for use in applications including gas sensing and ultraviolet radiation detection.

  18. Assessment of Diaphragm and External Intercostals Fatigue from Surface EMG using Cervical Magnetic Stimulation

    Directory of Open Access Journals (Sweden)

    Ya-Ju Chang

    2008-03-01

    Full Text Available This study was designed: (1 to test the reliability of surface electromyography (sEMG recording of the diaphragm and external intercostals contractions response to cervical magnetic stimulation (CMS, (2 to examine the amount and the types of inspiratory muscle fatigue that developed after maximum voluntary ventilation (MVV maneuvers.Ten male college students without physical disability (22.1±2.0 years old participated in the study and each completed a control (quiet breathing trial and a fatigue (MVV maneuvers trial sequentially. In the quiet breathing trial, the subjects maintained quiet breathing for five minutes. The subjects performed five maximal static inspiratory efforts and received five CMS before and after the quiet breathing. In the MVV trial, subjects performed five maximal inspiratory efforts and received five CMS before, immediately after, and ten minutes after two sets of MVV maneuvers performed five minutes apart. Maximal inspiratory pressure (PImax, sEMG of diaphragm and external intercostals during maximal static inspiratory efforts and during CMS were recorded. In the quiet breathing trial, high intraclass correlation coefficients (ICC=0.95-0.99 were observed in all the variables. In the MVV trial, the PImax, the EMG amplitude and the median power frequency during maximal static inspiratory efforts significantly decreased in both the diaphragm and the external intercostals immediately after the MVV maneuvers Sensors 2008, 8 2175 (P 0.05. It is concluded that the sEMG recordings of the diaphragm during maximal static inspiratory efforts and in response to CMS allow reproducible sequential assessment of diaphragm contractility. MVV maneuvers resulted in inspiratory muscles fatigue, possibly central fatigue.

  19. Severe pigment dispersion after iris-claw phakic intraocular lens implantation

    Directory of Open Access Journals (Sweden)

    Virgilio Galvis

    2017-01-01

    Full Text Available A 23-year-old female patient presented 3 months after the implantation of an Artisan® phakic intraocular lens with a severe depigmentation of the iris and peripheral anterior synechiae. Explantation of the intraocular lens and goniosynechialysis were performed. Eleven months after the explantation appearance of the iris significantly improved. There was no loss of lines of corrected distance visual acuity. Severe pigment dispersion after the implantation of an Artisan® phakic intraocular lens may happen and may require explantation of the lens. Iris depigmentation may improve with time.

  20. Severe pigment dispersion after iris-claw phakic intraocular lens implantation.

    Science.gov (United States)

    Galvis, Virgilio; Carreño, Néstor I; Tello, Alejandro; Laiton, Andrea N

    2017-12-01

    A 23-year-old female patient presented 3 months after the implantation of an Artisan® phakic intraocular lens with a severe depigmentation of the iris and peripheral anterior synechiae. Explantation of the intraocular lens and goniosynechialysis were performed. Eleven months after the explantation appearance of the iris significantly improved. There was no loss of lines of corrected distance visual acuity. Severe pigment dispersion after the implantation of an Artisan® phakic intraocular lens may happen and may require explantation of the lens. Iris depigmentation may improve with time.

  1. Contrast sensitivity after refractive lens exchange with a multifocal diffractive aspheric intraocular lens

    Directory of Open Access Journals (Sweden)

    Teresa Ferrer-Blasco

    2013-04-01

    Full Text Available PURPOSE: To evaluate distance and near contrast sensitivity (CS under photopic and mesopic conditions before and after refractive lens exchange (RLE and implantation of the aspheric AcrySof®ReSTOR® (SN6AD3 model intraocular lens (IOL. METHODS:Seventy-four eyes of 37 patients after RLE underwent bilateral implantation with the aspheric AcrySof ReSTOR IOL. The patient sample was divided into myopic and hyperopic groups. Monocular uncorrected visual acuity at distance and near (UCVA and UCNVA, respectively and monocular best corrected visual acuity at distance and near (BCVA and BCNVA, respectively were measured before and 6 months postoperatively. Monocular CS function was measured at three different luminance levels (85, 5 and 2.5 cd/m² before and after RLE. Post-implantation results at 6 months were compared with those found before surgery. RESULTS: Our results revealed that patients in both groups obtained good UCVA and BCVA after RLE at distance and near vision in relation to pre-surgery values. No statistically significant differences were found between the values of CS pre and post-RLE at distance and near, at any lighting condition and spatial frequency (p>0.002. CONCLUSIONS: Refractive lens exchange with aspheric AcrySof ReSTOR IOL in myopic and hyperopic population provided good visual function and yield good distance and near CS under photopic and mesopic conditions.

  2. Ocular distribution of antioxidant enzyme paraoxonase & its alteration in cataractous lens & diabetic retina

    Directory of Open Access Journals (Sweden)

    Subramaniam Rajesh Bharathidevi

    2017-01-01

    Interpretation & conclusions: Distribution of PON enzyme and its activity in ocular tissues is reported here. The study revealed maximal PON activity in lens and retina, which are prone to higher oxidative stress. Differential activities of PON were observed in the lens and retinal tissues from cataractous and diabetic patients, respectively.

  3. Cx43, ZO-1, alpha-catenin and beta-catenin in cataractous lens

    Indian Academy of Sciences (India)

    Specimens of the anterior lens capsule with an attached monolayer of lens epithelial cells (LECs) were obtained from patients (=52) undergoing cataract surgery. Specimens were divided into three groups based on the type of cataract: nuclear cataract, cortical cataract and posterior subcapsular cataract (PSC).

  4. Opaque iris claw lens in a phakic eye to correct acquired diplopia

    NARCIS (Netherlands)

    Landesz, M; Worst, JGF; Rij, GV; Houtman, WA

    1997-01-01

    A 25-year-old man had diplopia caused by abducens nerve paresis on both sides after cranial injury. Because of the patient's reports of persistent diplopia after surgical correction, a specially manufactured, tinted iris claw lens was implanted in the left eye, with the crystalline lens in situ.

  5. Depletion of Pax7+ satellite cells does not affect diaphragm adaptations to running in young or aged mice.

    Science.gov (United States)

    Murach, Kevin A; Confides, Amy L; Ho, Angel; Jackson, Janna R; Ghazala, Lina S; Peterson, Charlotte A; Dupont-Versteegden, Esther E

    2017-10-01

    Satellite cell depletion does not affect diaphragm adaptations to voluntary wheel running in young or aged mice. Satellite cell depletion early in life (4 months of age) has minimal effect on diaphragm phenotype by old age (24 months). Prolonged satellite cell depletion in the diaphragm does not result in excessive extracellular matrix accumulation, in contrast to what has been reported in hind limb muscles. Up-regulation of Pax3 mRNA+ cells after satellite cell depletion in young and aged mice suggests that Pax3+ cells may compensate for a loss of Pax7+ satellite cells in the diaphragm. Future investigations should focus on the role of Pax3+ cells in the diaphragm during adaptation to exercise and ageing. Satellite cell contribution to unstressed diaphragm is higher compared to hind limb muscles, which is probably attributable to constant activation of this muscle to drive ventilation. Whether satellite cell depletion negatively impacts diaphragm quantitative and qualitative characteristics under stressed conditions in young and aged mice is unknown. We therefore challenged the diaphragm with prolonged running activity in the presence and absence of Pax7+ satellite cells in young and aged mice using an inducible Pax7 CreER -R26R DTA model. Mice were vehicle (Veh, satellite cell-replete) or tamoxifen (Tam, satellite cell-depleted) treated at 4 months of age and were then allowed to run voluntarily at 6 months (young) and 22 months (aged). Age-matched, cage-dwelling, Veh- and Tam-treated mice without wheel access served as activity controls. Diaphragm muscles were analysed from young (8 months) and aged (24 months) mice. Satellite cell depletion did not alter diaphragm mean fibre cross-sectional area, fibre type distribution or extracellular matrix content in young or aged mice, regardless of running activity. Resting in vivo diaphragm function was also unaffected by satellite cell depletion. Myonuclear density was maintained in young satellite cell

  6. THE EFFECT OF INNER DIAPHRAGMS AND NON-CONTINUOUS SILL SECTION ON THE STIFFNESS OF AUTOMOTIVE B-PILLAR

    Directory of Open Access Journals (Sweden)

    C.F. Tan

    2017-11-01

    Full Text Available The paper discusses the knowledge on the behaviour of T-frame under specific loading will be obtained by experimental methods in order to investigate the deflection of the vehicle B-pillar or T-frame. In addition, a series of T-frame were designed with inner diaphragm at various location in the sill member in order to investigate the effect of inner diaphragm and noncontinuous closed hat section in the sill member. Lastly, the results from the experimental tests were compared with the finite element analysis results to demonstrate the effectiveness of the inner diaphragm in the automotive B-pillar.

  7. Colored Contact Lens Dangers

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  15. Overexpression of antioxidant enzymes in diaphragm muscle does not alter contraction-induced fatigue or recovery

    Science.gov (United States)

    McClung, Joseph M.; DeRuisseau, Keith C.; Whidden, Melissa A.; Van Remmen, Holly; Richardson, Arlan; Song, Wook; Vrabas, Ioannis S.; Powers, Scott K.

    2010-01-01

    Low levels of reactive oxygen species (ROS) production are necessary to optimize muscle force production in unfatigued muscle. In contrast, sustained high levels of ROS production have been linked to impaired muscle force production and contraction-induced skeletal muscle fatigue. Using genetically engineered mice, we tested the hypothesis that the independent transgenic overexpression of catalase (CAT), copper/zinc superoxide dismutase (CuZnSOD; SOD1) or manganese superoxide dismutase (MnSOD; SOD2) antioxidant enzymes would negatively affect force production in unfatigued diaphragm muscle but would delay the development of muscle fatigue and enhance force recovery after fatiguing contractions. Diaphragm muscle from wild-type littermates (WT) and from CAT, SOD1 and SOD2 overexpressing mice were subjected to an in vitro contractile protocol to investigate the force–frequency characteristics, the fatigue properties and the time course of recovery from fatigue. The CAT, SOD1 and SOD2 overexpressors produced less specific force (in N cm−2) at stimulation frequencies of 20–300 Hz and produced lower maximal tetanic force than WT littermates. The relative development of muscle fatigue and recovery from fatigue were not influenced by transgenic overexpression of any antioxidant enzyme. Morphologically, the mean cross-sectional area (in μm2) of diaphragm myofibres expressing myosin heavy chain type IIA was decreased in both CAT and SOD2 transgenic animals, and the percentage of non-contractile tissue increased in diaphragms from all transgenic mice. In conclusion, our results do not support the hypothesis that overexpression of independent antioxidant enzymes protects diaphragm muscle from contraction-induced fatigue or improves recovery from fatigue. Moreover, our data are consistent with the concept that a basal level of ROS is important to optimize muscle force production, since transgenic overexpression of major cellular antioxidants is associated with

  16. Spectral analysis and comparison of mineral deposits forming in opacified intraocular lens and senile cataractous lens

    Science.gov (United States)

    Lin, Shan-Yang; Chen, Ko-Hwa; Lin, Chih-Cheng; Cheng, Wen-Ting; Li, Mei-Jane

    2010-10-01

    This preliminary report was attempted to compare the chemical components of mineral deposits on the surfaces of an opacified intraocular lens (IOL) and a calcified senile cataractous lens (SCL) by vibrational spectral diagnosis. An opacified intraocular lens (IOL) was obtained from a 65-year-old male patient who had a significant decrease in visual acuity 2-years after an ocular IOL implantation. Another SCL with grayish white calcified plaque on the subcapsular cortex was isolated from a 79-year-old male patient with complicated cataract after cataract surgery. Optical light microscope was used to observe both samples and gross pictures were taken. Fourier transform infrared (FT-IR) and Raman microspectroscopic techniques were employed to analyze the calcified deposits. The curve-fitting algorithm using the Gaussian function was also used to quantitatively estimate the chemical components in each deposit. The preliminary results of spectral diagnosis indicate that the opacified IOL mainly consisted of the poorly crystalline, immature non-stoichiometric hydroxyapatite (HA) with higher content of type B carbonated apatites. However, the calcified plaque deposited on the SCL was comprised of a mature crystalline stoichiometric HA having higher contents of type A and type B carbonate apatites. More case studies should be examined in future.

  17. Combined 23-gauge transconjunctival vitrectomy and scleral fixation of intraocular lens without conjunctival dissection in managing lens complications.

    Science.gov (United States)

    Yeung, Ling; Wang, Nan-Kai; Wu, Wei-Chi; Chen, Kuan-Jen

    2018-04-23

    To evaluate the safety and efficacy of combined 23-gauge transconjunctival pars plana vitrectomy and scleral fixation of intraocular lens (IOL) without conjunctival dissection. A retrospective study in Chang Gung Memorial Hospital, Keelung and Taoyuan, Taiwan. Patients receiving combined 23-gauge transconjunctival pars plana vitrectomy and scleral fixation of IOL without conjunctival dissection were enrolled. The ocular findings, causes of lens complication, surgical procedures, type of IOL used, and complications were documented. We included 40 eyes from 39 patients (27 male, 12 female) with a mean age of 59.5 [standard deviation (±) 14.8] years old. The mean follow-up duration was 6.8 ± 5.4 months. The cause of lens complications was ocular trauma in 24 (60%) eyes, cataract surgery complications in 11 (28%) eyes, and spontaneous subluxation of crystalline lens in 5 (13%) eyes. The overall best corrected visual acuity (BCVA) (logMAR) improved from 1.359 ± 0.735 to 0.514 ± 0.582 (p IOL decentration was found in 3 (8%) eyes and 1 (3%) eye respectively. Combined 23-gauge transconjunctival vitrectomy and scleral fixation of IOL without conjunctival dissection is effective and safe in managing a wide variety of lens complications, with good postoperative comfort and visual recovery. Retrospective study, not applicable.

  18. Effect of aspherical and yellow tinted intraocular lens on blue-on-yellow perimetry

    Directory of Open Access Journals (Sweden)

    Rodrigo França de Espíndola

    2012-10-01

    Full Text Available PURPOSE: To investigate the possible effect of aspherical or yellow tinted intraocular lens (IOL on contrast sensitivity and blue-on-yellow perimetry. METHODS: This prospective randomized bilateral double-masked clinical study included 52 patients with visually significant bilateral cataracts divided in two groups; 25 patients (50 eyes received aspherical intraocular lens in one eye and spherical intraocular lens in the fellow eye; and 27 patients (54 eyes received ultraviolet and blue light filter (yellow tinted IOL implantation in one eye and acrylic ultraviolet filter IOL in the fellow eye. The primary outcome measures were contrast sensitivity and blue-on-yellow perimetry values (mean deviation [MD] and pattern standard deviation [PSD] investigated two years after surgery. The results were compared intra-individually. RESULTS: There was a statistically significant between-group (aspherical and spherical intraocular lens difference in contrast sensitivity under photopic conditions at 12 cycles per degree and under mesopic conditions at all spatial frequencies. There were no between-group significant differences (yellow tinted and clear intraocular lens under photopic or mesopic conditions. There was no statistically significant difference between all intraocular lens in MD or PSD. CONCLUSION: Contrast sensitivity was better under mesopic conditions with aspherical intraocular lens. Blue-on-yellow perimetry did not appear to be affected by aspherical or yellow tinted intraocular lens. Further studies with a larger sample should be carried out to confirm or not that hypotheses.

  19. "Ultimately, mom has the call": Viewing clinical trial decision making among patients with ovarian cancer through the lens of relational autonomy.

    Science.gov (United States)

    Asiedu, Gladys B; Ridgeway, Jennifer L; Carroll, Katherine; Jatoi, Aminah; Radecki Breitkopf, Carmen

    2018-04-14

    This study employs the concept of relational autonomy to understand how relational encounters with family members (FMs) and care providers may shape decisions around ovarian cancer patients' clinical trial (CT) participation. The study also offers unique insights into how FMs view patients' decision making. In-depth interviews were conducted with 33 patients with ovarian cancer who had been offered a CT and 39 FMs. Data were inductively analysed using a thematic approach and deductively informed by constructs derived from the theory of relational autonomy (RA). Patients' relationships, experiences and social status were significant resources that shaped their decisions. Patients did not give equal weight to all relationships and created boundaries around whom to include in decision making. Doctors' recommendations and perceived enthusiasm were described as influential in CT decisions. Both patients with ovarian cancer and their FMs maintained that patients have the "final say," indicating an individualistic autonomy. However, maintaining the "final say" in the decision-making process is constitutive of patients' relationships, emphasizing a relational approach to autonomy. FMs support patients' autonomy and they do so particularly when they believe the patient is capable of making the right choices. Although ethical principles underlying informed consent for CT participation emphasize individual autonomy, greater attention to relational autonomy is warranted for a more comprehensive understanding of CT decision making. © 2018 Mayo Clinic. Health Expectations published by John Wiley & Sons Ltd.

  20. Tinting of intraocular lens implants

    Energy Technology Data Exchange (ETDEWEB)

    Zigman, S.

    1982-06-01

    Intraocular lens (IOL) implants of polymethyl methacrylate (PMMA) lack an important yellow pigment useful as a filter in the visual process and in the protection of the retina from short-wavelength radiant energy. The ability to produce a yellow pigment in the PMMA used in IOL implants by exposure to near-ultraviolet (UV) light was tested. It was found that the highly cross-linked material in Copeland lens blanks was tinted slightly because of this exposure. The absorptive properties of lens blanks treated with near-UV light in this way approached that of the absorptive properties of human lenses. This finding shows that it is possible to alter IOL implants simply so as to induce a pale-yellow pigment in them to improve the visual process and to protect the retinas of IOL users.

  1. Tinting of intraocular lens implants

    International Nuclear Information System (INIS)

    Zigman, S.

    1982-01-01

    Intraocular lens (IOL) implants of polymethyl methacrylate (PMMA) lack an important yellow pigment useful as a filter in the visual process and in the protection of the retina from short-wavelength radiant energy. The ability to produce a yellow pigment in the PMMA used in IOL implants by exposure to near-ultraviolet (UV) light was tested. It was found that the highly cross-linked material in Copeland lens blanks was tinted slightly because of this exposure. The absorptive properties of lens blanks treated with near-UV light in this way approached that of the absorptive properties of human lenses. This finding shows that it is possible to alter IOL implants simply so as to induce a pale-yellow pigment in them to improve the visual process and to protect the retinas of IOL users

  2. Automated Fresnel lens tester system

    Energy Technology Data Exchange (ETDEWEB)

    Phipps, G.S.

    1981-07-01

    An automated data collection system controlled by a desktop computer has been developed for testing Fresnel concentrators (lenses) intended for solar energy applications. The system maps the two-dimensional irradiance pattern (image) formed in a plane parallel to the lens, whereas the lens and detector assembly track the sun. A point detector silicon diode (0.5-mm-dia active area) measures the irradiance at each point of an operator-defined rectilinear grid of data positions. Comparison with a second detector measuring solar insolation levels results in solar concentration ratios over the image plane. Summation of image plane energies allows calculation of lens efficiencies for various solar cell sizes. Various graphical plots of concentration ratio data help to visualize energy distribution patterns.

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  4. Lens system for SIMS analysis

    International Nuclear Information System (INIS)

    Martinez, G.; Sancho, M.; Garcia-Galan, J.C.

    1987-01-01

    A powerful version of the charge-density method is applied to the study of a combined objective and emission lens, suitable for highly localized analysis of a flat sample surface. This lens can extract secondary ions of equal or opposite polarity to that of the primary particles. A computer simulation of the ion trajectories for both modes is made. The behaviour for different values of the geometric parameters and polarizations is analyzed and useful data for design such as primary beam demagnification and secondary image position are given. (author) 4 refs

  5. The Effects of Phrenic Nerve Degeneration by Axotomy and Crush on the Electrical Activities of Diaphragm Muscles of Rats.

    Science.gov (United States)

    Alkiş, Mehmet Eşref; Kavak, Servet; Sayır, Fuat; Him, Aydin

    2016-03-01

    The aim of this study was to investigate the effect of axotomy and crush-related degeneration on the electrical activities of diaphragm muscle strips of experimental rats. In the present study, twenty-one male Wistar-albino rats were used and divided into three groups. The animals in the first group were not crushed or axotomized and served as controls. Phrenic nerves of the rats in the second and third groups were crushed or axotomized in the diaphragm muscle. Resting membrane potential (RMP) was decreased significantly in both crush and axotomy of diaphragm muscle strips of experimental rats (p phrenic nerves may produce electrical activities in the diaphragm muscle of the rat by depolarization time and half-repolarization time prolonged in crush and axotomy rats.

  6. Variation compensation and analysis on diaphragm curvature analysis for emphysema quantification on whole lung CT scans

    Science.gov (United States)

    Keller, Brad M.; Reeves, Anthony P.; Barr, R. Graham; Yankelevitz, David F.; Henschke, Claudia I.

    2010-03-01

    CT scans allow for the quantitative evaluation of the anatomical bases of emphysema. Recently, a non-density based geometric measurement of lung diagphragm curvature has been proposed as a method for the quantification of emphysema from CT. This work analyzes variability of diaphragm curvature and evaluates the effectiveness of a compensation methodology for the reduction of this variability as compared to emphysema index. Using a dataset of 43 scan-pairs with less than a 100 day time-interval between scans, we find that the diaphragm curvature had a trend towards lower overall variability over emphysema index (95% CI:-9.7 to + 14.7 vs. -15.8 to +12.0), and that the variation of both measures was reduced after compensation. We conclude that the variation of the new measure can be considered comparable to the established measure and the compensation can reduce the apparent variation of quantitative measures successfully.

  7. Enhanced Transmissions Through Three-dimensional Cascade Sharp Waveguide Bends Using C-slit Diaphragms.

    Science.gov (United States)

    Yang, Rui; Hu, Bowei; Zhang, Aofang; Gao, Dongxing; Wang, Hui; Shi, Ayuan; Lei, Zhenya; Yang, Pei

    2017-03-21

    Transmission properties through sharp rectangular waveguide bends are investigated to determine the cut-off bending angles of the wave propagation. We show that a simple metallic diaphragm at the bending corner with properly devised sub-wavelength defect apertures of C-slits would be readily to turn on the transmissions with scarce reflections of the propagating modes, while preserving the integrity of the transmitting fields soon after the bends. In particularly, our design also demonstrates the capability of eliminating all the unwanted cavity resonant transmissions that exist in the three-dimensional cascade sharp waveguide bends, and solely let the desired signals travel along the whole passage of the waveguide. The present approach, using C-slit diaphragms to support the sharp bending behaviors of the guided waves with greatly enhanced transmissions, would be especially effective in constructing novel waveguides and pave the way for the development of more compact and miniaturized electromagnetic systems that exploit these waveguide bends.

  8. Developing a new ultrasonic method to assess diaphragm movement and comparing the accuracy with existing methods

    DEFF Research Database (Denmark)

    Helbo Skaarup, Søren; Løkke, Anders; Laursen, Christian

    2017-01-01

    Introduction: Diaphragm is the most important respiratory muscle. Movement can be evaluated with ultrasound. Currently two different methods are used, M-mode and B-mode. However, diaphragm movement is complex.Aim: We hypothesized that the two existing methods are imprecise as they only measure...... film clips independently to assess inter-rater variability.Results: We found a linear correlation between FVC and diaphragmatic movement. M-mode had Pearson r=0.84 (95%CI 0.76-0.89), B-mode had r=0.68 (95%CI 0.55-0.79) and Area-measurement had r=0.84 (95%CI 0.77-0.90). Inter-rater agreement was r=0...

  9. Structure of diaphragm floor of reactor container, construction module and construction method thereof

    International Nuclear Information System (INIS)

    Hasegawa, Hiroshi; Oikawa, Tadaaki; Ushiroda, Koichi; Matsuura, Tadashi; Komaru, Toshimi; Nemoto, Yoichi; Makita, Tatsuo; Maezawa, Sumito.

    1998-01-01

    A diaphragm floor of a reactor container has a structure comprising iron beams buried in concretes and connection members connecting the iron beams and liners, in which the liners are supported by the iron beams, and the load of the iron reinforced concretes when formed on the liner is supported by the iron beams thereby enabling to construct a diaphragm floor with no or reduced amount of temporary support members. As a result, the construction operation can be promoted by reducing the amount of the temporary support members or making the removing operation of the temporary support members unnecessary. The concrete layer comprises at least two upper and lower layers of a firstly formed concrete layer and a subsequently formed concrete layer, and the iron beams have such a strength capable of enduring the load applied when the firstly formed concrete is placed. (N.H.)

  10. Laparoscopic repair of penetrating injury of the diaphragm: an ...

    African Journals Online (AJOL)

    In this study we review our experience in using laparoscopy as a diagnostic and therapeutic tool in dealing with penetrating diaphragmatic injuries due to stab wounds and look at the feasibility of using this procedure in other similar institutions. Thirty patients, all of whom were males 20-30 years of age, presented to the ...

  11. Irregular vascular pattern by contrast-enhanced ultrasonography and high serum Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein level predict poor outcome after successful radiofrequency ablation in patients with early-stage hepatocellular carcinoma.

    Science.gov (United States)

    Takada, Hitomi; Tsuchiya, Kaoru; Yasui, Yutaka; Nakakuki, Natsuko; Tamaki, Nobuharu; Suzuki, Shoko; Nakanishi, Hiroyuki; Itakura, Jun; Takahashi, Yuka; Kurosaki, Masayuki; Asahina, Yasuhiro; Enomoto, Nobuyuki; Izumi, Namiki

    2016-11-01

    Radiofrequency ablation (RFA) is considered the most effective treatment for early-stage hepatocellular carcinoma (HCC) patients unsuitable for resection. However, poor outcome after RFA has occasionally been reported worldwide. To predict such an outcome, we investigated imaging findings using contrast-enhanced ultrasonography (CEUS) with Sonazoid and serum tumor markers before RFA. This study included 176 early-stage HCC patients who had initially achieved successful RFA. Patients were examined using CEUS; their levels of alpha-fetoprotein (AFP), Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), and des-gamma-carboxy prothrombin before RFA were measured. Sonazoid provided parenchyma-specific contrast imaging and facilitated tumor vascular architecture imaging through maximum intensity projection (MIP). Kaplan-Meier analysis examined cumulative rates of local tumor progression, intrasubsegmental recurrence, and survival; factors associated with these were determined with Cox proportional hazards analysis. Local tumor progression (n = 15), intrasubsegmental recurrence (n = 46), and death (n = 18) were observed. Irregular pattern in MIP classification and serum AFP-L3 level (>10%) before RFA were identified as independent risk factors for local tumor progression and intrasubsegmental recurrence. These two factors were independently associated with poor survival after RFA (irregular pattern in MIP: hazard ratio, (HR) = 8.26; 95% confidence interval, (CI) = 2.24-30.3; P = 0.002 and AFP-L3 > 10%: HR = 2.94; 95% CI = 1.09-7.94; P = 0.033). Irregular MIP pattern by CEUS and high level of serum AFP-L3 were independent risk factors for poor outcome after successful RFA. The Patients with these findings should be considered as special high-risk group in early-stage HCC. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  12. Colored Contact Lens Dangers

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  13. Colored Contact Lens Dangers

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    Full Text Available ... Media Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare ... Media Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare ...

  14. Colored Contact Lens Dangers

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    Full Text Available ... Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare America ... Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare America ...

  15. In vitro glucose uptake by isolated rat hemi-diaphragm study of Aegle marmelos Correa root

    Directory of Open Access Journals (Sweden)

    Subban Ravi

    2009-03-01

    Full Text Available The methanol extract of the root of Aegle marmelos, a medicinal plant, was fractionated into eight fractions using column chromatography. The anti-diabetic activity of all the fractions was studied using the glucose uptake by isolated rat hemi-diaphragm in vitro model. Using the bioassay-guided fractionation, two compounds 1 and 2 were isolated by column chromatography and identified as 6-methyl-4-chromanone and skimmianine respectively by NMR and mass spectral methods.

  16. Investigation by the Rutherford backscattering method of impurity deposited on the T-3M tokamak diaphragm

    International Nuclear Information System (INIS)

    Danelyan, L.S.; Egorova, I.M.; Kulikauskas, V.S.; Baratov, D.G.; Belykh, T.A.

    1994-01-01

    The Rutherford backscattering of helium-4 ions was used for investigation of impurity deposited on the annular graphite diaphragm as a result of the interaction between hydrogen plasma and liquid-metal spray limiter. The experimental RBS spectra distributions of the impurity elements surface densities along the direction from plasma to the chamber wall are presented as depth of the elements. The erosion coefficient of the main liquid-metal limiter element has been estimated

  17. Oxidative damage induced by cigarette smoke exposure in mice: impact on lung tissue and diaphragm muscle,

    Directory of Open Access Journals (Sweden)

    Samanta Portão de Carlos

    2014-08-01

    Full Text Available OBJECTIVE: To evaluate oxidative damage (lipid oxidation, protein oxidation, thiobarbituric acid-reactive substances [TBARS], and carbonylation and inflammation (expression of phosphorylated AMP-activated protein kinase and mammalian target of rapamycin [p-AMPK and p-mTOR, respectively] in the lung parenchyma and diaphragm muscles of male C57BL-6 mice exposed to cigarette smoke (CS for 7, 15, 30, 45, or 60 days. METHODS: Thirty-six male C57BL-6 mice were divided into six groups (n = 6/group: a control group; and five groups exposed to CS for 7, 15, 30, 45, and 60 days, respectively. RESULTS: Compared with control mice, CS-exposed mice presented lower body weights at 30 days. In CS-exposed mice (compared with control mice, the greatest differences (increases in TBARS levels were observed on day 7 in diaphragm-muscle, compared with day 45 in lung tissue; the greatest differences (increases in carbonyl levels were observed on day 7 in both tissue types; and sulfhydryl levels were lower, in both tissue types, at all time points. In lung tissue and diaphragm muscle, p-AMPK expression exhibited behavior similar to that of TBARS. Expression of p-mTOR was higher than the control value on days 7 and 15 in lung tissue, as it was on day 45 in diaphragm muscle. CONCLUSION: Our data demonstrate that CS exposure produces oxidative damage, not only in lung tissue but also (primarily in muscle tissue, having an additional effect on respiratory muscle, as is frequently observed in smokers with COPD.

  18. Rupture traumatique du diaphragme au CHU Gabriel Touré de ...

    African Journals Online (AJOL)

    Rupture traumatique du diaphragme au CHU Gabriel Touré de Bamako, Mali. B T Dembélé, A Togo, A Traoré, Y Sidibé, M Konaté, A A Traoré, A Bah, T Koné, I Tounkara, L Kanté, I Diakité, B Karembé, A Koné, M.I Mangane, G Diallo ...

  19. Evaluation of bubbler/diaphragm techniques to measure surface level in the waste storage tanks

    International Nuclear Information System (INIS)

    Peters, T.J.; Hickman, B.J.; Colson, J.B.

    1993-10-01

    This report describes the results of tests conducted at the Pacific Northwest Laboratory (PNL) to determine if a bubbler technique can be used to determine the surface level in the waste tanks. Two techniques were evaluated. The first technique is a standard bubbler system in which a tube is placed below the surface of the liquid to be measured and air pressure inside a tube is increased until bubbles begin to become emitted from the tube. The air pressure then is a function of the pressure at the bottom of the tube. The second technique involves a system similar to the standard bubbler technique, but instead of bubbles being released into the material to be gauged, air pressure is increased against a diaphragm until enough pressure is applied to overcome the pressure of the liquid at the given depth, at which time the air then flows in a return loop back to a vent. The advantage of the diaphragm system is that it is a sealed system; thus no air is released into the waste tank materials, and it is not possible for the waste tank materials to get into the air flow. Based on the results of the tests conducted in this program, it appears that the bubbler and diaphragm systems that were tested could not be used for accurate measurements of the level in the waste tanks. Both exhibited deposits of simulated waste tank material at the end of the devices which affected the ability of the gauge to accurately determine changes in the surface level even though the measured value of the level was inaccurate. Further investigations into the cause of this inaccuracy may be warranted. Alternate diaphragm materials may improve the performance of this gauge

  20. Investigation of geometric design in piezoelectric microelectromechanical systems diaphragms for ultrasonic energy harvesting

    Science.gov (United States)

    Shi, Qiongfeng; Wang, Tao; Kobayashi, Takeshi; Lee, Chengkuo

    2016-05-01

    Acoustic energy transfer (AET) has been widely used for contactless energy delivery to implantable devices. However, most of the energy harvesters (ultrasonic receivers) for AET are macro-scale transducers with large volume and limited operation bandwidth. Here, we propose and investigate two microelectromechanical systems diaphragm based piezoelectric ultrasonic energy harvesters (PUEHs) as an alternative for AET. The proposed PUEHs consist of micro-scale diaphragm array with different geometric parameter design. Diaphragms in PUEH-1 have large length to width ratio to achieve broadband property, while its energy harvesting performance is compromised. Diaphragms in PUEH-2 have smaller length to width ratio and thinner thickness to achieve both broadband property and good energy harvesting performance. Both PUEHs have miniaturized size and wide operation bandwidth that are ideally suitable to be integrated as power source for implantable biomedical devices. PUEH-1 has a merged -6 dB bandwidth of 74.5% with a central frequency of 350 kHz. PUEH-2 has two separate -6 dB bandwidth of 73.7%/30.8% with central frequencies of 285 kHz/650 kHz. They can adapt to various ultrasonic sources with different working frequency spectrum. Maximum output power is 34.3 nW and 84.3 nW for PUEH-1 and PUEH-2 at 1 mW/cm2 ultrasound intensity input, respectively. The associated power density is 0.734 μW/cm2 and 4.1 μW/cm2, respectively. Better energy harvesting performance is achieved for PUEH-2 because of the optimized length to width ratio and thickness design. Both PUEHs offer more alignment flexibility with more than 40% power when they are in the range of the ultrasound transmitter.

  1. Customer loyalty among daily disposable contact lens wearers.

    Science.gov (United States)

    Patel, Neelam I; Naroo, Shehzad A; Eperjesi, Frank; Rumney, Nicholas J

    2015-02-01

    Optometric practices offer contact lenses as cash sale items or as part of monthly payment plans. With the contact lens market becoming increasingly competitive, patients are opting to purchase lenses from supermarkets and Internet suppliers. Monthly payment plans are often implemented to improve loyalty. This study aimed to compare behavioural loyalty between monthly payment plan members and non-members. BBR Optometry Ltd offers a monthly payment plan (Eyelife™) to their contact lens wearers. A retrospective audit of 38 Eyelife™ members (mean±SD: 42.7±15.0 years) and 30 non-members (mean±SD: 40.8±16.7 years) was conducted. Revenue and profits generated, service uptake and product sales between the two groups were compared over a fixed period of 18 months. Eyelife™ members generated significantly higher professional fee revenue (Ployalty among contact lens wearers, particularly service uptake and volume of lens purchases. Additionally the greater professional fees generated, render monthly payment plans an attractive business model and practice builder. Copyright © 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  2. Delayed diagnosis of homocystinuria presenting as bilateral congenital lens subluxation

    Directory of Open Access Journals (Sweden)

    Jelić-Vuković Marija

    2017-01-01

    Full Text Available Introduction. Homocystinuria is an autosomal recessively inherited defect leading to hyperhomocysteinemia and associated with ocular manifestations, mainly myopia and ectopia lentis. Case outline. A 26-year-old male with secondary glaucoma due to bilateral lens subluxation was admitted to the Department of vitreoretinal surgery. Horizontal nystagmus, bilateral lens subluxation, and bilateral amblyopia were first discovered at the age of three years. Preoperative laboratory workup revealed elevated levels of homocysteine. Bilateral pars plana lensectomy and vitrectomy followed by a sulcus fixation of the intraocular lens (ALCON MA60 Acrysof IOL were performed. The patient was prescribed folic acid, methionine, and pyridoxine, and was urged to maintain a methionine-low diet. After a bilateral lensectomy and sulcus fixation of the intraocular lens and a methionine restriction therapy combined with vitamin B6, B9, and B12 supplementation, his condition improved greatly. Conclusion. In this report of a rare case we emphasize the importance of examining differential diagnoses of lens subluxation, since early intervention can prevent serious complications.

  3. Scleral lens tolerance after corneal cross-linking for keratoconus

    NARCIS (Netherlands)

    Visser, Esther Simone; Soeters, Nienke; Tahzib, Nayyirih G.

    2015-01-01

    Purpose. Subjective and objective evaluation of scleral lens tolerance and fitting before and after corneal cross-linking (CXL) for progressive keratoconus. Methods. In this prospective cohort, evaluations were made of 18 unilateral eyes in patients who underwent CXL and had been wearing scleral

  4. Chapter 04: Bloodless wood specimen preparation for hand lens observation

    Science.gov (United States)

    Alex Wiedenhoeft

    2011-01-01

    The single most difficult physical skill involved in wood identification is producing a smoothly prepared surface for observing anatomical features. This skill must be practiced patiently; it takes time to become proficient at this task. Producing a cleanly cut surface is also the only appreciably dangerous aspect of wood identification with a hand lens; the tools used...

  5. Recovery of muscle function after deep neuromuscular block by means of diaphragm ultrasonography and adductor of pollicis acceleromyography with comparison of neostigmine vs. sugammadex as reversal drugs: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Cappellini, Iacopo; Picciafuochi, Fabio; Ostento, Daniele; Danti, Ginevra; De Gaudio, Angelo Raffaele; Adembri, Chiara

    2018-02-21

    The extensive use of neuromuscular blocking agents (NMBAs) during surgical procedures still leads to potential residual paralyzing effects in the postoperative period. Indeed, neuromuscular monitoring in an intra-operative setting is strongly advocated. Acetylcholinesterase inhibitors can reverse muscle block, but their short half-life may lead to residual curarization in the ward, especially when intermediate or long-acting NMBAs have been administered. Sugammadex is the first selective reversal drug for steroidal NMBAs; it has been shown to give full and rapid recovery of muscle strength, thus minimizing the occurrence of residual curarization. Acceleromyography of the adductor pollicis is the gold standard for detecting residual curarization, but it cannot be carried out on conscious patients. Ultrasonography of diaphragm thickness may reveal residual effects of NMBAs in conscious patients. This prospective, double-blind, single-center randomized controlled study will enroll patients (of American Society of Anesthesiologists physical status I-II, aged 18-80 years) who will be scheduled to undergo deep neuromuscular block with rocuronium for ear, nose, or throat surgery. The study's primary objective will be to compare the effects of neostigmine and sugammadex on postoperative residual curarization using two different tools: diaphragm ultrasonography and acceleromyography of the adductor pollicis. Patients will be extubated when the train-of-four ratio is > 0.9. Diaphragm ultrasonography will be used to evaluate the thickening fraction, which is the difference between the end expiratory thickness and the end inspiratory thickness, normalized to the end expiratory thickness. Ultrasonography will be performed before the initiation of general anesthesia, before extubation, and 10 and 30 min after discharging patients from the operating room. The secondary objective will be to compare the incidence of postoperative complications due to residual neuromuscular

  6. Monte Carlo analysis of thermal transpiration effects in capacitance diaphragm gauges with helicoidal baffle system

    International Nuclear Information System (INIS)

    Vargas, M; Stefanov, S; Wüest, M

    2012-01-01

    The Capacitance Diaphragm Gauge (CDG) is one of the most widely used vacuum gauges in low and middle vacuum ranges. This device consists basically of a very thin ceramic or metal diaphragm which forms one of the electrodes of a cap acitor. The pressure is determined by measuring the variation in the capacitance due to the deflection of the diaphragm caused by the pressure difference established across the membrane. In order to minimize zero drift, some CDGs are operated keeping the sensor at a higher temperature. This difference in the temperature between the sensor and the vacuum chamber makes the behaviour of the gauge non-linear due to thermal transpiration effects. This effect becomes more significant when we move from the transitional flow to the free molecular regime. Besides, CDGs may incorporate different baffle systems to avoid the condensation on the membrane or its contamination. In this work, the thermal transpiration effect on the behaviour of a rarefied gas and on the measurements in a CDG with a helicoidal baffle system is investigated by using the Direct Simulation Monte Carlo method (DSMC). The study covers the behaviour of the system under the whole range of rarefaction, from the continuum up to the free molecular limit and the results are compared with empirical results. Moreover, the influence of the boundary conditions on the thermal transpiration effects is investigated by using Maxwell boundary conditions.

  7. Exercise Prevents Diaphragm Wasting Induced by Cigarette Smoke through Modulation of Antioxidant Genes and Metalloproteinases

    Directory of Open Access Journals (Sweden)

    Gracielle Vieira Ramos

    2018-01-01

    Full Text Available Background. The present study aimed to analyze the effects of physical training on an antioxidant canonical pathway and metalloproteinases activity in diaphragm muscle in a model of cigarette smoke-induced chronic obstructive pulmonary disease (COPD. Methods. Male mice were randomized into control, smoke, exercise, and exercise + smoke groups, which were maintained in trial period of 24 weeks. Gene expression of kelch-like ECH-associated protein 1; nuclear factor erythroid-2 like 2; and heme-oxygenase1 by polymerase chain reaction was performed. Metalloproteinases 2 and 9 activities were analyzed by zymography. Exercise capacity was evaluated by treadmill exercise test before and after the protocol. Results. Aerobic training inhibited diaphragm muscle wasting induced by cigarette smoke exposure. This inhibition was associated with improved aerobic capacity in those animals that were submitted to 24 weeks of aerobic training, when compared to the control and smoke groups, which were not submitted to training. The aerobic training also downregulated the increase of matrix metalloproteinases (MMP-2 and MMP-9 and upregulated antioxidant genes, such as nuclear factor erythroid-2 like 2 (NRF2 and heme-oxygenase1 (HMOX1, in exercise + smoke group compared to smoke group. Conclusions. Treadmill aerobic training protects diaphragm muscle wasting induced by cigarette smoke exposure involving upregulation of antioxidant genes and downregulation of matrix metalloproteinases.

  8. Comparison of stethoscope bell and diaphragm, and of stethoscope tube length, for clinical blood pressure measurement.

    Science.gov (United States)

    Liu, Chengyu; Griffiths, Clive; Murray, Alan; Zheng, Dingchang

    2016-06-01

    This study investigated the effect of stethoscope side and tube length on auscultatory blood pressure (BP) measurement. Thirty-two healthy participants were studied. For each participant, four measurements with different combinations of stethoscope characteristics (bell or diaphragm side, standard or short tube length) were each recorded at two repeat sessions, and eight Korotkoff sound recordings were played twice on separate days to one experienced listener to determine the systolic and diastolic BPs (SBP and DBP). Analysis of variance was carried out to study the measurement repeatability between the two repeat sessions and between the two BP determinations on separate days, as well as the effects of stethoscope side and tube length. There was no significant paired difference between the repeat sessions and between the repeat determinations for both SBP and DBP (all P-values>0.10, except the repeat session for SBP using short tube and diaphragm). The key result was that there was a small but significantly higher DBP on using the bell in comparison with the diaphragm (0.66 mmHg, P=0.007), and a significantly higher SBP on using the short tube in comparison with the standard length (0.77 mmHg, P=0.008). This study shows that stethoscope characteristics have only a small, although statistically significant, influence on clinical BP measurement. Although this helps understand the measurement technique and resolves questions in the published literature, the influence is not clinically significant.

  9. High temperature energy harvesters utilizing ALN/3C-SiC composite diaphragms

    Science.gov (United States)

    Lai, Yun-Ju; Li, Wei-Chang; Felmetsger, Valery V.; Senesky, Debbie G.; Pisano, Albert P.

    2014-06-01

    Microelectromechanical systems (MEMS) energy harvesting devices aiming at powering wireless sensor systems for structural health monitoring in harsh environments are presented. For harsh environment wireless sensor systems, sensor modules are required to operate at elevated temperatures (> 250°C) with capabilities to resist harsh chemical conditions, thereby the use of battery-based power sources becomes challenging and not economically efficient if considering the required maintenance efforts. To address this issue, energy harvesting technology is proposed to replace batteries and provide a sustainable power source for the sensor systems towards autonomous harsh environment wireless sensor networks. In particular, this work demonstrates a micromachined aluminum nitride/cubic silicon carbide (AlN/3C-SiC) composite diaphragm energy harvester, which enables high temperature energy harvesting from ambient pulsed pressure sources. The fabricated device yields an output power density of 87 μW/cm2 under 1.48-psi pressure pulses at 1 kHz while connected to a 14.6-kΩ load resistor. The effects of pulse profile on output voltage have been studied, showing that the output voltage can be maximized by optimizing the diaphragm resonance frequency based on specific pulse characteristics. In addition, temperature dependence of the diaphragm resonance frequency over the range of 20°C to 600°C has been investigated and the device operation at temperatures as high as 600°C has been verified.

  10. Advanced performance of small diaphragm vacuum pumps through the use of mechatronics

    Science.gov (United States)

    Lachenmann, R.; Dirscherl, J.

    Oil-free diaphragm vacuum pumps have proven to be the best way in vacuum generation for the chemical laboratory and they also find increasing use as backing pumps for modern wide-range turbo molecular pumps. The majority of vacuum pumps in practical use pump only a rather small percentage of their lifetime at full gas load. A pump backing a turbo molecular pump does not have to pump a significant gas load when the high-vacuum pump is running at ultimate vacuum pressure. Also, for a vacuum distillation the vacuum pump has to operate at full speed only at the beginning to lower the pressure inside the system to a vacuum level where evaporation starts. In a rather leak-tight system the distillation process continues by evaporating from the hot liquid and condensing at the cold condenser without the need of a mechanical vacuum pump. Rotational speed controlled diaphragm pumps are now available through progress in mechatronics and offer high pumping speed capability for fast pump-down cycles and precise pressure control for distillations. At low gas load the rotational speed can be reduced, improving maintenance intervals, power consumption, noise, vibration and - surprisingly - also ultimate pressure. The different behaviour in pumping speed and ultimate pressure of rotational speed controlled diaphragm pumps in comparison to constant-speed pumps is related to the mechanical properties of the valves and gas dynamics .

  11. Stretchable Binary Fresnel Lens for Focus Tuning

    NARCIS (Netherlands)

    Li, X.; Wei, L.; Poelma, R.H.; Vollebregt, S.; Wei, J.; Urbach, Paul; Sarro, P.M.; Zhang, G.Q.

    2016-01-01

    This paper presents a tuneable binary amplitude Fresnel lens produced by wafer-level microfabrication. The Fresnel lens is fabricated by encapsulating lithographically defined vertically aligned carbon nanotube (CNT) bundles inside a polydimethyl-siloxane (PDMS) layer. The composite lens material

  12. 21 CFR 886.1400 - Maddox lens.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Maddox lens. 886.1400 Section 886.1400 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1400 Maddox lens. (a) Identification. A Maddox lens is a device...

  13. Crystalline lens power and refractive error.

    Science.gov (United States)

    Iribarren, Rafael; Morgan, Ian G; Nangia, Vinay; Jonas, Jost B

    2012-02-01

    To study the relationships between the refractive power of the crystalline lens, overall refractive error of the eye, and degree of nuclear cataract. All phakic participants of the population-based Central India Eye and Medical Study with an age of 50+ years were included. Calculation of the refractive lens power was based on distance noncycloplegic refractive error, corneal refractive power, anterior chamber depth, lens thickness, and axial length according to Bennett's formula. The study included 1885 subjects. Mean refractive lens power was 25.5 ± 3.0 D (range, 13.9-36.6). After adjustment for age and sex, the standardized correlation coefficients (β) of the association with the ocular refractive error were highest for crystalline lens power (β = -0.41; P lens opacity grade (β = -0.42; P lens power (β = -0.95), lower corneal refractive power (β = -0.76), higher lens thickness (β = 0.30), deeper anterior chamber (β = 0.28), and less marked nuclear lens opacity (β = -0.05). Lens thickness was significantly lower in eyes with greater nuclear opacity. Variations in refractive error in adults aged 50+ years were mostly influenced by variations in axial length and in crystalline lens refractive power, followed by variations in corneal refractive power, and, to a minor degree, by variations in lens thickness and anterior chamber depth.

  14. 21 CFR 886.3600 - Intraocular lens.

    Science.gov (United States)

    2010-04-01

    ... DEVICES OPHTHALMIC DEVICES Prosthetic Devices § 886.3600 Intraocular lens. (a) Identification. An intraocular lens is a device made of materials such as glass or plastic intended to be implanted to replace the natural lens of an eye. (b) Classification. Class III. (c) Date PMA or notice of completion of a...

  15. Colored Contact Lens Dangers

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    Full Text Available ... Mar 29, 2017 New Technology Helps the Legally Blind Be More Independent Oct 31, 2016 More Eye ... but intriguing study, scientists in England have given blind patients some functional vision, using human embryonic stem ...

  16. Colored Contact Lens Dangers

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    Full Text Available ... Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide Academy Publications EyeNet Ophthalmology Ophthalmology Retina Information for: International Ophthalmologists Media Medical Students Patients and ...

  17. Colored Contact Lens Dangers

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    Full Text Available ... Eye Health Home Annual Meeting Clinical Education Practice Management Member Services Advocacy Foundation About Subspecialties & More Academy Publications EyeNet Ophthalmology Ophthalmology Retina Information for: International Ophthalmologists Media Medical Students Patients and ...

  18. Colored Contact Lens Dangers

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    Full Text Available ... Halloween or any time of year, follow these guidelines: Get an eye exam from a licensed eye ... available in Spanish . Follow The Academy Professionals: Education Guidelines News Multimedia Public & Patients: Contact Us About the ...

  19. Colored Contact Lens Dangers

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    Full Text Available ... that decorative lenses do not require the same level of care or consideration as a standard contact ... By Kate Rauch In a small but intriguing study, scientists in England have given blind patients some ...

  20. Colored Contact Lens Dangers

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    Full Text Available ... also available in Spanish . Follow The Academy Professionals: Education Guidelines News Multimedia Public & Patients: Contact Us About the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms ...

  1. Colored Contact Lens Dangers

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    Full Text Available ... videos on your website Promotional materials for eye health observances EyeSmart resources are also available in Spanish . Follow The Academy Professionals: Education Guidelines News Multimedia Public & Patients: Contact Us About the Academy Jobs at ...

  2. Colored Contact Lens Dangers

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    Full Text Available ... contact lenses , from the U.S. Food and Drug Administration (FDA). Are the colored lenses you are considering ... Follow The Academy Professionals: Education Guidelines News Multimedia Public & Patients: Contact Us About the Academy Jobs at ...

  3. Colored Contact Lens Dangers

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    Full Text Available ... be purchased over-the-counter or on the Internet," says Thomas Steinemann, MD, professor of ophthalmology at ... also available in Spanish . Follow The Academy Professionals: Education Guidelines News Multimedia Public & Patients: Contact Us About ...

  4. Colored Contact Lens Dangers

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    Full Text Available ... Follow The Academy Professionals: Education Guidelines News Multimedia Public & Patients: Contact Us About the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of Service For Advertisers For Media Ophthalmology ...

  5. Colored Contact Lens Dangers

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    Full Text Available ... Kate Rauch In a small but intriguing study, scientists in England have given blind patients some functional ... 24, 2018 By Kate Rauch In a first, scientists in China have created artificial photoreceptors to help ...

  6. Colored Contact Lens Dangers

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    Full Text Available ... The Academy Professionals: Education Guidelines News Multimedia Public & Patients: Contact Us About the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of ...

  7. Colored Contact Lens Dangers

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    Full Text Available ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global ... an Ophthalmologist Patient Stories Español Eye Health / ...

  8. Colored Contact Lens Dangers

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    Full Text Available ... also available in Spanish . Follow The Academy Professionals: Education Guidelines News Multimedia Public & Patients: Contact Us About the Academy Jobs at the Academy Financial Relationships with Industry Medical ...

  9. The Ultrawideband Leaky Lens Antenna

    NARCIS (Netherlands)

    Bruni, S.; Neto, A.; Marliani, F.

    2007-01-01

    A novel directive and nondispersive antenna is presented: the ultrawideband (UWB) leaky lens. It is based on the broad band Cherenkov radiation occurring at a slot printed between different infinite homogeneous dielectrics. The first part of the paper presents the antenna concept and the UWB design.

  10. Acanthamoeba keratitis in Scotland: risk factors for contact lens wearers.

    Science.gov (United States)

    Seal, D V; Kirkness, C M; Bennett, H G; Peterson, M

    1999-01-01

    To investigate risk factors for Acanthamoeba keratitis amongst contact lens wearers in Scotland. Patients with Acanthamoeba keratitis in the Scottish study, all of whom wore contact lenses, were compared with 46 healthy asymptomatic contact lens-wearing controls. They were all visited at home for contact lens and environmental microbiological sampling. In addition, all 288 optical practices in the West of Scotland were polled for contact lens types and disinfecting solutions sold in 1995, and a sample, each of whom fitted more than 500 contact lenses per year, were polled for a second time. Independently, a poll was commissioned by the Eyecare Information Service in July/August 1995 to estimate the numbers of contact lens wearers in Scotland and the UK. Industry was polled for numbers of each contact lens disinfecting regimen sold in Scotland in 1995. West of Scotland, UK. All contact lens wearers among the 3 million population of the West of Scotland Health Board Areas. Risk factors for Acanthamoeba infection and recommendations for its prevention. When Acanthamoeba infection occurred, patients' home water systems were frequently (54%) found to be colonised by this amoeba. Patients more frequently washed their storage cases in tap water than controls (Pmethods (chlorine tablets or no disinfection). However further investigation showed that these methods were associated with an increased probability of rinsing the storage case in tap water, so that these two behaviours are confounded in the group studied. Failure to disinfect contact lenses, non-compliant use of chlorine tablets and/or introduction of tap water rinsing of storage cases were associated with increased risk of Acanthamoeba infection. New multipurpose solutions and hydrogen peroxide gave the lowest risk of Acanthamoeba infection, with no statistically significant difference between them. Ionic high-water content (FDA group 4) contact lenses were at increased risk of being associated with Acanthamoeba

  11. [Management of post-traumatic aphakia and aniridia: Retrospective study of 17 patients undergoing scleral-sutured artificial iris intraocular lens implantation. Management of aphakia-aniridia with scleral-sutured artificial iris intraocular lenses].

    Science.gov (United States)

    Villemont, A-S; Kocaba, V; Janin-Manificat, H; Abouaf, L; Poli, M; Marty, A-S; Rabilloud, M; Fleury, J; Burillon, C

    2017-09-01

    To evaluate the long-term outcomes of artificial iris intraocular lenses sutured to the sclera for managing traumatic aphakia and aniridia. All consecutive cases receiving a Morcher ® combination implant from June 2008 to February 2016 in Edouard-Herriot Hospital (Lyon, France) were included in this single-center retrospective study. Visual acuity, subjective degree of glare, quality of life and surgical complications were evaluated. Seventeen eyes of 17 patients were included, among which 82% were male. The mean age was 42 years. The injuries consisted of 23.5% contusion and 70.5% open globe injuries, of which 41% were globe ruptures. There was one postoperative case. A penetrating keratoplasty was performed at the same time for eight eyes. The mean follow-up was 32 months. Best-corrected visual acuity improved in 41.2%, remained the same in 17.6% and decreased in 41.2% of our cases. Distance vision averaged 1±0.25 line better and near vision 2.2±0.32 lines better when visual acuity was quantifiable before surgery. Glare improved in 80% of patients and remained stable in 20%, decreasing on average from 3.3/5 [min. 3-max. 4; SD: 0.48] before surgery to 1.9/5 [min. 0-max. 4; SD: 1.197] after surgery. Regarding the esthetic results, 78% of the patients declared themselves reasonably to very satisfied; 57% reported no limitation of activities of daily living, and 43% reported mild limitation. Ocular hypertension and glaucoma, found in 40% of eyes, were the main postoperative complications. Implantation of prosthetic iris device combined with an intraocular lens appears to be safe and effective in reducing glare disability and improving visual acuity. Close, long-term monitoring is essential for the success of this surgery. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  12. Lens stem cells may reside outside the lens capsule: an hypothesis

    Directory of Open Access Journals (Sweden)

    Meyer Rita A

    2007-06-01

    Full Text Available Abstract In this paper, we consider the ocular lens in the context of contemporary developments in biological ideas. We attempt to reconcile lens biology with stem cell concepts and a dearth of lens tumors. Historically, the lens has been viewed as a closed system, in which cells at the periphery of the lens epithelium differentiate into fiber cells. Theoretical considerations led us to question whether the intracapsular lens is indeed self-contained. Since stem cells generate tumors and the lens does not naturally develop tumors, we reasoned that lens stem cells may not be present within the capsule. We hypothesize that lens stem cells reside outside the lens capsule, in the nearby ciliary body. Our ideas challenge the existing lens biology paradigm. We begin our discussion with lens background information, in order to describe our lens stem cell hypothesis in the context of published data. Then we present the ciliary body as a possible source for lens stem cells, and conclude by comparing the ocular lens with the corneal epithelium.

  13. Modern lens antennas for communications engineering

    CERN Document Server

    Thornton, John

    2012-01-01

    The aim of this book is to present the modern design principles and analysis of lens antennas. It gives graduates and RF/Microwave professionals the design insights in order to make full use of lens antennas.  Why do we want to write a book in lens antennas? Because this topic has not been thoroughly publicized, its importance is underestimated. As antennas play a key role in communication systems, recent development in wireless communications would indeed benefit from the characteristics of lens antennas: low profile, and low cost etc.  The major advantages of lens antennas are na

  14. TU-E-201-02: Eye Lens Dosimetry From CT Perfusion Studies

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, D. [Toshiba America Medical Systems (United States)

    2015-06-15

    Madan M. Rehani, Massachusetts General Hospital and Harvard Medical School, Boston Methods for Eye Lens Dosimetry and Studies On Lens Opacities with Interventionalists Radiation induced cataract is a major threat among staff working in interventional suites. Nearly 16 million interventional procedures are performed annually in USA. Recent studies by the principal investigator’s group, primarily among interventional cardiologists, on behalf of the International Atomic Energy Agency, show posterior subcapsular (PSC) changes in the eye lens in 38–53% of main operators and 21–45% of support staff. These changes have potential to lead to cataract in future years, as per information from A-Bomb survivors. The International Commission on Radiological Protection has reduced dose limit for staff by a factor of 7.5 (from 150 mSv/y to 20 mSv/y). With increasing emphasis on radiation induced cataracts and reduction in threshold dose for eye lens, there is a need to implement strategies for estimating eye lens dose. Unfortunately eye lens dosimetry is at infancy when it comes to routine application. Various approaches are being tried namely direct measurement using active or passive dosimeters kept close to eyes, retrospective estimations and lastly correlating patient dose in interventional procedures with staff eye dose. The talk will review all approaches available and ongoing active research in this area, as well as data from surveys done in Europe on status of eye dose monitoring in interventional radiology and nuclear medicine. The talk will provide update on how good is Hp(10) against Hp(3), estimations from CTDI values, Monte Carlo based simulations and current status of eye lens dosimetry in USA and Europe. The cataract risk among patients is in CT examinations of the head. Since radiation induced cataract predominantly occurs in posterior sub-capsular (PSC) region and is thus distinguishable from age or drug related cataracts and is also preventable, actions on

  15. TU-E-201-02: Eye Lens Dosimetry From CT Perfusion Studies

    International Nuclear Information System (INIS)

    Zhang, D.

    2015-01-01

    Madan M. Rehani, Massachusetts General Hospital and Harvard Medical School, Boston Methods for Eye Lens Dosimetry and Studies On Lens Opacities with Interventionalists Radiation induced cataract is a major threat among staff working in interventional suites. Nearly 16 million interventional procedures are performed annually in USA. Recent studies by the principal investigator’s group, primarily among interventional cardiologists, on behalf of the International Atomic Energy Agency, show posterior subcapsular (PSC) changes in the eye lens in 38–53% of main operators and 21–45% of support staff. These changes have potential to lead to cataract in future years, as per information from A-Bomb survivors. The International Commission on Radiological Protection has reduced dose limit for staff by a factor of 7.5 (from 150 mSv/y to 20 mSv/y). With increasing emphasis on radiation induced cataracts and reduction in threshold dose for eye lens, there is a need to implement strategies for estimating eye lens dose. Unfortunately eye lens dosimetry is at infancy when it comes to routine application. Various approaches are being tried namely direct measurement using active or passive dosimeters kept close to eyes, retrospective estimations and lastly correlating patient dose in interventional procedures with staff eye dose. The talk will review all approaches available and ongoing active research in this area, as well as data from surveys done in Europe on status of eye dose monitoring in interventional radiology and nuclear medicine. The talk will provide update on how good is Hp(10) against Hp(3), estimations from CTDI values, Monte Carlo based simulations and current status of eye lens dosimetry in USA and Europe. The cataract risk among patients is in CT examinations of the head. Since radiation induced cataract predominantly occurs in posterior sub-capsular (PSC) region and is thus distinguishable from age or drug related cataracts and is also preventable, actions on

  16. Colored Contact Lens Dangers

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    Full Text Available ... Spanish . Follow The Academy Professionals: Education Guidelines News Multimedia Public & Patients: Contact Us About the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of Service For Advertisers For Media Ophthalmology Job Center © American ...

  17. Colored Contact Lens Dangers

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    Full Text Available ... Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye Health / News Halloween Hazard: The Hidden Dangers ... Decorative Contact Lenses Without a Prescription Leer en Español: Peligros asociados con los lentes de contacto de ...

  18. Contact lens surface by electron beam

    International Nuclear Information System (INIS)

    Shin, Jung Hyuck; Lee, Suk Ju; Hwang, Kwang Ha; Jeon Jin

    2011-01-01

    Contact lens materials needs good biocompatibility, high refractive index, high optical transparency, high water content etc. Surface treat method by using plasma and radiation can modify the physical and/or chemical properties of the contact lens surface. Radiation technology such as electron beam irradiation can apply to polymerization reaction and enhance the functionality of the polymer.The purpose of this study is to modify of contact lens surface by using Eb irradiation technology. Electron beam was irradiated to the contact lens surface which was synthesized thermal polymerization method and commercial contact lens to modify physical and chemical properties. Ft-IR, XP, UV-vis spectrophotometer, water content, oxygen trans-metastability were used to characterize the surface state, physicochemical, and optical property of the contact lens treated with Eb. The water content and oxygen transmissibility of the contact lens treated with Eb were increased due to increase in the hydrophilic group such as O-C=O and OH group on the contact lens surface which could be produced by possible reaction between carbon and oxygen during the Eb irradiation. All of the lenses showed the high optical transmittance above 90%. In this case of B/Es, TES, Ti contact lens, the optical transmittance decreased about 5% with increasing Eb dose in the wavelength of UV-B region. The contact lens modified by Eb irradiation could improve the physical properties of the contact lens such as water content and oxygen transmissibility

  19. Lens decenter and tilt measurement by interferogram

    Science.gov (United States)

    Hung, Min-Wei; Wu, Wen-Hong; Huang, Kuo-Cheng

    2009-11-01

    For the recent years, the vigorous development of the electro-optic industry, particularly the digital camera and the cellular phone camera, has placed a larger and larger demand for the optical devices. Among the optical lens, the aspherical optical lens plays the key component because the aspherical lens may provide better imaging quality then the spherical lens does. For the manufacturing reason, the aspherical lens is prone to a decenter or tilt issue with respect to the optical axes of its two surfaces. To measure decenter and tile error specifically would help to obviate the deficient lens, but most of the present measuring method can't provide this function. This paper proposed a new method to specifically measure the decenter and tile of lens by observing the interferogram of each surface. And the corresponding measuring instrument, which contains interferometer and motion stages, was introduced as well.

  20. Plasma Lens for Muon and Neutrino Beams

    Science.gov (United States)

    Kahn, Stephen; Korenev, Sergey; Bishai, Mary; Diwan, Milind; Gallardo, Juan; Hershcovitch, Ady; Johnson, Brant

    2008-04-01

    The plasma lens is examined as an alternate to focusing horns and solenoids for use in a neutrino or muon beam facility. The plasma lens concept is based on a combined high-current lens/target configuration. The current is fed at electrodes located upstream and downstream from the target where pion capturing is needed. The current flows primarily in the plasma, which has a lower resistivity than the target. A second plasma lens section, with an additional current feed, follows the target to provide shaping of the plasma stability. The geometry of the plasma is shaped to provide optimal pion capture. Simulations of this plasma lens system have shown a 25% higher neutrino production than the horn system. A plasma lens has additional advantage: larger axial current than horns, minimal neutrino contamination during antineutrino running, and negligible pion absorption or scattering. Results from particle simulations using a plasma lens will be presented.

  1. Autorefraction versus subjective refraction in a radially asymmetric multifocal intraocular lens

    NARCIS (Netherlands)

    van der Linden, Jan Willem; Vrijman, Violette; Al-Saady, Rana; El-Saady, Rana; van der Meulen, Ivanka J.; Mourits, Maarten P.; Lapid-Gortzak, Ruth

    2014-01-01

    To evaluate whether the automated refraction (AR) correlates with subjective manifest (MR) refraction in eyes implanted with radially asymmetric multifocal intraocular lens (IOLs). This retrospective study evaluated 52 eyes (52 patients) implanted with a radially asymmetric multifocal IOL (LS-312

  2. Autorefraction versus subjective refraction in a radially asymmetric multifocal intraocular lens

    NARCIS (Netherlands)

    Linden, J.W.M. van der; Vrijman, V.; El-Saady, R.; Meulen, I.J. van der; Mourits, M.P.; Lapid-Gortzak, R.

    2014-01-01

    PURPOSE: To evaluate whether the automated refraction (AR) correlates with subjective manifest (MR) refraction in eyes implanted with radially asymmetric multifocal intraocular lens (IOLs). METHODS: This retrospective study evaluated 52 eyes (52 patients) implanted with a radially asymmetric

  3. Anterior Lens Capsule and Iris Thicknesses in Pseudoexfoliation Syndrome.

    Science.gov (United States)

    Batur, Muhammed; Seven, Erbil; Tekin, Serek; Yasar, Tekin

    2017-11-01

    The aim of this study was to evaluate anatomic properties of the lens capsule and iris by anterior segment optical coherence tomography (AS-OCT) in patients with pseudoexfoliation (PEX). This prospective study included 62 eyes of 62 patients with PEX syndrome and 43 eyes of 43 age- and gender-matched controls. All subjects underwent full ophthalmologic examinations including AS-OCT. Pupillary diameter, midperipheral stromal iris thickness, central and temporal lens capsule thicknesses, and peripheral pseudoexfoliation material thickness on the anterior lens capsule surface were measured and recorded. Mean age was 66.8 ± 9.3 years in the PEX group and 65.5 ± 8.9 years in the control group (p = 0.44). The PEX group consisted of 62 patients: 38 men (61.3%) and 24 women (38.7%); the control group included 43 subjects: 25 men (58.1%) and 18 women (41.9%). Pupillary diameter after pharmacologic mydriasis was 21% smaller in the PEX group than controls. Mean midperipheral iris thickness was 36 ± 7.2 μm (7.8%) thinner in the PEX group than that of control group (p = 0.047). The central anterior capsule was a mean of 3.40 ± 0.51 μm (18%) thicker in the PEX group compared to the control group (p = 0.0001). The temporal anterior lens capsule was a mean of 0.17 ± 0.15 μm thicker in the PEX group compared to the control group (p = 0.81). With high-resolution OCT imaging, it has become possible to evaluate the anterior lens capsule without histologic examination and demonstrate that it is thicker than normal in PEX patients.

  4. Crystal diffraction lens for medical imaging

    International Nuclear Information System (INIS)

    Smither, R. K.; Roa, D. E.

    2000-01-01

    A crystal diffraction lens for focusing energetic gamma rays has been developed at Argonne National Laboratory for use in medical imaging of radioactivity in the human body. A common method for locating possible cancerous growths in the body is to inject radioactivity into the blood stream of the patient and then look for any concentration of radioactivity that could be associated with the fast growing cancer cells. Often there are borderline indications of possible cancers that could be due to statistical functions in the measured counting rates. In order to determine if these indications are false or real, one must resort to surgical means and take tissue samples in the suspect area. They are developing a system of crystal diffraction lenses that will be incorporated into a 3-D imaging system with better sensitivity (factors of 10 to 100) and better spatial resolution (a few mm in both vertical and horizontal directions) than most systems presently in use. The use of this new imaging system will allow one to eliminate 90% of the false indications and both locate and determine the size of the cancer with mm precision. The lens consists of 900 single crystals of copper, 4 mm x 4 mm on a side and 2--4 mm thick, mounted in 13 concentric rings

  5. Differences in daily disposable circle lens performance characteristics

    Directory of Open Access Journals (Sweden)

    Schafer JM

    2014-04-01

    Full Text Available Jeffery M Schafer, William T Reindel, Marjorie J Rah, Osbert Chan, Lening Zhang Bausch & Lomb Incorporated, Rochester, NY, USA Purpose: The purpose of this evaluation was to compare the performance characteristics of two cosmetically tinted contact lenses in the circle lens category that differ in lens design, lens material, and pigment print pattern: etafilcon A (1-Day Acuvue Define; Johnson & Johnson Vision Care and hilafilcon B (Naturelle; Bausch & Lomb Incorporated. Methods: Two hundred Asian subjects (400 eyes were enrolled in this 1-month parallel, bilateral, randomized study at ten investigative sites. Study lenses were dispensed at a screening/dispensing visit, and follow-up visits occurred at 2 weeks and 1 month. Lenses were worn on a daily disposable basis. Fit characteristics were evaluated at each visit, and slit-lamp evaluations were completed at each follow-up visit. Results: Of the 200 patients enrolled, 172 (344 eyes completed the study. The proportion of eyes with fully centered lenses was statistically significantly higher for the hilafilcon B group at the 2-week and 1-month visits, P<0.05. Over all visits, 0.6% of hilafilcon B eyes demonstrated incomplete corneal coverage, whereas for the etafilcon A group, 8.5% of eyes demonstrated incomplete corneal coverage and/or edge lift. The proportion of eyes with adequate lens movement was statistically significantly higher for the hilafilcon B group, P<0.05. Over all visits, none of the hilafilcon B eyes was reported to have excessive movement, whereas for etafilcon A lenses, 10.2% of eyes were reported to have excessive movement. Conclusions: Etafilcon A lenses were significantly less likely to be fully centered and significantly more likely to have incomplete corneal coverage and/or edge lift compared with the hilafilcon B lenses. Keywords: cosmetic contact lens, circle contact lens

  6. Clinical observation of capsular tension ring implantation in congenital lens subluxation treating by phacoemulsification

    OpenAIRE

    Liang-Nan Sun; Bai-Jun Li; Yuan-Fei Zhu; Xin-Hua Liu

    2017-01-01

    AIM: To evaluate the clinical results of capsular tension ring(CTR)implantation in phacoemulsification for eyes with congenital lens subluxation. METHODS: This study comprised 18 patients(31 eyes)with congenital ectopia lentis. All patients received phacoemulsification with CTR and intraocular lens(IOL)implantation. Visual acuity before and after surgery were examined. IOL decentration were measured with Image-Pro Plus image processing software. The complications were also recorded preoperati...

  7. Intravitreal Phacoemulsification Using Torsional Handpiece for Retained Lens Fragments

    Science.gov (United States)

    Kumar, Vinod; Takkar, Brijesh

    2016-01-01

    Purpose: To evaluate the results of intravitreal phacoemulsification with torsional hand piece in eyes with posteriorly dislocated lens fragments. Methods: In this prospective, interventional case series, 15 eyes with retained lens fragments following phacoemulsification were included. All patients underwent standard three-port pars plana vitrectomy and intravitreal phacoemulsification using sleeveless, torsional hand piece (OZiL™, Alcon's Infiniti Vision System). Patients were followed up for a minimum of six months to evaluate the visual outcomes and complications. Results: The preoperative best-corrected visual acuity (BCVA) ranged from light perception to 0.3. No complications such as thermal burns of the scleral wound, retinal damage due to flying lens fragments, or difficult lens aspiration occurred during intravitreal phacoemulsification. Mean post-operative BCVA at the final follow-up was 0.5. Two eyes developed cystoid macular edema, which was managed medically. No retinal detachment was noted. Conclusion: Intravitreal phacoemulsification using torsional hand piece is a safe and effective alternative to conventional longitudinal phacofragmentation. PMID:27621783

  8. KCC isoforms in a human lens epithelial cell line (B3) and lens tissue extracts.

    Science.gov (United States)

    Misri, Sandeep; Chimote, Ameet A; Adragna, Norma C; Warwar, Ronald; Brown, Thomas L; Lauf, Peter K

    2006-11-01

    We recently reported potassium-chloride cotransporter activity in human lens epithelial B3 (HLE-B3) cells. The purpose of the present study was to demonstrate in these cells as well as in human lens tissue the potassium-chloride cotransport (KCC) isoforms by reverse transcriptase-polymerase chain reaction (RT-PCR), Western blotting and immunofluorescence microscopy. Of the four KCC genes known to encode the respective proteins and their spliced variants, RT-PCR with both rat and human primers revealed the predicted cDNA fragments of KCC1, KCC3a, KCC3b, and KCC4 but not KCC2 in both HLE-B3 cells and in human lens tissue extracts from cataractous patients. Polyclonal rabbit (rb) anti-rat (rt) and anti-human (hm) antibodies against rtKCC1 and hmKCC3, respectively, and a commercially available rb-anti-mouse (ms) KCC4 antibody were used. Rb anti-rtKCC1-ECL3 [against epitopes within the large extracellular loop 3 (ECL3)] revealed a 150kDa band in HLE-B3 cells consistent with the known molecular weight of KCC1. Rb anti-hmKCC3-ECL3 yielded three bands of 150, 122 and 105kDa, evidence for the presence of KCC3a, KCC3b and possibly KCC3c isoforms. The 122 and 112kDa bands were also demonstrated by rb anti-hmKCC3-CTD [the C-terminal domain (CTD)]. Rb anti-msKCC4 antibody only showed a 100kDa band in HLE-B3 cells. In the human lens tissues, a 115kDa protein was detected with rb anti-rtKCC1-ECL3 and a 100kDa band with rb anti-msKCC4, however, no bands with rb anti-hmKCC3-ECL3 or rb anti-hmKCC3-CTD. Fluorescence microscopy revealed immunocytochemical cytoplasmic and membrane labeling of HLE-B3 cells with anti-KCC1, -KCC3 (laser confocal microscopy) and -KCC4 antibodies and a Cy3-tagged secondary antibody. Hence HLE-B3 cells expressed proteins of the KCC1, KCC3a, b, and KCC4 isoforms, whereas surgically removed cataractous lens tissue expressed only those of KCC1 and KCC4.

  9. Lens Coupled Quantum Cascade Laser

    Science.gov (United States)

    Hu, Qing (Inventor); Lee, Alan Wei Min (Inventor)

    2013-01-01

    Terahertz quantum cascade (QC) devices are disclosed that can operate, e.g., in a range of about 1 THz to about 10 THz. In some embodiments, QC lasers are disclosed in which an optical element (e.g., a lens) is coupled to an output facet of the laser's active region to enhance coupling of the lasing radiation from the active region to an external environment. In other embodiments, terahertz amplifier and tunable terahertz QC lasers are disclosed.

  10. Looking beyond the perfect lens

    International Nuclear Information System (INIS)

    Wee, W H; Pendry, J B

    2010-01-01

    The holy grail of imaging is the ability to see through anything. From the conservation of energy, we can easily see that to see through a lossy material would require lenses with gain. The aim of this paper therefore is to propose a simple scheme by which we can construct a general perfect lens, with gain-one that can restore both the phases and amplitudes of near and far fields.

  11. CONTACT LENS RELATED CORNEAL ULCER

    Directory of Open Access Journals (Sweden)

    AGARWAL P

    2010-01-01

    Full Text Available A corneal ulcer caused by infection is one of the major causes of blindness worldwide. One of the recent health concerns is the increasing incidence of corneal ulcers associated with contact lens user especially if the users fail to follow specific instruction in using their contact lenses. Risk factors associated with increased risk of contact lens related corneal ulcers are:overnight wear, long duration of continuous wear, lower socio-economic classes, smoking, dry eye and poor hygiene. The presenting symptoms of contact lens related corneal ulcers include eye discomfort, foreign body sensation and lacrimation. More serious symptoms are redness (especially circum-corneal injection, severe pain, photophobia, eye discharge and blurring of vision. The diagnosis is established by a thorough slit lamp microscopic examination with fluorescein staining and corneal scraping for Gram stain and culture of the infective organism. Delay in diagnosing and treatment can cause permanent blindness, therefore an early referral to ophthalmologist and commencing of antimicrobial therapy can prevent visual loss.

  12. Glycation precedes lens crystallin aggregation

    International Nuclear Information System (INIS)

    Swamy, M.S.; Perry, R.E.; Abraham, E.C.

    1987-01-01

    Non-enzymatic glycosylation (glycation) seems to have the potential to alter the structure of crystallins and make them susceptible to thiol oxidation leading to disulfide-linked high molecular weight (HMW) aggregate formation. They used streptozotocin diabetic rats during precataract and cataract stages and long-term cell-free glycation of bovine lens crystallins to study the relationship between glycation and lens crystallin aggregation. HMW aggregates and other protein components of the water-soluble (WS) and urea-soluble (US) fractions were separated by molecular sieve high performance liquid chromatography. Glycation was estimated by both [ 3 H]NaBH 4 reduction and phenylboronate agarose affinity chromatography. Levels of total glycated protein (GP) in the US fractions were about 2-fold higher than in the WS fractions and there was a linear increase in GP in both WS and US fractions. This increase was parallelled by a corresponding increase in HMW aggregates. Total GP extracted by the affinity method from the US fraction showed a predominance of HMW aggregates and vice versa. Cell-free glycation studies with bovine crystallins confirmed the results of the animals studies. Increasing glycation caused a corresponding increase in protein insolubilization and the insoluble fraction thus formed also contained more glycated protein. It appears that lens protein glycation, HMW aggregate formation, and protein insolubilization are interrelated

  13. 900 MW CP1 nuclear steam turbine retrofit thermal effects on low pressure diaphragms

    International Nuclear Information System (INIS)

    Buguin, A.; Gruau, P.; Lamarque, F.; Huggett, J.

    2015-01-01

    The steam turbines of the Koeberg units 1 and 2 operated by ESKOM in South Africa have been retrofitted in order to mitigate the generic problems of stress corrosion cracking of the original shrunk-on disk rotor design. As already done in Belgium and France, the implementation of welded rotors improves the turbine reliability and availability. Moreover, the new technology implemented associated with a new steam path allows a significant performance improvement. With a wealth of experience in CP1 retrofit, ALSTOM has put in place new technical features in the steam path in order to further improve the heat rate. Among them, steam balance holes drilled in the rotor disks have exacerbated the thermal sensitivity of the LP diaphragms. During the commissioning of the Unit 1 LP turbines following the retrofit, the load increase led to unacceptable vibrations. An investigation program was launched to determine the root causes of the problem. This paper presents the findings following the turbine inspection, as well as the recommendations and modifications to allow a smooth return to service of the unit. In addition, the results of the root cause analysis of the vibration incident are explained. Based on finite element calculations and site measurements, ALSTOM has established that the diaphragm thermal behavior, intensified by the steam balance holes, has led to radial rubbing. It was also established that the phenomena had no effect on the diaphragms mechanical integrity. Design changes have been proposed to ensure a safe and reliable long term operation of the units. These modifications have been successfully implemented onto the Koeberg Unit 2 Nuclear Steam Turbine commissioned in November 2012. (authors)

  14. Thermal Stresses Analysis and Optimized TTP Processes to Achieved CNT-Based Diaphragm for Thin Panel Speakers

    Directory of Open Access Journals (Sweden)

    Feng-Min Lai

    2016-01-01

    Full Text Available Industrial companies popularly used the powder coating, classing, and thermal transfer printing (TTP technique to avoid oxidation on the metallic surface and stiffened speaker diaphragm. This study developed a TTP technique to fabricate a carbon nanotubes (CNTs stiffened speaker diaphragm for thin panel speaker. The self-developed TTP stiffening technique did not require a high curing temperature that decreased the mechanical property of CNTs. In addition to increasing the stiffness of diaphragm substrate, this technique alleviated the middle and high frequency attenuation associated with the smoothing sound pressure curve of thin panel speaker. The advantage of TTP technique is less harmful to the ecology, but it causes thermal residual stresses and some unstable connections between printed plates. Thus, this study used the numerical analysis software (ANSYS to analyze the stress and thermal of work piece which have not delaminated problems in transfer interface. The Taguchi quality engineering method was applied to identify the optimal manufacturing parameters. Finally, the optimal manufacturing parameters were employed to fabricate a CNT-based diaphragm, which was then assembled onto a speaker. The result indicated that the CNT-based diaphragm improved the sound pressure curve smoothness of the speaker, which produced a minimum high frequency dip difference (ΔdB value.

  15. High Power DC Diaphragm Discharge Excited in a Vapor Bubble for the Treatment of Water

    Czech Academy of Sciences Publication Activity Database

    Lukeš, Petr; Člupek, Martin; Babický, Václav; Doležalová, Eva; Sisrová, Irena; Maršálková, Eliška; Maršálek, Blahoslav

    2013-01-01

    Roč. 33, č. 1 (2013), s. 83-95 ISSN 0272-4324 R&D Projects: GA AV ČR IAAX00430802; GA ČR(CZ) GD104/09/H080 Institutional support: RVO:61389021 ; RVO:67985939 Keywords : Diaphragm discharge * Water * Hydrogen peroxide * Phenol * Bacteria * Algae Subject RIV: BL - Plasma and Gas Discharge Physics; EF - Botanics (BU-J) Impact factor: 1.599, year: 2013 http://link.springer.com/content/pdf/10.1007%2Fs11090-012-9432-6.pdf

  16. Innervation of periesophageal region of cat's diaphragm - Implication for studies of control of vomiting

    Science.gov (United States)

    Tan, L. K.; Miller, A. D.

    1986-01-01

    The extent of the region of the diaphragm around the esophagus that displays greatly reduced activity during the expulsive phase of vomiting was determined from electromyographic studies in cats to be about 0.75-1.0 cm from the esophagus. Horseradish peroxidase injected into this region retrogradely labeled motoneurons throughout most of the rostral-caudal extent of the phrenic nucleus, with the exception of caudal C6 and rostral C7. This widespread intermingling of motoneurons that innervate the region of reduced activity with other phrenic motoneurons creates a difficulty for needed follow-up studies of diaphragmatic control during vomiting.

  17. Qualidade de vida de pacientes pseudofácicos submetidos à cirurgia de catarata com implante de lente intra-ocular acomodativa Quality of life of pseudophakic patients with accommodative intraocular lens implant

    Directory of Open Access Journals (Sweden)

    Filipe de Oliveira

    2004-06-01

    Full Text Available OBJETIVO: Avaliar a função visual e satisfação dos pacientes submetidos à cirurgia de catarata com implante de lente intra-ocular acomodativa e o impacto na sua qualidade de vida. MÉTODOS: Retrospectivamente, foram avaliados questionários aplicados após um ano da cirurgia de 22 pacientes que foram incluídos num estudo clínico para avaliar segurança e eficácia de uma lente intra-ocular de silicone de câmara posterior designada para corrigir visão para longe e perto. RESULTADOS: Do total dos pacientes operados, 16 (73% eram bilaterais e 6 (27% unilaterais, com idade média de 70,2 anos. Dos pacientes com implante unilateral, 5 (83,3% declararam melhora acentuada da visão e 1 (16,7% referiu máxima melhora. Quanto ao nível de satisfação, 5 (83,3% ficaram satisfeitos e 1 (16,7% muito satisfeito com o resultado cirúrgico. A visão noturna foi declarada como sem dificuldade por 3 (50,0%, pouca dificuldade por 2 (33,3% e dificuldade moderada por 1 (16,7%. No grupo bilateral, 7 (43,8% consideraram excelente a qualidade da visão para perto, 7 (43,8% muito boa, 1 (6,2% adequada e 1 (6,2% ruim. A visão intermediária foi classificada como excelente por 6 (37,5%, muito boa por 9 (56,3% e adequada por 1 (6,2%. A qualidade da visão para longe foi considerada excelente por 9 (56,3%, muito boa por 3 (43,8%, adequada por 2 (12,5% e não muito boa por 2 (12,5%. Em relação à visão noturna 9 (56,3% declararam não ter dificuldade alguma, 5 (31,2% pouca dificuldade e 2 (12,5% dificuldade moderada. CONCLUSÕES: Considerando a propriedade óptica da LIO, a maioria dos pacientes apresentou uma melhora considerável da função visual, sem a necessidade de correção óptica, e, portanto, com impacto positivo na qualidade de vida.PURPOSE: To evaluate the visual function and satisfaction of patients who underwent cataract surgery and were implanted with an accommodative intraocular lens and the impact in their quality of life. METHODS

  18. Pseudomonas aeruginosa Survival at Posterior Contact Lens Surfaces after Daily Wear

    Science.gov (United States)

    Wu, Yvonne T.; Zhu, Lucia S.; Tam, K. P. Connie; Evans, David J.; Fleiszig, Suzanne M. J.

    2015-01-01

    Purpose Pseudomonas aeruginosa keratitis is a sight-threatening complication of contact lens wear, yet mechanisms by which lenses predispose to infection remain unclear. Here, we tested the hypothesis that tear fluid at the posterior contact lens surface can lose antimicrobial activity over time during lens wear. Methods Daily disposable lenses were worn for 1, 2, 4, 6 or 8 h immediately after removal from their packaging, or after presoaking in sterile saline for 2 days to remove packaging solution. Unworn lenses were also tested, some coated in tears “aged” in vitro for 1 or 8 h. Lenses were placed anterior surface down into tryptic soy agar cradles containing gentamicin (100µg/ml) to kill bacteria already on the lens, and posterior surfaces inoculated with gentamicin-resistant P. aeruginosa for 3 h. Surviving bacteria were enumerated by viable counts of lens homogenates. Results Posterior surfaces of lenses worn by patients for 8 h supported more P. aeruginosa growth than lenses worn for only 1 h, if lenses were presoaked prior to wear (~ 2.4-fold, p = 0.01). This increase was offset if lenses were not presoaked to remove packaging solution (p = 0.04 at 2 h and 4 h). Irrespective of presoaking, lenses worn for 8 h showed more growth on their posterior surface than unworn lenses coated with tear fluid that was “aged” for 8 h vitro (~8.6-fold, presoaked, p = 0.003: ~ 5.4-fold from packaging solution, p = 0.004). Indeed, in vitro incubation did not impact tear antimicrobial activity. Conclusions This study shows that post lens tear fluid can lose antimicrobial activity over time during contact lens wear, supporting the idea that efficient tear exchange under a lens is critical for homeostasis. Additional studies are needed to determine applicability to other lens types, wearing modalities, and relevance to contact lens-related infections. PMID:25955639

  19. DISSECTING THE GRAVITATIONAL LENS B1608+656. I. LENS POTENTIAL RECONSTRUCTION

    NARCIS (Netherlands)

    Suyu, S. H.; Marshall, P. J.; Blandford, R. D.; Fassnacht, C. D.; Koopmans, L. V. E.; McKean, J. P.; Treu, T.

    2009-01-01

    Strong gravitational lensing is a powerful technique for probing galaxy mass distributions and for measuring cosmological parameters. Lens systems with extended source-intensity distributions are particularly useful for this purpose since they provide additional constraints on the lens potential (

  20. Clinical evaluation of direct and photosensitized ultraviolet radiation damage to the lens

    International Nuclear Information System (INIS)

    Hockwin, O.; Lerman, S.

    1982-01-01

    We are reporting a new, objective, and quantitative method for monitoring age-related molecular changes in the human ocular lens in vivo, as expressed by increases in at least two (nontryptophan) fluorescence wavelengths. These fluorescence wavelengths appear to be caused by photochemically induced changes in the lens, and they reflect the ultraviolet (UV) filtering capacity of the patients' ocular lenses. These data correlate with previously reported in vitro lens fluorescence changes that are associated with the aging process. This method will also detect alterations in lenticular fluorescence caused by photosensitized as well as direct UV radiation damage