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Sample records for lens diaphragm patient

  1. Diaphragm adaptations in patients with COPD

    Directory of Open Access Journals (Sweden)

    Heunks Leo MA

    2008-01-01

    Full Text Available Abstract 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 shortening. However, more recently, invasive evaluation of diaphragm contractile function, structure, and biochemistry demonstrated that cellular and molecular alterations occur, of which several can be considered pathologic of nature. Whereas the fiber type shift towards oxidative type I fibers in COPD diaphragm is regarded beneficial, rendering the overloaded diaphragm more resistant to fatigue, the reduction of diaphragm fiber force generation in vitro likely contributes to diaphragm weakness. The reduced diaphragm force generation at single fiber level is associated with loss of myosin content in these fibers. Moreover, the diaphragm in COPD is exposed to oxidative stress and sarcomeric injury. This review postulates that the oxidative stress and sarcomeric injury activate proteolytic machinery, leading to contractile protein wasting and, consequently, loss of force generating capacity of diaphragm fibers in patients with COPD. Interestingly, several of these presumed pathologic alterations are already present early in the course of the disease (GOLD I/II, although these patients appear not limited in their daily life activities. Treatment of diaphragm dysfunction in COPD is complex since its etiology is unclear, but recent findings indicate the ubiquitin-proteasome pathway as a prime target to attenuate diaphragm wasting in COPD.

  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. The Incidence and Risk Factors of Lens-iris Diaphragm Retropulsion Syndrome during Phacoemulsification.

    Science.gov (United States)

    Lim, Dong Hui; Shin, Dong Hoon; Han, Gyule; Chung, Eui Sang; Chung, Tae Young

    2017-08-01

    In the present study, the incidence and risk factors of lens-iris diaphragm retropulsion syndrome (LIDRS) were evaluated. Patients who underwent cataract surgery using phacoemulsification between June 2014 and December 2014 were included in the study. The preoperative ocular biometric and intraoperative surgical parameters were examined. The incidence of LIDRS and various risk factors were analyzed using an independent t-test, Pearson's chi-square test, and univariable and multivariable logistic regression analyses. Among 124 eyes of 124 patients, 100 (80.6%) had no LIDRS and 24 (19.4%) had LIDRS. LIDRS occurred in 13 of 31 vitrectomized eyes (41.9%) and 11 of 93 non-vitrectomized eyes (11.8%). Based on univariable analysis, age (odds ratio [OR], 0.920; p = 0.001), vitrectomized eye (OR, 5.038; p = 0.001), spherical equivalent (OR, 0.778; p < 0.001), axial length (OR, 1.716; p < 0.001), anterior chamber depth (OR, 3.328; p = 0.037), and 3.0 mm vs. 2.2 mm incision size (OR, 4.964; p = 0.001) were statistically significant risk factors associated with the development of LIDRS. Conditional multivariable logistic regression showed that vitrectomized eye (OR, 3.865; 95% confidence interval [CI], 1.201 to 12.436; p = 0.023), long axial length (OR, 1.709; 95% CI, 1.264 to 2.310; p = 0.001), and 3.0 vs. 2.2 mm incision size (OR, 3.571; 95% CI, 1.120 to 11.393; p = 0.031) were significant independent risk factors associated with LIDRS. LIDRS is a relatively common occurrence and was found to be associated with vitrectomized eye, long axial length, and larger incision size. Evaluating risk factors prior to cataract surgery can help reduce associated morbidity.

  4. Diaphragm Dysfunction in Mechanically Ventilated Patients.

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    Dot, Irene; Pérez-Teran, Purificación; Samper, Manuel-Andrés; Masclans, Joan-Ramon

    2017-03-01

    Muscle involvement is found in most critical patients admitted to the intensive care unit (ICU). Diaphragmatic muscle alteration, initially included in this category, has been differentiated in recent years, and a specific type of muscular dysfunction has been shown to occur in patients undergoing mechanical ventilation. We found this muscle dysfunction to appear in this subgroup of patients shortly after the start of mechanical ventilation, observing it to be mainly associated with certain control modes, and also with sepsis and/or multi-organ failure. Although the specific etiology of process is unknown, the muscle presents oxidative stress and mitochondrial changes. These cause changes in protein turnover, resulting in atrophy and impaired contractility, and leading to impaired functionality. The term 'ventilator-induced diaphragm dysfunction' was first coined by Vassilakopoulos et al. in 2004, and this phenomenon, along with injury cause by over-distention of the lung and barotrauma, represents a challenge in the daily life of ventilated patients. Diaphragmatic dysfunction affects prognosis by delaying extubation, prolonging hospital stay, and impairing the quality of life of these patients in the years following hospital discharge. Ultrasound, a non-invasive technique that is readily available in most ICUs, could be used to diagnose this condition promptly, thus preventing delays in starting rehabilitation and positively influencing prognosis in these patients. Copyright © 2016 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Clinical survey of lens care in contact lens patients.

    Science.gov (United States)

    Ky, W; Scherick, K; Stenson, S

    1998-10-01

    Overall, contact lenses provide a safe and effective modality for vision correction. However, problems do occasionally arise. Up to 80% of contact lens complications can be traced to poor patient compliance with recommended lens care guidelines. We conducted a survey to evaluate the level of patient compliance in specific areas of lens care and maintenance and to assess patient knowledge of basic contact lens information. Patients were asked to complete an anonymous 15 question survey that focused on lens care--specifically the use of contact lens cleaners, methods of disinfection, enzyme treatments, use of rewetting drops, and the frequency of follow-up exams. In addition, the survey included six true/false questions relating to contact lens care and safety. There were a total of 103 participants in the study. Approximately 24% of patients stated they never cleaned their lenses prior to disinfection, and 5% used saline solutions as their primary mode of disinfection. A sizable portion of those surveyed (43% of soft lens wearers and 71% of rigid gas permeable lens wearers) either never used enzyme cleaners or used them less than once a month. Seventy percent of patients either never used rewetting drops or used them less than once a day. Twenty-nine percent of patients consulted their eye care professionals every 2 years and 6% less often than every two years. Six questions assessed patient knowledge of contact lens care safety. Of a possible six out of six correct answers, the mean number of correct responses was 3.74. A sizable proportion of contact lens wearers do not adequately adhere to recommended contact lens care, and many have an inadequate understanding of contact lens care guidelines. Therefore, it is important that practitioners place more emphasis on patient education at the time of initial contact lens fitting and reinforce such instruction during follow-up visits.

  6. Metabolic capacity of the diaphragm in patients with COPD.

    NARCIS (Netherlands)

    Wijnhoven, J.H.; Janssen, A.J.M.; Kuppevelt, A.H.M.S.M. van; Rodenburg, R.J.T.; Dekhuijzen, P.N.R.

    2006-01-01

    Chronic obstructive pulmonary disease (COPD) is associated with an increased load on the diaphragm. Chronic loading on skeletal muscles results in metabolic changes and fiber-type shifts. Therefore, we investigated whether the load on the human diaphragm imposed by COPD altered oxidative enzyme

  7. Decreased diaphragm excursion in stroke patients with dysphagia as assessed by M-mode sonography.

    Science.gov (United States)

    Park, Geun-Young; Kim, Seong-Rim; Kim, Young Woo; Jo, Kwang Wook; Lee, Eu Jeen; Kim, Young Moon; Im, Sun

    2015-01-01

    To record diaphragm excursion via M-mode ultrasonography in stroke patients with dysphagia and determine whether they present reduced diaphragm excursion during voluntary cough compared with stroke patients without dysphagia and healthy subjects. Prospective cross-sectional study. University rehabilitation hospital. Acute stroke patients with dysphagia (n=23), acute stroke patients without dysphagia (n=24), and healthy control participants (n=27) (N=74). Not applicable. Diaphragm motions during quiet breathing, deep breathing, and voluntary coughing were recorded via ultrasonography using M-mode tracing (mm). Maximum inspiratory and expiratory pressures (cmH2O) and peak cough flow (L/min) during voluntary coughing were measured. The mean diaphragm movement (mm) of the hemiplegic side for all groups during quiet breathing, deep breathing, and voluntary coughing was 14.8±4.3, 17.6±4.8, and 20.9±3.7 (Pdysphagia explained up to 60% (Pdysphagia have decreased diaphragm excursion and compromised respiratory function during voluntary coughing. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  8. Respiratory muscle activity during REM sleep in patients with diaphragm paralysis.

    Science.gov (United States)

    Bennett, J R; Dunroy, H M A; Corfield, D R; Hart, N; Simonds, A K; Polkey, M I; Morrell, M J

    2004-01-13

    The diaphragm is the main inspiratory muscle during REM sleep. It was hypothesized that patients with isolated bilateral diaphragm paralysis (BDP) might not be able to sustain REM sleep. Polysomnography with EMG recordings was undertaken from accessory respiratory muscles in patients with BDP and normal subjects. Patients with BDP had a normal quantity of REM sleep (mean +/- SD, 18.6 +/- 7.5% of total sleep time) achieved by inspiratory recruitment of extradiaphragmatic muscles in both tonic and phasic REM, suggesting brainstem reorganization.

  9. Anatomical and physiological changes in pelvic diaphragm in patients with chagasic megacolon submitted to Duhamel surgery

    OpenAIRE

    Moreira Júnior,Hélio; Moreira,José P. T.; Isaac,Raniere R.; Almeida,Arminda C. de; Moreira,Hélio; Klug,Wilmar A.

    2013-01-01

    ORIGINAL CONTRIBUTION: understand the reasons why Duhamel surgery results in clinical improvement of constipation in patients with Chagasic colopathy. BACKGROUND: Duhamel surgery is one of the most widespread techniques for the treatment of Chagasic megacolon, with low rates of recurrence of constipation. OBJECTIVE: evaluate the anatomical and physiological changes in the pelvic diaphragm of patients with chagasic colopathy, as well as changes occurring after undergoing Duhamel surgery. DESIG...

  10. Anatomical and physiological changes in pelvic diaphragm in patients with chagasic megacolon submitted to Duhamel surgery

    OpenAIRE

    Hélio Moreira Júnior; José P.T. Moreira; Raniere R. Isaac; Arminda C. de Almeida; Hélio Moreira; Wilmar A. Klug

    2013-01-01

    Original contribution: understand the reasons why Duhamel surgery results in clinical improvement of constipation in patients with Chagasic colopathy. Background: Duhamel surgery is one of the most widespread techniques for the treatment of Chagasic megacolon, with low rates of recurrence of constipation. Objective: evaluate the anatomical and physiological changes in the pelvic diaphragm of patients with chagasic colopathy, as well as changes occurring after undergoing Duhamel surgery. Desig...

  11. Diaphragm Pacing as a Rehabilitative Tool for Patients With Pompe Disease Who Are Ventilator-Dependent: Case Series.

    Science.gov (United States)

    Smith, Barbara K; Fuller, David D; Martin, A Daniel; Lottenberg, Lawrence; Islam, Saleem; Lawson, Lee Ann; Onders, Raymond P; Byrne, Barry J

    2016-05-01

    Pompe disease is an inherited disorder notable for severe, progressive ventilatory compromise. Although ventilatory failure has been attributed to myofiber dysfunction secondary to diaphragmatic glycogen accumulation, neural involvement of the phrenic motor system is also a prominent feature. Direct diaphragm pacing supplements respiratory function in other disorders of the phrenic motor system. Accordingly, it is hypothesized that augmented neuromuscular activity via diaphragm pacing would promote weaning from mechanical ventilation in patients with Pompe disease who are unresponsive to conventional, muscle-directed treatments. Three patients with Pompe disease developed diaphragm paresis that resulted in chronic mechanical ventilation dependence. After preoperative inspiratory muscle strengthening exercises failed to improve function, fine-wire pacing electrodes were laparoscopically implanted into the diaphragm. Diaphragm conditioning was initiated the first postoperative week and consisted of gradual increases in stimulation parameters, lengthening of stimulation sessions, and ventilator weaning. Ventilation and intramuscular electromyographic activity were recorded periodically during conditioning to quantify diaphragm neuromuscular function. During paced breathing without mechanical ventilation, tidal volumes increased, and 2 patients were weaned from daytime ventilator dependence within the first 3 months of pacing, which has been sustained over the long-term. A third patient reduced reliance on daytime ventilation, but weaning was delayed by malacia of the large airways. In all patients, pacing appeared to facilitate spontaneous phrenic motor unit activity during independent breathing without ventilator or pacer support. The findings are consistent with the view that diaphragm pacing has potential rehabilitative value to reduce reliance on mechanical ventilation in people with Pompe disease, but further study is needed. Diaphragm pacing represents a

  12. Intraocular lens implantation in microphthalmic patients.

    Science.gov (United States)

    Sinskey, R M; Amin, P; Stoppel, J

    1992-09-01

    Microphthalmos is a developmental disorder of the eye consisting of a smaller than normal eye. This disorder can present as an isolated condition or associated with other systemic alterations. It is not uncommon for patients with microphthalmos to have congenital cataracts along with other ocular and systemic abnormalities. This paper reports the experience with 11 microphthalmic eyes of seven patients who had primary or secondary intraocular lens (IOL) implantation over a six-year period from 1985 to 1991. In all cases the IOL had a 13.5 mm or 14.0 mm overall diameter and a 6.0 mm or 6.5 mm optic. It was difficult to obtain documentation of objective visual improvement in many of these cases because of the associated nystagmus. However, all patients reported subjective improvements. These results suggest that with proper technique and lens selection microphthalmic patients should be considered for IOL implantation with relative safety and success.

  13. Ultrasound evaluation of diaphragm function and its application in critical patients, mechanical ventilation and brachial plexus block.

    Science.gov (United States)

    de la Quintana Gordon, F de B; Nacarino Alcorta, B; Fajardo Pérez, M

    2017-11-01

    Before diaphragm ultrasonography, assessment of diaphragm function was very difficult due to the complex nature of its exploration. The use of this new technique has shed light on diagnostic problems and treatment with an improvement in final outcomes for critically ill patients, in whom the incidence of diaphragm weakness or dysfunction has been underestimated. Better knowledge of diaphragm function enables us earlier diagnosis by quantification of diaphragm contractile activity or evaluation of functional status after delivery of plexus block anaesthesia, facilitating therapeutic decisions. It is also being used as a guide in the process of weaning from mechanical ventilation or as the safest approach for braquial plexus block. In this review we present how to perform a systematic exploration of diaphragm function and its clinical implications. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Investigation of lens morphology and mechanical characteristics of lens capsule and lens nucleus in patients with agerelated and diabetic cataract

    Directory of Open Access Journals (Sweden)

    A. S. Tishkova

    2014-07-01

    Full Text Available Purpose: To investigate the influence of carbohydrate metabolism on the structure and mechanical properties of the lens capsule and nucleus.Methods: Human lens pathology was studied in different forms of cataract. 220 patients with a cataract (220 eyes were included in this study. Morphological, immunohystological and immunocytochemical investigations of lens substance (antibodies to a- (a-А and a-В, b-, g- crystallines, spectroscopic analyses of smears and morphometric analyses of slices, investigation of lens morphology and mechanical caracteristics of lens capsule and lens nucleus were performed.Results: The capsule of the lens in patients with senile cataract contains more Na+, Cl-. The capsule of the lens in patients with senile cataract contains more Ca2+, O. Mechanical strength of the capsule in the case of diabetes mellitus was lower comparatively with senile cataract in the same age groups. More significant expression of a-В and b-crystallines was found in patients with diabetes mellitus comparatively with patients with age-related cataract. Morphological features were founded in patients with cortical and nuclear forms of senile cataract and the diabetic cataract.Conclusion: During surgery (ultrasonic microcoaxial phacoemulsification the equivalent of ultrasound was recorded. Lower density of the lens nucleus of patients with diabetes mellitus made it possible to use lower energy parameters. Using the torsion ultrasound in those cases allowed us to decrease the influence of ultrasound on eye tissues and reduce the time of achieving the maximum BCVA in the postsurgical period.

  15. Investigation of lens morphology and mechanical characteristics of lens capsule and lens nucleus in patients with agerelated and diabetic cataract

    Directory of Open Access Journals (Sweden)

    A. S. Tishkova

    2013-01-01

    Full Text Available Purpose: To investigate the influence of carbohydrate metabolism on the structure and mechanical properties of the lens capsule and nucleus.Methods: Human lens pathology was studied in different forms of cataract. 220 patients with a cataract (220 eyes were included in this study. Morphological, immunohystological and immunocytochemical investigations of lens substance (antibodies to a- (a-А and a-В, b-, g- crystallines, spectroscopic analyses of smears and morphometric analyses of slices, investigation of lens morphology and mechanical caracteristics of lens capsule and lens nucleus were performed.Results: The capsule of the lens in patients with senile cataract contains more Na+, Cl-. The capsule of the lens in patients with senile cataract contains more Ca2+, O. Mechanical strength of the capsule in the case of diabetes mellitus was lower comparatively with senile cataract in the same age groups. More significant expression of a-В and b-crystallines was found in patients with diabetes mellitus comparatively with patients with age-related cataract. Morphological features were founded in patients with cortical and nuclear forms of senile cataract and the diabetic cataract.Conclusion: During surgery (ultrasonic microcoaxial phacoemulsification the equivalent of ultrasound was recorded. Lower density of the lens nucleus of patients with diabetes mellitus made it possible to use lower energy parameters. Using the torsion ultrasound in those cases allowed us to decrease the influence of ultrasound on eye tissues and reduce the time of achieving the maximum BCVA in the postsurgical period.

  16. The effect of progressive high-intensity inspiratory muscle training and fixed high-intensity inspiratory muscle training on the asymmetry of diaphragm thickness in stroke patients.

    Science.gov (United States)

    Jung, Ju-Hyeon; Kim, Nan-Soo

    2015-10-01

    [Purpose] This study investigated the effects of progressive load and fixed load high-intensity inspiratory muscle training on the asymmetry of diaphragm thickness in stroke patients. [Subjects] Twenty-one stroke patients were assigned to one of three groups: progressive load high-intensity inspiratory muscle training (n = 8), fixed load high-intensity inspiratory muscle training (n = 6), and controls (n = 7). [Methods] The progressive load and fixed load high-intensity inspiratory muscle training participants undertook an exercise program for 20 minutes, three times weekly, for 6 weeks. After each session, diaphragm thickness was measured using ultrasonography. The diaphragm asymmetry ratio and diaphragm thickening ratio were standardized using a formula. [Results] After intervention, the diaphragm asymmetry ratio significantly differed among the three groups, and the diaphragm asymmetry ratio significantly increased in the control group. A significant increase was identified in the diaphragm thickening ratio within the progressive load and fixed load high-intensity inspiratory muscle training groups. [Conclusion] Progressive load and fixed load high-intensity inspiratory muscle training decreased the asymmetry of diaphragm thickness in stroke patients; this effect, in turn, increased the diaphragm thickening ratio in stroke patients. The two interventions examined here should be selectively applied to individuals in the clinical field.

  17. Rupture traumatique du diaphragme

    OpenAIRE

    Nordback, P.L.G.

    2006-01-01

    Résumé Rupture traumatique du diaphragme La rupture traumatique du diaphragme a été décrite la première fois par Sennertus en 1541. Ambroise Paré, en 1579, décrivit le premier cas de rupture traumatique du diaphragme diagnostiqué à l'autopsie. Une rupture traumatique du diaphragme existe chez 3 à 5% des patients polytraumatisés. En général la réparation chirurgicale est simple. La mortalité globale atteint 20 à 25%, elle est en général liée aux lésions associées, à la sévérité de la ...

  18. [Choice of surgical tactics in patients with multiple trauma and predominant injury of hollow abdominal organs, diaphragm, and pancreas].

    Science.gov (United States)

    Zamiatin, P N

    2004-08-01

    The experience of treatment of 67 suffered with predominant injury of hollow abdominal organs, diaphragm and pancreas is present. The choice of surgical tactics was depend of many factors: time from accident to operation, the severity stage of patients, presence of extraabdominal injuries, localization and degree of abdominal organ injuries.

  19. [Predictive value of ultrasonic diaphragm thickening fraction on successful weaning for patients with myasthenia gravis crisis].

    Science.gov (United States)

    Sun, Qiang; Shan, Feng; Dong, Hai; Jiang, Yan; Sun, Yongmei; Sun, Yunbo

    2017-07-01

    To confirm the predictive value of diaphragm thickening fraction (DTF) on successful weaning by bedside ultrasound in patients with myasthenia gravis crisis. A prospective study was conducted. The patients with myasthenia gravis crisis undergoing mechanical ventilation admitted to Department of Critical Care Medicine of the Affiliated Hospital of Qingdao University from March 2015 to February 2017 were enrolled. All patients underwent a low level pressure support mode of spontaneous breathing test (SBT), and rapid shallow breathing index (RSBI) was recorded. The indicators of right diaphragm thickness at the end of inspiration (DTei) and expiration (DTee) were determined by bedside ultrasound at 5 minutes and 60 minutes of SBT, and DTF was calculated, the changes in above parameters were observed during SBT. The patients were divided into successful weaning group and failure weaning group, and the differences in above indexes were compared between the two groups. Receiver operating characteristic curve (ROC) was used to evaluate the predictive value of DTF and RSBI at 60 minutes of SBT on successful weaning. A total of 37 patients were enrolled in the study. Ultrasonic measurement data of 63 person-times at 5 minutes of SBT and 50 at 60 minutes of SBT were obtained. There were no statistical differences in RSBI, DTei, DTee, and DTF at 5 minutes of SBT between successful weaning group (n = 33) and failure weaning group (n = 30). At 60 minutes of SBT, compared with successful weaning group (n = 33), the patients in failure weaning group (n = 17) had a higher RSBI (times×min -1 ×L -1 : 80.41±29.08 vs. 63.94±23.84, t = 2.146, P = 0.037), and lower DTee, DTei and DTF [DTee (mm): 22.00±6.25 vs. 25.45±4.99, t = 2.127, P = 0.039; DTei (mm): 27.94±6.19 vs. 38.48±6.15, t = 5.731, P = 0.000; DTF: (24.46±14.11)% vs. (62.04±30.21)%, t = 4.845, P = 0.000]. There were no statistical differences in RSBI, DTei, DTee, and DTF between 5 minutes and 60 minutes of SBT in 33

  20. Patient acceptability of the Tecnis® multifocal intraocular lens

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    Sood P

    2011-03-01

    Full Text Available Priyanka Sood1, Maria A Woodward21Emory Eye Center, Atlanta, GA, USA; 2Kellogg Eye Center, Ann Arbor, MI, USAAbstract: Cataract surgery has evolved. The goal of the surgeon includes both restoration of vision and refinement of vision. Patients' desire for spectacle independence has driven the market for presbyopia-correcting cataract surgery and development of novel intraocular lens (IOL designs. The Tecnis® Multifocal Intraocular Lens incorporates an aspheric, modified anterior prolate IOL with a diffractive multifocal lens design. The design aims to minimize spherical aberration and improve range of focus. The purpose of this review is to assess patient acceptability of the Tecnis® multifocal intraocular lens.Keywords: Tecnis®, intraocular lens, multifocal, presbyopia 

  1. The diaphragm

    International Nuclear Information System (INIS)

    Taourel, P.; Marty-Ane, B.; Pradel, J.; Metge, L.; Giron, J.; Bruel, J.M.

    1991-01-01

    CT permits the demonstration of normal diaphragmatic anatomy not visible on plain radiography of the chest. Having a knowledge of normal diaphragmatic anatomy, variants, attachments to the body wall and ligaments attaching to the diaphragm is important to be able to correctly interpret the body scans. CT permits to study diaphragmatic and peridiaphragmatic processes and notably to distinguish diaphragmatic and paradiaphragmatic tumors and pseudotumors, to localize peridiaphragmatic collections, to understand transdiaphragmatic routes and diaphragmatic hernia, and to recognize processes extending into retrocrural space and cardiophrenic angle [fr

  2. [Traumatic rupture of the diaphragm].

    Science.gov (United States)

    Mazuch, J; Kuník, Z; Herczegh, S; Pelc, J; Machan, L; Chamko, M

    1990-07-01

    Traumatic ruptures of the diaphragm occur most frequently at blunt injuries of the abdomen or thorax as a component of polytraumatism. At the acute stage they present a serious diagnostic problem since signs of polytrauma are predominant. The authors report 3 cases of traumatic rupture of the diaphragm with thoracotomy as the therapeutic approach. The first patient presented with severe polytraumatism and shock, rupture of the diaphragm, pericardium and lungs, along with serial fracture of the left ribs. The second patient was not in shock, he had suffered serial fracture of the left ribs and fracture of the pelvis. In both these cases of blunt injury to the thorax, careful examination of the patients resulted in early diagnosis and surgery. The third patient presented with open injury of the right side of the thorax, injured diaphragm and liver, serial fracture of the ribs, fractured sternum, and was in a state of deep shock. There was no mortality, all three patients recovered.

  3. Anatomical and physiological changes in pelvic diaphragm in patients with chagasic megacolon submitted to Duhamel surgery

    Directory of Open Access Journals (Sweden)

    Hélio Moreira Júnior

    2013-04-01

    Full Text Available Original contribution: understand the reasons why Duhamel surgery results in clinical improvement of constipation in patients with Chagasic colopathy. Background: Duhamel surgery is one of the most widespread techniques for the treatment of Chagasic megacolon, with low rates of recurrence of constipation. Objective: evaluate the anatomical and physiological changes in the pelvic diaphragm of patients with chagasic colopathy, as well as changes occurring after undergoing Duhamel surgery. Design: clinical data and results of cinedefecography, electromanometry and anorectal ultrasound of the anal canal were evaluated in patients with Chagasic colopathy, before and after Duhamel surgery. Location: Service of Coloproctology – Departament of Surgery, Faculdade de Medicina da Universidade Federal de Goiás. Patients: patients with positive serology for Chagas Disease, with constipation and radiological megacolon, who presented consecutively to the Chagas outpatient clinic and freely agreed to participate in this study, were prospectively included. Results: a total of 20 patients were included, with a mean age of 53.2 years, of which 16 were women. The following parameters were observed in the postoperative period: change in bowel frequency, of, on average, one evacuation every ten days to daily bowel movement; 16 patients used laxatives preoperatively and only one did, intermittently, in postoperative period. Electromanometry showed, postoperatively, a decrease in anal resting pressure (60.88 to 37.2 mmHg p < 0.001 and anal squeeze pressures (244.3 mL to 161.25 p = 0.01, whereas ultrasound showed that 75% of the patients had abnormalities of the internal anal sphincter in the posterior anal canal juxtaposed to the pulled-through colon. Postoperative rectal emptying observed in cinedefecographic tests occurred more quickly and with less effort when compared with the preoperative findings. There was a change in the anorectal angle postoperatively

  4. Patient compliance and its influence on contact lens wearing problems.

    Science.gov (United States)

    Collins, M J; Carney, L G

    1986-12-01

    One hundred consecutively presenting patients, fifty from each of two contact lens clinics, were questioned about the procedures encountered in care and maintenance of their contact lenses and asked to demonstrate their use of those procedures. Their clinic records were then analyzed for the occurrence of signs and symptoms that were related potentially to noncompliance with instructions and procedures, and that could not be otherwise explained. Only 26% of patients were fully complaint. Noncompliance with instructions was related strongly to the occurrence of signs and symptoms indicative of potential wearing problems. Improvements in the level of patient compliance with instructions is likely to bring about increased patient success with contact lens wearing.

  5. R gas under diaphragm

    OpenAIRE

    Ramachar Sreevathsa, Maddibande; Melanta, Khyati

    2016-01-01

    Introduction: The most common cause of gas under diaphragm is hollow viscous perforation. In 10% of cases it can be due to rare causes, both abdominal and extra-abdominal, one of them being intra abdominal infection by gas forming organisms. Presentation of the case: A 51 year old male patient, a poorly controlled diabetic, presented with a second episode of severe pain abdomen and abdominal distention, with lower abdominal tenderness. Plain Xray of the abdomen in erect posture showed gas ...

  6. Twenty years and twenty thousand contact lens patients.

    Science.gov (United States)

    Dixon, J M

    1981-01-01

    A self contained non commercial private office laboratory staffed by office personnel has been used to prepare contact lenses for private office patients. These lenses include hard contact lenses of various materials and various designs. During the past ten years extended wear hydrophilic soft lenses have been prepared in the same manner as hard lenses, all custom made with lens powers, base curves, diameters, and thickness designed according to the needs of each patient. This has provided strict medical supervision and lens maintenance with maximum convenience for patients and the ophthalmologist.

  7. Comparison of Diaphragmatic Breathing Exercise, Volume and Flow Incentive Spirometry, on Diaphragm Excursion and Pulmonary Function in Patients Undergoing Laparoscopic Surgery: A Randomized Controlled Trial

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    Gopala Krishna Alaparthi

    2016-01-01

    Full Text Available Objective. To evaluate the effects of diaphragmatic breathing exercises and flow and volume-oriented incentive spirometry on pulmonary function and diaphragm excursion in patients undergoing laparoscopic abdominal surgery. Methodology. We selected 260 patients posted for laparoscopic abdominal surgery and they were block randomization as follows: 65 patients performed diaphragmatic breathing exercises, 65 patients performed flow incentive spirometry, 65 patients performed volume incentive spirometry, and 65 patients participated as a control group. All of them underwent evaluation of pulmonary function with measurement of Forced Vital Capacity (FVC, Forced Expiratory Volume in the first second (FEV1, Peak Expiratory Flow Rate (PEFR, and diaphragm excursion measurement by ultrasonography before the operation and on the first and second postoperative days. With the level of significance set at p<0.05. Results. Pulmonary function and diaphragm excursion showed a significant decrease on the first postoperative day in all four groups (p<0.001 but was evident more in the control group than in the experimental groups. On the second postoperative day pulmonary function (Forced Vital Capacity and diaphragm excursion were found to be better preserved in volume incentive spirometry and diaphragmatic breathing exercise group than in the flow incentive spirometry group and the control group. Pulmonary function (Forced Vital Capacity and diaphragm excursion showed statistically significant differences between volume incentive spirometry and diaphragmatic breathing exercise group (p<0.05 as compared to that flow incentive spirometry group and the control group. Conclusion. Volume incentive spirometry and diaphragmatic breathing exercise can be recommended as an intervention for all patients pre- and postoperatively, over flow-oriented incentive spirometry for the generation and sustenance of pulmonary function and diaphragm excursion in the management of

  8. EVENTRATION OF DIAPHRAGM

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    I G A P Eka Pratiwi

    2012-11-01

    Full Text Available Eventration of diaphragm (ED refers to an abnormally high position of part or all of the diaphragm, but intact diaphragm, usually associated with a marked decrease in muscle fibers and a membranous appearance of the abnormal area with only the peripheral thoracic attachments showing normal muscle. Etiologically ED is congenital or acquired. Congenital diaphragmatic abnormalities occur in 1 per 2000 to 4000 birth, which 7% is diaphragmatic eventration. Most children with ED are asymptomatic when incidentally first seen, will not need theraphy. Those with symptoms develop acute respiratory distress, feeding difficulties, and recurrent pneumonitis. If the patient need assissted ventilation or cannot be weaned off the ventilator, she or he should be plicated. Failure to achieve extubation within a week of plication is an ominous prognostic sign. We reported a case of one month and four days old girl who was dispnea, feeding difficulty and bronchopneumonia caused by right ED with acquired etiology. Plication was done to repaired the symptom. But unfortunately this was not succeded because there was complication of postoperative treatment.

  9. Diaphragm versus diaphragm with spermicides for contraception.

    Science.gov (United States)

    Cook, L; Nanda, K; Grimes, D

    2003-01-01

    The diaphragm is usually used with a spermicide. However, some practitioners have suggested that spermicides offer no additional contraceptive protection and have advocated alternative guidelines for the use of diaphragms. The objective of this review was to compare the effectiveness, safety and acceptability of the diaphragm with and without spermicide. We searched MEDLINE, EMBASE, POPLINE, CINAHL, the Cochrane Controlled Trials Register, and reference lists of relevant articles. In addition, we contacted experts in the field to identify unpublished studies. Randomized controlled trials comparing women of reproductive age using the diaphragm with and without spermicide as the sole contraceptive method that reported clinical outcomes. Two reviewers independently extracted data on outcomes and trial characteristics and any discrepancies were resolved by consensus or by consultation with the third reviewer. The results of the one identified study are presented descriptively. We identified only one study. No significant difference was found in the pregnancy rates (with typical use or consistent use) or discontinuation rates between the diaphragm-with-spermicide and diaphragm-without-spermicide groups. There was a trend towards higher pregnancy rates in the diaphragm-without-spermicide group. However, this study failed to recruit the planned number of participants and was consequently underpowered. As only one underpowered study was identified, we cannot distinguish between the contraceptive effectiveness of the diaphragm with and without spermicide. We cannot draw any conclusion at this point, further research is needed. However, the study provides no evidence to change the commonly recommended practice of using the diaphragm with spermicide.

  10. 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.

  11. Central vault in dry eye patients successfully wearing scleral lens.

    Science.gov (United States)

    Sonsino, Jeffrey; Mathe, Dora Sztipanovits

    2013-09-01

    Scleral contact lenses are used to treat symptoms of severe dry eyes. Procedures for fitting scleral lenses have been vague because of lack of standardized guidelines. This retrospective case series sought to establish average vault over central cornea in successful scleral lens wearers with dry eyes. Anterior segment optical coherence tomography was used to measure the distance between the posterior lens surface and cornea in 20 eyes of 12 consecutive patients successfully fit in the Vanderbilt Scleral Lens Clinic. Mean vault was 380 ± 110 μm. There was no correlation between vault and corneal curvature or vault and visual acuity. With a large SD in average vault, precision in central vault does not seem to be important in scleral contact lenses for successful fit for dry eyes.

  12. Twenty years and twenty thousand contact lens patients.

    OpenAIRE

    Dixon, J M

    1981-01-01

    A self contained non commercial private office laboratory staffed by office personnel has been used to prepare contact lenses for private office patients. These lenses include hard contact lenses of various materials and various designs. During the past ten years extended wear hydrophilic soft lenses have been prepared in the same manner as hard lenses, all custom made with lens powers, base curves, diameters, and thickness designed according to the needs of each patient. This has provided st...

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

    Science.gov (United States)

    Tulaimat, Aiman; Trick, William E

    2017-01-01

    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.

  14. 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.

  15. Increase of lower esophageal sphincter pressure after osteopathic intervention on the diaphragm in patients with gastroesophageal reflux.

    Science.gov (United States)

    da Silva, R C V; de Sá, C C; Pascual-Vaca, Á O; de Souza Fontes, L H; Herbella Fernandes, F A M; Dib, R A; Blanco, C R; Queiroz, R A; Navarro-Rodriguez, T

    2013-07-01

    The treatment of gastroesophageal reflux disease may be clinical or surgical. The clinical consists basically of the use of drugs; however, there are new techniques to complement this treatment, osteopathic intervention in the diaphragmatic muscle is one these. The objective of the study is to compare pressure values in the examination of esophageal manometry of the lower esophageal sphincter (LES) before and immediately after osteopathic intervention in the diaphragm muscle. Thirty-eight patients with gastroesophageal reflux disease - 16 submitted to sham technique and 22 submitted osteopathic technique - were randomly selected. The average respiratory pressure (ARP) and the maximum expiratory pressure (MEP) of the LES were measured by manometry before and after osteopathic technique at the point of highest pressure. Statistical analysis was performed using the Student's t-test and Mann-Whitney, and magnitude of the technique proposed was measured using the Cohen's index. Statistically significant difference in the osteopathic technique was found in three out of four in relation to the group of patients who performed the sham technique for the following measures of LES pressure: ARP with P= 0.027. The MEP had no statistical difference (P= 0.146). The values of Cohen d for the same measures were: ARP with d= 0.80 and MEP d= 0.52. Osteopathic manipulative technique produces a positive increment in the LES region soon after its performance. © 2012 Copyright the Authors. Journal compilation © 2012, Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.

  16. 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.

  17. [Relation between ultrasound-measured diaphragm movement and partial pressure of carbon dioxide in blood from patients with acute hypercapnic respiratory failure after the start of noninvasive ventilation in an emergency department].

    Science.gov (United States)

    Sánchez-Nicolás, José Andrés; Cinesi-Gómez, César; Villén-Villegas, Tomás; Piñera-Salmerón, Pascual; García-Pérez, Bartolo

    2016-10-01

    To evaluate the correlation between variations in ultrasound-measured diaphragm movement and changes in the arterial partial pressure of carbon dioxide (PCO2) after the start of noninvasive ventilation (NIV). RDescriptive study of a prospective case series comprised of nonconsecutive patients aged 18 years or older with hypercapnic respiratory failure who were placed on NIV in an emergency department. We recorded clinical data, blood gas measurements, and ultrasound measurements of diaphragm movement. Twenty-one patients with a mean (SD) age of 83 (13) years were studied; 11 (52.4%) were women. The mean (SD) range of diaphragm movement and PCO2 values at 4 moments were as follows: 1) at baseline: diaphragm movement, 13.90 (7.7) mm and PCO2, 71.75 (11.4) mm Hg; 2) after 15 minutes on NIV: diaphragm movement, 17.10 (9.1) mm; 3) at 1 hour: diaphragm movement, 22.40 (10.4) mm and PCO2, 63.45 (16.0) mm Hg; and 4) at 3 hours: diaphragm movement, 26.60 (19.5) mm and PCO2, 61.85 (13.0) mm Hg. We detected a statistically significant correlation between the difference in range of diaphragm movement at baseline and at 15 minutes and the decrease in PCO2 after 1 hour of NIV (r=-0.489, P=.035). In patients with hypercapnic respiratory failure, the increase in range of diaphragm movement 15 minutes after starting NIV is associated with a decrease in PCO2 after 1 hour.

  18. Protocol for diaphragm pacing in patients with respiratory muscle weakness due to motor neurone disease (DiPALS: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    McDermott Christopher J

    2012-08-01

    Full Text Available Abstract Background Motor neurone disease (MND is a devastating illness which leads to muscle weakness and death, usually within 2-3 years of symptom onset. Respiratory insufficiency is a common cause of morbidity, particularly in later stages of MND and respiratory complications are the leading cause of mortality in MND patients. Non Invasive Ventilation (NIV is the current standard therapy to manage respiratory insufficiency. Some MND patients however do not tolerate NIV due to a number of issues including mask interface problems and claustrophobia. In those that do tolerate NIV, eventually respiratory muscle weakness will progress to a point at which intermittent/overnight NIV is ineffective. The NeuRx RA/4 Diaphragm Pacing System was originally developed for patients with respiratory insufficiency and diaphragm paralysis secondary to stable high spinal cord injuries. The DiPALS study will assess the effect of diaphragm pacing (DP when used to treat patients with MND and respiratory insufficiency. Method/Design 108 patients will be recruited to the study at 5 sites in the UK. Patients will be randomised to either receive NIV (current standard care or receive DP in addition to NIV. Study participants will be required to complete outcome measures at 5 follow up time points (2, 3, 6, 9 and 12 months plus an additional surgery and 1 week post operative visit for those in the DP group. 12 patients (and their carers from the DP group will also be asked to complete 2 qualitative interviews. Discussion The primary objective of this trial will be to evaluate the effect of Diaphragm Pacing (DP on survival over the study duration in patients with MND with respiratory muscle weakness. The project is funded by the National Institute for Health Research, Health Technology Assessment (HTA Programme (project number 09/55/33 and the Motor Neurone Disease Association and the Henry Smith Charity. Trial Registration: Current controlled trials ISRCTN53817913. The

  19. [The effect of crystalline lens extraction on intraocular pressure in patients with primary open-angle glaucoma].

    Science.gov (United States)

    Macarie, S; Macarie, Daniela

    2013-01-01

    This issue presents the results of a study on patients with cataract and primary open angle glaucoma who suffered lens extraction for cataract. We analise the effects of the lens extraction on the level of intraocular pressure at this patients.

  20. Foldable toric intraocular lens for astigmatism correction in cataract patients.

    Science.gov (United States)

    Mendicute, Javier; Irigoyen, Cristina; Aramberri, Jaime; Ondarra, Ana; Montés-Micó, Robert

    2008-04-01

    To evaluate the results of AcrySof toric intraocular lens (IOL) (Alcon) implantation to correct preexisting astigmatism in patients having cataract surgery. Ophthalmology Service, Donostia Hospital, San Sebastián, Spain. This prospective observational study included 30 eyes of 15 consecutive patients with more than 1.00 diopter (D) of preexisting corneal astigmatism having cataract surgery. Bilateral implantation of the AcrySof toric IOL was performed after phacoemulsification. The uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), residual refractive sphere, residual keratometric and refractive cylinders, and toric IOL axis were measured. The UCVA was 20/40 or better in 93.3% of eyes and 20/25 or better in 66.6%. All eyes achieved 20/25 or better BCVA. The mean refractive cylinder decreased significantly after surgery from -2.34 D +/- 1.28 (SD) to -0.72 +/- 0.43 D (P<.01). Vector analysis of attempted versus achieved correction showed that 100% of eyes were within +/-1.00 D and 80% and 93.9% were within +/-0.50 D for J(0) and J(45), respectively. The mean toric IOL axis rotation was 3.63 +/- 3.11 degrees, with rotation less than 10 degrees in 96.7% of eyes. The results indicate that phacoemulsification and posterior chamber AcrySof toric IOL implantation is an effective option to correct preexisting astigmatism in cataract surgery. The AcrySof toric IOL showed good rotational stability.

  1. 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

  2. Scleral lens influence on corneal curvature and pachymetry in keratoconus patients.

    Science.gov (United States)

    Soeters, Nienke; Visser, Esther Simone; Imhof, Saskia M; Tahzib, Nayyirih G

    2015-08-01

    To investigate the influence of full scleral lenses on corneal curvature and pachymetry in keratoconus patients. In this intervention study, 20 eyes of 14 patients were measured by Scheimpflug imaging (Pentacam HR, Oculus) at two time points: directly and ≥1 week after scleral lens removal. Steep, flat and maximal keratometry (K(steep), K(flat) and K(max)) and optical pachymetry were analyzed. A generalized estimating equation analysis was performed to correct for paired eyes. Directly after scleral lens removal, all three curvature parameters were significantly flatter compared to ≥1 week after scleral lens removal. Average K(steep) was 0.7 diopter (D) lower (Pscleral lens removal, average optical pachymetry was ±2.5% higher (Pscleral lens removal. Although scleral lenses do not mechanically touch the cornea, curvature and pachymetry seem to be influenced by scleral lens wear in keratoconus patients. The duration of these changes remain unclear. Copyright © 2015 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  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. 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.

  5. Nonceliac Diaphragm Disease of the Duodenum

    Directory of Open Access Journals (Sweden)

    Hugh J Freeman

    2000-01-01

    Full Text Available A 58-year-old, Indo-Canadian man presented with upper abdominal pain and the clinical features of a partial, gastric outlet obstruction. Subsequent studies, including endoscopic examination, revealed diaphragm-like strictures in the descending duodenum. Other reported causes such as celiac disease and drug-induced small bowel diaphragms were excluded. Possibly, the changes seen in this patient were related to ethnic food-induced, mucosal injury to the upper gastrointestinal tract. Further studies are needed to evaluate potential toxicity or protective effects of different ethnic diets and their relationship with the development of different intestinal diseases.

  6. Manual evaluation of the diaphragm muscle

    Directory of Open Access Journals (Sweden)

    Bordoni B

    2016-08-01

    Full Text Available Bruno Bordoni,1–3 F Marelli,2,3 B Morabito,2–4 B Sacconi5 1Department of Cardiology, Foundation Don Carlo Gnocchi IRCCS, Institute of Hospitalization and Care with Scientific Address, Milan, 2CRESO, School of Osteopathic Centre for Research and Studies, Castellanza, 3CRESO, School of Osteopathic Centre for Research and Studies, Falconara Marittima, 4Foundation Polyclinic University A Gemelli, University Cattolica del Sacro Cuore, 5Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Rome, Italy Abstract: The respiratory diaphragm is the most important muscle for breathing. It contributes to various processes such as expectoration, vomiting, swallowing, urination, and defecation. It facilitates the venous and lymphatic return and helps viscera located above and below the diaphragm to work properly. Its activity is fundamental in the maintenance of posture and body position changes. It can affect the pain perception and emotional state. Many authors reported on diaphragmatic training by using special instruments, whereas only a few studies focused on manual therapy approaches. To the knowledge of the authors, the existing scientific literature does not exhaustively examines the manual evaluation of the diaphragm in its different portions. A complete evaluation of the diaphragm is mandatory for several professional subjects, such as physiotherapists, osteopaths, and chiropractors not only to elaborate a treatment strategy but also to obtain information on the validity of the training performed on the patient. This article aims to describe a strategy of manual evaluation of the diaphragm, with particular attention to anatomical fundamentals, in order to stimulate further research on this less explored field. Keywords: diaphragm, osteopathic evaluation, manual therapy, chiropractic, physiotherapy

  7. Serial Diaphragm Ultrasonography to Predict Successful Discontinuation of Mechanical Ventilation.

    Science.gov (United States)

    Palkar, Atul; Mayo, Paul; Singh, Karan; Koenig, Seth; Narasimhan, Mangala; Singh, Anup; Darabaner, Rivkah; Greenberg, Harly; Gottesman, Eric

    2018-03-19

    Diaphragm excursion and contraction velocity measured using ultrasonography have been used to assess diaphragm function. We aimed to evaluate the performance of diaphragm ultrasonography during weaning from mechanical ventilation (MV). Diaphragm ultrasonography was performed on 73 mechanically ventilated patients who were being considered for extubation on three separate occasions: (1) on assist control mode (A/C) during consistent patient triggered ventilation, (2) following 30 min during a spontaneous breathing trial (SBT), (3) 4-24 h following extubation. Right hemidiaphragm excursion and contraction velocity were measured on A/C, during SBT, and following extubation. These measurements were correlated with the outcome of extubation. Twenty patients failed extubation: 6 of whom required re-intubation and 14 of whom required non-invasive ventilatory support. During SBT, the mean diaphragm excursions were 1.7 ± 0.82 cm in the group who failed extubation compared to 2.1 ± 0.9 cm in the group who were successfully extubated (p = 0.06). To predict successful extubation, a decrease in diaphragm excursion of < 16.4% between A/C and SBT had a sensitivity of 84.9% and a specificity of 65%. The area under curve (AUC) for receiver operative characteristics for above cut-off was 0.75. Diaphragm contraction velocity performed poorly in predicting weaning outcome. Diaphragm excursion measured during SBT is an imperfect predictor of the outcome of extubation. Maintenance of diaphragm excursion between A/C and SBT has good performance characteristics by AUC analysis. Diaphragm contraction velocity has poor ability to predict outcome of extubation.

  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. 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.

  10. Surgical Management of a Patient with Anterior Megalophthalmos, Lens Subluxation, and a High Risk of Retinal Detachment

    Directory of Open Access Journals (Sweden)

    María Carmen Guixeres Esteve

    2017-01-01

    Full Text Available The early development of lens opacities and lens subluxation are the most common causes of vision loss in patients with anterior megalophthalmos (AM. Cataract surgery in such patients is challenging, however, because of anatomical abnormalities. Intraocular lens dislocation is the most common postoperative complication. Patients with AM also seem to be affected by a type of vitreoretinopathy that predisposes them to retinal detachment. We here present the case of a 36-year-old man with bilateral AM misdiagnosed as simple megalocornea. He had a history of amaurosis in the right eye due to retinal detachment. He presented with vision loss in the left eye due to lens subluxation. Following the removal of the subluxated lens, it was deemed necessary to perform a vitrectomy in order to prevent retinal detachment. Seven months after surgery, an Artisan® Aphakia iris-claw lens was implanted in the anterior chamber. Fifteen months of follow-up data are provided.

  11. 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.

  12. Traumatic injuries of the diaphragm

    Directory of Open Access Journals (Sweden)

    Lokman Soyoral

    2012-06-01

    Full Text Available Objectives: In this study, patient characteristics, diagnosisand treatment of patients with traumatic injury of thediaphragm, and the outcomes were evaluated.Materials and methods: Between 2002 and 2012, 19patients were treated for blunt and penetrating diaphragmaticinjury at the Thoracic Surgery Clinics of two teachinghospitals. The patients were evaluated retrospectively.Results: The etiology of trauma was traffic accidents in8 cases, falls from height in three, earthquake-relatedwounds in two, and stab wounds in six cases (SW. Themost frequent complaints and physical findings were dyspnea,chest pain, abdominal distension and the absenceof respiratory sounds. The most frequently encounteredfinding from the chest radiography was disappearance ofdiaphragmatic shadow, elevation of the diaphragm, andvisceral herniation to the thorax. All patients underwentsurgery. A left diaphragmatic rupture was diagnosed in13, and a right diaphragmatic rupture in 6 patients. Fourteenpatients had visceral herniation without strangulation.In fourteen patients, the diaphragmatic injury wasaccompanied by intra-abdominal organ injuries, lung injuriesand the other system injuries. In one case, cardiac injury,and in four cases, an isolated diaphragmatic rupturewas diagnosed. The most commonly associated organ indiaphragmatic injury was the stomach. In all cases, thediaphragm was repaired by two layers of non-absorbablesutures. The mortality was approximately 5.6%, dependingon associated injuries.Conclusion: The prognosis of the blunt and sharp diaphragmaticinjuries depends on the severity of the concomitantinjuries, and on the problems that may arise dueto delays.

  13. 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.

  14. Demographics and behaviour of patients with contact lens-related infectious keratitis in singapore.

    Science.gov (United States)

    Lam, Janice S H; Tan, Grace; Tan, Donald T H; Mehta, Jodhbir S

    2013-10-01

    This study aims to identify the demographics and hygiene behaviours associated with contact lens (CL)-related microbial keratitis in Singapore. The hygiene and social behaviours of lens wearers presenting with infectious keratitis in Singapore were examined using an externally validated questionnaire. Fifty-eight consecutive lens wearers who presented with infectious keratitis at Singapore National Eye Centre were surveyed using a self-administered questionnaire. Patients' demographics, CL-related behaviour, attitude to aftercare visits and microbial study results were collected and analysed. More than half (55%) of the patients surveyed were female, and the average age of the participants was 25.7 ± 6.4 years. Ninety-six percent of participants used soft CL, with the majority wearing monthly disposable lenses (74.1%). Myopia was the commonest reason for use of CL. CL overwear (81%), sleeping (50.9%) and swimming (33%) with their CL were the major non-compliant behaviours discovered. When encountered with eye discomfort as a result of lens-related infective keratitis, 83% of patients sought the advice of general medical practitioners prior to presentation at the hospital. Many (59%) patients have encountered media coverage but only 24% had any behavioural change as a result. Many patients relied on the recommendations of eyecare practitioners when purchasing disinfecting solutions (26%) and other hygiene practices. Pseudomonas Aeruginosa was the most common organism grown in 22.4% of patients while 47% of patients were culture-negative. Inadequate lens cleaning, poor aftercare, sleeping and swimming with CL were the major non-compliant behaviours among participants, and these are significant factors when assessing risks in acquiring CL-related infectious keratitis. General eyecare practitioners are the first-line of contact in patients presenting with keratitis symptoms and play an important role in emphasising the need for regular aftercare and good hygiene

  15. Contact lens in keratoconus

    Directory of Open Access Journals (Sweden)

    Varsha M Rathi

    2013-01-01

    Full Text Available Contact lenses are required for the visual improvement in patients with keratoconus. Various contact lens options, such as rigid gas permeable (RGP lenses, soft and soft toric lenses, piggy back contact lenses (PBCL, hybrid lenses and scleral lenses are availble. This article discusses about selection of a lens depending on the type of keratoconus and the fitting philosophies of various contact lenses including the starting trial lens. A Medline search was carried out for articles in the English language with the keywords keratoconus and various contact lenses such as Rose k lens, RGP lens, hybrid lens, scleral lens and PBCL.

  16. Contact lens in keratoconus

    Science.gov (United States)

    Rathi, Varsha M; Mandathara, Preeji S; Dumpati, Srikanth

    2013-01-01

    Contact lenses are required for the visual improvement in patients with keratoconus. Various contact lens options, such as rigid gas permeable (RGP) lenses, soft and soft toric lenses, piggy back contact lenses (PBCL), hybrid lenses and scleral lenses are availble. This article discusses about selection of a lens depending on the type of keratoconus and the fitting philosophies of various contact lenses including the starting trial lens. A Medline search was carried out for articles in the English language with the keywords keratoconus and various contact lenses such as Rose k lens, RGP lens, hybrid lens, scleral lens and PBCL. PMID:23925325

  17. Evaluation of RGP Contact Lens Fitting in Keratoconus Patients Using Hierarchical Fuzzy Model and Genetic Algorithms.

    Science.gov (United States)

    Falahati Marvast, Fatemeh; Arabalibeik, Hossein; Alipour, Fatemeh; Sheikhtaheri, Abbas; Nouri, Leila; Soozande, Mehdi; Yarmahmoodi, Masood

    2016-01-01

    Keratoconus is a progressive non-inflammatory disease of the cornea. Rigid gas permeable contact lenses (RGPs) are prescribed when the disease progresses. Contact lens fitting and assessment is very difficult in these patients and is a concern of ophthalmologists and optometrists. In this study, a hierarchical fuzzy system is used to capture the expertise of experienced ophthalmologists during the lens evaluation phase of prescription. The system is fine-tuned using genetic algorithms. Sensitivity, specificity and accuracy of the final system are 88.9%, 94.4% and 92.6% respectively.

  18. Better Visual Outcome by Intraocular Lens Ejection in Geriatric Patients with Ruptured Ocular Injuries.

    Directory of Open Access Journals (Sweden)

    Hiroki Kaneko

    Full Text Available Ocular trauma is one of the leading causes of visual impairment worldwide. Because of the popularity of cataract surgeries, aged individuals with ocular trauma commonly have a surgical wound in their eyes. The purpose of this study was to evaluate the visual outcome of cases that were coincident with intraocular lens (IOL ejection in the eyes with ruptured open-globe ocular injuries. Consecutive patients with open-globe ocular injuries were first reviewed. Patients' characteristics, corrected distance visual acuities (CDVAs over 3 years after the trauma, causes of injuries, traumatic wound patterns, and coexistence of retinal detachment were examined. The relationships between poor CDVA and the other factors, including the complications of crystalline lens and IOL ejection, were examined. A total of 105 eyes/patients [43 eyes with rupture, 33 with penetrating, 28 with intraocular foreign body (IOFB, and 1 with perforating injuries] were included. Rupture injuries were common in aged patients and were mostly caused by falls, whereas penetrating and IOFB injuries were common in young male patients. CDVAs of the eyes with rupture injuries were significantly worse than those of the eyes with penetrating or IOFB injuries. CDVA from more than 50% of the ruptured eyes resulted in no light perception or light perception to 20/500. CDVA of the ruptured eyes complicated by crystalline lens ejection was significantly worse than that of those complicated by IOL ejection. The wounds of the ruptured eyes complicated by IOL ejection were mainly located at the superior corneoscleral limbus, whereas those of the eyes complicated by crystalline lens ejection were located at the posterior sclera. There were significant correlations between poor CDVA and retinal detachment and crystalline lens ejection. These results proposed a new trend in the ocular injuries that commonly occur in aged patients; history of cataract surgery might affect the final visual outcome

  19. Evolution of Diaphragm Thickness during Mechanical Ventilation. Impact of Inspiratory Effort.

    Science.gov (United States)

    Goligher, Ewan C; Fan, Eddy; Herridge, Margaret S; Murray, Alistair; Vorona, Stefannie; Brace, Debbie; Rittayamai, Nuttapol; Lanys, Ashley; Tomlinson, George; Singh, Jeffrey M; Bolz, Steffen-Sebastian; Rubenfeld, Gordon D; Kavanagh, Brian P; Brochard, Laurent J; Ferguson, Niall D

    2015-11-01

    Diaphragm atrophy and dysfunction have been reported in humans during mechanical ventilation, but the prevalence, causes, and functional impact of changes in diaphragm thickness during routine mechanical ventilation for critically ill patients are unknown. To describe the evolution of diaphragm thickness over time during mechanical ventilation, its impact on diaphragm function, and the influence of inspiratory effort on this phenomenon. In three academic intensive care units, 107 patients were enrolled shortly after initiating ventilation along with 10 nonventilated intensive care unit patients (control subjects). Diaphragm thickness and contractile activity (quantified by the inspiratory thickening fraction) were measured daily by ultrasound. Over the first week of ventilation, diaphragm thickness decreased by more than 10% in 47 (44%), was unchanged in 47 (44%), and increased by more than 10% in 13 (12%). Thickness did not vary over time following extubation or in nonventilated patients. Low diaphragm contractile activity was associated with rapid decreases in diaphragm thickness, whereas high contractile activity was associated with increases in diaphragm thickness (P = 0.002). Contractile activity decreased with increasing ventilator driving pressure (P = 0.01) and controlled ventilator modes (P = 0.02). Maximal thickening fraction (a measure of diaphragm function) was lower in patients with decreased or increased diaphragm thickness (n = 10) compared with patients with unchanged thickness (n = 10; P = 0.05 for comparison). Changes in diaphragm thickness are common during mechanical ventilation and may be associated with diaphragmatic weakness. Titrating ventilatory support to maintain normal levels of inspiratory effort may prevent changes in diaphragm configuration associated with mechanical ventilation.

  20. Better Visual Outcome by Intraocular Lens Ejection in Geriatric Patients with Ruptured Ocular Injuries

    Science.gov (United States)

    Sugita, Tadasu; Tsunekawa, Taichi; Matsuura, Toshiyuki; Takayama, Kei; Yamamoto, Kentaro; Kachi, Shu; Ito, Yasuki; Ueno, Shinji; Nonobe, Norie; Kataoka, Keiko; Suzumura, Ayana; Iwase, Takeshi; Terasaki, Hiroko

    2017-01-01

    Ocular trauma is one of the leading causes of visual impairment worldwide. Because of the popularity of cataract surgeries, aged individuals with ocular trauma commonly have a surgical wound in their eyes. The purpose of this study was to evaluate the visual outcome of cases that were coincident with intraocular lens (IOL) ejection in the eyes with ruptured open-globe ocular injuries. Consecutive patients with open-globe ocular injuries were first reviewed. Patients’ characteristics, corrected distance visual acuities (CDVAs) over 3 years after the trauma, causes of injuries, traumatic wound patterns, and coexistence of retinal detachment were examined. The relationships between poor CDVA and the other factors, including the complications of crystalline lens and IOL ejection, were examined. A total of 105 eyes/patients [43 eyes with rupture, 33 with penetrating, 28 with intraocular foreign body (IOFB), and 1 with perforating injuries] were included. Rupture injuries were common in aged patients and were mostly caused by falls, whereas penetrating and IOFB injuries were common in young male patients. CDVAs of the eyes with rupture injuries were significantly worse than those of the eyes with penetrating or IOFB injuries. CDVA from more than 50% of the ruptured eyes resulted in no light perception or light perception to 20/500. CDVA of the ruptured eyes complicated by crystalline lens ejection was significantly worse than that of those complicated by IOL ejection. The wounds of the ruptured eyes complicated by IOL ejection were mainly located at the superior corneoscleral limbus, whereas those of the eyes complicated by crystalline lens ejection were located at the posterior sclera. There were significant correlations between poor CDVA and retinal detachment and crystalline lens ejection. These results proposed a new trend in the ocular injuries that commonly occur in aged patients; history of cataract surgery might affect the final visual outcome after open

  1. Long-term results of intraocular lens implantation in pediatric patients.

    Science.gov (United States)

    Sinskey, R M; Stoppel, J O; Amin, P

    1993-05-01

    Between 1980 and 1990, 42 eyes of 34 patients (age range: 18 months to 18 years) were implanted with an intraocular lens, with 29 being primary implantations and 13 secondary. The primary implantation group comprised patients with congenital, developmental, and traumatic cataracts. Patients in the developmental and traumatic cataract groups achieved the best visual acuity. Those with congenital cataracts had the poorest visual outcome. Follow-up ranged from a minimum of three months to more than ten years. Overall the patients demonstrated an improvement in visual acuity and the psychological advantage of enhanced visual function without spectacles or contact lenses. We conclude that with proper case selection and a controlled, skilled surgical approach, the use of an intraocular lens for visual rehabilitation in the pediatric age group is a feasible approach.

  2. [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.

  3. 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.

  4. 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.

  5. 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].

  6. 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

  7. 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

    We present a rare case of an epiphrenic esophageal diverticulum, complicated by perforation and leakage below the diaphragm in a 57-year-old male patient. The patient was referred to the emergency department with suspected aspiration pneumonia. A thoracoabdominal computed tomography with oral...... 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...

  8. Mechanical ventilation, diaphragm weakness and weaning: A rehabilitation perspective

    Science.gov (United States)

    Martin, A Daniel; Smith, Barbara; Gabrielli, Andrea

    2013-01-01

    Most patients are easily liberated from mechanical ventilation (MV) following resolution of respiratory failure and a successful trial of spontaneous breathing, but about 25% of patients experience difficult weaning. MV use leads to cellular changes and weakness, which has been linked to weaning difficulties and has been labeled ventilator induced diaphragm dysfunction (VIDD). Aggravating factors in human studies with prolonged weaning include malnutrition, chronic electrolyte abnormalities, hyperglycemia, excessive resistive and elastic loads, corticosteroids, muscle relaxant exposure, sepsis and compromised cardiac function. Numerous animal studies have investigated the effects of MV on diaphragm function. Virtually all of these studies have concluded that MV use rapidly leads to VIDD and have identified cellular and molecular mechanisms of VIDD. Molecular and functional studies on the effects of MV on the human diaphragm have largely confirmed the animal results and identified potential treatment strategies. Only recently have potential VIDD treatments been tested in humans, including pharmacologic interventions and diaphragm “training”. A limited number of human studies have found that specific diaphragm training can increase respiratory muscle strength in FTW patients and facilitate weaning, but larger, multicenter trials are needed. PMID:23692928

  9. 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.

  10. Variability in diaphragm motion during normal breathing, assessed with B-mode ultrasound.

    Science.gov (United States)

    Harper, Caitlin J; Shahgholi, Leili; Cieslak, Kathryn; Hellyer, Nathan J; Strommen, Jeffrey A; Boon, Andrea J

    2013-12-01

    Clinical measurement, cross-sectional. To establish a set of normal values for diaphragm thickening with tidal breathing in healthy subjects. Normal values for diaphragm contractility, as imaged sonographically, have not been described, despite the known role of the diaphragm in contributing to spinal stability. If the normal range of diaphragm contractility can be defined in a reliable manner, ultrasound has the potential to be used clinically and in research as a biofeedback tool to enhance diaphragm activation/contractility. B-mode ultrasound was performed on 150 healthy subjects to visualize and measure hemi-diaphragm thickness on each side at resting inspiration and expiration. Primary outcome measures were hemi-diaphragm thickness and thickening ratio, stratified for age, gender, and body mass index. Interrater and intrarater reliability were also measured. Normal thickness of the diaphragm at rest ranged from 0.12 to 1.18 cm, with slightly greater thickness in men but no effect of age. Average ± SD change in thickness from resting expiration to resting inspiration was 20.0% ± 15.5% on the right and 23.5% ± 24.4% on the left; however, almost one third of healthy subjects had no to minimal diaphragm thickening with tidal breathing. There is wide variability in the degree of diaphragm contractility during quiet breathing. B-mode ultrasound appears to be a reliable means of determining the contractility of the diaphragm, an important muscle in spinal stability. Further studies are needed to validate this imaging modality as a clinical tool in the neuromuscular re-education of the diaphragm to improve spinal stability in both healthy subjects and in patients with low back pain.

  11. 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

  12. Is polysomnographic examination necessary for subjects with diaphragm pathologies?

    Science.gov (United States)

    Oruc, Ozlem; Sarac, Sema; Afsar, Gulgun Cetintas; Topcuoglu, Ozgur Bilgin; Kanbur, Serda; Yalcinkaya, Irfan; Tepetam, Fatma Merve; Kirbas, Gokhan

    2016-09-01

    While respiratory distress is accepted as the only indication for diaphragmatic plication surgery, sleep disorders have been underestimated. In this study, we aimed to detect the sleep disorders that accompany diaphragm pathologies. Specifically, the association of obstructive sleep apnea syndrome with diaphragm eventration and diaphragm paralysis was evaluated. This study was performed in Süreyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital between 2014-2016. All patients had symptoms of obstructive sleep apnea (snoring and/or cessation of breath during sleep and/or daytime sleepiness) and underwent diaphragmatic plication via video-assisted mini-thoracotomy. Additionally, all patients underwent pre- and postoperative full-night polysomnography. Pre- and postoperative clinical findings, polysomnography results, Epworth sleepiness scale scores and pulmonary function test results were compared. Twelve patients (7 males) with a mean age of 48 (range, 27-60) years and a mean body mass index of 25 (range, 20-30) kg/m2 were included in the study. Preoperative polysomnography showed obstructive sleep apnea syndrome in 9 of the 12 patients (75%), while 3 of the patients (25%) were regarded as normal. Postoperatively, patient complaints, apnea hypopnea indices, Epworth sleepiness scale scores and pulmonary function test results all demonstrated remarkable improvement. All patients suffering from diaphragm pathologies with symptoms should undergo polysomnography, and patients diagnosed with obstructive sleep apnea syndrome should be operated on. In this way, long-term comorbidities of sleep disorders may be prevented.

  13. Is polysomnographic examination necessary for subjects with diaphragm pathologies?

    Directory of Open Access Journals (Sweden)

    Ozlem Oruc

    Full Text Available OBJECTIVES: While respiratory distress is accepted as the only indication for diaphragmatic plication surgery, sleep disorders have been underestimated. In this study, we aimed to detect the sleep disorders that accompany diaphragm pathologies. Specifically, the association of obstructive sleep apnea syndrome with diaphragm eventration and diaphragm paralysis was evaluated. METHODS: This study was performed in Süreyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital between 2014-2016. All patients had symptoms of obstructive sleep apnea (snoring and/or cessation of breath during sleep and/or daytime sleepiness and underwent diaphragmatic plication via video-assisted mini-thoracotomy. Additionally, all patients underwent pre- and postoperative full-night polysomnography. Pre- and postoperative clinical findings, polysomnography results, Epworth sleepiness scale scores and pulmonary function test results were compared. RESULTS: Twelve patients (7 males with a mean age of 48 (range, 27-60 years and a mean body mass index of 25 (range, 20-30 kg/m2 were included in the study. Preoperative polysomnography showed obstructive sleep apnea syndrome in 9 of the 12 patients (75%, while 3 of the patients (25% were regarded as normal. Postoperatively, patient complaints, apnea hypopnea indices, Epworth sleepiness scale scores and pulmonary function test results all demonstrated remarkable improvement. CONCLUSION: All patients suffering from diaphragm pathologies with symptoms should undergo polysomnography, and patients diagnosed with obstructive sleep apnea syndrome should be operated on. In this way, long-term comorbidities of sleep disorders may be prevented.

  14. Mechanical Ventilation-induced Diaphragm Atrophy Strongly Impacts Clinical Outcomes.

    Science.gov (United States)

    Goligher, Ewan C; Dres, Martin; Fan, Eddy; Rubenfeld, Gordon D; Scales, Damon C; Herridge, Margaret S; Vorona, Stefannie; Sklar, Michael C; Rittayamai, Nuttapol; Lanys, Ashley; Murray, Alistair; Brace, Deborah; Urrea, Cristian; Reid, W Darlene; Tomlinson, George; Slutsky, Arthur S; Kavanagh, Brian P; Brochard, Laurent J; Ferguson, Niall D

    2018-01-15

    Diaphragm dysfunction worsens outcomes in mechanically ventilated patients, but the clinical impact of potentially preventable changes in diaphragm structure and function caused by mechanical ventilation is unknown. To determine whether diaphragm atrophy developing during mechanical ventilation leads to prolonged ventilation. Diaphragm thickness was measured daily by ultrasound in adults requiring invasive mechanical ventilation; inspiratory effort was assessed by thickening fraction. The primary outcome was time to liberation from ventilation. Secondary outcomes included complications (reintubation, tracheostomy, prolonged ventilation, or death). Associations were adjusted for age, severity of illness, sepsis, sedation, neuromuscular blockade, and comorbidity. Of 211 patients enrolled, 191 had two or more diaphragm thickness measurements. Thickness decreased more than 10% in 78 patients (41%) by median Day 4 (interquartile range, 3-5). Development of decreased thickness was associated with a lower daily probability of liberation from ventilation (adjusted hazard ratio, 0.69; 95% confidence interval [CI], 0.54-0.87; per 10% decrease), prolonged ICU admission (adjusted duration ratio, 1.71; 95% CI, 1.29-2.27), and a higher risk of complications (adjusted odds ratio, 3.00; 95% CI, 1.34-6.72). Development of increased thickness (n = 47; 24%) also predicted prolonged ventilation (adjusted duration ratio, 1.38; 95% CI, 1.00-1.90). Decreasing thickness was related to abnormally low inspiratory effort; increasing thickness was related to excessive effort. Patients with thickening fraction between 15% and 30% (similar to breathing at rest) during the first 3 days had the shortest duration of ventilation. Diaphragm atrophy developing during mechanical ventilation strongly impacts clinical outcomes. Targeting an inspiratory effort level similar to that of healthy subjects at rest might accelerate liberation from ventilation.

  15. 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

  16. Ultrasound Identification of Diaphragm by Novices Using ABCDE Technique.

    Science.gov (United States)

    Khurana, Jaasmit; Gartner, Stephanie C; Naik, Latha; Tsui, Ban C H

    2018-02-01

    In this study, we examined the consistency, rapidity, and reproducibility of the ABCDE technique for diaphragm identification. Operators using this method place the probe at the Anterior axillary line, watch for Breathing (lung sliding), and then move the probe Caudally to identify the Diaphragm for Examination. A convenience sample of 100 patients was recruited from the preadmission clinic. Two novice operators each scanned the diaphragm using a linear ultrasound transducer in B-mode. Both operators completed the examination on all participants using the ABCDE technique, their times were averaged, and clinical success was defined as identification of the diaphragm in less than 2 minutes. An average of 33.7 seconds was taken to scan and identify the right hemidiaphragm (RD) (median, 25 seconds; 95% confidence interval, 28.8-38.5 seconds) with a 98% clinical success ratio, and an average of 46.9 seconds was taken to identify the left hemidiaphragm (LD) (median, 39.5 seconds; 95% confidence interval, 40.2-53.6 seconds) with a 97% clinical success ratio. In patients with a body mass index (BMI) of less than 30 kg/m, a 100% success ratio was seen when scanning the RD and 97% when scanning the LD. For those with a BMI of 30 kg/m or greater, a 94% success rate was seen when scanning the RD and 97% when scanning the LD. No clinically significant differences were found between the times required for scanning either side of the diaphragm, regardless of the BMI. The ABCDE technique demonstrates a fast, reliable, and simple method in which ultrasound can be used to visualize the diaphragm.

  17. Interfractional diaphragm changes during breath-holding in stereotactic body radiotherapy for liver cancer.

    Science.gov (United States)

    Kawahara, Daisuke; Ozawa, Shuichi; Nakashima, Takeo; Tsuda, Shintaro; Ochi, Yusuke; Okumura, Takuro; Masuda, Hirokazu; Hioki, Kazunari; Suzuki, Tathsuhiko; Ohno, Yoshimi; Kimura, Tomoki; Murakami, Yuji; Nagata, Yasushi

    2018-01-01

    IGRT based on bone matching may produce a large target positioning error in terms of the reproducibility of expiration breath-holding on SBRT for liver cancer. We evaluated the intrafractional and interfractional errors using the diaphragm position at the end of expiration by utilising Abches and analysed the factor of the interfractional error. Intrafractional and interfractional errors were measured using a couple of frontal kV images, planning computed tomography (pCT) and daily cone-beam computed tomography (CBCT). Moreover, max-min diaphragm position within daily CBCT image sets with respect to pCT and the maximum value of diaphragm position difference between CBCT and pCT were calculated. The mean ± SD (standard deviation) of the intra-fraction diaphragm position variation in the frontal kV images was 1.0 ± 0.7 mm in the C-C direction. The inter-fractional diaphragm changes were 0.4 ± 4.6 mm in the C-C direction, 1.4 ± 2.2 mm in the A-P direction, and -0.6 ± 1.8 mm in the L-R direction. There were no significant differences between the maximum value of the max-min diaphragm position within daily CBCT image sets with respect to pCT and the maximum value of diaphragm position difference between CBCT and pCT. Residual intrafractional variability of diaphragm position is minimal, but large interfractional diaphragm changes were observed. There was a small effect in the patient condition difference between pCT and CBCT. The impact of the difference in daily breath-holds on the interfractional diaphragm position was large or the difference in daily breath-holding heavily influenced the interfractional diaphragm change.

  18. 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 ...

  19. Diaphragm function in animal models of chronic obstructive pulmonary disease

    NARCIS (Netherlands)

    Machiels, H.A.

    2008-01-01

    COPD is characterized by progressive and irreversible airway obstruction. The diaphragm is the main inspiratory muscle. In patients with COPD, structural and functional alterations are present in this skeletal muscle. Dysfunction of respiratory muscles limits the exercise capacity and activities of

  20. Facioscapulohumeral muscular dystrophy and respiratory failure; what about the diaphragm?

    Directory of Open Access Journals (Sweden)

    A. Hazenberg

    2015-01-01

    Discussion: We conclude that in patients with FSHD who have symptoms of nocturnal hypoventilation, an adequate assessment of the diaphragm is recommended. This is of great importance as we know that nocturnal hypoventilation can be treated effectively by non-invasive ventilation.

  1. 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...

  2. 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.

  3. Phacoemulsification with primary implantation of an intraocular lens in patients with uveitis

    Directory of Open Access Journals (Sweden)

    Pålsson S

    2017-08-01

    Full Text Available Sara Pålsson,1,2 Marita Andersson Grönlund,1,2 Dragana Skiljic,1,2 Madeleine Zetterberg1,2 1Department of Clinical Neuroscience/Ophthalmology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 2Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, Sweden Purpose: To evaluate the outcome of cataract surgery in adult patients with uveitis. Materials and methods: In this retrospective cohort study, medical charts of patients with uveitis and matched control patients without uveitis who underwent cataract surgery at the Eye Clinic, Sahlgrenska University Hospital, Mölndal, between January 2005 and December 2009 were analyzed. Results: The study included 58 eyes with and 283 eyes without uveitis. The most common etiologies were idiopathic anterior uveitis and Fuchs’ heterochromic uveitis. Postoperative visual acuity at 4 weeks was ≥0.5 decimal (0.3 logMAR in 48 eyes with uveitis (87.3% compared to 180 non-uveitic eyes (86.1%. Four eyes with uveitis (7.1% and one eye without uveitis (0.5% developed postoperative intraocular hypertension/glaucoma. Posterior capsule opacification developed in 11 eyes (19.0% with and 28 eyes (12.4% without uveitis. Conclusion: With appropriate perioperative anti-inflammatory regimen and surveillance, modern cataract surgery using phacoemulsification and primary intraocular lens implantation can be performed in patients with uveitis without greater risk of complications, yielding similar visual outcome as in patients without uveitis. Keywords: cataract, intraocular lens, phacoemulsification, uveitis

  4. 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

  5. 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.

  6. SU-G-IeP2-10: Lens Dose Reduction by Patient Position Modification During Neck CT Exams

    Energy Technology Data Exchange (ETDEWEB)

    Mosher, E; Lee, C [Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD (United States); Butman, J; Biassou, N; Folio, L [Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD (United States)

    2016-06-15

    Purpose: Irradiation of the lens during a neck CT may increase a patient’s risk of developing cataracts later in life. Radiologists and technologists at the National Institutes of Health Clinical Center (NIHCC) have developed new CT imaging protocols that include a reduction in scan range and modifying neck positioning using a head tilt. This study will evaluate the efficacy of this protocol in the reduction of lens dose. Methods: We retrieved CT images of five male patients who had two sets of CT images: before and after the implementation of the new protocol. The lens doses before the new protocol were calculated using an in-house CT dose calculator, National Cancer Institute dosimetry system for CT (NCICT), where computational human phantoms with no head tilt are included. We also calculated the lens dose for the patient CT conducted after the new protocol by using an adult male computational phantom with the neck position deformed to match the angle of the head tilt. We also calculated the doses to other radiosensitive organs including the globes of the eye, brain, pituitary gland and salivary glands before and after head tilt. Results: Our dose calculations demonstrated that modifying neck position reduced dose to the lens by 89% on average (range: 86–96%). Globe, brain, pituitary and salivary gland doses also decreased by an average of 65% (51–95%), 38% (−8–66%), 34% (−43–84%) and 14% (13–14%), respectively. The new protocol resulted in a nearly ten-fold decrease in lens dose. Conclusion: The use of a head tilt and scan range reduction is an easy and effective method to reduce radiation exposure to the lens and other radiosensitive organs, while still allowing for the inclusion of critical neck structures in the CT image. We are expanding our study to a total of 10 males and 10 females.

  7. 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.

  8. Contact lens in keratoconus

    OpenAIRE

    Rathi, Varsha M; Mandathara, Preeji S; Dumpati, Srikanth

    2013-01-01

    Contact lenses are required for the visual improvement in patients with keratoconus. Various contact lens options, such as rigid gas permeable (RGP) lenses, soft and soft toric lenses, piggy back contact lenses (PBCL), hybrid lenses and scleral lenses are availble. This article discusses about selection of a lens depending on the type of keratoconus and the fitting philosophies of various contact lenses including the starting trial lens. A Medline search was carried out for articles in the En...

  9. Compliance among soft contact lens wearers.

    OpenAIRE

    Kuzman, Tomislav; Barišić Kutija, Marija; Masnec, Sanja; Jandroković, Sonja; Mrazovac, Danijela; Jurišić, Darija; Škegro, Ivan; Kalauz, Miro; Kordić, Rajko

    2014-01-01

    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 ...

  10. Diaphragm

    Science.gov (United States)

    ... lost 10 pounds, had a baby, had an abortion, or was fitted when she was a virgin ... consult your doctor. © 1995- The Nemours Foundation. All rights reserved. Images provided by The Nemours Foundation, iStock, ...

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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.

  16. Toric Intraocular Lens Implantation for Correction of Astigmatism in Cataract Patients with Corneal Ectasia

    Directory of Open Access Journals (Sweden)

    Efstratios A. Parikakis

    2013-11-01

    Full Text Available Our purpose was to examine the long-term efficacy of toric intraocular lens (IOL implantation in cataract patients with high astigmatism due to corneal ectasia, who underwent phacoemulsification cataract surgery. Five eyes of 3 cataract patients with topographically stable keratoconus or pellucid macular degeneration (PMD, in which phacoemulsification with toric IOL implantation was used to correct high astigmatism, are reported. Objective and subjective refraction, visual acuity measurement and corneal topography were performed in all cases before and after cataract surgery. In all cases, there was a significant improvement in visual acuity, as well as refraction, which remained stable over time. Specifically, in subjective refraction, all patients achieved visual acuity from 7/10 to 9/10 with up to -2.50 cyl. Corneal topography also remained stable. Postoperative follow-up was 18-28 months. Cataract surgery with toric IOL implantation seems to be safe and effective in correcting astigmatism and improving visual function in cataract patients with topographically stable keratoconus or PMD.

  17. 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.

  18. 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.

  19. Nurse/physician communication through a sensemaking lens: shifting the paradigm to improve patient safety.

    Science.gov (United States)

    Manojlovich, Milisa

    2010-11-01

    Physician-nurse communication has been identified as one of the main obstacles to progress in patient safety. Breakdowns in communication between physicians and nurses often result in errors, many of which are preventable. Recent research into nurse/physician communication has borrowed heavily from team literature, tending to study communication as one behavior in a larger cluster of behaviors. The multicluster approach to team research has not provided enough analysis of and attention to communication alone. Research into communication specifically is needed to understand its crucial role in teamwork and safety. A critique of the research literature on nurse/physician communication published since 1992 revealed 3 dominant themes: settings and context, consensus building, and conflict resolution. A fourth implicit theme, the temporal nature of communication, emerged as well. These themes were used to frame a discussion on sensemaking: an iterative process arising from dialogue when 2 or more people share their unique perspectives. As a theoretical model, sensemaking may offer an alternative lens through which to view the phenomenon of nurse/physician communication and advance our understanding of how nurse/physician communication can promote patient safety. Sensemaking may represent a paradigm shift with the potential to affect 2 spheres of influence: clinical practice and health care outcomes. Sensemaking may also hold promise as an intervention because through sensemaking consensus may be built and errors possibly prevented. Engaging in sensemaking may overcome communication barriers without realigning power bases, incorporate contextual influences without drawing attention away from communicators, and inform actions arising from communication.

  20. Effect of supplementary implantation of a sulcus-fixated intraocular lens in patients with negative dysphotopsia.

    Science.gov (United States)

    Makhotkina, Natalia Y; Dugrain, Vincent; Purchase, Daniel; Berendschot, Tos T J M; Nuijts, Rudy M M A

    2018-02-01

    To evaluate whether the outcome of negative dysphotopsia treatment by implantation of a Sulcoflex intraocular lens (IOL) can be understood using individual biometry and optical modeling data. University Eye Clinic, Maastricht University Medical Centre, Maastricht, the Netherlands. Retrospective case series. Patients with negative dysphotopsia were treated with supplementary implantation of a sulcus-fixated IOL. Preoperative and postoperative ray-tracing optical models of eyes with negative dysphotopsia were constructed in the Zemax Optic Studio program using individual biometric data. The relationship between biometric parameters, ray-tracing data, and the course of negative dysphotopsia was evaluated. The study comprised 8 patients (10 eyes). After surgery, negative dysphotopsia resolved completely in 6 eyes, partially in 2 eyes, and persisted in 2 eyes. There was no relationship between the course of negative dysphotopsia and age, IOL power, or individual biometry results other than a larger angle κ that was observed in 2 patients with persistent negative dysphotopsia after surgery. Preoperative ray-tracing models showed a decrease in light irradiance at the periphery relative to the center of visual field. After sulcus-fixated IOL implantation, this decrease partially resolved, in particular, for a small pupil aperture (P < .05), and it was more prominent in patients in whom negative dysphotopsia resolved completely than in those with partial or persistent negative dysphotopsia (P = .065 at 1.5 mm aperture). Of all individual biometry results, only angle κ showed a relationship with the course of negative dysphotopsia. In patient-specific optical modeling of sulcus-fixated IOL implantation, the increase in simulated light irradiance at the periphery was related to the course of negative dysphotopsia. Copyright © 2018 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  1. Corneal aberration changes after rigid gas permeable contact lens wear in keratokonic patients

    Directory of Open Access Journals (Sweden)

    Fereshteh Shokrollahzadeh

    2016-12-01

    Conclusion: In this study, corneal aberrations remained unchanged 3 months after wearing RGP contact lens. Further studies with sufficient samples in different groups of keratoconus severity or baseline aberrations are needed to obtain more accurate results.

  2. 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.

  3. 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.

  4. 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.

  5. 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

  6. Effect of rigid corneal contact lens and corneal limbal stem cell transplantation for senile patients with pterygium

    Directory of Open Access Journals (Sweden)

    Jiang Lu

    2017-06-01

    Full Text Available AIM: To investigate the effect of rigid contact lens in the treatment after pterygium excision and limbal stem cell transplantation in senile patients. METHODS: Totally 90 elderly patients diagnosed as unilateral pterygium in our hospital from March 2015 to March 2016 were selected and divided into two groups, observation group and control group, 45 case with 45 eyes in each group. Observation group was treated with limbal stem cell transplantation and rigid contact lens. Control group was treated with limbal stem cell transplantation only. The following indicators were observed and compared: corneal healing time, visual analogue score(VASat 1, 3, 5 and 7d after surgery and the recurrence rate of pterygium. RESULTS: The score on corneal irritation of observation group was significantly lower than that of control group(PPPP>0.05.CONCLUSION: Autologous corneal stem cell transplantation combined with rigid contact lens for pterygium in elderly patients is effective with shorter healing time and less pain, and it does not increase the recurrence rate.

  7. 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

  8. Small-aperture corneal inlay in presbyopic patients with prior phakic intraocular lens implantation surgery: 3-month results

    Directory of Open Access Journals (Sweden)

    Huseynova T

    2013-08-01

    Full Text Available Tukezban Huseynova,1 Tomomi Kanamori,1 George O Waring IV,2 Minoru Tomita1,3,4 1Shinagawa LASIK Center, Tokyo, Japan; 2Medical University of South Carolina, Charleston, SC, USA; 3Wenzhou Medical College, Wenzhou, People’s Republic of China; 4Eye Can Cataract Surgery Center, Metro Manila, Philippines Abstract: We report a series of three case reports of KAMRA inlay implantation procedures in presbyopic patients with a history of prior phakic intraocular lens implantation surgery. Three-month results showed a two to five-line improvement for uncorrected near visual acuity. The absolute uncorrected near visual acuity change for case 1 was from J4 to J2, for case 2 was from J6 to J4, and for case 3 was from J10 to J5. No significant change of uncorrected distance visual acuity was observed in all three cases. Keywords: phakic intraocular lens, IOL, KAMRA, intracorneal inlay

  9. Prolonged use of a diaphragm and toxic shock syndrome.

    Science.gov (United States)

    Baehler, E A; Dillon, W P; Cumbo, T J; Lee, R V

    1982-08-01

    A case report is presented that involves the extended use of a contraceptive diaphragm and illustrates the problems in promptly establishing a clinical diagnosis of staphylococcal toxin syndrome. A 27-year old woman, 2 months postpartum, was admitted to the hospital after 24 hours of fever, shaking, chills, sweats, nausea and vomiting, and diminished urine output. She had been unable to remove a new coil spring diaphragm, used for the 1st time since parturition, for 3-1/2 days before admission. On the day of admission the diaphragm was removed with some difficulty. A purulent, foul-smelling vaginal discharge at the time the diaphragm was extracted was noted. She was lactating and had had no menses since conception. Her past medical history was unremarkable except for mitral valve prolapse. Evaluation at the time of admission was remarkable for a pulse rate of 120 beats/minute and orthostatic lightheadness. The blood pressure was 110/70 mm Hg when the patient was supine and fell less than 15 mm Hg systolic when she was seated. The white blood cell count was 17,000 with 63% segmented and 33% juvenile polymorphonuclear leukocytes. The sedimentation rate was 45 mm/hour. Multiple cultures of vagina, throat, urine, and blood were obtained. Vigorous intravenous fluid and electrolyte therapy was administered, and the patient was initially begun on ampicillin and tobramycin. Shortly after the appearance of the rash, staphylococcal toxic shock syndrome (TSS) was suspected, and the ampicillin was changed to oxacillin. The rash and strawberry tongue faded within 24 hours, and she became normotensive and afebrile by the 2nd hospital day. She was changed to oral dicloxacillin as the only antibiotic on the 4th hospital day, after the culture results were confirmed. At the time of discharge on the 6th hospital day, desquamation of the skin on the palms and soles had started and continued for another 7-10 days. A 10 day course of dicloxacillin was completed. Follow-up vaginal

  10. Diaphragms of the carotid and vertebral arteries: an under-diagnosed cause of ischaemic stroke.

    Science.gov (United States)

    Lenck, S; Labeyrie, M-A; Saint-Maurice, J-P; Tarlov, N; Houdart, E

    2014-04-01

    Diaphragms of the internal carotid and vertebral arteries as a cause of ischaemic stroke are reported and stenting of diaphragms as a therapeutic option in stroke secondary prevention is described. Five patients were cared for in our institution from 2000 to 2011 for recurrent ischaemic strokes which were classified to be of undetermined aetiology after completion of the usual investigations. Because the patients had already had ischaemic strokes in the territory of the same artery, a conventional digital subtracted angiography was performed. A diaphragm was identified on the artery that supplied the territory in which the stroke occurred. The stroke was therefore attributed to the diaphragm. Clinical and radiological data, treatment and the clinical course of the patients was retrospectively reviewed. The diaphragm was located in the vertebral artery in three cases and in the bulb of the internal carotid artery in two. In all cases cerebral MR showed ischaemic strokes of different ages downstream of the diaphragm. Stenting was performed in four cases. No patient had a symptomatic recurrent ischaemic event after stenting. Diaphragms are a rare cause of recurrent embolic strokes which are often not detected with non-invasive imaging. Stenting appears to be a therapeutic option in stroke secondary prevention. These observations suggest that conventional angiography should be performed in cases of recurrent ischaemic strokes in the territory of a single artery and in cases of ischaemic stroke of undetermined aetiology in young adults when the usual investigations are negative. © 2014 The Author(s) European Journal of Neurology © 2014 EFNS.

  11. 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.

  12. Prolonging contact lens wear and making contact lens wear safer.

    Science.gov (United States)

    Foulks, Gary N

    2006-02-01

    To summarize the present status of safety and efficacy of contact lens wear. Literature review. Ovid Medline searches were performed on records from 1966 through 2005 using keywords: keratitis, contact lens complications, extended-wear contact lenses, and silicone-hydrogel contact lenses. Patients desire comfort, clarity of vision, and prolonged contact lens wear when contact lenses are used to correct refractive error. Practitioners desire patient satisfaction but also require maintenance of the integrity of the eye and no complications that jeopardize vision or health of the eye. Improvements in the oxygen permeability of the contact lens materials, design of the contact lens and its surface, and solutions for the maintenance of the lens have reduced but not eliminated the risks of infection, inflammation, and conjunctival papillary reaction associated with contact lens wear. The lessons of past and recent history suggest that patient education and practitioner participation in the management of contact lens wear continue to be critical factors for patient satisfaction and safety in the extended wear of contact lenses. The availability of highly oxygen permeable contact lenses has increased the tolerance and safety of extended contact lens wear, but patient instruction and education in proper use and care of lenses is required and caution is advised.

  13. 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)

  14. 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.

  15. 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.)

  16. 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

  17. 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.

  18. 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.

  19. Design study of a flexible diaphragm

    Energy Technology Data Exchange (ETDEWEB)

    Whatley, M E; Morgan, J G

    1982-10-01

    A design study was made to meet the requirements for a diaphragm for a rotary seal at the discharge end of the Consolidated Fuel Reprocessing Program`s prototypic voloxidizer. Using a computer program called NEPSAP, the study examined thickness, outer radius, corrugation wavelength and corrugation amplitude as variables, and established the general effect of each on stiffness and stresses. The result comprises a basis for the selection of diaphragms for similar applications. Limited experimental measurements of stress validate the stress values calculated by NEPSAP.

  20. 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

  1. EFFECTS OF EXPERIMENTAL HUMAN ENDOTOXEMIA ON DIAPHRAGM FUNCTION

    NARCIS (Netherlands)

    Doorduin, J.; Leentjens, J.; Kox, M.; Hees, H.W.H. van; Hoeven, J.G. van der; Pickkers, P.; Heunks, L.M.A.

    2015-01-01

    INTRODUCTION: Systemic inflammation is a well-known risk factor for respiratory muscle weakness. Studies using animal models of inflammation have shown that endotoxin administration induces diaphragm dysfunction. However, the effects of in vivo endotoxin administration on diaphragm function in

  2. Reproducibility of diaphragm position assessed with a voluntary breath-holding device.

    Science.gov (United States)

    Takamatsu, Shigeyuki; Takanaka, Tsuyoshi; Kumano, Tomoyasu; Mizuno, Eiichi; Shibata, Satoshi; Ohashi, Shizuko; Kurata, Yuichi; Ueda, Shinichi; Hori, Naoki; Shouji, Saori; Noto, Kimiya; Kojima, Hironori; Matsui, Osamu

    2013-05-01

    To evaluate the reproducibility of diaphragm position in our new breath-holding radiotherapy for abdominal tumors using image-guided radiation therapy (IGRT) and a voluntary breath-holding device, Abches. Patients treated with abdominal tumors using IGRT with Abches were enrolled. Twenty patients without dementia or severe lung disease were analyzed. Each fraction of all patients was set up with kV cone-beam CT with reference to the vertebral bodies. Before daily treatment, electronic portal imaging device (EPID) images of the diaphragm at breath-holding exhale phase were acquired. The difference in the diaphragm position relative to the vertebral body was analyzed by comparing EPID images and the digitally reconstructed radiograph of the planning CT. We evaluated the reproducibility of two axes: superior-inferior (S-I) and right-left (R-L) with the EPID measurements. The 443 irradiation data sets were analyzed. The interfractional reproducibility of the diaphragm relative to vertebral bodies was 1.7 ± 1.4 mm in the S-I and 1.4 ± 1.2 mm in the R-L direction. This technique has good interfractional reproducibility and visibility of the diaphragm during irradiation. Its use is feasible in the routine clinical setting and irradiation.

  3. Reproducibility of diaphragm position assessed with a voluntary breath-holding device

    International Nuclear Information System (INIS)

    Takamatsu, Shigeyuki; Takanaka, Tsuyoshi; Kumano, Tomoyasu

    2013-01-01

    The purpose of this study was to evaluate the reproducibility of diaphragm position in our new breath-holding radiotherapy for abdominal tumors using image-guided radiation therapy (IGRT) and a voluntary breath-holding device, Abches. Patients treated with abdominal tumors using IGRT with Abches were enrolled. Twenty patients without dementia or severe lung disease were analyzed. Each fraction of all patients was set up with kV cone-beam CT with reference to the vertebral bodies. Before daily treatment, electronic portal imaging device (EPID) images of the diaphragm at breath-holding exhale phase were acquired. The difference in the diaphragm position relative to the vertebral body was analyzed by comparing EPID images and the digitally reconstructed radiograph of the planning CT. We evaluated the reproducibility of two axes: superior-inferior (S-I) and right-left (R-L) with the EPID measurements. The 443 irradiation data sets were analyzed. The interfractional reproducibility of the diaphragm relative to vertebral bodies was 1.7±1.4 mm in the S-I and 1.4±1.2 mm in the R-L direction. This technique has good interfractional reproducibility and visibility of the diaphragm during irradiation. Its use is feasible in the routine clinical setting and irradiation. (author)

  4. 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.

  5. 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.

  6. Implantation of phakic intraocular lens in 3 patients with oculocutaneous albinism.

    Science.gov (United States)

    van Rijn, Gwyneth A; Snoek, Colette; Joosse, Maurits; Saxena, Ruchi; Luyten, Gregorius P M

    2013-10-01

    We present 3 cases with oculocutaneous albinism in which a high refractive error was optically corrected by implantation of an Artisan iris-fixated phakic intraocular lens, with a follow-up of 8 to 14 years. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  7. Deterministic effect of lens at leukergy of patients who received low doses of ionising radiation.

    Science.gov (United States)

    Yeltokova, M; Zharliganova, D; Shaidarov, M; Bakhtin, M; Kazymbet, P; Tel, L; Dossakhanov, A; Kozhakbayeva, M; Hoshi, M

    2015-09-01

    To explore the possibility to use the lens extract as an in vitro stimulator to conduct a test of stimulated leukergy in liquidators of the accident consequences (LAC) on Chernobyl Nuclear Power Plant (CNPP) with a cataract in the long-term period. The study sample included 72 men-LAC on CNPP, at the age from 42 to 65 y, who have a cataract. The comparison group consisted of 60 men, with a cataract, of the same age, and who were not exposed to radiation. The control group was composed of 60 men, at the age of 42-58 y without lens pathology. Phenomenon of the stimulated leukergy was revealed in persons who had been exposed to radiation in the dose of 18.2 ± 0.58 cGy and was observed in 5.7-8.05 % (P < 0.001), suggesting a continued high auto-aggression to the lens antigens, and the strength of cell-mediated immunity. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. 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

  9. Bortezomib partially protects the rat diaphragm from ventilator-induced diaphragm dysfunction

    NARCIS (Netherlands)

    Agten, A.; Maes, K.; Thomas, D; Cielen, N.; Hees, H.W. van; Dekhuijzen, R.; Decramer, M.; Gayan-Ramirez, G.

    2012-01-01

    OBJECTIVE: Controlled mechanical ventilation leads to diaphragmatic contractile dysfunction and atrophy. Since proteolysis is enhanced in the diaphragm during controlled mechanical ventilation, we examined whether the administration of a proteasome inhibitor, bortezomib, would have a protective

  10. 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

  11. The feasibility of removable prefab diaphragm walls

    NARCIS (Netherlands)

    Amaarouk, R.; De Gijt, J.G.; Braam, C.R.

    2013-01-01

    A diaphragm wall is a cast in-situ reinforced concrete retaining wall applied in, among others, quay walls. The main advantages of this type of retaining wall are that it can be made in almost every preferred length and that it can resist high structural loads. However, there are several

  12. PECVD silicon nitride diaphragms for condenser microphones

    NARCIS (Netherlands)

    Scheeper, P.R.; Scheeper, P.R.; Voorthuyzen, J.A.; Voorthuyzen, J.A.; Bergveld, Piet

    1991-01-01

    The application of plasma-enhanced chemical vapour deposited (PECVD) silicon nitride as a diaphragm material for condenser microphones has been investigated. By means of adjusting the SiH4/NH3 gas-flow composition, silicon-rich silicon nitride films have been obtained with a relatively low tensile

  13. A biomechanical approach for in vivo diaphragm muscle motion prediction during normal respiration

    Science.gov (United States)

    Coelho, Brett; Karami, Elham; Haddad, Seyyed M. H.; Seify, Behzad; Samani, Abbas

    2017-03-01

    Lung cancer is one of the leading causes of cancer death in men and women. External Beam Radiation Therapy (EBRT) is a commonly used primary treatment for the condition. A major challenge with such treatments is the delivery of sufficient radiation dose to the lung tumor while ensuring that surrounding healthy lung parenchyma receives only minimal dose. This can be achieved by coupling EBRT with respiratory computer models which can predict the tumour location as a function of phase during the breathing cycle1. The diaphragm muscle contraction is mainly responsible for a large portion of the lung tumor motion during normal breathing, especially when tumours are in the lower lobes, therefore the importance of accurately modelling the diaphragm is paramount in lung tumour motion prediction. The goal of this research is to develop a biomechanical model of the diaphragm, including its active and passive response, using detailed geometric, biomechanical and anatomical information that mimics the diaphragmatic behaviour in a patient specific manner. For this purpose, a Finite Element Model (FEM) of the diaphragm was developed in order to predict the in vivo motion of the diaphragm, paving the way for computer assisted lung cancer tumor tracking in EBRT. Preliminary results obtained from the proposed model are promising and they indicate that it can be used as a plausible tool for effective lung cancer EBRT to improve patient care.

  14. 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

  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 lens system maintenance steps. Most common non-compliant behaviours were the ones that are crucial for maintaining lens sterility and preventing infection. Despite the low objective compliance rate, self grading was relatively high. Therefore, these results indicate the need for patient

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

    NARCIS (Netherlands)

    Mogalle, K. (Katja); A. Perez-Rovira (Adria); P. Ciet (Pierluigi); S.C.A. Wens (Stephan); P.A. van Doorn (Pieter); H.A.W.M. Tiddens (Harm); A.T. van der Ploeg (Ans); M. de Bruijne (Marleen)

    2016-01-01

    textabstractBackground: 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

  17. 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.

  18. Risk factors of persistent diplopia following secondary intraocular lens implantation in patients with sensory strabismus from uncorrected monocular aphakia.

    Science.gov (United States)

    Ahn, Ye Jin; Park, Shin Hae; Shin, Sun Young

    2016-01-01

    We aimed to compare clinical characteristics between diplopia-free and diplopia-persistent patients after successful strabismus surgery, when patients complained of diplopia following secondary intraocular lens (IOL) implantation after prolonged aphakia accompanied by sensory strabismus. Retrospective review of medical records of patients who complained of diplopia following secondary IOL placement with sensory strabismus after prolonged uncorrected monocular aphakia from isolated ocular trauma was done. We classified patients into two groups according to persistency of diplopia, 6 months after successful strabismus surgery. Clinical characteristics were compared between groups. A total of 31 patients were included. The diplopia-persistent group showed longer duration of uncorrected aphakia (p = 0.02), less severe corneal astigmatism (p = 0.04), a smaller exodeviation angle (p = 0.02), and more frequent vertical deviation (p = 0.015), extorsion (p = 0.022) and monocular nystagmus (p = 0.028) than the diplopia-free group. In all patients in the diplopia-free group, diplopia could be eliminated prior to strabismus surgery using loose prisms in free space, whereas seven patients in the diplopia-persistent group prior to surgery could not resolve diplopia. Our data will be helpful for ocular surgeons in determining whether to insert secondary IOL in prolonged aphakia with sensory strabismus, or whether strabismus surgery will eliminate diplopia that develops following secondary IOL placement in this situation.

  19. 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...

  20. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Ophthalmologist Patient Stories Español Eye Health / News Halloween Hazard: The Hidden Dangers of Buying Decorative Contact Lenses ... One Use Facts About Colored Contacts and Halloween Safety Colored Contact Lens Facts Over-the-Counter Costume ...

  1. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... an Ophthalmologist Patient Stories Español Eye Health / News Halloween Hazard: The Hidden Dangers of Buying Decorative Contact ... After One Use Facts About Colored Contacts and Halloween Safety Colored Contact Lens Facts Over-the-Counter ...

  2. Seismic Response of Plan-Asymmetric Structures with Diaphragm Flexibility

    Directory of Open Access Journals (Sweden)

    Hamed Eivani

    2018-01-01

    Full Text Available The seismic behavior of asymmetric structures with a flexible diaphragm was studied by conducting inelastic dynamic time-history analyses. Asymmetric structures with different configurations of mass, stiffness, and strength centers, in combination with a wide range of diaphragm flexibility, were evaluated. The behavior of structures was studied by considering three aspects: (1 effect of structural asymmetry on diaphragms deformation; (2 effect of diaphragm flexibility on demands of the lateral load-resisting elements; (3 optimum configuration of mass, stiffness, and strength centers to limit important engineering demand parameters in asymmetric structures with a flexible diaphragm. The results showed that the shear-dominant deformation of diaphragms is sensitive to both structure asymmetry specifications and the degree of diaphragm flexibility; therefore, it can be used for the qualitative classification of the seismic behavior of structures. Also, the center of strength in structures with flexible diaphragm is more important relative to the stiffness center and has a significant effect on engineering demands at all levels of diaphragm flexibility. Moreover, it was found that a suitable configuration of centers in torsionally stiff structures depends on the degree of diaphragm flexibility, in addition to the intensity of earthquakes (structure yield level and selected engineering demand parameter.

  3. 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...

  4. Superoxide dismutase/catalase mimetic EUK-134 prevents diaphragm muscle weakness in monocrotalin-induced pulmonary hypertension.

    Science.gov (United States)

    Himori, Koichi; Abe, Masami; Tatebayashi, Daisuke; Lee, Jaesik; Westerblad, Håkan; Lanner, Johanna T; Yamada, Takashi

    2017-01-01

    Patients with pulmonary hypertension (PH) suffer from inspiratory insufficiency, which has been associated with intrinsic contractile dysfunction in diaphragm muscle. Here, we examined the role of redox stress in PH-induced diaphragm weakness by using the novel antioxidant, EUK-134. Male Wistar rats were randomly divided into control (CNT), CNT + EUK-134 (CNT + EUK), monocrotaline-induced PH (PH), and PH + EUK groups. PH was induced by a single intraperitoneal injection of monocrotaline (60 mg/kg body weight). EUK-134 (3 mg/kg body weight/day), a cell permeable mimetic of superoxide dismutase (SOD) and catalase, was daily intraperitoneally administered starting one day after induction of PH. After four weeks, diaphragm muscles were excised for mechanical and biochemical analyses. There was a decrease in specific tetanic force in diaphragm bundles from the PH group, which was accompanied by increases in: protein expression of NADPH oxidase 2/gp91phox, SOD2, and catalase; 3-nitrotyrosine content and aggregation of actin; glutathione oxidation. Treatment with EUK-134 prevented the force decrease and the actin modifications in PH diaphragm bundles. These data show that redox stress plays a pivotal role in PH-induced diaphragm weakness. Thus, antioxidant treatment can be a promising strategy for PH patients with inspiratory failure.

  5. Sleep-disordered breathing in unilateral diaphragm paralysis or severe weakness.

    Science.gov (United States)

    Steier, J; Jolley, C J; Seymour, J; Kaul, S; Luo, Y M; Rafferty, G F; Hart, N; Polkey, M I; Moxham, J

    2008-12-01

    Few data exist concerning sleep in patients with hemidiaphragm paralysis or weakness. Traditionally, such patients are considered to sustain normal ventilation in sleep. In the present study, diaphragm strength was measured in order to identify patients with unilateral paralysis or severe weakness. Patients underwent polysomnography with additional recordings of the transoesophageal electromyogram (EMG) of the diaphragm and surface EMG of extra-diaphragmatic respiratory muscles. These data were compared with 11 normal, healthy subjects matched for sex, age and body mass index (BMI). In total, 11 patients (six males, mean+/-sd age 56.5+/-10.0 yrs, BMI 28.7+/-2.8 kg x m(-2)) with hemidiaphragm paralysis or severe weakness (unilateral twitch transdiaphragmatic pressure 3.3+/-1.7 cmH(2)O (0.33+/-0.17 kPa) were studied. They had a mean+/-sd respiratory disturbance index of 8.1+/-10.1 events x h(-1) during non-rapid eye movement (NREM) sleep and 26.0+/-17.8 events x h(-1) during rapid eye movement (REM) sleep (control groups 0.4+/-0.4 and 0.7+/-0.9 events x h(-1), respectively). The diaphragm EMG, as a percentage of maximum, was double that of the control group in NREM sleep (15.3+/-5.3 versus 8.9+/-4.9% max, respectively) and increased in REM sleep (20.0+/-6.9% max), while normal subjects sustained the same level of activation (6.2+/-3.1% max). Patients with unilateral diaphragm dysfunction are at risk of developing sleep-disordered breathing during rapid eye movement sleep. The diaphragm electromyogram, reflecting neural respiratory drive, is doubled in patients compared with normal subjects, and increases further in rapid eye movement sleep.

  6. 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.

  7. 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

  8. 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

  9. Laparoscopy or clinical follow-up to detect occult diaphragm injuries ...

    African Journals Online (AJOL)

    The mean follow-up time was 24 months (median: 24; interquartile range: 1–40). There was no morbidity or mortality in Group B. Conclusions: Clinical and radiological follow-up are feasible and appear to be safe, in the short term, in patients who harbour occult diaphragm injuries after left TA stab wounds. Until studies ...

  10. 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.

  11. 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.

  12. Diaphragm Muscle Adaptation to Sustained Hypoxia: Lessons from Animal Models with Relevance to High Altitude and Chronic Respiratory Diseases

    Directory of Open Access Journals (Sweden)

    Philip Lewis

    2016-12-01

    Full Text Available The diaphragm is the primary inspiratory pump muscle of breathing. Notwithstanding its critical role in pulmonary ventilation, the diaphragm like other striated muscles is malleable in response to physiological and pathophysiological stressors, with potential implications for the maintenance of respiratory homeostasis. This review considers hypoxic adaptation of the diaphragm muscle, with a focus on functional, structural, and metabolic remodeling relevant to conditions such as high altitude and chronic respiratory disease. On the basis of emerging data in animal models, we posit that hypoxia is a significant driver of respiratory muscle plasticity, with evidence suggestive of both compensatory and deleterious adaptations in conditions of sustained exposure to low oxygen. Cellular strategies driving diaphragm remodeling during exposure to sustained hypoxia appear to confer hypoxic tolerance at the expense of peak force-generating capacity, a key functional parameter that correlates with patient morbidity and mortality. Changes include, but are not limited to: redox-dependent activation of hypoxia-inducible factor (HIF and MAP kinases; time-dependent carbonylation of key metabolic and functional proteins; decreased mitochondrial respiration; activation of atrophic signaling and increased proteolysis; and, altered functional performance. Diaphragm muscle weakness may be a signature effect of sustained hypoxic exposure. We discuss the putative role of reactive oxygen species as mediators of both advantageous and disadvantageous adaptations of diaphragm muscle to sustained hypoxia, and the role of antioxidants in mitigating adverse effects of chronic hypoxic stress on respiratory muscle function.

  13. Heart Failure-Induced Diaphragm Myopathy

    Directory of Open Access Journals (Sweden)

    Aline Regina Ruiz Lima

    2014-07-01

    Full Text Available Background: Intracellular signaling pathways involved in skeletal myosin heavy chain (MyHC isoform alterations during heart failure (HF are not completely understood. We tested the hypothesis that diaphragm expression of mitogen-activated protein kinases (MAPK and myogenic regulatory factors is changed in rats with myocardial infarction (MI induced HF. Methods: Six months after MI rats were subjected to transthoracic echocardiography. After euthanasia, infarcted rats were subdivided in MI/HF- group (with no HF evidence; n=10, and MI/HF+ (with right ventricular hypertrophy and lung congestion; n=10. Sham-operated rats were used as controls (n=10. MyHC isoforms were analyzed by electrophoresis. Statistical analysis: ANOVA and Pearson correlation. Results: MI/HF- had left cardiac chambers dilation with systolic and diastolic left ventricular dysfunction. Cardiac injury was more intense in MI/HF+ than MI/HF-. MyHC I isoform percentage was higher in MI/HF+ than MI/HF-, and IIb isoform lower in MI/HF+ than Sham. Left atrial diameter-to-body weight ratio positively correlated with MyHC I (p=0.005 and negatively correlated with MyHC IIb (p=0.02. TNF-a serum concentration positively correlated with MyHC I isoform. Total and phosphorylated ERK was lower in MI/HF- and MI/HF+ than Sham. Phosphorylated JNK was lower in MI/HF- than Sham. JNK and p38 did not differ between groups. Expression of NF-κB and the myogenic regulatory factors MyoD, myogenin, and MRF4 was similar between groups. Conclusion: Diaphragm MyHC fast-to-slow shift is related to cardiac dysfunction severity and TNF-a serum levels in infarcted rats. Reduced ERK expression seems to participate in MyHC isoform changes. Myogenic regulatory factors and NF-κB do not modulate diaphragm MyHC distribution during chronic HF.

  14. 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.

  15. 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

  16. 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

  17. 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

  18. Implantation of ArtificialIris, a CustomFlex irisprosthesis, in a trauma patient with an Artisan lens: A case report and review.

    Science.gov (United States)

    Doroodgar, Farideh; Jabbarvand, Mahmoud; Niazi, Feizollah; Niazi, Sana; Sanginabadi, Azad

    2017-11-01

    To evaluate probable complications of ArtificialIris implantation with iris fixated intraocular lens. Development of photophobia, glare, and psychological strain during face-to-face communication in a 23-year-old man with a widespread traumatic iris defect terminate to make a decision for performing implantation of an ArtificialIris (Humanoptics, Erlangen, Germany) under the remnant iris without removing the patient's existing Artisan lens. Without any intraoperative or postoperative complications, the patient's visual acuity increased by 1 line, the endothelial cell loss was comparable with the cell loss associated with standard cataract surgery, and the anterior-chamber depth and anterior-chamber anatomy did not change. At the final follow-up examination, the mean intraocular pressure did not differ from baseline, and we achieved high level of patient satisfaction and subjective vision improvement. We discuss the particular importance of considering the patient's expectations, the appropriate measurements, ways to perfect color evaluation, and the types of ArtificialIris products. The implantation of the ArtificialIris in patients with aphakic iris-supported lenses (ie, pre-existing Artisan lenses) is a feasible approach and a useful option for patients with thin irises and iris hypoplasia who are at risk of subluxation or the dislocation of the posterior-chamber intraocular lens (PCIOL), and also those with sclerally fixed PCIOLs.

  19. 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.

  20. 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

  1. 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...

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

    African Journals Online (AJOL)

    AJRH Managing Editor

    Like many countries, Uganda's family planning programme is financially stretched, and clear support for the SILCS Diaphragm by ... Keywords: Diaphragm, family planning, Uganda, SILCS, introduction. Résumé. Cette étude des systèmes ...... and the Demand for Family Planning in Uganda: Further Analysis of the Uganda ...

  3. 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

  4. Cerium oxide nanoparticle treatment ameliorates peritonitis-induced diaphragm dysfunction

    Directory of Open Access Journals (Sweden)

    Asano S

    2015-10-01

    Full Text Available Shinichi Asano,1,2 Ravikumar Arvapalli,1 Nandini DPK Manne,1,2 Mani Maheshwari,1,3 Bing Ma,1,2 Kevin M Rice,1 Vellaisamy Selvaraj,1,2 Eric R Blough1–3 1Center for Diagnostic Nanosystems, 2Department of Pharmacology, Pharmaceutical Sciences and Research, School of Pharmacy, 3Department of Pharmacology, Physiology and Toxicology, Joan C Edwards School of Medicine, Marshall University, Huntington, WV, USA Abstract: The severe inflammation observed during sepsis is thought to cause diaphragm dysfunction, which is associated with poor patient prognosis. Cerium oxide (CeO2 nanoparticles have been posited to exhibit anti-inflammatory and antioxidative activities suggesting that these particles may be of potential use for the treatment of inflammatory disorders. To investigate this possibility, Sprague Dawley rats were randomly assigned to the following groups: sham control, CeO2 nanoparticle treatment only (0.5 mg/kg iv, sepsis, and sepsis+CeO2 nanoparticles. Sepsis was induced by the introduction of cecal material (600 mg/kg directly into the peritoneal cavity. Nanoparticle treatment decreased sepsis-associated impairments in diaphragmatic contractile (Po function (sham: 25.6±1.6 N/cm2 vs CeO2: 23.4±0.8 N/cm2, vs Sep: 15.9±1.0 N/cm2 vs Sep+CeO2: 20.0±1.0 N/cm2, P<0.05. These improvements in diaphragm contractile function were accompanied by a normalization of protein translation signaling (Akt, FOXO-1, and 4EBP1, diminished proteolysis (caspase 8 and ubiquitin levels, and decreased inflammatory signaling (Stat3 and iNOS. Histological analysis suggested that nanoparticle treatment was associated with diminished sarcolemma damage and diminished inflammatory cell infiltration. These data indicate CeO2 nanoparticles may improve diaphragmatic function in the septic laboratory rat. Keywords: cerium oxide nanoparticles, anti-inflammatory, nitric oxide, diaphragm

  5. Akreos Adapt AO Intraocular lens opacification after vitrectomy in a diabetic patient: a case report and review of the literature.

    Science.gov (United States)

    Cao, Dan; Zhang, Hongyang; Yang, Cheng; Zhang, Liang

    2016-06-08

    Postoperative optic opacification of hydrophilic acrylic intraocular lenses (IOLs) is an uncommon complication leading to IOL explantation. In the past decade, several studies reported that the granular deposits responsible for the opacification were probably calcium and phosphate salts; however, the exact mechanism causing calcification of IOLs is unknown. The aim of this study is to describe clinical and laboratory findings of a case of late postoperative opacification of an aspheric hydrophilic acrylic IOL (Akreos Adapt AO) after vitrectomy. A 60-year-old woman diagnosed with cataract and severe nonproliferative diabetic retinopathy (NPDR) underwent uneventful phacoemulsification and hydrophilic acrylic IOL (Akreos Adapt AO, Bausch & Lomb) implantation in both eyes. Seven months later, the woman came back with a complaint of blurry vision in the left eye. Fundus examination revealed vitreous hemorrhage in the left eye veiling the retinal detail. A 23-gauge vitrectomy with endolaser treatment was performed in the left eye. Ten months after the vitrectomy, the patient complained of decreased visual acuity in the left eye again. On slit-lamp examination, we observed a well circumscribed centrally and paracentrally located opacification within the pupillary area localized to the anterior surface of the IOL. The IOL was explanted from the left eye together with the capsular bag, and an iris-claw lens (Artisan Aphakia OPHTEC) was implanted. The explanted IOL was examined under pathological evaluation (alizarin red method). IOL opacification is a rare event. We described a case of postoperative opacification of the Akreos Adapt AO IOL after vitrectomy in a patient with proliferative diabetic retinopathy and found the deposits on the anterior surface of the IOL consisted of calcium aggregates. Given the higher frequency of postoperative opacification observed in diabetic patients, hydrophilic acrylic IOLs should be used with caution in patients with diabetes.

  6. Scleral lens influence on corneal curvature and pachymetry in keratoconus patients

    NARCIS (Netherlands)

    Soeters, Nienke; Visser, Esther Simone; Imhof, Saskia M; Tahzib, Nayyirih G

    OBJECTIVES: To investigate the influence of full scleral lenses on corneal curvature and pachymetry in keratoconus patients. METHODS: In this intervention study, 20 eyes of 14 patients were measured by Scheimpflug imaging (Pentacam HR, Oculus) at two time points: directly and ≥1 week after scleral

  7. [Scleral contact lens for ocular rehabilitation in patients with Stevens-Johnson syndrome].

    Science.gov (United States)

    Siqueira, Ana Carolina Punzi de; Santos, Myrna Serapião dos; Farias, Charles Costa de; Barreiro, Telma Regina Maria Pereira; Gomes, José Álvaro Pereira

    2010-01-01

    To evaluate the efficacy of scleral contact lenses use on the management of ocular sequelae from Stevens-Johnson syndrome patients. In a retrospective study, patients who suffered sequelae of Stevens-Johnson syndrome and started the use of scleral contact lenses were followed. Patients were submitted to an evaluation of symptoms through a questionnaire; ophthalmologic exam (visual acuity measurement, biomicroscopy, ocular surface staining with fluorescein drops, Schirmer test). Ten eyes of seven patients were analyzed. Visual acuity varied from hand movements to 20/25. All patients presented some degree of corneal opacity and slight symblepharon. In patients whose adaptation to scleral contact lenses was successful (90%), they all refered improvement of symptoms and sight. As for the biomicroscopic findings it was observed an improvement of conjunctival hyperemia and keratitis and a reduction of the mucous secretion in 90% the cases. A successful adaptation to scleral contact lenses was feasible on most patients, with relief of symptoms and better visual acuity, probably due to regularization of the surface. Scleral contact lenses represent an important and accessible alternative to reduce the limitations inferred by the damages from Stevens-Johnson syndrome.

  8. Discrimination between Clinically Relevant and Nonrelevant Acanthamoeba Strains Isolated from Contact Lens- Wearing Keratitis Patients in Austria

    Science.gov (United States)

    Walochnik, J.; Haller-Schober, E.-M.; Kölli, H.; Picher, O.; Obwaller, A.; Aspöck, H.

    2000-01-01

    Eighteen cases of Acanthamoeba-associated keratitis among contact lens wearers seen at the Department of Ophthalmology, Karl-Franzens-University, Graz, Austria, between 1996 and 1999 are reviewed. The amoebae were proven to be the causative agents in three patients. The aim of our study was to discriminate between clinically relevant and nonrelevant isolates and to assess the relatedness of the isolates to published strains. Altogether, 20 strains of free-living amoebae, including 15 Acanthamoeba strains, 3 Vahlkampfia strains, and 2 Hartmannella strains, were isolated from clinical specimens. The virulent Acanthamoeba strains were identified as A. polyphaga and two strains of A. hatchetti. To our knowledge this is the first determination of keratitis-causing Acanthamoeba strains in Austria. Clinically relevant isolates differed markedly from nonrelevant isolates with respect to their physiological properties. 18S ribosomal DNA sequence types were determined for the three physiologically most-divergent strains including one of the keratitis-causing strains. This highly virulent strain exhibited sequence type T6, a sequence type not previously associated with keratitis. Sequence data indicate that Acanthamoeba strains causing keratitis as well as nonpathogenic strains of Acanthamoeba in Austria are most closely related to published strains from other parts of the world. Moreover, the results of our study support the assumption that pathogenicity in Acanthamoeba is a distinct capability of certain strains and not dependent on appropriate conditions for the establishment of an infection. PMID:11060047

  9. Seismic resistance of composite floor diaphragms

    Science.gov (United States)

    Porter, M. L.; Greimann, L. F.

    1980-05-01

    The behavioral and strength characteristics of composite steel deck floor slab diaphragms are reported. Principal characteristics investigated include maximum load, ductility, stiffness, and failure mode. The addition of studs increases the flexural load capacity of one-way steel deck reinforced slabs by 10 to 30 percent. Non-studded specimens ultimately fail because of loss of interfacial force in the shear span. Studded specimens ultimately fail due to tearing of the deck near the stud. Two analysis procedures were used, a contributing forces approach and a shear-bond approach. The former was found to be a potential analysis procedure, and results from the shear-bond increase approach demonstrated its feasibility for studded specimens.

  10. 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

  11. 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.

  12. Tear film physiology and contact lens wear. II. Contact lens-tear film interaction.

    Science.gov (United States)

    Holly, F J

    1981-04-01

    The successful fitting of contact lenses requires the practitioner to take into account many properties of the specific lens type used but the practitioner must also understand patient factors including tear properties, use of appropriate solutions, procedures for lens cleaning, and efficiency of blinking. Selection of appropriate patients, selection of lens type, proper fitting, good maintenance, and training and monitoring of patients increase the probability of achieving success.

  13. Hypercapnia attenuates ventilator-induced diaphragm atrophy and modulates dysfunction

    NARCIS (Netherlands)

    Schellekens, W.J.M.; Hees, H.W.H. van; Kox, M.; Linkels, M.; Acuna, G.L.; Dekhuijzen, P.N.R.; Scheffer, G.J.; Hoeven, J.G. van der; Heunks, L.M.A.

    2014-01-01

    INTRODUCTION: Diaphragm weakness induced by prolonged mechanical ventilation may contribute to difficult weaning from the ventilator. Hypercapnia is an accepted side effect of low tidal volume mechanical ventilation, but the effects of hypercapnia on respiratory muscle function are largely unknown.

  14. Classifying Apnea of Prematurity by Transcutaneous Electromyography of the Diaphragm

    NARCIS (Netherlands)

    Kraaijenga, Juliette V.; Hutten, Gerard J.; de Waal, Cornelia G.; de Jongh, Frans H.; Onland, Wes; van Kaam, Anton H.

    2018-01-01

    Background: Treatment of apnea is highly dependent on the type of apnea. Chest impedance (CI) has inaccuracies in monitoring respiration, which compromises accurate apnea classification. Electrical activity of the diaphragm measured by transcutaneous electromyography (EMG) is feasible in preterm

  15. WORKABILITY OF THE ZIGZAG POLYMER DIAPHRAGM OF HIGH EARTHFILL COFFERDAM

    Directory of Open Access Journals (Sweden)

    Zverev Andrey Olegovich

    2017-05-01

    Full Text Available There are considered the results of stress-strain state analysis of polymer diaphragm in the body of the 50 m high earthfill cofferdam of Gibe III dam. The diaphragm is made of polyvinylchloride (PVC geomembrane and has a zigzag location. Computations were conducted with the finite element method. A thin geomembrane was modeled by rod-shaped finite elements. Computations showed that the diaphragm made of geomembrane is a sufficiently safe seepage-control element: there are small tensile stresses on its individual sections. The geomembrane damage may occur in it only in the part anchored to the upstream shell. Considerable tensile stresses appear in anchors which are comparable with the geomembrane tensile strength. If the geomembrane is made of PVC, there will be a margin of safety. It is not recommended to anchor the diaphragm into the upstream shell but make it only into the downstream shell.

  16. 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...

  17. 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 \

  18. Immune status of high-risk smoldering multiple myeloma patients and its therapeutic modulation under LenDex: a longitudinal analysis.

    Science.gov (United States)

    Paiva, Bruno; Mateos, María Victoria; Sanchez-Abarca, Luis Ignacio; Puig, Noemi; Vidriales, María-Belén; López-Corral, Lucía; Corchete, Luis A; Hernandez, Miguel T; Bargay, Joan; de Arriba, Felipe; de la Rubia, Javier; Teruel, Ana-Isabel; Giraldo, Pilar; Rosiñol, Laura; Prosper, Felipe; Oriol, Albert; Hernández, José; Esteves, Graça; Lahuerta, Juan José; Bladé, Joan; Perez-Simon, Jose Antonio; San Miguel, Jesús F

    2016-03-03

    There is significant interest in immunotherapy for the treatment of high-risk smoldering multiple myeloma (SMM), but no available data on the immune status of this particular disease stage. Such information is important to understand the interplay between immunosurveillance and disease transformation, but also to define whether patients with high-risk SMM might benefit from immunotherapy. Here, we have characterized T lymphocytes (including CD4, CD8, T-cell receptor γδ, and regulatory T cells), natural killer (NK) cells, and dendritic cells from 31 high-risk SMM patients included in the treatment arm of the QUIREDEX trial, and with longitudinal peripheral blood samples at baseline and after 3 and 9 cycles of lenalidomide plus low-dose dexamethasone (LenDex). High-risk SMM patients showed at baseline decreased expression of activation-(CD25/CD28/CD54), type 1 T helper-(CD195/interferon-γ/tumor necrosis factor-α/interleukin-2), and proliferation-related markers (CD119/CD120b) as compared with age-matched healthy individuals. However, LenDex was able to restore the normal expression levels for those markers and induced a marked shift in T-lymphocyte and NK-cell phenotype. Accordingly, high-risk SMM patients treated with LenDex showed higher numbers of functionally active T lymphocytes. Together, our results indicate that high-risk SMM patients have an impaired immune system that could be reactivated by the immunomodulatory effects of lenalidomide, even when combined with low-dose dexamethasone, and support the value of therapeutic immunomodulation to delay the progression to multiple myeloma. The QUIREDEX trial was registered to www.clinicaltrials.gov as #NCT00480363. © 2016 by The American Society of Hematology.

  19. Acanthamoeba keratitis. Contact lens and noncontact lens characteristics.

    Science.gov (United States)

    Chynn, E W; Lopez, M A; Pavan-Langston, D; Talamo, J H

    1995-09-01

    To identify potential differences in time to diagnosis and final visual outcome between contact lens and noncontact lens users with Acanthamoeba keratitis. Prior studies have shown early diagnosis and therapy to be related to outcome but have not analyzed differences among patients with and without contact lenses. A retrospective analysis of 11 consecutive cases (involving 13 eyes) of Acanthamoeba keratitis diagnosed at one institution over a 3-year period. Mean time to diagnosis was significantly longer in noncontact lens users versus those who wore contact lenses (mean, 5.8 versus 3.3 weeks). Fifty percent of patients who did not wear contact lenses had a poor outcome (visual acuity worse than 20/40 or penetrating keratoplasty) versus 14% of patients who wore contact lenses. Diagnoses were made later in patients without contact lenses, and these patients had a worse visual outcome than those with Acanthamoeba keratitis who wore contact lenses. All patients with unresponsive microbial keratitis, even those without contact lens use, should be evaluated for Acanthamoeba.

  20. 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.

  1. 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

    Energy Technology Data Exchange (ETDEWEB)

    Tsai, Hui-Yu; Liao, Ying-Lan [Chang Gung University, Taoyun, Taiwan (China); Chang Gung University / Chang Gung Memorial Hospital, Taoyun, Taiwan (China); Lai, Nan-Ku; Chen, Tou-Rong [Chung Shan Medical University Hospital, Taichung, Taiwan (China); Chung Shan Medical University, Taichung, Taiwan (China); Chen, Jun-Rong [Chang Gung University / Chang Gung Memorial Hospital, Taoyun, Taiwan (China)

    2015-06-15

    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

  2. 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.

  3. Targeting heat shock proteins mitigates ventilator induced diaphragm muscle dysfunction in an age-dependent manner

    Directory of Open Access Journals (Sweden)

    Hannah Ogilvie

    2016-09-01

    Full Text Available Intensive care unit (ICU patients are often overtly subjected to mechanical ventilation and immobilization, which leads to impaired limb and respiratory muscle function. The latter, termed ventilator-induced diaphragm dysfunction (VIDD has recently been related to compromised heat shock protein (Hsp activation. The administration of a pharmacological drug BGP-15 acting as a Hsp chaperone co-inducer has been found to partially alleviate VIDD in young rats. Considering that the mean age in the ICU is increasing, we aimed to explore whether the beneficial functional effects are also present in old rats. For that, we exposed young (7-8 months and old (28-32 months rats to five-day controlled mechanical ventilation and immobilization with or without systemic BGP-15 administration. We then dissected diaphragm muscles, membrane–permeabilized bundles and evaluated the contractile function at single fiber level. Results confirmed that administration of BGP-15 restored the force-generating capacity of isolated muscle cells from young rats in conjunction with an increased expression of Hsp72. On the other hand, our results highlighted that old rats did not positively respond to the BGP-15 treatment. Therefore, it is of crucial importance to comprehend in more depth the effect of VIDD on diaphragm function and ascertain any further age-related differences.

  4. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... lens because they can be purchased over-the-counter or on the Internet," says Thomas Steinemann, MD, ... Halloween Safety Colored Contact Lens Facts Over-the-Counter Costume Contacts May Contain Chemicals Harmful to Eyes ...

  5. 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.)

  6. 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

  7. 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.

  8. 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.

  9. 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.

  10. The clinical anatomy of the musculotendinous part of the diaphragm.

    Science.gov (United States)

    du Plessis, Maira; Ramai, Daryl; Shah, Sameer; Holland, Jessica D; Tubbs, R Shane; Loukas, Marios

    2015-11-01

    The thoracoabdominal diaphragm is a composite musculotendinous structure, separating the thoracic and abdominal cavities. Reemphasis of the already well-delineated variations of the muscular and tendinous portions, and blood and nerve supply of the diaphragm is becoming apparent. Scientific reports concerning reconstruction of the pericardium, activation of the muscle and the phrenic nerves by use of laparoscopically placed intramuscular electrodes, and repair of congenital and traumatic hernias reemphasize the importance of the muscular to tendinous relationships. The objective of this study, therefore, was to measure the ratio of the surface area of the tendinous central region to the muscular region of the diaphragm and provide a clear description across various specimens. We classified diaphragmatic measurements from 104 adult human diaphragms into six classes (I-VI) based on the ratio of surface area between its tendinous and muscular components. The majority of specimens, 56.7%, was attributed to class II and indicated a tendon-to-muscle ratio of between 10 and 15%; however, a small number of specimens indicated a very large tendon area at the expense of muscle bulk. Future research should be geared toward assessing the relationship between surface area of the musculature and its motor points with focus on interventions for herniation repair and recovery. Our results have shown that surgical interventions should be tailored to the individual, as diaphragm size may not necessarily predict tendon-to-muscle ratio.

  11. 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

  12. 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.

  13. Development of electrospun composite as substitutive diaphragm membrane

    Science.gov (United States)

    Mohsenzadeh, E.; Khenoussi, N.; Schacher, L.; Adolphe, D.; Hemmerlé, J.; Schneider, A.; Bahlouli, N.; Wagner-Kocher, C.

    2017-10-01

    The diaphragm is the most important muscle for respiration with a bi-domed structure, which is separating thoracic cavity from abdominal cavity. Partial formation of diaphragm, with unknown reason during fetal development caused a birth defect called congenital diaphragmatic hernia (CDH). It allows the abdomen contents to go up into the chest cavity resulting in pulmonary hypoplasia, which is the major cause of the mortality. There are several types of membrane, which can be used as prostheses to close the existing hole. In this project, we study the tensile properties of electrospun PA-6 nanowebs and electrospun PA-6/B composite as substitution membrane by a comparison with the tensile properties of tendon part of pig’s diaphragm.

  14. 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.

  15. 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...

  16. Contractual considerations in contact lens practice.

    Science.gov (United States)

    Classé, J G

    1986-03-01

    The use of forms in contact lens practice can save time, promote patient education, and reduce the opportunity for legal or economic disputes. The most commonly employed forms are those for contact lens fitting agreements, instructions for care and maintenance of lenses, prepaid service agreements, clinical investigations of investigatory lenses or solutions, and for extended wear patients. Sample forms are utilized for purposes of illustration.

  17. Pars Plana Vitrectomy in Treatment of Lens Injury

    Directory of Open Access Journals (Sweden)

    Remzi Avcı

    2013-01-01

    Full Text Available Lens injury due to traumas may present as loss of capsule integrity, cataract, lens subluxation, or lens luxation. In addition, lens subluxation and lens luxation may occur in pseudophakic patients due to trauma. Clear corneal, scleral or sclero-corneal phacoemulsification surgery, pars plana vitrectomy, pars plana vitrectomy with phaco-fragmentation, or pars plana vitrectomy with removal through corneal incision techniques are used in the treatment of lens injury due to traumas. Intraocular lens can be implanted in the bag, sulcus, or anterior chamber during the surgery. Depending on the circumstances, scleral fixated intraocular lenses or iris-claw lenses may also be preferred. Rehabilitation of such patients is not of a great concern today, with the advanced level of vitreoretinal surgery and cataract surgery techniques and with the current state of technology. (Turk J Ophthalmol 2013; 43: 51-4

  18. 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.

  19. 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.

  20. 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 ...

  1. 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.

  2. 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.

  3. An adjustable diaphragm/collimator for neutron diffraction experiments

    International Nuclear Information System (INIS)

    Simms, P.

    1981-01-01

    In single-crystal neutron diffraction experiments, the environment surrounding the specimen may produce unwanted scattering and this should be limited by a system of simple but easily adjustable diaphragms. Here a system is described which has been fitted to a number of neutron diffractometers at the Institut Laue-Langevin at Grenoble. (Auth.)

  4. Application of a plastic diaphragm for a silicon micropump

    Science.gov (United States)

    Kang, In-Byeong; Son, Mun-Tak; Haskard, Malcolm R.; Samaan, Noel D.; Ju, Byeong-Kwon

    1997-06-01

    The authors propose the use of a thin plastic film as a diaphragm for a silicon micropump. The plastic diaphragm allows large elastic deflection comprising a microsystem with corrosion resistant and low coefficient of friction. All aspects exploited through the development of a micropump with further advantages of eliminating several processing steps when compared with microdevices employing silicon as the thin vibration element. Low viscosity epoxy resigns and 100 micrometers polyethylene sticky tapes were used to overcome the relatively poor adhesion characteristics of plastics to silicon. The polyethylene sticky tape provides the weak bond onto a silicon wafer having microstructures fabricated by silicon bulk micromachining process. Type EPOFI 40200029 (Struers) low viscosity epoxy resin was used to obtain excellent sealing and high bonding strength between the silicon substrate and the plastic diaphragm. Low viscosity epoxy led to the deep penetration of the epoxy resulting in good sealing characteristics. The diaphragm and silicon micropump developed were tested with an external pneumatic actuator and showed excellent performance at pressures in the range of 0 - 30 psi.

  5. Facioscapulohumeral muscular dystrophy and respiratory failure; what about the diaphragm?

    NARCIS (Netherlands)

    Hazenberg, A.; Alfen, N. van; Voet, N.B.M.; Kerstjens, H.A.; Wijkstra, P.J.

    2015-01-01

    INTRODUCTION: We present a case of facioscapulohumeral muscular dystrophy (FSHD) with a diaphragm paralysis as the primary cause of ventilatory failure. FSHD is an autosomal dominant inherited disorder with a restricted pattern of weakness. Although respiratory weakness is a relatively unknown in

  6. REFRACTIVE NEUTRON LENS

    OpenAIRE

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

    2013-01-01

    Compound concave refractive lenses are used for focusing neutron beam. Investigations of spectral and focusing properties of a refractive neutron lens are presented. Resolution of the imaging system on the base of refractive neutron lenses depends on material properties and parameters of neutron source. Model of refractive neutron lens are proposed. Results of calculation diffraction resolution and focal depth of refractive neutron lens are discussed.

  7. 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.

  8. 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

  9. 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.

  10. 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

  11. Visual acuity and patient satisfaction at varied distances and lighting conditions after implantation of an aspheric diffractive multifocal one-piece intraocular lens.

    Science.gov (United States)

    Chang, Daniel H

    2016-01-01

    The aim of the study is to evaluate the visual acuity and patient satisfaction at varied distances under photopic and mesopic lighting conditions in patients bilaterally implanted with aspheric diffractive multifocal one-piece intraocular lenses. In this retrospective-prospective study, 16 patients with a mean age of 66.2±9.2 years (range: 50-81 years) who had undergone bilateral phacoemulsification surgery with implantation of a Tecnis multifocal one-piece intraocular lens (ZMB00) were evaluated. Monocular and binocular uncorrected and distance-corrected visual acuities were measured at distance (20 ft), intermediate (70-80 cm), and near (35-40 cm) under photopic (85 cd/m(2)) and mesopic (3 cd/m(2)) lighting conditions and were compared using the paired t-test. All patients also completed a subjective questionnaire. At a mean follow-up of 9.5±3.9 months, distance, near, and intermediate visual acuity improved significantly from preoperative acuity. Under photopic and mesopic conditions, 93.8% and 62.5% of patients, respectively, had binocular uncorrected intermediate visual acuity of 20/40 or better, and 62.5% and 31.3% of patients had binocular uncorrected near visual acuity of 20/20 or better. All patients were satisfied with their overall vision without using glasses and/or contact lenses when compared with before surgery. A total of 87.5% of patients reported no glare and 68.8% of patients reported no halos around lights at night. Tecnis multifocal one-piece intraocular lenses provide good distance, intermediate, and near visual acuity under photopic as well as mesopic lighting conditions. High levels of spectacle independence with low levels of photic phenomenon were achieved, resulting in excellent patient satisfaction.

  12. Prevalence, management and outcome of traumatic diaphragm injuries managed by the Pietermaritzburg Metropolitan Trauma Service.

    Science.gov (United States)

    D'Souza, N; Clarke, D; Laing, G

    2017-05-01

    INTRODUCTION This audit of traumatic diaphram injury (TDI) from a busy South African trauma service reviews the spectrum of disease and highlights current approaches to these injuries. METHODS The Pietermaritzburg Metropolitan Trauma Service (PMTS) has maintained an Electronic Surgical Registry (ESR) and a Hybrid Electronic Medical Record (HEMR) system since January 1 st 2012. RESULTS A total of 105 TDIs were identified and repaired during the study period. The mean patient age was 30 years (range 15-68 years - SD 9.7). The majority (92.4%) of patients were male (97/105). Penetrating trauma was the leading mechanism of injury (94%). 75 patients sustained a TDI from a stab wound, and the remaining 24 injuries resulted from gunshot wounds. Multiple associated injuries and high morbidity was seen with right diaphragm injury, blunt trauma, gunshot wounds and chronic diaphragmatic hernias. CONCLUSIONS TDI is a fairly uncommon injury with a local incidence of 1.6%. It presents in a spectrum from the obvious to the occult. Multiple associated injuries and high morbidity occur following blunt trauma or gunshot wounds, right diaphragm injury and chronic diaphragmatic hernias. Diagnostic laparoscopy offers a diagnostic and therapeutic tool to prevent progression of occult TDI to chronic diaphragmatic hernias.

  13. 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.

  14. Spontaneous dislocation of lens bag with acrylic lens after uneventful cataract surgery - unusual complication of cataract surgery.

    Science.gov (United States)

    Shah, Mehul A; Shah, Shreya M; Mehta, Ruchir; Shah, Prerna

    2015-01-01

    Spontaneous dislocation of intraocular lens with bag is rare. We report a case of a 56-year-old male who presented with spontaneous anterior dislocation of an in-the-bag intraocular lens 3 years after manual small incision cataract surgery. He had undergone manual small incision cataract surgery with foldable acrylic intraocular lens implantation, and 18 months after cataract surgery ND: YAG capsulotomy with uneventful post capsulotomy follow-up. 17 months after capsulotomy, the patient presented with sudden decrease of vision. On anterior segment examination, the intraocular lens with bag was dislocated into the anterior chamber. It was managed with intraocular lens explantation with bag, anterior vitrectomy and sclera fixated intraocular lens. Spontaneous intraocular lens dislocation with bag is possible after 1.5 years of uneventful surgery which may be managed using different techniques.

  15. 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

  16. Characterization of a human-pathogenic Acanthamoeba griffini isolated from a contact lens-wearing keratitis patient in Spain.

    Science.gov (United States)

    Heredero-Bermejo, I; Criado-Fornelio, A; De Fuentes, I; Soliveri, J; Copa-Patiño, J L; Pérez-Serrano, J

    2015-02-01

    Amoebae were isolated from contact lenses of a symptomatic lens wearer in Spain. Protozoa were characterized by studying their morphology, biology, protease activity and the 18S rRNA gene sequence. Morphology of the organism was observed by light microscopy, scanning electron microscopy and transmission electron microscopy. Its structure corresponded to an amphizoic amoeba. The protozoa grew well at 37 °C and poorly at lower temperatures. In addition, it was capable of lysing mammalian cells in vitro. A major 56 kDa proteolytic enzyme was observed in amoeba crude extracts by gelatin-sodium dodecyl sulphate-polyacrylamide gel electrophoresis. Most proteolytic enzymes in protozoa extracts showed significant activity over a wide range of pH (3-9) and temperature (8-45 °C) values. The assays on inhibition of protease activity indicated strongly that enzymes detected in amoeba extracts corresponded to serine proteases and, to a lesser extent, cysteine proteases. The use of proteinase inhibitors on a tissue culture model proved that the proteinase activity is critical for developing focal lesions in HeLa cell monolayers. Finally, partial sequencing of the 18S ribosomal RNA gene and phylogenetic analyses indicated that the isolate is closely related to Acanthamoeba griffini H37 from the UK (T3 genotype).

  17. 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

  18. [Postraumatic rupture of diaphragm with projection of the liver into the right pleural cavity--the case description].

    Science.gov (United States)

    Jabłoński, Sławomir; Wcisło, Edyta Santorek-strumiłłoszymon; Wawrzycki, Marcin; Misiak, Piotr; Kordiak, Jacek

    2009-05-01

    The proper initial diagnosis of acute diaphragm rupture in patients with multiple blunt trauma can be found difficult. It is the result of non specific clinical picture and dominating signs of injuries of other organs. Delayed diagnosis has a serious impact on worse conditions of diaphragm reconstruction and prognosis. A 53-year-old woman, with a severe abdomen injury after a car accident, is reported with perforation of the alimentary tract in two places (the small bowel and the sigmoid) and respiratory insufficiency caused by the projection of the liver into the thoracic cavity due to a large rupture of the right hemidiaphragm. The patient was initialy treated in another hospital in the intensive care ward where she was operated on three times by laparotomy acces owing to the perforations of the small and large bowels and the following complications. Eventually, she was admitted to our hospital one month after the accident so as to be treated for respiratory insufficiency. We described the difficulties in the treatment of this case in the late period after the injury. Finally the woman was treated with moderate success. Diaphragm laceration was repaired by the right thoracotomy access. In the next stage we performed the reconstruction of the alimentary tract and eliminated iloeostomy and colostomy during the fourth in turn laparotomy. Afterwards the patient in the state of the relative respiratory sufficiency was sent to the original hospital for further treatment.

  19. Non-compliance with lens care and maintenance in diabetic contact lens wearers.

    Science.gov (United States)

    O'Donnell, Clare; Efron, Nathan

    2004-11-01

    We hypothesize that diabetic contact lens wearers may represent a special group displaying higher levels of compliance with their lens care regimens as a result of learned behaviour relating to maintenance of their diabetic condition. To test this hypothesis, a prospective, single centre, controlled, masked study was performed whereby 29 diabetic contact lens patients and 29 non-diabetic control subjects were issued with disposable hydrogel contact lenses and a multipurpose lens care regimen. All participants were given identical instruction on lens care and maintenance. Compliance levels were assessed at a 12-month aftercare appointment by demonstration and questionnaire. Twenty-four different aspects of compliance were scored, 12 by observation and 12 by questionnaire report, of which only two showed a significant difference between the diabetic and control groups. Although the combined population of contact lens wearers was generally compliant, there were examples of non-compliance in both groups. Neither the duration of diabetes nor the degree of metabolic control appeared to have a significant effect on compliance. The results suggest that eye care practitioners cannot assume that diabetic patients will be more compliant with contact lens care and maintenance than non-diabetic patients.

  20. 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

  1. Laparoscopic repair of traumatic rupture of the left diaphragm cupola with prosthetic mesh.

    Science.gov (United States)

    Pojarliev, T; Tzvetkov, I; Blagov, J; Radionov, M

    2003-04-01

    We present the case of a 23-year-old patient who had a car accident with a steering wheel trauma 6 months previously. The patient complained of abdominal pain, getting easily tired, and breathing difficulties. A diagnosis of traumatic diaphragmatic hernia was established by a contrast radiographic examination. Laparoscopy confirmed a rupture of the left diaphragmatic cupola and prolapse of the stomach, small intestine, and colon in the left thoracic cavity. Laparoscopic repair of the diaphragm with polypropylene mesh was performed. The patient recovered rapidly and was discharged 72 h after the operation. The control radiographs and computed tomography (CT) contrast investigations showed no recurrence. The patient's preoperative complaints had resolved completely. The case is interesting because traumatic diaphragmatic hernia is sometimes difficult to diagnose. Its laparoscopic treatment is still a challenge for modern surgery, and there are not enough publications on the problem.

  2. 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...

  3. Diaphragm pico-liter pump for single-cell manipulation.

    Science.gov (United States)

    Anis, Yasser; Houkal, Jeffrey; Holl, Mark; Johnson, Roger; Meldrum, Deirdre

    2011-08-01

    A pico-liter pump is developed and integrated into a robotic manipulation system that automatically selects and transfers individual living cells of interest to analysis locations. The pump is a displacement type pump comprising one cylindrical chamber connected to a capillary micropipette. The top of the chamber is a thin diaphragm which, when deflected, causes the volume of the fluid-filled cylindrical chamber to change thereby causing fluid in the chamber to flow in and out of the micropipette. This enables aspirating and dispensing individual living cells. The diaphragm is deflected by a piezoelectric actuator that pushes against its center. The pump aspirates and dispenses volumes of fluid between 500 pL and 250 nL at flow rates up to 250 nL/s. The piezo-driven diaphragm arrangement provides exquisite control of the flow rate in and out of the capillary orifice. This feature, in turn, allows reduced perturbation of live cells by controlling and minimizing the applied shear stresses.

  4. 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.

  5. 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.

  6. 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.

  7. 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...

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. Disposable contact lenses vs. contact lens maintenance for extended wear.

    Science.gov (United States)

    Josephson, J E; Caffery, B E; Campbell, I; Slomovic, A R

    1990-01-01

    We compared a disposable extended wear contact lens modality with conventional extended wear over a 6-week period. To do so, we refit 31 patients who had successfully worn conventional extended wear contact lenses for more than 1 year. One eye was fit with the AcuvueR disposable contact lens, and a new extended wear lens of the type the patient had been wearing was placed on the other eye. At weekly intervals the disposable lens was discarded and a new disposable lens inserted. At the same time, the conventional lens on the fellow eye was cleaned, disinfected, and reinserted. After 6 weeks the ocular response, subjective impressions, and condition of the lenses in the two eyes were compared. Both lenses were then cultured. Three subjects had to discontinue disposable lens wear because of adverse reactions to trapped cellular debris and corneal microcysts. Although the results were not statistically significant, the Acuvue lens appeared to perform better than or equal to the conventional lens in biomicroscopic observation, visual acuity measurement, and subjective patient preference. Eighty-seven percent of patients preferred to continue with the disposable system. There were no differences found in the type or degree of microbial contamination of the lenses.

  13. Acanthamoeba keratitis and contact lens wear.

    Science.gov (United States)

    Lindsay, Richard G; Watters, Grant; Johnson, Richard; Ormonde, Susan E; Snibson, Grant R

    2007-09-01

    Acanthamoeba keratitis is a rare but serious complication of contact lens wear that may cause severe visual loss. The clinical picture is usually characterised by severe pain, sometimes disproportionate to the signs, with an early superficial keratitis that is often misdiagnosed as herpes simplex virus (HSV) keratitis. Advanced stages of the infection are usually characterised by central corneal epithelial loss and marked stromal opacification with subsequent loss of vision. In this paper, six cases of contact lens-related Acanthamoeba keratitis that occurred in Australia and New Zealand over a three-year period are described. Three of the patients were disposable soft lens wearers, two were hybrid lens wearers and one was a rigid gas permeable lens wearer. For all six cases, the risk factors for Acanthamoeba keratitis were contact lens wear with inappropriate or ineffective lens maintenance and exposure of the contact lenses to tap or other sources of water. All six patients responded well to medical therapy that involved topical use of appropriate therapeutic agents, most commonly polyhexamethylene biguanide and propamidine isethionate, although two of the patients also subsequently underwent deep lamellar keratoplasty due to residual corneal surface irregularity and stromal scarring. Despite the significant advances that have been made in the medical therapy of Acanthamoeba keratitis over the past 10 years, prevention remains the best treatment and patients who wear contact lenses must be thoroughly educated about the proper use and care of the lenses. In particular, exposure of the contact lenses to tap water or other sources of water should be avoided.

  14. 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...

  15. 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.

  16. 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.

  17. SU-E-J-140: Availability of Using Diaphragm Matching in Stereotactic Body Radiotherapy (SBRT) at the Time in Breath-Holding SBRT for Liver Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kawahara, D; Tsuda, S. [Course of Medical and Dental Sciences, Graduate School of Biomedical ' Health Sciences, Hiroshima University (Japan); Section of Radiation Therapy, Department of Clinical Support, Hiroshima University Hospital Health (Japan); Ozawa, S; Ohno, Y.; Kimura, T.; Nagata, Y. [Department of Radiation Oncology, Institute of Biomedical ' Health Science, Hiroshima University (Japan); Nakashima, T.; Aita, M.; Ochi, Y.; Okumura, T.; Masuda, H. [Section of Radiation Therapy, Department of Clinical Support, Hiroshima University Hospital Health (Japan)

    2014-06-01

    Purpose: IGRT based on the bone matching may produce a larger target positioning error in terms of the reproducibility of the expiration breath hold. Therefore, the feasibility of the 3D image matching between planning CT image and pretreatment CBCT image based on the diaphragm matching was investigated. Methods: In fifteen-nine liver SBRT cases, Lipiodol, uptake after TACE was outlined as the marker of the tumor. The relative coordinate of the isocenter obtained by the contrast matching was defined as the reference coordinate. The target positioning difference between diaphragm matching and bone matching were evaluated by the relative coordinate of the isocenter from the reference coordinate obtained by each matching technique. In addition, we evaluated PTV margins by van Herk setup margin formula. Results: The target positioning error by the diaphragm matching and the bone matching was 1.31±0.83 and 3.10±2.80 mm in the cranial-caudal(C-C) direction, 1.04±0.95 and 1.62±1.02 mm in the anterior-posterior(A-P) direction, 0.93±1.19 and 1.12±0.94 mm in the left-right(L-R) direction, respectively. The positioning error by the diaphragm matching was significantly smaller than the bone matching in the C-C direction (p<0.05). The setup margin of diaphragm matching and bone matching that we had calculated based on van Herk margin formula was 4.5mm and 6.2mm(C-C), and 3.6mm and 6.3mm(A-P), and 2.6mm and 4.5mm(L-R), respectively. Conclusion: IGRT based on a diaphragm matching could be one alternative image matching technique for the positioning of the patients with liver tumor.

  18. 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 ...

  19. 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. ...

  20. 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 ...

  1. 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 ...

  2. 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 ...

  3. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... with Colored Contact Lenses Julian: Teenager Blinded In One Eye By Non-Prescription Contact Lens Laura: Vision ... Robyn: Blurry Vision and Daily Eye Drops After One Use Facts About Colored Contacts and Halloween Safety ...

  4. 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 ... Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of Service For ...

  5. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... in a pair of colored contact lenses, Laura Butler of Parkersburg, W.Va., had "extreme pain in ... to wear any kind of contact lens. In Butler's case, the lenses caused an infection and left ...

  6. 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 ...

  7. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... an impulsive buy from a souvenir shop, but 10 hours after she first put in a pair ... Prescription Contact Lens Laura: Vision Loss After Just 10 Hours Robyn: Blurry Vision and Daily Eye Drops ...

  8. bubble chamber lens

    CERN Multimedia

    Before the days of electronic detectors, visual techniques were used to detect particles, using detectors such as spark chambers and bubble chambers. This plexiglass lens was used to focus the image of tracks so they could be photographed.

  9. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Contact Lens Facts Over-the-Counter Costume Contacts May Contain Chemicals Harmful to Eyes Four Ways Over- ... without a prescription are breaking the law, and may be fined $11,000 per violation. "Many of ...

  10. 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. " ...

  11. 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 ... an ophthalmologist — an eye medical doctor — who will measure each eye and talk to you about proper ...

  12. 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 ...

  13. Viscous froth lens

    Science.gov (United States)

    Green, T. E.; Bramley, A.; Lue, L.; Grassia, P.

    2006-11-01

    Microscale models of foam structure traditionally incorporate a balance between bubble pressures and surface tension forces associated with curvature of bubble films. In particular, models for flowing foam microrheology have assumed this balance is maintained under the action of some externally imposed motion. Recently, however, a dynamic model for foam structure has been proposed, the viscous froth model, which balances the net effect of bubble pressures and surface tension to viscous dissipation forces: this permits the description of fast-flowing foam. This contribution examines the behavior of the viscous froth model when applied to a paradigm problem with a particularly simple geometry: namely, a two-dimensional bubble “lens.” The lens consists of a channel partly filled by a bubble (known as the “lens bubble”) which contacts one channel wall. An additional film (known as the “spanning film”) connects to this bubble spanning the distance from the opposite channel wall. This simple structure can be set in motion and deformed out of equilibrium by applying a pressure across the spanning film: a rich dynamical behavior results. Solutions for the lens structure steadily propagating along the channel can be computed by the viscous froth model. Perturbation solutions are obtained in the limit of a lens structure with weak applied pressures, while numerical solutions are available for higher pressures. These steadily propagating solutions suggest that small lenses move faster than large ones, while both small and large lens bubbles are quite resistant to deformation, at least for weak applied back pressures. As the applied back pressure grows, the structure with the small lens bubble remains relatively stiff, while that with the large lens bubble becomes much more compliant. However, with even further increases in the applied back pressure, a critical pressure appears to exist for which the steady-state structure loses stability and unsteady

  14. 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...... movement of a single point at the diaphragm. Therefore, we developed a new method, Area-measurement, that assesses motion of the whole diaphragm dome. We wanted to evaluate which of the three methods is the most accurate.Methods: We examined nineteen healthy men and women, aged 21 to 26. Ultrasound...... and Forced Vital Capacity (FVC) measurement was performed simultaneously. We measured excursion of the right hemi-diaphragm with M-mode and cranio-caudal movement with B-mode. Using Area-measurement, we measured change in thoracic area by tracking the diaphragm. Two experienced ultrasound operators rated...

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

    KAUST Repository

    Shen, Zhiyuan

    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.

  16. Vibrating Cantilever Transducer Incorporated in Dual Diaphragms Structure for Sensing Differential Pneumatic Pressure

    OpenAIRE

    Cellatoglu, Akin; Karuppanan, Balasubramanian

    2012-01-01

    Pneumatic pressure cells with thin metallic spherical diaphragm of shallow spherical shell configuration linked with vibrating wire pickup or vibrating cantilever pickup were reported in the past. In order to enhance the sensitivity of the pressure cell this work considers dual diaphragm structure fitted with cantilever pickup. The design and development of the pressure cell with this dual diaphragm structure having cantilever pickup is presented here. The geometrical design is optimally made...

  17. Some parameters of the oxidative stress in lens, humour aqueous and serum of patients with diabetes and age-related cataract

    Directory of Open Access Journals (Sweden)

    Žorić Lepša

    2003-01-01

    Full Text Available Contemporary hypothesis considers the oxidative stress as a crucial event in age-related processes in the body, as well as in the age-related cataract formation. The secondary aging factors accelerate ageing processes. One of them is diabetes. With the aim of investigation of the noninsulin-dependent diabetes (Type II influence on cataract genesis here were analyzed contents of the lipid oxidation products (lipid peroxides - LP and total sulfhydryle groups (TSH in the lens’ corticonuclear blocks and antioxidative capacity in their humour aqueous expressed as percent of induced malondyaldehyde (% iMDA in 14 samples obtained from patients with cataract and diabetes mellitus type II (without diabetic complications and compared to 66 samples of patients with cataract without diabetes, as well as some parameters of the oxidative stress in serums (content of vitamin C, acrobat - A dehydroascorbate - DA and their relation, vitamin E, glutathione - GSH peroxidase - P and catalase - Cat activity, content of malondyaldehyde - MDA and % iMDA of 27 patients with age-related cataract and diabetes mellitus type II (without complications, and compared to the other 135 age-related cataract patients. Also were analyzed frequencies of the secondary senium diseases in a clinical group of 162 patients with cataract and sex and age matched 55 examined people without cataract, as a control group. Patients with diabetes and cataract have lower values of almost all investigated parameters of antioxidative defense in their serum and higher level of the lipid peroxidation products. Level of glutathione in their serums is significantly lower (p<0.05. Intensity of lipid peroxidation in corticonuclear lens blocks is higher in patients with diabetes, whereas their total sulfhydryle groups and % iMDA in humour aqueous shows lower antioxidant capacity in the same group, probably because of higher intensity of oxidative stress. Also, by investigation of frequencies of the

  18. Non-compliance in contact lens wear.

    Science.gov (United States)

    Claydon, B E; Efron, N

    1994-10-01

    Non-compliance is emerging as a critical issue in the contact lens field. This problem has been studied at depth in general health care situations and is seen as the responsibility of both practitioner and patient (client) working in a health care partnership. The contact lens practitioner and patient present a specific case for the study of non-compliance in areas such as hygiene, solution use, appointment attendance and wearing times. From 40 to 91% of contact lens patients have been reported as non-complaint in the use of recommended care and maintenance regimens and many of these are confused or ignorant about their behaviour. In order to arrive at a general set of conclusions from the studies published to date, it is important to understand the methodology of each study, it purpose, the definition of non-compliance used and the way the results were analysed and described. This review summarizes the research into non-compliance in the contact lens field to data. A set of general conclusions is drawn and a model for compliance in the context of contact lens practice is proposed.

  19. [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.

  20. 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

  1. Prevalence of corneal ulcer among contact lens wearers in Nigeria ...

    African Journals Online (AJOL)

    Corneal Ulceration has been described as the most serious complication of contact lens wear worldwide. The incidence of corneal ulceration in contact lens wearers in Nigeria was determined retrospectively. 1759 case notes of patients who had worn contact lenses for at least one year were obtained from eye clinics in ...

  2. 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…

  3. [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

  4. Importance of diagnostic laparoscopy in the assessment of the diaphragm after left thoracoabdominal stab wound: A prospective cohort study.

    Science.gov (United States)

    Yücel, Metin; Özpek, Adnan; Tolan, Hüseyin Kerem; Başak, Fatih; Baş, Gürhan; Ünal, Ethem; Alimoğlu, Orhan

    2017-03-01

    Stab wounds in the left thoracoabdominal region may cause diaphragmatic injury. The aim of the present study was to determine incidence of diaphragmatic injury and role of diagnostic laparoscopy in detection of injury in patients with left thoracoabdominal stab wound. Total of 81 patients (75 male, 6 female; mean age 27.5±9.8 years; range 14 to 60 years) who presented with left thoracoabdominal stab wound between April 2009 and September 2014 were evaluated. Laparotomy was performed on patients who had hemodynamic instability, signs of peritonitis, or organ evisceration. Remaining patients were followed conservatively. After 48 hours, diagnostic laparoscopy was performed on patients without laparotomy indication to examine the left diaphragm for injury. Follow-up and treatment findings were prospectively evaluated. Thirteen patients underwent laparotomy while diagnostic laparoscopy was performed on remaining 68 patients. Left diaphragmatic injury was observed in 19 patients (23.5%) in the study group. Four injuries were diagnosed by laparotomy and 15 were diagnosed by laparoscopy. Presence of hemopneumothorax did not yield difference in incidence of diaphragmatic injury (p=0.131). No significant difference was detected in terms of diaphragmatic injury with respect to entry site of stab wound in the thoracoabdominal region (p=0.929). It is important to evaluate the diaphragm in left thoracoabdominal stab injuries, and diagnostic laparoscopy is still the safest and most feasible method.

  5. 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.

  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. Screening for sleep-disordered breathing in neuromuscular disease using a questionnaire for symptoms associated with diaphragm paralysis.

    Science.gov (United States)

    Steier, J; Jolley, C J; Seymour, J; Teschler, H; Luo, Y M; Polkey, M I; Moxham, J

    2011-02-01

    Patients with neuromuscular disease (NMD) are at risk of developing sleep-disordered breathing (SDB) following respiratory muscle involvement. We hypothesised that a questionnaire based on clinical symptoms and signs of diaphragm weakness can be used to screen for SDB in such patients. We developed a self-administered multiple choice questionnaire containing five questions (Sleep-Disordered Breathing in Neuromuscular Disease Questionnaire (SiNQ)-5), scoring 0-10 points. 125 patients were enrolled: 32 with respiratory muscle weakness, 35 subjects with normal respiratory muscle strength and 58 patients with obstructive sleep apnoea (OSA). All subjects underwent full polysomnography. NMD patients with involvement of the respiratory muscles scored mean ± sd 6.8 ± 2.3 out of 10 points, significantly higher than both OSA patients 2.5 ± 2.3 and normal subjects 1.0 ± 2.0 (p < 0.001). A score of five or more points in the SiNQ-5 had a sensitivity of 86.2%, specificity of 88.5%, positive predictive value of 69.4% and a negative predictive value of 95.5% to identify NMD with combined SDB. A short self-administered questionnaire, the SiNQ-5, based on clinical symptoms can reliably screen for SDB in patients with diaphragm weakness. However, comorbidities, such as heart failure, that have symptoms influenced by posture could alter diagnostic accuracy.

  8. An unusual cause of acute cor pulmonale – Significance of the ‘continuous diaphragm sign’

    Science.gov (United States)

    Mohanan, Sandeep; Sajeev, C.G.; Muneer, Kader; Rajesh, G.; Krishnan, M.N.; Pillai, Vivek

    2014-01-01

    A patient presented with chest pain and clinical features of acute right heart failure. Initial work up revealed the presence of severe PAH. Acute pulmonary embolism is the commonest and most life-threatening cause for acute cor pulmonale. Even though the clinical picture suggested pulmonary embolism, a subtle sign was missed from the first chest X-ray taken in the emergency department. However on reanalysis the ‘continuous diaphragm sign’ later guided us towards the diagnosis. Our case represents one of the first reports of a rare etiology for acute cor pulmonale – hypersensitivity pneumonitis. Right ventricular dysfunction was caused by an acute rise in pulmonary artery pressures as well as by the compressive effects of pneumomediastinum. We emphasize the role played by a good quality chest X-ray early in the management of acute chest pain syndromes. However pulmonary embolism should be ruled out conclusively before redirecting attention to less malignant conditions. PMID:25443610

  9. 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

  10. 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.

  11. Respiratory Muscle Training Improves Diaphragm Citrate Synthase Activity and Hemodynamic Function in Rats with Heart Failure.

    Science.gov (United States)

    Jaenisch, Rodrigo Boemo; Bertagnolli, Mariane; Borghi-Silva, Audrey; Arena, Ross; Lago, Pedro Dal

    2017-01-01

    Enhanced respiratory muscle strength in patients with heart failure positively alters the clinical trajectory of heart failure. In an experimental model, respiratory muscle training in rats with heart failure has been shown to improve cardiopulmonary function through mechanisms yet to be entirely elucidated. The present report aimed to evaluate the respiratory muscle training effects in diaphragm citrate synthase activity and hemodynamic function in rats with heart failure. Wistar rats were divided into four experimental groups: sedentary sham (Sed-Sham, n=8), trained sham (RMT-Sham, n=8), sedentary heart failure (Sed-HF, n=7) and trained heart failure (RMT-HF, n=7). The animals were submitted to a RMT protocol performed 30 minutes a day, 5 days/week, for 6 weeks. In rats with heart failure, respiratory muscle training decreased pulmonary congestion and right ventricular hypertrophy. Deleterious alterations in left ventricular pressures, as well as left ventricular contractility and relaxation, were assuaged by respiratory muscle training in heart failure rats. Citrate synthase activity, which was significantly reduced in heart failure rats, was preserved by respiratory muscle training. Additionally, a negative correlation was found between citrate synthase and left ventricular end diastolic pressure and positive correlation was found between citrate synthase and left ventricular systolic pressure. Respiratory muscle training produces beneficial adaptations in the diaphragmatic musculature, which is linked to improvements in left ventricular hemodynamics and blood pressure in heart failure rats. The RMT-induced improvements in cardiac architecture and the oxidative capacity of the diaphragm may improve the clinical trajectory of patients with heart failure.

  12. 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

  13. 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

  14. 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)

  15. The diaphragm with and without spermicide for contraception: a Cochrane review.

    Science.gov (United States)

    Cook, L; Nanda, K; Grimes, D

    2002-04-01

    The diaphragm is usually used with a spermicide. However, some practitioners have suggested that spermicides offer no additional contraceptive protection and have advocated alternative guidelines for the use of diaphragms. The objective of this review was to compare the effectiveness, safety and acceptability of the diaphragm with and without spermicide. We searched Medline, Embase, Popline, CINAHL, the Cochrane Controlled Trials Register and reference lists of relevant articles. In addition, we contacted experts in the field to identify unpublished studies. Randomized controlled trials comparing women of reproductive age using the diaphragm with and without spermicide as the sole contraceptive method that reported clinical outcomes were selected. Two reviewers independently extracted data on outcomes and trial characteristics and any discrepancies were resolved by consensus or by consultation with the third reviewer. The results of the one identified study are presented descriptively. We identified only one study. No significant difference was found in the pregnancy rates (with typical use or consistent use) or discontinuation rates between the diaphragm-with-spermicide and diaphragm-without-spermicide groups. There was a trend towards higher pregnancy rates in the diaphragm-without-spermicide group. However, this study failed to recruit the planned number of participants and was consequently underpowered. As only one underpowered study was identified, we cannot distinguish between the contraceptive effectiveness of the diaphragm with and without spermicide. We cannot draw any conclusion at this point; further research is needed.

  16. 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

  17. Tempol Supplementation Restores Diaphragm Force and Metabolic Enzyme Activities in mdx Mice

    Directory of Open Access Journals (Sweden)

    David P. Burns

    2017-12-01

    Full Text Available Duchenne muscular dystrophy (DMD is characterized by striated muscle weakness, cardiomyopathy, and respiratory failure. Since oxidative stress is recognized as a secondary pathology in DMD, the efficacy of antioxidant intervention, using the superoxide scavenger tempol, was examined on functional and biochemical status of dystrophin-deficient diaphragm muscle. Diaphragm muscle function was assessed, ex vivo, in adult male wild-type and dystrophin-deficient mdx mice, with and without a 14-day antioxidant intervention. The enzymatic activities of muscle citrate synthase, phosphofructokinase, and lactate dehydrogenase were assessed using spectrophotometric assays. Dystrophic diaphragm displayed mechanical dysfunction and altered biochemical status. Chronic tempol supplementation in the drinking water increased diaphragm functional capacity and citrate synthase and lactate dehydrogenase enzymatic activities, restoring all values to wild-type levels. Chronic supplementation with tempol recovers force-generating capacity and metabolic enzyme activity in mdx diaphragm. These findings may have relevance in the search for therapeutic strategies in neuromuscular disease.

  18. Tempol Supplementation Restores Diaphragm Force and Metabolic Enzyme Activities in mdx Mice.

    Science.gov (United States)

    Burns, David P; Ali, Izza; Rieux, Clement; Healy, James; Jasionek, Greg; O'Halloran, Ken D

    2017-12-06

    Duchenne muscular dystrophy (DMD) is characterized by striated muscle weakness, cardiomyopathy, and respiratory failure. Since oxidative stress is recognized as a secondary pathology in DMD, the efficacy of antioxidant intervention, using the superoxide scavenger tempol, was examined on functional and biochemical status of dystrophin-deficient diaphragm muscle. Diaphragm muscle function was assessed, ex vivo, in adult male wild-type and dystrophin-deficient mdx mice, with and without a 14-day antioxidant intervention. The enzymatic activities of muscle citrate synthase, phosphofructokinase, and lactate dehydrogenase were assessed using spectrophotometric assays. Dystrophic diaphragm displayed mechanical dysfunction and altered biochemical status. Chronic tempol supplementation in the drinking water increased diaphragm functional capacity and citrate synthase and lactate dehydrogenase enzymatic activities, restoring all values to wild-type levels. Chronic supplementation with tempol recovers force-generating capacity and metabolic enzyme activity in mdx diaphragm. These findings may have relevance in the search for therapeutic strategies in neuromuscular disease.

  19. 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.)

  20. [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.

  1. 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

  2. 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 ...

  3. 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

  4. 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…

  5. 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 ...

  6. bubble chamber lens

    CERN Multimedia

    Was used in a PS experiment. Before the days of electronic detectors, visual techniques were used to detect particles, using detectors such as spark chambers and bubble chambers. This plexiglass lens was used to focus the image of tracks so they could be photographed.

  7. Thermal Lens Microscope

    Science.gov (United States)

    Uchiyama, Kenji; Hibara, Akihide; Kimura, Hiroko; Sawada, Tsuguo; Kitamori, Takehiko

    2000-09-01

    We developed a novel laser microscope based on the thermal lens effect induced by a coaxial beam comprised of excitation and probe beams. The signal generation mechanism was confirmed to be an authentic thermal lens effect from the measurement of signal and phase dependences on optical configurations between the sample and the probe beam focus, and therefore, the thermal lens effect theory could be applied. Two-point spatial resolution was determined by the spot size of the excitation beam, not by the thermal diffusion length. Sensitivity was quite high, and the detection ability, evaluated using a submicron microparticle containing dye molecules, was 0.8 zmol/μm2, hence a distribution image of trace chemical species could be obtained quantitatively. In addition, analytes are not restricted to fluorescent species, therefore, the thermal lens microscope is a promising analytical microscope. A two-dimensional image of a histamine molecule distribution, which was produced in mast cells at the femtomole level in a human nasal mucous polyp, was obtained.

  8. [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.

  9. 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

  10. 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

  11. 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].

  12. 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.

  13. 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.

  14. Monitoring of Diaphragm Position in Pulsatile Pnumatic Ventricular Assisted Device by Ultrasound Sensor

    Science.gov (United States)

    Kamimura, Tadayuki; Homma, Akihiko; Tsukiya, Tomonori; Kakuta, Yukihide; Lee, Hwansung; Tatsumi, Eisuke; Taenaka, Yoshiyuki; Kitamura, Soichiro

    A new method using ultrasound sensors to detect the diaphragm position of a ventricular assist device (VAD) was proposed. Two small ultrasound sensors of 2.4mm diameter were attached to the outside surface of blood chamber of a pneumatic VAD. The receiving crystal received the ultrasound from the transmitting crystal reflected by the diaphragm. The diaphragm position was calculated by using geometric relation among two sensors and ultrasound propagation time. Validity of this method was evaluated in a mock circulation test under various driving conditions of VAD by comparing the ultrasound signals with driving pressure waveforms. The ultrasound signals could detect full-fill (FF) and full-eject (FE) status shortly before the spikes appeared on pressure waves, which are currently available to detect FE and FF but accompanies excessive extension of the diaphragm. This method would be helpful to avoid overloading of diaphragm. Linear correlation was observed between the output from VAD and blood volume calculated from the change of diaphragm position multiplied by the heart rate. This monitoring method of diaphragm of a VAD was proven to have advantages over the current method toward better control of a pneumatic VAD.

  15. Interleukin-1 receptor antagonist protects against lipopolysaccharide induced diaphragm weakness in preterm lambs.

    Directory of Open Access Journals (Sweden)

    Kanakeswary Karisnan

    Full Text Available Chorioamnionitis (inflammation of the fetal membranes is strongly associated with preterm birth and in utero exposure to inflammation significantly impairs contractile function in the preterm lamb diaphragm. The fetal inflammatory response to intra-amniotic (IA lipopolysaccharide (LPS is orchestrated via interleukin 1 (IL-1. We aimed to determine if LPS induced contractile dysfunction in the preterm diaphragm is mediated via the IL-1 pathway. Pregnant ewes received IA injections of recombinant human IL-1 receptor antagonist (rhIL-1ra (Anakinra; 100 mg or saline (Sal 3 h prior to second IA injections of LPS (4 mg or Sal at 119d gestational age (GA. Preterm lambs were killed after delivery at 121d GA (term = 150 d. Muscle fibres dissected from the right hemi-diaphragm were mounted in an in vitro muscle test system for assessment of contractile function. The left hemi-diaphragm was snap frozen for molecular and biochemical analyses. Maximum specific force in lambs exposed to IA LPS (Sal/LPS group was 25% lower than in control lambs (Sal/Sal group; p=0.025. LPS-induced diaphragm weakness was associated with higher plasma IL-6 protein, diaphragm IL-1β mRNA and oxidised glutathione levels. Pre-treatment with rhIL-1ra (rhIL-1ra/LPS ameliorated the LPS-induced diaphragm weakness and blocked systemic and local inflammatory responses, but did not prevent the rise in oxidised glutathione. These findings indicate that LPS induced diaphragm dysfunction is mediated via IL-1 and occurs independently of oxidative stress. Therefore, the IL-1 pathway represents a potential therapeutic target in the management of impaired diaphragm function in preterm infants.

  16. 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

  17. 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.

  18. [Correct contact lens hygiene].

    Science.gov (United States)

    Blümle, S; Kaercher, T; Khaireddin, R

    2013-06-01

    Although contact lenses have long been established in ophthalmology, practical aspects of handling contact lenses is becoming increasingly less important in the clinical training as specialist for ophthalmology. Simultaneously, for many reasons injuries due to wearing contact lenses are increasing. In order to correct this discrepancy, information on contact lenses and practical experience with them must be substantially increased from a medical perspective. This review article deals with the most important aspects for prevention of complications, i.e. contact lens hygiene.

  19. 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.

  20. 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.

  1. 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.

  2. Inspiratory muscle training reduces diaphragm activation and dyspnea during exercise in COPD.

    Science.gov (United States)

    Langer, Daniel; Ciavaglia, Casey E; Faisal, Azmy; Webb, Katherine A; Neder, J Alberto; Gosselink, Rik; Dacha, Sauwaluk; Topalovic, Marko; Ivanova, Anna; O'Donnell, Denis E

    2018-03-15

    Among patients with COPD, those with the lowest maximal inspiratory pressures experience greater breathing discomfort (dyspnea) during exercise. In such individuals, inspiratory muscle training (IMT) may be associated with improvement of dyspnea but the mechanisms for this are poorly understood. Therefore, we aimed to identify physiological mechanisms of improvement in dyspnea and exercise endurance following inspiratory muscle training (IMT) in patients with COPD and low maximal inspiratory pressure (Pi,max). The effects of 8 weeks of controlled IMT on respiratory muscle function, dyspnea, respiratory mechanics, and diaphragm electromyography (EMGdi) during constant-work rate cycle exercise were evaluated in patients with activity-related dyspnea (Baseline Dyspnea Index training control group (n=10 each). Twenty subjects (FEV 1 = 47{plus minus}19 %predicted; Pi,max= -59{plus minus}14 cmH 2 O; cycle ergometer peak work rate= 47{plus minus}21 %predicted) completed the study; groups had comparable baseline lung function, respiratory muscle strength, activity-related dyspnea and exercise capacity. IMT, compared with control, was associated with greater increases in inspiratory muscle strength and endurance, with attendant improvements in exertional dyspnea and exercise endurance time (all pinspiratory pressures, breathing pattern and operating lung volumes during exercise. In conclusion, IMT improved inspiratory muscle strength and endurance in mechanically compromised patients with COPD and low Pi,max. The attendant reduction in EMGdi/EMGdi,max helped explain the decrease in perceived respiratory discomfort despite sustained high ventilation and intrinsic mechanical loading over a longer exercise duration.

  3. The effect of tai chi on chronic obstructive pulmonary disease: a pilot randomised study of lung function, exercise capacity and diaphragm strength.

    Science.gov (United States)

    Niu, Ruichao; He, Ruoxi; Luo, Bai-Ling; Hu, Chengping

    2014-04-01

    Although the benefits of exercise on the health of patients with chronic obstructive pulmonary disease (COPD) have been widely reported, the effect of Tai Chi as an alternative exercise has not been thoroughly evaluated in patients with COPD. This study reported a randomised controlled trial, which investigated the effects of Tai Chi on lung function, exercise capacity, and diaphragm strength in patients with COPD. Single blind randomised controlled study. Department of Respiratory Medicine, Xiangya Hospital, Central South University. Forty patients with COPD were randomised into either a control group or Tai Chi intervention group. Participants in the control group received only routine care, while participants in the Tai Chi group received routine care and completed a six-month Tai Chi exercise program. Lung function parameters, blood gas parameters, 6-min walking distance (6MWD), and diaphragm strength parameters. Lung function parameters (FEV1: 1.43 ± 0.08 and FEV1 (%) predicted: 47.6 ± 4.76), 6MWD (476 ± 15) and diaphragm strength parameters (TwPes: 1.17 ± 0.07, TwPga: -1.12 ± 0.06, and TwPdi: 1.81 ± 0.09) were found to be significantly increased in participants who successfully completed the six-month Tai Chi program compared to participants in the control group who only received routine care (pexercise program compared to the baseline (p0.05). Tai Chi enhances lung function, exercise capacity, and diaphragm strength. However, this is only preliminary research data and a larger trial is needed for more detailed results. Copyright © 2013 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  4. 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

  5. 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...

  6. 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

  7. Lead-Free Piezoelectric Diaphragm Biosensors Based on Micro-Machining Technology and Chemical Solution Deposition.

    Science.gov (United States)

    Li, Xiaomeng; Wu, Xiaoqing; Shi, Peng; Ye, Zuo-Guang

    2016-01-12

    In this paper, we present a new approach to the fabrication of integrated silicon-based piezoelectric diaphragm-type biosensors by using sodium potassium niobate-silver niobate (0.82KNN-0.18AN) composite lead-free thin film as the piezoelectric layer. The piezoelectric diaphragms were designed and fabricated by micro-machining technology and chemical solution deposition. The fabricated device was very sensitive to the mass changes caused by various targets attached on the surface of diaphragm. The measured mass sensitivity value was about 931 Hz/μg. Its good performance shows that the piezoelectric diaphragm biosensor can be used as a cost-effective platform for nucleic acid testing.

  8. Lead-Free Piezoelectric Diaphragm Biosensors Based on Micro-Machining Technology and Chemical Solution Deposition

    Directory of Open Access Journals (Sweden)

    Xiaomeng Li

    2016-01-01

    Full Text Available In this paper, we present a new approach to the fabrication of integrated silicon-based piezoelectric diaphragm-type biosensors by using sodium potassium niobate-silver niobate (0.82KNN-0.18AN composite lead-free thin film as the piezoelectric layer. The piezoelectric diaphragms were designed and fabricated by micro-machining technology and chemical solution deposition. The fabricated device was very sensitive to the mass changes caused by various targets attached on the surface of diaphragm. The measured mass sensitivity value was about 931 Hz/μg. Its good performance shows that the piezoelectric diaphragm biosensor can be used as a cost-effective platform for nucleic acid testing.

  9. Assessing the Needs for intermediate diaphragms in prestressed concrete bridges : summary of report.

    Science.gov (United States)

    2008-05-01

    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 because the use of IDs increases the cos...

  10. Syphon Diaphragms : A Method for Predicting Their Performance for Purposes of Instrument Design

    Science.gov (United States)

    Eaton, H N; Keulegan, G H

    1922-01-01

    Here, the purpose is to show that the characteristic performance of a syphon diaphragm can be predicted from a knowledge of its stiffness and of its dimensions. The proof is based on a mathematical analysis of this type of diaphragm, together with enough experimental data to prove the validity of the assumptions and the sufficiency of the analysis. Equations are developed for the performance of syphons under various conditions of loading, both for concentrated loads and for hydrostatic pressure.

  11. Mitochondrial content and distribution changes specific to mouse diaphragm after chronic normobaric hypoxia

    OpenAIRE

    Gamboa, Jorge L.; Andrade, Francisco H.

    2009-01-01

    Chronic hypoxia reduces aerobic capacity (mitochondrial content) in limb skeletal muscles, and one of the causes seems to be decreased physical activity. Diaphragm and other respiratory muscles, however, may have a different pattern of adaptation as hypoxia increases the work of breathing. Thus, we hypothesized that chronic hypoxia would not reduce mitochondrial content in mouse diaphragm. Adult male C57BL/6J mice were kept in normoxia (FiO2 = 21%, control) or normobaric hypoxia (FiO2 = 10%, ...

  12. Three-dimensional pore structure and ion conductivity of porous ceramic diaphragms

    OpenAIRE

    Wiedenmann, Daniel; Keller, Lukas; Holzer, Lorenz; Stojadinović, Jelena; Münch, Beat; Suarez, Laura; Fumey, Benjamin; Hagendorfer, Harald; Brönnimann, Rolf; Modregger, Peter; Gorbar, Michal; Vogt, Ulrich F.; Züttel, Andreas; Mantia, Fabio La; Wepf, Roger

    2013-01-01

    The ion conductivity of two series of porous ceramic diaphragms impregnated with caustic potash was investigated by electrochemical impedance spectroscopy. To understand the impact of the pore structure on ion conductivity, the three-dimensional (3-D) pore geometry of the diaphragms was characterized with synchrotron x-ray absorption tomography. Ion migration was calculated based on an extended pore structure model, which includes the electrolyte conductivity and geometric pore parameters, fo...

  13. 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.

  14. One-lung flooding reduces the ipsilateral diaphragm motion during mechanical ventilation.

    Science.gov (United States)

    Lesser, Thomas Günther; Schubert, Harald; Güllmar, Daniel; Reichenbach, Jürgen R; Wolfram, Frank

    2016-03-08

    Diaphragm motion during spontaneous or mechanical respiration hinders image-guided percutaneous interventions of tumours in lung and upper abdomen. Motion-tracking methods can be applied but increase procedure complexity and procedure time. One-lung flooding (OLF) generates a suitable acoustic pathway to lung tumours and likely suppress diaphragm motion. The aim of this study was to quantify the effect of OLF on ipsilateral diaphragm motion during contralateral one-lung ventilation. To measure the diaphragm motion, M-mode ultrasonography of the right hemidiaphragm was performed during spontaneous breathing and mechanical ventilation, as well as after right-side lung flooding, in three pigs. Diaphragm motion was analysed using magnetic resonance images during left-side lung flooding and mechanical ventilation, in four pigs. Double-lung ventilation increased the diaphragm movement in comparison with spontaneous breathing (17.8 ± 4.4 vs. 12.2 ± 3.4 mm, p = 0.014). Diaphragm movement on the flooded side during contralateral one-lung ventilation was significantly reduced compared to that during double-lung ventilation (3.9 ± 1.0 vs. 17.8 ± 4.4 mm, p = 0.041). By analysing the magnetic resonance images, the hemidiaphragm on the flooded side showed an average displacement of 4.2 mm, a maximum displacement of 15 mm close to the ventilated lung and no displacement at the lateral side. OLF leads to a drastic reduction of diaphragm motion on the ipsilateral side which implies that targeting and motion compensation algorithms for interventions like high-intensity focused ultrasound ablation of intrapulmonary and hepatic lesions might not be required.

  15. 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

  16. 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.

  17. Optimization of a VOC Sensor with a Bilayered Diaphragm Using FBAR as Strain Sensing Elements

    Directory of Open Access Journals (Sweden)

    Huihui Guo

    2017-08-01

    Full Text Available Film bulk acoustic resonators (FBARs are widely applied in mass bio-sensing and pressure sensors, owing to their extreme sensitivity and integration ability, and ability to miniaturize circuits. A volatile organic compound (VOC sensor with a polymer-coated diaphragm, using FBARs as a strain sensing element is proposed and optimized. This vapor sensor is based on organic vapor-induced changes of mechanical deformation of the micro-diaphragm. The four FBARs are located at the edge of the bi-layer diaphragm comprising silicon nitride and silicon oxide for strain extraction. In this work, the strain distribution of the FBAR area under vapor loads is obtained using the finite element analysis (FEA and the response frequency changes of the FBARs under vapor loads are obtained based on both the first-principle methods to deduce the elastic coefficient variation of aluminum nitride film in FBARs under the bending stresses and the Mason equivalent circuit model of the sensor using ADS software. Finally, optimizations are performed on both the bilayered diaphragm structure and sensing film. The diaphragm with a 0.7 μm silicon nitride layer and a 0.5 μm silicon oxide layer are considered to be the optimized design. The optimal coverage area of the sensing film for the diaphragm is around 0.8.

  18. 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.

  19. Rat diaphragm mitochondria have lower intrinsic respiratory rates than mitochondria in limb muscles.

    Science.gov (United States)

    Garcia-Cazarin, Mary L; Gamboa, Jorge L; Andrade, Francisco H

    2011-06-01

    The mitochondrial content of skeletal muscles is proportional to activity level, with the assumption that intrinsic mitochondrial function is the same in all muscles. This may not hold true for all muscles. For example, the diaphragm is a constantly active muscle; it is possible that its mitochondria are intrinsically different compared with other muscles. This study tested the hypothesis that mitochondrial respiration rates are greater in the diaphragm compared with triceps surae (TS, a limb muscle). We isolated mitochondria from diaphragm and TS of adult male Sprague Dawley rats. Mitochondrial respiration was measured by polarography. The contents of respiratory complexes, uncoupling proteins 1, 2, and 3 (UCP1, UCP2, and UCP3), and voltage-dependent anion channel 1 (VDAC1) were determined by immunoblotting. Complex IV activity was measured by spectrophotometry. Mitochondrial respiration states 3 (substrate and ADP driven) and 5 (uncoupled) were 27 ± 8% and 24 ± 10%, respectively, lower in diaphragm than in TS (P respire at lower rates, despite a higher content of respiratory complexes. The results invalidate our initial hypothesis and indicate that mitochondrial content is not the only determinant of aerobic capacity in the diaphragm. We propose that UCP1 and VDAC1 play a role in regulating diaphragm aerobic capacity.

  20. 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)

  1. Ageing and neurotrophic signalling effects on diaphragm neuromuscular function

    Science.gov (United States)

    Greising, Sarah M; Ermilov, Leonid G; Sieck, Gary C; Mantilla, Carlos B

    2015-01-01

    The age-related mechanisms underlying sarcopenia are largely unknown. We hypothesize that age-related neuromuscular changes depend on brain-derived neurotrophic factor (BDNF) acting through the tropomyosin-related kinase receptor B (TrkB). Maximal specific force and neuromuscular transmission failure were assessed at 6, 18 and 24 months following control, BDNF or phosphoprotein phosphatase 1 derivative (1NMPP1) treatment in male TrkBF616A mice. Phosphoprotein phosphatase-1 derivatives such as 1NMPP1 inhibit TrkB kinase activity as a result of this single amino acid mutation in the ATP binding domain. Maximal twitch and isometric tetanic force were reduced at 24 months compared to 6 and 18 months (P Neuromuscular transmission failure significantly increased at 18 and 24 months compared to 6 months (age × treatment interaction: P Neuromuscular transmission was improved following BDNF at 6 and 18 months and was impaired only at 6 months following 1NMPP1 treatment. Age and inhibition of TrkB kinase activity had similar effects on neuromuscular transmission failure, supporting a critical role for BDNF/TrkB signalling on neuromuscular changes in ageing. These results suggest that an age-related loss of endogenous BDNF precedes reductions in TrkB kinase activity in the diaphragm muscle. PMID:25630263

  2. Intraocular Lens Subluxation in Marfan Syndrome

    Science.gov (United States)

    Rodrigo, Bolaños-Jiménez; Paulina, López-Lizárraga E; Francesc, March de R; Eduardo, Telich-Tarriba J; Alejandro, Navas

    2014-01-01

    Purpose : Ectopia lentis (EL) is a major criteria for the diagnosis of Marfan syndrome, it may vary from an asymptomatic mild displacement to a significant subluxation that places the equator of the lens in the pupillary axis. The purpose of this work is to present the case of a patient with Marfan syndrome who received treatment for subluxation at our institution. Case Report : A 51-year-old female diagnosed with Marfan syndrome presented to the emergency department with bilateral eye redness, foreign body sensation and crusting around the eyes on awakening. She had the following history of cardiac and ophthalmologic complications, including: 1. Lens subluxation 2. High myopia 3. Aortic root dilation, 4. Mitral valve prolapse and 5. Tricuspid insufficiency. Conclusion : The ophthalmological management of Marfan patients is challenging and periodical follow-up is needed. Surgical versus conservative management is controversial, each case needs to be evaluated individually to analyze the risks and benefits of the procedures. PMID:25279020

  3. Recommendations for assessing patient-reported outcomes and health-related quality of life in patients with urticaria: a GA(2) LEN taskforce position paper

    DEFF Research Database (Denmark)

    Baiardini, I; Braido, F; Bindslev-Jensen, Carsten

    2011-01-01

    ) and the chronic urticaria questionnaire on quality of life CU-Q(2)oL. This latter tool, CU-Q(2)oL, is available in many languages and should be preferred, where available, over more generic instruments for assessing urticaria-specific effects on quality of life. CU-Q(2)oL is only suited for the investigation...... in clinical trials and routine practice for the evaluation of urticaria patients. We suggest that PROs should be considered as the primary outcome of future clinical trials. Two validated and disease-specific instruments for assessing PROs are available, the urticaria activity score (for symptoms...... of patients with chronic spontaneous urticaria. Similar instruments for other forms of urticaria have yet to be developed and validated. Also, tools for assessing other chronic spontaneous urticaria PROs besides quality of life and symptoms are needed....

  4. 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.

  5. Lens dislocation has a possible relationship with laser iridotomy

    OpenAIRE

    Mutoh, Tetsuya; Barrette, Kevin F; Matsumoto, Yukihiro; Chikuda, Makoto

    2012-01-01

    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 mo...

  6. 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.

  7. Panoramic lens applications revisited

    Science.gov (United States)

    Thibault, Simon

    2008-04-01

    During the last few years, innovative optical design strategies to generate and control image mapping have been successful in producing high-resolution digital imagers and projectors. This new generation of panoramic lenses includes catadioptric panoramic lenses, panoramic annular lenses, visible/IR fisheye lenses, anamorphic wide-angle attachments, and visible/IR panomorph lenses. Given that a wide-angle lens images a large field of view on a limited number of pixels, a systematic pixel-to-angle mapping will help the efficient use of each pixel in the field of view. In this paper, we present several modern applications of these modern types of hemispheric lenses. Recently, surveillance and security applications have been proposed and published in Security and Defence symposium. However, modern hemispheric lens can be used in many other fields. A panoramic imaging sensor contributes most to the perception of the world. Panoramic lenses are now ready to be deployed in many optical solutions. Covered applications include, but are not limited to medical imaging (endoscope, rigiscope, fiberscope...), remote sensing (pipe inspection, crime scene investigation, archeology...), multimedia (hemispheric projector, panoramic image...). Modern panoramic technologies allow simple and efficient digital image processing and the use of standard image analysis features (motion estimation, segmentation, object tracking, pattern recognition) in the complete 360° hemispheric area.

  8. Intracapsular Lens Extraction for the Treatment of Pupillary Block Glaucoma Associated with Anterior Subluxation of the Crystalline Lens

    Directory of Open Access Journals (Sweden)

    Yong Joon Kim

    2013-11-01

    Full Text Available Purpose: To report a case of pupillary block glaucoma associated with spontaneous crystalline lens subluxation into the anterior chamber in a 34-year-old man. Methods: 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. Results: 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. Conclusions: 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.

  9. 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

    Purpose To report a case of pupillary block glaucoma associated with spontaneous crystalline lens subluxation into the anterior chamber in a 34-year-old man. Methods 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. Results 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. Conclusions 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. PMID:24348413

  10. [Evaluation of colour vision according to type of implanted artificial foldable intraocular lens].

    Science.gov (United States)

    Stopyra, Wiktor

    2012-01-01

    The aim of research was comparing the colour vision of patients with blue light filtering artificial lens to the patients with implant without blue light filter. 99 patients (120 eyes) divided on three groups were examined. 40 patients (40 eyes) after cataract surgery with implantation of blue light filtering lens were the first group. 39 patients (40 eyes) who had implanted lens without filter were the second group. 20 patients (40 eyes) with own transparent lens were the third group. Farnsworth-Munsell 100 Hue test was used in research. Each patient made test on thirtieth day after cataract surgery. Following average total error score (TES) values in groups were observed: the first group--60.66, the second group--83.71, the third group--61.55. Average axis of disorder in blue-yellow range was following: patients after cataract surgery with implantation of blue light filtering lens--5.48, patients with implant without blue light filter--7.28, control group--5.74. 1. Kind of artificial intraocular lens has meaning in colour vision at pseudophakic patients. 2. Blue light filter of artificial intraocular foldable lens advantageously effects perception of colours. 3. Lack of blue light filter in artificial intraocular lens gets worse colour vision especially in blue-yellow range.

  11. Exploring diaphragm use as a potential HIV prevention strategy among women in the United States at risk.

    Science.gov (United States)

    Harvey, S Marie; Branch, Meredith R; Thorburn, Sheryl; Warren, Jocelyn; Casillas, America

    2008-04-01

    Given the immediate need for physical cervical barrier methods like the diaphragm to protect against HIV/STIs, understanding what factors influence the acceptability of these products and how to overcome obstacles to their use is important. We explored perceptions of the diaphragm and factors that might enhance its acceptability in 25 focus groups with racially/ethnically diverse young women in the U.S. at risk for HIV/STIs (N = 140). Women believed the diaphragm has positive attributes, and most indicated they would be more likely to use the diaphragm if they were confident they could use it correctly and it protected against HIV. They also considered it messy to use and difficult to insert or remove. Findings suggest that the diaphragm could be a desirable option for pregnancy and disease prevention for some women at risk for HIV/STIs. Although disadvantages to diaphragm use were identified, many could be eliminated through changes in product design and provider intervention.

  12. Classifying Apnea of Prematurity by Transcutaneous Electromyography of the Diaphragm.

    Science.gov (United States)

    Kraaijenga, Juliette V; Hutten, Gerard J; de Waal, Cornelia G; de Jongh, Frans H; Onland, Wes; van Kaam, Anton H

    2018-01-01

    Treatment of apnea is highly dependent on the type of apnea. Chest impedance (CI) has inaccuracies in monitoring respiration, which compromises accurate apnea classification. Electrical activity of the diaphragm measured by transcutaneous electromyography (EMG) is feasible in preterm infants and might improve the accuracy of apnea classification. To compare the accuracy of apnea classification based on diaphragmatic EMG (dEMG) and CI tracings in preterm infants. Fifteen cases of central apnea, 5 of obstructive apnea, and 10 of mixed apnea were selected from recordings containing synchronized continuous tracings of respiratory inductive plethysmography (RIP), airway flow, heart rate (HR), oxygen saturation (SpO2), and breathing activity measured by dEMG and CI. Twenty-two assessors (neonatologists, pediatricians-in-training, and nurses) classified each apnea twice; once based on dEMG, HR, and SpO2 tracings, and once based on CI, HR, and SpO2. The assessors were blinded to the type of respiratory tracing (dEMG or CI) and to the RIP and flow tracings. In total 1,320 assessments were performed, and in 71.1% the apnea was classified correctly. Subgroup analysis based on respiratory tracing showed that 74.8% of the dEMG tracings were classified correctly compared to 67.3% of the CI tracings (p apnea classification based on dEMG was present for central (86.7 vs. 80.3%, p apnea. The improved apnea classification based on dEMG tracing was independent of the type of assessor. Transcutaneous dEMG improves the accuracy of apnea classification when compared to CI in preterm infants, making this technique a promising candidate for future monitoring systems. © 2017 S. Karger AG, Basel.

  13. 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

  14. 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)

  15. 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.

  16. An unusual cause of acute cor pulmonale--significance of the 'continuous diaphragm sign'.

    Science.gov (United States)

    Mohanan, Sandeep; Sajeev, C G; Muneer, Kader; Rajesh, G; Krishnan, M N; Pillai, Vivek

    2014-01-01

    A patient presented with chest pain and clinical features of acute right heart failure. Initial work up revealed the presence of severe PAH. Acute pulmonary embolism is the commonest and most life-threatening cause for acute cor pulmonale. Even though the clinical picture suggested pulmonary embolism, a subtle sign was missed from the first chest X-ray taken in the emergency department. However on reanalysis the 'continuous diaphragm sign' later guided us towards the diagnosis. Our case represents one of the first reports of a rare etiology for acute cor pulmonale--hypersensitivity pneumonitis. Right ventricular dysfunction was caused by an acute rise in pulmonary artery pressures as well as by the compressive effects of pneumomediastinum. We emphasize the role played by a good quality chest X-ray early in the management of acute chest pain syndromes. However pulmonary embolism should be ruled out conclusively before redirecting attention to less malignant conditions. Copyright © 2014 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  17. Cranial irradiation in acute leukemia: dose estimate in the lens

    International Nuclear Information System (INIS)

    Kline, R.W.; Gillin, M.T.; Kun, L.E.

    1979-01-01

    Cranial irradiation for subclinical arachnoid infiltration is standard treatment in childhood acute lymphocytic leukemia. The incidental dose received by the ocular lens is of potential importance since these children evidence a significant long-term survival rate. Comparison of the lens dose using 6MV and 4MV photon beams and a cobalt unit is presented in terms of ion chamber measurements in a water phantom and thermo-luminescent dosimetry (TLD) measurements in a head phantom. TLD measurements on patients treated for acute lymphocytic leukemia (ALL) are examined and used to estimate the dose to the lens. It is demonstrated that the dose to the lens depends strongly on the choice of field margin and on the daily patient set-up. However, using parallel opposed beams in a clinically determined optimal set-up, the dose to the lens is approximately 20 to 30% of the midline central axis dose. By angling the treatment head to eliminate the geometrical divergence of the beam, it is possible to reduce the lens dose to approximately 15% of the midline dose

  18. Utility of a semi-scleral contact lens design in the management of the irregular cornea.

    Science.gov (United States)

    Romero-Jiménez, Miguel; Flores-Rodríguez, Patricia

    2013-06-01

    To evaluate the utility of the Rose K2 XL semi-scleral contact lens (Menicon Co. Ltd., Nagoya, Japan) in the management of the irregular cornea. Twenty-seven subjects (34 eyes) with irregular corneas referred for contact lens fitting were evaluated. A diagnostic trial set was used in the fitting process. Once the trial lens was considered optimal, a final lens was ordered from the manufacturer with the necessary changes in power, edge lift and diameter. We analyzed visual acuity, number of lenses ordered and patients' ability to wear and handle lenses. Twenty-three subjects (30 eyes) were fitted with the Rose K2 XL lens. Four subjects (4 eyes) decided not to conclude the fitting process for different reasons. Average logMAR visual acuity without correction and with the lens was 0.82 and 0.09, respectively (plenses (range 1-3) were necessary to achieve the optimal fit. Nineteen eyes (63%) were fitted with the first lens ordered. Three subjects (13%) had problems with lens handling, and three subjects (4 eyes) abandoned the wear of the lenses after three months due to discomfort (3 eyes) and unsatisfactory visual acuity (1 eye), respectively. Follow-up ranged from 6 to 9 months. Rose K2 XL semi-scleral contact lens provides good visual acuity and comfort in patients with irregular corneas. Copyright © 2012 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  19. Effects of inspiratory muscle training in elderly women on respiratory muscle strength, diaphragm thickness and mobility.

    Science.gov (United States)

    Souza, Helga; Rocha, Taciano; Pessoa, Maíra; Rattes, Catarina; Brandão, Daniella; Fregonezi, Guilherme; Campos, Shirley; Aliverti, Andrea; Dornelas, Armele

    2014-12-01

    Aging results in a decline in the function of the respiratory muscles. Inspiratory muscle training is emerging as a possible intervention to attenuate the decline of respiratory muscles in the elderly. The aim of this study was to evaluate the efficacy of inspiratory muscle training on respiratory strength, diaphragm thickness, and diaphragmatic mobility in elderly women. This was a controlled, randomized, and double-blind clinical trial, performed on 22 elderly women distributed in two groups, training (TG) and control (CG). Over an 8-week period a moderate intensity inspiratory muscle training protocol was followed in the TG, while CG followed a sham protocol. In addition maximum expiratory and inspiratory pressure, mobility of the diaphragm and diaphragmatic thickness were evaluated by ultrasound. After training, in TG maximal inspiratory pressure, maximal expiratory pressure, diaphragm thickness, and mobility increased by 37%, 13%, 11%, and 9% respectively, and their values were significantly higher than CG (p Inspiratory muscle training of moderate intensity improves respiratory muscle strength, diaphragm thickness, and diaphragm mobility in elderly women and it should be considered to minimize changes associated with senescence. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  20. Diaphragm correction factors for the FAC-IR-300 free-air ionization chamber.

    Science.gov (United States)

    Mohammadi, Seyed Mostafa; Tavakoli-Anbaran, Hossein

    2018-02-01

    A free-air ionization chamber FAC-IR-300, designed by the Atomic Energy Organization of Iran, is used as the primary Iranian national standard for the photon air kerma. For accurate air kerma measurements, the contribution from the scattered photons to the total energy released in the collecting volume must be eliminated. One of the sources of scattered photons is the chamber's diaphragm. In this paper, the diaphragm scattering correction factor, k dia , and the diaphragm transmission correction factor, k tr , were introduced. These factors represent corrections to the measured charge (or current) for the photons scattered from the diaphragm surface and the photons penetrated through the diaphragm volume, respectively. The k dia and k tr values were estimated by Monte Carlo simulations. The simulations were performed for the mono-energetic photons in the energy range of 20 - 300keV. According to the simulation results, in this energy range, the k dia values vary between 0.9997 and 0.9948, and k tr values decrease from 1.0000 to 0.9965. The corrections grow in significance with increasing energy of the primary photons. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Characteristic analysis of diaphragm-type transducer that is thick relative to its size

    Science.gov (United States)

    Ishiguro, Yuya; Zhu, Jing; Tagawa, Norio; Okubo, Tsuyoshi; Okubo, Kan

    2017-07-01

    In recent years, high-performance piezoelectric micromachined ultrasonic transducers (PMUTs) have been fabricated by micro electro mechanical systems (MEMS) technology. For high-resolution imaging, it is important to broaden the frequency bandwidth. By reducing the diaphragm size to increase the resonance frequency, the film thickness becomes relatively larger and hence the transmitting and receiving characteristics may different from those of a usual thin diaphragm. In this study, we examine the performance of a square-diaphragm-type lead zirconate titanate (PZT) transducer through simulations. To realize the desired resonance frequency of 20 MHz, firstly, the diaphragm size and the thickness of the layers of PZT and Si constituting a PMUT are examined, and then, three PZT/Si models with different thicknesses are selected. Subsequently, using the models, we analyze the transmitting efficiency, transmitting bandwidth, receiving sensitivity (piezoelectric voltage/electric charge), and receiving bandwidth using an FEM simulator. It is found that the proposed models can transmit ultrasound independently of the diaphragm vibration and have wide bandwidth of the receiving frequency as compared with that of a typical PMUT.

  2. 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.

  3. Contact Lens Wear at Altitude: Subcontact Lens Bubble Formation

    Science.gov (United States)

    1987-11-01

    incidence of (PMMA) lenses . Reported here are the results of contact lens subcontact lens bubble formation under scleral lenses at bubble studies with soft...vision from formation of large bubbles greater than 6,096 m (20,000 It). With soft contact lenses , bubble under their contact lenses . They also found...always located at the limbus and were without sequela to vision or corneal epithelial integrity. scleral lenses used by Jaeckle were permeable to gases

  4. 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

  5. [Contact lens-associated Paecilomyces lilacinus keratitis].

    Science.gov (United States)

    Mihailovic, N; Alnawaiseh, M; Zumhagen, L; Eter, N

    2017-01-01

    We present the case of a 23-year-old otherwise healthy female patient with contact lens-associated Paecilomyces lilacinus keratitis. The clinical findings stabilized after initial local antimycotic and antibacterial treatment; however, in the further course of local therapy an extensive relapse occurred which required treatment by perforating keratoplasty à chaud due to a penetrating corneal ulcer. The patient responded well to subsequent treatment with systemic and local antimycotic medication. After a few months HLA-matched keratoplasty was performed. During the follow-up time of 14 months there were no signs of recurrence of the infection.

  6. Discharge ignition in the diaphragm configuration supplied by DC non-pulsing voltage

    Science.gov (United States)

    Hlochová, L.; Hlavatá, L.; Kozáková, Z.; Krčma, F.

    2016-05-01

    This work deals with the ignition of the discharge in the diaphragm configuration generated in water solutions containing supporting NaCl electrolyte. The reactor has volume of 110 ml and it is made of polycarbonate. HV electrodes made of stainless steel are placed in this reactor. Ceramic (Shapal-MTM) diaphragm is placed in the barrier separating the cathode and the anode space. An electric power source supplies the reactor by constant DC voltage up to 4 kV and electric current up to 300 mA. The discharge ignition is compared in the reactor with different sizes of diaphragms. Measurements are carried out in electrolyte solutions with the same conductivity. Images of plasma streamers and bubble formation are taken by an ICCD camera iStar 734. Electrical characteristics are measured by an oscilloscope LeCroy LT 374 L in order to determine breakdown moments at different experimental conditions.

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

    KAUST Repository

    Shen, Zhiyuan

    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.

  8. Costal Exostosis Leading Diaphragm Laceration and Bronchiectasıs with Bronchial Web

    Directory of Open Access Journals (Sweden)

    Gokhan Yuncu

    2012-07-01

    Full Text Available Thoracic complications belong to exostosis with the other abnormality are extremely rare. A 40 year-old man presented with right-sided pleuritic chest pain. Computed tomographic scan of the chest revealed exostosis length 2.5 cm pushing pleura and diaphragm and compressing adjacent to lung and liver. Middle and lower lobe bronchiectasis was also identified. There were a web lesion in bronchial lumen at the level of middle lobe at bronchoscopy. In operation, diaphragm lac-eration was repaired with sutures. Bilobectomy inferior was performed and 10th costa was partially resected together with exostosis. Exostosis cases which lead to diaphragm laceration and bronchiectasis in addition with bronchial web as we present in this case are quite rare.

  9. Ventilatory muscle strength, diaphragm thickness and pulmonary function in world-class powerlifters.

    Science.gov (United States)

    Brown, Peter I; Venables, Heather K; Liu, Hymsuen; de-Witt, Julie T; Brown, Michelle R; Faghy, Mark A

    2013-11-01

    Resistance training activates the ventilatory muscles providing a stimulus similar to ventilatory muscle training. We examined the effects of elite powerlifting training upon ventilatory muscle strength, pulmonary function and diaphragm thickness in world-class powerlifters (POWER) and a control group (CON) with no history of endurance or resistance training, matched for age, height and body mass. Body composition was assessed using single-frequency bioelectrical impedance. Maximal static volitional inspiratory (P(I,max)) and expiratory (P(E,max)) mouth pressures, diaphragm thickness (T(di)) derived from ultrasound measurements and pulmonary function from maximal flow volume loops were measured. There were no differences in physical characteristics or pulmonary function between groups. P(I,max) (22 %, P powerlifters improve ventilatory muscle strength and increases diaphragm size. Whole-body resistance training may be an appropriate training mode to attenuate the effects of ventilatory muscle weakness experienced with ageing and some disease states.

  10. 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...

  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. 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.

  13. 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...

  14. 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)

  15. 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...

  16. Gabor lens theory

    International Nuclear Information System (INIS)

    Irani, A.A.

    1978-01-01

    The principle of using the space charge of an electron cloud to focus ion beams was first proposed by Gabor. Electrons are to be confined radially by means of an axial magnetic field B/sub z/ and axially by means of externally applied electric fields E/sub z/. An ion beam of charge density n/sub i/ much less than n/sub e/, the electron charge density can then be focused by the radial electric field set up by the electron cloud. The case considered here is that of a hollow cylindrical conductor charged to a potential +V with grounded rings on either side to set up the axial E/sub z/ field. A solenoid wound around the central conductor supplies the B/sub z/ field. Theoretical calculations are carried out for n/sub e/ maximum as a function of B/sub z/ due to radial confinement and V due to axial confinement and the focal length of the Gabor Lens is calculated

  17. A case of Alagille syndrome complicated by intraocular lens subluxation and rhegmatogenous retinal detachment

    Science.gov (United States)

    Fukumoto, Masanori; Ikeda, Tsunehiko; Sugiyama, Tetsuya; Ueki, Mari; Sato, Takaki; Ishizaki, Eisuke

    2013-01-01

    This case report describes a case of Alagille syndrome with developing intraocular lens subluxation and rhegmatogenous retinal detachment 4 years after cataract surgery. A 15-year-old female patient with Alagille syndrome-associated cataracts in both eyes underwent phacoemulsification aspiration and intraocular lens implantation. Four years postoperative, intraocular lens subluxation developed in her left eye. For treatment, extraction of the dislocated intraocular lens, anterior vitrectomy, and intraocular lens fixation was performed. Three weeks later, the patient developed rhegmatogenous retinal detachment, which was well-treated by pars plana vitrectomy. Cataract surgery needs to be performed carefully in patients with Alagille syndrome due to the weakness of the zonule of Zinn. Careful postoperative observation is necessary for patients with Alagille syndrome who have undergone intraocular surgery in order to facilitate early detection of a possible rhegmatogenous retinal detachment. PMID:23898221

  18. 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.

  19. High-Level Pressure Support Ventilation Attenuates Ventilator-Induced Diaphragm Dysfunction in Rabbits.

    Science.gov (United States)

    Ge, Huiqing; Xu, Peifeng; Zhu, Tao; Lu, Zhihua; Yuan, Yuehua; Zhou, Jiancang; Ying, Kejing

    2015-12-01

    The effects of different modes of mechanical ventilation in the same ventilatory support level on ventilator-induced diaphragm dysfunction onset were assessed in healthy rabbits. Twenty New Zealand rabbits were randomly assigned to 4 groups (n = 5 in each group). Group 1: no mechanical ventilation; group 2: controlled mechanical ventilation (CMV) for 24 hours; group 3: assist/control ventilation (A/C) mode for 24 hours; group 4: high-level pressure support ventilation (PSV) mode for 24 hours. Heart rate, mean arterial blood pressure, PH, partial pressure of arterial oxygen/fraction of inspired oxygen and partial pressure of arterial carbon dioxide were monitored and diaphragm electrical activity was analyzed in the 4 groups. Caspase-3 was evaluated by protein analysis and diaphragm ultra structure was assessed by electron microscopy. The centroid frequency and the ratio of high frequency to low frequency were significantly reduced in the CMV, A/C and PSV groups (P C groups (P = 0.001 and P = 0.028, respectively). Electromyography of diaphragm integral amplitude decreased by 90% ± 1.48%, 67.8% ± 3.13% and 70.2% ± 4.72% in the CMV, A/C and PSV groups, respectively (P C groups (P = 0.035 and P = 0.033, respectively). Irregular swelling of mitochondria along with fractured and fuzzy cristae was observed in the CMV group, whereas mitochondrial cristae were dense and rich in the PSV group. The mitochondrial injury scores (Flameng scores) in the PSV group were the lowest among the 3 ventilatory groups (0.93 ± 0.09 in PSV versus 2.69 ± 0.05 in the CMV [P C groups [2.02 ± 0.08, P < 0.01]). The diaphragm myoelectric activity was reduced in the PSV group, although excessive oxidative stress and ultra-structural changes of diaphragm were found. However, partial diaphragm electrical activity was retained and diaphragm injury was minimized using the PSV mode.

  20. 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

  1. Opaque contact lens treatment for older children with amblyopia.

    Science.gov (United States)

    Anderson, Justin E; Brown, Sandra M; Mathews, Taryn A; Mathews, Steven M

    2006-03-01

    To investigate the usefulness of daily-wear opaque contact lens treatment for older children with amblyopia. A retrospective chart review of all children undergoing opaque contact lens therapy for amblyopia between 2000 and 2003 was performed. All patients were included except for those younger than 5 years of age, those undergoing maintenance treatment only, those lost to follow-up, or those unable to cooperate with Snellen visual acuity testing. Thirteen children were identified, and seven met the inclusion criteria. The seven patients had a mean age of 7.5 years (range, 5.7-8.7 years). The causes of amblyopia were anisometropia (five patients), cataract (one patient), and strabismus (one patient). For all seven patients, the mean logMAR improvement in visual acuity was 0.52 (range, 0.26-1.22). The average duration of opaque contact lens use was 9.3 months (range, 2-21 months). Compliance problems were encountered in three patients. No major complications occurred, but one patient had an episode of mild superficial punctate keratitis. Daily-wear opaque contact lens treatment is a useful occlusion method for amblyopia treatment in older children with various practical and social impediments to skin patching. Meaningful improvement in visual acuity can be obtained, even in children older than 8 years of age.

  2. 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.

  3. 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.

  4. Comparison of Two Intraocular Lens Implantation Techniques in Pediatric Cataract Surgery in Terms of Postoperative Complications

    Directory of Open Access Journals (Sweden)

    Mustafa Erdoğan Cicik

    2018-03-01

    Full Text Available Background: Pediatric cataract surgery differs substantially from adult cataract surgery. Numerous studies have focused on reducing the development of postoperative complications. Aims: To compare two intraocular lens implantation techniques used in pediatric cataract surgery in terms of postoperative complications. Study Design: Case-control study. Methods: Patients who underwent pediatric cataract surgery and intraocular lens implantation between 2008 and 2016 were evaluated in this retrospective study. Patients aged 3-15 years with unilateral or bilateral cataract and without corneal pathology were included in the study. The patients were categorized into the following two groups: those who underwent posterior capsulorhexis and anterior vitrectomy using in-the-bag intraocular lens implantation (group 1 and those who underwent posterior capsulorhexis and intraocular lens implantation with the optic fixed behind the posterior capsulorhexis (group 2. Rates of postoperative visual axis opacification and complications (glaucoma, posterior synechiae, uveitic reaction, and intraocular lens decentration were evaluated in these groups. The implanted intraocular lenses were either monoblock (AcrySof SN60AT intraocular lens, triple-piece (AcrySof MA60BM intraocular lens foldable hydrophobic acrylic lenses, or multifocal lenses (AcrySof IQ ReSTOR. Results: This retrospective study included 52 eyes of 37 patients. Group 1 comprised 26 eyes of 20 patients and group 2 comprised 26 eyes of 17 patients. During the follow-up, visual axis opacification was observed in two patients in group 1 but no patients in group 2. Regarding postoperative complications, there was no uveitic reaction, posterior synechiae, or intraocular lens decentration in either group. There was no significant difference between the groups in terms of the postoperative complications (p>0.05. Conclusion: There was no significant difference between in-the-bag intraocular lens implantation

  5. The dangers of distilled water in contact lens maintenance.

    Science.gov (United States)

    Josephson, J E; Caffery, B E

    1988-03-01

    The reports of serious corneal infection associated with hydrogel lens wear prompted us to explore the level of sterility of the distilled water used by lens wearers in our practice. Fifty patients supplied samples of their partially-used distilled water for testing. Of the samples, 12% were found to be contaminated. Five samples of previously unopened distilled water were tested and no growth was found. We recommend that patients do not use distilled water for the care of hydrogel contact lenses. Rather, sterile unit dose or multi-dose (aerosol) nonpreserved, or preserved salines can be used.

  6. 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.

  7. Optical quality for keratoconic eyes with conventional RGP lens and simulated, customised contact lens corrections: a comparison.

    Science.gov (United States)

    Jinabhai, Amit; Neil Charman, W; O'Donnell, Clare; Radhakrishnan, Hema

    2012-05-01

    To compare monochromatic aberrations of keratoconic eyes when uncorrected, corrected with spherically-powered RGP (rigid gas-permeable) contact lenses and corrected using simulations of customised soft contact lenses for different magnitudes of rotation (up to 15°) and translation (up to 1mm) from their ideal position. The ocular aberrations of examples of mild, moderate and severe keratoconic eyes were measured when uncorrected and when wearing their habitual RGP lenses. Residual aberrations and point-spread functions of each eye were simulated using an ideal, customised soft contact lens (designed to neutralise higher-order aberrations, HOA) were calculated as a function of the angle of rotation of the lens from its ideal orientation, and its horizontal and vertical translation. In agreement with the results of other authors, the RGP lenses markedly reduced both lower-order aberrations and HOA for all three patients. When compared with the RGP lens corrections, the customised lens simulations only provided optical improvements if their movements were constrained within limits which appear to be difficult to achieve with current technologies. At the present time, customised contact lens corrections appear likely to offer, at best, only minor optical improvements over RGP lenses for patients with keratoconus. If made in soft materials, however, these lenses may be preferred by patients in term of comfort. Ophthalmic & Physiological Optics © 2012 The College of Optometrists.

  8. 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).

  9. The Level Of Contact Lens Practice In Port Harcourt, Rivers State Of ...

    African Journals Online (AJOL)

    The level of contact lens practice in Port Harcourt, Rivers State of Nigeria was investigated. The instruments of research were field work/direct observation, oral interviews of eye care practitioners, andthe assessment of clinical records of the contact lens patients from 2003 to 2006. Thirty five eye care practices were studied.

  10. 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).

  11. [Contact lens care and maintenance].

    Science.gov (United States)

    Bloise, L

    2017-04-01

    All contact lenses with replacement schedules longer than daily must be maintained. At each step of their use, the lenses may be contaminated. Contact lens solutions perform the essential functions of cleaning, decontaminating and preserving the lenses to prevent infectious problems and improve wearing comfort. Contact lens contamination essentially comes from hands, cleaning solutions, cases, water and the environment. The pathogenic microorganisms are mainly Gram-negative bacteria, fungi and amoebae. Contact lens deposits may or may not have an organic origin. Their presence increases the risk of infection because they serve as a nutrient matrix for microbes, and they are responsible for wearing discomfort. Contact lens solutions differ in their composition, their mechanism of action and the concentration of the various agents. To prescribe the best lens care system to each wearer and for each material, it is necessary to be very familiar with them. Maintenance is the main cause of discomfort with contact lenses, either through improper use, solution-material incompatibility, or a reaction of the wearer to the components. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  12. Sepsis is associated with a preferential diaphragmatic atrophy: a critically ill patient study using tridimensional computed tomography.

    Science.gov (United States)

    Jung, Boris; Nougaret, Stephanie; Conseil, Matthieu; Coisel, Yannaël; Futier, Emmanuel; Chanques, Gerald; Molinari, Nicolas; Lacampagne, Alain; Matecki, Stefan; Jaber, Samir

    2014-05-01

    Diaphragm and psoas are affected during sepsis in animal models. Whether diaphragm or limb muscle is preferentially affected during sepsis in the critically ill remains unclear. Retrospective secondary analysis study including 40 patients, comparing control (n = 17) and critically ill patients, with (n = 14) or without sepsis (n = 9). Diaphragm volume, psoas volume, and cross-sectional area of the skeletal muscles at the third lumbar vertebra were measured during intensive care unit (ICU) stay using tridimensional computed tomography scan volumetry. Diaphragm strength was evaluated using magnetic phrenic nerve stimulation. The primary endpoint was the comparison between diaphragm and peripheral muscle volume kinetics during the ICU stay among critically ill patients, with or without sepsis. Upon ICU admission, neither diaphragm nor psoas muscle volumes were significantly different between critically ill and control patients (163 ± 53 cm vs. 197 ± 82 cm for the diaphragm, P = 0.36, and 272 ± 116 cm vs. to 329 ± 166 cm for the psoas, P = 0.31). Twenty-five (15 to 36) days after admission, diaphragm volume decreased by 11 ± 13% in nonseptic and by 27 ± 12% in septic patients, P = 0.01. Psoas volume decreased by 11 ± 10% in nonseptic and by 19 ± 13% in septic patients, P = 0.09. Upon ICU admission, diaphragm strength was correlated with diaphragm volume and was lower in septic (6.2 cm H2O [5.6 to 9.3]) than that in nonseptic patients (13.2 cm H2O [12.3 to 15.6]), P = 0.01. During the ICU stay, both diaphragm and psoas volumes decreased. In septic patients, the authors report for the first time in humans preferential diaphragm atrophy compared with peripheral muscles.

  13. 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.

  14. 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.

  15. 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

  16. Rupture traumatique du diaphragme au CHU Gabriel Touré de ...

    African Journals Online (AJOL)

    1999-01-01

    Traumatic diaphragm injury is a classical entity in thoraco- abdominal traumatology. Our objectives were to determine the hospital frequency, describe the aetiological factors and the mechanisms of occurrence, analyze the therapeutic modalities. It was a retrospective and prospective 17- year study from January 1, 1999 to ...

  17. 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

    and 86 pm/cm for the fifth. The discrepancy in the sensitivity of the fifth sensor has been explained as being a result of the annealing of the other four sensors. Initial testing in JET A-1 aviation fuel revealed the unsuitability of silicone rubber diaphragms for prolonged usage in fuel. A second set...

  18. Abdominal Binding Improves Neuromuscular Efficiency of the Human Diaphragm during Exercise

    Directory of Open Access Journals (Sweden)

    Sara J. Abdallah

    2017-05-01

    Full Text Available We tested the hypothesis that elastic binding of the abdomen (AB would enhance neuromuscular efficiency of the human diaphragm during exercise. Twelve healthy non-obese men aged 24.8 ± 1.7 years (mean ± SE completed a symptom-limited constant-load cycle endurance exercise test at 85% of their peak incremental power output with diaphragmatic electromyography (EMGdi and respiratory pressure measurements under two randomly assigned conditions: unbound control (CTRL and AB sufficient to increase end-expiratory gastric pressure (Pga,ee by 5–8 cmH2O at rest. By design, AB increased Pga,ee by 6.6 ± 0.6 cmH2O at rest. Compared to CTRL, AB significantly increased the transdiaphragmatic pressure swing-to-EMGdi ratio by 85–95% during exercise, reflecting enhanced neuromuscular efficiency of the diaphragm. By contrast, AB had no effect on spirometric parameters at rest, exercise endurance time or an effect on cardiac, metabolic, ventilatory, breathing pattern, dynamic operating lung volume, and perceptual responses during exercise. In conclusion, AB was associated with isolated and acute improvements in neuromuscular efficiency of the diaphragm during exercise in healthy men. The implications of our results are that AB may be an effective means of enhancing neuromuscular efficiency of the diaphragm in clinical populations with diaphragmatic weakness/dysfunction.

  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. Improvement of diaphragm and limb muscle isotonic contractile performance by K+ channel blockade

    Directory of Open Access Journals (Sweden)

    Pollarine Jennifer

    2010-01-01

    Full Text Available Abstract The K+ channel blocking aminopyridines greatly improve skeletal muscle isometric contractile performance during low to intermediate stimulation frequencies, making them potentially useful as inotropic agents for functional neuromuscular stimulation applications. Most restorative applications involve muscle shortening; however, previous studies on the effects of aminopyridines have involved muscle being held at constant length. Isotonic contractions differ substantially from isometric contractions at a cellular level with regards to factors such as cross-bridge formation and energetic requirements. The present study tested effects of 3,4-diaminopyridine (DAP on isotonic contractile performance of diaphragm, extensor digitorum longus (EDL and soleus muscles from rats. During contractions elicited during 20 Hz stimulation, DAP improved work over a range of loads for all three muscles. In contrast, peak power was augmented for the diaphragm and EDL but not the soleus. Maintenance of increased work and peak power was tested during repetitive fatigue-inducing stimulation using a single load of 40% and a stimulation frequency of 20 Hz. Work and peak power of both diaphragm and EDL were augmented by DAP for considerable periods of time, whereas that of soleus muscle was not affected significantly. These results demonstrate that DAP greatly improves both work and peak power of the diaphragm and EDL muscle during isotonic contractions, which combined with previous data on isometric contractions indicates that this agent is suitable for enhancing muscle performance during a range of contractile modalities.

  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. 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

  3. 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.

  4. Recruitment and plasticity in diaphragm, intercostal, and abdominal muscles in unanesthetized rats.

    Science.gov (United States)

    Navarrete-Opazo, A; Mitchell, G S

    2014-07-15

    Although rats are a frequent model for studies of plasticity in respiratory motor control, the relative capacity of rat accessory respiratory muscles to express plasticity is not well known, particularly in unanesthetized animals. Here, we characterized external intercostal (T2, T4, T5, T6, T7, T8, T9 EIC) and abdominal muscle (external oblique and rectus abdominis) electromyogram (EMG) activity in unanesthetized rats via radiotelemetry during normoxia (Nx: 21% O2) and following acute intermittent hypoxia (AIH: 10 × 5-min, 10.5% O2; 5-min intervals). Diaphragm and T2-T5 EIC EMG activity, and ventilation were also assessed during maximal chemoreceptor stimulation ( 7% CO2, 10.5% O2) and sustained hypoxia (SH: 10.5% O2). In Nx, T2 EIC exhibits prominent inspiratory activity, whereas T4, T5, T6, and T7 EIC inspiratory activity decreases in a caudal direction. T8 and T9 EIC and abdominal muscles show only tonic or sporadic activity, without consistent respiratory activity. MCS increases diaphragm and T2 EIC EMG amplitude and tidal volume more than SH (0.94 ± 0.10 vs. 0.68 ± 0.05 ml/100 g; P muscles exhibit inspiratory activity during Nx; 2) MCS elicits greater ventilatory, diaphragm, and rostral T2-T5 EIC muscle activity vs. SH; and 3) AIH induces greater rostral EIC LTF than diaphragm LTF. Copyright © 2014 the American Physiological Society.

  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. Computation of blood flow in a diaphragm-type ventricular assist device

    Energy Technology Data Exchange (ETDEWEB)

    Doyle, M.G.; Tavoularis, S. [Univ. of Ottawa, Dept. of Mechanical Engineering, Ottawa, Ontario (Canada)]. E-mail: mdoyle@eng.uottawa,ca; Bourgault, Y. [Univ. of Ottawa, Dept. of Mechanical Engineering and Dept. of Mathematics and Statistics, Ottawa, Ontario (Canada)

    2004-07-01

    The finite element method was used to simulate blood flow in an idealized diaphragm-type ventricular assist device, taking into consideration fluid-structure interaction effects. The results of this pilot study have been partly validated versus available experimental and computational results. It is concluded that this is a feasible approach for the modelling of similar devices for design and optimization purposes. (author)

  8. Femtosecond Bessel light pulse formation by a multi-circular diaphragm

    International Nuclear Information System (INIS)

    Ushakova, E.E.; Kurilkina, S.N.

    2010-01-01

    The dynamics of the envelope of a new type of light field, a femtosecond Bessel light pulse (FBLP) formed from a Gaussian pulsed beam by means of a multi-circular diaphragm, has been investigated theoretically. It is shown that the FBLP possesses a steady structure that features a narrow central maximum and significantly suppressed subordinate maxima. (authors)

  9. The balanced two-string technique for sulcus intraocular lens implantation in the absence of capsular support.

    Science.gov (United States)

    Ibrahim, Hesham A; Sabry, Heba Nabil

    2015-01-01

    Purpose. To describe and explore an alternative approach for sulcus intraocular lens (IOL) implantation in the absence of capsular support. Methods. The commonly available one-piece poly(methyl methacrylate) (PMMA) lens is stabilized in the sulcus by two intraocular horizontal strings of 10/0 polypropylene suture passed through the lens dialing holes in opposite directions to achieve a mechanical balance. The horizontal strings of 10/0 polypropylene work as a rail track for the IOL optics, allowing some side to side lens adjustment even following wound closure. The stability of the IOL was tested in vitro. Six aphakic patients underwent in-sulcus IOL secondary implantation using the balanced two-string technique. Patients were followed up for a minimum of six months. Best spectacle corrected vision was assessed. Lens centration and lens tilt were measured by anterior segment optical coherence tomography (AS-OCT). Results. All patients had successful lens insertion. Best spectacle corrected visual acuity (BSCVA) improved in all patients. Lens decentration ranged between 0.21 mm and 0.9 mm (average 0.53 mm). Lens tilt ranged between 1.2° and 2.8° (average 2.17°). Conclusion. The mechanically balanced two-string technique is an alternative option for sulcus IOL implantation in absence of capsular support, allowing lens centration adjustment with no additional risks.

  10. The Balanced Two-String Technique for Sulcus Intraocular Lens Implantation in the Absence of Capsular Support

    Science.gov (United States)

    Ibrahim, Hesham A.; Sabry, Heba Nabil

    2015-01-01

    Purpose. To describe and explore an alternative approach for sulcus intraocular lens (IOL) implantation in the absence of capsular support. Methods. The commonly available one-piece poly(methyl methacrylate) (PMMA) lens is stabilized in the sulcus by two intraocular horizontal strings of 10/0 polypropylene suture passed through the lens dialing holes in opposite directions to achieve a mechanical balance. The horizontal strings of 10/0 polypropylene work as a rail track for the IOL optics, allowing some side to side lens adjustment even following wound closure. The stability of the IOL was tested in vitro. Six aphakic patients underwent in-sulcus IOL secondary implantation using the balanced two-string technique. Patients were followed up for a minimum of six months. Best spectacle corrected vision was assessed. Lens centration and lens tilt were measured by anterior segment optical coherence tomography (AS-OCT). Results. All patients had successful lens insertion. Best spectacle corrected visual acuity (BSCVA) improved in all patients. Lens decentration ranged between 0.21 mm and 0.9 mm (average 0.53 mm). Lens tilt ranged between 1.2° and 2.8° (average 2.17°). Conclusion. The mechanically balanced two-string technique is an alternative option for sulcus IOL implantation in absence of capsular support, allowing lens centration adjustment with no additional risks. PMID:25722884

  11. The Balanced Two-String Technique for Sulcus Intraocular Lens Implantation in the Absence of Capsular Support

    Directory of Open Access Journals (Sweden)

    Hesham A. Ibrahim

    2015-01-01

    Full Text Available Purpose. To describe and explore an alternative approach for sulcus intraocular lens (IOL implantation in the absence of capsular support. Methods. The commonly available one-piece poly(methyl methacrylate (PMMA lens is stabilized in the sulcus by two intraocular horizontal strings of 10/0 polypropylene suture passed through the lens dialing holes in opposite directions to achieve a mechanical balance. The horizontal strings of 10/0 polypropylene work as a rail track for the IOL optics, allowing some side to side lens adjustment even following wound closure. The stability of the IOL was tested in vitro. Six aphakic patients underwent in-sulcus IOL secondary implantation using the balanced two-string technique. Patients were followed up for a minimum of six months. Best spectacle corrected vision was assessed. Lens centration and lens tilt were measured by anterior segment optical coherence tomography (AS-OCT. Results. All patients had successful lens insertion. Best spectacle corrected visual acuity (BSCVA improved in all patients. Lens decentration ranged between 0.21 mm and 0.9 mm (average 0.53 mm. Lens tilt ranged between 1.2° and 2.8° (average 2.17°. Conclusion. The mechanically balanced two-string technique is an alternative option for sulcus IOL implantation in absence of capsular support, allowing lens centration adjustment with no additional risks.

  12. Analysis of diaphragm movement during tidal breathing and during its activation while breath holding using MRI synchronized with spirometry.

    Science.gov (United States)

    KOLAR, P; NEUWIRTH, J; SANDA, J; SUCHANEK, V; SVATA, Z; VOLEJNIK, J; PIVEC, M

    2009-01-01

    Using magnetic resonance imaging (MRI) in conjunction with synchronized spirometry we analyzed and compared diaphragm movement during tidal breathing and voluntary movement of the diaphragm while breath holding. Breathing cycles of 16 healthy subjects were examined using a dynamic sequence (77 slices in sagittal plane during 20 s, 1NSA, 240x256, TR4.48, TE2.24, FA90, TSE1, FOV 328). The amplitude of movement of the apex and dorsal costophrenic angle of the diaphragm were measured for two test conditions: tidal breathing and voluntary breath holding. The maximal inferior and superior positions of the diaphragm were subtracted from the corresponding positions during voluntary movements while breath holding. The average amplitude of inferio-superior movement of the diaphragm apex during tidal breathing was 27.3+/-10.2 mm (mean +/- SD), and during voluntary movement while breath holding was 32.5+/-16.2 mm. Movement of the costophrenic angle was 39+/-17.6 mm during tidal breathing and 45.5+/-21.2 mm during voluntary movement while breath holding. The inferior position of the diaphragm was lower in 11 of 16 subjects (68.75 %) and identical in 2 of 16 (12.5 %) subjects during voluntary movement compared to the breath holding. Pearson's correlation coefficient was used to demonstrate that movement of the costophrenic angle and apex of the diaphragm had a linear relationship in both examined situations (r=0.876). A correlation was found between the amplitude of diaphragm movement during tidal breathing and lung volume (r=0.876). The amplitude of movement of the diaphragm with or without breathing showed no correlation to each other (r=0.074). The movement during tidal breathing shows a correlation with the changes in lung volumes. Dynamic MRI demonstrated that individuals are capable of moving their diaphragm voluntarily, but the amplitude of movement differs from person to person. In this study, the movements of the diaphragm apex and the costophrenic angle were

  13. 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.

  14. The SNAP Strong Lens Survey

    Energy Technology Data Exchange (ETDEWEB)

    Marshall, P.

    2005-01-03

    Basic considerations of lens detection and identification indicate that a wide field survey of the types planned for weak lensing and Type Ia SNe with SNAP are close to optimal for the optical detection of strong lenses. Such a ''piggy-back'' survey might be expected even pessimistically to provide a catalogue of a few thousand new strong lenses, with the numbers dominated by systems of faint blue galaxies lensed by foreground ellipticals. After sketching out our strategy for detecting and measuring these galaxy lenses using the SNAP images, we discuss some of the scientific applications of such a large sample of gravitational lenses: in particular we comment on the partition of information between lens structure, the source population properties and cosmology. Understanding this partitioning is key to assessing strong lens cosmography's value as a cosmological probe.

  15. 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.

  16. 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.

  17. Myosin heavy chain and physiological adaptation of the rat diaphragm in elastase-induced emphysema

    Directory of Open Access Journals (Sweden)

    Stedman Hansell H

    2003-02-01

    Full Text Available Abstract Background Several physiological adaptations occur in the respiratory muscles in rodent models of elastase-induced emphysema. Although the contractile properties of the diaphragm are altered in a way that suggests expression of slower isoforms of myosin heavy chain (MHC, it has been difficult to demonstrate a shift in MHCs in an animal model that corresponds to the shift toward slower MHCs seen in human emphysema. Methods We sought to identify MHC and corresponding physiological changes in the diaphragms of rats with elastase-induced emphysema. Nine rats with emphysema and 11 control rats were studied 10 months after instillation with elastase. MHC isoform composition was determined by both reverse transcriptase polymerase chain reaction (RT-PCR and immunocytochemistry by using specific probes able to identify all known adult isoforms. Physiological adaptation was studied on diaphragm strips stimulated in vitro. Results In addition to confirming that emphysematous diaphragm has a decreased fatigability, we identified a significantly longer time-to-peak-tension (63.9 ± 2.7 ms versus 53.9 ± 2.4 ms. At both the RNA (RT-PCR and protein (immunocytochemistry levels, we found a significant decrease in the fastest, MHC isoform (IIb in emphysema. Conclusion This is the first demonstration of MHC shifts and corresponding physiological changes in the diaphragm in an animal model of emphysema. It is established that rodent emphysema, like human emphysema, does result in a physiologically significant shift toward slower diaphragmatic MHC isoforms. In the rat, this occurs at the faster end of the MHC spectrum than in humans.

  18. [Corneal protection in contact lens users].

    Science.gov (United States)

    Egorova, G B; Mitichkina, T S; Shamsudinova, A R

    2014-01-01

    To evaluate the efficacy of corneoprotective agents (Corneregel and Solcoseryl) in contact lens users. A total of 66 long-term contact lens wearers with dry eye symptoms and varying degrees of corneal epitheliopathy were monitored. All patients used artificial tears, which, however, were not effective enough to suppress manifestations of corneal epitheliopathy and to release the associated discomfort. The therapy was supplemented with Corneregel. The following examination methods were applied: biomicroscopy with fluorescent staining, Norn test, Schirmer's test, advanced tearscopy with digital image analysis of the precorneal tear film lipid layer, corneal confocal microscopy. In all cases the assessment was performed prior to starting Corneregel and repeated in 7 days, 14 days and 1 month. Complete corneal re-epithelization and restoration of the most superficial layer of the epithelium were achieved within 7-14 days. In case of severe initial epitheliopathy the effect of Corneregel was not sufficient and epithelium defects remained. These patients additionally received Solcoseryl Eye Gel. After the treatment course the condition of corneal epithelium ameliorated and contact lens wearing comfort increased. A longer precorneal tear film break-up time indicated an increase of tear film stability. The total tear production did not change significantly. The moistening effect of Corneregel and low-viscosity artificial tears together with intensive regeneration of corneal epithelium enables structural recovery of the epithelial membrane and considerable improvement of the anterior corneal stroma. At the first stage of corneoprotective treatment it is appropriate to use preservative-free artificial tears of low and high viscosity. If the effect of tear substitutive therapy is unsatisfactory it is recommended to prescribe Corneregel and Solcoseryl. The regimen is to be adjusted individually.

  19. One stage surgical treatment of aortic valve disease and aortic coarctation with aortic bypass grafting through the diaphragm and aortic valve replacement.

    Science.gov (United States)

    Yu, Zipu; Wu, Shengjun; Li, Chengchen; Zou, Yu; Ma, Liang

    2015-11-10

    To validate ascending aorta-lower abdominal aorta bypass grafting treatment for patients with descending aortic coarctation and an aortic valve disease. The three patients in whom a descending atypical aortic coarctation was associated with an aortic valve disease were treated with one stage surgical treatment with aortic bypass grafting through the diaphragm and aortic valve replacement in our heart center. Operative technique consisted of performing ascending aorta-lower abdominal aorta bypass grafting through diaphragm muscle and implementing aortic valve replacement. The mean time for extracorporeal circulation and occluding clamp of aorta was recorded. Blood pressure data for pre- and post-operation was measured in the limbs. Computer-enhanced transvenous angiograms of pre- and post-operation were applied for detection of aortic stenosis. The other adverse events were noticed in outpatient service during a follow-up period. The mean extracorporeal circulation time was 54 ± 11 min. The mean time for occluding clamp of aorta was 34 ± 6 min. An arterial pressure gradient was totally corrected after surgical treatment. Post-operation computer-enhanced transvenous angiograms showed the grafts to be open with a fluent flow. The patients had no gastrointestinal tract complications. No adverse event was noticed during a follow-up period in outpatient service. Treatment of ascending aorta-lower abdominal aorta bypass is advisable for patients with descending aortic coarctation and an aortic valve disease.

  20. Computer-aided lens assembly

    Science.gov (United States)

    Tomlinson, Richard; Alcock, Rob; Petzing, Jon; Coupland, Jeremy

    2004-01-01

    We propose a computer-aided method of lens manufacture that allows assembly, adjustment, and test phases to be run concurrently until an acceptable level of optical performance is reached. Misalignment of elements within a compound lens is determined by a comparison of the results of physical ray tracing by use of an array of Gaussian laser beams with numerically obtained geometric ray traces. An estimate of misalignment errors is made, and individual elements are adjusted in an iterative manner until performance criteria are achieved. The method is illustrated for the alignment of an air-spaced doublet.

  1. Colored Contact Lens Dangers

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    Full Text Available ... Academy Publications EyeNet Ophthalmology Ophthalmology Retina Information for: International Ophthalmologists Media Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists ...

  2. 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 ...

  3. Predicting scleral GP lens entrapped tear layer oxygen tensions.

    Science.gov (United States)

    Jaynes, Jared M; Edrington, Timothy B; Weissman, Barry A

    2015-02-01

    Over the past decade, utilization of scleral gas permeable (GP) contact lenses has steadily increased. Scleral GP lenses offer yet another option for patients suffering from visually debilitating corneal and tear conditions. Oxygen delivery to the cornea in the presence of a contact lens system continues to be a subject of interest, and scleral GP lenses are no exception. This paper utilizes an existing model based on simultaneous two lens systems (piggyback lenses) as a resistance to oxygen in series, and applies this model to scleral GP lens systems. Theoretical oxygen tensions are calculated for tear layers trapped beneath scleral contact lens systems and the anterior corneal surface with a simple single chamber corneal model using a computer software spreadsheet. Only the best case scenario for current scleral gas permeable lenses (thickness and Dk)/tear layer values allow sufficient tear layer oxygen tension (approximately 100 mmHg) to preclude corneal hypoxia. The results of the spreadsheet model suggest that clinicians would be prudent to prescribe scleral GP lenses manufactured in the highest Dk materials available and to fit without excessive corneal clearance to minimize anterior segment hypoxia. Copyright © 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  4. 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.

  5. 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.

  6. Contact-lens-related microbial keratitis: case report and review

    Directory of Open Access Journals (Sweden)

    Mark Eltis

    2011-10-01

    Full Text Available Bacterial keratitis is a serious, potentially blinding, complication most often involving overnight contact lens wear. This case report reviews the management of a patient with bacterial keratitis and discusses the etiology, differential diagnosis, classification and risk factors associated with the condition.

  7. 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

  8. Drug and Contact Lens Interactions | Muntingh | South African ...

    African Journals Online (AJOL)

    "A patient who damages or loses his or her expensive hydrophilic contact lens will be annoyed - but the complaint will be much louder if the damage is caused by drugs without appropriate warning". This opening sentence from a short article by DV Ingram from the Sussex Eye Hospital, is indicative of a potential problem for ...

  9. A microcapillary lens for X-rays

    CERN Document Server

    Dudchik, Y I

    1999-01-01

    A new design of a compound refractive lens for X-rays is proposed. The lens is made as a set of glue microlenses placed in a glass capillary. The technique of lens fabrication is described. Results of ray tracing calculations for 8 and 15 keV photons are represented.

  10. 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

  11. [Contact lens related corneal ulcers: clinical, microbiological and therapeutic features].

    Science.gov (United States)

    Benhmidoune, L; Bensemlali, A; Bouazza, M; Karami, R; El Mansouri, H; El Belhadji, M; Rachid, R; Chakib, A; Amraoui, A

    2013-09-01

    Corneal ulcers in contact lens wearers are becoming more common, and can sometimes lead to severe complications. The purpose of this study is to define the epidemiological, clinical, microbiological and therapeutic considerations of these ulcers within the above context. We conducted an uncontrolled, descriptive, retrospective study of 51 patients presenting with contact lens related corneal ulcers to the ophthalmology department of the August 20, 1953 Hospital in Casablanca between January 2009 and January 2012. The average age of our patients was 22 years, with a gender ratio of 7.5 female to male. General risk factors (diabetes and tuberculosis) were found in 17.5% of cases. The average length of hospital stay was 15 days. Of our patients, 58.8% wore cosmetic contact lenses and 41.18% wore therapeutic contact lenses. Mean duration prior to consultation was 5 days. The predominant clinical signs were eye pain and redness, with a decrease in visual acuity worse than 1/10 in 82.3% of patients. In 70.6% of cases, the ulcer was central. The average size was 4.3mm. An anterior chamber reaction was found in 47.1%. Corneal bacterial cultures were positive in 47.8%. Pathogens found were Staphylococcus aureus, Pseudomonas aeruginosa and Acanthamœba. Contact lens and solution cultures were positive in 73.6% of cases. Outcomes were favorable with local and systemic antibiotic treatment adapted to microbiological results in only 41.2% of cases. In the remaining patients, significant secondary opacities persisted. Cosmetic and therapeutic contact lens wear is a major cause of corneal ulcer. Delayed consultation results in severe sequelae with persistently decreased visual acuity. The ophthalmologist plays an important role in preventing complications of contact lens wear, through better hygiene instruction and follow-up of his or her patients. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  12. 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.

  13. Spinning pipe gas lens revisited

    CSIR Research Space (South Africa)

    Mafusire, C

    2008-01-01

    Full Text Available , there is little information on optical phase aberrations and no study to date on the propagation parameters of the laser beam, but has rather remained rooted in the domain of ray optics. Researchers revisit the spinning pipe gas lens in this paper with new...

  14. 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 ...

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    Full Text Available ... people with high myopia? Mar 29, 2017 New Technology Helps the Legally Blind Be More Independent Oct ... Multimedia Public & Patients: Contact Us About the Academy Jobs at the Academy Financial Relationships with Industry Medical ...

  16. Colored Contact Lens Dangers

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  18. Colored Contact Lens Dangers

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  19. 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 ...

  20. Colored Contact Lens Dangers

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    Full Text Available ... popping touch. But colored contact lenses are popular year-round, not just at Halloween. But few know the ... also available in Spanish . Follow The Academy Professionals: Education Guidelines News Multimedia Public & Patients: Contact Us About ...

  1. Colored Contact Lens Dangers

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    Full Text Available ... 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 Public Technicians ...

  2. Colored Contact Lens Dangers

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    Full Text Available ... Health A-Z Symptoms Glasses & Contacts Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye Health / News Halloween Hazard: The Hidden Dangers of Buying Decorative ...

  3. 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 ...

  4. 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 ...

  5. Colored Contact Lens Dangers

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    Full Text Available ... Patient Stories Español Eye Health / News Halloween Hazard: The Hidden Dangers of Buying Decorative Contact Lenses Without ... been properly fitted by an eye care professional, the lenses stuck to my eye like a suction ...

  6. 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 ...

  7. Contact Lens Risks

    Science.gov (United States)

    ... Tap and distilled water have been associated with Acanthamoeba keratitis, a corneal infection that is resistant to ... to: Advice for Patients With Soft Contact Lenses: Acanthamoeba Keratitis Infections Related to Complete® MoisturePlus Multi Purpose ...

  8. Tube entrance lens focus control

    Science.gov (United States)

    Weisser, D. C.; Fifield, L. K.; Kitchen, T. F. G.; Tunningley, T. B.; Lobanov, N. R.; Muirhead, A. G.

    2013-02-01

    The entrance of the accelerator tube in a large electrostatic accelerator imposes a strong lens that dominates the beam optics. The magnification of the lens is large because of the low injection energy, the high voltage gradient of the acceleration tube and the long distance to the terminal. In the absence of the acceleration, the magnification would produce an unacceptably large beam spot at the terminal. The tyranny of the lens is especially irksome when the accelerator is required to operate at a lower terminal voltage than the one corresponding to the nominal gradient at high voltage. One way around the difficulty, used in NEC Pelletron accelerators, is to insert a series of nylon and steel rods that short together units of the acceleration structure at the terminal leaving the ones near the entrance close to the nominal gradient for optimum transmission. This operation takes time and risks the loss of insulating gas. Another alternative used in the 25URC at Oak Ridge National Laboratory, is to focus the beam at the tube entrance, substantially diluting the effect of the entrance lens. The beam then diverges and so requires an additional lens part way to the terminal. This solution is only partially effective and still necessitates use of shorting rods for low voltage operation. The fact that these elaborate strategies are used is evidence that the alternative of lowering the injection energy as the terminal voltage is lowered imposes enough problems that it is not used in practice. We have modeled a solution that controls the voltage gradient at the tube entrance using an external power supply. This not only maintains the focusing effect of the lens but provides the opportunity to tune the beam by adjusting the entrance lens. A 150 kV power supply outside the pressure vessel feeds a controllable voltage through a high voltage feed-through to the fifth electrode of the accelerator tube. Thus 150 kV on this electrode creates the nominal gradient of 30 kV per

  9. Not only hard contact lens wear but also soft contact lens wear may be associated with blepharoptosis

    NARCIS (Netherlands)

    I. Bleyen (Isabel); C.A. Hiemstra; T. Devogelaere (Thibaut); W.A. van den Bosch (Willem); R.J. Wubbels (René J.); A.D.A. Paridaens (Dion)

    2011-01-01

    textabstractObjective: The authors attempt to establish an association between prolonged hard and soft contact lens wear and ptosis. Design: Single-center retrospective consecutive series. Participants: All patients between 18 and 50 years of age who were diagnosed with unilateral or bilateral

  10. 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.

  11. 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

  12. 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

  13. 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

  14. 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

  15. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Eye Health A-Z Symptoms Glasses & Contacts Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye ... colored contact lenses , from the U.S. Food and Drug Administration (FDA). Are the colored lenses you are ...

  16. Colored Contact Lens Dangers

    Medline Plus

    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 ...

  17. Efficient selection of a single harmonic emission using a multi-color laser field with an aperture-iris diaphragm

    Science.gov (United States)

    Wei, Pengfei; Tian, Qili; Zeng, Zhinan; Jiang, Jiaming; Miao, Jing; Zheng, Yinghui; Ge, Xiaochun; Li, Chuang; Li, Ruxin; Xu, Zhizhan

    2014-08-01

    The efficient selection of an almost pure single harmonic emission (the 14th harmonic at 57 nm) from the harmonic comb has been experimentally achieved in an argon gas cell using a multi-color laser field with an aperture-iris diaphragm. When compared with the non-diaphragm case, the purity of the selected single harmonic emission (i.e. the contrast ratio) in the case of using the aperture-iris diaphragm is dramatically increased by approximately order of magnitude. Therefore, the modification of the multi-color laser field by using such an aperture-iris diaphragm before focusing is demonstrated to be an effective way of improving the phase-matching conditions for selective enhancement of the single harmonic emission.

  18. Efficient selection of a single harmonic emission using a multi-color laser field with an aperture-iris diaphragm

    International Nuclear Information System (INIS)

    Wei, Pengfei; Tian, Qili; Zeng, Zhinan; Jiang, Jiaming; Miao, Jing; Zheng, Yinghui; Ge, Xiaochun; Li, Chuang; Li, Ruxin; Xu, Zhizhan

    2014-01-01

    The efficient selection of an almost pure single harmonic emission (the 14th harmonic at 57 nm) from the harmonic comb has been experimentally achieved in an argon gas cell using a multi-color laser field with an aperture-iris diaphragm. When compared with the non-diaphragm case, the purity of the selected single harmonic emission (i.e. the contrast ratio) in the case of using the aperture-iris diaphragm is dramatically increased by approximately order of magnitude. Therefore, the modification of the multi-color laser field by using such an aperture-iris diaphragm before focusing is demonstrated to be an effective way of improving the phase-matching conditions for selective enhancement of the single harmonic emission. (paper)

  19. Field verification for the effectiveness of continuity diaphragms for skewed continuous P/C P/S concrete girder bridges.

    Science.gov (United States)

    2009-10-01

    The research presented herein describes the field verification for the effectiveness of continuity diaphragms for : skewed continuous precast, prestressed, concrete girder bridges. The objectives of this research are (1) to perform : field load testi...

  20. 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.

  1. [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.

  2. Initial Pulmonary Respiration Causes Massive Diaphragm Damage and Hyper-CKemia in Duchenne Muscular Dystrophy Dog

    Science.gov (United States)

    Nakamura, Akinori; Kobayashi, Masanori; Kuraoka, Mutsuki; Yuasa, Katsutoshi; Yugeta, Naoko; Okada, Takashi; Takeda, Shin'ichi

    2013-01-01

    The molecular mechanism of muscle degeneration in a lethal muscle disorder Duchene muscular dystrophy (DMD) has not been fully elucidated. The dystrophic dog, a model of DMD, shows a high mortality rate with a marked increase in serum creatine kinase (CK) levels in the neonatal period. By measuring serum CK levels in cord and venous blood, we found initial pulmonary respiration resulted in massive diaphragm damage in the neonates and thereby lead to the high serum CK levels. Furthermore, molecular biological techniques revealed that osteopontin was prominently upregulated in the dystrophic diaphragm prior to the respiration, and that immediate-early genes (c-fos and egr-1) and inflammation/immune response genes (IL-6, IL-8, COX-2, and selectin E) were distinctly overexpressed after the damage by the respiration. Hence, we segregated dystrophic phases at the molecular level before and after mechanical damage. These molecules could be biomarkers of muscle damage and potential targets in pharmaceutical therapies. PMID:23851606

  3. An improved water cooled nuclear reactor with a diaphragm pressuriser for low pressures and temperatures

    International Nuclear Information System (INIS)

    Gardner, F.J.; Morris, D.J.

    1990-01-01

    A pressuriser for a water cooled reactor is described. It comprises a pressure vessel divided into a water space and a gas space by a movable diaphragm sealingly secured to the pressure vessel. The pressuriser may be arranged as an integral unit in a reactor pressure vessel. In this case, the pressure vessel is divided into an upper chamber and a lower chamber by a casing. The reactor core and primary coolant circuit are arranged in the lower chamber and the pressuriser is arranged in the upper chamber. The diaphragm may be loaded by springs and dampers to prevent its oscillation or it may be an elastic membrane. Alternatively, the pressuriser may be a unit separate from the reactor pressure vessel. (author)

  4. 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.

  5. 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.)

  6. Finite element studies of the mechanical behaviour of the diaphragm in normal and pathological cases.

    Science.gov (United States)

    Pato, M P M; Santos, N J G; Areias, P; Pires, E B; de Carvalho, M; Pinto, S; Lopes, D S

    2011-06-01

    The diaphragm is a muscular membrane separating the abdominal and thoracic cavities, and its motion is directly linked to respiration. In this study, using data from a 59-year-old female cadaver obtained from the Visible Human Project, the diaphragm is reconstructed and, from the corresponding solid object, a shell finite element mesh is generated and used in several analyses performed with the ABAQUS 6.7 software. These analyses consider the direction of the muscle fibres and the incompressibility of the tissue. The constitutive model for the isotropic strain energy as well as the passive and active strain energy stored in the fibres is adapted from Humphrey's model for cardiac muscles. Furthermore, numerical results for the diaphragmatic floor under pressure and active contraction in normal and pathological cases are presented.

  7. Retained soft contact lens masquerading as a chalazion: a case report.

    Science.gov (United States)

    Agarwal, Pankaj Kumar; Ahmed, Taha Y; Diaper, Charles J M

    2013-02-01

    A misplaced contact lens is a common ocular emergency presenting to the eye casualty. We report a case of lost soft contact lens which migrated in the lid and presented 13 years later with symptomatic eye lid swelling. Authors in the past have reported migration and subsequent retention of lost hard lenses in locations such as the superior fornix and eyelid. To the best of our knowledge, misplaced soft contact lens masquerading as a chalazion has not been reported in the literature. Consideration should be given to the possibility of a retained contact lens in a patient with a history of a lost or misplaced lens, and examination of the ocular surface with double eversion of the upper lid should be performed.

  8. Retained soft contact lens masquerading as a chalazion: A case report

    Directory of Open Access Journals (Sweden)

    Pankaj Kumar Agarwal

    2013-01-01

    Full Text Available A misplaced contact lens is a common ocular emergency presenting to the eye casualty. We report a case of lost soft contact lens which migrated in the lid and presented 13 years later with symptomatic eye lid swelling. Authors in the past have reported migration and subsequent retention of lost hard lenses in locations such as the superior fornix and eyelid. To the best of our knowledge, misplaced soft contact lens masquerading as a chalazion has not been reported in the literature. Consideration should be given to the possibility of a retained contact lens in a patient with a history of a lost or misplaced lens, and examination of the ocular surface with double eversion of the upper lid should be performed.

  9. Modern Phacoemulsification and Intraocular Lens Implantation (Refractive Lens Exchange) Is Safe and Effective in Treating High Myopia.

    Science.gov (United States)

    Srinivasan, Bhaskar; Leung, Hiu Ying; Cao, He; Liu, Shu; Chen, Lizhen; Fan, Alex Hoi

    Improved efficacy, predictability, and safety of modern phacoemulsification have resulted in cataract surgery being considered as a refractive procedure. Refractive lens exchange by definition is a surgery aimed at replacing the cataractous or clear crystalline lens with an intraocular lens (IOL) in cases of high ametropia. The excellent intraocular optics of this procedure provide a better visual outcome as compared with laser refractive surgery in high myopia. With advances in technology and IOL formulas, the predictability of refractive outcome after cataract surgery in high myopes has improved. The option of addressing presbyopia using multifocal/accommodating IOLs or monovision results in patients achieving reasonable spectacle independence. The most important concern with respect to phacoemulsification in high myopia is the risk of pseudophakic retinal detachment. High myopia is an independent risk factor for retinal detachment, and recent publications have reported a much lesser risk of retinal detachment specifically attributable to phacoemulsification in high myopes, especially if a thorough posterior segment evaluation is done and patients are followed up until development of complete posterior vitreous detachment. Refractive lens exchange is an effective and safe option to correct high myopia and can significantly improve quality of life in select patients.

  10. 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.

  11. A green method of diaphragm spring's anti-rusting with high quality and efficiency

    Science.gov (United States)

    Huang, Xinming; Hua, Wenlin

    2017-10-01

    This paper introduces a green method of diaphragm spring's anti-rusting, which is of high quality, high efficiency and low consumption. It transforms the phosphating way of anti-rusting to physical anti-rusting that directly coat anti-rusting oil on the surface of the spring, and transforms the manual-oiling or oil-immersion to fully-automatically ultrasonic oiling. Hence, this method will completely change the way of diaphgragm spring's anti-rusting.

  12. Contraceptive efficacy of a novel spermicidal microbicide used with a diaphragm: a randomized controlled trial.

    Science.gov (United States)

    Barnhart, Kurt T; Rosenberg, Michael J; MacKay, H Trent; Blithe, Diana L; Higgins, Jim; Walsh, Terri; Wan, Livia; Thomas, Michael; Creinin, Mitchell D; Westhoff, Carolyn; Schlaff, William; Archer, David F; Ayers, Charletta; Kaunitz, Andrew; Das, Sutapa; Moench, Thomas R

    2007-09-01

    Women need products that protect against both pregnancy and sexually transmitted infections, including human immunodeficiency virus (HIV). The acid buffering gel is a nondetergent spermicide that may provide this dual protection by reinforcing normal vaginal acidity to inactivate both sperm and acid-sensitive sexually transmitted pathogens. The objective of this study was to assess the gel's contraceptive effects, safety, and acceptability. We conducted a multicenter, randomized, double-masked, noninferiority study at 11 centers, comparing 621 women who used an acid buffering gel plus diaphragm with 300 women who used a nonoxynol-9 spermicide plus diaphragm for 6 months. A double-masked study extension followed 234 women for an additional 6 months of use. The 6-month pregnancy rate per hundred women was 10.1% (95% confidence interval [CI] 7.1-13.1%) for acid buffering gel and 12.3 (95% CI 7.7-16.9) for nonoxynol-9 spermicide users. The difference in rates was -2.2% with a 95% CI -7.7 to 3.3%. Consistent and correct use 6-month pregnancy rates were 4.7% for acid buffering gel and 6.1% for nonoxynol-9 spermicide users, calculated from those cycles where diary entries indicated such use. Adverse events and acceptability were similar between the two groups. Pregnancy probabilities were similar between groups participating in the 12-month study extension. An acid buffering gel used with a diaphragm is a safe, acceptable contraceptive with efficacy comparable to that of a common commercial spermicide with diaphragm. ClinicalTrials.gov, www.ClinicalTrials.gov, NCT00065858 I.

  13. Morphological, histochemical, and myosin isoform analysis of the diaphragm of adult horses, Equus caballus.

    Science.gov (United States)

    Cobb, M A; Schutt, W A; Hermanson, J W

    1994-03-01

    The horse provides an interesting model for study of the structure and function of the mammalian diaphragm. Multiple regions of diaphragm from seven adult horses were prepared for histochemistry, immunocytochemistry, myosin heavy chain electrophoresis, and native myosin electrophoresis. Two additional adults were dissected to demonstrate myofiber and central tendon morphology and stained for acetylcholinesterase to demonstrate motor endplates. All regions of the adult diaphragm were histochemically characterized by a preponderance of type I fibers with some type IIa fibers. Type IIb fibers were absent in all adult specimens. Myosin heavy chain electrophoresis supported the histochemical study: two isoform bands were present on SDS gels that comigrated at the same rate as rat type I and IIa myosin heavy chain isoforms. No isoform was determined to comigrate with rat type IIb heavy chain isoforms. Native myosin isoform analysis revealed two isoforms that comigrated with rat FM-4 and FM-3 (FM = fast myosin) and two isoforms that comigrated with rat SM-1 and SM-2 (SM = slow myosin) isoforms. In some samples, a third slow native myosin isoform was observed that comigrated at the same rate as the SM-3 of the equine biceps brachii muscle. This doublet (or "triplet") of slow isoforms is unique to some horse muscles compared with other adult animals studied. It is not known if these multiple slow native myosin isoforms confer some functional advantage to the equine muscles. The adult equine diaphragm also differs in its morphology by having a large central tendon compared to that in other mammals, and is predominantly slow in fiber type and myosin isoform composition.

  14. 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

  15. Acoustic emission (AE) health monitoring of diaphragm type couplings using neural network analysis

    Science.gov (United States)

    Godinez-Azcuaga, Valery F.; Shu, Fong; Finlayson, Richard D.; O'Donnell, Bruce

    2005-05-01

    This paper presents the latest results obtained from Acoustic Emission (AE) monitoring and detection of cracks and/or damage in diaphragm couplings, which are used in some aircraft and engine drive systems. Early detection of mechanical failure in aircraft drive train components is a key safety and economical issue with both military and civil sectors of aviation. One of these components is the diaphragm-type coupling, which has been evaluated as the ideal drive coupling for many application requirements such as high speed, high torque, and non-lubrication. Its flexible axial and angular displacement capabilities have made it indispensable for aircraft drive systems. However, diaphragm-type couplings may develop cracks during their operation. The ability to monitor, detect, identify, and isolate coupling cracks on an operational aircraft system is required in order to provide sufficient advance warning to preclude catastrophic failure. It is known that metallic structures generate characteristic Acoustic Emission (AE) during crack growth/propagation cycles. This phenomenon makes AE very attractive among various monitoring techniques for fault detection in diaphragm-type couplings. However, commercially available systems capable of automatic discrimination between signals from crack growth and normal mechanical noise are not readily available. Positive classification of signals requires experienced personnel and post-test data analysis, which tend to be a time-consuming, laborious, and expensive process. With further development of automated classifiers, AE can become a fully autonomous fault detection technique requiring no human intervention after implementation. AE has the potential to be fully integrated with automated query and response mechanisms for system/process monitoring and control.

  16. The anatomy of the thoracic duct at the level of the diaphragm: A cadaver study.

    Science.gov (United States)

    Defize, Ingmar L; Schurink, Bernadette; Weijs, Teus J; Roeling, Tom A P; Ruurda, Jelle P; van Hillegersberg, Richard; Bleys, Ronald L A W

    2018-03-03

    Injury and subsequent leakage of unrecognized thoracic duct tributaries during transthoracic esophagectomy may lead to chylothorax. Therefore, we hypothesized that thoracic duct anatomy at the diaphragm is more complex than currently recognized and aimed to provide a detailed description of the anatomy of the thoracic duct at the diaphragm. The thoracic duct and its tributaries were dissected in 7 (2 male and 5 female) embalmed human cadavers. The level of origin of the thoracic duct and the points where tributaries entered the thoracic duct were measured using landmarks easily identified during surgery: the aortic and esophageal hiatus and the arch of the azygos vein. The thoracic duct was formed in the thoracic cavity by the union of multiple abdominal tributaries in 6 cadavers. In 3 cadavers partially duplicated systems were present that communicated with interductal branches. The thoracic duct was formed by a median of 3 (IQR: 3-5) abdominal tributaries merging 8.3cm (IQR: 7.3-9.3cm) above the aortic hiatus, 1.8cm (IQR: -0.4 to 2.4cm) above the esophageal hiatus, and 12.3cm (IQR: 14.0 to -11.0cm) below the arch of the azygos vein. This study challenges the paradigm that abdominal lymphatics join in the abdomen to pass the diaphragm as a single thoracic duct. In this study, this occurred in 1/7 cadavers. Although small, the results of this series suggest that the formation of the thoracic duct above the diaphragm is more common than previously thought. This knowledge may be vital to prevent and treat post-operative chyle leakage. Copyright © 2018 Elsevier GmbH. All rights reserved.

  17. 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

  18. 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

  19. Immunoglobulin concentration in tears of contact lens wearers.

    Science.gov (United States)

    Maurya, Rajendra P; Bhushan, Prashant; Singh, Virendra P; Singh, Mahendra K; Kumar, Prakash; Bhatia, Ravindra P S; Singh, Usha

    2014-01-01

    To evaluate changes in the concentration of tear immunoglobulins in contact lens wearers. A total of 45 cases including 23 contact lens wearers (43 eyes) and 22 age and sex matched healthy controls having no ocular pathology were studied for immunoglobulins (IgA, IgG, IgM) in their tears by single radial immunodiffusion method. Most of the cases used soft (56.6%) and semi-soft gas permeable (30.4%) contact lenses. Tear IgM was detected in only 17.4% and tear IgG in 43.6% of contact lens wearers, while in controls IgG was detected in 9.1% but none of the controls had IgM. There was a significant rise in total tear IgA (13.17 ± 4.44 mg/dl) in contact lens wearer as compared to controls (8.93 ± 3.79 mg/dl). Rise of tear IgA was more in symptomatic patients (15.38 ± 5.28 mg/dl) and in those wearing hard (19.73 ± 5.43 mg/dl) and semi-soft contact lenses (13.31 ± 5.43 mg/dl). A significant increase in tear IgA was noticed in subjects wearing lenses for >3 years (15.69 ± 5.39 mg/dl). About 43.4% of lens wearers were symptomatic and 80% of their lenses showed deposits and/or haziness. All cases with IgM in tear were symptomatic. The relation of immunoglobulin concentration with increasing duration of wear and material of contact lens shows that tear immunoglobulin rise accrues due to mechanical stimulation, hence contact lenses should not be used for a long period and lenses of hard nature should be discouraged. The maintenance, cleaning and deproteinization of the lenses are of high importance to avoid immunostimulation.

  20. 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 ...

  1. Opaque contact lens color choices among women of different ethnic groups.

    Science.gov (United States)

    Gaume, Amber; Prager, Thomas C; Bergmanson, Jan P G; Quintero, Sam; Harden, John; Perrigin, Judith; Piccolo, Marc

    2003-04-01

    The opaque contact lens (OCL) market is profitable and expanding. This pilot study sought to identify OCL color preferences among women of three ethnic groups, African American (A), white (W), and Hispanic Americans (H). Sixty-three brown-eyed female subjects (19 A; 22 W; 22 H), 18 to 35 years of age, with uncorrected near visual accuity of at least 20/50 were recruited. Each subject was presented with OCLs of three different color pattern designs in each of four colors (blue, green, gray, and hazel). The subjects viewed their appearance in a mirror while wearing each lens. Once all lenses had been observed, the subjects chose their lens color preference. Using the nonparametric Kruskal-Wallis test, an ethnic preference was shown for all but the gray contact lenses. In group A 47.4% rated the hazel lens as their first choice whereas 0% chose the blue lens. In contrast, 45.5% of group C chose the blue lens over the other colors but did not favor the hazel lens, which was their first choice only 4.5% of the time. Group H demonstrated the most diversity in color preference, however, 36.4% chose green as their overall lenscolor preference. Distinct differences exist in OCL color preferences among the three ethnic groups studied. Improved understanding of this ethnic difference could increase the efficiency of the trial lens process while possibly decreasing inventory costs when one ethnic group dominates a practice patient base.

  2. Changes in types of muscle fibers induced by transcutaneous electrical stimulation of the diaphragm of rats

    Directory of Open Access Journals (Sweden)

    D. Costa

    2008-09-01

    Full Text Available The objective of the present study was to assess the effect of transcutaneous electrical diaphragmatic stimulation (TEDS on different types of diaphragm muscle fibers. Male Wistar rats (8-12 weeks old were divided into 2 experimental groups (N = 8 in each group: 1 control, 2 animals submitted to TEDS [frequency = 50 Hz; T ON/T OFF (contraction/relaxation time = 2/2 s; pulse duration = 0.4 ms, intensity = 5 mA with a 1 mA increase every 3 min for 20 min] for 7 days. After completing this treatment period, the I, IIA, IIB, and IID diaphragm muscle fibers were identified using the mATPase technique. Statistical analysis consisted of the normality, homoscedasticity and t-tests (P < 0.05. There was a 19.6% (P < 0.05 reduction in the number of type I fibers and a 49.7% increase (P < 0.05 in type IID fibers in the TEDS group compared with the control group. An important result of the present study was that electrical stimulation with surface electrodes was efficient in altering the distribution of fibers in diaphragm muscle. This therapeutic resource could be used in the treatment of respiratory muscle alterations.

  3. Incorporation of beams into bossed diaphragm for a high sensitivity and overload micro pressure sensor.

    Science.gov (United States)

    Yu, Zhongliang; Zhao, Yulong; Sun, Lu; Tian, Bian; Jiang, Zhuangde

    2013-01-01

    The paper presents a piezoresistive absolute micro pressure sensor, which is of great benefits for altitude location. In this investigation, the design, fabrication, and test of the sensor are involved. By analyzing the stress distribution of sensitive elements using finite element method, a novel structure through the introduction of sensitive beams into traditional bossed diaphragm is built up. The proposed configuration presents its advantages in terms of high sensitivity and high overload resistance compared with the conventional bossed diaphragm and flat diaphragm structures. Curve fittings of surface stress and deflection based on ANSYS simulation results are performed to establish the equations about the sensor. Nonlinear optimization by MATLAB is carried out to determine the structure dimensions. The output signals in both static and dynamic environments are evaluated. Silicon bulk micromachining technology is utilized to fabricate the sensor prototype, and the fabrication process is discussed. Experimental results demonstrate the sensor features a high sensitivity of 11.098 μV/V/Pa in the operating range of 500 Pa at room temperature, and a high overload resistance of 200 times overpressure to promise its survival under atmosphere. Due to the excellent performance above, the sensor can be applied in measuring the absolute micro pressure lower than 500 Pa.

  4. Square Diaphragm CMUT Capacitance Calculation Using a New Deflection Shape Function

    Directory of Open Access Journals (Sweden)

    Md Mosaddequr Rahman

    2011-01-01

    Full Text Available A new highly accurate closed-form capacitance calculation model has been developed to calculate the capacitance of capacitive micromachined ultrasonic transducers (CMUTs built with square diaphragms. The model has been developed by using a two-dimensional polynomial function that more accurately predicts the deflection curve of a square diaphragm deformed under the influence of a uniform external pressure and also takes account of the fringing field capacitances. The model has been verified by comparing the model-predicted deflection profiles and capacitance values with experimental results published elsewhere and finite element analysis (FEA carried out by the authors for different material properties, geometric specifications, and loading conditions. New model-calculated capacitance values are found to be in excellent agreement with published experimental results with a maximum deviation of 1.7%, and a maximum deviation of 1.5% has been observed when compared with FEA results. The model can help in improving the accuracy of the design methodology of CMUT devices and other MEMS-based capacitive type sensors built with square diaphragms.

  5. 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 .

  6. 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.

  7. Joining structure between diaphragms for reactor container and foundations for reactor

    International Nuclear Information System (INIS)

    Furukawa, Hideyasu; Maki, Yasufumi; Honma, Keiji.

    1990-01-01

    In the conventional joining structure of a diaphragm floor for a reactor container, it is necessary to join lower end steel reinforcements in the radial direction to thread couplers welded to a rim plate of foundations for the reactor main body in view of the application of steel reinforcements. However, since there are many perforations for pipelines in the vicinity thereof, this method involves a drawback. According to the method of the present invention, the rim plate recessed at the top end of the foundations for the reactor main body are removed and steel reinforcements are fixed by means of a fixing plate in the diaphragm floor, and loads caused in the joined portions are transmitted by studs disposed on a horizontal plate recessed at the top of the foundations for the reactor main body. Fixed loads of equipments and pipelines, as well as downward pressing loads upon accidents are directly transmitted as a surface pressure to the foundations for the reactor main body, while radial and tangential loads upon accidents or earthquakes are transmitted by way of the studs from the diaphragm floor to the foundations for the reactor main body and, accordingly, the amount of contraction materials can be reduced and the number of steps such as of operation can be saved. (N.H.)

  8. From Memories to Diaries: A Portrait of Hope Captured from the Lens of a Nurse Educator as a Breast Cancer Patient

    Science.gov (United States)

    de Guzman, Allan B.; dela Rosa, Praxedes SM; Catambay, Dexter Jayrald S.; Centeno, Angelica M.; Cheng, Lorenze Anthony A.; Castro, Jonathan Agustin R.

    2009-01-01

    Breast cancer is the most common malignancy affecting women worldwide. While it is true that hope influences how these victims view and live their lives, little is known as to how hope is lived and experienced by a breast cancer patient whose professional background and practice is nursing. This narrative-interpretive study purports to create a…

  9. 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...

  10. Les traumatismes du diaphragme en urgence clinique et ...

    African Journals Online (AJOL)

    La radiographie standard du thorax mettait en évidence des images digestives dans le thorax. Un drainage premier du thorax a été réalisé chez 18 patients présentant un hémothorax, un pneumothorax ou un hémo-pneumothorax. La voie d'abord de la laparotomie était médiane (n=24), sous-costale gauche (n=4) et ...

  11. 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.

  12. Power prediction for one-piece and three-piece intraocular lens implantation after cataract surgery in patients with chronic angle-closure glaucoma: a prospective, randomized clinical trial.

    Science.gov (United States)

    Rhiu, Soolienah; Lee, Eun Suk; Kim, Tae-im; Lee, Hye Sun; Kim, Chan Yun

    2012-12-01

    To assess the accuracy of intraocular lens (IOL) power prediction for cataract surgery in chronic angle-closure glaucoma (CACG) patients with different IOLs' implantation. This prospective randomized clinical trial included 45 eyes with CACG and 48 eyes with normal controls undergoing cataract surgery. In the CACG group, 23 eyes (51%) had three-piece IOL implantation and 22 eyes (49%) had one-piece IOL implantation. In the normal control group, 25 eyes (52%) had three-piece IOL implantation and 23 eyes (48%) had one-piece IOL implantation. Using the SRK/T formula, the mean difference between the predicted and actual postoperative spherical equivalent [mean absolute error (MAE)] was obtained and converted to natural logarithm (ln) for statistical analysis. The power of the implanted IOL was calculated to predict postoperative SE using three formulas: SRK II, Holladay II and Hoffer Q by post hoc analysis in each group. The predictive accuracy of each formula was analysed by comparing the lnMAE. In the one-piece IOL group, there was no difference in lnMAE between the CACG and normal control group (p = 0.314). In the three-piece IOL group, the lnMAE of the CACG group was larger than that of the normal control group (p one-piece IOL group. Implantation of one-piece IOLs provides similar power prediction accuracy comparable to normal cataract patients; this result may be explained by the IOL haptic configuration or design. © 2012 The Authors. Acta Ophthalmologica © 2012 Acta Ophthalmologica Scandinavica Foundation.

  13. 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.

  14. Lack of CFTR in skeletal muscle predisposes to muscle wasting and diaphragm muscle pump failure in cystic fibrosis mice.

    Directory of Open Access Journals (Sweden)

    Maziar Divangahi

    2009-07-01

    Full Text Available Cystic fibrosis (CF patients often have reduced mass and strength of skeletal muscles, including the diaphragm, the primary muscle of respiration. Here we show that lack of the CF transmembrane conductance regulator (CFTR plays an intrinsic role in skeletal muscle atrophy and dysfunction. In normal murine and human skeletal muscle, CFTR is expressed and co-localized with sarcoplasmic reticulum-associated proteins. CFTR-deficient myotubes exhibit augmented levels of intracellular calcium after KCl-induced depolarization, and exposure to an inflammatory milieu induces excessive NF-kB translocation and cytokine/chemokine gene upregulation. To determine the effects of an inflammatory environment in vivo, sustained pulmonary infection with Pseudomonas aeruginosa was produced, and under these conditions diaphragmatic force-generating capacity is selectively reduced in Cftr(-/- mice. This is associated with exaggerated pro-inflammatory cytokine expression as well as upregulation of the E3 ubiquitin ligases (MuRF1 and atrogin-1 involved in muscle atrophy. We conclude that an intrinsic alteration of function is linked to the absence of CFTR from skeletal muscle, leading to dysregulated calcium homeostasis, augmented inflammatory/atrophic gene expression signatures, and increased diaphragmatic weakness during pulmonary infection. These findings reveal a previously unrecognized role for CFTR in skeletal muscle function that may have major implications for the pathogenesis of cachexia and respiratory muscle pump failure in CF patients.

  15. Double-magnetic-lens beta spectrometer for measurements of nucleus excited state lifetime

    International Nuclear Information System (INIS)

    Alikov, B.A.; Lizurej, G.I.; Muminov, T.M.; Ormandzhiev, S.I.; Salikhbaev, U.S.; Usmanov, R.R.; Kholbaev, I.

    1977-01-01

    Described is a design of an installation made on the basis of a double magnetic-lens beta spectrometer intended for measurement of lifetimes of nucleus excited states by the method of e-e-delayed coincidences. A system of the Hubert conic diaphragms is used in the spectrometer, and plastic scintillation detectors and photomultipliers are used as a registering system. The experimental arrangement is considered, and the main parameters of a stabilized current rectifier, developed for the supply of the spectrometer windings are given. Also presented is the lay-out of the time spectrometer of e-e-delayed coincidences which uses units of fast spectra metric electronics and the system of amplification stabilization. Besides, analytically studied were focusing characteristics of the magnetic-lens spectrometer for the case when the magnetic field shape may be considered triangular. Using the above installation obtained was the time spectrum of delayed coincidences between conversion electrons of K241 and K104 keV in a 136 E/ r nucleus, and determined was the half-life of 104 keV state (Tsub(1/2)=0.53+-0.02 ns) which is in a good agreement with the known value of Tsub(1/2)=0.52+-0.02 ns

  16. Medical image of the week: unilateral diaphragm paralysis

    Directory of Open Access Journals (Sweden)

    Yun S

    2014-01-01

    Full Text Available No abstract available. Article truncated after 150 words. An 85 year old woman with a history of COPD presented to the emergency department (ED with shortness of breath and cyanosis of her fingers. Her symptoms have been waxing and waning since she recovered from pneumonia a year ago. A week prior to admission, she visited an outpatient clinic for worsening cough, which was treated with levofloxacin, however her shortness of breath and cyanosis persisted. O2 saturation with 4 L oxygen was 85% and CT chest without contrast showed unilateral diaphragmatic paralysis with basilar atelectasis (Figure 1. She has no history of cardiac surgery, poliomyelitis or cervical spondylosis. Also, no cervical or lung mass was found on CT scan. Her diaphragmatic paralysis is most likely secondary to phrenic nerve injury. Unilateral diaphragmatic paralysis is usually asymptomatic and does not require treatment in most of cases. However, patients with underlying lung disease can present with shortness of breath and cyanosis …

  17. Peak Skin and Eye Lens Radiation Dose From Brain Perfusion CT Based on Monte Carlo Simulation

    Science.gov (United States)

    Zhang, Di; Cagnon, Chris H.; Pablo Villablanca, J.; McCollough, Cynthia H.; Cody, Dianna D.; Stevens, Donna M.; Zankl, Maria; Demarco, John J.; Turner, Adam C.; Khatonabadi, Maryam; McNitt-Gray, Michael F.

    2014-01-01

    OBJECTIVE. The purpose of our study was to accurately estimate the radiation dose to skin and the eye lens from clinical CT brain perfusion studies, investigate how well scanner output (expressed as volume CT dose index [CTDIvol]) matches these estimated doses, and investigate the efficacy of eye lens dose reduction techniques. MATERIALS AND METHODS. Peak skin dose and eye lens dose were estimated using Monte Carlo simulation methods on a voxelized patient model and 64-MDCT scanners from four major manufacturers. A range of clinical protocols was evaluated. CTDIvol for each scanner was obtained from the scanner console. Dose reduction to the eye lens was evaluated for various gantry tilt angles as well as scan locations. RESULTS. Peak skin dose and eye lens dose ranged from 81 mGy to 348 mGy, depending on the scanner and protocol used. Peak skin dose and eye lens dose were observed to be 66–79% and 59–63%, respectively, of the CTDIvol values reported by the scanners. The eye lens dose was significantly reduced when the eye lenses were not directly irradiated. CONCLUSION. CTDIvol should not be interpreted as patient dose; this study has shown it to overestimate dose to the skin or eye lens. These results may be used to provide more accurate estimates of actual dose to ensure that protocols are operated safely below thresholds. Tilting the gantry or moving the scanning region further away from the eyes are effective for reducing lens dose in clinical practice. These actions should be considered when they are consistent with the clinical task and patient anatomy. PMID:22268186

  18. Peak skin and eye lens radiation dose from brain perfusion CT based on Monte Carlo simulation.

    Science.gov (United States)

    Zhang, Di; Cagnon, Chris H; Villablanca, J Pablo; McCollough, Cynthia H; Cody, Dianna D; Stevens, Donna M; Zankl, Maria; Demarco, John J; Turner, Adam C; Khatonabadi, Maryam; McNitt-Gray, Michael F

    2012-02-01

    The purpose of our study was to accurately estimate the radiation dose to skin and the eye lens from clinical CT brain perfusion studies, investigate how well scanner output (expressed as volume CT dose index [CTDI(vol)]) matches these estimated doses, and investigate the efficacy of eye lens dose reduction techniques. Peak skin dose and eye lens dose were estimated using Monte Carlo simulation methods on a voxelized patient model and 64-MDCT scanners from four major manufacturers. A range of clinical protocols was evaluated. CTDI(vol) for each scanner was obtained from the scanner console. Dose reduction to the eye lens was evaluated for various gantry tilt angles as well as scan locations. Peak skin dose and eye lens dose ranged from 81 mGy to 348 mGy, depending on the scanner and protocol used. Peak skin dose and eye lens dose were observed to be 66-79% and 59-63%, respectively, of the CTDI(vol) values reported by the scanners. The eye lens dose was significantly reduced when the eye lenses were not directly irradiated. CTDI(vol) should not be interpreted as patient dose; this study has shown it to overestimate dose to the skin or eye lens. These results may be used to provide more accurate estimates of actual dose to ensure that protocols are operated safely below thresholds. Tilting the gantry or moving the scanning region further away from the eyes are effective for reducing lens dose in clinical practice. These actions should be considered when they are consistent with the clinical task and patient anatomy.

  19. Retrospective analysis of surgical strategies for traumatic lens dislocation in 105 cases

    Directory of Open Access Journals (Sweden)

    Sheng-Xiang Guo

    2016-06-01

    Full Text Available AIM: To retrospectively analyze the surgical strategies and outcome of traumatic lens dislocation. METHODS: Retrospective study. Clinical data of 105 cases(105 eyesdiagnosed with traumatic lens dislocation from April to June 2014 in our hospital were recruited. According to position of dislocated lens and complicated situations, different surgical approaches were performed, including intracapsular lens extraction, phacoemulsification, vitrectomy through pars plana and lensectomy.Meanwhile, vitreo-retinal or anti-glaucoma surgeries were performed in complicated cases.Preoperative and postoperative LogMar(Logarithm of the Minimum Angle of Resolutionvisual acuity were compared by paired t-test. Perioperative complications including expulsive choroidal hemorrhages and recurrent retinal detachment were recorded and assessed. RESULTS: All 105 dislocated lenses were removed completely. Visual acuity of 91 eyes(86.7%were significantly improved postoperatively.The visual acuity of most patients was 0.1-0.3(42 eyes, 40.0%and 1 patient's visual acuity with lens subluxation reached more than 0.8 postoperatively. Expulsive choroidal hemorrhages occurred in 1 eye intraoperatively and 1 eye postoperatively. Recurrent retinal detachment was observed in 2 eyes postoperatively. CONCLUSION: According to position of the lens dislocation, personalized surgery strategy is critical for therapy of traumatic lens dislocation.Expulsive choroidal hemorrhage is one of most several complications and should be managed properly.

  20. Early ICU Standardized Rehabilitation Therapy for the Critically Injured Burn Patient

    Science.gov (United States)

    2014-10-01

    Patients were excluded if they had a prior history of MV, chest tube or thoracoabdominal surgery. Images were analyzed using Image J for diaphragm...as maximum distance between the pleural and peritoneal 165 margins of the diaphragm muscle. 35 Quadriceps thickness was measured as the maximum 166

  1. Insurgence of Fusarium keratitis associated with contact lens wear.

    Science.gov (United States)

    Alfonso, Eduardo C; Cantu-Dibildox, Jorge; Munir, Wuqaas M; Miller, Darlene; O'Brien, Terrence P; Karp, Carol L; Yoo, Sonia H; Forster, Richard K; Culbertson, William W; Donaldson, Kendall; Rodila, Jill; Lee, Yunhee

    2006-07-01

    To describe the clinical presentation and course of patients who developed keratitis due to Fusarium while wearing nontherapeutic soft contact lenses. A retrospective review of microbiologic records from January 1, 2004, through April 15, 2006, was performed, identifying all patients with corneal ulceration and a culture positive for Fusarium species. Medical records of 34 patients were reviewed for clinical characteristics, treatment regimens, and microbiologic features. The most common antimicrobial medications administered prior to Fusarium diagnosis were antibacterials in 31 of 34 patients. No distinct preponderance of any one brand of either contact lens or solution was identified. The microbiologic corneal cultures found Fusarium oxysporum in 20 cases, Fusarium solani in 3 cases, Fusarium species not further identifiable in 10 cases, and no growth in 1 case. Patients with a delayed onset of treatment had a tendency for prolonged treatment until cure. Fusarium has previously been an unusual organism in the etiology of infectious keratitis in the setting of nontherapeutic soft contact lens wear. A delay in proper diagnosis and intervention may contribute to a prolonged treatment course. The microbial spectrum of contact lens-related keratitis may be evolving with higher participation of Fusarium species compared with prior reports.

  2. Assessing Scleral Contact Lens Satisfaction in a Keratoconus Population.

    Science.gov (United States)

    Bergmanson, Jan P G; Walker, Maria K; Johnson, Leah A

    2016-08-01

    To assess perceived comfort and related experiences of adapted keratoconic scleral contact lens (17-18.2 mm) wearers with a history of wearing other contact lens modalities and to compare these subjective clinical effects with previous experiences. Twenty-four keratocones were recruited, signed an informed consent approved by the University Internal Review Board, and were asked to complete a survey and a dry eye questionnaire. Previous lens wearing experience included soft, piggy back, and hybrid lenses but predominantly was corneal gas permeable. An overwhelming majority strongly preferred the comfort and vision with the scleral contact lenses. This cohort of keratoconus patients were on average dry eye suspects according to a dry eye questionnaire but contained individuals with either normal or significantly dry eye scores. However, patients stated that they experienced less dryness with their scleral lenses, but slightly more than half of these patients experienced, at least occasionally, midday fogging. The scleral contact lenses are extremely well accepted by keratoconic patients because of comfort and vision these devices provide. For many patients, they offer further relief from dryness symptoms. However, midday fogging remains a limitation for many wearers.

  3. Modeling Corneal Oxygen with Scleral Gas Permeable Lens Wear.

    Science.gov (United States)

    Compañ, Vicente; Aguilella-Arzo, Marcel; Edrington, Timothy B; Weissman, Barry A

    2016-11-01

    The main goal of this current work is to use an updated calculation paradigm, and updated boundary conditions, to provide theoretical guidelines to assist the clinician whose goal is to improve his or her scleral gas permeable (GP) contact lens wearing patients' anterior corneal oxygen supply. Our model uses a variable value of corneal oxygen consumption developed through Monod equations that disallows negative oxygen tensions within the stroma to predict oxygen tension at the anterior corneal surface of scleral GP contact lens wearing eyes, and to describe oxygen tension and flux profiles, for various boundary conditions, through the lens, tears, and cornea. We use several updated tissue and boundary parameters in our model. Tear exchange with GP scleral lenses is considered nonexistent in this model. The majority of current scleral GP contact lenses should produce some levels of corneal hypoxia under open eye conditions. Only lenses producing the thinnest of tear vaults should result in anterior corneal surface oxygen tensions greater than a presumed critical oxygen tension of 100 mmHg. We also find that corneal oxygen tension and flux are each more sensitive to modification in tear vault than to changes in lens oxygen permeability, within the ranges of current clinical manipulation. Our study suggests that clinicians would be prudent to prescribe scleral GP lenses manufactured from higher oxygen permeability materials and especially to fit without excessive corneal clearance.

  4. SU-D-BRA-04: Improvement of Diaphragm Motion Reproducibility in MRI Using Audiovisual Biofeedback for Lung Cancer Radiotherapy.

    Science.gov (United States)

    Kim, Taeho

    2012-06-01

    Previous studies have investigated the effect of AV biofeedback on the external respiratory signal reproducibility. This is the first study investigating the effect of AV biofeedback to improve the motion reproducibility of the internal anatomy. The aim of the project is to test the hypothesis that AV biofeedback improves the diaphragm motion reproducibility. An AV biofeedback system has been employed with MRI acquisitions. The AV biofeedback system utilized (1) the external marker position on the abdomen using an RPM system (Real-time Position Management, Varian) to audio-visually guide a human subject for regular breathing and (2) a fast Gradient-Recalled-Echo (fGRE) MR pulse sequence of 3 Tesla GE MRI (GE Healthcare) to monitor the diaphragm motion (200ms). The improvement in the diaphragm motion reproducibility using the AV biofeedback system combined with MRI has been assessed in 26 studies with 13 healthy human subjects. Each subject underwent two studies for assessment of the diaphragm motion reproducibility both with AV biofeedback and without (free breathing). The second study features a reversed order of breathing conditions. The total MRI acquisitions across the 26 studies are 202 measurements including sagittal and coronal planes. Average RMSE (root mean square error) of diaphragm displacement obtained from MRI analysis has been reduced from 2.7mm of free breathing to 1.6mm of AV biofeedback breathing (p-value < 0.05). Additionally, the average RMSE of diaphragm motion period was reduced from 1.84s with free breathing to 0.34s with AV biofeedback breathing (p- value < 0.05). 22% of average displacement error was reduced using AV biofeedback in the first study, and 47% reduction in the second study. The study demonstrated the improvement in the diaphragm motion reproducibility using AV biofeedback. This system can provide clinically applicable motion management of the internal anatomy in MRI and for Image Guided Radiotherapy (IGRT). © 2012 American

  5. Intestinal ischemia-reperfusion induced diaphragm contractility dysfunction: Electrophysiological and ultrastructural study in a neonatal rat model.

    Science.gov (United States)

    Taşkınlar, Hakan; Naycı, Ali; Çömelekoğlu, Ülkü; Polat, Gürbüz; Zorludemir, Suzan; Avlan, Dinçer

    2016-03-01

    To evaluate the remote effect of intestinal ischemia reperfusion (IR) injury mediated by tumor necrosis factor alpha (TNF-α) on diaphragm contractility functions and whether administration of NAC may counteract the possible detrimental effects in an experimental neonatal rat model. 40 Wistar rat pups were randomized into four groups; ten animals in each. Intestinal ischemia was conducted by obstructing mesentery of intestines by a silk loop. In the control group; only laparotomy was performed. After 1h ischemia, reperfusion was conducted for 1h in 1h group, 24h for 24h group and 24h for 24h+NAC group but administration of NAC (150mg/kg/day) intraperitoneally twice a day was performed. Inflammatory response was evaluated by tissue TNF-α level and contractility functions by mechanic activity studies of the diaphragm. Electrophysiology of the diaphragm and the phrenic nerve was conducted to determine neuropathy or myopathy and transmission electron microscopy was performed to evaluate ultrastructural changes in the phrenic nerve. Diaphragm tissue TNF-α level significantly increased in 1h and 24h groups (P=0.004, P=0.0001; respectively). Diaphragm mechanic activation force and duration significantly decreased at 1h and 24h (P=0.004, P=0.02 and P=0.0001, P=0.0001; respectively). NAC administration significantly prevented decrease in the maximal contraction and the duration (PIntestinal IR induced elevation of TNF-α level in the diaphragm. Impairment in the diaphragm contractility and neuropathic changes in the phrenic nerve occurred even in the first hour of reperfusion. NAC administration prevented these detrimental effects. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Research on one manual zoom liquid lens

    Science.gov (United States)

    Zhao, Cunhua; Shi, Yongpeng; Li, Wenjiao; Li, Congcong

    2011-11-01

    In liquid zoom lens, the accurate fixed-focus location needs the accurate calculation of focal length. That is to say, the accurate calculation of surface curvature must be obtained. Therefore, the research of their relation in liquid zoom lens becomes extremely important which has a directly theoretical instruction for the design of liquid zoom lenses. In our paper, the relation is studied. A manual liquid lens is reported which has upper and nether components with specificaton Φ12×5mm. The zoom lens is obtained by the upper component circumvolving down into the nether components.

  7. Numerical analyses of planer plasmonic focusing lens

    Science.gov (United States)

    Chou, Yen-Yu; Lee, Yeeu-Chang

    2018-03-01

    The use of polystyrene (PS) sphere lithography has been widely applied in the fabrication of micron and nano structures, due to their low cost and ease of fabrication in large scale applications. This study evaluated the feasibility of plasmonic lens base on metal thin films with nanohole structures fabricated by using PS sphere lithography through three-dimensional (3D) finite difference time domain (FDTD) method. We calculated the intensity profile of lens with various wavelength of incident light, lens size, cutting positions, diameters of nanohole, and periods of nanohole to investigate the geometric parameters influence on the focusing properties of the plasmonic lens.

  8. Does the level of available oxygen impact comfort in contact lens wear?: A review of the literature.

    Science.gov (United States)

    Dillehay, Sally M

    2007-05-01

    Wear of low-Dk/t lenses has long been associated with signs and symptoms indicative of hypoxia and with patient symptoms of dryness and discomfort. Although patient discomfort during soft contact lens wear has been generally attributed to lens dehydration, research studies aimed at verifying that connection have been unsuccessful. With the advent of high-Dk/t silicone hydrogel lenses, not only have improvements in clinical signs of hypoxia been documented, but improvements in patient symptoms of dryness and discomfort also have been documented. This literature review was undertaken to examine historic and current literature to determine whether the level of available oxygen is associated with patient symptoms of dryness and discomfort. Literature was reviewed related to soft contact lens dehydration, corneal hypoxia, patient symptoms of dryness and discomfort, and current clinical studies of silicone hydrogel lens wear. Through the years, the body of knowledge has grown supporting a connection between decreased levels of available oxygen to the cornea caused by low-Dk/t contact lens wear and negative impacts on the signs of corneal health and patient symptoms. Available published literature suggests that many of these changes in patient signs and symptoms seen with low-Dk/t lens wear may be related to an inflammatory response. Clinical studies of high-Dk/t silicone hydrogel lenses further support a significant connection between the level of available oxygen during contact lens wear and improved patient symptoms of comfort, including dryness.

  9. Exchange of tears under a contact lens is driven by distortions of the contact lens.

    Science.gov (United States)

    Maki, Kara L; Ross, David S

    2014-12-01

    We studied the flow of the post-lens tear film under a soft contact lens to understand how the design parameters of contact lenses can affect ocular health. When a soft contact lens is inserted, the blinking eyelid causes the lens to stretch in order to conform to the shape of the eye. The deformed contact lens acts to assume its un-deformed shape and thus generates a suction pressure in the post-lens tear film. In consequence, the post-lens tear fluid moves; it responds to the suction pressure. The suction pressure may draw in fresh fluid from the edge of the lens, or it may eject fluid there, as the lens reassumes its un-deformed shape. In this article, we develop a mathematical model of the flow of the post-lens tear fluid in response to the mechanical suction pressure of a deformed contact lens. We predict the amount of exchange of fluid exchange under a contact lens and we explore the influence of the eye's shape on the rate of exchange of fluid. © The Author 2014. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology. All rights reserved. For permissions please email: journals.permissions@oup.com.

  10. [Advantage of higher oxygen transmissibility material Piggyback lens for keratoconus correction].

    Science.gov (United States)

    Xie, Pei-Ying; Chi, Hui; Yang, Li-Na

    2011-01-01

    To evaluate the oxygen transmissibility of new material Piggyback lens combined with silicone hydrogel lens and higher Dk RGPCL. To investigate the improving of visual acuity, ocular shape and comfortable, also orthokeratology results and safety of this new system for keratoconus correction. Calculating the oxygen transmission (Dk/t) of the new Piggyback system involves Ohm's Law. Compare the changes of ocular surface curves and astigmatism with or without Si-SCL fitting, RGPCL vision and Piggyback lens vision. Investigate the comfortable improving and ocular complications, and changes of corneal shape after fitted with Piggyback lens by using corneal topography. Selected silicone hydrogel lens was pure vision (B&L PV, 36% water, Dk/t 110) lens, RGPCL material was Menicon Z, Dk/t 95.9 and Boston XO, Dk/t 58.8. It was calculated to 44.4 Dk/t and 34.4 Dk/t with these two combinations. Twenty two moderate and severe keratoconus patients (28 eyes) fitted with the Piggyback lens successfully. Corneal K reading and astigmatism decreased significantly after wore the Si-SCL. Compared with RGPCL vision(4.82 ± 0.11), Piggyback lens vision (4.93 ± 0.08) was significant increased (t = -10.395, P < 0.01) 90% cases improved comfort vs prior RGPCL wear alone. Only few cases appeared slight conjunctival hyperemia and corneal staining. Corneal topography showed corneal flatter, spherical and regular reshaping results after 6 months wore the Piggyback lens. By fitting Piggyback systems using new Si-SCL and higher Dk RGPCL materials may help problematic keratoconic patients improve visual acuity, comfort and safety, increase wearing time and orthokeratology results further.

  11. Results and complications of scleral fixated (Sutured posterior chamber intraocular lens implantation

    Directory of Open Access Journals (Sweden)

    Amoozadeh J

    2001-08-01

    Full Text Available Optical rehabilitation of the patient with aphakia who cannot tolerate contact lenses present a therapeutic challenge. In the absence of capsular support, anterior chamber lenses have been widely used. On the other hand intraocular lens implantation of scleral sutured posterior chamber intraocular lens during penterating keratoplasty or insufficient iris support is recommended. The purpose of this study is to evaluate the clinical outcome and complication in 17 patients who underwent scleral-fixation of an intraocular lens.We studied prospectively the results of posterior chamber intraocular lens implantation by scleral fixation in 17 eyes of 17 patients without a complete posterior lens capsule support at farabi Eye Hospital. Uncorrected visual acuity improved from counting finger to 20/40 or better in 9 eyes (53 percent. The following complications were observed during the mean postoperative follow-up of 7.2 (range 3-12 months; increased intraocular pressure in 5 eyes, vitreous hemorrhage and icr hyphema in 2 eyes, cystoid macular edema (CME and vitritis in one eye, and endophthalmitis and retinal detachment in one eye. Posterior chamber intraocular lens implantation by scleral fixation is a relatively safe procedure and can be recommended for many patients

  12. A safe technique for in-the-bag intraocular lens implantation in pediatric cataract surgery.

    Science.gov (United States)

    Khokhar, Sudarshan; Sharma, Reetika; Patil, Bharat; Sinha, Gautam; Nayak, Bhagabat; Kinkhabwala, Ravish Akhilkumar

    2015-01-01

    To describe a safe technique for in-the-bag intraocular lens (IOL) implantation in pediatric cataract patients who undergo lens aspiration with primary posterior capsulorhexis and anterior vitrectomy. Sixty eyes of 45 consecutive patients with congenital/developmental cataract underwent lens aspiration with primary posterior continuous curvilinear capsulorhexis (PCCC) with anterior vitrectomy and in-the-bag IOL implantation using the described technique of IOL implantation using anterior capsule as support. All eyes had stable IOL at the end of surgery and none of the eyes had lens decentration/dislocation in posterior vitreous. Implantation of in-the-bag IOL is difficult in children who undergo primary PCCC with anterior vitrectomy. Our technique of implanting IOL by pushing it against the back surface of anterior capsule is a safe method and results in no complications related to faulty IOL implantation.

  13. Ectopic intraocular lens: An unusual complication of cataract surgery

    Directory of Open Access Journals (Sweden)

    Mehul A Shah

    2014-01-01

    Full Text Available We wish to report an unusual complication of intraocular lens (IOL insertion following uneventful phacoemulsification. After successful phacoemulsification surgery, a hydrophobic acrylic IOL was loaded in the injector for insertion into the capsular bag. During insertion, the IOL inadvertently extended into the corneal stromal lamella. The complication was recognized at a late stage, and the foldable acrylic lens was retrieved and reinserted correctly in the bag. The anterior chamber was made viscoelastically taut and was maintained in this state for 10 min, followed by a routine viscoelastic wash and air bubble injection. Cornea was slightly edematous with stromal haze, and the corneal thickness was 908 μm. At the 1-month follow-up visit, the patient′s vision was 20/40, the stromal haze had subsided, the corneal thickness was 572 μm, and the patient was comfortable. Though it was unknown complication, following proper management patient recovered satisfactorily.

  14. Modeling and Parameter Estimation of Spacecraft Fuel Slosh with Diaphragms Using Pendulum Analogs

    Science.gov (United States)

    Chatman, Yadira; Gangadharan, Sathya; Schlee, Keith; Ristow, James; Suderman, James; Walker, Charles; Hubert, Carl

    2007-01-01

    Prediction and control of liquid slosh in moving containers is an important consideration in the design of spacecraft and launch vehicle control systems. Even with modern computing systems, CFD type simulations are not fast enough to allow for large scale Monte Carlo analyses of spacecraft and launch vehicle dynamic behavior with slosh included. It is still desirable to use some type of simplified mechanical analog for the slosh to shorten computation time. Analytic determination of the slosh analog parameters has met with mixed success and is made even more difficult by the introduction of propellant management devices such as elastomeric diaphragms. By subjecting full-sized fuel tanks with actual flight fuel loads to motion similar to that experienced in flight and measuring the forces experienced by the tanks, these parameters can be determined experimentally. Currently, the identification of the model parameters is a laborious trial-and-error process in which the hand-derived equations of motion for the mechanical analog are evaluated and their results compared with the experimental results. This paper will describe efforts by the university component of a team comprised of NASA's Launch Services Program, Embry Riddle Aeronautical University, Southwest Research Institute and Hubert Astronautics to improve the accuracy and efficiency of modeling techniques used to predict these types of motions. Of particular interest is the effect of diaphragms and bladders on the slosh dynamics and how best to model these devices. The previous research was an effort to automate the process of slosh model parameter identification using a MATLAB/SimMechanics-based computer simulation. These results are the first step in applying the same computer estimation to a full-size tank and vehicle propulsion system. The introduction of diaphragms to this experimental set-up will aid in a better and more complete prediction of fuel slosh characteristics and behavior. Automating the

  15. 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)

  16. 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.

  17. Corrective effect of diaphragm pacing on the decrease in cardiac output induced by positive pressure mechanical ventilation in anesthetized sheep.

    Science.gov (United States)

    Masmoudi, Hicham; Persichini, Romain; Cecchini, Jérôme; Delemazure, Julie; Dres, Martin; Mayaux, Julien; Demoule, Alexandre; Assouad, Jalal; Similowski, Thomas

    2017-02-01

    Positive pressure ventilation (PPV) is a fundamental life support measure, but it decreases cardiac output (CO). Diaphragmatic contractions produce negative intrathoracic and positive abdominal pressures, promoting splanchnic venous return. We hypothesized that: 1) diaphragm pacing alone could produce adequate ventilation without decreasing CO; 2) diaphragm pacing on top of PPV could improve CO. Of 11 anesthetized and mechanically ventilated ewes (39.6±5.9kg), 3 were discarded from analysis because of hemodynamic instability during the experiment, and 8 retained for analysis. Phrenic stimulation electrodes were inserted in the diaphragm (implanted phrenic nerve stimulation, iPS). CO was measured by the thermodilution technique (pulmonary artery catheter). CO during end-expiratory apnea served as reference. Median CO was 9.77 [6.25-11.25] lmin -1 during end-expiratory apnea, 8.25 [5.06-9.25] lmin -1 during "PPV" (-15%) (pventilation was comparable to its PPV counterpart (median 92% [74-97], NS). Diaphragm pacing alone can produce adequate ventilation without reducing CO. Superimposed onto PPV, diaphragm pacing can reduce the PPV-induced decrease in CO. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. The diaphragm is better protected from oxidative stress than hindlimb skeletal muscle during CLP-induced sepsis.

    Science.gov (United States)

    Talarmin, Hélène; Derbré, Frédéric; Lefeuvre-Orfila, Luz; Léon, Karelle; Droguet, Mickaël; Pennec, Jean-Pierre; Giroux-Metgès, Marie-Agnès

    2017-09-01

    The aim of this study was to determine whether non-lethal sepsis induced by cecal ligation and puncture (CLP) modulates oxidative damage and enzymatic antioxidant defenses in diaphragm and hindlimb skeletal muscles (soleus and Extensor Digitorus Longus (EDL)). Female Wistar rats were divided into four experimental groups: (1) control animals, (2) animals sacrificed 2 hours or (3) 7 days after CLP, and (4) sham-operated animals. At the end of the experimental procedure, EDL, soleus, and diaphragm muscles were harvested and 4-hydroxynonenal (HNE)-protein adducts and protein carbonyl contents were examined in relation to superoxide dismutase and catalase expression and activities. We observed that both non-respiratory oxidative (i.e. soleus) and glycolytic skeletal muscles (i.e. EDL) are more susceptible to sepsis-induced oxidative stress than diaphragm, as attested by an increase in 4-HNE protein adducts and carbonylated proteins after 2 hours of CLP only in soleus and EDL. These differences could be explained by higher basal enzymatic antioxidant activities in diaphragm compared to hindlimb skeletal muscles. Together, these results demonstrate that diaphragm is better protected from oxidative stress than hindlimb skeletal muscles during CLP-induced sepsis.

  19. Eye lens membrane junctional microdomains: a comparison between healthy and pathological cases

    Energy Technology Data Exchange (ETDEWEB)

    Buzhynskyy, Nikolay; Scheuring, Simon [Institut Curie, Equipe Inserm Avenir, UMR168-CNRS, 26 Rue d' Ulm, 75248 Paris Cedex 05 (France); Sens, Pierre [ESPCI, CNRS-UMR 7083, 75231 Paris (France); Behar-Cohen, Francine, E-mail: simon.scheuring@curie.fr [UMRS Inserm 872, Universite Paris Descartes, Centre de Recherches des Cordeliers, 15 rue de l' Ecole de Medecine, 75270 Paris Cedex 06 (France)

    2011-08-15

    The eye lens is a transparent tissue constituted of tightly packed fiber cells. To maintain homeostasis and transparency of the lens, the circulation of water, ions and metabolites is required. Junctional microdomains connect the lens cells and ensure both tight cell-to-cell adhesion and intercellular flow of fluids through a microcirculation system. Here, we overview membrane morphology and tissue functional requirements of the mammalian lens. Atomic force microscopy (AFM) has opened up the possibility of visualizing the junctional microdomains at unprecedented submolecular resolution, revealing the supramolecular assembly of lens-specific aquaporin-0 (AQP0) and connexins (Cx). We compare the membrane protein assembly in healthy lenses with senile and diabetes-II cataract cases and novel data of the lens membranes from a congenital cataract. In the healthy case, AQP0s form characteristic square arrays confined by connexons. In the cases of senile and diabetes-II cataract patients, connexons were degraded, leading to malformation of AQP0 arrays and breakdown of the microcirculation system. In the congenital cataract, connexons are present, indicating probable non-membranous grounds for lens opacification. Further, we discuss the energetic aspects of the membrane organization in junctional microdomains. The AFM hence becomes a biomedical nano-imaging tool for the analysis of single-membrane protein supramolecular association in healthy and pathological membranes.

  20. Eye lens membrane junctional microdomains: a comparison between healthy and pathological cases

    Science.gov (United States)

    Buzhynskyy, Nikolay; Sens, Pierre; Behar-Cohen, Francine; Scheuring, Simon

    2011-08-01

    The eye lens is a transparent tissue constituted of tightly packed fiber cells. To maintain homeostasis and transparency of the lens, the circulation of water, ions and metabolites is required. Junctional microdomains connect the lens cells and ensure both tight cell-to-cell adhesion and intercellular flow of fluids through a microcirculation system. Here, we overview membrane morphology and tissue functional requirements of the mammalian lens. Atomic force microscopy (AFM) has opened up the possibility of visualizing the junctional microdomains at unprecedented submolecular resolution, revealing the supramolecular assembly of lens-specific aquaporin-0 (AQP0) and connexins (Cx). We compare the membrane protein assembly in healthy lenses with senile and diabetes-II cataract cases and novel data of the lens membranes from a congenital cataract. In the healthy case, AQP0s form characteristic square arrays confined by connexons. In the cases of senile and diabetes-II cataract patients, connexons were degraded, leading to malformation of AQP0 arrays and breakdown of the microcirculation system. In the congenital cataract, connexons are present, indicating probable non-membranous grounds for lens opacification. Further, we discuss the energetic aspects of the membrane organization in junctional microdomains. The AFM hence becomes a biomedical nano-imaging tool for the analysis of single-membrane protein supramolecular association in healthy and pathological membranes.