A Novel Dual-wavelength, Dual-function Laser System for Presbyopia and Glaucoma Treatments

To update the accommodation mechanisms and propose a dual-wavelength, dual-function laser system for presbyopia and glaucoma treatments.Study Design: Laser sclera softening (LSS) for increased accommodation of presbyopic eyes.Place and Duration of Study: New Taipei City, Taiwan, between Jan., 2023 and Feb., 2023.Methodology: Accommodation gain (AG) can be improved by: (i) thermal shrinkage of the scleral stroma and ciliary body, or (ii) softening of the scleral stroma (with temperature range of 700C to 900C), such that the the lens front and back curvature change (or lens thickening), leading to the thickening of ciliary body and its apex, and the increase of the space of ciliary body and lens equation (SCL), and the length of the posterior vitreal zonules (PVZ) increases.Results: A novel dual-color laser system having wavelength A and B, acting on the front-zone and back-zone of the sclera, respectively, where laser-A has a deep thermal penetration the sclera and ciliary body (CB) (0.5 to 1.0 mm); and laser-B has a shallow penetration depth in the sclera (0.3 to 0.5 mm), based on the optical property of the sclera. Laser-A (having a wavelength about0.8 to 0.98 um) leads to thermal shrinkage of the ciliary body such that the CLS is increased for accommodation gain which is much more effective than the prior art.Conclusion: The increase of AG can be achieved by scleral softening and ciliary body shrinkage which increase the SCL. A proposed novel dual-color laser system acting on the front-zone and back-zone of the sclera, respectively, could provide higher AG than that of single wavelength, or prior arts using scleral ablation. However, further clinical studies are required to justified the proposed novel system with predicted advantages and efficacy based on the optical properties of sclera.

Accommodative Gain in Presbyopic Eye Using a New Procedure of Laser Scleral Softening (LSS): Part-II. Formulas for Volume Efficacy

Purpose: To derive and provide, for the first time, comprehensive analytic formulas for scleral softening volume efficacy (SVE) for accommodative gain (AG) via the increased space between ciliary body and lens (SCL) and mobility of the posterior vitreous zonules (PVZ).Study Design: To increase the AG of presbyopic eye by a new procedure, laser scleral softening (LSS).Place and Duration of Study: New Taipei City, Taiwan, between June 2022 and July 2022.Methodology: The SVE is calculated based on the time and spatial integral of the scleral temperature profiles, T(z,t), solutions of a heat diffusion equation. Analytic formulas for SVE is derived based on the covered area given by a triangle area. The SVE of a 3-D model is governed by the "volume" covered by the laser beam, or its spot size area, the effective penetration depth (z"), which is an increasing function of laser dose, but a decreasing function of the absorption coefficient (A), due to the Beer's law of laser intensity, I(z)=I0exp(-Az). The efficacy depth-range (dZ) and time-ranges (dT) are defined for efficient softening with T(z,t)>T*, where T* is the scleral softening threshold temperature.Results: The accommodative gain is proportional to the 3-D SVE given by: SEV(3D) = SEV(1D) x laser beam spot (2-D area) x total number of spots (N) acting on the sclera, which is proportional to the efficacy ranges dZ and dT, in which dZ is an increasing of laser irradiation time, whereas dT is a decreasing function of depth. Softening of the scleral tissue after a thermal laser leading to the increase of PVZ mobility and SCL. However, the actual relation of SVE and the PVZ and SCL changes require measured data.Conclusion: Safety and efficacy of scleral softening for presbyopia treatment depend upon the laser parameters (intensity, dose, spot size, wavelength) and the effective depths. The SVE is proportional to the efficacy depth-range (dZ) and time-range (dT), in which dZ is an increasing of laser irradiation time and dT is a decreasing function of depth. The AG is proportional to the SVE(in 3-D).

Efficacy Theory and Proposed Protocol for Presbyopia Correction using Scleral Softening by Non-invasive Infrared Diode Lasers

Purpose: To derive and provide analytic formulas and proposed protocol for accommodative gain of presbyopia eyes via laser scleral softening, which causes increased space between ciliary body and lens (SCL) and mobility of the posterior vitreal zonules (PVZ).Study Design: To increase the accommodation of presbyopia by laser scleral heating/softening.Place and Duration of Study: New Taipei City, Taiwan, between April 2022 and June 2022.Purpose: To analyze the safety and efficacy of presbyopia treatment via scleral softening.Methodology: The scleral softening efficacy is calculated based on the rate equation of scleral tissue with a rate coefficient given by an Arrhenius formula, Temperature spatial and temporal profiles are given by the numerical solutions of a heat diffusion equation with a volume heating source. Various effective depths including tissue damage depth, temperature penetration depth and conversion depth, governed by tissue absorption coefficient, light intensity and dose (or irradiation time), and the related threshold values, are introduced in replacing the conventional penetration depth based on a Beer's law.Results: Given the the temperature spatial and temporal profiles, scleral softening efficacy can be calculated. Scleral surface damage can be prevented by cooling window. The suggested protocol for scleral softening treatments include: a diode laser at about 1.45 to 1.5 祄 or about 1.86 to1.9 祄, or about 2.0 to 2.15 祄, wavelength (with absorption coefficient about 20 to 100 cm-1); laser power about 0.2 to 0.8 W per spot, having a total of 4 to 16 spots; and irradiation time of 100 to 600 ms. Results of corneal thermal shrinkage are demonstrated by the topography changes of pig eyes, in which the scleral softening does not affect the corneal shapes. The accommodative gain is proportional to the softening efficacy (Seff) of the scleral tissue after a thermal laser leading to the increase of PVZ mobility and SCL. However, the actual relation of Seff and the PVZ and SCL changes require measured data.Conclusion: Safety and efficacy of scleral softening for presbyopia treatment depend upon the laser parameters (intensity, dose, spot size, wavelength) and the effective depths. By choosing the laser treated areas, a dual function treatment using scleral softening for presbyopia, and cornea stromal shrinkage for hyperopia is proposed and demonstrated by topography of pig eyes.

Efficacy Analysis of Corneal Photo-vitrification (CPV) for Improved Vision of Age-related Macular Degeneration (AMD) Eyes

Purpose: To analyze the safety and efficacy of corneal photovitrification (CPV) for improved visions of age-related macular degeneration (AMD) eyes.Study Design: Using CPV for improved visions of AMD eyes.Place and Duration of Study: New Taipei City, Taiwan, and Austin, TX, USA; between April, 2022 and June, 2022.Methodology: The CPV efficacy is calculated based on the rate equation given by dM/dt=-k(t) M(t), where M(t) is the PCV-treated corneal stroma; and k(t) is the rate coefficient given by an Arrhenius formula, k(t) = A0 exp[?Ea/(RT(t,z)], where t and z are the laser irradiation time and depth of the cornea stroma; Ea is the activation energy and R is the gas constant. The temperature spatial and temporal profiles are given by the numerical solutions of a heat diffusion equation with a volume heating source. Various effective depths including the tissue damage depth, temperature penetration depth and conversion depth, governed by the tissue absorption coefficient, light intensity and dose (or irradiation time), and the related threshold values, are introduced in replacing the conventional penetration depth based on a Beer's law.Results: The suggested protocol for CPV treatments include: a diode laser at about 2 祄 wavelength (with absorption coefficient about 100 cm-1). The laser dose is about 25 J/cm2/spot and irradiation time of 150 ms.Conclusion: The efficacy of CPV may be predicted/calculated by our modeling based on rate equation and the corneal stroma temperature rise due to laser heating. The preferred retinal locus (PRL) movement observed post-CPV is caused mainly by neuroadaptation.

Correlation of iris collagen and in-vivo anterior segment structures in patients in different stages of chronic primary angle-closure in both eyes

Purpose: To compare the density of iris collagen and anterior segment parameters in eyes with chronic primary angle closure glaucoma (CPACG) and their fellow eyes with confirmed or suspected primary angle closure (PAC/PACS). Methods: Nineteen patients with CPACG in one eye and PAC/PACS in the fellow eye requiring trabeculectomy in the CPACG eye and iridectomy in the fellow eye were recruited. Anterior segment optical coherence tomography (AS-OCT) measurements were conducted under light and dark conditions. Iris specimens, obtained by iridectomy/trabeculectomy, were analyzed by sirius red polarization for quantifying type I/III collagen density. AS-OCT parameters and type I/III collagen densities were compared between the two eyes. Results: The iris curvatures were flatter in CPACG eyes in light and dark conditions (P < 0.05). The iris areas in light condition and iris thicknesses in dark condition were smaller in CPACG eyes (P < 0.05). The density of collagen type I in CPACG eyes was lower (P = 0.048). The light-to-dark changes in CPACG eyes and PAC/PACS eyes, respectively, were ?0.679 ± 0.701 and ?1.627 ± 0.802 mm for pupil diameters, and 0.069 ± 0.113 and 0.258 ± 0.157 mm2 for iris areas, which differed significantly (P < 0.001). With the decrease of type I collagen, anterior chamber width increased and iris areas decreased in dark condition. Conclusion: Dynamic changes in pupil diameter and iris areas differed significantly between CPACG eyes and their fellow PAC/PACS eyes. Decreased type I collagen density in iris tissue was associated with decreased iris area and increased anterior chamber width, which may contribute to disease progression.

Is endobronchial ultrasound-guided transbronchial needle aspiration with a stylet necessary for lymph node screening in lung cancer patients?

During endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), a needle is commonly used with a stylet, although recently the stylet has been omitted. This prospective study aimed to compare the quality of specimens obtained by EBUS-TBNA performed with and without a stylet. Between November 2013 and November 2014, 131 patients with lung cancer underwent EBUS-TBNA, with a total of 148 mediastinal or hilar lymph nodes sampled both with and without an inner-stylet, yielding 296 cytological specimens. Specimens were scored cytologically using five parameters: background blood or clot, amount of cellular material, degree of cellular degeneration, degree of cellular trauma, and retention of appropriate architecture. The procedure with a stylet required significantly longer operation time than without a stylet (14.5±0.8 vs 12.7±1.1 min, P<0.001). Excellent specimens were obtained in 261/296 and 260/296 samples in the procedures with and without a stylet, respectively (P=0.9), while the remaining 35 and 36 samples, respectively, were adequate. The diagnosing and staging of lung cancer using EBUS-TBNA did not differ significantly between the groups. In conclusion, specimen collection by EBUS-TBNA without a stylet is easier and faster than the procedure using a stylet and absence of a stylet did not alter specimen quality or diagnostic accuracy.

Optimization and head-to-head comparison of MISSR-PCR, ERIC-PCR, RAPD and 16S rRNA evolutionary clock for the genotyping of Vibrio cholerae isolated in China.

Purpose: To establish a new genotyping method for Vibrio cholerae and compare it with other methods. Materials and Methods: In the current study, a modified inter simple sequence repeat-polymerase chain reaction (MISSR-PCR) system was developed via several rounds of optimisation. Comparison study was then conducted between MISSR-PCR and three other methods, including enterobacterial repetitive intergenic consensus sequences-based PCR (ERIC-PCR), randomly amplified polymorphic DNA (RAPD) and 16S rRNA evolutionary clock, for the detection and genetic tracing of Vibrio cholerae isolated from seafood in China. Result: The results indicated that the MISSRPCR system could generate the highest polymorphic fingerprinting map in a single round PCR and showed the best discriminatory ability for Vibrio cholerae genotyping by clearly separating toxigenic/nontoxigenic strains, local/foreign strains, and O1/O139/non-O1/non-O139 serogroup strains, comparing to ERIC-PCR, RAPD and 16S rRNA evolutionary clock. Moreover, the MISSR-PCR is superior to previously described traditional simple sequence repeat based PCR method on genotyping by more clearly separating different clusters. Conclusion: To the best of our knowledge, this is the first head-to-head comparison of four detection and genotyping methods for Vibrio cholerae. The MISSRPCR system established here could serve as a simple, quick, reliable and cost-effective tool for the genotyping and epidemiological study.

Knowledge, attitudes and behaviours related to HIV/AIDS among female migrant workers in the restaurant industry in Guangzhou, China / Conocimientos, actitudes y comportamientos relacionados con el VIH/SIDA entre las trabajadoras emigrantes en la industria de restaurantes en Guangzhou, China

OBJECTIVE: The goal of the present study was to assess knowledge and attitudes related to HIV/AIDS among the migrant female workers in the restaurant industry in Guangzhou City, China. METHODS: We performed a questionnaire survey using a judgmental sampling method in the health examination clinic of Yuexiu District of Guangzhou during March 2011. A total of 428 participants completed and returned the questionnaires and data were analysed by descriptive statistics, t-test, one way ANOVA, and Wilcoxon test. RESULTS: Of 428 respondents, the average score of HIV/AIDS-related knowledge was 19.6 (full marks, 26). Knowledge on HIV/AIDS among respondents was classified as poor for 8.2%, fair for 42.5%, and good for 49.3%. The average score of AIDS-related attitudes of respondents was 7.2 (full marks, 10). Most of the respondents (88.8%) had relatively positive attitudes toward AIDS. Unmarried status, ages less than 30 years old and higher levels of education had higher scores of knowledge. Among the respondents who had sex experiences, 57.7% (130/225) reported that they never or only some of the time used condom. The young, unmarried women had significantly higher proportion of condom use than those above 30 years old, and/or married ones. CONCLUSIONS: Overall, a half of respondents had only moderate and low levels of awareness about HIV/AIDS knowledge, although most of them had tolerant and positive attitudes toward HIV/AIDS. In addition, a relatively lower rate of condom use was reported. The findings indicate that there exists broad space for improvement of knowledge and behaviours toward HIV/AIDS for migrant women in China.

OBJETIVO: El objetivo del presente estudio fue evaluar los conocimientos y actitudes relacionadas con el VIH/SIDA entre las trabajadoras emigrantes en la industria de restaurantes en la ciudad de Guangzhou, China. MÉTODOS: Realizamos una encuesta en forma de cuestionario utilizando un método de muestreo a juicio en la clínica de examen de salud del distrito de Yuexiu de Guangzhou en marzo de 2011. Un total de 428 participantes llenaron y entregaron los cuestionarios, y los datos fueron analizados mediante estadísticas descriptivas, prueba t, ANOVA unidireccional, y prueba de Wilcoxon. RESULTADOS: De las 428 encuestadas, la puntuación media de los conocimientos relacionados con el VIH/SIDA fue 19.6 (puntuación máxima, 26). El conocimientos sobre el VIH/SIDA entre las encuestadas fue clasificado de pobre por el 8.2 por ciento, aceptable por el 42.5%, y bueno por el 49.3%. La puntuación promedio de las actitudes relacionadas con el SIDA entre las encuestadas fue 7.2 (puntuación máxima, 10). La mayoría de las encuestadas (88.8%) tenían actitudes relativamente positivas hacia el SIDA. El estado civil de soltero, las edades menores de 30 años, y los niveles de educación más altos, estuvieron asociados con puntuaciones más altas de conocimiento. Entre las encuestadas que tenían experiencias sexuales, el 57.7% (130/225) reportó no haber usado condones nunca, o sólo algunas veces. Las mujeres jóvenes solteras hicieron un uso del condón en proporción significativamente mayor que las mujeres mayores de 30 años, y/o las casadas. CONCLUSIONES: En general, la mitad de las encuestadas tenía sólo niveles de conciencia moderados y bajos en cuanto a conocimientos de VIH/SIDA, aunque la mayoría de ellas tenía actitudes tolerantes y positivas hacia el VIH/SIDA. Además, se reportó una tasa relativamente baja de uso del condón. Los hallazgos indican que existe un amplio espacio para mejorar tanto los conocimientos como las conductas hacia el VIH/SIDA para las mujeres emigrantes en China.

A Randomized Trial of Ligustrazini Hydrochlorioi in the Treatment of Viral Encephalitis in Children.

Introduction: Chuanxiong is a herb used in traditional Chinese medicine for the Treatment of viral encephalitis. In animal studies it has shown to inhibit the synthesis and activity of Thromboxane (TXA2) and abate the imbalance between Thromboxane (TXA2) and Prostacyclin (PGI2). As a result, cerebral edema, ischemia and hypoxia could be improved. The aim of this study is to evaluate its effect in the treatment of viral encephalitis in children. Methodology: Ninety-nine patients with viral encephalitis were randomly divided into two groups. Ligustrazini Hydrochlorioi (LH) consisting of 51 cases (males 30, females 21; age 5 years and nine month±8 years and 2month) was given LH 4mg/kg per day in 100- 300mls of 10% glucose and infused intravenously over a three to four hour period, for 7 days as a course of treatment. A control groups of 48 cases(males 31, females 17; age 5 years and three month±4 years and three month) received the conventional treatment of Vitamin C(2.0-3.0g), Coenzyme A(100u) and Adenosine Triphosphate(ATP)(40mg) in 100-300 mls of 10% glucose infused intravenously daily for 7 days. Results: The total response rate in the LH group and the control group were 94.12% and 68.75% respectively (u=3.271 p<0.05). The average time to improvement was 4.29±1.41 days and 7.31±2.66 days respectively. No adverse effect was observed in both groups. Conclusion: We conclude that LH is an effective, safe and well tolerated treatment for children encephalitis.

Isolation and molecular characterization of a cax gene from Capsella bursa-pastoris

A new cation exchangers (CAXs) gene was cloned and characterized from Capsella bursa-pastoris by rapid amplification of cDNA ends (RACE). The full-length cDNA sequence of cax from C. bursa-pastoris (designated as Cbcax51) was 1754 bp containing a 1398 bp open reading frame encoding a polypeptide of 466 amino-acid residues with a calculated molecular mass of 50.5 kDa and an isoelectric point of 5.69. The predicted CbCAX51 contained an IMP dehydrogenase/GMP reductase domain, two Na+/Ca2+ exchanger protein domains. Comparative and bioinformatics analyses revealed that CbCAX51 showed extensive homology with CAX from other plant species. The expression analysis by different treatments indicated that Cbcax51 could be activated by cold triggering and was related to the cold acclimation process, but its expression is regulated negatively by drought and not affected by ABA or salt.

Espectroscopia por ressonância magnética de prótons em epilepsia mioclônica juvenil sugere o comprometimento de uma rede neuronal específica / Proton magnetic resonance spectroscopy study of juvenile myoclonic epilepsy patients suggests involvement of a specific neuronal network

OBJECTIVES: The neuroanatomical basis and the neurochemical abnormalities that underlay juvenile myoclonic epilepsy (JME) are not fully defined. While the thalamus plays a central role in synchronization of widespread regions of the cerebral cortex during a seizure, emerging evidence suggests that all cortical neurons may not be homogeneously involved. The purpose of this study was to investigate the cerebral metabolic differences between patients with JME and normal controls. METHODS: All patients had a JME diagnosis based on seizure history and semiology, EEG recording, normal magnetic resonance neuroimaging (MRI) and video-EEG. Forty JME patients (JME-P) were submitted to 1.5 T MRI proton spectroscopy (1H-MRS), multi-voxel with PRESS sequence (TR/TE = 1500/30 ms) over the following locations: prefrontal cortex (PC), frontal cortex (FC), thalamus, basal nuclei, posterior cingulate gyrus (PCG), insular, parietal and occipital cortices. We determined ratios for integral values of N-acetyl aspartate (NAA) and glutamine-glutamate (GLX) over creatine-phosphocreatine (Cr). The control group (CTL) consisted of 20 age and sex-matched healthy volunteers. RESULTS: Group analysis demonstrated a tendency for lower NAA/Cr ratio of JME-P compared to CTL predominantly on FC, PC, thalamus and occipital cortex. When compared to CTL, JME-P had a statistically significant difference in GLX/Cr on FC, PC, insula, basal nuclei, PCG and on thalamus. When evaluating the relationship among the various components of this epileptic network among JME-P, the strongest correlation occurred between thalamus and PC. Also, we found a significant negative correlation between NAA/Cr and duration of epilepsy. CONCLUSION: Reductions in NAA may represent loss or injury of neurons and/or axons, as well as metabolic dysfunction while glutamate is considered to be an excitatory neurotransmitter in the brain which is involved in the pathogenesis of epileptogenic seizures.

Concentric sclerosis: imaging diagnosis and clinical analysis of 3 cases.

Baló's Concentric sclerosis (BCS) is a rare demyelinating disease considered to be a variant of multiple sclerosis (MS). The typical magnetic resonance imaging (MRI) changes associated with BCS consist of concentric rings or onions' cross-section on T1-weighted (T1W) images. Because MRI reveals pathological changes consistent with autopsy in the focus of BCS, it plays an important role in the before-death diagnosis of BCS. We report three cases of BCS diagnosed antemortem on the basis of the typical concentric rings pattern on MRI and on the basis of clinical findings and cerebrospinal fluid (CSF) examination. BCS often occurs in the prime of life, acutely or subacutely. Then come cerebral multifocal symptoms and signs. We find that BCS is not always an acute and irreversible pathological process as described in the past.

Laparoscopic bilateral nephroureterectomy and bladder cuff excision for native renal pelvic and ureteral transitional cell carcinoma after renal transplantation.

A 37-years-old female who was suffering from end-stage renal disease for about 6 years received allograft renal transplantation 4 years ago. She has been receiving 50mg of Cyclosporin A orally daily for immuno-suppression since then. Gross haematuria was noted and computerised tomography showed native left renal pelvic and ureteral multi-focal transitional cell carcinoma with severe hydronephrosis. Laparoscopic bilateral nephroureterectomy and bladder cuff excision were performed. In the past, history of previous operation was considered a relative contraindication for laparoscopic surgery. To our knowledge, we present the first case of laparoscopic treatment for native renal pelvic and ureteral transitional cell carcinoma after renal allograft transplantation without a hand-assisted device. This case shows the feasibility of laparoscopic bilateral nephroureterectomy in patients with transplanted kidneys.

Studies on efficacy of praziquantel and mebendazole-medicated salt in treatment of Echinochasmus fujianensis infection.

The therapeutic effect of praziquantel and mebendazole-medicated salt has been studied in 109 cases with Echinochasmus fujianensis infection. These cases were randomly divided into four groups: 2 groups with a single dose of praziquantel 5 mg/kg or 2.5 mg/kg; and other 2 groups with mebendazole 800mg or 400 mg in 10d table salt. Four weeks after treatment, the egg negative conversion rates were 100%, 92.3%, 85.2% and 71.4% respectively, the egg reduction rates were 84.8-100%, and side-effects were mild. The symptoms caused by infection such as abdominal pain, diarrhea, distension and anorexia were obviously relieved. These data indicated that praziquantel is the drug of choice in the treatment of Echinochasmus fujianensis. The dosage is only 2.5 mg/kg, and its egg negative conversion rate and reduction rate reach 92.3% and 95.4%, respectively. For convenience, the dosage can be made according to their age. Children under 12 take half a tablet (100 mg), and one tablet (200 mg) for those over 12. This dosage is approximately equal to 2.5-5.0 mg/kg. Although the efficacy of mebendazole is lower than praziquantel, its egg negative conversion rate also reaches 71.4-85%. Mebendazole-medicated salt can be used for treating Echinochasmus fujianensis infection as the presence of co-infection with nematodes.

Nationwide survey of human parasite in China.

A nationwide survey of human parasites in China was conducted during 1988-1992, with a coverage of 30 provinces/autonomous regions/municipalities (P/A/M). A total of 2,848 pilot sites in 726 counties were selected by random sampling, and 1,477,742 individuals residing on were surveyed by fecal examination. The status of paragonimiasis, hydatid diseases, cysticercosis and trichinellosis were summarized through data review. The overall infection rate of intestinal parasites was 62.6% whereas at provincial level, the highest infection rate (94.7%) was recovered in Hainan, and the lowest (17.5%) in Heilong-jiang. A high proportion (43.3%) of polyparasitism among the infected population (882,080) was revealed. Altogether 56 species of parasites comprising protozoa (19), trematode (16), cestodes (8), nematodes (12) and thorny-headed worm (1) were discovered. During the survey a new species and several new records were documented. The number of the population infected with common intestinal parasites was estimated. The diversities of parasite distribution were noted in different nationalities as well as in varied occupations.