A remote operating slit lamp microscope system. Development and its utility in ophthalmologic examinations.

OBJECTIVES: To develop a remote-operating slit lamp microscope system (the remote slit lamp) as the core for highly specialized ophthalmology diagnoses, and to compare the utility of this system with the conventional slit lamp microscope system (the conventional slit lamp) in making a diagnosis. METHODS: The remote slit lamp system was developed. Three factors were evaluated in comparison to the conventional slit lamp. The ability to acquire skills was investigated using a task loading system among specialists and residents in ophthalmology. Participants repeated a task up to ten times and the time required for each task was analyzed. The consistency of the two systems in making a diagnosis was investigated using eyes of patients with ocular diseases as well as healthy volunteers. RESULTS: The remote slit lamp is composed of a patient's unit and ophthalmologist's unit connected by high-speed internet. The two units share images acquired by the slit lamp in addition to the images and voices of patients and ophthalmologists. Both ophthalmology specialists and residents could minimize the completion times after several trials. The remote slit lamp took more time than the conventional slit lamp. Both systems showed a high consistency in evaluations among eyes with healthy eyes or those with ocular diseases. CONCLUSIONS: The remote slit lamp has a similar diagnostic ability, but required more examination time in comparison to the conventional slit lamp. The currently developed remote slit lamp has the potential to be employed for tele-medicine purposes in the field of ophthalmology.

Troglitazone suppresses cell growth of myeloid leukemia cell lines by induction of p21WAF1/CIP1 cyclin-dependent kinase inhibitor.

In a human eosinophilic leukemia cell line, EoL-1, cell proliferation was suppressed by 2-day treatment with troglitazone. EoL-1 cells treated with troglitazone were arrested and maintained in the G0/G1 phase in the cell cycle. This suppression correlated with the up-regulation of mRNA for p21WAF1/CIP1 cyclin-dependent kinase (Cdk) inhibitor. The inhibitory effects of troglitazone on cell proliferation and expression of p21 mRNA were observed in a human myelomonocytic cell line, U937, and a human myelomonoblastic cell line, KPB-M15. In addition, in EoL-1 cells, p21 protein was induced by troglitazone treatment and the induction was inhibited by protein synthesis inhibitor, cycloheximide. These data suggest that troglitazone inhibits cell proliferation in myeloid leukemia cell lines at least in part by induction of p21 Cdk inhibitor.

Field-of-view dependence of lidar signals by use of Newtonian and Cassegrainian telescopes.

The dependence of lidar return signals on the aperture size of the field stop is examined. Observational results are presented for both Newtonian and Cassegrainian telescopes. Analytic expressions are derived for the lidar geometric form factors, in satisfactory agreement with the experiments.

Simultaneous determination of platinum(II) and palladium(II) by reversed phase high-performance liquid chromatography with spectrophotometric detection after collection on and elution from resin coated with dimethylglyoxal bis(4-phenyl-3-thisomicarbazone).

Amberlite XAD-7 resin coated with dimethylglyoxal bis(4-phenyl-3-thiosemicarbazone) (DMBS) was prepared and applied to the preconcentration of platinum(II) and palladium(II) from aqueous solution. Platinum(II) and palladium(II) were collected quantitatively on resin coated with the reagent (DMBS-XAD-7) from acidic solution in the presence of iodide ion by a bach method. The metal ions were then easily eluted from DMBS-XAD-7 as their DMBS chelates with a small volume of N,N-dimethylformamide. This collection and elution method was applied to the simultaneous determination of platinum(II) and palladium(II) by reversed-phase high-performance liquid chromatography with spectrophotometric detection using an ODS column and acetone-water as the mobile phase. The proposed method was applied to the determination of the metals in commercially available samples.

Apheresis technologies: an international perspective.

The developments in apheresis techniques and their clinical applications world-wide are technologically driven. In the past, apheresis survey statistics have high-lighted both the differences by region in clinical practice and in the types of technologies utilized. Such differences have provided a basis for the scientific and clinical assessments of these apheresis technologies and their clinical outcomes and have stimulated the marketing and business development of new technologies world-wide. A review of the regional practices and technologies utilized provides a perspective on the future role of apheresis and its developments in clinical practice. While technology is a driving force for the development of new techniques for clinical practice, it is not the only market force. For technology introduction, several other important issues need to be considered. Regulations at the local and, most importantly, the federal level impact the timing for new technology introduction. Reimbursement by healthcare payers is critically important from the initiation of the development of a technology through its clinical use. Clinical trials are critically important to show the safety and clinical- and cost-effectiveness of the technology in order for payers to provide reimbursement for its use, but these trials are sometimes long and costly. Research funding availability at the governmental and commercial levels critically impacts new technology investigation and its introduction. Apheresis technology developments offer new hopes and promises for the clinical team; however, their development, introduction, and utilization will be influenced by the prevailing market forces.

Are selective macromolecule removal plasmapheresis systems useful for autoimmune diseases or hyperlipidemia?

Although technical limitations exist with existing selective removal systems, very few products are available and no major clinical trials have demonstrated the superiority or equivalence of selective removal systems over plasma exchange. It is generally recognized that selective removal systems are preferable, and that selective macromolecule removal plasmapheresis systems are useful for autoimmune diseases or hyperlipidemia. In the treatment of a disease with a selective removal device, the disease pathogen should be identified and the efficacy of removal demonstrated. In general, for plasmapheresis applications, there is a need to better understand the pathophysiology of the disease states and to identify the pathogenic molecules. With such information, development of the optimal selective removal method will be possible. There is the need for clinical studies to compare selective removal and plasma exchange for specific disease states. Incentives for the development of improved selective removal technologies where cost effectiveness could be demonstrated should be encouraged.