Gender-based differences in the job titles and lifestyles in the cataract and refractive surgery society in Japan.

To investigate sex differences in the titles and lifestyles of Japanese ophthalmologists, we evaluated work places and private lives. Retrospective cross-sectional study. The study included 1721 members (1344 males and 377 females) of the Japanese Society of Cataract and Refractive Surgery. An online, anonymized questionnaire was distributed to the society members. The questionnaire included 40 questions to collect data on profiles, lifestyles, job title, families, spouses, children, household chores, child-rearing, and work satisfaction. In total, 219 members (144 males and 75 females; 53.4 ±â€…1.0 and 51.3 ±â€…9.9 years old, respectively) completed the questionnaire. The job title, working time, annual income, marriage rate, and the number of children significantly differed between male and female respondents. Female respondents had greater responsibilities toward house chores, child care, and nursing, whereas several male doctors had spouses who did not work or worked for shorter times, earned a lower income, and contributed greater toward family responsibilities. Female respondents changed their job titles after having children more frequently than male respondents. Both males and females had limited time available for community activities and volunteer work. There were no significant differences in daily sleep duration. Both sexes were equally satisfied with their career choice of ophthalmology; however, fewer females recommended ophthalmology as a career for students and children compared to males. There are significant sex differences among ophthalmologists in Japan in terms of family responsibilities; this topic has received insufficient attention.

Automatic Diagnosis of Diabetic Retinopathy Stage Focusing Exclusively on Retinal Hemorrhage.

Background and Objectives: The present study evaluated the detection of diabetic retinopathy (DR) using an automated fundus camera focusing exclusively on retinal hemorrhage (RH) using a deep convolutional neural network, which is a machine-learning technology. Materials and Methods: This investigation was conducted via a prospective and observational study. The study included 89 fundus ophthalmoscopy images. Seventy images passed an image quality review and were graded as showing no apparent DR (n = 51), mild nonproliferative DR (NPDR; n = 16), moderate NPDR (n = 1), severe NPDR (n = 1), and proliferative DR (n = 1) by three retinal experts according to the International Clinical Diabetic Retinopathy Severity scale. The RH numbers and areas were automatically detected and the results of two tests-the detection of mild-or-worse NPDR and the detection of moderate-or-worse NPDR-were examined. Results: The detection of mild-or-worse DR showed a sensitivity of 0.812 (95% confidence interval: 0.680-0.945), specificity of 0.888, and area under the curve (AUC) of 0.884, whereas the detection of moderate-or-worse DR showed a sensitivity of 1.0, specificity of 1.0, and AUC of 1.0. Conclusions: Automated diagnosis using artificial intelligence focusing exclusively on RH could be used to diagnose DR requiring ophthalmologist intervention.

Iatrogenic Removal of the Intima in the Middle Cerebral Artery by a Stent Retriever: A Report of Two Cases.

BACKGROUND: Mechanical thrombectomy improves functional outcomes in patients with acute ischemic stroke. However, stent retrievers have the risk of vascular damage. CASE DESCRIPTION: We present 2 cases of patients with acute internal carotid artery occlusion who experienced removal of the intima by a stent retriever. In both patients, a 6 × 30-mm Solitaire stent was fully deployed from the M2 portion and slowly withdrawn. White membranes were retrieved outside the strut in both patients. Histopathologic examination showed that one membrane consisted of thickened intima and internal elastic lamina and the other consisted of calcified intima and internal elastic lamina. One patient who suffered embolic stroke experienced recurrent infarction within 24 hours after operation, and the damaged vessel was occluded on magnetic resonance angiography 21 days after stroke. In another patient with carotid artery dissection, the damaged vessel showed asymptomatic stenosis on magnetic resonance angiography 90 days after stroke. Arteries with both atherosclerosis and vessel dissection may be vulnerable to high radial expansion force. CONCLUSIONS: Full deployment of a relatively large-sized stent into a vulnerable vessel may cause vessel dissection after removal of the intima. Appropriate material selection and treatment strategy while considering stroke etiology and the occlusion site are important to prevent vessel damage.

Psychometric properties of the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25), Japanese version.

BACKGROUND: The importance of evaluating the outcomes of health care from the standpoint of the patient is now widely recognized. The purpose of this study is to develop and test a Japanese version of the National Eye Institute Visual Function Questionnaire (NEI VFQ-25). METHODS: A Japanese version was developed with a previously standardized method. The questionnaire and optional items were completed by 245 patients with cataracts, glaucoma, or age-related macular degeneration, by 110 others before and after cataract surgery, and by a reference group (n = 31). We computed rates of missing data, measured reproducibility and internal consistency reliability, and tested for convergent and discriminant validity, concurrent validity, known-groups validity, factor structure, and responsiveness to change. RESULTS: Based on information from the participants, some items were changed to 2-step items (asking if an activity was done, and if it was done, then asking how difficult it was). The near-vision and distance-vision subscales each had 1 item that was endorsed by very few participants, so these items were replaced with items that were optional in the English version. For example, more than 60% of participants did not drive, so the driving question was excluded. Reliability and validity were adequate for all subscales except driving, ocular pain, color vision, and peripheral vision. With cataract surgery, most scores improved by at least 20 points. CONCLUSION: With minor modifications from the English version, the Japanese NEI VFQ-25 can give reliable, valid, responsive data on vision-related quality of life, for group-level comparisons or for tracking therapeutic outcomes.

Dehydrogenation versus oxygenation in two-electron and four-electron reduction of dioxygen by 9-alkyl-10-methyl-9,10-dihydroacridines catalyzed by monomeric cobalt porphyrins and cofacial dicobalt porphyrins in the presence of perchloric acid.

Dehydrogenation of 10-methyl-9,10-dihydroacridine (AcrH(2)) by dioxygen (O(2)) proceeds efficiently, accompanied by the two-electron and four-electron reduction of O(2) to produce H(2)O(2) and H(2)O, which are effectively catalyzed by monomeric cobalt porphyrins and cofacial dicobalt porphyrins in the presence of perchloric acid (HClO(4)) in acetonitrile (MeCN) and benzonitrile (PhCN), respectively. The cobalt porphyrin catalyzed two-electron reduction of O(2) also occurs efficiently by 9-alkyl-10-methyl-9,10-dihydroacridines (AcrHR; R = Me, Et, and CH(2)COOEt) to yield 9-alkyl-10-methylacridinium ion (AcrR+) and H(2)O(2). In the case of R = Bu(t) and CMe(2)COOMe, however, the catalytic two-electron and four-electron reduction of O(2) by AcrHR results in oxygenation of the alkyl group of AcrHR rather than dehydrogenation to yield 10-methylacridinium ion (AcrH+) and the oxygenated products of the alkyl groups, i.e., the corresponding hydroperoxides (ROOH) and the alcohol (ROH), respectively. The catalytic mechanisms of the dehydrogenation vs the oxygenation of AcrHR in the two-electron and four-electron reduction of O(2), catalyzed by monomeric cobalt porphyrins and cofacial dicobalt porphyrins, respectively, are discussed in relation to the C(9)-H or C(9)-C bond cleavage of AcrHR radical cations produced in the electron-transfer oxidation of AcrHR.

Corneal endothelial cell morphology in patients undergoing cataract surgery.

PURPOSE: To evaluate the effect of age, gender, axial length, and presence of type II diabetes on corneal endothelial cell morphology in patients undergoing cataract surgery. METHODS: The corneal endothelial cell morphology was investigated in 1,819 eyes of 1,394 patients before cataract surgery. The parameters examined include cell density, coefficient of variation of cell area, and percentage of hexagonal cells. The effects of age, gender, axial length, and presence of type II diabetes on these parameters were evaluated. RESULTS: The mean values in endothelial cell density, coefficient of variation of cell area, and percentage of hexagonal cells in all eyes, were 2,543 +/- 254 cells/mm2 (range, 1906-3,252), 0.64 +/- 0.10 (range, 0.34-1.00), and 37.9 +/- 7.1% (range, 17.6-61.7), respectively. Stepwise multiple regression analysis revealed that age was the only explanatory variable to be relevant to corneal endothelial cell density (R = -0.201, p < 0.0001), coefficient of variation of cell area (R = 0.066, p = 0.0046), and percentage of hexagonal cells (R = -0.086, p = 0.0002). The other variables, including gender, axial length, and presence of type II diabetes mellitus, were found to be irrelevant to any of the parameters of corneal endothelial cells. CONCLUSIONS: Age is the major relevant factor in corneal endothelial cell morphology in patients before cataract surgery.