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The MAFB gene encodes an important basic leucine zipper transcription factor that functions in glomerular podocytes, macrophages, and osteoclasts. Recently, MAFB was identified as the gene that was responsible for causing nephropathy with focal segmental glomerulosclerosis (FSGS) with multicentric carpotarsal osteolysis (MCTO) or Duane retraction syndrome (DRS). Here, we describe a patient with nephropathy associated with FSGS who exhibited a novel stop-gain variant in the MAFB gene (NM_005461:c.590C>A (p.Ser197Ter)). The patient’s father exhibited proteinuria with FSGS with possible DRS, whereas the patient exhibited nephropathy with FSGS and nearly normal eye movement and hearing function, as well as intact bone structure in the extremities. Conventional oral steroids or immunosuppressive drugs have not demonstrated effectiveness for patients with nephropathy who exhibit pathogenic variants in MAFB, except for a patient with nephropathy with FSGS and MCTO who experienced attenuated proteinuria within the subnephrotic range in response to cyclosporine A (CyA) treatment for at least 4 years. Thus, we attempted administration of CyA in our patient. Unexpectedly, the patient demonstrated good and rapid responses to CyA, including a partial reduction in proteinuria from approximately 2.0 g/g Cr to proteinuria within the subnephrotic range (0.27 g/g Cr) after 13 months of observation. Our findings suggest that CyA may be a suitable treatment option for patients with nephropathy with FSGS who exhibit pathogenic MAFB variants.

Aims/Introduction The objective of the present study was to clarify the association of the type and number of first‐degree family history of diabetes (FHD) with the clinical characteristics, especially with residual β‐cell function, in type 2 diabetes patients. Materials and Methods A total of 1,131 type 2 diabetes patients were recruited and divided into four groups according to FHD information as follows: (i) patients without FHD (FHD−); (ii) those with at least one sibling who had diabetes without parental diabetes (FHD+); (iii) those with one parent (FHD++); or (iv) those with both parents (FHD+++) who had diabetes with or without a sibling with diabetes. Results The percentages of the FHD−, FHD+, FHD++ and FHD+++ groups were 49.4%, 13.4%, 34.0% and 3.2%, respectively. Patients in the FHD++ and FHD+++ groups were significantly younger at the time of diabetes diagnosis (P, In type 2 diabetes patients patients, the degree of the associations between family history of diabetes and clinical characteristics differs according to the number and the type of family history of diabetes. In particular, family history of diabetes in both parents is most strongly associated with impaired residual β‐cell function.

Background: Although lower household economic status is known to be a risk factor for obesity among school-age children, such an association among toddlers remains unclear. The present study investigated the association between household economic status and obesity in toddlers. Design: We conducted a cross-sectional study of children aged 4 years attending daycare centers in Japan. Information on subjective household economic status [“affluent”, “neither”, “less affluent”, or “non-affluent”] was collected via questionnaire from the children’s guardians in 2015. Based on measured values of height and weight, obesity was defined using the International Obesity Task Force cut-offs of overweight (BMI ≥17.47 for boys and ≥17.19 for girls). We used the logistic regression model to investigate the association between household economic status and obesity. Results: Among 1,848 respondents, the prevalence of obesity was 6.8%. Non-affluent household economic status was associated with a significantly higher probability of obesity in toddlers; the multivariate adjusted odds ratio for “non-affluent” households was 2.31 (95% confidence interval, 1.23–4.33) compared with “affluent” households. Conclusion: Perception of non-affluent economic status by the guardian was associated with a higher probability of toddler obesity. This result suggests that non-affluent household economic status is associated with obesity in toddlers.

BackgroundMild cognitive impairment (MCI) is a high-risk condition for conversion to dementias, including Alzheimer's disease (AD) dementia. However, individuals with MCI show heterogeneity in patterns of pathology, and MCI does not always convert to AD dementia. Detailed subtyping of MCI and accurate prediction of the patients in whom MCI will convert to AD dementia may support new trial designs and enable evaluation of the efficacy of drugs within small numbers of patients during clinical trials. MethodsWe constructed a decision tree model by the heterogeneous mixture learning (HML) method, integrating cerebrospinal fluid (CSF) biomarker data, structural MRI data, APOE genotype data, and a recorded age at examination. The decision tree model was applied to predict conversion to AD dementia and to identify subtypes of MCI. After the test performances of HML models were assessed, MCI subjects were classified into some subtypes based on a decision tree. Then, we characterized each MCI subtype in terms of the degree of CSF biomarker abnormalities and brain atrophy, declines of cognitive functions, and gene expression alterations derived from peripheral blood samples.ResultsWe identified five subtypes of MCI using the HML approach and categorized them into three groups: those similar to CN subjects with low conversion rates; those with intermediate conversion rates; and those similar to patients with AD with high conversion rates. Furthermore, the subtypes with intermediate conversion rates were separated into the subtype with CSF biomarker abnormalities or the subtype with brain atrophy. The results from the CSF inflammation marker and gene expression analysis suggested the occurrence of aberrant inflammatory immune responses in the CSF and blood of the subjects in the subtypes with CSF biomarker abnormalities. ConclusionThe subtypes that were identified in this study exhibited varying conversion rates to AD as well as differing levels of biological features. Focusing on specific subtypes in which conversion to AD can be predicted with the most accuracy could enable more efficient clinical trials to be conducted.

Terahertz absorption spectroscopy was employed to measure the ground state pure rotational transitions of the water isotopologue HD 18 O . A total of 105 pure rotational transitions were observed in the 0.5–5.0 THz region with ∼ 100 kHz accuracy for the first time. The observed positions were fit to experimental accuracy using the Euler series expansion of the asymmetric-top Hamiltonian together with the literature Microwave, Far-IR and IR data in the ground state and ν 2 . The new measurements and predictions reported here support the analysis of astronomical observations by high-resolution spectroscopic telescopes such as SOFIA and ALMA where laboratory rest frequencies with uncertainties of 1 MHz or less are required for proper analysis of velocity resolved astrophysical data.

Background Epidural anesthesia is widely used for postoperative analgesia and rarely causes permanent neurological complications. We report a case of paraplegia following abdominal surgery under combined epidural/general anesthesia. Case presentation A 75-year-old woman underwent a scheduled abdominal total hysterectomy and bilateral salpingo-oophorectomy for suspected endometrial cancer. In the operating room, an epidural catheter was inserted at T11/12 while the patient was conscious. The needle entered smoothly, with no observed bleeding, paresthesia, or pain, and general anesthesia was induced. During surgery, 4 mL of 0.25% levobupivacaine and 0.1 mg of fentanyl were administered via the epidural catheter, and a solution of 2.5 μg/mL fentanyl and 0.2% levobupivacaine was continuously infused at 4 mL/h for postoperative analgesia. The patient promptly regained consciousness and could move her bilateral lower extremities without difficulty upon leaving the operating room. During the first postoperative night, she complained of an absence of sensation and weakness in the lower extremities. By the morning of the second postoperative day, she had developed paralysis and sensory losses associated with touch, temperature, pinprick, and vibration below T5. The epidural infusion was stopped. Magnetic resonance imaging (MRI) revealed a hyperintense area of the thoracic cord from T8 to T11, and spinal cord infarction was suspected. Ossification of the yellow spinal ligaments between T11 and T12, resulting in thoracic canal stenosis and thoracic spinal cord compression, were observed. Notably, the epidural catheter was inserted at the same site where the thoracic canal stenosis was present. Conclusions Permanent neurological complications of epidural anesthesia are rare. Studies of neurological complications after epidural/spinal anesthesia have noted the possibility of spinal anomalies, such as lumbar stenosis, in relation to neurological complications after epidural/spinal anesthesia. In this case, the onset of spinal cord infarction may have occurred coincidentally with catheter insertion into the site of existing spinal stenosis. Therefore, it is important to evaluate lower extremity symptoms and consider spinal disease before administering epidural anesthesia. Spinal cord infarction may be prevented by preoperatively identifying spinal lesions using computed tomography or MRI in cases of suspected spinal disease.

Background Medullary cystic kidney disease Type 1 is an autosomal dominant tubulointerstitial kidney disease (ADTKD). Recently, mucin 1 (MUC1) was identified as a causal gene of medullary cystic kidney disease (ADTKD-MUC1). However, the MUC1 mutation was found to be a single cytosine insertion in a single copy of the GC-rich variable number of tandem repeats (VNTRs), which are very difficult to analyze by next-generation sequencing. To date, other mutations have not been detected in ADTKD-MUC1, and the mutant MUC1 protein has not been analyzed because of the difficulty of genetically modifying the VNTR sequence. Methods We conducted whole-exome analyses of an ADTKD family by next-generation sequencing. We also performed histopathological analyses of a renal biopsy from a pedigree family member. We constructed a mutant protein expression vector based on the patient genome sequence and characterized the nature of the mutant protein. Results We found a novel frameshift mutation before the VNTR in the MUC1 gene. The resulting mutant MUC1 protein had a very similar amino acid sequence and predicted 3D structure to the previously reported mutant protein. Notably, the recombinant mutant MUC1 protein was trapped in the cytoplasm and appeared to self-aggregate. The patient native mutant protein was also found in urine exosomes. Conclusions This novel frameshift mutation in the MUC1 gene and consequent mutant protein may contribute to the future discovery of the pathophysiology of ADTKD-MUC1. The mutant MUC1 protein in urine exosomes may be used for non-DNA-related diagnosis.

We have demonstrated spectroscopy of Ca, Rb, In, K, Ga, and Yb atomic lines in 398–423 nm. Using an etalon of an ultralow-expansion coefficient, we have determined ratios of the resonance frequencies of these atoms. The etalon has small group-delay-dispersion mirrors to be an accurate frequency reference over a wavelength span of a few tens of nanometer. The etalon resonance frequencies are calibrated with accurately known transition frequencies of Ca at 423 nm and Rb at 422 nm. Based on this calibration, the absolute frequencies are also determined for some atomic lines with smaller uncertainties than earlier reports.

Patients with severe neurological disorders often require enteral nutrition (EN). Since long-term EN can cause multiple complications, reinstating the oral intake of food is beneficial. Olfactory stimulation using black pepper oil (BPO), a strong appetite stimulant, was reported to facilitate swallowing in older people. Therefore, the effects of olfactory stimulation with BPO were investigated in pediatric patients receiving long-term EN due to neurological disorders. The effects of scenting with BPO for 1 min immediately before every meal were evaluated in ten patients: 4 boys and 6 girls, aged 19-97 months (51 +/- 26 months). The neurological disorders included periventricular leukomalacia (3 patients), hypoxic ischemic encephalopathy (3), Costello syndrome (1), Russell-Silver syndrome (1), Miller-Dieker syndrome (1), and cerebral palsy of unknown etiology (1). In eight of these patients, BPO intervention was continued for 3 months. Five of these eight patients showed increases in the amount of oral intake with desirable effects including facilitated swallowing movement, although complete elimination of the need for EN was not achieved. In the other three patients, BPO intervention was not effective; severe cerebral tissue loss, profound malformation or intractable seizures seemed to reduce the efficacy of BPO. In two cases, BPO intervention was discontinued due to cough or because the odor of BPO was unbearable to the family. In conclusion, olfactory stimulation with BPO facilitated oral intake in a subset of patients on long-term EN. BPO stimulation may be useful for facilitating oral intake when used in combination with conventional methods.

Tsubouchi Shoyo (1859–1935) was a teacher of English and drama at Tokyo Senmon Gakko and subsequently, in 1928, translated the complete works of Shakespeare into Japanese for the first time. He was also a stage director who attempted to produce Shakespeare. Around 1920, he wrote an essay in which he recollected Shakespearean productions by two foreign travelling companies, the Miln Company (1891) and the Allan Wilkie Company (1912). Tsubouchi regarded the Miln Company productions as more “authentic” than those of the Allan Wilkie Company, because Miln's productions followed the “old-style productions of Shakespearean plays”. On the other hand he considered Wilkie's direction as “in his own style and petty”. My purpose in this essay is to ask where Tsubouchi's notion of “authenticity” came from. What was his definition of “old-style Shakespearean productions”?

We consider an M/G/1-type, two-phase queueing system, in which the two phases in series are attended alternatively and exhaustively by a moving single-server according to a batch-service in the first phase and an individual service in the second phase. We show that the two-phase queueing system reduces to a new type of single-vacation model with non-exhaustive service. Using a double transform for the joint distribution of the queue length in each phase and the remaining service time, we derive Laplace-Stieltjes transforms for the sojourn time in each phase and the total sojourn time in the system. Furthermore, we provide the moment formula of sojourn times and numerical examples of an approximate density function of the total sojourn time.

Purpose: To perform quantitative three-dimensional analysis of changes of idiopathic full-thickness stage 3 macular holes following vitrectomy and gas tamponade using confocal scanning laser tomography to study the mechanism of repairing the holes and to correlate with visual recovery. Methods: We studied 44 patients, 10 men and 34 women, aged between 40 and 76 years (mean 65.5 years) with stage 3 macular holes with symptoms of 1–4 months’ duration (mean 2.7 months). Using the Heidelberg Retina Tomograph, we measured the macular area within 1 week before surgery (3.5±1.6 days), and between 2 and 4 weeks (2.4±0.6 weeks) and at least 3 months (3.8±0.8 months) after surgery.Results: All 44 eyes showed closure of the holes and flattening of cuff and retinal striae after vitrec- tomy and gas tamponade. All the eyes showed small flat depressions that corresponded to each macular hole with the area of 0.027–0.184 mm2 (0.110±0.042 mm2). Thirty-nine (89%) of 44 eyes showed large concave depressions that appeared to correspond to the preoperative retinal striae, with areas of 0.844 to 5.563 mm2 (3.688±1.263 mm2). The areas of the postoperative small depressions and large depressions were significantly correlated with the area, volume, and depth of the macular holes and the area of the cuff and retinal striae prior to treatment. Postoperative visual acuity showed significant correlations with the areas of the postoperative small depressions and large depressions. Conclusions: Confocal scanning laser tomography is potentially useful as a noninvasive diagnostic technique for quantitative measurements of changes of macular holes by vitrectomy and gas tamponade. Post-operative small depressions corresponding to the healed macular holes appeared to be caused by gliosis involving sealing of the holes. The large depressions and their concave shape may result from postoperative changes of the retina, including swelling of ganglion cells and loss of outer and inner segments of photoreceptor cells in regions of preoperative cuff and retinal striae.

AIM To determine the mechanical effects of pilocarpine on the trabecular-iris angle opening in eyes with narrow angles, compared with its effects on healthy control subjects with wide angles. METHODS A narrow angle was defined as 25° or less of trabecular-iris angle on ultrasound biomicroscopic examination. The change in anterior chamber depth (ACD), trabecular-iris angle (TIA), angle opening distance (AOD, distance between trabecular meshwork and iris) measured at 250 μm and 500 μm from the scleral spur (AOD250 and AOD500), and iris thickness was determined in 30 eyes of 30 patients (13 men and 17 women, between 63 and 82 years (mean 70.4 years)) with narrow angles and in 30 sex and age matched control subjects with wide angles before and 1 hour after the instillation of 2% pilocarpine hydrochloride by ultrasound biomicroscopy. RESULTS In all eyes with narrow angles, pilocarpine increased the TIA, AOD250, and AOD500; these changes increased significantly and linearly as the corresponding pretreatment values decreased ( r = 0.807, p = 0.0001; r = 0.787, p = 0.0001; r = 0.852, p = 0.0001). Of 30 eyes with wide angles, 23 eyes whose ACD was 2670 μm and more showed a decrease in the TIA, AOD250, and AOD500; the changes in TIA, AOD250, and AOD500 also significantly correlated with the corresponding pretreatment values ( r = 0.913, p = 0.0001; r = 0.882, p = 0.0001; r = 0.895, p = 0.0001). Pilocarpine induced a smaller decrease in ACD in eyes with narrow angles than in those with wide angles (p = 0.0001). There was a linear correlation between the increase in ACD change and the decrease in pretreatment ACD in eyes with narrow angles and those with wide angles ( r = 0.781, p = 0.0003; r = 0.798, p = 0.0001). CONCLUSIONS The finding that pilocarpine increases angular width in patients with narrow angles indicates that this agent is useful for treating patients with narrow angles and angle closure glaucoma. The prediction of the pilocarpine induced change in the angle may assist ophthalmologists in treating such patients.

To establish normative values for the anterior segment in normal infants and children in relation to age.Anterior segments were measured in 46 normal infants and children (21 males and 25 females, aged from 1 to 60 months (mean 17.09 (SD 16.99) months)), by use of ultrasound biomicroscopy.Anterior chamber depth, trabecular-iris angle, angle opening (trabecular-iris) distances at 250 and 500 microm from the scleral spur, and the thickness of the thickest part of the iris were 1724-3473 microm (2505 (SD 480) microm), 15.35-44.79 degrees (28.74 (7.46) degrees ), 116-367 microm (247.4 (65.9) microm), 166-509 microm (349.5 (87.1) microm), and 249-579 microm (434.6 (74.6) microm), respectively. All factors in this study showed a significant correlation with logarithm of age (r = 0.937, p = 0. 0001; r = 0.867, p = 0.0001; r = 0.929, p = 0.0001; r = 0.917, p = 0. 0001; r = 0.748, p = 0.0001), and significantly correlated with each other.Ultrasound biomicroscopy is a powerful tool for obtaining precise images and measurement of the development of the anterior segment in infants and children. Normative values were established for anterior segment dimensions in relation to age. Anterior chamber depth, trabecular-iris angle, angle opening distances at 250 and 500 microm from the scleral spur, and iris thickness showed linear increases in relation to logarithm of age.

Objectives. We investigated the relationship between the stage of diabetic retinopathy and pulse wave velocity (PWV).Methods. This was a cross-sectional study of 689 patients (406 men and 283 women) with type 2 diabetes who were admitted to our hospital from 2004 to 2007. Brachial-ankle pulse wave velocity (baPWV) was measured by an arterial pressure measurement device as PWV/ABI. Diagnosis of diabetic retinopathy was made by ophthalmologists based on the Davis classification: no diabetic retinopathy (NDR), simple retinopathy (SDR), pre-proliferative retinopathy (pre-PDR), and proliferative retinopathy (PDR).Results. There was a significant difference in PWV between patients without diabetic retinopathy (1657.0±417.9 m/s (mean ± SD)) and with diabetic retinopathy (1847.1±423.9 m/s) (P<0.001). In addition, the stage of diabetic retinopathy was associated with aortic PWV (1657.0±417.9 m/s in NDR (n=420),1819.4±430.3 m/s in SDR (n=152),1862.1±394.0 m/s in pre-PDR (n=54), and1901.1±433.5 m/s in PDR (n=63) (P<0.001)).Conclusions. In patients with diabetic retinopathy, even in those with SDR, PWV was higher than that in patients without diabetic retinopathy. Physicians should therefore pay attention to the value of PWV and macroangiopathy regardless of the stage of diabetic retinopathy.

Users often use modified maps on Web pages for acquiring information such as sightseeing information and places to go for the first time. However, people cannot visualize the appearance of the station exit and the surrounding buildings. Therefore, we propose a system for transforming modified maps into streaming video based on the features of modified maps. Our system performs analysis of the modified maps and transforms them into streaming video. In this analysis, the system determines the type of modified maps by extracting semantic relations and positional relations among geographical objects on them. In this transformation, the system shows the streaming video by letting film syntax apply to street view based on the type of modified maps. Additionally, we experimented with analyzing the modified maps.

Purpose To compare the intraocular pressure lowering effect of adjustable sutures and laser suture lysis for trabeculectomy in eyes with primary open angle glaucoma. Methods Fifty patients with primary open angle glaucoma were studied. Eyes were assigned randomly to either trabeculectomy augmented with mitomycin C with adjustable sutures or with laser suture lysis. Patients were followed up for 12 months and success rate based on intraocular pressure was compared. Adjustable sutures were carried out as reported by Wells et al. Results Mean baseline intraocular pressure was 27.8±2.8 mm Hg in the adjustable suture group and 27.3±2.9 mm Hg in the laser suture lysis group (P=0.7). Mean postoperative intraocular pressure was 12.1±2.0 mm Hg at 3 months, 12.7±3.2 mm Hg at 6 months, and 12.9±3.4 mm Hg at 12 months in the adjustable suture group and 12.1±2.6 mm Hg at 3 months, 13.1±4.7 mm Hg at 6 months, and 13.4±3.5 mm Hg at 12 months in the laser suture lysis group. There was no significant difference in the mean intraocular pressure between the groups at any time point. At 12 months, 24 patients (96%) in the adjustable suture group and 23 patients (92%) in the laser suture lysis group achieved an intraocular pressure of ≥20 mm Hg without medication and a minimum of 30 percent reduction (P=0.7). Significant anterior chamber reduction was found in no patient (0%) in the adjustable suture group and 6 patients (24%) in the laser suture lysis group after loosening of the adjustable sutures or laser suture lysis. Conclusions There was no significant difference in hypotensive efficacy between adjustable suture group and laser suture lysis group. The use of adjustable sutures may reduce the incidence of shallow anterior chamber and hypotony after postoperative intraocular pressure lowering procedures.

PURPOSE To study any correlation between a short-term change in conjunctival hyperemia severity and the intraocular pressure-lowering effect induced by latanoprost. PATIENTS AND METHODS A 114 patients (56 females and 58 males) with open-angle glaucoma or ocular hypertension were studied. Their mean age was 60.9±15.0 years (range, 25 to 87 y). The primary outcome measure was the change in conjunctival hyperemia grade at 2 days and the change in intraocular pressure at 6 months after the start of latanoprost administration. RESULTS Mean intraocular pressure before and 6 months after latanoprost administration was 22.5±3.8 mm Hg and 16.5±2.9 mm Hg, respectively (P

Due to the rapid advance of mobile devices and on-line global map services, way-finding in outdoor environments is becoming much easier and comfortable. However, some people are still complaining to navigation systems for their poor guidance. In the infancy of such systems, many navigation systems had weak points with some reasons such as i) lack of map data enough to guide routes precisely, ii) no other way than the shortest path route search method, and iii) no consecutive map update. However, present mobile navigation systems have conquered those problems; we can now access to on-line map, which are continuously updating, over high-speed mobile networks and can be supported by much smarter route search functions. However, there is still an unclear point about why we get lost with the powerful navigation systems: someone is still confused and struggling in their route searches. In our research, instead of exploring further navigational functions, we will focus on the human ability about map reading and understanding. Actually, in our experiment based on iPhone with navigation software, we could clarify the problems and the reasons from the different map-reading abilities by people.

Purpose To compare the intraocular pressure (IOP)–lowering effect of combined viscocanalostomy and phacoemulsification and combined trabeculectomy and phacoemulsification with mitomycin C in eyes with primary open-angle glaucoma. Design Prospective randomized 1-year trial. Participants Forty consecutive patients (40 eyes) with primary open-angle glaucoma and cataract. Intervention Eyes were assigned randomly either to trabeculectomy with mitomycin C or to viscocanalostomy in combination with phacoemulsification and intraocular lens implantation. Main Outcome Measures Success rate based on IOP. Results Mean baseline IOP was 24.0±2.0 mmHg in the viscocanalostomy group and 23.7±2.6 mmHg in the trabeculectomy group ( P = 0.7). Mean postoperative IOP was 13.7±2.2 mmHg at 3 months, 14.8±3.3 mmHg at 6 months, and 14.9±3.0 mmHg at 12 months in the viscocanalostomy group and 12.1±4.0 mmHg at 3 months, 13.8±4.7 mmHg at 6 months, and 14.1±4.4 mmHg at 12 months in the trabeculectomy group. There was no significant difference in the mean IOP between the groups at any time. At 12 months, 17 patients (85%) in the viscocanalostomy group and 16 patients (80%) in the trabeculectomy group achieved an IOP of 20 mmHg or less without medication ( P = 0.7). Complications included 2 cases (10%) of flat/shallow anterior chamber and 4 cases (20%) of hypotony in the trabeculectomy group, whereas intraoperative microperforation of Descemet's membrane occurred in 3 cases (15%) in the viscocanalostomy group. Conclusions There was no significant difference in IOP reduction between viscocanalostomy and trabeculectomy with mitomycin C in combination with phacoemulsification and intraocular lens implantation in patients with primary open-angle glaucoma.

PURPOSE To evaluate the ocular hypotensive response of bunazosin hydrochloride 0.01% administered as adjunctive therapy in patients with glaucoma who were already receiving latanoprost 0.005% or timolol 0.5%. METHODS Patients with primary open angle glaucoma who had received latanoprost (n = 60) or timolol (n = 60) for 6 months or longer were enrolled and prospectively randomized to receive additional administration of bunazosin or placebo. One hundred twenty eyes of 120 patients were thus divided into 4 subgroups of 30 patients each. Bunazosin was administered twice daily, and timolol or latanoprost was administered per label. The patients were followed up for 3 months. Responders were defined as having a reduction in intraocular pressure of greater than 2 mm Hg from baseline. RESULTS Mean baseline intraocular pressure was 22.3 +/- 3.0 mm Hg in the bunazosin subgroup and 22.3 +/- 3.1 mm Hg in the placebo subgroup of the latanoprost arm, and 22.5 +/- 3.5 mm Hg in the bunazosin subgroup and 22.3 +/- 3.0 mm Hg in the placebo subgroup of the timolol arm. In the bunazosin subgroups of both arms, intraocular pressure was significantly reduced compared with baseline measurements (P < 0.05) with mean intraocular pressure measurement reductions of 2.1 +/- 2.4 mm Hg and 2.8 +/- 2.1 mm Hg in the latanoprost arm and 2.6 +/- 2.1 mm Hg and 2.8 +/- 2.1 mm Hg in the timolol arm at 6 and 12 weeks after the start of the follow-up, respectively. In the latanoprost group, bunazosin provided a further reduction of intraocular pressure (7.7%) at 12 weeks from that initially obtained at 2 weeks (P = 0.0377). In the placebo subgroups of the latanoprost and timolol arms, no significant change was found between at baseline and at any visit after the start of the follow-up. In the latanoprost and timolol arms, there was a significant difference in intraocular pressure and its change between the bunazosin subgroup and placebo subgroup at any visit after 4 weeks from the start of the follow-up (P < 0.01). CONCLUSION Bunazosin hydrochloride 0.01% may provide an additional intraocular pressure reduction in patients already receiving latanoprost or timolol. Since adding bunazosin to eyes treated with latanoprost caused a relatively small hypotensive response at 2 weeks and provided a further reduction from 2 weeks to 12 weeks, longer than 4 weeks may be required to evaluate a clinically meaningful response to treatment. Further investigation on more cases and longer follow-up are needed.

We consider an M/G/1 queue with time-limited service and two types of vacations, in whichever single server serves customers until the timer expires or the queue becomes empty, whichever occurs first, and then takes type 1 or type 2 vacations. A type 1 vacation is taken at a timer expiration, while a type 2 vacation in the every case of system emptiness. The customer that had its service interrupted due to the timer expiration may be attended by the nonpreemptive discipline. Applying the analysis results to the time-limited service polling system, we derive an approximate probability density function for evaluating the system delay variance, and formulate an optimal assignment problem of the total time of limited service-periods.

PURPOSE To compare the intraocular pressure-lowering effect of unoprostone isopropyl (unoprostone) 0.12% and latanoprost 0.005%. A correlation between the intraocular pressure-lowering effect of unoprostone and latanoprost was also evaluated. METHODS A single-masked randomized study included 18 patients between 49 and 68 years (mean, 60.7 +/- 5.1 years) with an intraocular pressure of both eyes from 21 to 27 mm Hg. The patients were prospectively randomized to receive latanoprost in the right eye and unoprostone in the left eye, or unoprostone in the right eye and latanoprost in the left eye. The patients were followed up for 8 weeks. This study evaluated the intraocular pressure-lowering effect and incidence of drug-related side effects. RESULTS Mean baseline intraocular pressure was 22.8 +/- 1.2 mm Hg in latanoprost-treated eyes and 22.4 +/- 1.0 mm Hg in unoprostone-treated eyes; there was no statistically significant difference between these groups. Mean intraocular pressure at 8 weeks after the start of the administration was 16.7 +/- 2.0 mm Hg in latanoprost-treated eyes and 19.0 +/- 1.5 mm Hg in unoprostone-treated eyes. Patients in the latanoprost-treated group showed a greater intraocular pressure reduction compared with those in the unoprostone-treated group. Mean intraocular pressure changes in latanoprost-treated eyes were significantly greater at every visit (P < 0.0001). A change of intraocular pressure at 8 weeks in the latanoprost-treated eyes was significantly correlated with that in the contralateral unoprostone-treated eyes (r = 0.665, P = 0.0013) (Figure). There was no significant difference in the rate of ocular side effects between latanoprost- and unoprostone-treated eyes. CONCLUSIONS Latanoprost appears to have a more beneficial effect for intraocular pressure control compared with unoprostone. An intraocular pressure reduction in the latanoprost-treated eyes was significantly correlated with that in the contralateral unoprostone-treated eyes. There was no significant difference in the incidence of ocular side effects between both drugs. Further investigation using more cases and longer follow-up periods are needed.

Aminoacetonitrile, CH2NH2CN, has been considered one of the important precursors of glycine, the simplest amino acid, and was identified in Sgr B2(N) by Belloche et al. based on their reanalysis of previous laboratory measurements. However, these laboratory measurements were limited to the 1 mm wavelength region even for the normal species, and recent new radio telescopes like ALMA require rest frequencies in a higher frequency range. Therefore, we have extended the pure rotational spectra of aminoacetonitrile and its amino-hydrogen-deuterated isotopologues (NHDCH2CN and ND2CH2CN) up to 1.2 THz and 0.6 THz, respectively. Belloche et al. indicated that the normal species may have been misassigned in a previous microwave study by Bogey et al. We found that two more b-type spectral transitions were misassigned, and all b-type transition frequencies above Ka = 2 had to be remeasured. For isotopologues, spectra above 40 GHz were observed for the first time and higher order centrifugal distortion constants have been determined. The extension of the measurements helped improve the molecular constants. The errors in the frequency catalog data of normal and deuterated isotopologues are on the order of 100 kHz up to 1.2 THz and 0.6 THz, respectively, which are precise enough for the future astronomical observations.

PURPOSE: To study results of 2-year follow-up of radiotherapy for subfoveal choroidal neovascular membrane associated with age-related macular degeneration. METHODS: In a randomized prospective clinical study, 101 patients received a low-dose radiotherapy or no treatment. In the treatment group, subfoveal choroidal neovascular membranes were treated with 20 Gy of 6-MV photons to the macula of the affected eye. RESULTS: The overall complete follow-up rate was 84.2% (85/101). No measurable treatment-related morbidity was seen during or after treatment. Mean changes in log of minimal angle of resolution (logMAR) of visual acuity and area of choroidal neovascular membrane for 2-year follow-up were +0.226 ± 0.373 and 143.5 ± 53.1% in the treatment group, and +0.563 ± 0.370 and 190.3 ± 81.4% in the control group; a significant difference was found ( P P = .0008). In patients with smaller choroidal neovascular membrane (≤1.5 mm 2 ) or better visual acuity (≥60/200) at baseline, the treatment group showed a significantly smaller increase in area of choroidal neovascular membrane and a significantly smaller decrease in LogMAR visual acuity for 2 years, whereas there was no significant difference in patients with larger choroidal neovascular membrane (>1.5 mm 2 ) or poorer visual acuity ( CONCLUSIONS: Radiotherapy appeared to have a favorable treatment effect in eyes with subfoveal neovascular membrane associated with AMD. Favorable factors for radiotherapy were a smaller area of choroidal neovascular membrane and better visual acuity.

PURPOSE: To evaluate the long-term safety and efficacy, in a large series of patients, of polyacrylic intraocular lens implants 1 and 3 years after surgery, compared with polymethylmethacrylate intraocular lens implants. METHODS: This was a randomized, prospective study of 1,514 eyes of 1,202 patients that were examined for a 1-year follow-up study and 1,264 eyes of 990 patients that were examined for a 3-year follow-up study. All the patients were prospectively randomized to receive a polyacrylic or polymethylmethacrylate intraocular lens implant. A standardized surgical protocol was performed using a phacoemulsification technique and capsulorhexis. Any surgical complications were excluded, and all patients had standard postoperative medication and follow-up. Postoperative measurements included spectacle-corrected visual acuity, occurrence of postoperative sight-threatening or lens-related complications, and adverse reactions. Results were compared between the polyacrylic intraocular lens and polymethylmethacrylate intraocular lens groups. Results were also compared with standards for polymethylmethacrylate intraocular lens that were established by the US Food and Drug Administration and a previous study for silicone lens. RESULTS: The overall complete follow-up rates were 79.9% for 1-year follow-up and 69.5% for 3-year follow-up. At 1 year, the mean logarithm of the minimum angle of resolution (logMAR) of visual acuity was 0.037 ± 0.150 and 0.042 ± 0.154 in best case patients of the polyacrylic intraocular lens group and polymethylmethacrylate intraocular lens group, respectively. At 3 years, the mean logMAR visual acuity was 0.038 ± 0.155 and 0.054 ± 0.181 in best case patients in the polyacrylic intraocular lens group and polymethylmethacrylate intraocular lens group. There was no significant difference between groups at 1 and 3 years. At 1 year, 96.8% of best case patients in the polyacrylic intraocular lens group and 95.8% of those in the polymethylmethacrylate intraocular lens group achieved corrected visual acuity of 0.5 or better. At 3 years, 96.4% of best case patients in the polyacrylic intraocular lens group and 94.9% of those in the polymethylmethacrylate group achieved a corrected visual acuity of 0.5 or better; no significant difference was found at 1 and 3 years. The rate of sight-threatening complications was 1.2% for the polyacrylic intraocular lens group of all patients and 1.5% for the polymethylmethacrylate intraocular lens group at 1 year, and 1.6% for the polyacrylic intraocular lens group and 1.4% for the polymethylmethacrylate intraocular lens group at 3 years. No significant difference was found between the groups. The cumulative rate of Nd:YAG capsulotomy for the polyacrylic intraocular lens group (7.1%) was significantly lower than that for the polymethylmethacrylate intraocular lens group (38.1%) through 3 years ( P CONCLUSIONS: Polyacrylic intraocular lenses demonstrated safe and effective performance through long-term follow-up at a level equal to or better than polymethylmethacrylate intraocular lenses. Patients undergoing polyacrylic intraocular lens implantation achieved excellent postoperative visual acuity and experienced a low rate of postoperative complications, adverse reactions, and Nd:YAG capsulotomy. These long-term clinical results are an important outcome database for the ongoing use of this foldable optic material.

AIM To perform ultrasound biomicroscopic analysis of pseudophakic pupillary block glaucoma induced by lens capsule and a Soemmering9s ring and its resolution, and to elucidate the pathophysiology of this glaucoma. METHODS A woman with pseudophakic pupillary block glaucoma underwent successful neodymium:YAG (Nd:YAG) laser photodisruption of the lens capsule through a laser iridotomised coloboma with resolution of the pupillary block. The Humphrey ultrasonic biomicroscope model 840 was employed to observe the anterior segment before and after laser photodisruption. RESULTS Ultrasound biomicroscopic examination revealed the intraocular lens (IOL) was displaced forward, shallowing the central anterior chamber. The anterior hyaloid face was relatively posterior to the posterior capsule. The iris was in apposition to the anterior capsule, which was in touch with the IOL optics. A massive Soemmering9s ring, which extended from the IOL optics to the ciliary processes, was displaced anteriorly. The Soemmering9s ring consisted of several tightly packed layers. The ciliary processes rotated anteriorly. After Nd:YAG laser photodisruption of the capsule, ultrasound biomicroscopic images showed the resolution of the pupillary block and the anterior rotation of the ciliary process. The Soemmering9s ring moved posteriorly, and the layers in the ring became loose. CONCLUSIONS A massive Soemmering9s ring may one of potential causes of pupillary block after cataract surgery. Ultrasound biomicroscopy is potentially useful as a non-invasive diagnostic technique for clinical diagnosis and differentiation between Soemmering9s ring induced pupillary block glaucoma and other forms of pupillary block.

BACKGROUND/AIM—Limited treatments are available for this disease process. A pilot study was performed to determine the toxicity and efficacy of external beam radiotherapy for subfoveal neovascular membranes and subretinal haemorrhage associated with pathological myopia. METHODS—A randomised, prospective study was carried out on 39 patients with subfoveal neovascularisation associated with high myopia. 20 patients underwent radiotherapy and the remaining 19 were observed as a randomised comparison group. All patients were followed up for at least 24 months. Subfoveal choroidal neovascular membranes (CNVMs) were treated with a single lateral 6 MV photon beam to a dose of 10 Gy in five fractions over 5-7 days. Post-treatment measurements included corrected visual acuity, area of CNVM, and occurrence of radiotherapy related complications, and adverse reactions. To assess changes of area of CNVM, the initial (pretreatment) size of the CNVM was set to 100%, and all post-treatment measurements were normalised relative to the initial size. RESULTS—No significant acute morbidity was noted. There was no significant difference in age, sex, refractive error, visual acuity, and area of CNVM at baseline between the treatment group and control group. The mean change of the size of the CNVM for 2 years was 155% (SD 156%) in the treatment group and 249% (124%) in the control group. The increase in the size of CNVM in the treatment group was significantly smaller than that in the control group (p = 0.0452). In the treated eyes, the visual acuity before and 1 and 2 years after radiotherapy were 0.111 (22.2/200), 0.091 (18.2/200), and 0.086 (19.2/200), respectively. In the control eyes, visual acuity before and 1 and 2 years after the start of the follow up were 0.141 (34.2/200), 0.089 (17.8/200), and 0.063 (12.6/200). The patients in the treatment group showed no significant change for 2 years, and those in the control group showed a significant decrease in the visual acuity (p = 0.0033). The changes of logMAR of visual acuity for 2 years after the start of the follow up were +0.019 (0.443) in the treatment group and +0.347 (0.374) in the control group. There was a statistically significant difference between them (p = 0.0173). Multiple regression analysis on the treatment group showed that the most significant predictive variable for the visual acuity 2 years after the treatment was the combination of pretreatment visual acuity and refractive error. CONCLUSIONS—Radiotherapy appeared to have a favourable treatment effect in eyes with subfoveal neovascular membranes and haemorrhage associated with pathological myopia. Further investigation is needed to evaluate the efficacy of radiotherapy for subfoveal neovascularisation associated with pathological myopia.

· Background: Our objective was to estimate the agreement between two different ultrasound biomicroscopes (UBMs) and to evaluate the clinical implications of the measurements obtained. · Methods: We measured the anterior chamber depth, trabecular-iris angle, angle opening distance at 250 and 500 µm from the scleral spur, iris thickness and scleral-iris angle using the Humphrey UBM model 840 and Rion UBM UX-02 in 25 eyes of 25 normal volunteers. · Results: No significant difference was found in the mean values of any parameters measured by the Humphrey and Rion systems. Correlation coefficients of greater than 90% were observed for the parameters studied. Each system showed high reproducibility for all measured parameters. There were significant differences between the two systems in coefficients of variation for all parameters measured except the anterior chamber depth. · Conclusions: The parameters measured with the Humphrey and Rion systems showed correlation coefficients of greater than 90%. The Humphrey system showed better reproducibility than the Rion system.

AIM—To establish normative values for the anterior segment in premature infants in relation to postconceptional age and birth weight. METHODS—Anterior segments were measured in 39 premature infants, 25 to 39 weeks' gestational age by use of ultrasound biomicroscopy and a muscle hook with topical anaesthesia. RESULTS—Anterior chamber depth, trabecular-iris angle, angle opening (trabecular-iris) distances at 250 and 500 µm from the scleral spur, and the thickness of the thickest part of the iris showed linear increases in relation to postconceptional age and birth weight. CONCLUSIONS—Ultrasound biomicroscopy is a powerful tool for obtaining precise images and measurement of the anterior segment in preterm neonates. Normative values were established for anterior segment dimensions in relation to postconceptional age and birth weight.

Precise frequency measurement of the rotational lines of D2O in the terahertz (far-infrared) region is demonstrated as a case study of a high-precision far-infrared spectroscopy using a tunable radiation source. Frequencies of about 150 rotational lines of D2O were measured in the 0.5 – 5 THz region. Measured frequencies provide an excellent frequency standard for the terahertz region together with our measurements on H216O (v=0 and v2=1 vibrational states), H217O, and H218O. Molecular parameters of Watson's A-reduced Hamiltonian have been obtained to reproduce the observed frequencies.