Search

Background: To compare the ability of multicolor imaging (MCI) with red-free fundus photography (RFP) to detect glaucomatous retinal nerve fiber layer (RNFL) thinning., Methods: A total of 127 eyes of 79 patients with glaucoma underwent MCI using blue light, RFP, and circumpapillary optical coherence tomography (OCT) scanning on the same day. Angular location and width of the RNFL defects (RNFLDs) identified on the MCI and RFP were independently measured, and compared with those of RNFL thinning indicated by abnormal color codes on OCT., Results: The angular location and width of the RNFLDs determined by both MCI and RFP were well correlated with those of RNFL thinning determined by OCT (all P ≤ 0.013). The correlation of angular width with OCT was significantly stronger for MCI than for RFP (R = 0.708 vs. R = 0.616, P = 0.009). The superiority of MCI to RFP in the detection of OCT-determined RNFL thinning was significant in the inferior (P = 0.025) and marginally significant in the superior (P = 0.084) hemisectors. Thinner RNFL and longer axial length were significantly associated with better visualization of RNFLD by MCI than by RFP, respectively in the superior (OR = 0.948, P = 0.048) and inferior (OR = 1.490, P = 0.012) hemisectors., Conclusions: RNFLD on MCI correlated well with OCT measurement of RNFL thinning in eyes with glaucoma. MCI performed better than conventional RFP in the detection of OCT-determined RNFL thinning, specifically in eyes with thinner RNFL and those with myopia. MCI may be more useful than conventional RFP in evaluating glaucomatous RNFL thinning., Competing Interests: Declaration of Conflict of Interest No conflicting relationship exists for any author., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Purpose: To describe the parapapillary choroidal microvasculature dropout (CMvD) in glaucomatous eyes without β-zone parapapillary atrophy (β-PPA) and compare its characteristics with that of CMvD with β-PPA., Methods: Peripapillary choroidal microvasculature was evaluated on en face images obtained using optical coherence tomography angiography. CMvD was defined as a focal sectoral capillary dropout with no visible microvascular network identified in the choroidal layer. Peripapillary and optic nerve head structures, including the presence of β-PPA, peripapillary choroidal thickness and lamina cribrosa curvature index were evaluated using the images obtained by enhanced depth-imaging optical coherence tomography., Results: The study included 100 glaucomatous eyes with CMvD (25 without and 75 with β-PPA) and 97 eyes without CMvD (57 without and 40 with β-PPA). Regardless of the presence of β-PPA, eyes with CMvD tended to have a worse visual field at a given RNFL thickness than eyes without CMvD, with patients having eyes with CMvD having lower diastolic blood pressure and more frequent cold extremities than patients with eyes lacking CMvD. Peripapillary choroidal thickness was significantly smaller in eyes with than without CMvD, but was not affected by the presence of β-PPA. β-PPA without CMvD was not associated with vascular variables., Conclusions: CMvD were found in the absence of β-PPA in glaucomatous eyes. CMvDs had similar characteristics in the presence and absence of β-PPA. Clinical and optic nerve head structural characteristics potentially relevant to compromised optic nerve head perfusion were dependent on the presence of CMvD, rather than the presence of β-PPA.

This study aimed to compare adverse reactions following BNT162b2 and influenza vaccinations in healthcare workers. This study included healthcare workers who received the BNT162b2 vaccine and/or inactivated influenza vaccine, quadrivalent (IIV4), on 18-29 October 2021 at a tertiary hospital in Korea. IIV4 was administered and BNT162b2 was subsequently administered one week later. The participants responded to a mobile questionnaire regarding adverse events. The overall adverse reaction rates were 90.6% in the BNT162b2 + IIV4 group, 90.4% in the BNT162b2 alone group, and 44.1% in the IIV4 alone group ( p < 0.001). Fever occurred in 19.5%, 26.9%, and 3.3% of participants in the BNT162b2 + IIV4, BNT162b2 alone, and IIV4 alone groups, respectively ( p < 0.001). The most common local and systemic adverse reactions were injection site pain (65.0%) and fatigue (58.6%), respectively. Injection-site pain was experienced by 88.7%, 88.5%, and 37.5% of the BNT162b2 + IIV4, BNT162b2 alone, and IIV4 alone groups, respectively ( p < 0.001). Fatigue was experienced by 74.8%, 78.8%, and 38.6% of the BNT162b2 + IIV4, BNT162b2 alone, and IIV4 alone groups, respectively ( p < 0.001). Adverse reactions occurred at a significantly higher frequency after BNT162b2 than after IIV4. The frequency of adverse reactions one week after vaccination with IIV4 and BNT162b2 was not different from that after vaccination with BNT162b2 alone. Therefore, coadministration of influenza vaccine with BNT162b2 can be expected to be safe.

Purpose: Animal-assisted intervention (AAI) is an effective intervention that improves the mental and physical health. However, few have examined the efficacy of pet insects as a form of AAI for prefrail and frail elderly. This study aimed to ascertain the effects of pet insects on physical performance and psychological health in community-dwelling frail elderly individuals with a chronic disease., Patients and Methods: This study was an 8 week prospective single-arm interventional pilot study that enrolled prefrail and frail community-dwelling adults aged 70 years and older, all of whom had a chronic disease and attended a daycare facility. Pet insects and appropriate equipment were provided, and supporting programs were used to educate participants about how to rear the insects and how to get close to them. Pre- and post-interventional physical and psychological functions were evaluated., Results: A total of 23 subjects (mean age, 82.78 years) were enrolled in the final analysis. The timed up-and-go-test (TUG) was used to measure functional mobility, and grip strength was used as a measure of muscle strength; both showed significant changes after the 8-week intervention (Δ = -0.35±0.73 sec, P = 0.034; and Δ = 0.73±0.99 kg, P = 0.002, respectively). In addition, the insomnia severity index (ISI) and average sleep duration improved significantly (Δ = -2.91±5.64, P = -0.021; and Δ = 0.87±1.98, P = 0.047, respectively). There were no significant changes in the results of other psychometric tests. Logistic regression analysis using the forward stepwise selection method revealed that the baseline ISI score and the absence of other comorbidities were significantly associated with the probability of positive changes in both the TUG and HS tests after the intervention., Conclusion: Pet insects may be an effective and easily applicable type of AAI, which improves physical function and sleep in prefrail and frail elderly individuals., Competing Interests: The authors report no conflicts of interest in this work., (© 2022 Park et al.)

Microneedles have emerged as a novel transdermal delivery tool that enables the delivery of various products such as drugs, vaccines, or cosmetic ingredients. Although the demand for solid microneedles composed of biocompatible polymer is increasing, the manufacture of microneedles using poly-lactic acid (PLA) with rapid drug-releasing is yet to be established and the process is still in its infancy. Here, we propose a novel strategy for the fabrication of PLA solid microneedles which enable a drug to be burst-released based on a solvent-casting process. This approach offers extreme simplicity, broad geometric capability, cost-effectiveness, and scalability based on high fidelity-replicas. It was verified that microneedles of various heights (250-500 μm) could be fabricated with appropriate mechanical strength to penetrate the stratum corneum layer of skin. By adding sugar in the composition of PLA microneedle, it was observed that both hydrophilic and hydrophobic drugs can be rapidly released within 30 min. Our burst drug-releasing PLA microneedle having both characteristics of solid microneedle and soluble microneedle and its fabrication approach based on solvent-casting will contribute to getting microneedle technology close to commercialization and beyond existing technical limitations.

This study aimed to present the prognosis after minor acute ischemic stroke (AIS) or transient ischemic attack (TIA), using a definition of subsequent stroke in accordance with recent clinical trials. In total, 9,506 patients with minor AIS (National Institutes of Health Stroke Scale ≤ 5) or high-risk TIA (acute lesions or ≥ 50% cerebral artery steno-occlusion) admitted between November 2010 and October 2013 were included. The primary outcome was the composite of stroke (progression of initial event or a subsequent event) and all-cause mortality. The cumulative incidence of stroke or death was 11.2% at 1 month, 13.3% at 3 months and 16.7% at 1 year. Incidence rate of stroke or death in the first month was 12.5 per 100 person-months: highest in patients with large artery atherosclerosis (17.0). The risk of subsequent events shortly after a minor AIS or high-risk TIA was substantial, particularly in patients with large artery atherosclerosis., Competing Interests: Authors Lesén E, Hedberg J, Tank A and Fita EG are employees of AstraZeneca. Independent of the submitted work, Bae HJ reports: grants from AstraZeneca Korea, Bayer, BMS Korea, Boehringer Ingelheim, Daichi Sankyo, Dong-A Pharmaceutical, Korean Drug Co. Ltd., Servier, Shin Poong Pharm. Co. Ltd and Yuhan Corporation; grants and personal fees from ESAI-Korea and Shire Korea Ltd; and personal fees from Amgen Asia Holding Limited, and Otsuka Korea outside the submitted work. The other authors report no conflicts., (© 2022 The Korean Academy of Medical Sciences.)

Optically left-handed materials refract the propagating light in the opposite direction. Most research has focused on the design of various structures, including split-ring resonators, either on planes or in particle cluster forms to resonate with specific light frequencies. However, for particle-based materials, the circuital structures for optical left-handedness have not been fully understood and the effect of interior structure on the optical handedness have not been investigated. Additionally, scalable methods to deploy the unique characteristics of the materials have not been reported so far and are still urgent. Here, optically left-handed nanopearl beads are synthesized in up to 1.25 L solutions. Nanopearl beads contain assembled Au nanocolloids, a dielectric sphere, and a thin silica layer that fixes the assembled structures to sustainably yield unique inductance-capacitance circuits at specific visible-near-infrared frequencies. The frequencies are tunable by modulating the interior structures. Investigation of the circuit structures and Poynting vectors generated within the nanopearl beads suggest the likelihood of their left-handedness. Moreover, the effects of interior structures on the optical handedness of the nanopearl beads are extensively investigated. The results could help commercialize optically left-handed materials and pioneer fields that have not been realized so far.

Background: The post-colonoscopy periprosthetic joint infection (PJI) risk in patients with total prosthetic knee joints has limited research. The present study investigated the PJI risk and determined the risk factors for post-colonoscopy PJI in total knee arthroplasty (TKA) recipients. The hypothesis was that colonoscopy is associated with an increased PJI risk in patients with total prosthetic knee joints. This study can potentially help guide the decision making for prophylactic antibiotic use for colonoscopy., Methods: This nationwide matched cohort study used claims data from the Health Insurance Review and Assessment Service database and enrolled patients who underwent unilateral TKA between 2008 and 2016. The history of diagnostic colonoscopy was investigated at least 1 year postoperatively. The propensity score was matched between colonoscopy and non-colonoscopy cohorts, and the post-colonoscopy PJI risk was compared. The PJI risk following invasive colonoscopic procedures, including biopsy, polypectomy, and mucosal or submucosal resection, was investigated, and the risk factors for post-colonoscopy PJI were determined., Results: In total, 45,612 and 211,841 patients were matched in the colonoscopy and control cohorts, respectively. The colonoscopy cohort had greater 9-month and 1-year PJI risks from the index colonoscopy date than the matched controls (9 months: hazard ratio [HR] 1.836, P = .006; 1 year: HR 1.822, P = .031). Invasive colonoscopic procedures did not increase the PJI risk at any time point post-colonoscopy. The only significant risk factor for PJI was post-traumatic arthritis (adjusted HR 4.034, P = .023)., Conclusion: Colonoscopy was associated with an increased PJI risk in TKA recipients, regardless of concomitant invasive colonoscopic procedures., Level of Evidence: III, Prognostic., (Copyright © 2021 Elsevier Inc. All rights reserved.)

In clinical practice, most patients with monoclonal gammopathy of undetermined significance (MGUS) undergo long-term follow-up without disease progression. There is insufficient real-world data about how closely and whether anything other than disease progression should be monitored. Herein, we performed a nationwide study of 470 patients with MGUS with a 10-year follow-up to determine the patterns of disease progression and other comorbidities. During the follow-up period, 158 of 470 patients with MGUS (33.62%) progressed to symptomatic monoclonal gammopathies. Most of these were multiple myeloma (134/470 patients, 28.51%), and those diagnosed within 2 years after diagnosis of MGUS was high. Approximately 30-50% of patients with MGUS had hypertension, diabetes, hyperlipidemia, and osteoarthritis at the time of diagnosis, and these comorbidities were newly developed during the follow-up period in approximately 50% of the remaining patients with MGUS. Approximately 20-40% of patients with MGUS have acute or chronic kidney failure, thyroid disorders, disc disorders, peripheral neuropathy, myocardial infarction, stroke, and heart failure during the follow-up period. Altogether, when MGUS is diagnosed, close follow-up of the possibility of progression to multiple myeloma is required, especially within 2 years after diagnosis; simultaneously, various comorbidities should be considered and monitored during the follow-up of patients with MGUS. Continuous research is needed to establish appropriate follow-up guidelines., (© 2021. The Author(s).)

Purpose: To evaluate monocular and binocular visual performance and patient-reported outcomes following combined implantation of a diffractive extended depth of focus (EDoF) IOL (Carl Zeiss AT LARA 829MP) and a diffractive trifocal IOL (Carl Zeiss AT LISA tri 839MP)., Methods: This prospective study enrolled consecutive patients undergoing lens phacoemulsification of cataract and combined implantation of an EDoF IOL in the dominant eye and a trifocal IOL in the nondominant eye. Assessment included uncorrected visual acuity at near distances (UNVA), intermediate distances (UIVA), and far distances (UDVA), uncorrected defocus curve, contrast sensitivity (CS), reading speed, and patient satisfaction, evaluated six months after the surgery with the Visual Function Questionnaire (VFQ-25)., Results: A total of 25 patients were enrolled. At six months postoperatively, outcomes of binocular UNVA, UIVA, and UDVA were superior to those of monocular outcomes. The binocular defocus curve showed significantly better results in comparison with the AT LISA tri IOL eyes at defocus levels of -1.0 D and -1.5 D ( P =0.008 and P =0.002, respectively) and compared to the AT LARA IOL eyes at defocus levels of -3.0, -3.5 D, and -4.0 D ( P =0.019, P =0.019, and P =0.035, respectively). All of the patients were spectacle-free at far and intermediate distances, while 4% of patients needed spectacles at the near distance. Reading speed showed a rather high and gentle slope curve between 0.1 logMAR and 0.4 logMAR, and optical phenomena were improved after combined implantation of IOLs except halos. There were no significant differences in CS between the binocular and monocular results of each IOL., Conclusions: The combined implantation of an EDoF IOL and a trifocal IOL seems to be a good option for patients with demands for spectacle independence in their daily life, with minimal photic phenomena., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2021 Ji Eun Song et al.)

We investigated longitudinal changes in the spherical equivalent refractive error (SE) in hyperopic children with or without refractive accommodative esotropia (AccET). A total of 456 patients met the inclusion criteria: 190 (41.7%) in the hyperopic control group and 266 (58.3%) in the AccET group. All patients received at least 3 years of follow-up after spectacle prescription. Subgroups were divided according to age when spectacles were prescribed, presence of amblyopia, or initial SE. Longitudinal changes in SE in children with hyperopia showed a gradual decrease, although SE of younger children with AccET increased over the first 4 years and then decreased thereafter. SE in eye with higher SE was tended to decrease significantly in patient with Acc ET than hyperopic control group (group × time p = 0.015). Amblyopic eyes showed a greater decreased in SE compared with non-amblyopic eyes, but it was not statistically significant ( p = 0.07). SE was significantly decreased in children with more hyperopia (≥ 3 D) compared with children with less hyperopia (<3 D) ( p = 0.008). Emmetropization of hyperopia was faster in hyperopic patients without AccET and could be affected by the age of the initial spectacles prescription, initial amount of SE, or presence of amblyopia.

This study aimed to determine whether nonalcoholic fatty liver disease (NAFLD) is an independent risk factor for CVD and to identify the most useful NAFLD diagnostic tool for predicting CVD. Data from a total of 23,376 Korean adults without established CVD were analyzed. Cardiovascular risk was calculated using the Framingham Risk Score (FRS) 2008. The presence of NAFLD was defined as moderate-to-severe fatty liver disease diagnosed by ultrasonography. Scores for fatty liver were calculated using four NAFLD scoring systems (Fatty Liver Index, FLI; Hepatic Steatosis Index, HSI; Simple NAFLD Score, SNS; Comprehensive NAFLD Score, CNS), and were compared and analyzed according to cardiovascular risk group. Using the FRS, 67.4% of participants were considered to be at low risk of CVD, 21.5% at intermediate risk, and 11.1% at high risk. As the risk of CVD increased, both the prevalence of NAFLD and the score from each NAFLD scoring system increased significantly ( p < 0.001). In the unadjusted analysis, the CNS had the strongest association with high CVD risk; in the adjusted analysis, the FLI score was most strongly associated with high CVD risk. Fatty liver is an important independent risk factor for CVD. Therefore, the available NAFLD scoring systems could be utilized to predict CVD.

Purpose: To evaluate the results of operating an in-hospital coronavirus disease 2019 screening station on an outpatient basis and to identify the effectiveness and necessity of such a screening station., Patients and Methods: This cross-sectional study included 1345 individuals who were tested for COVID-19 using real-time reverse transcription polymerase chain reaction (RT-PCR) at an in-hospital screening station on an outpatient basis. The subjects were healthcare workers (HCWs) with suspected COVID-19 symptoms or exposure to patients with confirmed COVID-19, caregivers at the hospital for complete enumeration, and patients who were scheduled to be admitted to a nonrestricted area in the hospital or to visit for outpatient treatment, but had suspected COVID-19 symptoms. The subjects were divided and compared as follows: HCW versus non-HCW groups and RT-PCR positive versus negative groups., Results: A total of 140 had symptoms, 291 wanted to be tested, and 664 were asymptomatic but were screened. Seven subjects had positive results for COVID-19. Compared with the non-HCWs, the HCWs were younger and had a lower rate of underlying medical conditions. In addition, there were more women, individuals with exposure to confirmed cases, and individuals with symptoms or those who just wanted to be tested. The frequency of all symptoms was high among the HCWs. The results of the logistic regression analysis showed that the HCWs were significantly associated with the presence of symptoms, having an odds ratio of 23.317 (confidence interval, 15.142-35.907L; P < 0.001). The positive group had a high rate of exposure to patients with confirmed COVID-19 and had more subjects with symptoms or those who wanted to be tested., Conclusion: In-hospital screening stations are a relatively safe way to protect and support HCWs and to reduce and manage the spread of infection within the hospital effectively during an outbreak in the community., Competing Interests: The authors report no conflicts of interest., (© 2021 Choi et al.)

Tyrian purple, mainly composed of 6,6'-dibromoindigo (6BrIG), is an ancient dye extracted from sea snails and was recently demonstrated as a biocompatible semiconductor material. However, its synthesis remains limited due to uncharacterized biosynthetic pathways and the difficulty of regiospecific bromination. Here, we introduce an effective 6BrIG production strategy in Escherichia coli using tryptophan 6-halogenase SttH, tryptophanase TnaA and flavin-containing monooxygenase MaFMO. Since tryptophan halogenases are expressed in highly insoluble forms in E. coli, a flavin reductase (Fre) that regenerates FADH 2 for the halogenase reaction was used as an N-terminal soluble tag of SttH. A consecutive two-cell reaction system was designed to overproduce regiospecifically brominated precursors of 6BrIG by spatiotemporal separation of bromination and bromotryptophan degradation. These approaches led to 315.0 mg l -1 6BrIG production from tryptophan and successful synthesis of regiospecifically dihalogenated indigos. Furthermore, it was demonstrated that 6BrIG overproducing cells can be directly used as a bacterial dye.

Background: Radioactive iodine (RAI) treatment is a standard treatment in differentiated thyroid cancer (TC). However, its adverse effects on cardiovascular diseases (CVDs) have not been clearly elucidated., Methods: In this retrospective cohort study based on the Korean National Health Insurance Service-National Health Screening Cohort (2002-2015), we analyzed 4,845 patients with TC with a median follow-up of 66 months. We evaluated and compared the risk of CVD between patients treated with and without RAI therapy. The primary CVD outcome was defined as a composite of ischemic stroke (IS), ischemic heart disease (IHD), hemorrhagic stroke (HS), or heart failure (HF)., Results: Overall, 2,533 patients (52.3%) received RAI treatment with a median cumulative dosage of 103 mCi [interquartile range (IQR), 40-162 mCi]. The incidence of the primary CVD outcome in patients who did not receive RAI therapy and those who did was 17.32 [95% confidence interval (CI), 15.07-19.90] and 13.96 (95% CI, 12.17-16.01) per 1,000 person-years, respectively, indicating an adjusted hazard ratio (HR) of 0.87 (95% CI, 0.71-1.07) after multivariate adjustments for variable confounding factors. The risks of IS (HR, 0.83; 95% CI, 0.51-1.34), IHD (HR, 0.90; 95% CI, 0.71-1.13), HS (HR 1.01; 95% CI, 0.49-2.09), and HF (HR 0.89; 95% CI, 0.49-1.63) were comparable between the patients who received RAI therapy and those who did not. There was no cumulative dose-dependent risk for CVD in TC patients who received RAI treatment., Conclusions: RAI treatment is a prevalent and crucial treatment for TC, and has been used in more than half of TC patients in Korea from 2004 to 2015. This study found no significant between-group difference for the CVD risk in patients with TC who received RAI treatment and those who did not, giving further evidence to allay concerns related to the adverse effects of RAI., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/atm-20-5222). The authors have no conflicts of interest to declare., (2020 Annals of Translational Medicine. All rights reserved.)

Purpose: To compare the clinical outcomes of mix-and-match implantation of a diffractive extended depth of focus intraocular lens (IOL) (TECNIS Symfony ZXR00; Johnson & Johnson Vision) and a diffractive bifocal IOL (TECNIS ZLB00 +3.25 diopters [D]; Johnson & Johnson Vision) and bilateral implantation of a diffractive trifocal IOL (AcrySof IQ PanOptix; Alcon Laboratories, Inc)., Methods: This prospective comparative study compares the clinical outcomes of patients with age-related cataract undergoing cataract surgery using the IOLs described. Patients were divided into the mix-and-match group and the trifocal group. Assessment included monocular and binocular uncorrected distance visual acuity (UDVA), intermediate visual acuity (UIVA at 60 cm), and near visual acuity (UNVA at 40 cm), uncorrected defocus curves, contrast sensitivity, and reading speed. Quality of vision was measured with the Visual Function Questionnaire (VFQ-25)., Results: A total of 50 patients (25 in each group) were enrolled. At 6 months postoperatively, outcomes of binocular UDVA, UIVA, and UNVA were similar in both groups. The binocular defocus curve only differed at vergences of -0.50 to -1.00 D (better for the mix-and-match group; P = .032 and .004, respectively) and at -4.00 D (better for the trifocal group; P = .001). Significantly higher reading speeds in the mix-and-match group were measured at 0.7 and 0.5 logMAR (P = .038 and .034, respectively). There were no significant differences between groups for contrast sensitivity and the results of the questionnaire., Conclusions: The mix-and-match implantation seemed to be a good option for patients with high demands for distance and intermediate visual acuity, whereas the trifocal IOL appeared to be more suitable for patients with enhanced near vision demands. [J Refract Surg. 2020;36(8):528-535.]., (Copyright 2020, SLACK Incorporated.)

Background: A larger optical zone for photorefractive keratectomy may improve optical quality and stability. However, there is need for limiting ablation diameter in that a larger ablation diameter requires greater ablation depth, and minimizing ablation depth may reduce adverse effects on postoperative wound healing, haze and keratoectasia. In this study, we compared the changes in clinical outcomes and the degree of regression between a 6.0 mm optical zone and 6.5 mm optical zone following PRK., Methods: The records of 95 eyes that had undergone PRK with a 6.0 OZ (n = 40) and a 6.5 OZ (n = 55) were retrospectively reviewed. We compared data including the spherical equivalent of manifest refraction (SE of MR), simulated K (Sim K), thinnest corneal thickness, change in thinnest corneal thickness (the initial value divided by corrected diopter [ΔTCT/CD]), Q value, corneal higher order aberrations (HOAs) and spherical aberration (SA) pre-operation, at 3 and 6 months postoperative and at the last follow-up visit (Mean; 20.71 ± 10.52, 17.47 ± 6.57 months in the 6.0 and 6.5 OZ group, respectively)., Results: There were no significant differences in the SE of MR, Sim K and UDVA between the 6.0 OZ group and the 6.5 OZ group over 1 year of follow-up after PRK, and the 6.0 OZ group required less ΔTCT/CD than the 6.5 OZ group. The 6.5 OZ group showed better results in terms of post-operative HOAs of RMS, SA and Q value. When comparing that pattern of change in Sim K, there was no significant difference between the 6.0 OZ group and the 6.5 OZ group., Conclusions: The clinical refractive outcomes and regression after PRK using Mel 90 excimer laser with a 6.0 OZ were comparable to those with a 6.5 OZ.

We evaluated surgical outcomes of bilateral rectus (BLR) recession in patients with intermittent exotropia who underwent diagnostic monocular occlusion. Records of patients with intermittent exotropia who were preoperatively examined one-hour monocular occlusion and underwent BLR recession were reviewed retrospectively. Patients were classified into two groups based on change in exodeviation angle: responders (≥5 change in prism diopters [PD] after occlusion) or non-responders (<5 PD change after occlusion). BLR recession amount was determined by maximal angle deviation after occlusion tests in both groups. Overall follow-up period was 38.81 ± 24.09 months for non-responders (n = 106) and 38.52 ± 19.87 months for responders (n = 142) (p = 0.766). There was no difference in deviation before monocular occlusion between the two groups. Mean angle of deviation at distance (24.23 ± 6.27 PD) and near fixation (25.46 ± 6.78 PD) increased to distance (29.95 ± 6.43 PD) and near deviation (32.15 ± 6.17 PD) after occlusion in the responder group. At postoperative 1 year, surgical success rate was higher in responders (71.1%) than in non-responders (52.8%) (p = 0.003). Kaplan-Meier survival analysis revealed significantly higher surgical success in responders (p = 0.001, log-rank test). Preoperative diagnostic monocular occlusion in patients with intermittent exotropia can influence surgical outcomes by identifying the latent exodeviation angle.

Medieval European stained glass windows are known to display various splendid colors and remove harmful airborne substances. At present, the functions of medieval stained glass windows are imperative, from the environment, health, and energy perspectives, to develop multi-functional windows that report/control environmental conditions and remove harmful substances by utilizing visible-near-infrared light sources. Here, we suggest a strategy to mimic medieval European stained glasses for devising plasmonic-based multi-functional smart stained glass windows. The stained glass windows are prepared from the deposition of gold nanoparticles on a glass that is preliminarily coated with a responsive colloidal nanosheet. The temperature responsiveness of the nanosheet enables the effective control the gold nanoparticle density of the stained glasses. Therefore, the windows can display blue, violet, and cranberry colors. The colors become iridescent by introducing a photonic crystal monolayer. The stained glass windows are hydrochromic: they switch the colors (blue ↔ cranberry) and modulate light transmittance depending on humidity conditions. Moreover, they can remove formaldehyde under the illumination of a low-power indoor light. These functions provide a new platform for the futuristic smart windows that clean indoor air for the human health and save energy.

The present study aims to improve the hydrophobicity and durability of bacterial cellulose (BC) nonwoven by functionalization with poly(fluorophenol). To this end, laccase was first entrapped onto BC and then used to polymerize the fluorophenol {4-[4-(trifluoromethyl) phenoxy] phenol} in-situ . The polymerization of fluorophenol by laccase was confirmed through 1 H NMR and MALDI-TOF analyses. The effect of poly(fluorophenol) on BC nonwoven was determined by evaluation of the surface hydrophobicity and olephobicity properties such as water contact angle (WCA), oil contact angle (OCA), surface energy and water/oil absorption time. After BC functionalization with poly(fluorophenol) (20 mM), the WCA increased from 54.5 ± 1.2° to 120 ± 1.5° while the surface energy decreased (11.58 ± 1.4 mN/m). The OCA was also increased from 46.5 ± 2.5° to 87 ± 2° along to the decrease of surface energy (8.7 ± 1.5°). X-ray photoelectron spectroscopy (XPS) analysis confirmed an increase in the fluorine content in BC from 5.27 to 17.57%. The findings confirmed the polymerization of fluorophenol by laccase and its entrapment onto a BC nanofiber structure. The durability of the functionalization with poly(fluorophenol) was confirmed by evaluating the washing fastness, tensile strength after washing and dimensional stability. The results indicate that the functionalized BC nonwoven had higher tensile strength (×10 times) and better dimensional stability (30%) than the non-functionalized BC nonwoven material., (Copyright © 2019 Song, Silva, Cavaco-Paulo and Kim.)

Manipulation of both pore diameters and heights of two-dimensional periodic porous polymer films is important to extensively control their characteristics. However, except for using different sized colloid templates in replication methods, an effective method that tunes these factors has rarely been reported. We found that both parameters are controllable by adjusting the flow behaviors of polystyrene colloids and curing resin precursors during the preparation of phenolic resin and poly(dimethylsiloxane) periodic porous films by embedding their precursors into colloidal crystal monolayers. We adjust the flow behaviors by either varying film preparation temperatures (≥glass transition temperature of polystyrene) or using the precursors mixed with different amounts of solvents that renders the colloids viscous. Consequently, the pore diameters and film heights change by 36-56 and 56-84%, respectively. Such modulation results in the change in height to diameter ratios and the areal fractions of resins at air-film interfaces, thereby significantly changing the water contact angles on these surfaces and their photonic characteristics. This straightforward method does not require additional steps, differently sized colloids, or different amounts of precursors for these parameter controls.

Periodontal diseases are infectious polymicrobial inflammatory diseases that lead to destruction of the periodontal ligament, gingiva, and alveolar bone. Sequential colonization of a broad range of bacteria, including Fusobacterium nucleatum and Porphyromonas gingivalis, is an important phenomenon in this disease model. F. nucleatum is a facultative anaerobic species thought to be a key mediator of dental plaque maturation due to its extensive coaggregation with other oral bacteria, while P. gingivalis is an obligate anaerobic species that induces gingival inflammation by secreting various virulence factors. The formation of a bacterial complex by these two species is central to the pathogenesis of periodontal disease. Reactive oxygen species (ROS) are produced during bacterial infections and are involved in intracellular signaling. However, the impact of oral bacteria-induced ROS on the ecology of F. nucleatum and P. gingivalis has yet to be clarified. In the present study, we investigated ROS production induced in primary human oral cells by F. nucleatum and P. gingivalis and its effect on the formation of their bacterial complexes and further host cell apoptosis. We found that in primary human gingival fibroblasts (GFs), two NADPH oxidase isoforms, NOX1 and NOX2, were activated in response to F. nucleatum infection but not P. gingivalis infection. Accordingly, increased NADPH oxidase activity and production of superoxide anion were observed in GFs after F. nucleatum infection, but not after P. gingivalis infection. Interestingly, in NOX1, NOX2, or NOX1/NOX2 knockdown cells, the number of P. gingivalis decreased when the cells were coinfected with F. nucleatum. A similar pattern of host cell apoptosis was observed. This implies that F. nucleatum contributes to attachment of P. gingivalis by triggering activation of NADPH oxidase in host cells, which may provide an environment more favorable to strict anaerobic bacteria and have a subsequent effect on apoptosis of host cells.

Background & Aims: To assess the presence of growth retardation during long-term implementation of ketogenic diet (KD) among children with epilepsy, and verify the presence of catch-up growth in same patients 1 year after diet discontinuation., Methods: Retrospective chart review of 20 males and 20 females was performed and z scores of height, weight and body mass index was obtained at baseline, 2 years into KD, and 1 year after discontinuation of KD., Results: Our analysis revealed significant reduction in both height and weight gain among children with epilepsy after prolonged KD. After a year of diet discontinuation, significant catch-up growth was evident in both height and weight. In regard to specific subsets, ambulation had favorable influence on growth during KD and after diet discontinuation. Uncontrolled epilepsy, and younger age at the start of KD contributed a negative impact on a child's growth., Conclusions: This preliminary observation into long-term growth pattern among recipients of KD will aid both health care providers and patients alike in planning for long-term care extending beyond the duration of dietary treatment., (Copyright © 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Objective: To compare intra- and postoperative complications, operation time, and duration of hospital stay, and to evaluate cost-effectiveness between total vaginal hysterectomy (TVH) and total laparoscopic hysterectomy (TLH) groups., Material & Methods: Patients undergoing TVH or TLH for a large uterus weighing more than 300 g were recruited from January to December 2007: 150 cases of TVH and 100 cases of TLH, were used. Evaluated variables are as follows: age, parity, previous surgical history, intra- and postoperative complications, hysterectomy specimen weight, operation time, duration of hospital stay and total cost. Total cost ($US) include admission, anesthesia and operation costs., Results: There was no difference in demographics, intra- and postoperative complications, and uterine weight. However, operation time in TLH (mean, 179.9 min) was significantly longer than TVH (mean, 93.8 min; P < 0.05). The mean length of hospital stay was 6.13 days in TVH group and 5.78 days in TLH group, respectively (P < 0.05). TVH was more cost-effective than TLH. There was significant difference in total cost between the two groups (TVH, mean $1815.7 vs TLH, mean $2560.5; P < 0.05). When the total cost was analyzed in detail, there was no difference in admission cost. However, the significant mean differences in anesthesia cost (TVH, $165 vs TLH, $245) and operation cost (TVH, $30.3 vs TLH, $768) were demonstrated (P < 0.05)., Conclusion: TVH should not be abandoned for cases with a large uterus, and skilled surgeons for vaginal approach should preferentially perform TVH rather than TLH for the management of large uteruses.

Transferrin-binding protein (TfBP) has been shown to be a novel protein, structurally related to the chicken heat shock protein 108. The physiological function of this protein, however, has not yet been established. Antiserum to TfBP selectively stains transferrin- and iron-rich oligodendrocytes and choroidal epithelium in the adult and embryonic chick brain, suggesting a role for this protein in transferrin and iron storage in these cells. In this study, we further demonstrate TfBP-immunoreactivity (IR) in the blood vessels of the embryonic chick central nervous system. A strong TfBP-IR was present in blood vessels from E6, declined from E10 and was absent by E18. Thus, the expression of the TfBP in the blood vessels precedes its expression in the oligodendrocytes. At the subcellular level, TfBP-IR was confined to the cytoplasm of capillary pericytes while the Tf-receptor IR was associated with the capillary endothelium of the brain. The up-regulated expression of TfBP, together with the Tf-receptor of the brain capillaries, suggests that pericytes may be associated with the high iron uptake required for the metabolic demands of the developing brain.