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BACKGROUND: In recent years, three-dimensional (3D) digital exoscope systems have been developed and reported to form an adequate alternative to the conventional operating microscope.OBJECTIVE: To illustrate essential and practical features in a surgical video comparing a robotic arm 3D digital exoscope and a conventional operating microscope to clip a middle cerebral artery aneurysm.METHODS: We used a mouth switch-controlled operating microscope (OPMI PENTERO 900; Carl Zeiss Meditec AG) and robotic arm-controlled 3D digital Aeos exoscope (Aesculap Inc). We assessed the following visualization and optical features: overall visualization quality, color and contrast quality, range and quality of magnification, and adjustment of focus. In addition, we assessed maneuverability for changing surgical site within and viewing angle of the surgical field.RESULTS: We found that both modalities are suitable for this surgery and offer distinct qualities. The microscope enables faster magnification adjustment and continuous mouth switch-controlled focus adjustments. The advantages of the exoscope include the adaptation of color and contrast settings, and the surgeon can keep both hands in the surgical field while the camera pivots around its working field.CONCLUSION: The exoscope and operating microscope offer a similar high-quality visualization of, and smooth maneuvering within, the surgical field. The method of visualization and maneuvering is, however, very distinct. Therefore, a surgeon's acquaintance and experience with the specific features and how to optimally use them in surgery are of utmost importance. Further analyses of both systems are needed to evolve these tools.

Few reports have shown that superior oblique myokymia (SOM) may result from vascular compression of the trochlear nerve and may be curable using microvascular decompression (MVD).To report the clinical characteristics and surgical treatment of 2 cases of SOM and provide a review of the related literature.Two patients with SOM were treated using MVD with the lateral supracerebellar infratentorial approach. The patients underwent diagnostic magnetic resonance imaging and three-dimensional fusion imaging preoperatively. A lateral suboccipital craniotomy was performed in the park-bench position. The trochlear nerve and branches of the superior cerebellar artery were confirmed after opening the cerebellomesencephalic fissure over the tentorial surface of the cerebellum. The vessel, which compressed the root exit zone of the trochlear nerve, was transposed far from the nerve and attached to the surface of the midbrain using Teflon felt and fibrin glue.The first case showed compression on both the ventral and rostral sides of the trochlear nerve root exit zone, and the second showed compression only on the ventral side. Large bridging veins on the tentorial surface of the cerebellum complicated the approach in the second case. Postoperatively, both patients had immediate and complete resolution of symptoms without recurrence at the 24-mo and 17-mo follow-ups, respectively. Five previous reports described the complete resolution of SOM after MVD.A presentation of an intermittent fluttering ocular sensation should prompt magnetic resonance imaging for ipsilateral trochlear nerve compression. The lateral supracerebellar infratentorial approach allows safe and efficacious MVD for SOM.

We discover a new cavitation phenomenon in amorphous polymers sandwiched between two thick slide glasses from the static melt induced by thermal treatment. By quenching atactic polystyrene (aPS) samples from the static melt under the glass transition temperature (Tg) and annealing them above Tg for thick slide glasses, cavities are created to relax the negative pressure. Cavity growth undergoes an Ostwald ripening-like process in cases of large molecular weight, while it undergoes a viscous fingering process in cases of small molecular weight. The induction time for cavity formation is found to decrease with the increase of the annealing temperature and with the decrease of molecular weight. In contrast, no cavities are observed in an aPS sample between two thin cover glasses because the negative pressure can be relaxed by bending the whole thin cover glasses. We discover a new cavitation phenomenon in amorphous polymers sandwiched between two thick slide glasses from the static melt induced by thermal treatment. By quenching atactic polystyrene samples from the static melt under the glass transition temperature (Tg) and annealing them above Tg, cavities are created to relax the negative pressure. Cavity growth undergoes an Ostwald ripening-like process in cases of large molecular weight while it undergoes a viscous fingering process in cases of small molecular weight.

Purpose: To describe features characteristic of vitreous hemorrhage in patients with Terson syndrome observed through a microsurgical scope. Methods: Between May 2015 and February 2019, 12 eyes of 10 patients with vitreous hemorrhage occurring after subarachnoid hemorrhage (SAH) underwent pars plana vitrectomy. Results: During vitreous surgery, we found 10 of 12 eyes did not have posterior vitreous detachment (PVD). Furthermore, we observed in 9 of the 10 eyes without PVD (90.0%) that there was no hemorrhage in the posterior vitreous cavity at the posterior pole while we removed vitreous hemorrhage. We confirmed that this clean space could be the posterior precortical vitreous pocket (PPVP). Conclusion and importance: Terson syndrome may have no hemorrhage in the PPVP regardless of the presence of severe vitreous hemorrhage. The cases presented in our study may suggest one of the mechanisms of Terson syndrome. Keywords: Posterior precortical vitreous pocket, Posterior vitreous detachment, Subarachnoid hemorrhage, Terson syndrome, Vitreous hemorrhage

In this paper, we propose a new protocol for on-line user authentication based on multiple personal data. Needless to say, some kind of personal data must be used for authentication. In most cases, the type (e.g. finger print and vein) of the personal data is fixed, and authentication is done by comparing the input data with those registered in the system. In this paper, we propose a protocol that allows authentication based on 1 out of n types of personal data. For registration, the user may register 1 out of n types of personal data, and use it for authentication. If n is large, the difficulty for a third party to spoof the original user can be higher because he/she must try a lot of times before getting the correct data type to attack. The basic idea of the proposed protocol is to "normalize" all types of personal data into the same format, and conduct authentication using the same machine learning model. This idea is verified via experiments on several public databases.

A 49-year-old man noticed bilateral acute visual loss after a subarachnoid hemorrhage caused by right vertebral artery dissection. Ophthalmologic findings were consistent with a diagnosis of Terson syndrome. A 25-gauge pars plana vitrectomy was performed after phacoemulsification with intraocular lens implantation; all procedures were uneventful. However, the operative field was very hazy. A small transparent circle, presumably the basement of Cloquet canal, was observed in the center of the cloudy operative field. We concluded that the posterior capsule had been stained by the vitreous hemorrhage. Therefore, a posterior capsulotomy was performed around the small circle, resulting in a clear operative field, and the surgery proceeded safely.

In the present study, two female patients with unilateral scleritis without systemic complications were examined. Both patients were suffering from ocular pain and received corticosteroid therapy. The first patient, a 45-year-old woman, was diagnosed with scleritis and iritis in her right eye. Topical corticosteroid treatment could eradicate the iritis but not the scleritis. Oral corticosteroid administration and corticosteroid pulse therapy were applied with little effect. The application of systemic cyclosporine had a satisfactory effect in controlling the scleritis. The other patient, a 60-year-old woman, was suffering from scleritis and lid swelling in her right eye. Not only did topical and systemic corticosteroid therapy prove insufficient, they also resulted in the elevation of her intraocular pressure. After termination of corticosteroid therapy, the systemic cyclosporine was applied orally. Subsequently, the patient's scleritis improved without any severe side effects. Scleritis is a painful and destructive inflammatory disease of the sclera that causes congestion of the scleral venous plexus. In this study, we have established a new grading system for assessing activity in scleritis that can score the extent of ocular pain and the area of congestion. This system provides a practical method for following the clinical course and monitoring the outcome of therapy. We report two cases of unilateral scleritis that were resistant to corticosteroid therapy but responsive to systemic administration of cyclosporine. Findings from these cases indicate that cyclosporine is an effective drug for controlling severe scleritis.

The melt memory of isotactic polystyrene spherulites from the melt is investigated using optical microscopy. When the melting–recrystallization processes are repeated by raising and lowering the temperature after the reset of the melt and the subsequent seeding process, the number of the spherulites is found to decrease with the cumulative melting time. The spherulites appear at the same positions as the original ones, and the higher the melt temperature is, the faster their number decreases. At the initial stage, the number density of spherulites rapidly decreases with the cumulative melting time. After the initial stage, the number density of spherulites exponentially decays with the cumulative melting time and approaches a finite value. This asymptotic value decreases with the melt temperature.

Biotypes of Echinochloa crus-galli var. formosensis with resistance to cyhalofop-butyl, an acetyl-CoA carboxylase (ACCase) inhibitor, have been found in dry-seeded rice fields in Okayama, Japan. We collected two lines with suspected resistance (Ecf27 and Ecf108) from dry-seeded rice fields and investigated their sensitivity to cyhalofop-butyl and other herbicides. Both lines exhibited approximately 7-fold higher resistance to cyhalofop-butyl than a susceptible line. Ecf108 was susceptible to penoxsulam, an acetolactate synthase (ALS) inhibitor. On the other hand, Ecf27 showed resistance to penoxsulam and two other ALS inhibitors: propyrisulfuron and pyriminobac-methyl. The alternative herbicides butachlor, thiobencarb, and bispyribac-sodium effectively controlled both lines. To examine the molecular mechanisms of resistance, we amplified and sequenced the target-site encoding genes in Ecf27, Ecf108, and susceptible lines. Partial sequences of six ACCase genes and full-length sequences of three ALS genes were examined. One of the ACCase gene sequences encodes a truncated aberrant protein due to a frameshift mutation in both lines. Comparisons of the genes among Ecf27, Ecf108, and the susceptible lines revealed that none of the ACCases and ALSs in Ecf27 and Ecf108 have amino acid substitutions that are known to confer herbicide resistance, although a single amino acid substitution was found in each of three ACCases in Ecf108. Our study reveals the existence of a multiple-herbicide resistant biotype of E. crus-galli var. formosensis at Okayama, Japan that shows resistance to cyhalofop-butyl and several ALS inhibitors. We also found a biotype that is resistant only to cyhalofop-butyl among the tested herbicides. The resistance mechanisms are likely to be non-target-site based, at least in the multiple-herbicide resistant biotype.

We demonstrate a case of ocular impairment caused by a hydroxyapatite filler injection and review the prior literature on clinical presentations. A healthy woman, who received a hydroxyapatite filler injection into the glabella for nose augmentation suddenly had symptoms of nausea, diplopia, visual loss in the left eye, and impaired consciousness. Her left eye showed paresis of the inferior branch of the oculomotor nerve, conjunctival injection, cell infiltration in the anterior chamber, and multiple white spots in the nasal fundus. Purpura was detected in the area from the glabella to the left forehead. An orbital computed tomography (CT) scan demonstrated high-density deposits along vessels in the left medial orbit and forehead. Although her consciousness stabilized after a few days, the vision in her left eye deteriorated due to corneal edema and both hypopyon and hyphema in the anterior chamber, and the skin from the glabella to the left forehead developed necrosis. Multiple plaques were observed within the conjunctival and scleral vessels. After 2 months, diplopia and visual loss issues were mostly resolved. A histological examination of the conjunctiva specimen showed multiple foreign bodies plugged vessels that could be dissolved by decalcification. Recently, the number of complications by cosmetic filler injections has increased. The migrated hydroxyapatite particles in vessels cause multiple vascular emboli that can lead to various symptoms.

Immunoglobulin (Ig) G4-related disease (IgG4-RD) is a chronic inflammatory disorder characterized by elevated serum level of IgG4 and abundant infiltration of IgG4-bearing plasmacytes and fibrosis in various organs, typically including the lacrimal glands, salivary glands, pancreas, thyroid gland, lungs, and kidneys. Lacrimal and orbital involvements are called IgG4-related ophthalmic disease, often presenting as orbital myositis, perineuritis of the optic and trigeminal nerves, and orbital inflammation. In particular, a characteristic finding is infraorbital nerve enlargement on magnetic resonance imaging. Systemic screening is necessary to establish the diagnosis of IgG4-RD, and it must be distinguished from neoplastic disease. Corticosteroid treatment is effective in inducing remission but some patients may relapse during tapering of pharmacotherapy. This review encompasses the history, clinical profile, diagnostic criteria, treatment, and prognosis of IgG4-RD.

Three-dimensional structural analyses of huge spherulites of poly(oxyethylene) (PEG) using X-ray computerized tomography (CT) in blends of PEG and amorphous poly(d,l-lactic acid) are reported for the first time. Slit-shaped cracks that were straight or curved were clearly observed using X-ray CT. Furthermore, they appeared to form a set of spokes, presenting a signature of a huge spherulite. Several aspects that are representative of an axialite structure are presented, and they are in good agreement with the intuitively proposed structural model for axialite long ago, although the size scale is much larger in our study.

A novel aquachloridooxidodiperoxidomolybdate(vi), [MoClO(O2)2(OH2)](-), was crystallised as tetraethylammonium and triethylmethylammonium salts from strongly acidic aqueous solutions, and was structurally analysed by single crystal X-ray diffraction and NMR spectroscopy. The aqueous behaviour of the present anion observed by (17)O NMR agrees with that reported in a previous speciation study.

A dipotassium diaquadiphosphatooctaperoxotetramolybdate, [K2(P2O7){MoO(O2)2}2{MoO(O2)2(OH2)}2]2–, was crystallised as a tetramethylammonium salt and its structure was determined by single-crystal X-ray diffraction. The diaquadiphosphatooctaperoxotetramolybdate moiety (POPMo4) consists of four molybdenum decahedra and one μ4-diphosphate group. All Mo atoms bear two peroxo groups at their equatorial positions. Two of the four Mo atoms are also coordinated by a water molecule. The four molybdenum decahedra are separated and linked by the diphosphate group. The POPMo4 moieties are linked by potassium atoms to form an infinite anionic 1D double chain. The chains are connected by hydrogen bonds to water of crystallisation molecules to form a 2D network. POPMo4 or its precursor gives a 31P NMR signal at δ = –7.3 ppm in the reaction solution and is stable at low pH and a high Mo/diphosphate molar ratio.

The unit-cell parameters of the three title salts, namely, tripotassium, K3[Mo2(CHO2)O3(O2)4], trirubidium, Rb3[Mo2(CHO2)O3(O2)4], and triammonium μ-(formato-κ2O:O′)-μ-oxido-bis[oxidobis(peroxido-κ2O,O′)molybdate(VI)], (NH4)3[Mo2(CHO2)O3(O2)4], which were all crystallized at pH 3, are quite similar, but the potassium and rubidium salt structures are noncentrosymmetric, whereas that of the ammonium salt is centrosymmetric. Formate acts as anO:O′-bridging ligand in the complex anion and is bound to a μ-oxido-bis(oxidodiperoxidomolybdate) unit.

A polyoxometalate-silver ethynide composite cluster, [Ag42(CO3){C≡CC(CH3)3}27(α-A-SiW9Nb3O40)2](-) (1), demonstrates that we can select the binding site of a polyoxometalate to the silver alkynide cluster by tuning the surface charge of the precursor polyoxometalate. Multidimensional and multinuclear NMR spectra revealed that 1 maintains its precise atomic connectivity in the solution.

The self-assembly of dissolved symmetric bolaamphiphilic molecules is studied using dissipative particle dynamics simulations. Specifically, we investigate how interactions between the dual hydrophilic ends of the molecules affect the self-assembly process. Simulations show that four types of self-assembled structures (spherical micelles, tubes, vesicles, and wormlike micelles) are obtained from a random configuration of symmetric bolaamphiphilic molecules in solution. We find that the self-assembled structures change from spherical micelles to tubes, then to vesicles, and finally to wormlike micelles as the repulsive interactions between the hydrophilic ends increase. The molecular shapes in vesicles tend to be more rodlike than those in spherical micelles, tubes, or wormlike micelles.

An orange-yellow vanadomolybdate complex was prepared by heating a 100 mM MoVI–20 mM VV–0.45 M HCl–20% (v/v) CH3CN system at 70 °C for 24 h, being isolated as the tetrapropylammonium (Pr4N+) salt. ...

Kimihito Maeda, Yuichiro Ohara, Masato Hashimoto, Hiroshi OhguroDepartment of Ophthalmology, Sapporo Medical University, School of Medicine, Sapporo, JapanPurpose: To investigate whether serum levels of soluble Fas (sFas) and interleukin-6 (IL-6) could function as an index of the efficacy of steroid pulse treatment, we examined the serum level of these proteins before and after steroid pulse treatment in thyroid-associated ophthalmopathy patients.Methods: We gathered the blood of thyroid-associated ophthalmopathy patients before or after steroid pulse treatment, obtained serum with a centrifuge, and measured the serum levels of sFas and IL-6 by enzyme-linked immunosorbent assay (ELISA).Results: There was no difference in serum IL-6 value between pre- and poststeroid pulse treatment. Serum sFas value was significantly decreased in both pre- and poststeroid pulse treatment. Furthermore, there was a recognizable improvement in the degree of the extraocular muscle thickening after treatment in cases in whom the serum sFas value was lower than 3 ng/ml prior to the beginning of the therapy. In patients who had a serum sFas value of more than 3 ng/ml, there was no improvement in the degree of thickening of the extraocular muscle.Conclusions: Serum level of sFas is an accurate index of the outcome of steroid pulse treatment in thyroid-associated ophthalmopathy and may become a useful index to gauge the status of convalescence.Keywords: sFas, IL-6, ELISA, thyroid associated ophthalmopathy, steroid pulse treatment

The micelle formation in amphiphilic solution is investigated by molecular dynamics (MD) simulation of coarse-grained rigid amphiphiles with explicit solvent molecules. In our simulation model, the intensity of the hydrophilic interaction and the hydrophobic interaction can be varied independently. Our simulations show that various kinds of micellar structures are formed at a lower temperature by quenching from a random configuration of amphiphilic molecules in solution at a higher temperature. The micellar shape changes from a disc (bilayer) into a cylinder and then into a sphere as the intensity of the hydrophilic interaction increases. It is also found that the micelle formation proceeds in a stepwise fashion through the coalescence of smaller micelles. From the analysis of the orientational order for the amphiphilic molecules, it is concluded that the orientational order parameters can be used to distinguish the micellar shapes clearly.

The speciation in the phosphitomolybdate system, H+–MoO42−–(HP)O32−, has been determined from combined potentiometric and 31P NMR measurements in 0.600 M Na(Cl) medium at 298(1) K. Potentiometric titration data were collected in the ranges 2.5 < −log[H+] < 6.2, 40.0 ≤ [Mo]tot ≤ 240.0 mM, 10.0 ≤ [P]tot ≤ 40.0 mM and 1 ≤ [Mo]tot/[P]tot ≤ 10. 31P NMR data were collected in the same ranges with the exception that −log[H+] was decreased to 0.8. The pKa values of phosphite were determined by means of potentiometric (1.5 < −log[H+] < 8.6) and 31P NMR chemical shift data (0.0 < −log[H+] < 12.0). The following logβ (3σ) values were deduced: H(HP)O3−, 6.09(2); H2(HP)O3, 7.23(4) (pKa = 1.14). In the phosphitomolybdate system, the following complexes were found along with their formation constants ((HP) denotes phosphite): Mo5(HP)24−, 65.31(4); Mo6(HP)25−, 71.94(5); Mo5(HP)4−, 51.25(8); Mo5(HP)3−, 54.9(3); Mo6(HP)2−, 68.99(9); Mo7(HP)5−, 71.25(3); Mo7(HP)4−, 74.2(2). Because hydrolysis and oxidation of phosphite to phosphate were observed by NMR, with a mixed-hetero species of low [Mo]tot/[P]tot ratio being detected, the four-component H+–MoO42−–(HP)O32−–HPO42− system was also studied in the same way over the range 0.8 < −log[H+] < 6.2 and [Mo]tot/[P]tot fixed at 1.5. The following mixed heteropolyanion species have been found (P denotes the phosphate group): Mo5(HP)P5−, 62.27(6); Mo5(HP)P4−, 66.76(4). The equilibrium speciation in the two systems are illustrated by distribution diagrams. In addition, the aqueous structures are proposed for all the species formed in the systems.

To evaluate the usefulness of the signal intensity ratio (SIR) of the optic nerve to the white matter (WM) on short tau inversion recovery (STIR) images to diagnose acute optic neuritis (AON). The 405 consecutive patients with suspected orbital diseases underwent orbital magnetic resonance imaging (MRI) using a 3-T scanner between June 2008 and August 2011. Among them, 108 optic nerves (33 AON and 75 control) were retrospectively analysed. The averaged SIR (SIRave) and maximum SIR (SIRmax) were defined as the averaged signal intensity (SI) of the optic nerve divided by that of WM, and the maximum SI of the optic nerve divided by averaged SI of WM, respectively. These values were compared between AON and control using the Mann–Whitney U test. A P

A novel diphosphoheptadecatungstate complex, [(P2O7)W17O51]4− was prepared from a 200 mM (M = mol dm−3) W(VI)–10 mM P2O74−–0.6 M HCl–40% (v/v) CH3CN system, and characterized by IR, UV–vis, 31P NMR...

症例は38歳，男性．じん肺検診で，胸部CT上左肺S8に約1cm大の結節影を認めた．CTで腫瘤の辺縁は比較的明瞭で周囲に淡い浸潤影を伴っていた．喀痰細胞診，CTガイド下穿刺細胞診では悪性の所見は認めなかったが，画像所見上悪性の可能性が否定できないことから，胸腔鏡下肺部分切除を施行した．胸腔鏡下では腫瘍の位置が同定できず，小開胸を追加，用手的に同定し，肺部分切除を施行した．標本を術中迅速病理診に提出し，肺梗塞疑いの所見を得たため，それ以上の胸腔内操作を追加せず手術終了とした．本症例は多血症を合併しており，肺梗塞との因果関係が推測された．肺梗塞により腫瘤影を呈したまれな症例を経験したので報告する．

A 79-year-old woman presented with sudden unilateral visual loss after an ocular motor disturbance and pulsatile tinnitus. Neuro-ophthalmologic examination showed a presumed right posterior ischemic optic neuropathy (PION), oculosympathetic, and third, sensory fifth, and sixth cranial nerve pareses. Selective angiography of the right internal and external carotid arteries confirmed a posterior-draining dural carotid cavernous sinus fistula (CCF) fed by the right meningohypophyseal trunk and right middle meningeal artery. Angiography also showed an ophthalmic-middle meningeal arterial anastomosis. We postulate that the PION was caused by an arterial steal, because blood was drawn into the fistula and away from the intraorbital optic nerve.