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PurposeTo examine the effects of caffeinated coffee consumption on intraocular pressure (IOP), ocular perfusion pressure (OPP), and ocular pulse amplitude (OPA) in those with or at risk for primary open-angle glaucoma (POAG).MethodsWe conducted a prospective, double-masked, crossover, randomized controlled trial with 106 subjects: 22 with high tension POAG, 18 with normal tension POAG, 20 with ocular hypertension, 21 POAG suspects, and 25 healthy participants. Subjects ingested either 237 ml of caffeinated (182 mg caffeine) or decaffeinated (4 mg caffeine) coffee for the first visit and the alternate beverage for the second visit. Blood pressure (BP) and pascal dynamic contour tonometer measurements of IOP, OPA, and heart rate were measured before and at 60 and 90 min after coffee ingestion per visit. OPP was calculated from BP and IOP measurements. Results were analysed using paired t-tests. Multivariable models assessed determinants of IOP, OPP, and OPA changes.ResultsThere were no significant differences in baseline IOP, OPP, and OPA between the caffeinated and decaffeinated visits. After caffeinated as compared with decaffeinated coffee ingestion, mean mm Hg changes (±SD) in IOP, OPP, and OPA were as follows: 0.99 (±1.52, P<0.0001), 1.57 (±6.40, P=0.0129), and 0.23 (±0.52, P<0.0001) at 60 min, respectively; and 1.06 (±1.67, P<0.0001), 1.26 (±6.23, P=0.0398), and 0.18 (±0.52, P=0.0006) at 90 min, respectively. Regression analyses revealed sporadic and inconsistent associations with IOP, OPP, and OPA changes.ConclusionConsuming one cup of caffeinated coffee (182 mg caffeine) statistically increases, but likely does not clinically impact, IOP and OPP in those with or at risk for POAG. [ABSTRACT FROM AUTHOR]

Abstract: This paper proposes an efficient multiuser adaptive modulation and coding (AMC) scheme that considers inevitable feedback delay by employing short-term and long-term channel state information (CSI) in time-varying frequency-selective fading channels. By taking the statistic of the true signal-to-noise ratio (SNR) at a given predicted SNR value into account, the required transmit power to meet the target packet-error-rate (PER) can be obtained and used for user selection, power allocation, and modulation and coding set (MCS) selection. In addition, a simple and useful approximation method of obtaining the required transmit power is proposed. The performance of the proposed scheme is shown to be much better than that of conventional schemes without considering the feedback delay or the prediction error. The proposed scheme can also reduce the feedback resource while maintaining the system throughput by allocating different feedback resources to different users according to their prediction error variances. [Copyright &y& Elsevier]

Background. Microvascular decompression (MVD) for hemifacial spasm (HFS) provides a long-term cure rate. Delayed facial palsy (DFP) is not an unusual complication, but it has only been sporadically described in the literature. The purpose of this report is to evaluate the incidence of delayed facial palsy after MVD and its clinical course and final results. Methods. From January, 1998 to April, 2004, 410 patients underwent microvascular decompression for hemifacial spasm at our Institute. During this time, 21 patients (5.4%) developed delayed facial weakness; eighteen of them were given steroid medication and they were followed up in the out-patient clinic. Findings. Twenty-one patients developed DFP after microvascular decompression an incidence of 5.4%. There were seventeen women (81.0%) among the 21 patients with DFP who were included in this study. In twenty of them, the symptoms of HFS improved completely after the operation, but the spasm remained with one of them. The onset of palsy occurred between postoperative day 7 and 23 (average: 12.1 days). The palsy was at least Grade II or worse on the House-Brackmann (HB) scale. The time to recovery averaged 5.7 weeks (range: 25 days–17 weeks); 20 patients improved to complete recovery and 1 patient remained with minimal weakness, as Grade II on the HB scale, at the follow-up examination. Conclusion. Our findings demonstrated that the incidence of DFP was not so low as has been reported the literature, and it did not have any striking predisposing factors. Even though the degree of facial palsy was variable, almost all patients exhibited a complete recovery without any further special treatment. The etiology of DFP and its association with herpes infection should be further clarified. [ABSTRACT FROM AUTHOR]

Aims: To determine the prevalence of intraocular pressure (IOP) alterations following intravitreal injection of triamcinolone acetonide (IVTA) and to assess possible risk factors of IOP elevation in eyes receiving single and/or repeat injections. Methods: Retrospective, consecutive case series. 570 consecutive eyes of 536 patients who received a single IVTA injection (4 mg/0.1 ml) and a second set of 43 eyes of 40 patients who received a second injection. Retrospective review of all IVTA cases performed by three vitreoretinal surgeons over a 42 month period beginning in 2000. The main outcome measure was change in IOP defined as absolute value of IOP elevation (5 mm Hg or higher, 10 mm Hg or higher), and percentage of baseline (30% or higher increase from baseline IOP). Results: Of the 528 eyes receiving single injections, 281 (53.2%) had an IOP elevation; 267 eyes (50.6%) experienced an elevation of IOP of at least 30%, and 245 (45.8%) and 75 (14.2%) eyes had an increase of 5 mm Hg or 10 mm Hg or more, respectively. Baseline IOP greater than 16 mm Hg is a risk factor for post-injection IOP elevation. Of the 43 eyes which received a second injection, 28 (65.1%) experienced an increase in IOP of at least 30% of baseline. Filtering surgery was required in five (0.094%) of the single and one (2.3%) of repeat injection eyes. Conclusions: Elevated IOP after IVTA is common and patients should be monitored beyond 6 months post-injection. Patients with a baseline IOP more than 16 mm Hg or receiving a second injection should be carefully monitored for an elevated IOP. [ABSTRACT FROM AUTHOR]

This paper presents elite-based simplex-GA hybrid approach combined with multipop-GA (ESGA) to determining the location, size, and number of capacitors to improve voltage profile and minimize power losses in unbalanced distribution systems. One of the main obstacles in applying GA to complex problems has been the high computational cost due to their slow convergence rate. To alleviate this difficulty, ESGA hybrid approach was developed that combines elite-based simplex-GA hybrid approach with multipop-GA. The objective function formulated consists of two terms: cost for energy losses and cost related to capacitor purchase and capacitor installation. The cost function associated with capacitor placement is considered as a step function due to banks of standard discrete capacities. Its efficiency was proved through the application in IEEE 13-bus and 34-bus test systems and was compared with several methods using GA. [ABSTRACT FROM AUTHOR]

High-power, large-angle (>=10°), collective Thomson scattering diagnostics can provide localized density and velocity distribution data of confined alpha particles, ICRH simulated alpha particles, and ions related to ICRH and neutral beam energy deposition. Millimeter-wave gyrotron systems are under development for TFTR and JET. Scattering with a submillimeter gyrotron is being investigated for Alcator C-Mod. Major design issues include plasma accessibility, scattering angle, orientation to magnetic field, spectra of non-Maxwellian velocity distributions, signal-to-noise ratio, refraction, electron cyclotron emission, and beam and viewing dumps. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented regarding a 26-year-old Korean man with Guillain-Barré syndrome.

A large-angle, 60-GHz collective Thomson scattering (CTS) diagnostic system for localized measurements of DT alpha-particle velocity distribution and fraction is being implemented on TFTR. Calculations of expected CTS spectra, signal-to-noise ratio per receiver channel, and estimated error in determining the temperature and fraction of alpha particles are being carried out. The experimental spectra are simulated by adding noise to the theoretical calculation by a Monte Carlo technique. Error analysis is then performed by using a relative intensity calibrated nonlinear curve fitting code to calculate the desired plasma parameters (T[sub i], T[sub α], n[sub α]/n[sub i]). Simulation results indicate that expected background emission of 20 eV during Supershot in TFTR poses no problem to the experiment. Also short integration times (<10 ms) can be used to resolve the energetic ion features, thus offering a possibility for the study of temporal evolution of energetic ion velocity distribution during a single plasma shot. [ABSTRACT FROM AUTHOR]

A novel new method is proposed to measure the internal magnetic field pitch angle in tokamaks by measuring the frequency of the lower hybrid resonance in the collective Thomson scattered spectrum. The resonance frequency has a dependence of 1.2 and 2.0 GHz/deg pitch angle for ITER and C-MOD-like plasma parameters, respectively, using a submillimeter-wave diagnostic source. Sensitivity to other plasma parameters such as electron density, temperature, energetic ion fraction, and magnetic field is shown to be weak. [ABSTRACT FROM AUTHOR]

Theoretical scattered spectra from energetic ions in tokamak plasmas (TFTR and Alcator C-Mod) are calculated. A new numerical code that calculates the collective Thomson scattered spectrum with a completely arbitrary distribution function was developed to model scattered spectra in ICRF heated and DT burning plasmas. Calculated spectra for nonthermal minority He³ ions in ICRF heated plasmas along with results from Maxwellian distributions are shown. [ABSTRACT FROM AUTHOR]

Dermatofibroma (DF) is a common benign fibrohistiocytic tumour with a predilection for the legs in middle-aged women. Giant DF, a rare clinical variant of DF, is characterized by its unusually large size. Granular cell change is typical of granular cell tumour, but can be observed in diverse cell lineages. Traumatic factors may be involved in the pathogenesis of giant DF and cellular granularity. We describe a 49-year-old Korean man with a giant DF showing granular cell differentiation, which may have been caused in part by multiple treatments with bee-venom acupuncture. [ABSTRACT FROM AUTHOR]

High-power, large-angle (> 10°), collective Thomson scattering diagnostics can provide localized density and velocity distribution data of confined alpha particles, ICRH simulated alpha particles, and ions related to ICRH and neutral beam energy deposition. Millimeter-wave gyrotron systems are under development for TFTR and JET. Scattering with a submillimeter gyrotron is being investigated for Alcator C-Mod. Major design issues include plasma accessibility, scattering angle, orientation to magnetic field, spectra of non-Maxwellian velocity distributions, signal-to-noise ratio, refraction, electron cyclotron emission, and beam and viewing dumps. [ABSTRACT FROM AUTHOR]

Introduction: Hernia repair is one of the most frequently performed surgical procedures worldwide, yet more than half of hernias may be untreated in African countries that lack adequate and affordable surgical care. Although this disease burden can be effectively reduced by surgical repair, public health efforts to promote repair have been sparse because of the presumed high cost of surgery. Objective: To review the epidemiology and treatment of hernias in African countries and to assess the efficacy and safety of using low-cost mesh for repair in resource-limited settings. Methods: An extensive literature search was performed using PubMed and the Cochrane Library to locate pertinent background information and studies that used low-cost alternatives to commercial mesh. Results: Most hernia repairs in Africa are performed as high-risk emergency procedures. When treatment is provided, fewer than 5% are repaired using implanted mesh because of its high cost, despite the demonstrated improvement in clinical outcomes with tension-free repair. A total of four studies using low-cost mesh were reviewed. Three of the studies compared postoperative outcomes for repairs using sterile mosquito nets with those using commercial surgical mesh. The fourth study randomized patients to receive either an indigenous bilayer device or the Prolene Hernia System. No significant differences in recurrence or in incidence of wound complications between repairs using low-cost and commercial mesh were observed. The price of low-cost mesh was generally less than 1/1,000 the price of commercial mesh. Conclusions: There were no significant differences in outcomes between repairs using low-cost and commercial mesh. While the size of the study populations and the limited time for follow-up preclude conclusive measures of effectiveness, recurrence, and long-term complications, these studies demonstrate that providing an improved standard of surgical care need not be prohibitively expensive. [ABSTRACT FROM AUTHOR]

Aim: To determine the predictive value of the 2 week post-selective laser trabeculoplasty (SIT) intraocular pressure (lOP) by comparing it to the 4 week and 3 month values. Methods: A retrospective chart review of eyes that underwent SLT between 2001 and 2004 was performed. The primary outcome measure was lOP. Demographic and medical data were collected for correlational analysis. Results: 132 eyes of 95 patients were identified, none was excluded. Of the eyes that exhibited a decrease in lop of >1 mmHg at 2 weeks postoperatively, 99.24% continued to show a lowered lOP at the 4 week and 3 month visits. For these patients, the Pearson's r value between 2 weeks and 4 weeks was 0.708 (p value=0.01) while the r value between 2 weeks and 3 months was 0.513 (p value=0.01). Conclusions: The 2 week visit post-SLT predicted the 4 week and 3 month visits if the 2 week visit demonstrated a decrease in lOP. These findings suggest that those patients who had a decreased lOP at 2 weeks and are at their goal lOP may not need to be screened until 3 months postoperatively. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented requesting for further cases and studies to determine the pathophysiological mechanisms of Erythema annulare centrifugum and isotopic response.

Objective: Organophosphate insecticide (OPI) self-poisoning is a major medical problem in many countries. Several studies have demonstrated that the base deficit (BD) is a prognostic tool that is correlated with the severity of injury and predicted mortality, particularly in trauma patients. Here, we aimed to investigate the prognostic significance of BD in OPI poisoning. Methods: This retrospective observational study was conducted between January 1, 2006, and January 31, 2015, at a single emergency department (ED). The BD values were divided into quartiles according to the number of patients: 3 mEq/L or less, 3–5.9 mEq/L, 6–9.9 mEq/L, and 10 mEq/L or greater. Survival at 30 days from ED admission was estimated using the Kaplan–Meier survival analysis. Results: Among 154 patients, 31 died, yielding a mortality of 20.1%. The highest BD quartile (≥ 10 mEq/L) and the 6–9.9 mEq/L group were associated with an increased risk of 30-day mortality. Patients with a BD of 10 mEq/L or greater had a 5.85-fold higher risk of 30-day mortality and patients with a BD of 6–9.9 mEq/L had a 5.40-fold higher risk of 30-day mortality compared to patients with a BD of 3 mEq/L or less. The area under the curves of the BD and the Acute Physiology and Chronic Health Evaluation II score for mortality were 0.748 (95% confidence interval (CI), 0.660–0.835) and 0.852 (95% CI, 0.789–0.915), respectively. Conclusions: This study showed that the BD is a predictor of 30-day mortality in patients with OPI poisoning. [ABSTRACT FROM AUTHOR]

Ikaros is known as a critical regulator of lymphocyte development. We examined the regulatory role of Ikaros in LPS/IFN-γ-induced inducible nitric oxide synthase (iNOS) expression by macrophages. Our results showed that IK6 (Ikaros dominant negative isoform) induction increases the iNOS expression. Ikaros DNA binding activity on the iNOS promoter was decreased, and a mutation of the Ikaros-binding site on the iNOS promoter resulted in an increase in LPS/IFN-γ-induced iNOS expression. LPS/IFN-γ increased the histone (H3) acetylation on the Ikaros DNA binding site. These results suggest that Ikaros acts as a negative regulator on iNOS expression. Treatment with a casein kinase 2 (CK2) inhibitor reversed LPS/IFN-γ-induced decrease in Ikaros DNA binding activity. Moreover, overexpression of kinase-inactive CK2 decreased iNOS expression and a significant amount of CK2α1 translocated into the nucleus in LPS/IFN-γ-treated cells. Overall, these data indicate that LPS/IFN-γ decreases the Ikaros DNA binding activity via the CK2 pathway, resulting in an increase of iNOS expression. [ABSTRACT FROM AUTHOR]

A third-harmonic electron cyclotron emission diagnostic using ultrawide bandwidth (asymp; 40 GHz) heterodyne receivers centered on 120 GHz with 14 channels per radial view is described for localized, long wavelength (5 ... λ ... 50 cm), fast time response (≈ 1 µs) fluctuation studies in the PBX-M tokamak. The optically gray emission signal will have a γñ[sub e]/n[sub e] + (3/β)&Ttilde;[sub e]/T[sub e] dependence on temperature and density fluctuations where γ≤ 1 and 1 ≤ β ≤ 3 depending on local optical depth. Electron temperature fluctuation sensitivity is estimated to be 0.2% ≤ &Ttilde;[sub e]/T[sub e] ≤ 2.9% depending on local optical depth and fluctuation frequency in the 0.1-1 MHz range. Spatial resolution of approximately 3 cm radially and 5 cm vertically are estimated for 2 keV plasmas with low suprathermal electron emission. [ABSTRACT FROM AUTHOR]

Collective Thomson scattering in the Tara Tandem Mirror axicell at MIT was accomplished with a 137-GHz, ∼0.4-kW, 75-ms pulsed gyrotron. Ion cyclotron waves, ion Bernstein wave harmonics, and other plasma fluctuations possibly due to microinstabilities and magnetohydrodynamic (MHD) activity have been observed during ion cyclotron resonance frequency (ICRF) heating. The observation of ion Bernstein waves may be due to an enhanced ion thermal fluctuation spectrum in an ICRF heated plasma. [ABSTRACT FROM AUTHOR]

In D-T plasmas, the understanding of the physics of confined a particles is extremely valuable for the future fusion plasma device. Among the various proposed α diagnostics, an X-mode collective Thomson scattering system employing a high-power gyrotron source (P...200 kW, f=60 GHz, pulse length ...0.5 s, and modulation frequency=10-25 kHz) is being designed for TFTR. The detailed description of the gyrotron source, transmission lines, optical designs, beam and viewing dump design, and receiver system will be presented in this paper. In particular, the test results of the beam and viewing dump indicate that the stray light can be reduced by 60 dB. The background emission level (∼20 eV) near 60-GHz range during high Q discharge may also be reduced with beam and viewing dump further. The optical system is designed to measure the radial profile of a particles and to orient the incident wavevector (k[sub 0]) to test the electromagnetic effects of the scattered spectrum. Prior to the study of α physics in D-T plasmas, this scattering system will be used to measure not only a bulk ion temperature but also the scattered spectrum due to fast ions produced by NB and ICRF heating in TFTR. This work was supported by the U.S. Department of Energy Contract No. DE-AC02-76-CHO-3073. [ABSTRACT FROM AUTHOR]