Outcomes of 23-gauge pars plana vitrectomy in combined scleral buckling and vitrectomy for complex rhegmatogenous retinal detachments

Rhegmatogenous retinal detachments associated with proliferative vitreoretinopathy, giant retinal tears, ocular trauma, proliferative diabetic retinopathy, or necrotizing retinitis are considered more complex than those without these factors. The aim of the current review is to address the surgical outcomes and complications of 23-gauge pars plana vitrectomy with scleral buckling (23GPPV/SB) for repair of these complex retinal detachments. This retrospective study involved 54 eyes of 53 patients who underwent 23GPPV/SB between July 2007 and September 2009. Preoperative diagnosis, surgical technique, preoperative and postoperative visual acuities, intraoperative and postoperative complications, and anatomic reattachment rates were examined. Fifty-four eyes of 53 patients were reviewed in this study and indications for surgery varied. Mean logarithm of the minimal angle of resolution (logMAR) pre- and post-operative visual acuities were 1.166 (20/293) and 0.780 (20/120), respectively, which led to a statistically significant improvement in logMAR (P=0.0165). Single operation and final reattachment rates were 87% (47 of 54 eyes) and 100%, respectively. Postoperative complications included choroidal effusion/hemorrhage (14.8%, 8 of 54 eyes) and vitreous hemorrhage (11.1%, 6 of 54 eyes). Other more infrequent complications included hyphema (9.3%, 5 of 54 eyes), hypotony (5.6%, 3 of 54 eyes) and ocular hypertension > 35 mmHg (3.7%, 2 of 54 eyes). A total of 31.5% (17 of 54 eyes) of patients had a complication in the postoperative time period, but 58.8% of these resolved spontaneously without requiring an intervention. 23GPPV/SB may be considered for complex retinal detachment repair with good anatomic reattachment rates, but with relatively high complication rates

Probing Within Partially Coherent Microcavity Frequency Combs via Optical Pulse Shaping

Recent investigations of microcavity frequency combs based on cascaded four-wave mixing have revealed a link between the evolution of the optical spectrum and the observed temporal coherence. Here we study a silicon nitride microresonator for which the initial four-wave mixing sidebands are spaced by multiple free spectral ranges (FSRs) from the pump, then fill in to yield a comb with single FSR spacing, resulting in partial coherence. By using a pulse shaper to select and manipulate the phase of various subsets of spectral lines, we are able to probe the structure of the coherence within the partially coherent comb. Our data demonstrate strong variation in the degree of mutual coherence between different groups of lines and provide support for a simple model of partially coherent comb formation

EFFECTS OF TERNARY ADDITIONS OF ALUMINUM-35 w/o URANIUM ALLOYS

The effects of a number of ternary additions on the constitution, casting, and fabricating characteristics and the physical properties of aluminum- 35 wt.% uranium were investigated. Initial investigations were concerned with the effects of 3 at.% ternary additions on the microstructure and press-forging characteristics of the alloy. It was found that additions of this magnitude often introduced extrinsic phases in the alloy. At the 3 wt% level, additions of germanium, silicon, tin, or zirconium inhibited the formation of UAl/sub 4/ and thereby increased the extent of the aluminum matrix in the alloy. It was also noted that these additions decreased the pressures required for extruding, and the tin addition also improved the homogeneity of cast shapes. Lead and palladium also improved the homogeneity of the cast material; however, neither of these was an effective inhibitor of UAl/sub 4/ and free lead was detected in the alloy to which lead had been added as the ternary. From these studies it appears that tin and zirconium are as effective as silicon in enhancing the fabricating characteristics of rior when evaluated on the bases of casting qualities and recycling characteristics. (auth

Draft genome sequences of 64 type strains of 50 species and 25 subspecies of the genus Staphylococcus Rosenbach 1884

Members of the genus Staphylococcus have been isolated from humans, animals, and the environment. Accurate identification with whole-genome sequencing requires access to data derived from type strains. We provide sequence data for type strains of 64 taxa in the genus that at the time of this writing have standing in the nomenclatur

Current Density Measurements of an Annular-Geometry Ion Engine

The concept of the annular-geometry ion engine, or AGI-Engine, has been shown to have many potential benefits when scaling electric propulsion technologies to higher power. However, the necessary asymmetric location of the discharge cathode away from thruster centerline could potentially lead to non-uniformities in the discharge not present in conventional geometry ion thrusters. In an effort to characterize the degree of this potential nonuniformity, a number of current density measurements were taken on a breadboard AGI-Engine. Fourteen button probes were used to measure the ion current density of the discharge along a perforated electrode that replaced the ion optics during conditions of simulated beam extraction. Three Faraday probes spaced apart in the vertical direction were also used in a separate test to interrogate the plume of the AGI-Engine during true beam extraction. It was determined that both the discharge and the plume of the AGI-Engine are highly uniform, with variations under most conditions limited to 10% of the average current density in the discharge and 5% of the average current density in the plume. Beam flatness parameter measured 30 mm from the ion optics ranged from 0.85 0.95, and overall uniformity was shown to generally increase with increasing discharge and beam currents. These measurements indicate that the plasma is highly uniform despite the asymmetric location of the discharge cathode

Evaluation of early and late presentation of patients with ocular mucous membrane pemphigoid to two major tertiary referral hospitals in the United Kingdom

PURPOSE: Ocular mucous membrane pemphigoid (OcMMP) is a sight-threatening autoimmune disease in which referral to specialists units for further management is a common practise. This study aims to describe referral patterns, disease phenotype and management strategies in patients who present with either early or established disease to two large tertiary care hospitals in the United Kingdom.\ud \ud PATIENTS AND METHODS: In all, 54 consecutive patients with a documented history of OcMMP were followed for 24 months. Two groups were defined: (i) early-onset disease (EOD:<3 years, n=26, 51 eyes) and (ii) established disease (EstD:>5 years, n=24, 48 eyes). Data were captured at first clinic visit, and at 12 and 24 months follow-up. Information regarding duration, activity and stage of disease, visual acuity (VA), therapeutic strategies and clinical outcome were analysed.\ud \ud RESULTS: Patients with EOD were younger and had more severe conjunctival inflammation (76% of inflamed eyes) than the EstD group, who had poorer VA (26.7%=VA<3/60, P<0.01) and more advanced disease. Although 40% of patients were on existing immunosuppression, 48% required initiation or switch to more potent immunotherapy. In all, 28% (14) were referred back to the originating hospitals for continued care. Although inflammation had resolved in 78% (60/77) at 12 months, persistence of inflammation and progression did not differ between the two phenotypes. Importantly, 42% demonstrated disease progression in the absence of clinically detectable inflammation.\ud \ud CONCLUSIONS: These data highlight that irrespective of OcMMP phenotype, initiation or escalation of potent immunosuppression is required at tertiary hospitals. Moreover, the conjunctival scarring progresses even when the eye remains clinically quiescent. Early referral to tertiary centres is recommended to optimise immunosuppression and limit long-term ocular damage.\ud \u