A case of intractable infectious keratitis and subsequent flap necrosis after laser in situ keratomileusis

We report on a patient in whom intractable infectious keratitis and subsequent lamellar flap necrosis necessitating flap amputation after laser in situ keratomileusis (LASIK). A 34-year-old woman undergoing LASIK complained of blurred vision and pain in the left eye. The best spectacle-corrected visual acuity was 0.01, and slit-lamp examination showed a marked presence of stromal infiltrates involving the flap and the underlying stroma in that eye. The patient was treated topically with hourly instillation of micronomicin, levofloxacin, and cefmenoxime, together with systemic administration of imipenem, but the left eye developed corneal flap necrosis. We performed surgical debridement of the diseased stroma and excised the lamellar flap. Since nontuberculous mycobacterium was detected on the surgical instruments, we then added oral clarithromycin, and substituted systemic administration of amikacin with that of imipenem. At one month after the flap removal, the visual acuity gradually improved to 0.7, but the stromal opacity of the central cornea and hyperopic shift of +3.0 diopters remained. LASIK can cause intractable keratitis, resulting in significant visual disturbance that presumably results from insufficient antisepsis of the medical instruments used for this surgery, supporting the importance of strict sterilization of these instruments

A Clinical Evaluation of a Plastic Temporary Filling Material (Dura Seal®)

Recently Dura Seal, a kind of plastic, has been marketed as a temporary filling material. This clinical study was done to determine whether or not Dura Seal has the properties advertised by the manufacturer. A total of 135 teeth, including 110 vital teeth and 25 pulpless teeth, were prepared for metal inlay cavities. The prepared cavities were sealed with Dura Seal for an average of 12.0 days. Dura Seal was found to be easily removable, to show no pulp damage, and to have considerable mechanical strength

Studies of dust transport in long pulse plasma discharges in the large helical device

Three-dimensional trajectories of incandescent dust particles in plasmas were observed with stereoscopic fast framing cameras in a large helical device. It proved that the dust is located in the peripheral plasma and most of the dust moves along the magnetic field lines with acceleration in the direction that corresponds to the plasma flow. ICRF heated long pulse plasma discharges were terminated with the release of large amounts of dust from a closed divertor region. After the experimental campaign, the traces of exfoliation of carbon rich mixed-material deposition layers were found in the divertor region. Transport of carbon dust is investigated using a modified dust transport simulation code, which can explain the observed dust trajectories. It also shows that controlling the radius of the dust particles to less than 1 mm is necessary to prevent the plasma termination by penetration of dust for the long pulse discharges. Dust transport simulation including heavy metal dust particles demonstrates that high heating power operation is effective for shielding the main plasma from dust penetration by an enhanced plasma flow effect and a high heat load onto the dust particles in the peripheral plasma. It shows a more powerful penetration characteristic of tungsten dust particles compared to that of carbon and iron dust particles

Characterization of Ion Cyclotron Wall Conditioning Using Material Probes in LHD

The ion cyclotron wall conditioning (ICWC) is one of the conditioning methods to reduce impurities and to remove tritium from the plasma facing components. Among the advantages of ICWC are the possible operation under strong magnetic field for fully torus area based on the charge exchange damage observed in thin SS samples arranged on a hexahxedron block holder with three different facings, the areas influenced by ICWC is estimated. On the plasma facing area of the material holder, high density of helium bubbles is observed by transmission electron microscope (TEM). But the other areas show no observable damage. The fact that the bubble were observed only in a sample facing the plasma implies that the effective particles, most probably charge exchange neutrals come to the wall straightly Thus, cleaning of the surfaces un-exposed to plasma directly and those in shadow area is difficult by ICWC

Current Status of Large Helical Device and Its Prospect for Deuterium Experiment

Achievement of reactor relevant plasma condition in Helical type magnetic devices and exploration in its related plasma physics and fusion engineering are the aim of the Large Helical Device (LHD) project. In the recent experiments on LHD, we have achieved ion-temperature of 8.1 keV at 1 × 1019 m−3 by the optimization of wall conditioning using long pulse discharge by Ion Cyclotron Heating (ICH). The electron temperature of 10 keV at 1.6 × 1019 m−3 was also achieved by the optimization of Electron Cyclotron Heating (ECH). For further improvement in plasma performance, the upgrade of the Large Helical Device (LHD), including the deuterium experiment, is planned. In this paper, the recent achievements on LHD and the upgrade of LHD are described

Acrolein Induces Endoplasmic Reticulum Stress and Causes Airspace Enlargement

BACKGROUND: Given the relative abundance and toxic potential of acrolein in inhaled cigarette smoke, it is surprising how little is known about the pulmonary and systemic effects of acrolein. Here we test the hypothesis whether systemic administration of acrolein could cause endoplasmic reticulum (ER) stress, and lung cell apoptosis, leading to the enlargement of the alveolar air spaces in rats. METHODS: Acute and chronic effects of intraperitoneally administered acrolein were tested. Mean alveolar airspace area was measured by using light microscopy and imaging system software. TUNEL staining and immunohistochemistry (IHC) for active caspase 3 and Western blot analysis for active caspase 3, and caspase 12 were performed to detect apoptosis. The ER-stress related gene expression in the lungs was determined by Quantitative real-time PCR analysis. Acrolein-protein adducts in the lung tissue were detected by IHC. RESULTS: Acute administration of acrolein caused a significant elevation of activated caspase 3, upregulation of VEGF expression and induced ER stress proteins in the lung tissue. The chronic administration of acrolein in rats led to emphysematous lung tissue remodeling. TUNEL staining and IHC for cleaved caspase 3 showed a large number of apoptotic septal cells in the acrolein-treated rat lungs. Chronic acrolein administration cause the endoplasmic reticulum stress response manifested by significant upregulation of ATF4, CHOP and GADd34 expression. In smokers with COPD there was a considerable accumulation of acrolein-protein adducts in the inflammatory, airway and vascular cells. CONCLUSIONS: Systemic administration of acrolein causes endoplasmic reticulum stress response, lung cell apoptosis, and chronic administration leads to the enlargement of the alveolar air spaces and emphysema in rats. The substantial accumulation of acrolein-protein adducts in the lungs of COPD patients suggest a role of acrolein in the pathogenesis of emphysema

Stable sustainment of plasmas with electron internal transport barrier by ECH in the LHD

The long pulse experiments in the Large Helical Device has made progress in sustainment of improved confinement states. It was found that steady-state sustainment of the plasmas with improved confinement at the core region, that is, electron internal transport barrier (e-ITB), was achieved with no significant difficulty. Sustainment of a plasma having e-ITB with the line average electron density ne_ave of 1.1 × 1019 m−3 and the central electron temperature Te0 of ∼3.5 keV for longer than 5 min only with 340 kW ECH power was successfully demonstrated

Progress of long pulse discharges by ECH in LHD

Using ion cyclotron heating and electron cyclotron heating (ECH), or solo ECH, trials of steady state plasma sustainment have been conducted in the superconducting helical/stellarator, large helical device (LHD) (Ida K et al 2015 Nucl. Fusion 55 104018). In recent years, the ECH system has been upgraded by applying newly developed 77 and 154 GHz gyrotrons. A new gas fueling system applied to the steady state operations in the LHD realized precise feedback control of the line average electron density even when the wall condition varied during long pulse discharges. Owing to these improvements in the ECH and the gas fueling systems, a stable 39 min discharge with a line average electron density ne_ave of 1.1  ×  1019 m−3, a central electron temperature Te0 of over 2.5 keV, and a central ion temperature Ti0 of 1.0 keV was successfully performed with ~350 kW EC-waves. The parameters are much improved from the previous 65 min discharge with ne_ave of 0.15  ×  1019 m−3 and Te0 of 1.7 keV, and the 30 min discharge with ne_ave of 0.7  ×  1019 m−3 and Te0 of 1.7 keV

Extension of operational regime in high-temperature plasmas and effect of ECRH on ion thermal transport in the LHD

A simultaneous high ion temperature (Ti) and high electron temperature (Te) regime was successfully extended due to an optimized heating scenario in the LHD. Such high-temperature plasmas were realized by the simultaneous formation of an electron internal transport barrier (ITB) and an ion ITB by the combination of high power NBI and ECRH. Although the ion thermal confinement was degraded in the plasma core with an increase of Te/Ti by the on-axis ECRH, it was found that the ion thermal confinement was improved at the plasma edge. The normalized ion thermal diffusivity ${{\chi}_{\text{i}}}/T_{\text{i}}^{1.5}$ at the plasma edge was reduced by 70%. The improvement of the ion thermal confinement at the edge led to an increase in Ti in the entire plasma region, even though the core transport was degraded