Ring Keratitis Associated With Topical Abuse of a Dilute Anesthetic After Refractive Surgery

Anesthetic toxic keratitis is rare and presents as a ring keratitis, which is often misdiagnosed as Acanthamoeba keratitis. Here, we report an unusual case of toxic keratitis caused by topical abuse of a dilute anesthetic. A 26-year-old woman presented with bilateral corneal edema, ring infiltrates, pigmented keratic precipitate, Descemet's membrane folding, and strong anterior chamber reactions 2 weeks after laser subepithelial keratomileusis surgery. Tracing back her medical history, topical dilute 0.1% proparacaine was prescribed and frequently used for 1 month. Toxic keratitis was suspected. After discontinuation of the topical anesthetic and initiation of treatment with topical 20% autologous serum, complete corneal epithelialization was achieved within 1 week. Corneal infiltrates and anterior chamber reaction gradually subsided. Vision improved from finger counting to 20/20 in the right eye and 20/25 in the left eye, but confocal microscopy showed decreased corneal endothelial cells. Topical abuse of a dilute topical anesthetic can cause severe toxic keratitis and endothelial cell loss. The physician must be aware of the signs of topical anesthetic abuse and should not prescribe even a dilute anesthetic for long-term use. Autologous serum can help in the recovery of toxic keratitis

Esophageal Food Impaction: A Homemade Suction Tube Attached to Esophagogastroduodenoscopy for Food Bolus Removal

The most common esophageal foreign body in adults is impacted food bolus. Polypectomy snares, Dormia baskets, retrieval nets, rat-tooth forceps, alligator forceps or polyp graspers are usually used to remove it. Here, we report the case of a 78-year-old woman whose esophagogastroduodenoscopy (EGD) showed a firm goose liver impacted tightly in the lower esophagus; all of the above-mentioned retrieval instruments could not remove it. We used a homemade device by attaching a modified nasogastric tube to an EGD and successfully removed the goose liver by suction under endoscopic visualization. The method is very effective to remove firm and tightly impacted materials in a narrow lumen. When the usual retrieval instruments fail, a homemade suction tube attached to an EGD is an alternative

Single crystalline beta-SiAlON nanowhiskers: preparation and enhanced properties at high temperature

Single crystalline β-SiAlON (z = 1.0) nanowhiskers with uniform morphology were prepared using a reaction sintering method at 1773 K for 6 h under flowing nitrogen atmosphere. The as-synthesized whiskers were well-crystallized with about 100-200 nm in diameter and a few hundred microns in length. According to the thermodynamic calculation, Al(g) and SiO(g) are important intermediate reactants to synthesize β-SiAlON whiskers. In the experiment, the two phases was controlled by changing the flow rate of nitrogen to make β-SiAlON whiskers grow in a stable way. The formation of β-SiAlON whiskers occurred through a vapor-solid (VS) mechanism. SiAlON was found to grow as a single crystal whisker from the (1010) plane of the granule. Furthermore, an enhanced oxidation resistance for β-SiAlON whiskers at high temperature was also observed using the thermogravimetry method (TG), demonstrating that β-SiAlON whiskers with uniform morphology is a promising candidate as a reinforcing agent in composite

Automatic Emergency Dust-Free solution on-board International Space Station with Bi-GRU (AED-ISS)

With a rising attention for the issue of PM2.5 or PM0.3, particulate matters have become not only a potential threat to both the environment and human, but also a harming existence to instruments onboard International Space Station (ISS). Our team is aiming to relate various concentration of particulate matters to magnetic fields, humidity, acceleration, temperature, pressure and CO2 concentration. Our goal is to establish an early warning system (EWS), which is able to forecast the levels of particulate matters and provides ample reaction time for astronauts to protect their instruments in some experiments or increase the accuracy of the measurements; In addition, the constructed model can be further developed into a prototype of a remote-sensing smoke alarm for applications related to fires. In this article, we will implement the Bi-GRU (Bidirectional Gated Recurrent Unit) algorithms that collect data for past 90 minutes and predict the levels of particulates which over 2.5 micrometer per 0.1 liter for the next 1 minute, which is classified as an early warningComment: 11 pages, 5 figures, and 1 tabl

Plasmonic Circular Nanostructure for Enhanced Light Absorption in Organic Solar Cells

This study attempts to enhance broadband absorption in advanced plasmonic circular nanostructures (PCN). Experimental results indicate that the concentric circular metallic gratings can enhance broadband optical absorption, due to the structure geometry and the excitation of surface plasmon mode. The interaction between plasmonic enhancement and the absorption characteristics of the organic materials (P3HT:PCBM and PEDOT:PSS) are also examined. According to those results, the organic material's overall optical absorption can be significantly enhanced by up to ~51% over that of a planar device. Additionally, organic materials are enhanced to a maximum of 65% for PCN grating pitch = 800 nm. As a result of the PCN's enhancement in optical absorption, incorporation of the PCN into P3HT:PCBM-based organic solar cells (OSCs) significantly improved the performance of the solar cells: short-circuit current increased from 10.125 to 12.249 and power conversion efficiency from 3.2% to 4.99%. Furthermore, optimizing the OSCs architectures further improves the performance of the absorption and PCE enhancement

Clinicopathologic Evaluation of Prognostic Factors for Squamous Cell Carcinoma of the Buccal Mucosa

BackgroundThe purpose of this research was to evaluate the prognostic significance of clinicopathologic variables on the survival rate for squamous cell carcinoma of the buccal mucosa (BMSCC). We analyzed the outcomes of surgical therapy for this aggressive cancer and compared these results with those in the literature.MethodsWe reviewed the medical charts of 172 patients treated in our institution between 1990 and 2005. There were 22 patients excluded from our studies: 20 patients with advanced tumors who received no treatment or palliative treatment, and 2 patients who had received preoperative radiotherapy (RT). The remaining 150 patients were treated with surgeries and among them, 56 patients had undergone postoperative RT. The influence of clinicopathologic factors on the survival rate was analyzed with the Kaplan-Meier method and log-rank test. Multivariate analysis was assessed with Cox's regression model.ResultsThere were 148 males and 2 females, with a mean age of 53.5 years. The prevalence rate of habitual betel quid chewing documented in charts among 113 patients was 75%. The 5-year overall survival rate and disease-specific survival rate for all patients were 64% and 69%, respectively. For patients with stages I, II, III, and IV disease, the 5-year disease-specific survival rates were 90%, 77%, 52%, and 47%, respectively (p< 0.001). According to the multivariate analysis, the pathologic staging and histologic grading of the tumor were independently the important prognostic factors affecting survival rate. There were 80 patients who developed locoregional recurrence in lymph nodes in the follow-up diagnoses. Distant metastases occurred in 14 patients, with 11 of them also having locoregional recurrence. The distant metastases were found in the lungs (8/14), T-spine (3/14), liver (2/14) and brain (1/14).ConclusionPathologic stage and histologic grade are the most important prognostic factors

Thrombolysis in Myocardial Infarction Frame Count in Single-Vessel Disease After Angioplasty

SUMMARYBackgroundWe compared the thrombolysis in myocardial infarction (TIMI) frame count and examined the impact of angioplasty on the count between patients with normal coronary angiograms and those with single-vessel disease (SVD).MethodsIn 780 consecutive patients referred for coronary angiography, TIMI frame count was measured for 149 patients who had SVD and 32 patients with normal angiograms who underwent the procedure for electro-physiologic study or valvular heart disease survey.ResultsComparison of each of the three vessels in the normal vessel group with the corresponding non-stenotic vessels in the SVD group showed similar counts in each of the left anterior descending artery (LAD), left circumflex artery (LCX), and right coronary artery (RCA). For the stenotic vessels, after successful angioplasty, the counts were all reduced (LAD, 54.5 ±28.8 vs. 34.0 ±19.3; LCX, 67.3 ±31.1 vs. 34.1 ±19.0; RCA, 33.2 ±28.1 vs. 19.3 ±7.9; all p <0.05). In addition, the count in the RCA after angioplasty was lower, compared with the RCA of the normal group (19.3 ±7.9 vs. 29.1 ±14.6, p = 0.001). Multivariate analysis showed that the use of oral calcium channel blockers was the only independent predictor for the reduction in RCA after angioplasty.ConclusionIn patients with SVD, the data of TIMI frame count in the nonstenotic vessels were similar to those without the disease, suggesting that the count in the normal artery is not affected by the adjacent stenotic artery. For the stenotic vessels, angioplasty had differential effects on each of the three arteries, indicating the existence of distinct properties, which is affected by calcium channel blockers, for individual coronary arteries in response to atherosclerosis and/or angioplasty

Discordant Findings of Skeletal Metastasis Between Tc99m MDP Bone Scans and F18 FDG PET/CT Imaging for Advanced Breast and Lung Cancers—Two Case Reports and Literature Review

Traditionally, Tc99m methyl diphosphate (MDP) bone scintigraphy provides high-sensitivity detection of skeletal metastasis from breast and lung cancers in regular follow-up. Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT), based on the glucose metabolism of malignant cells, plays a role in describing rumor growth, proliferation of neoplasm and the extent of metastasis. In general, concordant findings of skeletal metastasis are seen on both types of image, especially in cases of breast and lung cancer. However, there were extremely discordant findings of skeletal metastasis between bone scans and F18 FDG PET/CT imaging in two cases among 300 consecutive F18 FDG PET/CT follow-up exams of patients with malignancies, during the past year, in our center. Both cases, one of breast cancer and one of lung cancer, had negative bone scintigraphic findings, but a diffusely high grade of F18 FDG avid marrow infiltration in the axial spine, leading to the diagnosis of stage IV disease in both cases. Owing to variant genetic aberrance of malignance, F18 FDG PET/CT reveals direct evidence of diffuse, rapid neoplasm metabolism in the bone marrow of the spine, but not of secondary osteoblastic reactions in vivo. F18 FDG PET/CT should always be employed in the follow-up of patients with malignancies

Validation of bidimensional measurement in nasopharyngeal carcinoma

<p>Abstract</p> <p>Background</p> <p>Our previous study showed a close relationship between computed tomography (CT)-derived bidimensional measurement of primary tumor and retropharyngeal nodes (BDMprn) and gross tumor volume of primary tumor and retropharyngeal nodes (GTVprn) in nasopharyngeal carcinoma (NPC) and better prognosis for NPC patients with smaller BDMprn. In this study, we report the results on of a study to validate the use of BDM in a separate cohort of NPC patients.</p> <p>Methods</p> <p>We retrospectively reviewed 103 newly diagnosed NPC cases who were treated with radiotherapy/concurrent chemoradiotherapy (CCRT) or CCRT with adjuvant chemotherapy from 2002 to 2009. We used magnetic resonance imaging (MRI) to measure BDMprn. We calculated overall survival, recurrence-free and distant metastasis-free survival curves and set a BDMprn cut off point to categorize patients into a high- or low-risk group. We then used Cox proportional hazard model to evaluate the prognostic influence of BDMprn after correcting age, gender and chemotherapy status.</p> <p>Results</p> <p>After adjusting for age, gender, and chemotherapy status, BDMprn remained an independent prognostic factor for distant metastasis [Hazard ratio (HR) = 1.046; <it>P </it>= 0.042] and overall survival (HR = 1.012; <it>P </it>= 0.012). Patients with BDMprn < 15 cm²had a greater 3-year overall survival rate than those with BDMprn ≧ 15 cm²(92.3% vs. 73.7%; <it>P </it>= 0.009). They also had a greater 3-year distant metastasis-free survival (94% vs.75%; <it>P </it>= 0.034).</p> <p>Conclusion</p> <p>The predictive ability of BDMprn was validated in a separate NPC cohort. A BDMprn of 15 cm²can be used to separate NPC patients into high- and low-risk groups and predict survival rates and metastasis potential. It can, therefore, be used as a reference to design clinical trials, predict prognosis, and make treatment decisions.</p