Design method for zoom systems based on tunable lenses

It is well known that tunable lenses, with refractive power that can be varied, e.g., by changing the curvature of a membrane, can replace the motion of lens groups in zoom systems. Similar to classical zoom systems, the performance of these systems is heavily influenced by the fundamental first-order layout. Moreover, the first-order layout sets the most important requirements for the employed tunable lenses. In this contribution, we present a method for the analysis of a large number of possible first-order solutions for typical requirements and for the selection of the most promising layouts. The first-order solution space is mapped, allowing the layouts to be automatically filtered and plotted depending on pre-defined characteristics. Ray tracing of the marginal and chief rays combined with the traditional thin lens aberration theory provide efficient estimations of the expected installation space requirements and performance for each first-order layout. Using an example, we demonstrate good agreement between these estimations and the corresponding real lens layout, optimized by commercial raytracing software. The presented design method for zoom systems based on tunable lenses is compared with similar approaches for classical zoom lenses

Increased serum levels of procollagen type III peptide in severely injured patients

Objectives: To determine the serum concentrations of procollagen type in peptide in severely injured patients with different outcomes and to evaluate the relationship between serum procollagen type III peptide concentrations, sources of increased posttraumatic fibrotic activity (wounds, lung, liver, kidney), and decreased elimination of procollagen type III peptide (liver). Design: Prospective study. Setting: Surgical ICU, university hospital. Patients: Fifty-seven patients (mean injury severity score: 38.5 points, range 13 to 75 points), between 16 and 70 yrs of age, treated in our institution within 6 hrs after the accident. Measurements: Serial measurements were started on admission and continued on a 6-hr basis. After 48 hrs, the monitoring interval was extended to 24 hrs until recovery (but at least until day 14) or death. At each point of evaluation, pulmonary and circulatory function parameters and chest radiographs (once a day) were evaluated, the results were recorded, and blood samples were drawn to determine procollagen type III peptide, total bilirubin, creatinine, [gamma]-glutamyl transferase, polymorphonuclear elastase, and other parameters. Statistic evaluation was done with the Wilcoxon test, Spearman rank correlation, and a multiple regression model. Results: Mean procollagen type m peptide serum concentrations (+/- sd) were significantly different in patients who died (8.0 +/- 3.8 U/mL) compared with those patients who survived with organ failure (2.7 +/- 1.3 U/mL) or without complications (1.4 +/- 0.5 U/mL), respectively. Significant correlations of procollagen type HI peptide concentrations with the serum bilirubin concentrations (r = .7), days with need of mechanical ventilation (r = .64), Pao2/Fio2 ratio (r = -.6), polymorphonuclear elastase (r = .6), serum creatinine concentrations (r = .55), and injury severity score (r = .33) were observed. There was a tendency toward higher serum procollagen type III peptide concentrations in patients with severe skeletal injuries. Conclusions: Serum procollagen type III peptide concentrations in severely injured patients may be considerably increased in correlation with injury severity and outcome. Procollagen type III peptide serum concentrations seem to reflect the sum of increased collagen formation from wound healing and fibrogenesis of mediator-related organ damage (especially lung) and decreased procollagen type HI peptide excretion due to impaired liver function. Further data are necessary to evaluate the role of hepatic elimination in these patients

Inflammatory mediators, infection, sepsis, and multiorgan failure after severe trauma

The relation of (multiple) organ failure (OF) to the release of inflammatory mediators and the incidence of infection and sepsis was studied prospectively in 100 patients with multiple trauma (injury severity score=37). Sixteen patients died of OF, 47 patients survived OF, and 37 patients had no OF. Fifteen (24%) of the patients with OF showed no signs of infection. In patients with early onset of OF (n=45), infection followed with a lag of 2 or more days. In 16 (44%) of these patients, infection led to a deterioration in organ function. With late onset of OF (n=18), infection preceded OF in nine patients. Polymorphonuclear leukocyte—elastase, neopterin, C-reactive protein, lactate, antithrombin III, and phospholipase A discriminated significantly among the three outcome groups. Of all factors, only polymorphonuclear leukocyte—elastase showed a difference between patients with and without infection or sepsis, respectively. These data indicate that infection might not play a crucial role in the pathogenesis of posttraumatic OF in a substantial portion of patients with trauma. Early OF, especially, seems to be mainly influenced by the direct sequelae of tissue damage and shock (eg, the release of inflammatory mediators). Since infection and sepsis did not lead to an augmented release of mediators in patients with trauma, the role of both entities remains unclear

Zoom systems with tunable lenses and linear lens movements

Background: Classical zoom lenses are based on movements of sub-modules along the optical axis. Generally, a constant image plane position requires at least one nonlinear sub-module movement. This nonlinearity poses a challenge for the mechanical implementation. Tuneable lenses can change their focal length without moving along the optical axis. This offers the possibility of small system lengths. Since the focal range of tuneable lenses with significant aperture diameters is still limited, the use of tuneable optics in zoom lenses is usually restricted to miniaturized applications. Methods: To solve the challenge of the nonlinear movement in classical zoom lenses and the limitations of tuneable lenses for macroscopic applications we propose a combination of both concepts. The resulting ‘Hybrid Zoom Lens’ involves linear movements of sub modules as well as changing the focal length of a tuneable lens. The movements of the sub-modules and the focal length tuning of the lens are already determined by the collinear layout of the zoom lens. Therefore, we focus on collinear considerations and develop a method that allows a targeted choice of specific collinear layouts for our ‘Hybrid zoom lenses’. Results: Based on examples and an experimental setup we demonstrate the feasibility of our approach. We apply the proposed method to examples of classical zoom lenses and zoom lenses based exclusively on tuneable lenses. Thereby we are able to show possible advantages of our ‘Hybrid zoom lenses’ over these widespread system types. Conclusions: We demonstrate important collinear considerations for the integration of tuneable lenses into a zoom lens. We show that the combination of classical zoom lens concepts with tuneable lenses offers the possibility to reach smaller system lengths for macroscopic zoom lenses while requiring only a small focal tuning range of the tuneable lens

Extracorporeal life support in patients with acute myocardial infarction complicated by cardiogenic shock-Design and rationale of the ECLS-SHOCK trial

Background In acute myocardial infarction complicated by cardiogenic shock the use of mechanical circulatory support devices remains controversial and data from randomized clinical trials are very limited. Extracorporeal life support (ECLS) venoarterial extracorporeal membrane oxygenation provides the strongest hemodynamic support in addition to oxygenation. However, despite increasing use it has not yet been properly investigated in randomized trials. Therefore, a prospective randomized adequately powered clinical trial is warranted. Study Design The ECLS-SHOCK trial is a 420-patient controlled, international, multicenter, randomized, open-label trial. It is designed to compare whether treatment with ECLS in addition to early revascularization with percutaneous coronary intervention or alternatively coronary artery bypass grafting and optimal medical treatment is beneficial in comparison to no-ECLS in patients with severe infarct-related cardiogenic shock. Patients will be randomized in a 1:1 fashion to one of the two treatment arms. The primary efficacy endpoint of ECLS-SHOCK is 30-day mortality. Secondary outcome measures such as hemodynamic, laboratory, and clinical parameters will serve as surrogate endpoints for prognosis. Furthermore, a longer follow-up at 6 and 12 months will be performed including quality of life assessment. Safety endpoints include peripheral ischemic vascular complications, bleeding and stroke. Conclusions The ECLS-SHOCK trial will address essential questions of efficacy and safety of ECLS in addition to early revascularization in acute myocardial infarction complicated by cardiogenic shock