Capsule membrane suture fixation of decentered sulcus intraocular lenses

Different surgical methods are used to fixate the subluxated sulcus intraocular lens (IOL) in the absence of in-bag fixation, ranging from iris and scleral suturing to optic capture of the IOL. A new technique, which we have termed capsule membrane suture fixation, provides an additional method for securing a subluxated or decentered sulcus-based IOL to the remnant capsule or a capsular membrane. This method can also be used in secondary surgery for fixation, repositioning, or removal and replacement of IOLs. In this technique, the IOL haptics are sutured to the fibrotic elements of the capsular membrane to center and secure the IOL to the capsular membrane and prevent complications associated with uveal touch.     

Identification of a Novel Clone,ST736, among Enterococcus faecium Clinical Isolates and Its Association with Daptomycin Nonsusceptibility

Resistance to daptomycin in enterococcal clinical isolates remains rare but is being increasingly reported in the United States and worldwide. There are limited data on the genetic relatedness and microbiological and clinical characteristics of daptomycin-nonsusceptible enterococcal clinical isolates. In this study, we assessed the population genetics of daptomycin-nonsusceptible Enterococcus faecium (DNSE) clinical isolates by multilocus sequence typing (MLST) and whole-genome sequencing analysis. Forty-two nonduplicate DNSE isolates and 43 randomly selected daptomycin-susceptible E. faecium isolates were included in the analysis. All E. faecium isolates were recovered from patients at a tertiary care medical center in suburban New York City from May 2009 through December 2013. The daptomycin MICs of the DNSE isolates ranged from 6 to >256 μg/ml. Three major clones of E. faecium (ST18, ST412, and ST736) were identified among these clinical isolates by MLST and whole-genome sequence-based analysis. A newly recognized clone, ST736, was seen in 32 of 42 (76.2%) DNSE isolates and in only 14 of 43 (32.6%) daptomycin-susceptible E. faecium isolates (P < 0.0001). This report provides evidence of the association between E. faecium clone ST736 and daptomycin nonsusceptibility. The identification and potential spread of this novel E. faecium clone and its association with daptomycin nonsusceptibility constitute a challenge for patient management and infection control at our medical center.     

Radial changes of extracellular potential amplitude and integral characteristics and the inverse problem in electroneurography

The possibility of solving the inverse problem in electroneurography, i.e. of estimating the main parameters specifying the activated fibre's functional state, using the amplitude and integral characteristics of the surface potentials generated by infinite homogeneous fibres, has been analysed. An analytical expression has been found for the amplitude of the negative phase A_nph of the single fibre extracellular action potential (SFEAP) as a function of the wavelength b, the fibre-electrode distance y and a scale factor A_o proportional to the intracellular action potential amplitude V_m, to the square of the fibre radius a and to the ratio of the axoplasm conductivity τ_a and volume conductor conductivity τ_e. For a large fibre-electrode distance, typical of surface recordings, an analytical expression of the integral of the negative phase I_nph of the SFEAP as a function of A_o, b, y and the propagation velocity v was also found. Simple methods are proposed for estimating v, the location of the electrical centre of the activated fibres' territory and the product of the number of activated fibres N, duration T_in of the intracellular action, potential and of the factor A_o. The estimation errors due to the temporal and spatial dispersion of the activated fibres were analysed as a function of the fibre-electrode distance and the territory shape.     

Influence of the fiber length on the power spectra of single muscle fiber extracellular potentials.

Influence of the fiber length on the power spectra of the single muscle fiber extracellular action potentials (SMFEAPs) as well as on the spectral changes under alterations in the propagation velocity (v) and intracellular action potential duration (Tin) was studied theoretically for a fiber-electrode distance typical of surface recordings. It was shown that the magnitude and distribution of the SMFEAP spectral power depend on the fiber length. The shorter the fiber, the wider the frequency region in which the total spectral power is distributed and the smaller the spectrum max amplitude. The fiber length affects the spectrum changes that are due to alterations in v or Tin, and, consequently, the spectrum characteristic frequencies--Fmax, Fmed and Fmean, as well as the total spectral amplitude (TSA) and total power (TP). Whereas for a relatively long fiber Fmax depends linearly on v and Fmed and Fmean increase with v increasing, for a short fiber the linearity of the relation between Fmax and v can be disturbed, and Fmed and Fmean can decrease with v increasing. Under the condition of a relatively short fiber, a change in Tin can cause changes not only in Fmed and Fmean, but in Fmax as well. It was shown, that as a result of the finite length of the muscle fibers as well as of the asymmetry of the end-plate location in relation to the fiber ends, dips can be observed in the spectrum even in a case of monopolar recording. Positions of the dips in the power spectra depend on propagation velocity.     

Mass screening in the diagnosis of precancerous diseases of the stomach]

The authors emphasize the importance of diagnosticating and systematic observation of cancer preneoplasms for earlier detection of stomach cancer. For this purpose a clinico-laboratory test for thiocompounds in the urine has been used. The former has been found to be convenient for mass screening because of its prompt performance. Nearly 3.5% of 10000 healthy persons under examination have been screened by means of the mentioned test. The effectiveness of the test was checked up through an x-ray examination of the stomach of the screened persons, i.e. of those who have shown the positive result. Cancer preneoplasms have been detected in 32.5% of the x-ray screened persons. It is concluded that the used mass screening test, followed by an x-ray examination of those patients who showed a positive result for thiocompounds in the urine, could be used as a pattern for the detection of pretumor lesions.     

Automated phonocardiographic screening for heart disease in children

Mass screening for heart disease in children can be accomplished by automatic analysis of phonocardiograms (PCG) obtained from five routine auscultation points. An ECG signal serves as reference. PCG signals exceeding 20% of the amplitude of the first heart sound S1 in the diastolic interval and 40% of S1 in the systolic interval are considered as abnormal. Signals in the systolic interval with an amplitude between 20 and 40% of S1 are classified as normal if their duration is less than two-thirds of the interval from the first to second heart sound. Thus, the method takes into account innocent murmurs and classifies them as normal. The splitting of the second sound is detected by monitoring its duration at a level of 20% of S1. This method was tested on 2,583 children aged from 3 to 14 years and on 345 children with proven heart disease. The results obtained showed a sensitivity of 96.5% and a specificity of 92.4%.     

Site-specific synthesis of oligonucleotides containing malondialdehyde adducts of deoxyguanosine and deoxyadenosine via a postsynthetic modification strategy

Malondialdehyde (MDA) and its reactive equivalent, base propenal, are products of oxidative damage to lipids and DNA, respectively; they are mutagenic in bacterial and mammalian systems, and MDA is carcinogenic in rats. MDA adducts of deoxyguanosine (M1dG), deoxyadenosine (OPdA), and deoxycytidine (OPdC) have been characterized. We have developed site-specific syntheses of M1dG and OPdA adducted oligonucleotides that rely on a postsynthetic modification strategy. This work provides an alternative route to the M1dG adducted oligonucleotide and, to date, the only viable strategy for the site-specific synthesis of OPdA-modified oligonucleotides. The stability of the modified oligonucleotides was examined by UV thermal melting studies (Tm). In contrast to the M1dG adduct, OPdA caused very little change in the Tm.