Computer-based virtual reality simulator for phacoemulsification cataract surgery training

Recent research in virtual reality indicates that computer-based simulators are an effective technology to use for surgeons learning to improve their surgical skills in a controlled environment. This article presents the development of a virtual reality simulator for phacoemulsification cataract surgery training, which is the most common surgical technique currently being used to remove cataracts from the patient’s eyes. The procedure requires emulsifying the cloudy natural lens of the eye and restoring vision by implanting an artificial lens through a small incision. The four main procedures of cataract surgery, namely corneal incision, capsulorhexis, phacoemulsification, and intraocular lens implantation, are incorporated in the simulator for virtual surgical training by implementing several surgical techniques. The surgical activity that are applied on the anatomy of the human eye, such as incision, grasping, tearing, emulsification, rotation, and implantation, are simulated in the system by using different types of mesh modifications. A virtual reality surgical simulator is developed, and the main procedures of phacoemulsification cataract surgery are successfully simulated in the system. The simulation results of the training system show that the developed simulator is capable of generating a virtual surgical environment with faithful force feedback for medical residents and trainees to conduct their training lessons via the computer using a pair of force-feedback haptic devices. In addition, the successful simulation of the mesh modifications on the human eyeball with visual realism and faithful force feedback throughout the surgical operation shows that the developed simulator is able to serve as a virtual surgical platform for surgeons to train their surgical skills.     

Stabilization of discrete-time Markovian jump linear systems via time-delayed controllers

This paper is concerned with the stabilization problem for a class of discrete-time Markovian jump linear systems with time-delays both in the system state and in the mode signal. The delay in the system state may be time-varying. The delay in the mode signal is manifested as a constant mismatch of the modes between the controller and the system. We first show that the resulting closed-loop system is a time-varying delayed Markovian jump linear system with extended state space. Then a sufficient condition is proposed for the design of a controller such that the closed-loop system is stochastically stable. Finally, numerical simulation is used to illustrate the developed theory.     

On the density profile within random and oriented wood-based composite panels: horizontal distribution

Wood composites are produced from the processing of discontinuous wood elements such as flakes and strands, with resin and other additives. Consolidation of the loose mat structure into a panel is achieved under heat and pressure, and the final product structure and properties are therefore governed not only by the properties of the wood elements but also by the forming and pressing processes. This paper deals with the density variation within the horizontal plane of flakeboards, in an approach that combines a structural model, based on the layout of the flakes, together with the consolidation model and mass transfer, both resulting from the hot-pressing process. The density distribution within the panels manufactured according to several possible combinations of random orientation and placement of flakes is analyzed, and the significant influence of the random character of the orientation of flakes during the forming process is highlighted.     

Metabolism of the antiandrogenic drug (Flutamide) by human CYP1A2

The antiandrogenic drug, flutamide, is widely used in the treatment of carcinoma of the prostate. The present study examines the metabolism of flutamide by human liver microsomes and purified recombinant human cytochrome P450s (CYP), expressed as fusion proteins. These studies show the principal role of CYP1A2 in the metabolism of flutamide to 2-hydroxyflutamide. A minor metabolite is formed during the metabolism of flutamide by CYP3A4 in the presence of an excess of added purified NADPH-P450 reductase. The metabolism of flutamide is inhibited by low concentrations of alpha-naphthoflavone and ketoconazole. Other substrates of CYP1A2, such as phenacetin, imipramine, caffeine, and estradiol, are also inhibitors of flutamide metabolism by CYP1A2. Of interest is the inhibition of flutamide metabolism by its metabolite, 2-hydroxyflutamide, and the inhibition of the 2- and 4- hydroxylation of estradiol by flutamide. CV1 cells do not metabolize flutamide to 2-hydroxyflutamide. In assays performed using this cell line transfected with the cDNA for the androgen receptor, flutamide is a pure antagonist, and 2-hydroxyflutamide, while a more potent androgen receptor (AR) antagonist, activates the AR at higher concentrations. Stable expression of CYPIA2 in these CV1 cells causes flutamide to exhibit agonistic properties at higher concentrations, a behavior not exhibited by cells stably transfected only with the expression vector encoding the AR. These findings raise the possibility that increased conversion of flutamide to 2-hydroxyflutamide or accumulation of 2-hydroxyflutamide in cells may contribute to the anomalous responses to flutamide that are observed in some advanced prostate cancers.     

Fatal acute pulmonary oedema after inhalation of fumes from polytetrafluoroethylene (PTFE)

The cases of three patients with acute pulmonary oedema caused by inhalation of fumes from heated polytetrafluoroethylene (PTFE) in a plastic factory are described. One patient died from profound hypoxaemia and shock shortly after admission, and the other two patients survived after medical treatment. This is the first report of fatal pulmonary oedema in a worker exposed to PTFE heated in a plastic extruding operation. From this observation, it appears that inhalation exposure to pyrolytic products from polytetrafluoroethylene can cause fatal respiratory complications. Special precautions are warranted in this kind of operation to prevent workers from being exposed to these substances.     

Thermo Sequenase DNA polymerase and T. acidophilum pyrophosphatase: new thermostable enzymes for DNA sequencing

A combination of thermostable enzymes has been developed that produces higher quality cycle sequences. Thermo Sequenase DNA polymerase is a thermostable enzyme engineered to catalyze the incorporation of ddNTPs with an efficiency several thousandfold better than other thermostable DNA polymerases. Since the enzyme also catalyzes pyrophosphorolysis at dideoxy termini, a thermostable inorganic pyrophosphatase is needed to remove the pyrophosphate produced during sequencing reactions. Thermoplasma acidophilum inorganic pyrophosphatase (TAP) is thermostable and effective for converting pyrophosphate to orthophosphate. The use of the combination of Thermo Sequenase polymerase and TAP for cycle sequencing yields sequence data with uniform band intensities, allowing the determination of longer, more accurate sequence reads. Uniform band intensities also facilitate interpretation of sequence anomalies and the presence of mixed templates. Sequencing PCR products of DNA amplified from heterozygous diploid individuals results in signals of equal intensity from each allele.     

Caffeine-induced release of intracellular Ca2+ from Chinese hamster ovary cells expressing skeletal muscle ryanodine receptor. Effects on full-length and carboxyl-terminal portion of Ca2+ release channels

The ryanodine receptor (RyR)/Ca2+ release channel is an essential component of excitation-contraction coupling in striated muscle cells. To study the function and regulation of the Ca2+ release channel, we tested the effect of caffeine on the full-length and carboxyl-terminal portion of skeletal muscle RyR expressed in a Chinese hamster ovary (CHO) cell line. Caffeine induced openings of the full length RyR channels in a concentration-dependent manner, but it had no effect on the carboxyl-terminal RyR channels. CHO cells expressing the carboxyl-terminal RyR proteins displayed spontaneous changes of intracellular [Ca2+]. Unlike the native RyR channels in muscle cells, which display localized Ca2+ release events (i.e., "Ca2+ sparks" in cardiac muscle and "local release events" in skeletal muscle), CHO cells expressing the full length RyR proteins did not exhibit detectable spontaneous or caffeine-induced local Ca2+ release events. Our data suggest that the binding site for caffeine is likely to reside within the amino-terminal portion of RyR, and the localized Ca2+ release events observed in muscle cells may involve gating of a group of Ca2+ release channels and/or interaction of RyR with muscle-specific proteins.     

Pituitary-adrenal suppression in preterm, very low birth weight infants after inhaled fluticasone propionate treatment

Systemic corticosteroids prescribed for treatment of pulmonary diseases in preterm, very low birth weight infants caused severe suppression of the hypothalamic-pituitary-adrenal axis and produced serious physiological and metabolic disturbances. However, the effect of inhaled corticosteroids on their pituitary-adrenal functions is not known. We prospectively evaluate the pituitary-adrenal function using the human CRH stimulation test in a cohort of very low birth weight infants at risk for hypothalamic-pituitary-adrenal axis suppression in a double blind, randomized pilot study designed for assessing the efficacy and adverse effects of inhaled fluticasone propionate in newborn preterm infants who required mechanical ventilation for treatment of respiratory distress syndrome. Twenty-five preterm (< 32 gestational weeks), very low birth weight (< 1500 g) infants were randomized to receive inhaled fluticasone propionate (n = 13) or a placebo inhaler (n = 12). The medication was given every 12 h (fluticasone propionate, 1,000 micrograms/day) for 14 days. All surviving infants had their pituitary-adrenal functions assessed by human CRH test on the following morning immediately after completion of the 2-week course. All basal (0 min) and post-stimulation (15, 30, and 60 min) plasma ACTH and serum cortisol concentrations were significantly suppressed in the inhaled fluticasone group compared to their corresponding levels in the placebo group [basal plasma ACTH concentrations (F = 6.0; P = 0.02), poststimulation plasma ACTH concentrations (F > 8.6; P < 0.01), basal serum cortisol concentrations (F = 5.6; P = 0.03), and poststimulation serum cortisol concentrations (F > 15.6; P < 0.001)]. This is the first study in very low birth weight infants that demonstrates unequivocally that cumulative high dose inhaled corticosteroids can induce moderately severe suppression of both the pituitary and adrenal glands. The systemic bioactivity is probably associated with pulmonary vascular absorption, which effectively circumvents the hepatic first pass metabolism. Until the question of safety can be adequately addressed, inhaled fluticasone propionate should be used with cautionin preterm infants.