Defining Dry Eye from a Clinical Perspective

Over the past decades, the number of patients with dry eye disease (DED) has increased dramatically. The incidence of DED is higher in Asia than in Europe and North America, suggesting the involvement of cultural or racial factors in DED etiology. Although many definitions of DED have been used, discrepancies exist between the various definitions of dry eye disease (DED) used across the globe. This article presents a clinical consensus on the definition of DED, as formulated in four meetings with global DED experts. The proposed new definition is as follows: “Dry eye is a multifactorial disease characterized by a persistently unstable and/or deficient tear film (TF) causing discomfort and/or visual impairment, accompanied by variable degrees of ocular surface epitheliopathy, inflammation and neurosensory abnormalities.” The key criteria for the diagnosis of DED are unstable TF, inflammation, ocular discomfort and visual impairment. This definition also recommends the assessment of ocular surface epitheliopathy and neurosensory abnormalities in each patient with suspected DED. It is easily applicable in clinical practice and should help practitioners diagnose DED consistently. This consensus definition of DED should also help to guide research and clinical trials that, to date, have been hampered by the lack of an established surrogate endpoint.     

Differential induction of metallothionein synthesis by interleukin-6 and tumor necrosis factor-alpha in rat tissues

Metallothionein (MT) synthesis induced by the inflammatory cytokines, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF), was studied in vivo. Administration of recombinant human IL-6 or TNF to rats caused the acute phase responses including rapid decreases in plasma zinc (Zn), and increases in plasma copper (Cu) and ceruloplasmin. Hepatic concentration of MT-I, one of MT isoforms, began to increase within 3 h after the injection of IL-6 or TNF. In IL-6-treated rats, MT-I concentration in liver reached a maximum level at 12 h and decreased with a transient rebound, whereas, in TNF-treated rats, a high level of MT-I lasted for about 48 h. MT-II, the other MT isoform, was induced more than MT-I in liver by both cytokines. MT-I was also induced in lung and heart by TNF, but little by IL-6. The data suggest that IL-6 may be responsible for MT synthesis in liver, whereas TNF may be responsible not only in liver but also in lung and heart. Furthermore plasma concentration of MT did not always reflect the enhanced concentration of MT by TNF and IL-6 in liver, suggesting involvement of many factors influencing plasma MT levels. The interrelation between IL-6 and TNF for MT synthesis has also been discussed.     

A new lateral MOS-gated thyristor with controlling base-current

A new lateral MOS-gated thyristor, called the Base-Current-Controlled Thyristor, is described. This device is designed so that most holes at the on-stage reach the P base through the floating P⁺ region adjacent to the P base and the on-state MOSFET. At the turn-off stage, the interruption of the hole current to the P base due to switching off the above MOSFET occurs simultaneously with the conventional turn-off operation. The concept of this device is verified experimentally by using the fabricated lateral device with the external MOSFET. This device exhibits a better trade-off relation between the on-state voltage and the turn-off time compared uith the conventional MOS-gated thyristor     

A transceiver PIC for bidirectional optical communication fabricated by bandgap energy controlled selective MOVPE

A transceiver PIC consisting of a DFB-LD, a receiver PD and a Y-shaped branch waveguides is realized by in-plane bandgap energy controlled selective MOVPE. Both active and passive core layers are formed in one step selective growth, and complicated fabrication procedure is no longer required. More than 1 mW fiber coupled power and 7 GHz receiver bandwidth are obtained. The modulation and detection operations at 500 Mb/s are successfully demonstrated.     

Distinct promoter sequences of two precursor genes for salmon gonadotropin-releasing hormone in masu salmon

Three phase partitioning (TPP) uses t-butanol and ammonium sulfate to precipitate enzymes and proteins from aqueous solutions. The method is useful both upstream with crude samples and downstream where a scaleable simple step is needed. About 25 enzymes and proteins have been isolated by various laboratories using TPP-t-butanol. The relation of t-butanol used in TPP, with n-butanol used as an extraction agent from Morton's work, is reviewed. Some t-butanol appears bound to TPP-precipitated proteins which are actually protein-t-butanol coprecipitates. They float above denser aqueous salts because bound t-butanol increases their buoyancy, similar to the behavior of many lipoproteins. On redissolving TPP-precipitated enzymes, total and specific activities usually are regained and sometimes increased. Sulfate ion-in large concentrations-likely exerts itself through its kosmotropic action as in conventional salting out. t-Butanol likewise appears to be a kosmotrope and crowding agent at room temperature or above, whereas C1 and C2 cosolvents (e.g., ethanol) do not so behave except at near or below zero temperatures. However, kosmotropy is not the entire origin of TPP, nor probably of conventional salting out. Electrostatic forces, capacity to force protein conformation tightening and protein hydration shifts, also contribute. Electrostatic forces, and the tendency for salt ions to bind and tighten protein molecule conformation, are indicated by the sharp pH dependency of both conventional salting out and TPP, around pH regions where proteins undergo conformation changes. Sulfate anion is densely-perhaps extraordinarily-hydrated, adding much to its effective size, and therefore it has a tendency to crowd or exclude proteins, when sulfate concentrations are in the 0.5 to 3 M range.     

Periodic limb movement disorder in neuroleptic-induced akathisia

We recorded all-night polysomnograms of four schizophrenic patients with neuroleptic-induced akathisia (NIA) before and during treatment with clonazepam. Also, four non-akathitic schizophrenic patients were recorded all-night polysomnograms as control subjects. Daily treatment with 1.5 to 3 mg clonazepam improved subjective complaints of all the 4 patients with NIA. Three of 4 patients with NIA exhibited periodic limb movements (PLM) on bilateral legs, but none of 4 control subjects showed PLM. Total number of PLM and PLM per hour decreased during clonazepam treatment. Moreover, mean inter-movement intervals of PLM of 3 patients were prolonged on bilateral legs. NIA might change its feature as PLM during night sleep.     

A stacking mechanism for setting bills upright in an automated teller machine

 To deal with circulated bills in various conditions regarding size, shape, and rigidity, we have developed a new bill-stacking cassette that can accept and re-dispense various-sized bills. This cassette stacks the bills upright by using deforming guides and sheet rollers under our newly developed “phase control”. It was experimentally verified by stacking tests that the cassette can handle bills in various conditions; thus, we conclude that the new cassette is practical for stacking circulated bills and re-dispensing them securely. Received: 14 August 2001/Accepted: 11 December 2001