Diagnosis of systemic causes of uveitis; a matter of ophthalmologist and internist

OBJECTIVE: To assess how often the aetiology is established in patients with uveitis, what systemic disease are found and what is the contribution of the internist to the diagnostic process. DESIGN: Retrospective study. SETTING: University Hospital Leiden, the Netherlands. METHOD: From January 1987 to April 1992, 342 patients presented with uveitis. All patients underwent a standard ophthalmological examination. Referral to an internist and individualised laboratory screening followed in patients with recurrent, chronic, bilateral or panuveitis. Recorded were: ophthalmological data, results of laboratory screening, results of analysis by the internist, final diagnosis and presence of systemic disease. RESULTS: 149 (44%) patients were examined by the internist, 18 (5.2%) were seen by another specialist. In 169 (49%) patients a specific diagnosis was made. 74 (22%) had a systemic disease, 74 a primary ocular disease. In 28 (8%) a systemic disease was presumed (5% were HLA-B27 positive, 3% had abnormal laboratory results); 5 (1%) patients had endophthalmitis as a complication of a septic process. CONCLUSION: In approximately 1/3 of the patients with uveitis a systemic disease was found. Examination by the internist tailored to the individual patient is essential in the evaluation of uveitis patients.     

Agonist-induced calcium waves in oscillatory cells: a biological example of Burgers' equation

Oscillations in cytosolic Ca2+ concentrations in living cells are often a manifestation of propagating waves of Ca2+. Numerical simulations with a realistic model of inositol 1,4,5-trisphosphate (IP3)-induced Ca2+ wave trains lead to wave speeds that increase linearly at long times when (a) IP3 levels are in the range for Ca2+ oscillations, (b) a gradient of phase is established by either an initial ramp or pulse of IP3, and (c) IP3 concentrations asymptotically become uniform. We explore this phenomenon with analytical and numerical methods using a simple two-variable reduction of the De Young-Keizer model of the IP3 receptor that includes the influence of Ca2+ buffers. For concentrations of IP3 in the oscillatory regime, numerical solution of the resulting reaction diffusion equations produces nonlinear wave trains that shows the same asymptotic growth of wave speed. Due to buffering, diffusion of Ca2+ is quite slow and, as previously noted, these waves occur without appreciable bulk movement of Ca2+. Thus, following Neu and Murray, we explore the behavior of these waves using an asymptotic expansion based on the small size of the buffered diffusion constant for Ca2+. We find that the gradient in phase of the wave obeys Burgers' equation asymptotically in time. This result is used to explain the linear increase of the wave speed observed in the simulations.     

Retinal neurostimulator for a multifocal vision prosthesis.

A neurostimulator application-specific integrated circuit (ASIC) with scalable circuitry that can stimulate 14 channels, has been developed for an epi-retinal vision prosthesis. This ASIC was designed to allow seven identical units to be connected to control up to 98 channels, with the ability to stimulate 14 electrodes simultaneously. The neurostimulator forms part of a vision prosthesis, designed to restore vision to patients who have lost their sight due to retinal diseases such as retinitis pigmentosa and macular degeneration. For charge balance, the neurostimulator was designed to stimulate with current sources and sinks operating together, and with the ability to drive a hexagonal mosaic of electrodes to reduce the electrical crosstalk that occurs when multiple bipolar stimulation sites are active simultaneously. A hexagonal mosaic of electrodes surrounds each stimulation site and has been shown to effectively isolate each site, increasing the ability to inject localized independent charge into multiple regions simultaneously.     

The seismic kernel system — a large-scale exercise in fortran 77 portability

The portability of software has become a major commercial issue in recent times. Such portability does not come easily, as few if any computer languages are really portable in practice. An additional complicating factor, especially in the commercial environment, is that the resulting software must be efficient. This paper describes the design and successful implementation of a 500,000+ line portable FORTRAN 77 package for the processing of seismic data. The package exhibits demonstrably high efficiency on a wide variety of machines from minicomputers to the largest supercomputers. Experiences gained during this exercise throw much light on the integration of the various thought processes which occur during the software engineering cycle, especially the notion of locality.     

The role of forest and bioenergy strategies in the global carbon cycle

Forest and bioenergy strategies offer the prospect of reduced CO₂ emissions to the atmosphere. Such strategies can affect the net flux of carbon to the atmosphere through 4 mechanisms: storage of C in the biosphere; storage of C in forest products; use of biofuels to displace fossil-fuel use; use of wood products which often displaces other products that require more fossil fuel for their production. We use the mathematical model GORCAM (Graz/Oak Ridge Carbon Accounting Model) to examine these mechanisms for 16 land-use scenarios. Over long time intervals the amount of C stored in the biosphere and in forest products reaches a steady state and continuing mitigation of C emissions depends on the extent to which fossil fuel use is displaced by the use of bioenergy and wood products. The relative effectiveness of alternative forest and bioenergy strategies and their impact on net C emissions strongly depend, for example, on the productivity of the site, its current usage, and the efficiency with which the harvest is used. When growth rates are high and harvest is used efficiently, the dominant opportunity for net reduction in C emissions is seen to be fossil-fuel displacement. At the growth rates and efficiencies of harvest utilization adopted in many of our base scenarios, the net C balance at the end of 100 years is very similar whether trees are harvested and used for energy and traditional forest products, or reforestation and forest protection strategies are implemented. The C balance on a plantation system that provides a constant output of biomass products can look different than the balance of a single parcel of land.     

Fast full‐color reflective display via photoluminescent enhancement

Reflective displays are advantageous in applications requiring low power or daylight readability. However, there are no low‐cost reflective technologies capable of displaying bright colors. By employing photoluminescence to more efficiently use ambient light, we created a prototype display that provides bright, full color in a simple, low‐cost architecture. This prototype includes a novel electrokinetic shutter, a layer that incorporates patterned luminescent red, green, and blue sub‐pixel elements, and a novel optical out‐coupling scheme. The luminescent elements convert otherwise‐wasted portions of the incident spectrum to light in the desired color band, resulting in improved color saturation and lightness. This prototype provides a color gamut that is superior to competing reflective display technologies that utilize color filters in single‐layer side‐by‐side sub‐pixel architectures. The current prototype is capable of switching in <0.5 s; future displays based on an alternative electro‐optic shutter technology should achieve video rate operation. A transflective version of this technology has also been prototyped. The transflective version utilizes its backlight with a power efficiency that is at least three times that of a conventional liquid crystal display. These photoluminescence‐based technologies enable a host of applications ranging from low‐power mobile products and retail pricing signage to daylight readable signage for outdoor advertising segments.     

Synthesis of ceramic membranes

Non-supported -alumina films are prepared from a boehmite colloidal suspension. After calcination at 600°C, the microstructure is characterized by a mean pore diameter of 3 nm, a porosity of 50% and a tortuosity of 5.5. The structure is formed by card packed, plate-shaped particles, giving rise to slit-shaped pores. Supported -alumina films, made by a slipcasting process using the same boehmite precursor, have a similar structure as the non-supported films. The slipcasting process is very sensitive to support characteristics and frequently yields defect films. Polyvinylalcohol (PVA) (molecular weight 72000 g mol^–1) is added to the boehmite precursor (0.25 gg^–1 film) to improve this process. This addition results in a less critical and better controllable drying and calcining procedure. The addition of PVA is necessary to slipcast defect free -alumina films on supports with pore diameters of 0.4 m or smaller and on multi-layer supports. It has no significant effect on the resultant microstructure of the -alumina film, provided all PVA is removed by appropriate thermal treatment. The slipcasting rate is slower, resulting in thinner films of 3–5 m at identical slipcasting times.     

Microstructure and Microchemistry of Polymer-Derived Crystalline SiC Fibers

Stoichiometric and near-stoichiometric silicon carbide fibers, derived from the polymer polycarbosilane, have been characterized by scanning Auger and transmission electron microscope techniques. Excess carbon usually appeared in the fibers, but it could be eliminated by controlling processing conditions. The fibers consisted mainly of submicrometer-sized SiC microcrystals, with a considerably twinned and stacking-faulted β-SiC structure. Free carbon, which appeared in the form of graphite, was the only detectable intergranular phase in the nonstoichioinetric SiC fibers, while the stoichiometric SiC fibers contained no detectable second phase whatsoever.     

Assessment of the relative agronomic effectiveness of phosphate rocks under glasshouse conditions

Six phosphate rocks (PRs) of varying reactivities were compared with monocalcium phosphate (MCP) in a glasshouse experiment growing perennial ryegrass (Lolium perenne cv. Nui) as the test plant on four soils of contrasting P sorption capacity and exchangeable Ca. The cumulative dry matter yield over 10 harvests showed a significant response to P application in all soils. Based on relative yield and P uptake, MCP was the most effective P fertilizer followed by the reactive phosphate rocks, which were superior to the unreactive rocks in all soils. The relative agronomic effectiveness (RAE) and substitution ratio (SR) of individual PR fertilizers, calculated with respect to MCP using the methods of vertical and horizontal comparison, respectively, were similar over a range of fertilizer rate. There was a decline or slight increase in the performance of PRs with time in the low P sorption soils but a consistent increase in the high P sorption soils. Some initial influence of exchangeable Ca content of the soils on the relative performance of PRs was also observed. Generally the PRs performed better in high P sorption soils than low P sorption soils and in low exchangeable Ca soils than high exchangeable Ca soils.