Silicone oil injection and removal in 27-gauge vitreous surgery

Dear Editor,The advent of 23-gauge(G),25-G,and 27-G vitrectomy systems[1]since the beginning of the 21stcentury has allowed vitrectomy via a smaller incision compared to the 20-G system;hence the name"microincision vitrectomy surgery".Microincision vitrectomy surgery has gainedpopularity among vitreoretinal surgeons.

Differentiation of premacular hemorrhages with niveau formation

Dear Editor,W e present three anatomical forms of premacular hemorrhage with niveau formation:hemorrhage in posterior precortical vitreous pocket(intrapocket hemorrhage),sub-internal limiting membrane(ILM)hemorrhage,and premacular retrocortical hemorrhage.Niveau formation is the formation of a horizonal boundary between fluid and blood cells when they accumulate in a closed space,because blood cells with higher specific gravity settle in a standing position.

Intraocular lens implantation and vitrectomy using 0.025% povidone-iodine in irrigation solution for bleb-related endophthalmitis

Dear Editor,We report the results of using Balanced Salt Solution(BSS)Plus containing 0.025%povidone-iodine,a microbicidal and safe solution[1-2],in combined intraocular lens(IOL)implantation and vitrectomy in two cases of bleb-related endophthalmitis.In both cases,hypopyon and a purulent bleb were observed.

Study of Factors Affecting Medical Incident: 2 Powdered Medication Dispensing

Medical incidents have been collected, analyzed and built up preventive measures by each medical institution for a long time. For powdered medication, there is the problem that it is difficult to tell at a glance the quantity of the active ingredient in the medication that has been dispensed and the quantities that have been mixed together. Therefore, special prevention measures are considered essential. In this study, we examined the work content of pharmacists’ powdered medication dispensing, using an eye-tracking technology of measuring a human eye movement, and studied on factors that affect medical incident. Participants were five pharmacists with 8 to 26 years of working experience (expert), and five pharmacists with less than one year of working experience (newcomer). Gaze measurement experiments were implemented for powdered medication dispensing during regular work activity. The gaze measurement equipment used was Tobii Pro Glasses 2. Based on the results of the eye tracking, newcomer had a longer dispensing time than expert for all powdered medication dispensing. In particular, it was suggested that there is a close relationship to “years of experience” and “weighing and mixing skills.” Experts did unwasted and efficient movements, when preparing the dispensing apparatus, taking medications from the shelves, and scanning the barcode in the powders dispensing checking system. These movements led to shorter working time in experts. In contrast, newcomer had individual differences at the dispensing. Even with the same pharmacist, the work progression differed depending upon the prescription. Therefore, it is thought that the factor of common error was inadequate check and overlooked. The state that it’s messy on the workplace is also considered highly likely to cause dispensing mistakes. At the weighing, expert started weighing after the inspection of the prescription and checking weighed amount. However, certain newcomer dispensed to depend on the powders dispensing checking system only for the weighing process, without the inspection of the prescription or checking weighed amount. Irregular doses for infants and older patients require fine adjustments;therefore, the powders dispensing checking system may not find all dispensing errors. It is important for a pharmacist to, first, be written calculated weight on the prescription and checked by themselves, and next to begin dispensation work. In the future, as well as the powdered medication dispensing, it is necessary to make use of measures for preventing errors in the various dispensing process, such as the medication inspection, sterile products preparation, clinical practice et al.

Upconversion time-stretch infrared spectroscopy

High-speed measurement confronts the extreme speed limit when the signal becomes comparable to the noise level.In the context of broadband mid-infrared spectroscopy,state-of-the-art ultrafast Fourier-transform infrared spectrometers,in particular dual-comb spectrometers,have improved the measurement rate up to a few MSpectra s^(-1),which is limited by the signal-to-noise ratio.Time-stretch infrared spectroscopy,an emerging ultrafast frequency-swept mid-infrared spectroscopy technique,has shown a record-high rate of 80 MSpectra s^(-1) with an intrinsically higher signal-to-noise ratio than Fourier-transform spectroscopy by more than the square-root of the number of spectral elements.However,it can measure no more than~30 spectral elements with a low resolution of several cm-i.Here,we significantly increase the measurable number of spectral elements to more than 1000 by incorporating a nonlinear upconversion process.The one-to-one mapping of a broadband spectrum from the mid-infrared to the near-infrared telecommunication region enables low-loss time-stretching with a single-mode optical fiber and low-noise signal detection with a high-bandwidth photoreceiver.We demonstrate high-resolution mid-infrared spectroscopy of gas-phase methane molecules with a high resolution of 0.017 cm^(-1).This unprecedentedly high-speed vibrational spectroscopy technique would satisfy various unmet needs in experimental molecular science,e.g.,measuring ultrafast dynamics of rreversible phenomena,statistically analyzing a large amount of heterogeneous spectral data,or taking broadband hyperspectral images at a high frame rate.

Label-free mid-infrared photothermal live-cell imaging beyond video rate

Advancement in mid-infrared(MIR)technology has led to promising biomedical applications of MIR spectroscopy,such as liquid biopsy or breath diagnosis.On the contrary,MIR microscopy has been rarely used for live biological samples in an aqueous environment due to the lack of spatial resolution and the large water absorption background.Recently,mid-infrared photothermal(MIP)imaging has proven to be applicable to 2D and 3D single-cell imaging with high spatial resolution inherited from visible light.However,the maximum measurement rate has been limited to several frames s-1,limiting its range of use.Here,we develop a significantly improved wide-field MIP quantitative phase microscope with two orders-of-magnitude higher signal-to-noise ratio than previous MIP imaging techniques and demonstrate live-cell imaging beyond video rate.We first derive optimal system design by numerically simulating thermal conduction following the photothermal effect.Then,we develop the designed system with a homemade nanosecond MIR optical parametric oscillator and a high full-well-capacity image sensor.Our high-speed and high-spatial-resolution MIR microscope has great potential to become a new tool for life science,in particular for live-cell analysis.

外周神经母细胞性肿瘤临床病理特点

外周神经母细胞性肿瘤（peripheralneuroblastictumors，pNT）由神经母细胞瘤（neuroblastoma）、节细胞性神经母细胞瘤（ganglioneuroblastoma，GNB）和节细胞神经瘤（ganglioneuroma，GN）组成，是起源于交感神经系统的胚胎性肿瘤，也是儿童最常见的颅外恶性实体瘤。据报道，美国每年新增pNT诊断病例约有650例，病死率占儿童恶性肿瘤的15％。pNT的临床生物学行为具有高度异质性，预后取决于患儿诊断时的年龄、临床分期、组织学类型以及特异性遗传学异常情况。