Fusion product measurements by nuclear diagnostics in the Joint European Torus deuterium-tritium 2 campaign (invited).

A new deuterium-tritium experimental, DTE2, campaign has been conducted at the Joint European Torus (JET) between August 2021 and late December 2021. Motivated by significant enhancements in the past decade at JET, such as the ITER-like wall and enhanced auxiliary heating power, the campaign achieved a new fusion energy world record and performed a broad range of fundamental experiments to inform ITER physics scenarios and operations. New capabilities in the area of fusion product measurements by nuclear diagnostics were available as a result of a decade long enhancement program. These have been tested for the first time in DTE2 and a concise overview is provided here. Confined alpha particle measurements by gamma-ray spectroscopy were successfully demonstrated, albeit with limitations at neutron rates higher than some 1017 n/s. High resolution neutron spectroscopy measurements with the magnetic proton recoil instrument were complemented by novel data from a set of synthetic diamond detectors, which enabled studies of the supra-thermal contributions to the neutron emission. In the area of escaping fast ion diagnostics, a lost fast ion detector and a set of Faraday cups made it possible to determine information on the velocity space and poloidal distribution of the lost alpha particles for the first time. This extensive set of data provides unique information for fundamental physics studies and validation of the numerical models, which are key to inform the physics and scenarios of ITER.

Upgrade and absolute calibration of the JET scintillator-based fast-ion loss detector.

The JET FILD is a scintillator-based Fast-ion Loss Detector optimized to measure fusion-born alpha-particle losses. This work covers its upgrade and absolute calibration in preparation for the following JET DT experiments. A fast scintillator material (TG-Green) has been installed in the JET FILD. A heater jacket is installed around the fiber bundle, responsible for transmitting the light from the scintillator plate, to anneal the fiber obscuring due to neutron damage. The JET FILD has been upgraded with a 1 Mpx camera and 2 MHz photomultiplier data acquisition hardware. Full-orbit simulations give an estimate of the shading effects on the scintillator plate of the first wall structures and provide a synthetic signal of the JET FILD. A detector instrument function enables absolute values of fast-ion losses using calibration factors. The calibration factors are made available in a shot-to-shot basis for the characterized species and energies and with corrections for the diagnostic conditions. The fast acquisition system sets the Nyquist frequency (1 MHz) above the typical mode frequencies (≈102 kHz), thus making it possible to identify MHD-induced fast-ion losses.

Improvements to the Faraday cup fast ion loss detector and magnetohydrodynamic induced fast ion loss measurements in Joint European Torus plasmas.

Upgrades to electronic hardware and detector design have been made to the JET thin-foil Faraday cup fast ion loss detector [Darrow et al., Rev. Sci. Instrum. 75, 3566 (2004)] in anticipation of the upcoming deuterium-tritium (DT) campaign. An improved foil stack design has been implemented, which greatly reduces the number of foil-to-foil shorts, and triaxial cabling has mitigated ambient noise pickup. Initial tests of 200 kHz digitizers, as opposed to the original 5 kHz digitizers, have provided enhanced analysis techniques and direct coherence measurements of fast ion losses with magnetohydrodynamic activity. We present recent loss measurements in JET deuterium plasmas correlated with kink modes, fishbone modes, edge-localized modes, and sawteeth. Sources of systematic noise are discussed with emphasis on capacitive plasma pickup. Overall, the system upgrades have established a diagnostic capable of recording alpha particle losses due to a wide variety of resonant fast ion transport mechanisms to be used in future DT-experiments and modeling efforts.

Bilateral primary optic nerve lymphoma.

A 69-year-old man was examined for bilateral infiltrative optic neuropathy. Optic nerve biopsy confirmed a malignant B cell lymphoma. Systemic examination and investigations failed to show involvement of other sites.

Clinical characteristics of retinal venous occlusions occurring at different sites.

AIMS: To identify the contributory factors associated with different sites of occlusion and the presence or absence of optic nerve head swelling (ONHS). METHODS: 874 cases of retinal venous occlusion (RVO) were prospectively examined at a tertiary referral centre and classified according to three defined sites of occlusion: arteriovenous crossing RVO (AV-RVO); optic cup RVO (OC-RVO); and optic nerve sited RVO. Optic nerve sited RVOs were further divided on the basis of presence (ONHS-RVO) and absence (NONHS-RVO) of ONHS. RVOs not occurring at any of the defined sites were grouped as no-site RVO (NS-RVO). Important clinical parameters were compared among four of the five subgroups by multivariate analysis of variance and chi(2) test (NS-RVO excluded). RESULTS: The overall multivariate analysis of variance for differences in the mean age, systolic and diastolic blood pressure, body mass index, and intraocular pressure (IOP) among the four subgroups were highly significant (p <0.0001). The F ratios indicated that the differences in the mean age and IOP accounted for this statistical trend. The mean age was statistically significantly lower in the ONHS-RVO group compared to the rest of the groups (p <0.0001). The mean age was significantly higher in OC-RVO compared to the AV-RVO group (p <0.05). The mean IOP was significantly higher in OC-RVO than in the rest of the groups (p <0.01 to 0.0001), while it was also higher in the NONHS-RVO group compared to the ONHS-RVO and AV-RVO groups (p <0.0001). The prevalence of primary open angle glaucoma (POAG), sex, laterality, involvement of the fellow eye, smoking and hypertension were compared by chi(2) tests. POAG was significantly more prevalent in the OC-RVO group than in the rest of the groups (p <0.0083), while it was also significantly more prevalent in the NONHS-RVO group compared to AV-RVO or ONHS-RVO (p <0.0083) groups. Smoking was significantly more prevalent in AV-RVO than in the rest of the groups (p <0.05). The proportion of male sex was significantly higher in ONHS-RVO compared to the AV-RVO group (p <0.05). Hypertension was significantly more prevalent in the AV-RVO than in the ONHS-RVO or NONHS-RVO groups (p <0.05). CONCLUSION: A new classification of RVO based on the site of occlusion and ONHS has been evaluated. The higher prevalence of hypertension and smoking in AV-RVO suggests a particular importance of cardiovascular risk factors in this group. The association of POAG with CRVO has been confirmed, but only for those cases without ONHS. A distinctive relation between raised IOP and OC-RVO has been demonstrated, suggesting a causal association. RVOs with ONHS tend to occur in younger people, with a higher proportion of males, and a lower prevalence of hypertension and POAG, suggesting that other causal factors may be important in this group. The new scheme resolves the confusion in the literature regarding classification of RVO, and has diagnostic, causal, prognostic, and therapeutic implications.

Border Cave revisited: a revised ESR chronology.

In view of a decade of progress in ESR dating we have revised the ESR chronology of Border Cave. A detailed gamma ray survey in 1994 and newly calculated beta attenuation data led to total dose rate estimations that are between 0 and 30% smaller than previously estimated. Accordingly, the resulting ESR age estimates are between 0 and 30% older. The ESR dates are now in good agreement with independent age estimates, particularly(14)C and amino acid racemization. New ESR dates for the lowermost dated sedimentary layer, 5 WA (white ash), indicate that the sedimentation of the sequence started around 200 ka ago.

The macular hole: report of an Australian surgical series and meta-analysis of the literature.

PURPOSE: To report an Australian series of macular hole surgery by pars plana vitrectomy and fluid-gas exchange, and to identify factors influencing the outcome of the surgery through meta-analysis of the literature. METHODS: Fifty-six consecutive cases of macular hole were treated by pars plana vitrectomy, fluid-gas exchange and face-down positioning for at least 7 days, and prospectively followed for 3-12 months. Thirty-six reports of macular hole surgery were reviewed. A meta-analysis on the pre- and postoperative parameters was performed on 389 cases, in which case-specific data-points were available. RESULTS: In the current series, anatomical closure was achieved in all (100%) of 16 stage 2, and in 35 (87.5%) of 40 stage 3 or 4 macular holes. At least 2 logMAR lines of improvement in visual acuity were seen in 10 (62.5%) stage 2 and 20 (50.0%) stage 3 or 4 holes. Postoperative visual acuity was 6/12 or better in 10 (62.5%) stage 2 and 17 (42.5%) stage 3 or 4 holes. In both the current series and the meta-analysis, favourable surgical outcomes were associated with stage 2 macular holes, better preoperative visual acuity, and shorter preoperative duration. Adjuvant use was associated with a higher rate of anatomical closure but there was no clear benefit in terms of postoperative visual acuity. CONCLUSION: Our experience and the results of the meta-analysis suggest that macular hole surgery should be offered as early as possible once full-thickness neuroretinal defect occurs.

Indocyanine green angiographic features of varix of the vortex vein ampulla.

Varix of the vortex vein ampulla is a rare, benign, asymptomatic condition, which may be confused with a choroidal naevus or melanoma. A 28-year-old man was referred to a tertiary retinal practice with a diagnosis of choroidal naevus. The lesion was an elevated choroidal mass in the superonasal peripheral retina measuring 2 by 1 disc diameters. It was dark red to burgundy in colour and disappeared under digital pressure applied to the globe. The methods used in diagnosis were colour fundus photography, fluorescein angiography and indocyanine green angiography using a scanning laser ophthalmoscope. On fluorescein angiography the lesion was initially hypofluorescent, becoming isofluorescent 25 s after dye injection. Indocyanine green angiography demonstrated the lesion to be two separate dilatations of the vortex vein ampullae. The dilatations collapsed when pressure was applied to the globe. A choroidal mass that collapses under pressure applied to the globe should suggest a varix of the vortex vein ampulla. Indocyanine green angiography is useful in demonstrating the outline of the varix of the vortex vein ampulla.

Pattern of vascular nonperfusion in retinal venous occlusions occurring within the optic nerve with and without optic nerve head swelling.

OBJECTIVE: To investigate the significance of optic nerve head swelling (ONHS) in relation to the pattern of vascular nonperfusion, visual acuity (VA), and demographic profile in retinal venous occlusions (RVOs) occurring within the optic nerve. METHODS: Cases of RVO occurring within the optic nerve were divided on the basis of the presence (105 cases) or absence (163 cases) of ONHS. This division was performed by examining the color stereo fundus photographs in conditions masked from other clinical parameters. Duration of symptoms before assessment, age, and sex distributions were compared. The vein involved was identified, and the occlusion was confirmed to have occurred within the optic nerve by observing that the vein pierced the lamina cribrosa as a dilated vein. Fluorescein angiographs were examined, and the extent of vascular nonperfusion in the macula and peripheral retina was quantified from grade 1 to grade 4. The extent of break in the perifoveal capillary arcade was graded as 0, less than or equal to 90 degrees, and greater than 90 degrees. Best-corrected VA was assessed using the Snellen chart. RESULTS: The 2 groups were comparable in terms of the duration of the symptoms before examination. The mean age was significantly younger in the group with ONHS (58.3 vs 65.1 years, P<. 001). Age distribution by sex demonstrated a higher proportion of men younger than 50 years in the ONHS group (19.1% vs 8.6%, P =.01). The group without ONHS involved the papillary vein more frequently (31.3% vs 17.1%, P =.01). The respective proportions of grade 1, 2, 3, and 4 vascular nonperfusion in the macula were 90.5%, 9.5%, 0%, and 0% in the ONHS group, and 62.6%, 14.7%, 13.5%, and 9.2% in the group without ONHS (P<.001). The corresponding proportions for the peripheral retina were 90.4%, 8.7%, 0%, and 1.0% in the ONHS group, and 62.7%, 13.0%, 18.0%, and 6.2% in the group without ONHS (P<.001). In 64.6% of cases with ONHS and 42.9% of cases without, the perifoveal arcade was intact. A break greater than 90 degrees in the perifoveal arcade was present in 12.5% of cases with and 23.6% of cases without ONHS (P =.004). The median VA was significantly better in the ONHS group (6/24 vs 6/48, P =.005). CONCLUSIONS: The RVOs occurring within the optic nerve can be subdivided into 2 distinct groups on the basis of ONHS. The presence of ONHS is associated with younger age, less severe vascular nonperfusion, and better VA. This is consistent with a retrocribrosal site of occlusion, which has access to the pial plexus that can provide collateral channels for retinal venous drainage.

Intravitreal triamcinolone and elevated intraocular pressure.

PURPOSE: To ascertain whether intravitreal triamcinolone given for subretinal neovascularization is associated with an ocular pressure rise. METHODS: A total of 113 patients with angiographically proven subretinal neovascularization were enrolled into a prospective study of the effects of intravitrea triamcinolone. Intraocular pressure was one of the parameters studied. RESULTS: Approximately 30% of the study group developed a significant rise (> or =5 mm Hg) in intraocular pressure above baseline during the first 3 months. CONCLUSIONS: Patients considering this form of treatment should be fully informed of the known risks of intraocular injections of steroids.

Role of glutathione S-transferases in the resistance of human colon cancer cell lines to doxorubicin.

The anthracycline doxorubicin has little activity against colorectal cancers. It is hypothesized that this is attributable to a multifactorial resistance mechanism in which the glutathione S-transferases (GST) may play a role. We studied the relationship between GST expression and doxorubicin resistance in four human colon adenocarcinoma cell lines (HT-29, LoVo, SW620, and Caco-2), with the goal of modulating GST activity to overcome resistance. Caco-2 cells were the most resistant to doxorubicin, showing an IC50 value approximately 80- to 90-fold higher than HT-29 or LoVo and 600-fold higher than SW620. Total GST catalytic activity was significantly higher in Caco-2 cells compared with the other lines. All four cell lines expressed GST-pi at the catalytic activity, protein, and mRNA levels; however, no significant differences were observed among the cell lines. GST-mu expression was not detectable at the protein and mRNA levels, and the four cell lines displayed very low catalytic activity toward a GST-mu-selective substrate. Caco-2 cells showed a unique, highly expressed GST-alpha-immunoreactive band that was not detected in the other lines; however, the glutathione peroxidase activity of Caco-2 cells was the lowest among the four cell lines. Neither ethacrynic acid nor glutathione analogues that function as GST class-selective inhibitors were able to potentiate the cytotoxic effects of doxorubicin in these colon cancer cell lines, as demonstrated in both microplate colorimetric and clonogenic assays. The multidrug resistance-associated protein and P-glycoprotein were either not detectable or expressed at such low levels that they are not likely to contribute to the differences in doxorubicin sensitivity observed among these cell lines.

Widespread choroidal insufficiency in primary open-angle glaucoma.

PURPOSE: The purpose of this study was to investigate choroidal perfusion in glaucoma, using histological and angiographic techniques. METHODS: We examined the choroidal vasculature in clinicopathological slides from 25 cases of primary open-angle glaucoma, five cases of optic atrophy, and 18 normal eyes. We measured choroidal thickness at fixed distances from the disk margin with light microscopy. Using a quantitative computer image analysis system, we established the depth of all vessels and the best fitting diameter and width-to-length ratio for each vessel in three pairs of eyes. Separate statistical analyses were done on the parapapillary area and the whole choroid. We compared standard fluorescein angiographic measures to peak choroidal filling time in a further 78 glaucoma and 84 normal eyes. RESULTS: Choroids were significantly (approximately 50 microns) thinner in glaucoma than in normal or optic atrophy irrespective of fundal position. Vessel frequency and mean diameter, relative to normal, showed greatest decrease near the choriocapillaris. Peak choroidal filling was the only fluorescein angiographic measure that was significantly delayed in glaucoma irrespective of age. CONCLUSIONS: Reduced choroidal thickness in primary open-angle glaucoma is primarily due to loss of the innermost choroidal vessels. Overall size decreases without significant flattening. These changes are not seen with optic atrophy alone and may be correlated with the delayed choroidal perfusion seen in fluorescein angiography.

Activated protein C resistance--low incidence in glaucomatous optic disc haemorrhage and central retinal vein occlusion.

PURPOSE: Activated protein C (APC) resistance has recently been reported as conferring a sevenfold increase in the risk of venous thrombosis. It is linked to a genetic mutation in the factor V gene which occurs commonly (about 2% to 4% of the community have the mutation). Glaucoma patients with nerve fibre layer (NFL) haemorrhages on the optic disc and patients with central retinal vein occlusion (CRVO) were tested for APC resistance to determine if there was an association. METHODS: Twenty-three patients with glaucomatous NFL haemorrhages and 23 patients with CRVO were tested. The CRVO cases included 11 with relatively young age of onset (mean 45.1 +/- 6.9 years) without conventional vascular risk factors. Eighty randomly selected Red Cross blood donor samples and 33 staff members were tested as controls. Clotting times with and without exogenous APC were recorded and an APC ratio determined. Cases with APC resistance were tested to confirm that they had the factor V Leiden gene. RESULTS: No cases of APC resistance were identified in the glaucoma patients and only one of the younger CRVO patients tested positive, but four of 113 controls tested positive. The difference in prevalence between groups is not significant. The mean APC ratios for the three groups were very similar: NFL haemorrhages 5.46(+/- 1.62), CRVO 5.70(+/- 1.56), controls 5.34 ( +/- 1.19) p > 0.5. CONCLUSION: There was not clear association detected between glaucomatous NFL haemorrhages or CRVO and APC resistance in this sample of patients. This negative finding is important due its known association with venous thrombosis elsewhere in the body.

Visual outcome of excimer laser photorefractive keratectomy for myopia. A comparison of three laser delivery systems in Australia.

PURPOSE: To compare the performance of the three excimer laser delivery systems in correcting myopia. METHODS: The first generation excimer laser systems produced by Summit, VISX and LEI were examined. The first 40 consecutive eyes with six-month refractive results were selected from the LEI centre. Forty consecutive eyes, matched for age and attempted corrections, were then selected from each of the Summit and VISX centres. The postoperative visual results were examined retrospectively and compared among the three groups. RESULTS: At six-month follow-up, the mean and standard deviation of the spherical equivalent refraction were +0.27 (SD, 0.65) dioptre in the Summit group, -0.33 (SD, 0.83) dioptre in the VISX group and -0.62 (SD, 0.89) dioptre in the LEI group (P = 0.0001, ANOVA). Thirty-five eyes (88%) in the Summit group, 33 eyes (83%) in the VISX group and 28 eyes (70%) in the LEI group achieved corrections within 1 dioptre of intended corrections (P = 0.131, chi 2 test). Four eyes (10%) in the Summit group, two eyes (5%) in the VISX group and one eye (3%) in the LEI group were overcorrected by more than 1 dioptre at six-month follow-up. Unaided visual acuity (Snellen equivalent) was 6/12 or better in 37 eyes (93%) in the Summit group, 34 eyes (85%) in the VISX group and 34 eyes (87%) in the LEI group (data missing in one eye). Loss of one or more lines of best corrected visual acuity (Snellen equivalent) was found in 6 of 39 eyes (15%) in the Summit group, 10 of 40 eyes (25%) in the VISX group and 4 of 36 eyes (11%) in the LEI group (P = 0.258, chi 2 test). Regression between one and six month follow-up differed significantly (P = 0.001, ANOVA) among the groups, with the mean of -1.25 (SD, 0.94) dioptres in the Summit group, -0.59 (SD, 1.01) dioptre in the VISX group and -0.40 (SD, 0.99) dioptre in the LEI group. CONCLUSIONS: Statistically comparable results were found in the three groups in terms of refraction and visual acuity six months after myopic photorefractive keratectomy. No statistical differences were found between the groups in terms of significant overcorrection or loss of best corrected acuity. The group treated using the Summit system demonstrated significantly greater regression than the other groups, necessitating larger initial hyperopic shifts.

[Functional study of Swanson's metacarpophalangeal arthroplasties in rheumatoid arthritis]. / Etude fonctionnelle des arthroplasties métacarpophalangiennes de Swanson dans l'arthrite rhumatoïde.

To validate a functional hand evaluation and to obtain an historical control group in a project of metacarpophalangeal total joint prosthesis, we reviewed our experience over a ten year period of Swanson's metacarpophalangeal joint arthroplasty in rheumatoid arthritis. Forty-nine implants in fourteen rheumatoid arthritis patients were reviewed clinically, radiologically and evaluated by the Arthritic Hand Function Test. The mean follow up was 4.5 years. All patients were ready to repeat the experience except one. The mean metacarpophalangeal joint range of motion was 37 degrees (18 degrees to 55 degrees) with a mean of 7 degrees ulnar deviation. Although their functional performance was 50% of normal, all patients completed the test. The strength was generally greater on the operated side. The low complication rate (6% fracture rate) with the successful functional outcome of Swanson's metacarpophalangeal joint arthroplasty in rheumatoid arthritis will be the gold standard for any new implant to develop.

Ophthalmodynamometry and corticosteroids in central retinal vein occlusion.

PURPOSE: This is the first report of the monitoring of the clinical progress of a central retinal vein occlusion by measuring the retinal venous collapse pressure using ophthalmodynamometry. METHOD: A 38-year-old woman with a nonischaemic central retinal vein occlusion received systemic prednisone. The dose of prednisone was increased and decreased both abruptly and gradually. The response was monitored by weekly measurements of visual acuity, retinal appearance and retinal venous collapse pressure. The retinal appearance was assessed by comparison of repeated stereo colour photographs and fluorescein angiographs. Retinal venous collapse pressure was estimated by taking the mean of four or more ophthalmodynamometric measurements. RESULTS: An inverse relationship between the ophthalmodynamometric retinal venous collapse pressure and systemic prednisone dosage was observed. The visual acuity and retinal appearance remained unchanged throughout the follow-up. CONCLUSIONS: Ophthalmodynamometry in this case was a useful method of quantitatively monitoring the response of central retinal vein occlusion to systemic prednisone. The response would not have been detected if only visual acuity and retinal appearance were used to monitor the progress.

Isolated bulbar conjunctival Kaposi's sarcoma.

We present a case of an isolated bulbar conjunctival Kaposi's sarcoma in a man with HIV infection. This is an unusual site for the initial presentation of Kaposi's sarcoma and in this site can be confused with a caroticocavernous fistula, cavernous haemangioma or chronic subconjunctival haemorrhage. Biopsy is required to confirm the diagnosis in isolated disease. Local radiotherapy is the preferred treatment for isolated Kaposi's sarcoma.