Combined use of baking soda and electric toothbrushing for removal of artificial extrinsic stain on enamel surface: An in vitro study.

BACKGROUND: This study aimed to investigate the combined effect of baking soda and electric toothbrushing on the removal of artificial extrinsic stain in vitro. MATERIAL AND METHODS: Flat enamel surfaces of 15 bovine incisors were artificially stained with 10% citric acid / 3% ferric chloride solution followed by 1% tannic acid solution. These specimens were randomly divided into three groups (n = 5) - Group S+B: brushing with an electric toothbrush and baking soda, Group S+C: brushing with an electric toothbrush and fluoride dentifrice, Group S: brushing only with an electric toothbrush. Color values (L*, a*, and b*) and surface roughness were measured before and after brushing (after 1, 2, 3, and 5 min). The data were statistically analyzed using two-way analysis of variance and Tukey's honest significant difference test as a post hoc test (p< 0.05). RESULTS: The L* value of Group S+B increased over time, and was significantly different between before brushing and at 5 min (p< 0.05). A significant difference in the ΔE* value of Group S+B was found at 5 min (p< 0.05). However, no significant difference was found in the ΔE* values of Group S+C and Group S. No significant differences in Ra were found in any of the groups. CONCLUSIONS: The results of this study suggest that the combined use of baking soda and electric toothbrushing has an excellent stain-removing effect compared with electric toothbrushing with a fluoride dentifrice. Additionally, the changes in surface roughness were similar to the changes caused by the use of general dentifrices. Key words:Baking soda, dentifrice, extrinsic stain removal, color change, surface roughness.

Choroidal structure determined by binarizing optical coherence tomography images in eyes with reticular pseudodrusen.

PURPOSE: To compare the choroidal structure beneath the macular area in eyes with reticular pseudodrusen (RPD) and age-matched controls. METHODS: This study was performed at Nara Medical University Hospital, Japan. Twenty eyes of 14 patients (82.3±4.2 years, mean ± standard deviation) with RPD and 35 eyes of 20 age-matched controls (81.5±6.0 years) were studied. The choroidal structure was determined by binarizing the images obtained by enhanced depth imaging optical coherence tomography in all patients and controls. The total, luminal, and stromal choroidal areas were quantified by the binarization method. RESULTS: The total choroidal area of the eyes with RPD was significantly smaller than that of control eyes (P=0.001, unpaired t-test). Both the luminal and stromal areas in eyes with RPD were significantly smaller than that of control eyes (P=0.001, paired t-test), but there was no significant difference in the luminal/stromal ratio between eyes with RPD and control eyes. CONCLUSION: The total, luminal, and stromal choroidal areas in eyes with RPD were smaller than those of the control eyes. The reduction of the choroidal luminal and stromal areas may be due to a loss of the oxygen demand of the choroid due to RPE dysfunction.

Lateral Position of the External Carotid Artery: A Rare Variation to Be Recognized During Carotid Endarterectomy.

BACKGROUND: External carotid artery (ECA) positioned laterally to the internal carotid artery (ICA) at the level of the common carotid artery (CCA) bifurcation is occasionally encountered during carotid endarterectomy (CEA). This study aimed to determine the frequency of this phenomenon and provide technical tips for performing CEA. METHODS: The study included 199 consecutive patients (209 carotid arteries) who underwent CEA at Otaru Municipal Medical Center in 2007-2014. The position of the ECA with respect to the ICA at the CCA bifurcation was preoperatively rated as either lateral or normal, using three-dimensional computerized tomographic angiography (3-D CTA) anteroposterior projections. Postoperative diffusion-weighted images (DWIs), and postoperative 3-D CTA images were reviewed. RESULTS: Among the 209 carotid arteries with atherosclerosis, 11 instances (5.3 %) of lateral position of the ECA were detected in 11 patients. Ten of these arteries (91 %) were right-sided (odds ratio 11.1; 95 % confidence interval 1.38-88.9). Wider longitudinal exposure of the arteries was used during CEA, and the CCA and ECA were rotated clockwise or counter clockwise. The ICA lying behind the ECA along the surgical access route was then pulled out laterally and moved to the shallow surgical field. Cross-clamping, arteriotomy, plaque removal, and wall suturing were performed as usual. No cerebral infarcts were detected on postoperative DWIs, and 3-D CTA revealed no CCA and ICA kinking. CONCLUSIONS: Lateral position of the ECA is not extremely rare in patients undergoing CEA for atherosclerosis and may be a congenital variation, although this is still controversial. CEA can be performed safely if the arteries from the CCA to the ICA are rotated, and the ICA is moved to the shallow surgical field under wider longitudinal exposure. Although no postoperative cerebral infarcts were detected, the risk of artery-to-artery embolism resulting from artery repositioning prior to plaque removal should be taken into consideration.

The effect of blue-blocking intraocular lenses on circadian biological rhythm: protocol for a randomised controlled trial (CLOCK-IOL colour study).

INTRODUCTION: Blue light information plays an important role in synchronising internal biological rhythm within the external environment. Circadian misalignment is associated with the increased risk of sleep disturbance, obesity, diabetes mellitus, depression, ischaemic heart disease, stroke and cancer. Meanwhile, blue light causes photochemical damage to the retina, and may be associated with age-related macular degeneration (AMD). At present, clear intraocular lenses (IOLs) and blue-blocking IOLs are both widely used for cataract surgery; there is currently a lack of randomised controlled trials to determine whether clear or blue-blocking IOLs should be used. METHODS AND ANALYSIS: This randomised controlled trial will recruit 1000 cataract patients and randomly allocate them to receive clear IOLs or blue-blocking IOLs in a ratio of 1:1. The primary outcomes are mortality and the incidence of cardiovascular disease, cancer and AMD. Secondary outcomes are fasting plasma glucose, triglycerides, cholesterol, glycated haemoglobin, sleep quality, daytime sleepiness depressive symptoms, light sensitivity, the circadian rhythm of physical activity, wrist skin temperature and urinary melatonin metabolite. Primary outcomes will be followed until 20 years after surgery, and secondary outcomes will be assessed at baseline and 1 year after surgery. ETHICS AND DISSEMINATION: Ethical approval has been obtained from the Institutional Review Board of Nara Medical University (No. 13-032). The findings of this study will be communicated to healthcare professionals, participants and the public through peer-reviewed publications, scientific conferences and the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) home page. TRIAL REGISTRATION NUMBER: UMIN000014680.

Targeting VE-PTP activates TIE2 and stabilizes the ocular vasculature.

Retinal and choroidal neovascularization (NV) and vascular leakage contribute to visual impairment in several common ocular diseases. The angiopoietin/TIE2 (ANG/TIE2) pathway maintains vascular integrity, and negative regulators of this pathway are potential therapeutic targets for these diseases. Here, we demonstrated that vascular endothelial-protein tyrosine phosphatase (VE-PTP), which negatively regulates TIE2 activation, is upregulated in hypoxic vascular endothelial cells, particularly in retinal NV. Intraocular injection of an anti-VE-PTP antibody previously shown to activate TIE2 suppressed ocular NV. Furthermore, a small-molecule inhibitor of VE-PTP catalytic activity (AKB-9778) activated TIE2, enhanced ANG1-induced TIE2 activation, and stimulated phosphorylation of signaling molecules in the TIE2 pathway, including AKT, eNOS, and ERK. In mouse models of neovascular age-related macular degeneration, AKB-9778 induced phosphorylation of TIE2 and strongly suppressed NV. Ischemia-induced retinal NV, which is relevant to diabetic retinopathy, was accentuated by the induction of ANG2 but inhibited by AKB-9778, even in the presence of high levels of ANG2. AKB-9778 also blocked VEGF-induced leakage from dermal and retinal vessels and prevented exudative retinal detachments in double-transgenic mice with high expression of VEGF in photoreceptors. These data support targeting VE-PTP to stabilize retinal and choroidal blood vessels and suggest that this strategy has potential for patients with a wide variety of retinal and choroidal vascular diseases.

Multifocal electroretinograms in age-related macular degeneration before and after photodynamic therapy.

PURPOSE: To evaluate multifocal electroretinograms (mfERG) and macular retinal thickness before and after photodynamic therapy (PDT) for predominantly classic choroidal neovascularization (CNV) (classic type) and occult with no classic CNV (occult type). METHODS: Recording of mfERG and measurement of macular retinal thickness were performed before and after PDT in 19 patients (19 eyes) with the classic type and 24 (26 eyes) with the occult type. The evaluation items were the amplitude of the first negative wave (N1), the amplitude from the peak of the negative wave to that of the following positive wave (P1), and the peak latencies of the negative and positive waves. RESULTS: Compared with mfERG before PDT, that after PDT showed a significant decrease in the P1 latency in the central area (31.1 ± 1.9 ms before and 29.6 ± 1.6 ms after PDT) for the classic type and significant decreases in both the central (32.0 ± 2.0 ms before and 30.5 ± 2.4 ms after PDT) and peripheral (30.2 ± 2.0 ms before and 29.5 ± 2.0 ms after PDT) areas for the occult type. Optical coherence tomography showed significant decreases in macular retinal thickness in both groups (464 and 314 µm before and after PDT, respectively, for the classic type and 516 and 340 µm for the occult type). CONCLUSIONS: After PDT, retinal function evaluated by mfERG improved for both the classic and occult types, and the recovery of P1 latency may be due to improvement in retinal edema.

Effect of tilt of 2 acrylic intraocular lenses on high-order aberrations.

PURPOSE: To investigate the high-order aberrations (HoAs) in pseudophakia between 2 foldable acrylic intraocular lenses (IOL) with differences in the tilt of IOL. SETTING: Department of Ophthalmology, Nara Medical University, Nara, Japan. METHOD: Sixty-four eyes that had uncomplicated phacoemulsification and IOL implantation were assigned to 1 of 2 groups: Acryfold 60BB (HOYA [n=30 eyes]) and AcrySof MA60AC (Alcon [n=34 eyes]). All patients had best corrected visual acuity better than 20/25. High-order aberrations were measured using the Hartmann-Shack aberrometer at 4.0 mm and 6.0 mm wavefront aperture diameters, and the IOL tilt and decentration were measured using Scheimpflug videophotography. RESULTS: There was a significant difference in the IOL tilt (60BB=2.22 degrees +/- 1.44 (SD), 60AC=3.18 +/- 1.84 degrees; P=.041, Mann-Whitney U test), but no difference in IOL decentration (P>.05). In the cornea, there were no differences between the 2 groups in HoAs at 4.0 mm and 6.0 mm aperture diameters (P>.05, Mann-Whitney U test). In the whole eye, there was no difference between the 2 groups in spherical-like aberrations, coma-like aberrations, and total aberrations at the 4.0 mm and 6.0 mm aperture diameters (P>.05). The compensation of the internal optics with the 60BB group was better than with the 60AC group for coma-like (P=.037) and total aberrations (P=.010) at 6.0 mm aperture diameter. CONCLUSION: The smaller tilt of the IOL induced more compensation for the coma-like and total aberrations at the 6.0 mm aperture diameter. The IOL tilt should be small, especially in a large pupil, with regard to HoAs.

Long-term observation of the refraction with a reversed-optic posterior chamber intraocular lens.

A 73-year-old man had phacoemulsification and implantation of a posterior chamber intraocular lens (PC IOL) in both eyes. In the right eye, the optic was unintentionally reversed in the bag. In the left eye, the posterior capsule was ruptured and the IOL haptics were fixated in the ciliary sulcus. The refraction in the sulcus-fixated left eye was stable from 1 month to 4 years. The right eye had a myopic shift at 1 month, with a regression of 1.50 diopters that continued for 2 years. The final IOL position in the right eye was 0.25 mm anterior to the position predicted by the SRK/T formula. It took 2 years for the refraction in the eye with the reversed-optic PC IOL to become stable. A large myopic shift and gradual regression in refraction may stem from a different wound-healing reaction than that of properly fixated IOLs.

Thickness monitoring of optical filters for DWDM applications.

A method for thickness monitoring and turning-point prediction during deposition of narrow band pass optical filters (NBPF) for dense-wavelength-division-multiplexing (DWDM) applications is proposed. The method is based on a recurrent approach, with relative transmittance .tting, and includes partial coherence and monochromator bandpass e.ects. We show that the partial coherence e.ects in thin .lm structures are signi.cant and can not be neglected. The proposed method is applicable for precise thickness monitoring and deposition control of any complex multilayer coating.