Name: using an automated hirschberg test app to evaluate ocular alignment
Uploaded: 2020-03-24T15:00:00
Description: Watch this Scientific Journal Video about Using an Automated Hirschberg Test App to Evaluate Ocular Alignment at JoVE.com

この作品は、NIHグラントR44EY025902とマスアイ&イヤーキュアキッズグラントによって部分的にサポートされました。

この研究は、シェルシンキ宣言の教義に従って行われました, シェペンスアイ研究所で (ボストン, マサチューセッツ州) スポールディングリハビリテーション病院 (ボストン, マサチューセッツ州).インフォームド・コンセントは参加者全員から得られました。この研究は、マスアイと耳(マサチューセッツ州ボストン)の地元の機関審査委員会によって承認されました。
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W., Deng, L., Weissberg, E. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Detection+of+Strabismus+by+Non-Health+Care+Professionals+in+an+Ethnically+Diverse+Set+of+Images.">Detection of Strabismus by Non-Health Care Professionals in an Ethnically Diverse Set of Images.</a> JAMA Ophthalmology. 134 (1), 30-36 (2016).</li><li>Hunter, D. G., Guyton, D. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Vertical+location+of+the+corneal+light+reflex+in+strabismus+photography.">Vertical location of the corneal light reflex in strabismus photography.</a> Archives of Ophthalmology. 116 (6), 767-771 (1998).</li><li>Eskridge, J. B., Wick, B., Perrigin, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Hirschberg+test:+a+double-masked+clinical+evaluation.">The Hirschberg test: a double-masked clinical evaluation.</a> American Journal of Optometry and Physiological Optics. 65 (9), 745-750 (1988).</li><li>Hasebe, S., Ohtsuki, H., Tadokoro, Y., Okano, M., Furuse, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+reliability+of+a+video-enhanced+Hirschberg+test+under+clinical+conditions.">The reliability of a video-enhanced Hirschberg test under clinical conditions.</a> Investigative Ophthalmology &amp; Visual Science. 36 (13), 2678-2685 (1995).</li><li>Pundlik, S., Tomasi, M., Liu, R., Houston, K., Luo, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+and+Preliminary+Evaluation+of+a+Smartphone+App+for+Measuring+Eye+Alignment.">Development and Preliminary Evaluation of a Smartphone App for Measuring Eye Alignment.</a> Translational Vision Science &amp; Technology. 8 (1), 19 (2019).</li><li>Cheng, W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+EyeTurn+App+for+School+Vision+Screening.">The EyeTurn App for School Vision Screening.</a> American Academy of Optometry Annual Meeting. , (2018).</li><li>Committee on Practice and Ambulatory Medicine and Section on Ophthalmology. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Use+of+Photoscreening+for+Children's+Vision+Screening.">Use of Photoscreening for Children's Vision Screening.</a> Pediatrics. 109 (3), 524-525 (2002).</li><li>Simons, B. D., Siatkowski, R. M., Schiffman, J. C., Berry, B. E., Flynn, J. T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pediatric+photoscreening+for+strabismus+and+refractive+errors+in+a+high-risk+population.">Pediatric photoscreening for strabismus and refractive errors in a high-risk population.</a> Ophthalmology. 106 (6), 1073-1080 (1999).</li><li>Kerr, N. C., Somes, G., Enzenauer, R. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+effect+of+developmentally-at-risk+status+on+the+reliability+of+the+iScreen(R)+photorefractive+device+in+young+children.">The effect of developmentally-at-risk status on the reliability of the iScreen(R) photorefractive device in young children.</a> The American Journal of Orthopedics. 61, 117-123 (2011).</li><li>Arnold, R. W., O'Neil, J. W., Cooper, K. L., Silbert, D. I., Donahue, S. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluation+of+a+smartphone+photoscreening+app+to+detect+refractive+amblyopia+risk+factors+in+children+aged+1-6+years.">Evaluation of a smartphone photoscreening app to detect refractive amblyopia risk factors in children aged 1-6 years.</a> Clinical Ophthalmology. 12, 1533-1537 (2018).</li></ol>

専門家の訓練を受けていない人は、EyeTurnアプリを使用して目の写真をキャプチャし、眼のアライメント測定値を取得することができます。アプリは、任意の解釈や診断ではなく、ミスアライメントの大きさを提供します。検眼医や眼科医などの眼科医は、ミスアライメントが有意であるかどうかを判断し、測定が行われた条件を含む他の要因を考慮した後、診断を行う必要があります。
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眼のアライメントの測定は、しばしば、視力ケアクリニックで行われます。プリズム中和を伴うカバーテストは、眼のずれの程度(斜視)を定量化するための一般的に使用される臨床方法である。この方法には高度なトレーニングと経験が必要です。幼児1、脳損傷または脳卒中2の個人、または発達障害の患者が完全に試験に従事することができない場合、正確な測定はより困難になります。さらに、学校スクリーニングでは、斜視は米国人口4の推定5-8%で小児期に発症し、斜視55、6、76に起因する弱視の症例の約30〜40%を有する弱視の実質的な危険因子であるため、7学校スクリーニングにおける眼配整列検査の必要性がある。しかし、通常、学校の看護師は、このようなスクリーニングのためのプリズム中和で標準的なカバーテストを行うための訓練を受けていません。非眼科医療専門家にとって、斜視スクリーニングにおける追加の課題は、断続的な斜視(ミスアライメントが常に現れるわけではない)であり、ミスアライメントの小さな大きさは視覚的に明白ではない(<15プリズムディオプター[Δ])8。
斜視の検出と測定の課題に対処するために、私たちは目の間の角膜反射の変位を比較することによって写真のヒルシュベルク法9を実装し、自動化するスマートフォンアプリ(EyeTurn)を開発しました。従来の写真のヒルシュベルク法は診療所10,11,11において良好な再現性を有することが示されているが、専用のスタンドアロンデバイスのコストは幅広い採用の障壁となっている。標準的なスマートフォンで目の位置合わせを測定するための使いやすいツールを提供することで、学校の視力スクリーニングで広く採用され、非アイケアの専門家によって使用されると仮定します。我々の以前の評価研究は、アプリの測定が60Δまでのesotropiaおよび外視の斜視の大きさに対するプリズムおよび代替カバーテスト12の現在の臨床標準と一致することを示している。パイロットスクールスクリーニング研究では、標準的な学校視力スクリーニングプロトコル13によって逃した断続的な外視を持つ子供を学校の看護師が検出するのを助けることができることを示しました。
アプリのiOSバージョンは、現在、研究目的のために要求に応じて研究者や臨床医が利用できます。依頼者には、これまで学校の看護師、小児眼科医、検眼医、神経眼科医、および斜視の専門家が含まれています。この記事の目的は、さまざまな表示条件、すなわち近くおよび遠い固定距離の下で、眼の配置を評価するためにアプリを使用するための詳細なアプリプロトコルを共有することです。双眼鏡の融合を破るために目のカバーの有無。

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>EyeTurn</td>
			<td>EyeNexo</td>
			<td></td>
			<td>Smartphone app for measureing eye misalignment</td>
		</tr>
	</tbody>
</table>

using an automated hirschberg test app to evaluate ocular alignment

スマートフォンアプリは、眼のミスアライメントの客観的な測定のための自動写真ヒルシュベルクテストを実行するために開発されました。高解像度の画像に基づいて虹彩中心に対して携帯電話のカメラフラッシュによって生成された角膜反射の違いを計算することにより、アプリは、ヒルシュベルクテストを行う肉眼よりもはるかに高い精度でミスアライメントを測定することができます。これは、臨床金標準プリズムと代替カバーテストと比較することにより、以前の臨床評価研究で検証されています.この記事の目的は、ユーザーが同等の実行を実行するためにアプリを使用できるように、異なる固定距離の眼のアラインメントを測定する方法に関するテスト技術を説明することです。テストは、通常、プリズムを使用して診療所で行われます。

本研究では、写真のヒルシュベルク試験を行うスマートフォンアプリを用いて、眼のアライメントを評価するプロトコルについて説明する。アプリのインターフェイスを図 1に示します。ユーザーは、カバーテストを実行するか、近くまたは遠い固定距離のいずれかで、両方の目がターゲットに同時に固定された患者を測定することを選択でき?...

Watch this Scientific Journal Video about Using an Automated Hirschberg Test App to Evaluate Ocular Alignment at JoVE.com

Using an Automated Hirschberg Test App to Evaluate Ocular Alignment

スマートフォンアプリを使用して、近くおよび遠い固定条件下でマニフェストと断続的な眼のずれ(斜視)を測定するためのHirschbergテストを実行するプロトコルを提示します。

自動ヒルシュベルクテストアプリを使用した眼のアライメントの評価

A smartphone app has been developed to perform the automated photographic Hirschberg test for objective measurement of ocular misalignment. By computing ...

私たちが開発したモバイルアプリは、研究や臨床使用のための斜視を測定するために使用することができます。この方法は、標準的な携帯電話のカメラとアプリソフトウェアのみを使用して実行される広範な訓練と経験を現在必要とする容易な斜体測定を容易にする。アプリインターフェイスでは、カバーテストを実行するか、近くまたは遠くまで固定距離で、両方の目をターゲットに同時に固定した患者を測定することができます。近い固定で単一のスナップショットを使用してトロピアを測定するには、アプリを起動し、モードを[カバーなし]に設定します。[近く]を選択し、患者の目の高さで患者から約40センチメートルの横方向に携帯電話を配置し、後部カメラを患者に向けます。この時点でオフにする必要があり、懐中電灯に固定するように患者に指示します。正確な調節を必要とするテストのために、懐中電灯の真下または上の電話の背面に固定ターゲットを貼り付ける。患者が固定していることを確認したら、丸いボタンを押してアプリで分析するスナップショットを撮ります。分析が完了すると、検出された四肢境界、目の中心、角膜反射の位置がアプリに表示されます。これらの特徴が明らかな誤りなしに検出されたことを確認した後、目の位置合わせに関連する測定値を観察します。次に、[保存] ボタンを押して現在のテストを電話機に保存するか、戻る矢印ボタンを押して再テストを行います。アプリ内の遠方固定のための断続的な眼のずれを測定するには、モードをカバーテストに設定し、[Far]を選択します。患者の目の間に置かれるフラッシュカメラと目の高さで患者から約40センチメートル、横向きの方向に電話を保持します。患者に電話のすぐ上を見るように指示し、約6メートル離れたターゲットに。患者が片目をカバーし、丸いボタンを押して、アプリが検出を開始します。患者が適切に固定されていることを確認しながら、すぐに閉塞を取り除いさせる。アプリは、オクルージョンが削除されるとすぐに自動的に写真を撮ります。分析が完了すると、検出された四肢境界、目の中心、角膜反射の位置がアプリに表示されます。これらの特徴が明らかなエラーなしで検出されたことを確認した後、データを保存するか、テストを繰り返す前に、プリズム・ディオプターでアイアライメントの測定結果を確認します。アプリでの角度カッパ測定では、測定カッパ角度を選択します。患者から約40センチメートルの横方向に電話機を配置し、他の目を覆いながら懐中電灯に固定するために検査される眼を使用するように患者に指示する。患者が適切に固定されていることを確認しながら、アプリによって分析されるスナップショットを取るために丸いボタンをタップします。分析が完了すると、検出された四肢境界、目の中心、角膜反射の位置がアプリに表示されます。これらの特徴が明らかなエラーなしで検出されたことを確認した後、Kappaの角度の測定結果を度単位で確認します。この代表的な解析では、2つの眼の四肢境界と懐中電灯の角膜反射を正しく検出し、眼のアライメント測定が画像解析エラーの対象ではないことを示唆した。この特定の場合、患者は左目の大きな角膜反射オフセットから明らかなように外視を残していた。アプリは、小さな斜視角度と未知のカッパ角度の場合、それはアプリが逸脱した目を決定するために信頼性が低いので、しかし、どの目が逸脱したかを報告しませんでした。比較のために、ここでは斜視のない例を示す。この分析では、誤ったリンブ検出が観察される。角膜反射の検出は正しいが、緑色の円は明らかに四肢の境界と一致せず、テストを繰り返す必要があることを示している。14人の被験者の本分析では、10人の被験者が外眼症を呈し、4人の被験者が外眼症を呈した。線形回帰分析は、斜視角の目の測定が臨床カバー試験測定と一致していることを明らかにした。アプリを使用する場合、留意する必要がある 2 つの重要なことがあります。1 つは、特定のテストごとにカバー テストと固定モードを正しく設定します。2つは、目の特徴検出が正しいかどうかを確認します。アプリはストラビスマス測定のみを可能にし、診断を与えません。臨床医は、診断を行うために、眼の測定と他の視力測定を組み合わせる必要があります。

using-an-automated-hirschberg-test-app-to-evaluate-ocular-alignment

Research

JoVE Journal

Medicine

An in vivo Assay to Test Blood Vessel Permeability

This method is based on the intravenous injection of Evans Blue in mice as the test animal model. Evans blue is a dye that binds albumin. Under physiologic conditions the endothelium is impermeable to albumin, so Evans blue bound albumin remains restricted within blood vessels. In pathologic conditions that promote increased vascular permeability endothelial cells partially lose their close contacts and the endothelium becomes permeable to small proteins such as albumin. This condition allows for extravasation of Evans Blue in tissues. A healthy endothelium prevents extravasation of the dye in the neighboring vascularized tissues. Organs with increased permeability will show significantly increased blue coloration compared to organs with intact endothelium. The level of vascular permeability can be assessed by simple visualization or by quantitative measurement of the dye incorporated per milligram of tissue of control versus experimental animal/tissue. Two powerful aspects of this assay are its simplicity and quantitative characteristics. Evans Blue dye can be extracted from tissues by incubating a specific amount of tissue in formamide. Evans Blue absorbance maximum is at 620 nm and absorbance minimum is at 740 nm. By using a standard curve for Evans Blue, optical density measurements can be converted into milligram dye captured per milligram of tissue. Statistical analysis should be used to assess significant differences in vascular permeability.

An in vivo Assay to Test Blood Vessel Permeability

We are presenting an in vivo assay to test blood vessel permeability. This assay is based on intravenous injection of a dye and subsequent visualization of its diffusion into interstitial spaces.

アン<em生体内で&gt;</em血管透過性をテストする&gt;アッセイ

This method is based on the intravenous injection of Evans Blue in mice as the test animal model. Evans blue is a dye that binds albumin. Under ...

医学

Using Quantitative Real-time PCR to Determine Donor Cell Engraftment in a Competitive Murine Bone Marrow Transplantation Model

Murine bone marrow transplantation models provide an important tool in measuring hematopoietic stem cell (HSC) functions and determining genes/molecules that regulate HSCs. In these transplant model systems, the function of HSCs is determined by the ability of these cells to engraft and reconstitute lethally irradiated recipient mice. Commonly, the donor cell contribution/engraftment is measured by antibodies to donor- specific cell surface proteins using flow cytometry. However, this method heavily depends on the specificity and the ability of the cell surface marker to differentiate donor-derived cells from recipient-originated cells, which may not be available for all mouse strains. Considering the various backgrounds of genetically modified mouse strains in the market, this cell surface/ flow cytometry-based method has significant limitations especially in mouse strains that lack well-defined surface markers to separate donor cells from congenic recipient cells. Here, we reported a PCR-based technique to determine donor cell engraftment/contribution in transplant recipient mice. We transplanted male donor bone marrow HSCs to lethally irradiated congenic female mice. Peripheral blood samples were collected at different time points post transplantation. Bone marrow samples were obtained at the end of the experiments. Genomic DNA was isolated and the Y chromosome specific gene, Zfy1, was amplified using quantitative Real time PCR. The engraftment of male donor-derived cells in the female recipient mice was calculated against standard curve with known percentage of male vs. female DNAs. Bcl2 was used as a reference gene to normalize the total DNA amount. Our data suggested that this approach reliably determines donor cell engraftment and provides a useful, yet simple method in measuring hematopoietic cell reconstitution in murine bone marrow transplantation models. Our method can be routinely performed in most laboratories because no costly equipment such as flow cytometry is required.

Determining donor cell engraftment presents a challenge in mouse bone marrow transplant models that lack well-defined phenotypical markers. We described a methodology to quantify male donor cell engraftment in female transplant recipient mice. This method can be used in all mouse strains for the study of HSC functions.

競争力のあるマウス骨髄移植モデルにおけるドナー細胞の生着を​​決定するために、定量的リアルタイムPCRを用いて

Murine bone marrow transplantation models provide an important tool in measuring hematopoietic stem cell (HSC) functions and determining genes/molecules ...

Using a Knee Arthrometer to Evaluate Tissue-specific Contributions to Knee Flexion Contracture in the Rat

Normal knee range of motion (ROM) is critical to well-being and allows one to perform basic activities such as walking, climbing stairs and sitting. Lost ROM is called a joint contracture and results in increased morbidity. Due to the difficulty of reversing established knee contractures, early detection is important, and hence, knowing risk factors for their development is essential. The rat represents a good model with which the effect of an intervention can be studied due to the similarity of rat knee anatomy to that of humans, the rat's ability to tolerate long durations of knee immobilization in flexion, and because mechanical data can be correlated with histologic and biochemical analysis of knee tissue.
Using an automated arthrometer, we demonstrate a validated, precise, reproducible, user-independent method of measuring the extension ROM of the rat knee joint at specific torques. This arthrometer can be used to determine the effects of interventions on knee joint ROM in the rat.

The goal of the protocol is to measure the extension range of motion of the rat knee. The effects of various diseases that increase the stiffness of the knee joint and the effectiveness of treatments can be quantified.

膝 Arthrometer を使用してラットの膝関節屈曲拘縮への組織固有の貢献を評価するには

Normal knee range of motion (ROM) is critical to well-being and allows one to perform basic activities such as walking, climbing stairs and sitting. Lost ...

Sucrose Preference and Novelty-Induced Hypophagia Tests in Rats using an Automated Food Intake Monitoring System

The prevalence and incidence of depressive disorders are rising worldwide, affecting about 322 million individuals, underlining the need for behavioral studies in animal models. In this protocol, to study depression-like and anhedonic behavior in rats, the established sucrose preference and novelty-induced hypophagia tests are combined with an automated food and liquid intake monitoring system. Prior to testing, in the sucrose preference paradigm, male rats are trained for at least 2 days to consume a sucrose solution in addition to tap water. During the test, rats are again exposed to water and sucrose solution. Consumption is registered every second by the automated system. The ratio of sucrose to total water intake (sucrose preference ratio) is a surrogate parameter for anhedonia. In the novelty-induced hypophagia test, male rats undergo a training period in which they are exposed to a palatable snack. During training, rodents show a stable baseline snack intake. On test day, the animals are transferred from home cages into a fresh, empty cage representing a novel unknown environment with access to the known palatable snack. The automated system records the total intake and its underlying microstructure (e.g., latency to approaching the snack), providing insight into anhedonic and anxious behaviors. The combination of these paradigms with an automated measuring system provides more detailed information, along with higher accuracy by reducing measuring errors. However, the tests use surrogate parameters and only depict depression and anhedonia in an indirect manner.

Presented here is a protocol to study depression-like and anhedonic behavior in rats. It combines two well-established behavioral methods, the sucrose preference and novelty-induced hypophagia tests, with an automated food and liquid intake monitoring system, to indirectly investigate rodent behavior using surrogate parameters.

自動食物摂取モニタリングシステムを用いたラットにおけるショ糖嗜好と新規性誘発性低血圧試験

The prevalence and incidence of depressive disorders are rising worldwide, affecting about 322 million individuals, underlining the need for behavioral ...

Endothelial Cell Transcytosis Assay as an In Vitro Model to Evaluate Inner Blood-Retinal Barrier Permeability

Dysfunction of the blood-retinal barrier (BRB) contributes to the pathophysiology of several vascular eye diseases, often resulting in retinal edema and subsequent vision loss. The inner blood-retinal barrier (iBRB) is mainly composed of retinal vascular endothelium with low permeability under physiological conditions. This feature of low permeability is tightly regulated and maintained by low rates of paracellular transport between adjacent retinal microvascular endothelial cells, as well as transcellular transport (transcytosis) through them. The assessment of retinal transcellular barrier permeability may provide fundamental insights into iBRB integrity in health and disease. In this study, we describe an endothelial cell (EC) transcytosis assay, as an in vitro model for evaluating iBRB permeability, using human retinal microvascular endothelial cells (HRMECs). This assay assesses the ability of HRMECs to transport transferrin and horseradish peroxidase (HRP) in receptor- and caveolae-mediated transcellular transport processes, respectively. Fully confluent HRMECs cultured on porous membrane were incubated with fluorescent-tagged transferrin (clathrin-dependent transcytosis) or HRP (caveolae-mediated transcytosis) to measure the levels of transferrin or HRP transferred to the bottom chamber, indicative of transcytosis levels across the EC monolayer. Wnt signaling, a known pathway regulating iBRB, was modulated to demonstrate the caveolae-mediated HRP-based transcytosis assay method. The EC transcytosis assay described here may provide a useful tool for investigating the molecular regulators of EC permeability and iBRB integrity in vascular pathologies and for screening drug delivery systems.

Endothelial Cell Transcytosis Assay as an In Vitro Model to Evaluate Inner Blood-Retinal Barrier Permeability

This protocol illustrates an in vitro endothelial cell transcytosis assay as a model to evaluate inner blood-retinal barrier permeability by measuring the ability of human retinal microvascular endothelial cells to transport horseradish peroxidase across cells in caveolae-mediated transcellular transport processes.

内血網膜バリア透過性を評価する ためのin vitro モデルとしての内皮細胞トランスサイトーシスアッセイ

Dysfunction of the blood-retinal barrier (BRB) contributes to the pathophysiology of several vascular eye diseases, often resulting in retinal edema and ...

Semi-Automated Planimetric Quantification of Dental Plaque Using an Intraoral Fluorescence Camera

Dental plaque accumulation is quantified using clinical indices or, otherwise, the planimetric plaque index (PPI),&#160;which measures the relative area of a tooth that is covered by plaque deposits. Compared to clinical indices, the PPI has a higher discriminatory power, but traditional planimetry is a time-consuming analysis, as the plaque-covered and clean tooth areas have to be determined manually for each image using image-processing software. Here, we present a method for the semi-automated planimetric quantification of dental plaque, which allows for the rapid processing of up to 1,000 images simultaneously. The method exploits the enhanced contrast between disclosed plaque, sound tooth surfaces, and soft tissues in fluorescence images acquired with an intraoral camera. Careful execution of the clinical procedures and accurate image acquisition are crucial steps for the successful semi-automated identification of the plaque-covered areas. The method is suitable for planimetry on sound facial and oral tooth surfaces, on most composite resin restorations, and on teeth with orthodontic brackets, but not on metallic restorations. Compared to traditional PPI recordings, semi-automated planimetry considerably reduces the amount of time spent on the analysis, as well as the subjective human input, thus increasing the reproducibility of planimetric measurements.

This study presents a semi-automated digital image analysis procedure for the planimetric quantification of disclosed dental plaque based on images acquired with an intraoral fluorescence camera. The method allows for the rapid and reliable quantification of dental plaque in the research environment.

口腔内蛍光カメラを用いた歯垢の半自動平面定量

Dental plaque accumulation is quantified using clinical indices or, otherwise, the planimetric plaque index (PPI),&#160;which measures the relative area ...

白内障手術におけるIOL回転による後部被膜混濁の予防

Rotating the Intraocular Lens to Prevent Posterior Capsular Opacification in Cataract Surgeries

Posterior capsule opacification (PCO) is a common postoperative complication of extracapsular cataract surgery, which is caused by the proliferation and migration of lens epithelial cells and can affect long-term visual outcomes significantly. The most effective treatment for PCO is neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy; however, this treatment is associated with posterior segment complication and can break the stability of capsular bag, affecting the position and function of trifocal or toric intraocular lenses (IOLs). Advances in surgical procedures, IOL design, and pharmacy have reduced the rate of PCO in recent years, concentrating on the inhibition of proliferative lens epithelial cells (LECs). This protocol aimed to clear LECs more thoroughly during phacoemulsification and IOL implantation. The first several steps, including clear corneal incision, continuous circular capsulorhexis, hydrodissection, hydrodelineation, and phacoemulsification, were completed as conventional procedures. After placing the IOL into the capsular bag, rotation of the IOL by at least 360&#176; was performed using an irrigation/aspiration tip or a hook, with slight stress on the posterior capsule. Some residuals occurred in the originally transparent capsular bag after rotation of the IOLs. Then, these materials and the viscoelastic were cleared completely using an irrigation/aspiration system. A clear posterior capsule was observed after the surgery in patients undergoing this method. This method of rotating IOLs is a simple, effective, and safe way to prevent PCO by clearing residual LECs and can be carried out without extra tools or skills.

著者スポットライト:白内障手術における視覚転帰の向上:IOL回転による後部嚢混濁を防ぐための新しい技術 

The present protocol describes removing residual epithelial cells by rotating the intraocular lens in extracapsular cataract surgery without extra tools for preventing posterior capsular opacification.

白内障手術における後莢膜不透明化を防ぐための眼内レンズの回転

Posterior capsule opacification (PCO) is a common postoperative complication of extracapsular cataract surgery, which is caused by the proliferation and ...

臨床規模のCAR-T細胞製造のための自動処理装置

Chimeric Antigen Receptor T Cell Manufacturing on an Automated Cell Processor

Chimeric antigen receptor (CAR)-T cells represent a promising immunotherapeutic approach for the treatment of various malignant and non-malignant diseases. CAR-T cells are genetically modified T cells that express a chimeric protein that recognizes and binds to a cell surface target, resulting in the killing of the target cell. Traditional CAR-T cell manufacturing methods are labor-intensive, expensive, and may carry the risk of contamination. The CliniMACS Prodigy, an automated cell processor, allows for manufacturing cell therapy products at a clinical scale in a closed system, minimizing the risk of contamination. Processing occurs semi-automatically under the control of a computer and thus&#160;minimizes human involvement in the process, which saves time and reduces variability and errors.
This manuscript and video describes the T cell transduction (TCT) process for manufacturing CAR-T cells using this processor. The TCT process involves CD4+/CD8+ T cell enrichment, activation, transduction with a viral vector, expansion, and harvest. Using the Activity Matrix, a functionality that allows ordering and timing of these steps, the TCT process can be customized extensively. We provide a walk-through of CAR-T cell manufacturing in compliance with current Good Manufacturing Practice&#160;(cGMP) and discuss required release testing and preclinical experiments that will support an Investigational New Drug (IND) application. We demonstrate&#160;the feasibility and discuss the advantages and disadvantages of using a&#160;semi-automatic process for clinical CAR-T cell manufacturing. Finally, we describe an ongoing investigator-initiated clinical trial that targets pediatric B-cell malignancies [NCT05480449] as an example of how this manufacturing process can be applied in a clinical setting.

著者スポットライト:CAR-T細胞製造と遺伝子治療生産の進歩 

This article details the manufacturing process for chimeric antigen receptor T cells for clinical use, specifically using an automated cell processor capable of performing viral transduction and cultivation of T cells. We provide recommendations and describe pitfalls that should be considered during the process development and implementation of an early-phase clinical trial.