PMMA Ring Research Articles

A virtual phantom for patient-specific QA On A 1.5T MR-linac.

Create a virtual ArcCHECK-MR phantom, customized for a 1.5TMR-linac, with consideration of the different density regions within the quality assurance (QA) phantom, aiming to streamline the utilization of this specialized QA device. A virtual phantom was constructed in the treatment planning system (TPS) to replicate the ArcCHECK-MR's composition, consisting of five distinct layers: "Outer" (representing the outer PMMA ring), "Complex" (simulating the printed circuit boards), "Detectors" (encompassing the detector area), "Inner" (signifying the inner PMMA ring) and "Insert" (representing the PMMA insert). These layers were defined based on geometric data and represented as contour points on a set of dummy CT images. Additionally, a setup platform was integrated as contoured structures. To determine the relative electron density (RED) values of the external and internal PMMA components, measurements were taken at 25 points in the insert using an ion chamber. A novel method for establishing the exit/entrance dose ratio (EEDR) for ArcCHECK-MR was introduced. The RED of higher density region was derived by evaluating the local gamma index passing rate results with criteria of 2% dose difference and 2mm distance-to-agreement. The performance of the virtual phantom was assessed for Unity 7 FFF beams with a 1.5T magnetic field. The radii of the five ring structures within the virtual phantom measured 133.0mm, 110.0mm, 103.4mm, 100.0mm, and 75.0mm for the "Outer," "Complex," "Detectors," "Inner" and "Insert" regions, respectively. The RED values were as follows: ArcCHECK-MR PMMA had a RED of 1.130, "Detectors" were assumed to have a RED of 1.000, "Complex" had a RED of 1.200, and the setup QA phantom justified a RED of 1.350. Early validation results demonstrate that the 5-layer virtual phantom, when compared to the commonly used bulk overridden phantom, offers improved capability in MR-linac environments. This enhancement led to an increase in passing rates for the local gamma index by approximately 5 ∼ 6%, when applying the criteria of 2%, 2mm. We have successfully generated a virtual representation of the distinct regions within the ArcCHECK-MR using a TPS, addressing the challenges associated with its use in conjunction with a 1.5T MR-linac. We consistently observed favorable local gamma index passing rates across two 1.5T MR-linac and ArcCHECK-MR unit combinations. This approach has the potential to minimize uncertainties in the creation of the QA phantom for ArcCHECK-MR across various institutions.

Biologic stromal ring to manage stromal melting after intrastromal corneal ring segment implantation

We report a new technique to replace a manufactured poly(methyl methacrylate) (PMMA) ring with a biologic stromal ring fashioned from human corneal donor tissue in eyes with stromal melting above the PMMA ring. The biologic stromal ring is prepared using manual or femtosecond laser trephination of a donor cornea to obtain a 360-degree ring that is denuded and adjusted to match the PMMA ring being replaced. The biologic ring is attached to the PMMA ring. The PMMA ring is pushed and retrieved from the other side, which installs the biologic ring in place. Six biologic stromal rings were implanted successfully in 5 eyes of 5 patients with previous stromal melting; no complications were reported up to 6 months postoperatively. The biologic stromal ring stopped and healed the melting, prevented further ring complications, and preserved the therapeutic refractive effect of the previously implanted PMMA ring.

Fast and easy fabrication methodology of Fresnel zone plates for the extreme ultraviolet and soft x-ray regions.

Zone plate design and efficient methods for the fabrication of zone plates for extreme ultraviolet (EUV) and soft x-ray applications in a newly developed scanning reflection microscope are presented. Based on e-beam lithography, three types of transmission zone plates with focal lengths between 6 and 15mm are reported: (i)phase-shifting zone plates made by 190nm thick PMMA rings on Si3N4 membranes, (ii)absorbing zone plates made by 75nm thick Au ring structures on Si3N4, and (iii)freestanding Au rings of 50nm thickness and increased transmission in the EUV range. Experiments at the DELTA synchrotron facility reveal a minimum spot size and resulting spatial resolution of 9±3 μm, which is the theoretical limit resulting from the synchrotron beam parameters at 60eV photon energy. Images of a Ti/Si chessboard test pattern are recorded exploiting the energy dependence of the element-specific reflectance.

Experimental Technique for Dynamic Fragmentation of Liquid-Driving Expanding Ring

Expanding ring experiment is an important method for dynamic fragmentation of solid under 1D tensile loading. Based on the split Hokinson pressure bar (SHPB), a liquid-driving experimental technology was developed for conducting expanding ring tests. The loading fixture includes a hydraulic cylinder filled with water, which is pushed by a piston connected to the input bar. As the water is driven, it expands the metallic ring specimen in the radial direction. The approximately incompressible property of the water makes it possible to drive the specimen in very high radial velocity by low velocity movement of piston, according to the large sectional area ratio of the cylinder to specimen. Using liquid-driving expanding ring device, 1060 aluminum rings (ductile materials)/PMMA rings (brittle materials) were fragmented and the fragments were recovered. Impact deformation of free-flying fragments was avoided through the use of “sample soft-capture” technology. The fragmentation process was observable by high speed camera through modifying the driving direction of the water. From the observations of the fracture morphology and the residual internal cracks of the recovered fragments, it is concluded that the fracture of the rings is caused by the circumferential tensile stress.

Methacrylate 기질 복합레진과 Silorane 기질 복합레진의 치아 수복 시 중합수축응력거동

치아의 수복에 사용되는 재료인 Methacrylate 기질 복합레진(Clearfil AP-X)과 Silorane 기질 복합레진(Filtek P90)을 대상으로 스트레인게이지법과 FEM 분석법으로 중합수축응력거동을 분석하였다. 또한 복합레진의 탄성계수와 수축변형률을 중합수축응력과 관계시켜 이론식을 제시하고 이 식의 계산결과와 FEM 분석법의 결과를 비교하였다. 스트레인 게이지법으로 측정한 결과, 중합수축응력의 최대값은 Clearfil AP-X가 Filtek P90 보다 약 2.8배 높게 나타났다. FEM 분석 결과, Von-Mises 응력은 복합레진 수복재와 PMMA 링사이의 계면부에서 최대로 되었으며 시편표면의 계면부가 내부보다 응력집중이 더 컸음을 알았다. 예측식을 통한 반경 방향의 수축응력은 평면응력상태의 FEM 분석법을 통한 값과 비교하여 오차 5% 이내로 정확했음을 확인하였다. Polymerization shrinkage stress analysis of dimethacrylate-based composite (Clearfil AP-X, Kuraray) and silorane-based composite (Filtek P90, 3M ESPE) used for dental composite restorations was performed using strain-gage measurement and FEM analysis. A theoretical equation based on Young's modulus and polymerization shrinkage of the composite resin was proposed to predict the polymerization shrinkage stress. Experimental results showed that the maximum shrinkage stress of Clearfil AP-X was about 2.8 times higher than Filtek P90. FEM analysis agreed with such experimental stress behaviours and showed that the maximum Von-Mises stress appeared near the margin of the filled resin adhered with PMMA ring. The stress concentration at the interface on the specimen surface was higher than that in the interior. The maximum error of shrinkage stress by the theoretical equation was reasonable within 5% in comparison to FEM results under plane stress.

The Effect of In-Vivo Collagen Cross-Linking Procedure on the Material of Intracorneal Ring Segments

The material of Intracorneal Rings Segments (ICRS) has seemed to be polymerized after the absorption of Riboflavin and UV illumination in laboratory settings. This study aimed to assess the potential impact of in-vivo corneal crosslinking (CXL) on the chemical composition of ICRS. Within this contex, three ICRS samples (S1, S2 and S3) were extracted from patients' cornea, which formerly had undergone CXL treatment. Alterations on the chemical structure of PMMA rings were studied using Ultraviolet-Visible (UV-Vis) spectroscopy and Fourier Transform-Infrared (FT-IR) spectroscopy. An extracted ICRS from a patient who didn’t underwent CXL treatment, was also used as reference (S0). UV-Vis spectroscopy didn't identify any change in the specimens S1, S2 and S3. Nevertheless, FT-IR spectroscopic analysis showed alterations in the spectra of ICRS material of samples S1, S2 and S3, mainly at the 2800 to 3200 cm-1 spectral region [modification in band intensities of CH2 (2850 cm-1 and 2925 cm-1) and CH3 (2950cm-1)]. In conclusion, our results suggest crosslinking reaction in ICRS material after in-vivo CXL treatment. This should be taken into consideration prior to any CXL treatment of post ICRS implanted cornea.

Outcome of Capsular Tension Ring (CTR) Implant in Complicated Cataracts.

Surgery in the presence of zonular weakness or subluxated lens was a great surgical challenge and included intracapsular cataract extraction with anterior chamber IOL implantation or pars plana lensectomy and vitrectomy with a sutured (IOL). Modern surgical approache involves placement of endocapsular flexible PMMA ring that prevents iatrogenic loss of zonular support, minimizing vitreous loss and enables placement of in the bag IOL. To evaluate frequency and indications of capsular tension ring (CTR) implant and analyse the visual and anatomical outcome in various complicated cataract surgeries. Retrospective screening of database of 6000 consecutive cataract surgeries was done. BCVA, complete ocular examination with SLEx, intraocular pressure, direct ophthalmoscope, fundus examination with +78/+90D were noted. CTR was implanted in cases where Zonular dialysis of > 3 clock hours was present or capsular bag instability was detected during capsulorhexis or subsequent intraoperative maneuvers. In cases with capsulorrhexis extension, CTR was not implanted. Records were analysed for indication of CTR implant and clinical outcome on Day 1, 1 month and 6 month follow up. In this series CTR implant was done in 45 cases. The indications were hypermature senile cataract in 9 cases, hypermature senile cataract with lens induced glaucoma in 9 cases, pseudoexfoliation syndrome in 9 cases, post blunt injury traumatic cataract in 6 cases, iridochoroidal coloboma in 6 cases, hypermature cataract with pseudoexfoliation and marfan syndrome in 3 cases respectively. Decision of CTR implant was intraoperative in 42 patients. At 6 month follow up, 39 patients had best corrected visual acuity ≥6/12. IOL decentration was detected in only 3 cases, but without any subjective visual complaints. As per the results CTR was used very infrequently (0.75%) but remains useful in cataract surgeries with difficult pre and intraoperative conditions. It gives good postoperative result and creates satisfied patients.

Experiments and numerical simulations of plate gap model for high energetic materials

Experimental and numerical study for detonation propagation was conducted using the system in which the high energy materials and air gaps alternately stacked. The aim of this simulation is an extraction of information of the EOS for detonation product at arbitrary initial density from the numerical simulation with EOS at TMD (theoretical maximum density). In this report, we described the numerical procedure and an example of the calculation result. On the other hand, the experiment was designed for confirmation of the validity of our reactive flow simulation. The experimental system for this study consists of the pellet explosives and PMMA rings, PMMA pipe and booster explosive part. The pellets and the rings were alternately stacked in the PMMA pipe to make the system. The diameter of the pellet was 20 mm and the thicknesses were 10 or 5 mm. The thickness of the ring was varied to adjust the size of the air gaps between the pellets. The sample explosive was a composition A5 (RDX 98.8 wt%). The relationship between the bulk density which was estimated by the thicknesses of the pellets and the air gaps and the average detonation velocity was compared with the data for RDX. The slopes of those relationships differed mutually. Although the experimental results can be used for confirmation of the validity of the numerical procedure, it does not simulate the detonation wave in the powdered explosive. It may show the interesting process that consists of the shock wave in air, shock to detonation transition and steady detonation.

치아/복합레진 수복부의 중합 수축시 검출된 음향방출의 통계적 검증

치아의 와동에 수복된 치과용 복합레진을 광(LED) 조사를 통해 정화 수축시키면서 음향방출(acoustic emission, AE) 신호를 검출하였다. 비모수 통계법인 Mann-Whitney법과 Kruskal-Wallis법을 이용하여 시편의 재질과 계면의 접착조건에 따른 AE hit event 수와 최대진폭을 비교 평가하였다. PMMA와 치아시편으로부터 검출된 선호의 최대진폭은 정착조건에 따른 차이가 없었지만 스테인리스 시편으로부터 검출된 신호는 접착조건에 따라 최대 진폭의 차이가 있었다(p<0.05). AE hit event 수는 양호한 접착조건에서 시편의 재질에 따라 차이가 있었고(p<0.05), 세가지 재질의 시편 모두 접착조건이 양호한 실험에서 AE 신호가 적게 검출되었다. SEM을 이용하여 계면에 생성된 캡을 측정한 결과 AE가 많이 검출되고 검출된 신호의 최대 진폭이 큰 시편에서 갱의 폭이 넓고 형성 비율이 높았다. Acoustic emission (AE) signals are detected during the polymerization shrinkage of composite resin restoration in artificial dental ring according to various interfacial treatment conditions. AE amplitudes and the number of AE hit events were compared through the non-parametric statistics of Mann-Whitney method and Kruskal-Wallis method. The AE amplitudes detected from the PMMA and human tooth ring specimens were not significantly different according to adhesive conditions. The stainless steel ring specimen, meanwhile, had a difference in AE amplitude (p<0.05). The quantity of hit events for the human molar dentin specimens of the good bonding state was much less than that for the steel ring specimen but more than that for the PMMA ring specimen. For the same substrate, the better the bonding state, the less the AE hit events (p<0.05). The degree of marginal disintegration measured by SEM was proportional to the amount of AE hit events detected.

Clinical and pathological effects of different acrylic intracorneal ring segments in corneal additive surgery

The objective of this work was to evaluate the potential use of less stiff materials based on acrylic copolymers of methyl methacrylate/2-ethylhexyl acrylate (MMA/EHA) as devices to correct, stabilize and improve the effect of poly(methyl methacrylate) (PMMA) intracorneal ring segments. MMA/EHA and PMMA intracorneal ring segments were surgically implanted in the corneas of Lohmann Classic hens. The effects of the intracorneal ring segments were assessed by optical measurements and corneal tolerance was evaluated through biomicroscopic examination over a 90-day observation period and by conventional histology. The experimental results demonstrated that the intracorneal ring segments made of MMA/EHA copolymers provided a significant change in the corneal curvature and an improved in vivo response compared to those obtained for PMMA rings, which was attributed to the higher flexibility of the copolymeric materials, indicating that these systems might be considered suitable as an alternative to those currently used, for application in clinical practice.

Noncontact Optical Measurement of Lens Capsule Thickness in Human, Monkey, and Rabbit Postmortem Eyes

To measure interspecies thickness differences in the central anterior and posterior capsules of postmortem crystalline lenses, by a technique that maintains the anatomic integrity of the lens. Central capsule thickness was measured with a custom-built, noncontact optical system, using a focus detection technique. Anterior and posterior lens capsule thickness measurements were performed on 22 human, 29 monkey, and 34 New Zealand White rabbit intact postmortem lenses in situ. Eyes were prepared for optical measurements by bonding a PMMA ring to the sclera in the region of the ciliary body after the conjunctiva, adipose, and muscle tissues were removed. The posterior pole was removed by making a circumferential incision through the sclera approximately 7 mm posterior to the limbus. Excess vitreous was removed to expose the posterior capsule surface, and the eye assembly was placed on a Teflon slide. The cornea and iris were sectioned to expose the anterior capsule surface. After the experiments, the lenses were excised, placed in 10% buffered formalin, and prepared for histology. Lens capsule thickness was measured from the histologic slides and compared to the optical results. Central anterior lens capsule thickness was 8.2 +/- 5.5 (human), 7.5 +/- 4.4 (monkey), and 10.7 +/- 4.2 (rabbit) microm optically and 12.4 +/- 2.5 (human), 10.7 +/- 3.7 (monkey), and 10.4 +/- 2.0 (rabbit) microm histologically. Central posterior capsule thickness was 6.3 +/- 2.2 (human), 5.9 +/- 1.7 (monkey), and 7.8 +/- 2.3 (rabbit) microm optically and 4.1 +/- 1.5 (human), 3.5 +/- 1.6 (monkey), and 4.7 +/- 2.5 (rabbit) microm histologically. The central anterior and posterior lens capsule thicknesses do not appear to vary considerably among human, rabbit, and monkey eyes. There were significant differences between optical in situ measurements and histology, which indicates that histologic preparation may affect lens capsule thickness.

In vitro study on the closure of posterior capsulorrhexis in the human eye.

An unexplained clinical observation is the development of posterior capsular opacification (PCO), even when the central part of the posterior capsule has been removed. The purpose of this study was to investigate in vitro the mechanisms involved in the closure of the posterior capsulorrhexis in a capsular bag model. A sham extracapsular cataract extraction was performed in 71 human donor eyes, followed by a central posterior capsulorrhexis 3 to 4 mm in diameter. Each capsular bag was pinned to a PMMA ring with a central hole of 5 mm and placed in a Petri dish. The capsular bags were cultured and monitored for 3 to 7 weeks by phase-contrast microscopy, after which they were prepared for light, transmission, and scanning electron microscopy. Proliferation of lens epithelial cells (LECs) within the posterior rhexis area was found in 22 cases (31%) of which 3 had a complete closure. In the absence of the posterior capsule, a monolayer of LECs was observed growing on a basal lamina, consisting of loosely arranged fibers. Further observations on noncultured capsular bags revealed that this basal lamina corresponds to the anterior hyaloid membrane. This study corroborates the clinical observation that LECs that remain after cataract extraction have the potential to proliferate, in the absence of their natural substrate, on a basal lamina of vitreous origin and are able to close the posterior capsulorrhexis partially or totally in approximately one third of cases.

Low-dose-rate ionizing irradiation for inhibition of secondary cataract formation

Introduction: Secondary cataract formation limits visual function after cataract surgery. Various experimental methods utilizing the pharmacologic inhibition of lens epithelial cell proliferation have been proposed. However, diffusion into the anterior chamber may lead to damage of corneal endothelial cells. This study evaluated the inhibition of lens epithelial cell proliferation with a capsular bag ring, labeled with a β-emitting radioisotope. Methods and Materials: In vitro studies using rabbit lens epithelial cells were performed to investigate the dose-dependent effect of irradiation. Based on these results, P-32–labeled PMMA rings were implanted into the capsular bag of NZW rabbits in vivo after phacoemulsification. Animals were examined for development of posterior capsule opacification over a period of 12 weeks following surgery. Radiation damage to the surrounding ocular tissue was subsequently analyzed in histologic sections using TUNEL assay and proliferation marker. Results: Irradiation of lens epithelial cells in vitro with >5 Gy resulted in a dose-dependent decrease in the number of cells. BrdU testing demonstrated a near complete inhibition of cell proliferation. In vivo, implantation of P-32–labeled PMMA rings led to inhibition of epithelial cell proliferation and secondary cataract formation but was not able to fully inhibit aberrant differentiation of some remaining cells. Histologic examination showed no evidence of radiation damage of the ciliary body or the corneal endothelium. Conclusions: Low-dose beta irradiation exhibits the potential for inhibition of lens epithelial cell proliferation both in vitro and in vivo. Further investigation of various nuclides and their radiation profiles is needed to optimize the prevention of posterior capsule opacification due to epithelial cell proliferation.

Lens epithelial cell proliferation onto the intraocular lens optic in vitro

Purpose: To determine how lens epithelial cells (LECs) proliferate onto an intraocular lens (IOL) after extracapsular cataract surgery.Setting: Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.Methods: We cultured the capsular bags retaining LECs of eight human eye-bank eyes and six rabbit eyes that had had extracapsular lens extraction with in-the-bag implantation of a poly(methyl methacrylate) (PMMA) IOL and a PMMA ring. Cell proliferation onto the IOL optic was monitored by a time-lapse video system.Results: Cells proliferated onto the IOL optic via the anterior capsulotomy margin, the inner surface of the anterior capsule, and the posterior capsule. They formed cell sheets similar to the membranes observed in clinical cases.Conclusions: Since the cells proliferated from the anterior capsule as well as from the posterior capsule onto the IOL optic, the membranes observed clinically on the IOL optic may be LEC sheets.

Trial of a disc lens for intercapsular cataract extraction

The preliminary results are presented of a prospective trial of a new 'disc' intraocular lens. (Pharmacia Model CD801A). Forty-four lenses were implanted into the capsular bag using an intercapsular cataract extraction technique. The lens is a one-piece all-polymethylmethacrylate (PMMA) lens with a 6 mm biconvex optic. The optic sits within a 9 mm diameter flexible PMMA ring. Two haptic stalks link this flexible haptic ring to the optic. The lens was assessed for its ease of insertion, its rate of decentration, the incidence of posterior capsular opacity and its effects on pupillary function. Results of the trial at three months follow-up are presented. They show that the lens is easy to insert into the capsular bag even through small pupils. It is very easy to dial, placing no stress on the bag when doing so. The incidence of decentration of 1 mm or greater was 5%, and the incidence of posterior capsular fibrosis at three months was 2%. As predicted, the lens sits well back in the eye, clear of the pupil.