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Sample records for anterior segment syndrome

  1. Toxic Anterior Segment Syndrome (TASS

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    Özlem Öner

    2011-12-01

    Full Text Available Toxic anterior segment syndrome (TASS is a sterile intraocular inflammation caused by noninfectious substances, resulting in extensive toxic damage to the intraocular tissues. Possible etiologic factors of TASS include surgical trauma, bacterial endotoxin, intraocular solutions with inappropriate pH and osmolality, preservatives, denatured ophthalmic viscosurgical devices (OVD, inadequate sterilization, cleaning and rinsing of surgical devices, intraocular lenses, polishing and sterilizing compounds which are related to intraocular lenses. The characteristic signs and symptoms such as blurred vision, corneal edema, hypopyon and nonreactive pupil usually occur 24 hours after the cataract surgery. The differential diagnosis of TASS from infectious endophthalmitis is important. The main treatment for TASS formation is prevention. TASS is a cataract surgery complication that is more commonly seen nowadays. In this article, the possible underlying causes as well as treatment and prevention methods of TASS are summarized. (Turk J Oph thal mol 2011; 41: 407-13

  2. Mild toxic anterior segment syndrome mimicking delayed onset toxic anterior segment syndrome after cataract surgery

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    Su-Na Lee

    2014-01-01

    Full Text Available Toxic anterior segment syndrome (TASS is an acute sterile postoperative anterior segment inflammation that may occur after anterior segment surgery. I report herein a case that developed mild TASS in one eye after bilateral uneventful cataract surgery, which was masked during early postoperative period under steroid eye drop and mimicking delayed onset TASS after switching to weaker steroid eye drop.

  3. Toxic anterior-segment syndrome (TASS

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    Cetinkaya S

    2014-10-01

    Full Text Available Servet Cetinkaya,1 Zeynep Dadaci,2 Hüsamettin Aksoy,3 Nursen Oncel Acir,2 Halil Ibrahim Yener,4 Ekrem Kadioglu5 1Ophthalmology Clinics, Turkish Red Crescent Hospital, Konya, 2Department of Ophthalmology, Faculty of Medicine, Mevlana University, Konya, 3Ophthalmology Clinics, Karaman State Hospital, Karaman, 4Konya Eye Center Hospital, Konya, 5Ophthalmology Clinics, Beyhekim State Hospital, Konya, Turkey Purpose: To evaluate the clinical findings and courses of five patients who developed toxic anterior-segment syndrome (TASS after cataract surgery and investigate the cause.Materials and methods: In May 2010, on the same day, ten patients were operated on by the same surgeon. Five of these patients developed TASS postoperatively.Results: Patients had blurred-vision complaints on the first day after the operation, but no pain. They had different degrees of diffuse corneal edema, anterior-chamber reaction, fibrin, hypopyon, iris atrophies, and dilated pupils. Their vision decreased significantly, and their intraocular pressures increased. Both anti-inflammatory and antiglaucomatous therapies were commenced. Corneal edema and inflammation resolved in three cases; however, penetrating keratoplasty was needed for two cases and additional trabeculectomy was needed for one case. Although full investigations were undertaken at all steps, we could not find the causative agent.Conclusion: TASS is a preventable complication of anterior-segment surgery. Recognition of TASS, differentiating it from endophthalmitis, and starting treatment immediately is important. Controlling all steps in surgery, cleaning and sterilization of the instruments, and training nurses and other operation teams will help us in the prevention of TASS. Keywords: cataract, phacoemulsification, TASS, corneal edema, inflammation

  4. Evaluation of Anterior Segment's Structures in Tilted Disc Syndrome

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    Ozsoy, Ercan; Demirel, Ersin Ersan; Cumurcu, Tongabay

    2016-01-01

    Purpose. To evaluate anterior segment's structures by Pentacam in patients with tilted disc syndrome (TDS). Methods. Group 1 included forty-six eyes of forty-six patients who have the TDS. Group 2 including forty-six eyes of forty-six cases was the control group which was equal to the study group in age, gender, and refraction. A complete ophthalmic examination was performed in both groups. All cases were evaluated by Pentacam. The axial length (AL) of eyes was measured by ultrasound. Quantitative data obtained from these measurements were compared between two groups. Results. There was no statistically significant difference for age, gender, axial length, and spherical equivalent measurements between two groups (p = 0.625, p = 0.830, p = 0.234, and p = 0.850). There was a statistically significant difference for central corneal thickness (CCT), corneal volume (CV), anterior chamber angle (ACA), and pupil size measurements between two groups (p = 0.001, p = 0.0001, p = 0.003, and p = 0.001). Also, there was no statistically significant difference for anterior chamber depth (ACD), anterior chamber volume (ACV), and lens thickness (LT) measurements between two groups (p = 0.130, p = 0.910, and p = 0.057). Conclusion. We determined that CCT was thinner, CV was less, and ACA was narrower in patients with TDS. There are some changes in the anterior segment of the eyes with tilted disc. PMID:27648303

  5. Síndrome tóxica do segmento anterior Toxic anterior segment syndrome

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    Luiz Filipe de Albuquerque Alves

    2013-02-01

    Full Text Available A síndrome tóxica do segmento anterior (STSA é uma severa reação inflamatória aguda causada por agente não infeccioso que entra no segmento anterior, resultando em lesão celular tóxica com necrose e apoptose mediado por resposta imunológica. Neste relato de caso de STSA são enfatizadas as causas mais comuns para o aparecimento da síndrome, apontam para os cuidados que devem ser tomados no processo de esterilização do material cirúrgico além de revisar a melhor conduta diante desses casos. Em conclusão notou-se que o foco principal deve ser a prevenção, pois o tratamento busca apenas suprimir a resposta inflamatória secundária. O tratamento nos casos de STSA consiste em intensa instilação de esteróides tópicos com seguimento rigoroso e controle de complicações tardias como o glaucoma.Toxic anterior segment syndrome is acute inflammatory reaction caused by a noninfectious substance that enters the anterior segment, resulting in extracellular damage with necrosis and apoptosis during an immune response. We have the report of a case of toxic anterior segment syndrome (TASS, in which the authors seek to emphasize the most common causes of the appearance of these syndrome. They point out the care that must be taken in the process of sterilization of surgical material, in addition to reviewing the best conduct when faced with these cases. In conclusion, it was noted that the main focus should be on prevention, as treatment only seeks to suppress the secondary inflammatory response. Treatment in cases of toxic anterior segment syndrome (TASS consists of intense instillation of topical steroids with strict follow-up and control of late complications such as glaucoma.

  6. Anterior Segment Findings in Women with Polycystic Ovary Syndrome

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    Karaca Adıyeke, Seda; Karaca, Ibrahim; Yıldırım, Suna; Adıyeke, Mehmet; Uyar, İbrahim; Türe, Gamze

    2017-01-01

    Objectives: This study aimed to investigate the anterior segment in women with polycystic ovary syndrome (PCOS) and to compare them with those of healthy reproductive-age female volunteers. Materials and Methods: The study included 50 right eyes of 50 women with PCOS (group 1) and 50 right eyes of 50 healthy women (group 2). Intraocular pressure, Schirmer’s test, tear film break-up time and central corneal thickness were evaluated in all subjects. Correlations between serum hormone (estradiol and testosterone) levels and observed findings were also investigated. Results: Mean central corneal thickness values were significantly higher in the PCOS group (p=0.001). The mean intraocular pressures values were similar between the two groups (p=0.560). Schirmer’s test results and tear film break-up time values were significantly lower in the PCOS group (p=0.001 and p=0.001 respectively). Serum estradiol levels were moderately positively correlated with mean central corneal thickness (r=0.552), weakly positively correlated with intraocular pressure (r=0.351) and weakly negatively correlated with tear film break-up time (r=-0.393). Serum free testosterone levels were weakly correlated with intraocular pressure (r=0.342) and central corneal thickness (r=0.303), and showed weak negative correlations with Schirmer’s test results (r=-0.562) and tear film break-up time (r=-0.502). Conclusion: PCOS leads to physiological and structural changes in the eye. Dry eye symptoms were more severe and central corneal thickness measurements were greater in patients with PCOS. Those are correlated serum testosterone and estradiol levels. PMID:28182154

  7. Anterior Segment Findings in Women with Polycystic Ovary Syndrome

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    Seda Karaca Adıyeke

    2017-01-01

    Full Text Available Objectives: This study aimed to investigate the anterior segment in women with polycystic ovary syndrome (PCOS and to compare them with those of healthy reproductive-age female volunteers. Materials and Methods: The study included 50 right eyes of 50 women with PCOS (group 1 and 50 right eyes of 50 healthy women (group 2. Intraocular pressure, Schirmer’s test, tear film break-up time and central corneal thickness were evaluated in all subjects. Correlations between serum hormone (estradiol and testosterone levels and observed findings were also investigated. Results: Mean central corneal thickness values were significantly higher in the PCOS group (p=0.001. The mean intraocular pressures values were similar between the two groups (p=0.560. Schirmer’s test results and tear film break-up time values were significantly lower in the PCOS group (p=0.001 and p=0.001 respectively. Serum estradiol levels were moderately positively correlated with mean central corneal thickness (r=0.552, weakly positively correlated with intraocular pressure (r=0.351 and weakly negatively correlated with tear film break-up time (r=-0.393. Serum free testosterone levels were weakly correlated with intraocular pressure (r=0.342 and central corneal thickness (r=0.303, and showed weak negative correlations with Schirmer’s test results (r=-0.562 and tear film break-up time (r=-0.502. Conclusion: PCOS leads to physiological and structural changes in the eye. Dry eye symptoms were more severe and central corneal thickness measurements were greater in patients with PCOS. Those are correlated serum testosterone and estradiol levels.

  8. Toxic Anterior Segment Syndrome following Phacoemulsification Secondary to Overdose of Intracameral Gentamicin

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    Yaran Koban

    2014-01-01

    Full Text Available Objective. To report a case of toxic anterior segment syndrome (TASS that was caused by inadvertent anterior chamber and cornea stromal injection with high dose gentamicin following cataract surgery. Methods. Case report. Results. We report a 72-year-old female patient who developed TASS that was caused by high dose gentamicin (20 mg/0.5 mL, which was inadvertently used during the formation of the anterior chamber and hydration of the corneal incision. Unlike previous cases, hyphema and hemorrhagic fibrinous reaction were seen in the anterior chamber. Despite treatment, bullous keratopathy developed and penetrating keratoplasty was performed. The excised corneal button was sent for histopathological examination. Conclusions. Subconjunctival gentamicin is highly toxic to the corneal endothelium and anterior chamber structures. Including it on the surgical table carries a potentially serious risk for contamination of the anterior chamber.

  9. Toxic Anterior Segment Syndrome following Phacoemulsification Secondary to Overdose of Intracameral Gentamicin

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    Koban, Yaran; Genc, Selim; Cagatay, Halil Huseyin; Ekinci, Metin; Gecer, Melin; Yazar, Zeliha

    2014-01-01

    Objective. To report a case of toxic anterior segment syndrome (TASS) that was caused by inadvertent anterior chamber and cornea stromal injection with high dose gentamicin following cataract surgery. Methods. Case report. Results. We report a 72-year-old female patient who developed TASS that was caused by high dose gentamicin (20 mg/0.5 mL), which was inadvertently used during the formation of the anterior chamber and hydration of the corneal incision. Unlike previous cases, hyphema and hemorrhagic fibrinous reaction were seen in the anterior chamber. Despite treatment, bullous keratopathy developed and penetrating keratoplasty was performed. The excised corneal button was sent for histopathological examination. Conclusions. Subconjunctival gentamicin is highly toxic to the corneal endothelium and anterior chamber structures. Including it on the surgical table carries a potentially serious risk for contamination of the anterior chamber. PMID:25574173

  10. TOXIC ANTERIOR SEGMENT SYNDROME (TASS WITH SEVERE PIGMENT DISPERSION

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    Stephen Sudhakar

    2014-09-01

    Full Text Available AIM: To clinically analyze the cases of TASS with severe pigment dispersion following uncomplicated cataract surgery in a tertiary care teaching hospital from January 2011 to January 2013. DESIGN: Retrospective case series study. MATERIALS AND METHODS: The records of all eyes developing TASS with severe pigment dispersion following uncomplicated Cataract surgery were retrospectively reviewed. Clinical outcomes including visual acuity, intraocular pressure and complications were recorded at 1st post-operative day, 7th post-operative day and after six weeks of follow up visits. RESULTS: TASS with severe pigment dis pension was recorded in five out of 1060 patients. All cases were females. Phacoemulsification with foldable IOL was done in 2 patients and Small Incision Cataract Surgery (SICS with in bag posterior chamber IOL was done in three patients. All patients had pain which was less severe when compared to the amount of inflammation. Visual acuity ranged from 6/36 to perception of light. All the five patients had rim to rim corneal edema which was seen from the first post-operative day and persisted at six weeks follow up. Pupils were dilated and fixed in all patients. Intraocular pressure was raised in four out of five patients who poorly responded to medical treatment. Dense pigment clumps were seen in the corneal endothelium and on the surgical wound site after one week in three out of five patients and increased at 6 weeks of follow up. Visual acuity did not improve in any of the patient even with treatment. The reduced visual acuity was due to worsening corneal edema and dense pigment clumping in corneal endothelium. CONCLUSION: TASS with severe pigment dispersion has more complication than routine TASS. The complication are due to dense pigment clumping in cornea and angle of anterior chamber causing corneal endothelial de-compensation and raised Intraocular pressure, which persisted even after the inflammation subsided. Although the

  11. Evaluation of anterior segment parameters in patients with pseudoexfoliation syndrome using Scheimpflug imaging

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    Alime Gunes

    2016-06-01

    Full Text Available ABSTRACT Purpose: To evaluate anterior segment parameters in patients with pseudoexfoliation syndrome (PXS using Scheimpflug imaging. Methods: Forty-three PXS patients and 43 healthy control subjects were included in this cross-sectional study. All participants underwent a detailed ophthalmologic examination. Anterior segment parameters were measured using a Scheimpflug system. Results: Considering the PXS and control groups, the mean corneal thicknesses at the apex point (536 ± 31 and 560 ± 31 µm, respectively, p=0.001, at the center of the pupil (534 ± 31 and 558 ± 33 µm, respectively, p=0.001, and at the thinnest point (528 ± 30 and 546 ± 27 µm, respectively, p=0.005 were significantly thinner in PXS patients. Visual acuity was significantly lower (0.52 ± 0.37 versus 0.88 ± 0.23, p<0.001 and axial length was significantly longer (23.9 ± 0.70 mm versus 23.2 ± 0.90 mm, p=0.001 in the PXS eyes than in the control eyes. There were no statistically significant differences in the mean values of keratometry, anterior chamber angle, anterior chamber depth, corneal volume, and anterior chamber volume between the PXS and control eyes. Conclusions: The patients with PXS had thinner corneas, worse visual acuity, and longer axial length compared with those in the healthy controls.

  12. Toxic Anterior Segment Syndrome after Foldable Artiflex Iris-Fixated Phakic Intraocular Lens Implantation

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    Lucien A. M. van Philips

    2011-01-01

    Full Text Available Toxic anterior segment syndrome (TASS developed in four cases after uneventful implantation of a foldable iris-fixated phakic intraocular lens (pIOL. Two cases occurred sequentially in one patient. The TASS subsided without complications in all cases after intensive topical steroid treatment. A multitude of possible causes is considered for the occurrence of these TASS cases. From the sterilization and cleaning of surgical instruments to the possibility of endotoxines in ophthalmic viscosurgical devices (OVD. These rare cases should alert the surgeon to the possibility of TASS after pIOL implantation.

  13. A New Potential Cause in the Development of Toxic Anterior Segment Syndrome: Fibrin Glue

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    Selçuk Sızmaz

    2014-08-01

    Full Text Available Objectives: To present a potential cause for toxic anterior segment syndrome (TASS. Materials and Methods: We report 4 cases of TASS that occurred following uneventful phacoemulsification and intraocular lens implantation. Results: The 4 cases were the first consecutive 2 cases of 2 different surgery days, 5 months apart. The most prominent sign of TASS was limbus-to-limbus corneal edema. Pain and/or intraocular pressure rise were also common. All surgical and presurgical procedures were checked after the first outbreak, whereas the second outbreak required further investigation. Fibrin glue remnants from preceding pterygium surgery with conjunctival autografting were found to be the potential cause. Despite intensive corticosteroid therapy, corneal edema did not resolve in 2 patients who underwent keratoplasty. Conclusion: TASS is a sight-threatening condition which requires thorough investigation for prevention of new cases. All steps must be carefully revised. (Turk J Ophthalmol 2014; 44: 280-3

  14. Recurrent progressive anterior segment fibrosis syndrome following a descemet-stripping endothelial keratoplasty in an infant with congenital aniridia

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    Mihir Kothari

    2014-01-01

    Full Text Available Progressive anterior segment fibrosis syndrome (ASFS, after intraocular surgery in older children (≥9 years and adults with congenital aniridia, is described in the literature. In this report, we describe an unique case of ASFS in an infant with congenital aniridia following a combined trabeculotomy-ectomy and its recurrence after a descemet stripping endothelial keratoplasty. The ophthalmologists should be well aware of this entity and warn the parents about its possibilities. Use of immunomodulators or prolonged anti-inflammatory therapy may be considered to prevent its occurrence.

  15. Anterior segment complications of retinal photocoagulation.

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    Kanski, J J

    1975-03-01

    Seven patients had anterior segment complications following xenon arc retinal photocoagulation. Irreversible keratopathy was induced in two cases; all patients showed evidence of iris injury. The absorption of radiation by the iris was considered the main factor in producing overheating of the anterior segment.

  16. Impact of Indocyanine Green Concentration, Exposure Time, and Degree of Dissolution in Creating Toxic Anterior Segment Syndrome: Evaluation in a Rabbit Model

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    Tamer Tandogan

    2016-01-01

    Full Text Available Purpose. To investigate the role of indocyanine green (ICG dye as a causative material of toxic anterior segment syndrome (TASS in an experimental rabbit model. Method. Eight eyes of four rabbits were allocated to this study. Capsular staining was performed using ICG dye, after which the anterior chamber was irrigated with a balanced salt solution. The effects of different concentrations (control, 0.25, 0.5, and 1.0%, exposure times (10 and 60 seconds, and the degree of dissolution (differently vortexed were investigated. The analysis involved anterior segment photography, ultrasound pachymetry, prostaglandin assay (PGE2 Parameter Assay, R&D systems, Inc., and scanning electron microscopy of each iris. Result. There was no reaction in the control eye. A higher aqueous level of PGE2 and more severe inflammatory reaction were observed in cases of eyes with higher concentration, longer exposure time, and poorly dissolved dye. Additionally, scanning electron microscopy revealed larger and coarser ICG particles. Conclusion. TASS occurrence may be associated with the concentration, exposure time, and degree of dissolution of ICG dye during cataract surgery.

  17. Clinical Research Progress of Toxic Anterior Segment Syndrome%眼前节毒性反应综合征的临床研究进展

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    刘昞莉

    2011-01-01

    Toxic anterior segment syndrome ( TASS ) is a rare and sterile postoperative inflammatory reaction, which is different from infectious inflammation.It is belong to particular postoperative inflammatory reaction, with typical clinical features and serious secondary complications.Its causes have been identified to relate to poisonous substance accessing the anterior chamber, such as intraocular irrigating solutions, preservative, disinfectant used in disinfecting equipment, bacterial endotoxin,metal ion on the surface of instrument,viscoelastic materials of denaturation, impurity in steam sterilization, antibiotic, anesthetic and intraocular lens etc.In recent years,with the improvement of anterior segment surgery,TASS has emerged in large numbers.This article reviewed the toxic anterior segment syndrome, including of the clinical manifestation, pathology characteristic, etiopathogenisis, diagnosis, differential diagnosis, treatment and prevention.%眼前节毒性反应综合征(TASS)是一种少见的、无菌性的术后炎性反应,属于特殊类型的术后炎症,具有典型的临床特征并可引起严重的继发性反应.TASS发生与多种进入眼前房物质的毒性作用有关,如眼内灌注液、防腐剂、消毒设备使用的消毒剂、细菌内毒素、器械表面的金属离子残渣、变性的黏弹剂、高压蒸气杂质、抗生素、麻醉药物以及使用的人工晶体等.近年来,随着眼前节手术的发展,本病有逐渐增加的趋势.现TASS的从临床表现、病理特征、病因、诊断和鉴别诊断、治疗及预防措施等方面对其予以综述.

  18. Morphogenesis of the anterior segment in the zebrafish eye

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    Link Brian A

    2005-06-01

    Full Text Available Abstract Background The ocular anterior segment is critical for focusing incoming light onto the neural retina and for regulating intraocular pressure. It is comprised of the cornea, lens, iris, ciliary body, and highly specialized tissue at the iridocorneal angle. During development, cells from diverse embryonic lineages interact to form the anterior segment. Abnormal migration, proliferation, differentiation, or survival of these cells contribute to diseases of the anterior segment such as corneal dystrophy, lens cataract, and glaucoma. Zebrafish represent a powerful model organism for investigating the genetics and cell biology of development and disease. To lay the foundation for genetic studies of anterior segment development, we have described the morphogenesis of this structure in zebrafish. Results As in other vertebrates, the zebrafish anterior segment derives from diverse origins including surface ectoderm, periocular mesenchyme, and neuroepithelium. Similarly, the relative timing of tissue differentiation in the anterior segment is also conserved with other vertebrates. However, several morphogenic features of the zebrafish anterior segment differ with those of higher vertebrates. These include lens delamination as opposed to invagination, lack of iris muscles and ciliary folds, and altered organization in the iridocorneal angle. In addition, substantial dorsal-ventral differences exist within the zebrafish anterior segment. Conclusion Cumulatively, our anatomical findings provide a reference point to utilize zebrafish for genetic studies into the mechanisms of development and maintenance of the anterior segment.

  19. Adjacent Segment Pathology after Anterior Cervical Fusion.

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    Chung, Jae Yoon; Park, Jong-Beom; Seo, Hyoung-Yeon; Kim, Sung Kyu

    2016-06-01

    Anterior cervical fusion has become a standard of care for numerous pathologic conditions of the cervical spine. However, subsequent development of clinically significant disc disease at levels adjacent to fused discs is a serious long-term complication of this procedure. As more patients live longer after surgery, it is foreseeable that adjacent segment pathology (ASP) will develop in increasing numbers of patients. Also, ASP has been studied more intensively with the recent popularity of motion preservation technologies like total disc arthroplasty. The true nature and scope of ASP remains poorly understood. The etiology of ASP is most likely multifactorial. Various factors including altered biomechanical stresses, surgical disruption of soft tissue and the natural history of cervical disc disease contribute to the development of ASP. General factors associated with disc degeneration including gender, age, smoking and sports may play a role in the development of ASP. Postoperative sagittal alignment and type of surgery are also considered potential causes of ASP. Therefore, a spine surgeon must be particularly careful to avoid unnecessary disruption of the musculoligamentous structures, reduced risk of direct injury to the disc during dissection and maintain a safe margin between the plate edge and adjacent vertebrae during anterior cervical fusion.

  20. Anterior Segment Imaging in Ocular Surface Squamous Neoplasia

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    Sally S. Ong

    2016-01-01

    Full Text Available Recent advances in anterior segment imaging have transformed the way ocular surface squamous neoplasia (OSSN is diagnosed and monitored. Ultrasound biomicroscopy (UBM has been reported to be useful primarily in the assessment of intraocular invasion and metastasis. In vivo confocal microscopy (IVCM shows enlarged and irregular nuclei with hyperreflective cells in OSSN lesions and this has been found to correlate with histopathology findings. Anterior segment optical coherence tomography (AS-OCT demonstrates thickened hyperreflective epithelium with an abrupt transition between abnormal and normal epithelium in OSSN lesions and this has also been shown to mimic histopathology findings. Although there are limitations to each of these imaging modalities, they can be useful adjunctive tools in the diagnosis of OSSN and could greatly assist the clinician in the management of OSSN patients. Nevertheless, anterior segment imaging has not replaced histopathology’s role as the gold standard in confirming diagnosis.

  1. Anterior and posterior centers jointly regulate Bombyx embryo body segmentation.

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    Nakao, Hajime

    2012-11-15

    Insect embryo segmentation is largely divided into long and short germ types. In the long germ type, each segment primordium is represented on a large embryonic rudiment of the blastoderm, and segmental patterning occurs nearly simultaneously in the syncytium. In the short germ type, however, only anterior segments are represented in the small embryonic rudiment, usually located on the egg posterior, and the rest of the segments are added sequentially from the posterior growth zone in a cellular context. The long germ type is thought to have evolved from the short germ type. It is proposed that this transition, which appears to have occurred multiple times over the course of evolution, was realized through the acquisition of a localized anterior instruction center. Here, I examined the early segmentation process in the silkmoth Bombyx mori, a lepidopteran insect, in which the mechanisms of anterior-posterior (AP) axis formation have not been well analyzed. In this insect, both the long germ and short germ features have been reported. The mRNAs for two key genes involved in insect AP axis formation, orthodenticle (Bm-otd) and caudal (Bm-cad), are localized maternally in the germ anlage, where they act as anterior and posterior instruction centers, respectively. RNAi studies indicate that, while Bm-cad affects the formation of all the even skipped (Bm-eve) stripes, there is also anterior Bm-eve stripe formation activity that involves Bm-otd. Thus, there is redundancy in Bm-eve stripe formation activity that must be coordinated. Some genetic interactions, identified either experimentally or hypothetically, are also introduced, which might enable robust AP formation in this organism.

  2. Wellens' syndrome with segmental wall-motion abnormalities

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    Bugan, Baris; Celik,Turgay; Celik,Murat; Dermikoh,Sait; Iyisoy,Atila; Serdar ,Firtina

    2010-01-01

    Turgay Celik1, Baris Bugan1, Serdar Firtina1, Murat Celik2, Sait Demirkol1, Atila Iyisoy11Gulhane Military Medical Academy, Department of Cardiology, Ankara, Turkey; 2Van Army District Hospital, Department of Cardiology, Van, TurkeyAbstract: Wellens' syndrome is a pattern of electrocardiographic T-wave changes associated with critical, proximal left anterior descending (LAD) artery stenosis. We herein report 2 cases of Wellens' syndrome with segmental wall-motion abnormalities...

  3. Anterior cutaneous nerve entrapment syndrome: management challenges

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    Chrona E

    2017-01-01

    Full Text Available Eleni Chrona,1,2 Georgia Kostopanagiotou,1 Dimitrios Damigos,3 Chrysanthi Batistaki1 1Second Department of Anesthesiology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” Hospital, Athens, 2Department of Anesthesiology, General Hospital of “Ag. Panteleimon,” Piraeus, 3Department of Medical Psychology, Medical School of Ioannina, University of Ioannina, Ioannina, Greece Abstract: Anterior cutaneous nerve entrapment syndrome (ACNES is a commonly underdiagnosed and undertreated chronic state of pain. This syndrome is characterized by the entrapment of the cutaneous branches of the lower thoracoabdominal intercostal nerves at the lateral border of the rectus abdominis muscle, which causes severe, often refractory, chronic pain. This narrative review aims to identify the possible therapeutic strategies for the management of the syndrome. Seventeen studies about ACNES therapy were reviewed; of them, 15 were case–control studies, case series, or case reports, and two were randomized controlled trials. The presently available management strategies for ACNES include trigger point injections (diagnostic and therapeutic, ultrasound-guided blocks, chemical neurolysis, and surgical ­neurectomy, in combination with systemic medication, as well as some emerging techniques, such as radiofrequency ablation and neuromodulation. An increased awareness of the syndrome and the use of specific diagnostic criteria for its recognition are required to facilitate an early and successful management. This review compiles the proposed ­management strategies for ACNES. Keywords: anterior cutaneous nerve entrapment syndrome, intercostal, neuralgia, management

  4. Genetics in Ophthalmology II–Anterior Segment Diseases

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    Canan Aslı Utine

    2012-10-01

    Full Text Available Genetic diseases are congenital or acquired hereditary diseases that result from structural/functional disorders of the human genome. Today, the genetic factors that play a role in many diseases are being highlighted with the rapid progress in the field of genetics science. It becomes increasingly important that physicians from all disciplines have knowledge about the basic principles of genetics, patterns of inheritance, etc., so that they can follow the new developments. In genetic eye diseases, ophthalmologists should know the basic clinical and recently rapidly developing genetic characteristics of these diseases in order to properly approach the diagnosis and treatment and to provide genetic counseling. In this paper, anterior segment eye diseases of genetic origin are reviewed, and aniridia, anterior segment dysgenesis, glaucoma, corneal dystrophies, cataract, ectopia lentis, myopia, and other refractive errors are covered. (Turk J Ophthalmol 2012; 42: 378-85

  5. Unilateral persistent fetal vasculature coexisting with anterior segment dysgenesis.

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    Khokhar, Sudarshan; Gupta, Shikha; Arora, Tarun; Gogia, Varun; Dada, Tanuj

    2013-08-01

    Persistent fetal vasculature (PFV) is a common congenital developmental anomaly of the eye which results from failure of the embryological primary vitreous and hyaloid vasculature to regress by the time of birth (Int Ophthalmol Clin 48: 53-62, 2008). Typically, it is divided into anterior, posterior or combined types and is characterized by the presence of a vascular stalk located between the optic disc and the posterior lens capsule (Int Ophthalmol Clin 48: 53-62, 2008). Although it has been reported to manifest itself differently, in our case it presented in a microphthalmic eye as anterior segment dysgenesis with broad-based mid-peripheral synechiae, posterior embryotoxon, iridoschisis, ectropion uveae, hypotony and subluxated cataractous lens with a taut anterior hyaloid face which are rare associations with PFV.

  6. Refraction and eye anterior segment parameters in schizophrenic patients

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    Tongabay Cumurcu

    2015-06-01

    Full Text Available ABSTRACT Purpose: To evaluate the difference in terms of refractive errors and anterior segment parameters between schizophrenic patients and healthy volunteers. Methods: This study compared 70 patients (48 men who were diagnosed with schizophrenia with a control group of 60 (35 men who were similar in terms of age, gender, education, and socioeconomic level. Anterior segment examination was performed using a Scheimflug system. Axial length and lens thickness (LT were measured using optic biometry. The following tests were administered to the psychiatric patient group: Brief Psychiatric Rating Scale (BPRS, Scale for the Assessment of Negative Symptoms (SANS, and Scale for the Assessment of Positive Symptoms (SAPS. Results: Mild myopia was detected in both the schizophrenic and control groups, with no statistically significant difference (p>0.005. Corneal volume (CV, anterior chamber volume (ACV, anterior chamber depth (ACD, and central corneal thickness (CCT values were lower in the schizophrenic group, and there was a statistically significant between-group difference (p=0.026, p=0.014, p=0.048, and p=0.005, respectively. LT was greater in schizophrenics, and the difference was found to be statistically significant (p=0.006. A statistically significant negative correlation was found between SAPS and cylinder values (p=0.008. The axial eye length, cylinder value, pupil diameter, mean keratometric value, and anterior chamber angle revealed no statistically significant difference between the groups (p>0.05. Conclusion: No statistically significant difference was detected in terms of refraction disorders between schizophrenics and the healthy control group, while some differences in anterior chamber parameters were present. These results demonstrate that schizophrenics may exhibit clinical and structural differences in the eye.

  7. Novel mutations in PXDN cause microphthalmia and anterior segment dysgenesis.

    Science.gov (United States)

    Choi, Alex; Lao, Richard; Ling-Fung Tang, Paul; Wan, Eunice; Mayer, Wasima; Bardakjian, Tanya; Shaw, Gary M; Kwok, Pui-Yan; Schneider, Adele; Slavotinek, Anne

    2015-03-01

    We used exome sequencing to study a non-consanguineous family with two children who had anterior segment dysgenesis, sclerocornea, microphthalmia, hypotonia and developmental delays. Sanger sequencing verified two Peroxidasin (PXDN) mutations in both sibs--a maternally inherited, nonsense mutation, c.1021C>T predicting p.(Arg341*), and a paternally inherited, 23-basepair deletion causing a frameshift and premature protein truncation, c.2375_2397del23, predicting p.(Leu792Hisfs*67). We re-examined exome data from 20 other patients with structural eye defects and identified two additional PXDN mutations in a sporadic male with bilateral microphthalmia, cataracts and anterior segment dysgenesis--a maternally inherited, frameshift mutation, c.1192delT, predicting p.(Tyr398Thrfs*40) and a paternally inherited, missense substitution that was predicted to be deleterious, c.947 A>C, predicting p.(Gln316Pro). Mutations in PXDN were previously reported in three families with congenital cataracts, microcornea, sclerocornea and developmental glaucoma. The gene is expressed in corneal epithelium and is secreted into the extracellular matrix. Defective peroxidasin has been shown to impair sulfilimine bond formation in collagen IV, a constituent of the basement membrane, implying that the eye defects result because of loss of basement membrane integrity in the developing eye. Our finding of a broader phenotype than previously appreciated for PXDN mutations is typical for exome-sequencing studies, which have proven to be highly effective for mutation detection in patients with atypical presentations. We conclude that PXDN sequencing should be considered in microphthalmia with anterior segment dysgenesis.

  8. Anterior cutaneous nerve entrapment syndrome: management challenges

    Science.gov (United States)

    Chrona, Eleni; Kostopanagiotou, Georgia; Damigos, Dimitrios; Batistaki, Chrysanthi

    2017-01-01

    Anterior cutaneous nerve entrapment syndrome (ACNES) is a commonly underdiagnosed and undertreated chronic state of pain. This syndrome is characterized by the entrapment of the cutaneous branches of the lower thoracoabdominal intercostal nerves at the lateral border of the rectus abdominis muscle, which causes severe, often refractory, chronic pain. This narrative review aims to identify the possible therapeutic strategies for the management of the syndrome. Seventeen studies about ACNES therapy were reviewed; of them, 15 were case–control studies, case series, or case reports, and two were randomized controlled trials. The presently available management strategies for ACNES include trigger point injections (diagnostic and therapeutic), ultrasound-guided blocks, chemical neurolysis, and surgical neurectomy, in combination with systemic medication, as well as some emerging techniques, such as radiofrequency ablation and neuromodulation. An increased awareness of the syndrome and the use of specific diagnostic criteria for its recognition are required to facilitate an early and successful management. This review compiles the proposed management strategies for ACNES. PMID:28144159

  9. Acute exertional anterior compartment syndrome in an adolescent female.

    Science.gov (United States)

    Fehlandt, A; Micheli, L

    1995-01-01

    Acute compartment syndromes usually occur as a complication of major trauma. While the chronic exertional anterior tibial compartment syndrome is well described in the sports medicine literature, reports of acute tibial compartment syndromes due to physical exertion, or repetitive microtrauma, are rare. The case of an adolescent female who developed an acute anterior compartment syndrome from running in a soccer game is described in this report. Failure to recognize the onset of an acute exertional compartment syndrome may lead to treatment delay and serious complications. Whereas the chronic exertional anterior compartment syndrome is characterized by pain that diminishes with the cessation of exercise, the onset of the acute exertional anterior compartment syndrome is heralded by pain that continues, or increases, after exercise has stopped. Compartment pressure measurement confirms the clinical diagnosis and helps guide treatment. True compartment syndromes require urgent fasciotomy.

  10. Experimental Study on the Prevention of Anterior Segment Ischemia by Preservation of Anterior Ciliary Vessels

    Institute of Scientific and Technical Information of China (English)

    Yanna Li; Guanghuan Mai; Zhijian Wang; Xinping Yu; Huanyun Yu; Yan Guo; Xiaoming Lin; Daming Deng; Ying Kang

    2003-01-01

    Purpose: To observe the effect of preserving anterior ciliary vessels (ACVs) on anteriorsegments of rabbit eyes undergoing tenotomy of extraocular muscles.Methods: Thirty-two adult New Zealand white rabbits were divided into four groups.Same procedures were done in both eyes in each group except that left eyes underwentpreservation of ACVs. In the first group medial and lateral recti, in the second group,superior and inferior recti, in the third group, medial, lateral and superior or inferior rectiand in the fourth group, all four recti, underwent tenotomy. Slit-lamp examination,intraocular pressure (IOP) measurement, total protein and lactic acid quantification inaqueous humor were done in all eyes pre- and post-operatively. By four weeks afteroperation, the eyes were enucleated for histological examination and electron microscopy.All data were analyzed using SPSS version 10.Results: In the left eyes of both group 1 and group 2, no inflammatory response wasobserved. In the left eyes of group 3 and 4, we observed mild inflammatory response withslit-lamp examination, which disappeared in one wk. However, we did not findsignificant changes in IOP, total protein and lactic acid of aqueous humor, histology andelectron microscopic examination in these groups. In the right eyes in group 2, 3 and 4,we observed moderate to severe inflammatory changes, a few even developed anteriorsegment ischemia, appeared as decreased IOP, increased total protein and lactic acid inaqueous humor, along with pathological and electron-microscopic changes.Conclusion: Simultaneous tenotomy of three or four recti or two vertical recti on one eyemay decrease anterior segment blood flow even lead to ischemia. ACVs preservation mayprotect the blood circulation in anterior segment. Our study suggests that ACVspreservation in strabismus surgeries especially those involving multi-recti tenotomies mayprevent potential anterior segment ischemia.

  11. Anterior segment dysgenesis (Peters' anomaly) in two snow leopard (Panthera uncia) cubs

    DEFF Research Database (Denmark)

    Hamoudi, Hassan; Rudnick, Jens-Christian; Prause, Jan Ulrik

    2013-01-01

    Two sibling snow leopards, a male and a female, with bilateral anterior segment dysgenesis (ASD), are reported. Both snow leopards also had colobomas of both upper eyelids. All eyes exhibited a central corneal opacity associated with a defect in posterior corneal stroma, endothelium and Descemet...... remnant of the hyaloid artery. The male had hydrocephalus and thus some of the features of Peters' plus syndrome (Peters' anomaly in addition to systemic malformations). The histological findings in the eyes of these snow leopard siblings are identical with those described in humans with Peters' anomaly....

  12. Anterior segment spectral domain optical coherence tomography imaging of patients with anterior scleritis.

    Science.gov (United States)

    Levison, Ashleigh L; Lowder, Careen Y; Baynes, Kimberly M; Kaiser, Peter K; Srivastava, Sunil K

    2016-08-01

    The purpose of the study was to describe the findings seen on anterior segment spectral domain optical coherence tomography (SD-OCT) in patients with anterior scleritis and determine the feasibility of using SD-OCT to image and grade the degree of scleral inflammation and monitor response to treatment. All patients underwent slit lamp examination by a uveitis specialist, and the degree of scleral inflammation was recorded. Spectral domain OCT imaging was then performed of the conjunctiva and scleral tissue using a standardized acquisition protocol. The scans were graded and compared to clinical findings. Twenty-eight patients with anterior scleritis and ten patients without ocular disease were included in the study. Seventeen of the scleritis patients were followed longitudinally. Common findings on SD-OCT in patients with active scleritis included changes in hyporeflectivity within the sclera, nodules, and visible vessels within the sclera. There was significant variation in findings on SD-OCT within each clinical grade of active scleritis. These changes on SD-OCT improved with treatment and clinical improvement. SD-OCT imaging provided various objective measures that could be used in the future to grade inflammatory activity in patients with anterior scleritis. Longitudinal imaging of patients with active scleritis demonstrated that SD-OCT may have great utility in monitoring response to treatment.

  13. Diagnostics of anterior eye segment in cats and dogs

    Directory of Open Access Journals (Sweden)

    Hadži-Milić Milan

    2006-01-01

    Full Text Available Diagnostics of the anterior segment of the eye present the most frequent diagnostics implemented in ophthalmology and by most veterinary practicians as well. This paper presents the complete diagnostics in the most concise form possible. The procedure with animals is presented first, followed by the equipment, and then anamnesis. The following diagnostic methods are presented: examination in a lighted room which include an examination from a distance, taking a smear, the Schirmer tear test (STT, an examination from close by, examination in a dark room which comprises the elementary examinations, such as the use of focal lighting and examination using a direct ophthalmoscope, and special examination in a dark room, such as biomicroscopy, gonioscopy and keratoscopy. Additional examination methods are also included.

  14. The relationship between the morphological features of A1 segment of anterior cerebral artery and anterior communicating artery aneurysms

    Institute of Scientific and Technical Information of China (English)

    冯文峰

    2013-01-01

    Objective To improve the predictability of surgical clipping and guide the steam shaping of microcatheters in endovascular embolization by analyzing the association of morphological features of A1 segment of anterior cerebral artery(ACA) with formation and classification of anterior

  15. Measurement of anterior chamber volume with rotating scheimpflug camera and anterior segment optical coherence tomography

    Institute of Scientific and Technical Information of China (English)

    FU Jing; LI Shu-ning; WANG Xiao-zhen; WU Ge-wei; MU Da-peng; WANG Jian; WANG Ning-li

    2010-01-01

    Background Measurement of anterior segment parameters plays an important role in diagnosis and treatment of glaucoma. The objective of this study was to evaluate the repeatability and reproducibility of anterior chamber volume (ACV) measurements with rotating scheimpflug camera (RSC) and to examine agreement with anterior segment optical coherence tomography (AS-OCT). Methods Thirty nine healthy normal subjects were recruited from the Eye Center of Tongren Hospital. ACV was measured using RSC and AS-OCT in a randomly selected eye for each subject. For RSC measurements, both automatic and manual ACV measurements and 2 independent operators' ACV measurements were obtained. All subjects were invited for 3 visits within a week to evaluate repeatability and reproducibility of ACV measurement by RSC. Agreement was evaluated between RSC and AS-OCT. Results Good repeatability and reproducibility were found for both automatic and manual ACV measurements obtained by RSC. For intrasession repeatability, coefficient of variation (CVw) and intraclass correlation coefficient (ICC) values for automatic were 3.52% and 0.98; the values for manual were 3.44% and 0.97, respectively. For intersession reproducibility, the respective CVw and ICC values were 3.96% and 0.96. Good agreement was also found in 2 operators for both automatic and manual ACV measurements; nevertheless, poor agreement was found between RSC and AS-OCT (95% confidence interval (CI) for agreement of automatic RSC measurement versus AS-OCT were -96.3 to 72.8 μl and 95% CI for agreement of manual RSC measurement versus AS-OCT were between -41.7 to 10.1 μl). Conclusions Both RSC automatic and manual ACV measurements showed good repeatability and reproducibility, and showed comparable agreement between 2 independent operators, but poor agreement was found between RSC and AS-OCT.

  16. Kartagener syndrome with focal segmental glomerulosclerosis.

    Science.gov (United States)

    Momeni, Ali; Doroushi, Behzad; Taheri, Nadia

    2013-11-01

    Primary ciliary dyskinesia is characterized by congenital impairment of mucociliary clearance. Kartagener syndrome (KS) is a clinical variant of primary ciliary dyskinesia which is involved in situs inversus associated with chronic respiratory infections. In addition, glomerular disease in KS syndrome is rare and reported cases are limited. We had a 27-year-old female patient with KS who presented with proteinuria, hematuria, normal kidney function, and a family history of systemic lupus erythematosus. Kidney biopsy showed segmental scar with adhesion to Bowman capsule, which was indicative of focal segmental glomerulosclerosis.

  17. Acute Coronary Syndrome and ST Segment Monitoring.

    Science.gov (United States)

    Carey, Mary G

    2016-09-01

    Acute coronary syndrome (ACS) is caused by a critical obstruction of a coronary artery because of atherosclerotic coronary artery disease. Three specific conditions are included: ST elevation myocardial infarction, non-ST elevation myocardial infarction, and unstable angina. The ST segment on the electrocardiogram is a sensitive and specific marker of myocardial ischemia and infarction; however, ST segment deviation is regional not global, thus the ECG lead must be placed over the affected region of the myocardium. This article describes ACS and infarction and the use of ST segment monitoring to detect these conditions.

  18. Pupil Tracking for Real-Time Motion Corrected Anterior Segment Optical Coherence Tomography

    Science.gov (United States)

    Carrasco-Zevallos, Oscar M.; Nankivil, Derek; Viehland, Christian; Keller, Brenton; Izatt, Joseph A.

    2016-01-01

    Volumetric acquisition with anterior segment optical coherence tomography (ASOCT) is necessary to obtain accurate representations of the tissue structure and to account for asymmetries of the anterior eye anatomy. Additionally, recent interest in imaging of anterior segment vasculature and aqueous humor flow resulted in application of OCT angiography techniques to generate en face and 3D micro-vasculature maps of the anterior segment. Unfortunately, ASOCT structural and vasculature imaging systems do not capture volumes instantaneously and are subject to motion artifacts due to involuntary eye motion that may hinder their accuracy and repeatability. Several groups have demonstrated real-time tracking for motion-compensated in vivo OCT retinal imaging, but these techniques are not applicable in the anterior segment. In this work, we demonstrate a simple and low-cost pupil tracking system integrated into a custom swept-source OCT system for real-time motion-compensated anterior segment volumetric imaging. Pupil oculography hardware coaxial with the swept-source OCT system enabled fast detection and tracking of the pupil centroid. The pupil tracking ASOCT system with a field of view of 15 x 15 mm achieved diffraction-limited imaging over a lateral tracking range of +/- 2.5 mm and was able to correct eye motion at up to 22 Hz. Pupil tracking ASOCT offers a novel real-time motion compensation approach that may facilitate accurate and reproducible anterior segment imaging. PMID:27574800

  19. Gluteus minimus: an intramuscular EMG investigation of anterior and posterior segments during gait.

    Science.gov (United States)

    Semciw, Adam I; Green, Rodney A; Murley, George S; Pizzari, Tania

    2014-02-01

    Gluteus minimus is believed to consist of two structurally and functionally unique segments (anterior and posterior); however there is a lack of electromyography (EMG) research that attempts to verify current theoretical knowledge of this muscle. The purpose of this study was therefore to evaluate the function of gluteus minimus during gait, and to determine whether anterior and posterior segments are functionally independent. Bipolar fine wire intramuscular EMG electrodes were inserted into anterior and posterior gluteus minimus segments of fifteen healthy volunteers (9 males) according to previously verified guidelines. Participants completed a series of four walking trials, followed by maximum voluntary isometric contractions in five different positions. Temporal and amplitude variables for each segment were compared across the gait cycle with independent t-tests. The relative contribution of each segment to the maximum resisted trials was compared with Mann-Whitney U tests (α = 0.05). Anterior and posterior segments were contracting at different relative intensities for three of the five maximum resisted trials (effect size = 0.39 to 0.62, P gait cycle (effect size = 0.96 to 1.03, P phase (effect size = 0.83, P = 0.034). Gluteus minimus is therefore composed of functionally independent segments. These results build on contemporary theoretical knowledge and may signify hip stabilising roles for each segment across different phases of the gait cycle.

  20. Effects of age on ocular anterior segment dimensions measured by optical coherence tomography

    Institute of Scientific and Technical Information of China (English)

    QIN Bing; ZHOU Xing-tao; HUANG David; CHU Ren-yuan

    2011-01-01

    Background Older subjects tend to have smaller ocular anterior segment. The present study aimed to measure anterior segment dimensions with optical coherence tomography (OCT) and quantitatively assess the effect of age and other factors.Results Sixty-six eyes of 33 normal subjects (aged 22-65 years, 19 Asians, 14 Caucasians) were enrolled. For every 1 year of age, corneal diameter was 0.033 mm narrower (P <0.01), anterior chamber width was 0.031 mm narrower (P <0.01), corneal vault was 0.016 mm lower (P<0.01), and anterior chamber depth was 0.025 mm lower (P<0.01). Asian eyes had smaller corneal diameter (P=0.035) and anterior chamber width (P=0.015) compared with those of Caucasian eyes. Body height showed positive correlation with corneal diameter (0.039 mm per centimeter of height, P <0.01) and corneal vault (0.024 mm per centimetre of height, P <0.01). Gender did not have an independent effect on anterior segment dimensions.Conclusions Anterior segment dimensions were smaller in older subjects. Age-related changes may affect the tolerability of long-term implants such as phakic intraocular lens.

  1. Rare times rare: The hyponatremia, rhabdomyolysis, anterior compartment syndrome sequence.

    Science.gov (United States)

    Dubin, Ina; Gelber, Moshe; Schattner, Ami

    2016-05-01

    Primary polydipsia occurs in up to 25% of patients with chronic psychiatric disorders (especially schizophrenia), related to the disease, its treatment or both. Urine output fails to match intake >10 L/day and water intoxication may develop. Rhabdomyolysis is a rare complication of hyponatremia, and an acute anterior compartment syndrome of the leg, an emergency, may be very rarely associated.

  2. Compartment syndrome with mononeuropathies after anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Kindle, Brett J; Murthy, Naveen; Stolp, Kathryn

    2015-05-01

    Compartment syndrome rarely follows anterior cruciate ligament reconstruction. However, when it does, it may result in mononeuropathies that are amenable to neurolysis. The authors of this study present an 18-yr-old woman who sustained a right anterior cruciate ligament tear and underwent uneventful anterior cruciate ligament reconstruction using femoral and popliteal nerve blocks. Postoperatively, she developed compartment syndrome requiring emergent fasciotomies. At 11 wks after fasciotomy, results of electrophysiologic tests showed evidence of severe fibular and tibial neuropathies. Magnetic resonance images showed extensive tricompartmental myonecrosis. Fibular and tibial neurolysis as well as decompression were performed, followed by intensive outpatient rehabilitation. At the 6-mo follow-up, she reported resolution of pain as well as significant improvement in sensation, strength, and function. Early recognition and intervention are crucial to prevent serious neurologic damage. Excessive tourniquet pressure and anesthetic nerve blocks may have been responsible.

  3. Gluteus medius: an intramuscular EMG investigation of anterior, middle and posterior segments during gait.

    Science.gov (United States)

    Semciw, Adam I; Pizzari, Tania; Murley, George S; Green, Rodney A

    2013-08-01

    Previous electromyographic (EMG) studies of gluteus medius (GMed) have not accurately quantified the function of the three proposed structurally and functionally unique segments (anterior, middle and posterior). Therefore this study used anatomically verified locations for intramuscular electrode recordings in three segments of GMed to determine whether the segments are functionally independent. Bipolar fine wire electrodes were inserted into each segment of GMed in 15 healthy individuals. Participants completed a series of four walking trials, followed by maximum voluntary isometric contractions (MVICs) in five different positions. Temporal and amplitude variables for each segment were compared across the gait cycle using ANOVA. The relative contributions of each segment to the MVIC trials were compared with non-parametric tests. All segments showed a biphasic response during the stance phase of gait. There were no differences in amplitude variables (% MVIC) between segments, but the anterior segment had a later peak during both the first and second bursts.For the MVIC trials, there were significant differences in amplitude between segments in four of the five test positions. These data indicate that GMed is composed of three functionally independent segments. This study contributes to the theoretical understanding of the role of GMed.

  4. Application of Fourier Domain OCT Imaging Technology to the Anterior Segment of the Human Eye

    Science.gov (United States)

    Wojtkowski, Maciej; Marcos, Susana; Ortiz, Sergio; Grulkowski, Ireneusz

    The anterior segment is the front part of the human eye, which forms the optical system and hence directly impacts vision. Traumatic or pathological changes in the anterior segment may lead to vision loss and, in some cases, even blindness. Since the eighteenth century, optical instrumentation for measuring and imaging the anterior segment of the human eye has been developing along with modern ophthalmology. The application of OCT to the anterior segment imaging is particularly of interest, since this could potentially provide substantial complementary information regarding the large-scale architecture of the cornea and the crystalline lens, or on small portions of tissue imaged with high spatial resolutions comparable to regular microscopy. Especially an introduction of Fourier domain detection in OCT has opened new frontiers in OCT ophthalmic applications. The resultant substantial speed improvement enables rapid image acquisition, helping to reduce artifacts due to patient motion. Thus, it is currently possible to perform high-speed, in vivo, three-dimensional volumetric imaging over large scales within a reasonable time limit and without reducing system sensitivity. This chapter describes the state-of the art OCT technology dedicated to anterior segment imaging and indicates all important parameters which are required for optimization of the performance of OCT instrument.

  5. Anterior segment intraocular metallic foreign body causing chronic hypopyon uveitis

    OpenAIRE

    Mete, Güler; Turgut, Yılmaz; Osman, Arslanhan; Gülşen, Ülkü; Hakan, Artaş

    2010-01-01

    Intraocular foreign body (IOFB) is a common association of penetrating ocular trauma. Early diagnosis and removal of IOFBs especially if they are metallic is very important to determine further management and the final result of treatment. Missed IOFB may present in different clinical aspects that may limit its detection and symptoms may only become apparent after a prolonged period of time. We report a case of a missed metallic intraocular foreign body in the anterior chamber over a 2-year p...

  6. Risk Factors for the Development of Adjacent Segment Disease Following Anterior Cervical Arthrodesis

    OpenAIRE

    Ezgi Akar; Mehmet Ufuk Akmil; Merih İş

    2015-01-01

    Aim: The aim of this study was to clinically and radiologically evaluate the efficacy of anterior cervical discectomy and fusion (ACDF) in the treatment of adjacent level degeneration. Methods: We retrospectively evaluated 89 patients (55 females, 34 males) who underwent ACDF. Adjacent segment degeneration findings were evaluated by investigating new osteophyte formation, growth of existing osteophytes, ossification of the anterior longitudinal ligament, presence of inter...

  7. Swept source OCT imaging of human anterior segment at 200 kHz

    Science.gov (United States)

    Karnowski, Karol; Gora, Michalina; Kaluzny, Bartlomiej; Huber, Robert; Szkulmowski, Maciej; Kowalczyk, Andrzej; Wojtkowski, Maciej

    2009-02-01

    We present applicability of the high speed swept-source optical coherence tomography for in vivo imaging of the anterior segment of the human eye. Three dimensional imaging of the cornea with reduced motion artifacts is possible by using swept source with Fourier domain mode locking operating at 200kHz with 1300nm central wavelength. High imaging speeds allow for assessment of anterior and posterior corneal topography and generation of thickness and elevation maps.

  8. A case of optic-nerve hypoplasia and anterior segment abnormality associated with facial cleft

    Directory of Open Access Journals (Sweden)

    Miyake T

    2016-07-01

    biomicroscopy revealed that almost all directions were open except for the peripheral anterior synechia. Since magnetic resonance imaging revealed ventriculomegaly associated with an interhemispheric cyst at birth, a ventriculoperitoneal shunt was inserted at 12 days of age. At 25 months of age, her condition suddenly deteriorated due to occlusion of the ventricular shunt catheter, and she died 5 days later. In this patient, amniotic band syndrome was presumed to be the primary cause due to the clinical findings. Conclusion: We experienced a case of optic-nerve hypoplasia and anterior segment abnormality that occurred with facial cleft. The cause of these abnormalities is unclear, yet amniotic band syndrome is a possible candidate. Keywords: facial cleft, optic-nerve hypoplasia, amniotic band syndrome

  9. Anterior Segment Tomography with the Cirrus Optical Coherence Tomography

    Directory of Open Access Journals (Sweden)

    Eduardo B. Rodrigues

    2012-01-01

    Full Text Available Optical coherence tomography (OCT is an optical acquisition method to examine biological tissues. In recent years, OCT has become an important imaging technology used in diagnosing and following macular pathologies. Further development enabled application of optical coherence tomography in evaluation of the integrity of the nerve fiber layer, optic nerve cupping, anterior chamber angle, or corneal topography. In this manuscript we overview the use of OCT in the clinical practice to enable corneal, iris, ciliary body, and angle evaluation and diagnostics.

  10. The complementary benefit of anterior segment optical coherence tomography in penetrating keratoplasty

    Directory of Open Access Journals (Sweden)

    Yenerel NM

    2013-07-01

    Full Text Available Nursal Melda Yenerel,1 Raciha Beril Kucumen,2 Ebru Gorgun3 1Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey; 2Yeditepe University Medical Faculty, Department of Ophthalmology, Istanbul, Turkey; 3Dunya Goz Eye Hospital, Istanbul, Turkey Purpose: To evaluate the utility of anterior segment optical coherence tomography (AS-OCT assessment in the pre- and postsurgical management of full-thickness corneal grafts. Methods: Seventy eyes of 58 patients who had penetrating keratoplasty were included in the study. High resolution AS-OCT scans of the cornea and the anterior segment were performed before and after transplantation in 17 eyes with the VisanteTM optical coherence tomography. Fifty-three eyes were examined in the late postoperative period. Results: The mean follow-up was 4.3 years (range, 1–15 years. Six different graft–host junctions were identified. Three patients with graft rejection, four patients with anterior synechia, and three patients with corneal ulcer were evaluated. Preoperative evaluation of eyes with semiopaque and totally opaque corneas revealed important information about anterior segment structures additional to slit-lamp findings. Conclusion: AS-OCT is a useful complementary tool for the evaluation of penetrating corneal transplantation surgery and in the management of its postoperative complications. Keywords: anterior segment optical coherence tomography, imaging techniques, penetrating keratoplasty

  11. Changes of the vasculature and innervation in the anterior segment of the RCS rat eye.

    Science.gov (United States)

    May, Christian Albrecht

    2011-12-01

    Investigating the anterior eye segment vasculature and innervation of dystrophic RCS rats, two major unique findings were observed: in the iris, young adult animals with retinal dystrophy showed an increase in substance P nerve fibres and a dilation of arterioles and capillaries. This finding continued during ageing. In the pars plana region, the surface covered by venules decreased continuously with age. In older animals, this decrease was parallelled by a local decrease of sympathetic TH-positive nerve fibres supplying these venules. For both conditions, no comparable data exists so far in the literature. They might point to a unique situation in the anterior eye segment of the dystrophic RCS rat.

  12. 7.1 T MRI to Assess the Anterior Segment of the Eye

    NARCIS (Netherlands)

    Langner, Soenke; Martin, Heiner; Terwee, Thom; Koopmans, Steven A.; Krueger, Paul C.; Hosten, Norbert; Schmitz, Klaus-Peter; Guthoff, Rudolf F.; Stachs, Oliver

    2010-01-01

    PURPOSE. Visualization of the anterior segment and biometric evaluation of the entire crystalline lens pose significant challenges for imaging techniques because of tissue-induced distortion artifacts. The present study was conducted to demonstrate the advantages of high-resolution magnetic resonanc

  13. Curcumin, A Potential Therapeutic Candidate for Anterior Segment Eye Diseases: A Review.

    Science.gov (United States)

    Liu, Xiu-Fen; Hao, Ji-Long; Xie, Tian; Mukhtar, Nour Jama; Zhang, Wiley; Malik, Tayyab Hamid; Lu, Cheng-Wei; Zhou, Dan-Dan

    2017-01-01

    Curcumin, the major curcuminoid of the turmeric, has been extensively used in many countries since ancient time for preventing and/or treating a multitude of diseases. This review is to illustrate the researches on the properties of curcumin and its potential therapeutic efficacy in major anterior segment eye diseases. The bio-medical potential of curcumin is restricted because of its low solubility and digestive bioavailability. This review will discuss promising research in improving curcumin bioavailability through structural modification. In vitro and in vivo research made progress in studying the beneficial effects of curcumin on major anterior segment eye diseases, including anti-angiogenesis effect in corneal diseases; anti-inflammation or anti-allergy effects in dry eye disease, conjunctivitis, anterior uveitis; anti-proliferation and pro-apoptosis effects in pterygium; anti-oxidative stress, anti-osmotic stress, anti-lipid peroxidation, pro-apoptosis, regulating calcium homeostasis, sequestrating free radicals, protein modification and degradation effects in cataracts; neuroprotective effects in glaucoma. Curcumin exhibited to be a potent therapeutic candidate for treating those anterior segment eye diseases.

  14. Curcumin, A Potential Therapeutic Candidate for Anterior Segment Eye Diseases: A Review

    Science.gov (United States)

    Liu, Xiu-Fen; Hao, Ji-Long; Xie, Tian; Mukhtar, Nour Jama; Zhang, Wiley; Malik, Tayyab Hamid; Lu, Cheng-Wei; Zhou, Dan-Dan

    2017-01-01

    Curcumin, the major curcuminoid of the turmeric, has been extensively used in many countries since ancient time for preventing and/or treating a multitude of diseases. This review is to illustrate the researches on the properties of curcumin and its potential therapeutic efficacy in major anterior segment eye diseases. The bio-medical potential of curcumin is restricted because of its low solubility and digestive bioavailability. This review will discuss promising research in improving curcumin bioavailability through structural modification. In vitro and in vivo research made progress in studying the beneficial effects of curcumin on major anterior segment eye diseases, including anti-angiogenesis effect in corneal diseases; anti-inflammation or anti-allergy effects in dry eye disease, conjunctivitis, anterior uveitis; anti-proliferation and pro-apoptosis effects in pterygium; anti-oxidative stress, anti-osmotic stress, anti-lipid peroxidation, pro-apoptosis, regulating calcium homeostasis, sequestrating free radicals, protein modification and degradation effects in cataracts; neuroprotective effects in glaucoma. Curcumin exhibited to be a potent therapeutic candidate for treating those anterior segment eye diseases. PMID:28261099

  15. Effects of 1% cyclopentolate hydrochloride on anterior segment parameters obtained with Pentacam in young adults

    Directory of Open Access Journals (Sweden)

    Ceyhun Arici

    2014-08-01

    Full Text Available Purpose: To investigate the effects of topically applied 1% cyclopentolate hydrochloride on anterior segment parameters obtained with a Pentacam rotating Scheimpflug camera in healthy young adults. Methods: Anterior segment analyses of 25 eyes from 25 young adults (Group 1, before and after 45 min of 1% cyclopentolate hydrochloride application, were performed. For a control group (cycloplegia-free, Group 2, 24 eyes of 24 age- and sex-matched healthy cases were evaluated twice at 45 min intervals. The results obtained from the groups were compared statistically. Results: The mean ages of the groups were 23.04 ± 3.42 (range, 18-29 and 22.4 ± 2.05 (range, 18-27 years for Groups 1 and 2, respectively (p=0.259. In Group 1, measurements between the two analyses were significantly different for the values of anterior chamber depth (ACD, anterior chamber angle (ACA, and anterior chamber volume (ACV (p<0.05, whereas no statistical difference was found for the central corneal thickness (CCT and keratometry (K1, K2 measurements. In Group 2, none of these parameters were statistically different between the two analyses. Conclusions: Topically applied 1% cyclopentolate hydrochloride caused an increase in the ACD and ACV values, and a decrease in the ACA value. However, it had no significant effect on the CCT and keratometry measurements. It is important to consider these effects when using the Pentacam device on young adults with cycloplegia and when applying it for various reasons.

  16. The muscle pattern of the Drosophila abdomen depends on a subdivision of the anterior compartment of each segment

    OpenAIRE

    Krzemień, Joanna; Fabre, Caroline C. G.; Casal, José; Lawrence, Peter A

    2012-01-01

    In the past, segments were defined by landmarks such as muscle attachments, notably by Snodgrass, the king of insect anatomists. Here, we show how an objective definition of a segment, based on developmental compartments, can help explain the dorsal abdomen of adult Drosophila. The anterior (A) compartment of each segment is subdivided into two domains of cells, each responding differently to Hedgehog. The anterior of these domains is non-neurogenic and clones lacking Notch develop normally; ...

  17. Anterior opercular syndrome induced by Epstein-Barr virus encephalitis.

    Science.gov (United States)

    Matsushima, Takashi; Nishioka, Kenya; Tanaka, Ryota; Yokoyama, Kazumasa; Hattori, Nobutaka

    2016-01-01

    We report a 19-year-old female presenting with fever, drooling, anarthria, and voluntary facial movement disruption, characteristic of anterior opercular syndrome (AOS). Serological examination revealed Epstein-Barr virus (EBV) infection following acute encephalitis with severe ataxia. A single-photon emission computerized tomography (SPECT) examination indicated hypoperfusion in the left perisylvian region, bilateral thalamus, occipital lobe, and cerebellum. This is the first report of AOS related to EBV encephalitis. SPECT was a useful method for detecting the damaged region of the operculum. In addition, AOS is a clinically distinct entity that may help us understand the mechanisms of language circuits within the operculum.

  18. Anterior Ischemic Optic Neuropathy as a Manifestation of HELLP Syndrome

    Directory of Open Access Journals (Sweden)

    Boby Varkey Maramattom

    2014-01-01

    Full Text Available Thrombotic microangiopathies (TMAs are a group of disorders characterized by occurrence of thrombi of fibrin and/or platelets with microvascular occlusion and organ ischemia especially the kidney and brain. Hemolysis with a microangiopathic blood smear, elevated liver enzymes, and low platelet count (HELLP syndrome is a type of TMA peculiar to pregnancy and may be associated with neurological complications. Visual complications in HELLP are usually related to cortical blindness. We present the first case of HELLP associated with bilateral anterior ischemic optic neuropathy (AION and blindness which resolved with plasma exchange.

  19. Haploinsufficient Bmp4 ocular phenotypes include anterior segment dysgenesis with elevated intraocular pressure

    Directory of Open Access Journals (Sweden)

    Nusinowitz Steven

    2001-11-01

    Full Text Available Abstract Background Glaucoma is a blinding disease usually associated with high intraocular pressure (IOP. In some families, abnormal anterior segment development contributes to glaucoma. The genes causing anterior segment dysgenesis and glaucoma in most of these families are not identified and the affected developmental processes are poorly understood. Bone morphogenetic proteins (BMPs participate in various developmental processes. We tested the importance of Bmp4 gene dosage for ocular development and developmental glaucoma. Results Bmp4+/- mice have anterior segment abnormalities including malformed, absent or blocked trabecular meshwork and Schlemm's canal drainage structures. Mice with severe drainage structure abnormalities, over 80% or more of their angle's extent, have elevated IOP. The penetrance and severity of abnormalities is strongly influenced by genetic background, being most severe on the C57BL/6J background and absent on some other backgrounds. On the C57BL/6J background there is also persistence of the hyaloid vasculature, diminished numbers of inner retinal cells, and absence of the optic nerve. Conclusions We demonstrate that heterozygous deficiency of BMP4 results in anterior segment dysgenesis and elevated IOP. The abnormalities are similar to those in human patients with developmental glaucoma. Thus, BMP4 is a strong candidate to contribute to Axenfeld-Rieger anomaly and other developmental conditions associated with human glaucoma. BMP4 also participates in posterior segment development and wild-type levels are usually critical for optic nerve development on the C57BL/6J background. Bmp4+/- mice are useful for studying various components of ocular development, and may allow identification of strain specific modifiers affecting a variety of ocular phenotypes.

  20. Right anterior segmental hepatic duct emptying directly into the cystic duct in a living donor

    Institute of Scientific and Technical Information of China (English)

    Yasunao; Ishiguro; Masanobu; Hyodo; Takehito; Fujiwara; Yasunaru; Sakuma; Nobuyuki; Hojo; Koichi; Mizuta; Hideo; Kawarasaki; Alan; T; Lefor; Yoshikazu; Yasuda

    2010-01-01

    A 35-year-old mother was scheduled to be the living donor for liver transplantation to her second son,who suffered from biliary atresia complicated with biliary cirrhosis at the age of 2 years.The operative plan was to recover the left lateral segment of the mother's liver for living donor transplantation.With the use of cholangiography at the time of surgery,we found the right anterior segmental duct(RASD) emptying directly into the cystic duct,and the catheter passed into the RASD.After repairing the inci...

  1. Corneal sensitivity and correlations between decreased sensitivity and anterior segment pathology in ocular leprosy.

    OpenAIRE

    Karaçorlu, M A; Cakiner, T; Saylan, T

    1991-01-01

    Leprosy is one of the leading causes of corneal hyposensitivity. In this article the corneal sensitivity of 143 leprosy patients was examined, and correlations between corneal hyposensitivity and anterior segment pathology were detected. Twenty four healthy volunteers were examined as controls. Various degrees of corneal loss of sensitivity were found in 46.2% of leprosy patients. Lagophthalmos, chronic lepromatous granulomatous uveitis, iris atrophy, and social blindness were found 4.5-16.6 ...

  2. High-resolution spectral domain anterior segment optical coherence tomography in type 1 boston keratoprosthesis

    OpenAIRE

    2013-01-01

    Purpose: To report the results of imaging using high-resolution, Fourier domain anterior segment optical coherence tomography (AS-OCT) to evaluate patients with a type 1 Boston Keratoprosthesis (KPro). Methods: We performed a retrospective comparative study of patients in whom we implanted the Boston KPro. A total of 26 eyes of 23 patients from the Cornea Service at the University of California Davis Eye Center were included. Subjects were evaluated with the Spectralis AS-OCT (Heidelberg Engi...

  3. Effect of Intracameral Lidocaine Anesthesia on the Anterior Segment of Rabbit Eyes

    Institute of Scientific and Technical Information of China (English)

    Hui Yang; Danying Zheng; Zhenping Zhang

    2002-01-01

    Purpose: To evaluate the effect of intracameral anesthesia on the anterior segment ofrabbit eyes using chinese-made lidocaine.Method: The study comprised eight eyes of four white rabbits which were divided intothree groups according to the concentration of the lidocaine given. They are 0.5%, 1%,2% lidocaine groups and balanced salt solution(BSS)control group. Each groupcontained two eyes.After 0.5 ml of the anesthetic agent was injected into the anteriorchamber and retainedthere for ten minutes, the rabbits were executed and the eye balls wereenucleated. Pathological examinations of the anterior segment, including cornea, iris andcilliary body, were carried out immediately.Result:The pathological study revealed no abnormal findings in lidocaine 0. 5% and 1%groups compared with the control group, where as in the lidocaine 2% group, muchabnormal pathological change was found, including the shrinkage of corneal endothelium,stroma edema of iris and cilliary body.Conclusion: Using intracameral anesthesia of high concentration of chinese-made lidocainewould run a risk of damaging the anterior segment of rabbit eye. But at the low concentrationusually usedin cataract surgery, no adverse effect was found.

  4. Risk Factors for the Development of Adjacent Segment Disease Following Anterior Cervical Arthrodesis

    Directory of Open Access Journals (Sweden)

    Ezgi Akar

    2015-06-01

    Full Text Available Aim: The aim of this study was to clinically and radiologically evaluate the efficacy of anterior cervical discectomy and fusion (ACDF in the treatment of adjacent level degeneration. Methods: We retrospectively evaluated 89 patients (55 females, 34 males who underwent ACDF. Adjacent segment degeneration findings were evaluated by investigating new osteophyte formation, growth of existing osteophytes, ossification of the anterior longitudinal ligament, presence of intervertebral disc space narrowing, sagittal alignment and range of motion (ROM using serial radiographs and magnetic resonance imaging. Results: The mean age of the 89 patients was 41.3 (24-76 years. The mean follow-up duration was 34.3 (12-64 months. Radiographic evidence of adjacent segment degeneration was observed in 12 patients (13.4%. Nine (75% patients had new complaints. Of the patients who had degenerative changes, 7 were (58% were male, 5 (42% were female; the mean age was 46 (30- 62 years. It was observed that the level of fusion and the number of fusion did not increase the adjacent segment degeneration. All of 12 patients were observed to have a non lordotic cervical spine and increased ROM. Conclusion: Development of degeneration at the level adjacent to region anterior cervical discectomy and fusion performed is higher compared to non-adjacent levels. The level of fusion and the number of fusion levels have no effect on the development of degeneration. (The Medical Bulletin of Haseki 2015; 53:120-3

  5. Coracoid syndrome: a neglected cause of anterior shoulder pain

    Science.gov (United States)

    GIGANTE, ANTONIO; BOTTEGONI, CARLO; BARBADORO, PAMELA

    2016-01-01

    Purpose the present prospective open-label study was designed to gain further insights into a condition thought to constitute a neglected but not uncommon syndrome characterized by anterior shoulder pain and tenderness to palpation over the apex of the coracoid process, not related to rotator cuff or pectoralis minor tendinopathy, long head of the biceps tendon disorders, or instability. The aim was to clarify its prevalence, clinical characteristics, differential diagnosis and response to corticosteroid injections. Methods patients with primary anterior shoulder pain precisely reproduced by deep pressure on the apex of the coracoid process were recruited. Patients with clinical or instrumental signs of other shoulder disorders were excluded. Patients were given an injection of triamcinolone acetonide 40 mg/ml 1 ml at the coracoid trigger point. They were evaluated after 15, 30 and 60 days and at 2 years using Equal Visual Analog Scale (EQ-VAS) and the Italian version of the Simple Shoulder Test (SST). Results between January 1 and December 31 2010, we treated 15 patients aged 26–66 years. The majority were women (86.67%). At 15 days, 6 (40%) patients reported complete resolution of their symptoms, while 9 (60%) complained of residual symptoms and received another injection. At 30 days, 14 (93.33%) patients were pain-free and very satisfied. At 2 years, the 14 patients who had been asymptomatic at 30 days reported that they had experienced no further pain or impaired shoulder function. The analysis of variance for repeated measures showed a significant effect of time on EQ-VAS and SST scores. Conclusions the present study documents the existence, and characteristics, of a “coracoid syndrome” characterized by anterior shoulder pain and tenderness to palpation over the apex of the coracoid process and showed that the pain is usually amenable to steroid treatment. This syndrome should be clearly distinguished from anterior shoulder pain due to other causes, in

  6. Anterior maxillary osteotomy: A technical note for superior repositioning: A bird wing segment

    Directory of Open Access Journals (Sweden)

    V Sadesh Kannan

    2014-01-01

    Full Text Available Aim: The aim of this study is to evaluate the efficacy of a single piece bird wing osteotectomy segment during anterior maxillary osteotomy (AMO markedly reduces the duration of the surgery by nearly one-half of the time during bone removal with the conventional method thereby reducing the kinking effect to the palatal pedicle and gives good perfusion to the anterior segment. Materials and Methods: This study was conducted at Karpaga Vinayaga Institute of Dental Sciences composing of 20 patients in which male: female ratio was 8:12, with a mean age of 25-30 years. This bird wing segment technique is performed following presurgical orthodontics under the guidance of clinical assessment of the gummy smile with an incisal show when the lip is at repose (vertical maxillary excess, especially for the calculated amount of superior repositioning. It is calculated by subtracting 2 mm from the total amount of an incisor show when the lip is at repose. The normal incisal show when the lip is at repose is 2 mm. After conventional primary AMO cut was performed, the precise calculated. Results: All our cases were tested positive for pulp vitality, no relapse, and minimal edema and with no changes in the bite or dentoalveolar relation followed until 1 year postoperatively indicating a good perfusion to the anterior segment and all the patients were satisfied esthetically and free of complaints. Conclusion: This simple technique allows the precise amount of calculated bone removal in a single piece from the nasal floor markedly reduces the duration of the surgery by nearly one-half of the time during bone removal with the conventional method there by reducing the kinking effect to the palatal pedicle and maintains good perfusion.

  7. The changes of inflammatory cytokines and their clinical significance in patients of inferior ST-segment elevation acute myocardial infarction with anterior ST-segment depression

    Institute of Scientific and Technical Information of China (English)

    叶明

    2014-01-01

    Objective To investigate the level of Hs-CRP,Fib,IL-6,TNF-α,MDA,SOD,and analyze the correlation between the level of plasma inflammatory cytokines and clinical significance in patients with anterior ST-segment depression.Methods We chose 360 patients with inferior ST Segment elavation acute myocardial infarction from May 2007 to Sep 2012 in emergency department of

  8. Computed tomography angiography and magnetic resonance imaging performance of acute segmental single compartment syndrome following an Achilles tendon repair: A case report and literature review

    Institute of Scientific and Technical Information of China (English)

    Li-Feng Jiang; Hang Li; Zeng-Feng Xin; Li-Dong Wu

    2016-01-01

    Acute compartment syndrome of the lower extremity is a serious postinjury complication that requires emergency treatment.Early diagnosis is of paramount importance for a good outcome.Four muscle compartments in the calf (anterior,lateral,deep posterior,and superficial posterior) may be individually or collectively affected.Acute segmental single-compartment syndrome is an extremely rare condition characterized by high pressure in a single compartment space with threatening of the segmental tissue viability.In this case report,we describe a young man with Achilles tendon rupture who complained of postoperative pain in the anterior tibial region.Emergent computed tomography angiography and magnetic resonance imaging revealed local muscle edema.Segmental anterior compartment syndrome was diagnosed and fasciotomy was performed.

  9. Stability of the anterior maxillary segment and teeth after segmental Le Fort I osteotomy and postoperative skeletal elastic fixation with or without occlusal splint

    OpenAIRE

    2015-01-01

    ABSTRACT Objectives To assess the short term dental and skeletal stability of the anterior maxillary segment after segmental Le Fort I osteotomy with postoperative skeletal elastic fixation with or without occlusal splint. Material and Methods 29 consecutive patients underwent segmental Le Fort I osteotomy and elastic skeletal fixation was applied. Patients were divided into two groups according to whether a fixed occlusal splint was used for six weeks (group A) or dismounted perioperatively ...

  10. Stability of the anterior maxillary segment and teeth after segmental le fort I osteotomy and postoperative skeletal elastic fixation with or without occlusal splint

    DEFF Research Database (Denmark)

    Blæhr, Tue Lindberg; Jensen, Thomas; Due, Karen Margrethe;

    2014-01-01

    OBJECTIVES: To assess the short term dental and skeletal stability of the anterior maxillary segment after segmental Le Fort I osteotomy with postoperative skeletal elastic fixation with or without occlusal splint. MATERIAL AND METHODS: 29 consecutive patients underwent segmental Le Fort I.......83 to 1.69°). There was no statistically significant difference in stability between the two groups at the P value 0.05. CONCLUSIONS: The skeletal anterior fixation with postoperative elastics for eight weeks may not compromise the early postoperative dental and skeletal stability of the anterior segment...... osteotomy and elastic skeletal fixation was applied. Patients were divided into two groups according to whether a fixed occlusal splint was used for six weeks (group A) or dismounted perioperatively (group B). Changes in landmarks and reference planes between the two timepoints were estimated on lateral...

  11. Deep Learning Guided Partitioned Shape Model for Anterior Visual Pathway Segmentation.

    Science.gov (United States)

    Mansoor, Awais; Cerrolaza, Juan J; Idrees, Rabia; Biggs, Elijah; Alsharid, Mohammad A; Avery, Robert A; Linguraru, Marius George

    2016-08-01

    Analysis of cranial nerve systems, such as the anterior visual pathway (AVP), from MRI sequences is challenging due to their thin long architecture, structural variations along the path, and low contrast with adjacent anatomic structures. Segmentation of a pathologic AVP (e.g., with low-grade gliomas) poses additional challenges. In this work, we propose a fully automated partitioned shape model segmentation mechanism for AVP steered by multiple MRI sequences and deep learning features. Employing deep learning feature representation, this framework presents a joint partitioned statistical shape model able to deal with healthy and pathological AVP. The deep learning assistance is particularly useful in the poor contrast regions, such as optic tracts and pathological areas. Our main contributions are: 1) a fast and robust shape localization method using conditional space deep learning, 2) a volumetric multiscale curvelet transform-based intensity normalization method for robust statistical model, and 3) optimally partitioned statistical shape and appearance models based on regional shape variations for greater local flexibility. Our method was evaluated on MRI sequences obtained from 165 pediatric subjects. A mean Dice similarity coefficient of 0.779 was obtained for the segmentation of the entire AVP (optic nerve only =0.791 ) using the leave-one-out validation. Results demonstrated that the proposed localized shape and sparse appearance-based learning approach significantly outperforms current state-of-the-art segmentation approaches and is as robust as the manual segmentation.

  12. PROTEUS SYNDROME - SEGMENTAL OVERGROWTH WITH MULTIPLE NEVI

    Directory of Open Access Journals (Sweden)

    Ramasamy

    2015-01-01

    Full Text Available Proteus syndrome is a rare hamartomatous disorder characterized by various cutaneous and subcutaneous lesions , including vascular malformations , lipomas , hyperpigmentation , and several types of nevi. Partial gigantism with limb or digital overgrowth is pathognomonic of Proteus syndrome. We report a case of proteus syndrome in a 45 year old man , who presented with hypertrophy of index finger of both hands and middle , ring fing er of left hand , verrucous lesions over left axilla and two firm swellings over left palm for the past 15 years. Clinical findings , histopathology and imaging studies fulfilled the criteria of proteus syndrome which is rarely reported in literature.

  13. Bilateral Anterior Opercular Syndrome With Partial Kluver-Bucy Syndrome in a Stroke Patient: A Case Report.

    Science.gov (United States)

    Cho, Ah-Ra; Lim, Young-Ho; Chung, Sae-Hoon; Choi, Eun-Hi; Lim, Jong Youb

    2016-06-01

    Bilateral anterior opercular syndrome and partial Kluver-Bucy syndrome are associated with bilateral middle cerebral artery lesions. The combination of these two syndromes has only been reported in a child with limbic encephalitis. In this case, a 44-year-old woman with bilateral middle cerebral artery infarction, which occurred 2 years prior, could walk independently. However, she showed automatic-voluntary dissociation and anarthria with preserved writing skills. She also presented hypersexuality, hypermetamorphosis, and memory disturbances. Here, we report a case of an adult stroke patient who suffered from bilateral anterior opercular syndrome accompanied by partial Kluver-Bucy syndrome.

  14. Bilateral Anterior Opercular Syndrome With Partial Kluver–Bucy Syndrome in a Stroke Patient: A Case Report

    Science.gov (United States)

    2016-01-01

    Bilateral anterior opercular syndrome and partial Kluver–Bucy syndrome are associated with bilateral middle cerebral artery lesions. The combination of these two syndromes has only been reported in a child with limbic encephalitis. In this case, a 44-year-old woman with bilateral middle cerebral artery infarction, which occurred 2 years prior, could walk independently. However, she showed automatic-voluntary dissociation and anarthria with preserved writing skills. She also presented hypersexuality, hypermetamorphosis, and memory disturbances. Here, we report a case of an adult stroke patient who suffered from bilateral anterior opercular syndrome accompanied by partial Kluver–Bucy syndrome. PMID:27446793

  15. Corneal sensitivity and correlations between decreased sensitivity and anterior segment pathology in ocular leprosy.

    Science.gov (United States)

    Karaçorlu, M A; Cakiner, T; Saylan, T

    1991-02-01

    Leprosy is one of the leading causes of corneal hyposensitivity. In this article the corneal sensitivity of 143 leprosy patients was examined, and correlations between corneal hyposensitivity and anterior segment pathology were detected. Twenty four healthy volunteers were examined as controls. Various degrees of corneal loss of sensitivity were found in 46.2% of leprosy patients. Lagophthalmos, chronic lepromatous granulomatous uveitis, iris atrophy, and social blindness were found 4.5-16.6 times more frequently in eyes which developed severe corneal hyposensitivity.

  16. Adjustable muscle plication: a new surgical technique for strabismic patients with high risk for anterior segment ischemia

    Institute of Scientific and Technical Information of China (English)

    Carlos; Laria; David; P.Pi?ero

    2015-01-01

    <正>INTRODUCTION Anterior ciliary arteries provide 70%of the vascular supply of the anterior segment.A significant interruption of the vascular flow of these arteries increases the risk for anterior ischemia.Although the frequency of this special condition is low after strabismus surgery(1:13 000)[1],its effects may involve substantial visual problems[2].We report the successful outcome of a new surgical approach for strabismus management in a case of high risk for anterior ischemia.Specifically,we show the correction of the horizontal ocular deviation by means of an adjustable muscle

  17. Visualization of Tear Clearance Using Anterior Segment Optical Coherence Tomography and Polymethylmethacrylate Particles.

    Science.gov (United States)

    Zheng, Xiaodong; Yamaguchi, Masahiko; Kamao, Tomoyuki; Sakane, Yuri; Goto, Tomoko; Shiraishi, Atsushi; Ohashi, Yuichi

    2016-11-01

    We previously reported 2 new methods, anterior segment optical coherence tomography (AS-OCT) and polymethylmethacrylate particles suspended in fluorescein solution (PPF), for the evaluation of tear clearance and rapid tear flow after blinking (tear Krehbiel flow). Here, we investigated age-related OCT tear clearance and tear film thickness (TFT) and the potential correlation of OCT tear clearance and PPF velocity indicative of tear Krehbiel flow. Normal subjects separated into young and older groups received 5 μL of saline solution into the lower conjunctival sac, and an image of the central lower eyelid tear meniscus was captured by AS-OCT immediately and 30 seconds after natural blinking. Tear meniscus height (TMH) and tear meniscus area (TMA) were measured, and their percentage decrease was defined as OCT clearance rate. A Spectralis OCT Anterior Segment Module captured the central corneal tear film layer for TFT measurements. OCT clearance rates were significantly higher in young versus older subjects (P = 0.0002). When all subjects were analyzed, age was significantly and negatively correlated with TMH clearance rate (r = -0.4928, P = 0.0003) and TMA clearance rate (r = -0.4596, P = 0.0008). TFT values were significantly and negatively correlated with age (r = -0.6662, P clearance rates and PPF velocity (TMH rate: r = 0.2926, P = 0.0392; TMA rate: r = 0.3274, P = 0.0205). AS-OCT and PPF might be novel techniques for quantitative evaluation of tear clearance and Krehbiel flow.

  18. Ultraviolet absorption by contact lenses and the significance on the ocular anterior segment.

    Science.gov (United States)

    Chandler, Heather

    2011-07-01

    It is well established that both acute and chronic ultraviolet (UV) exposure can lead to various ophthalmic pathologic conditions in the anterior segment. Several scientific studies have demonstrated that after UV exposure, the unprotected cornea is vulnerable to damage in the epithelial, stromal, and endothelial cellular layers. DNA damage, apoptosis, and altered protease expression are all examples of harmful changes that can occur within the cornea after irradiation. Beyond the cornea, damage associated with UV exposure, such as decreased antioxidant levels and increased reactive oxygen species production, has been noted in the aqueous humor and crystalline lens. Ultraviolet-blocking contact lenses have the potential to provide protection against such exposure to harmful UV radiation. Experimental use of UV-absorbing contact lenses prevented detrimental cellular changes to the cornea and maintained corneal clarity after UV exposure. Additionally, studies suggest that shielding the aqueous humor and crystalline lens from irradiation with UV-absorbing contact lenses aids in protection against precataractous changes. Despite ongoing research, to date, neither chronic nor clinical studies have been performed in humans to demonstrate that wearing UV-blocking contact lenses reduces the risk of developing cataracts or other ocular disorders within the anterior segment. This article will discuss the impact of UV exposure on ocular tissue and the need for adequate UV protection, with particular emphasis on UV-blocking contact lenses.

  19. Observation of posterior corneal vesicles with in vivo confocal microscopy and anterior segment OCT

    Directory of Open Access Journals (Sweden)

    Ryou Watanabe

    2010-10-01

    Full Text Available Ryou Watanabe, Toru Nakazawa, Nobuo FuseDepartment of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, JapanAbstract: The histopathology of posterior corneal vesicles (PCV has not yet been revealed. A 15-year-old girl, who was diagnosed by slit-lamp microscopy as PCV, was examined using specular microscopy, in vivo confocal microscopy, and anterior segment OCT (optical coherence tomography. Anterior segment OCT showed that the thickness of both corneas was within normal limits. At the same time, in vivo confocal microscopy revealed endothelial cells in the rounded dark areas, acellular hyporeflective layers on the Descemet’s membrane, and hyperreflective linear lesions. These findings were not reported previously by slit-lamp and specular microscopy. The abnormal findings only existed at the Descemet’s membrane and corneal endothelial layer. Previous reports dealing with posterior polymorphous dystrophy (PPMD examined using in vivo confocal microscopy reported almost the same findings, suggesting that PCV and PPMD may be the same at the microstructural level.Keywords: cornea, Descemet’s membrane, imaging

  20. In Vivo Confocal Microscopy and Anterior Segment Optic Coherence Tomography Findings in Ocular Ochronosis

    Directory of Open Access Journals (Sweden)

    Elif Demirkilinc Biler

    2015-01-01

    Full Text Available Purpose. To report clinical and in vivo confocal microscopy (IVCM findings of two patients with ocular ochronosis secondary due to alkaptonuria. Materials and Methods. Complete ophthalmologic examinations, including IVCM (HRT II/Rostock Cornea Module, Heidelberg, Germany, anterior segment optical coherence tomography (AS-OCT (Topcon 3D spectral-domain OCT 2000, Topcon Medical Systems, Paramus, NJ, USA, corneal topography (Pentacam, OCULUS Optikgeräte GmbH, Wetzlar, Germany, and anterior segment photography, were performed. Results. Biomicroscopic examination showed bilateral darkly pigmented lesions of the nasal and temporal conjunctiva and episclera in both patients. In vivo confocal microscopy of the lesions revealed prominent degenerative changes, including vacuoles and fragmentation of collagen fibers in the affected conjunctival lamina propria and episclera. Hyperreflective pigment granules in different shapes were demonstrated in the substantia propria beneath the basement membrane. AS-OCT of Case 1 demonstrated hyporeflective areas. Fundus examination was within normal limits in both patients, except tilted optic discs with peripapillary atrophy in one of the patients. Corneal topography, thickness, and macular OCT were normal bilaterally in both cases. Conclusion. The degenerative and anatomic changes due to ochronotic pigment deposition in alkaptonuria can be demonstrated in detail with IVCM and AS-OCT. Confocal microscopic analysis in ocular ochronosis may serve as a useful adjunct in diagnosis and monitoring of the disease progression.

  1. Reproducibility of Scleral Spur Identification and Angle Measurements Using Fourier Domain Anterior Segment Optical Coherence Tomography

    Directory of Open Access Journals (Sweden)

    Ricardo J. Cumba

    2012-01-01

    Full Text Available Purpose. To evaluate intraobserver and interobserver agreement in locating the scleral spur landmark (SSL and anterior chamber angle measurements obtained using Fourier Domain Anterior Segment Optical Coherence Tomography (ASOCT images. Methods. Two independent, masked observers (SR and AZC identified SSLs on ASOCT images from 31 eyes with open and nonopen angles. A third independent reader, NPB, adjudicated SSL placement if identifications differed by more than 80 μm. Nine months later, SR reidentified SSLs. Intraobserver and interobserver agreement in SSL placement, trabecular-iris space area (TISA750, and angle opening distance (AOD750 were calculated. Results. In 84% of quadrants, SR’s SSL placements during 2 sessions were within 80 μm in both the X- and Y-axes, and in 77% of quadrants, SR and AZC were within 80 μm in both axes. In adjudicated images, 90% of all quadrants were within 80 μm, 88% in nonopen-angle eyes, and 92% in open-angle eyes. The intraobserver and interobserver correlation coefficients (with and without adjudication were above 0.9 for TISA750 and AOD750 for all quadrants. Conclusions. Reproducible identification of the SSL from images obtained with FD-ASOCT is possible. The ability to identify the SSL allows reproducible measurement of the anterior chamber angle using TISA750 and AOD750.

  2. Comparison of anterior segment parameters with pentacam according to age in emmetropic eyes

    Directory of Open Access Journals (Sweden)

    Yasin Çınar

    2013-12-01

    Full Text Available Objective: It was aimed to compare anterior segment parametersobtained by rotating Scheimpflug camera systemaccording to age groups.Methods: 290 eyes of 145 emmetropic subjects wereincluded in the study. Subjects were divided in threeage groups. Group 1 comprised the subjects age up to20 years, Group 2 comprised the subjects age between21 and 40 and Group 3 comprised the subjects between41 years and older. In all subjects, flat keratometry (K1,steep keratometry (K2, mean corneal power (Km,maximum keratometry (Kmax, central corneal thickness(CCT, apex corneal thickness (ACT, thinnest cornealthickness (TCT, anterior chamber volume (ACV and anteriorchamber depth (ACD were obtained by using rotatingScheimpflug camera system. To eliminate operatordependent variables, automatic release mode was used.All measurements were obtained by the same examiner.Results: The study included 72 female and 73 male subjects.The mean age of the subjects was 31.37±12.29years (range, 8-65. There were no significant differencesin keratometric values between age groups. Therewas significant difference between Groups 1 and 3 andGroups 2 and 3 in the mean CCT, ACT and TCT (p<0.05.There was significant difference between the groups inthe mean ACD and ACV. There significant positive correlationbetween age and CCT (r=0.181, p=0.001, ACT(r=0.161, p=0.006 and TCT (r=0.16, p=0.006. Therewere significant negative correlations between age andACD (r=-0.376, p<0.001 and ACV (r=-0.367, p<0.001.Conclusion: In the emmetropic eyes, significant reductionwas found in ACD and ACV, while there was significantincrease in CCT, ACT and TCT by age.Key words: Corneal topography, anterior segment, emetropic eyes, pentacam

  3. Segmental rigidity and spinal myoclonus as a paraneoplastic syndrome.

    OpenAIRE

    Roobol, T H; Kazzaz, B. A.; Vecht, C. J.

    1987-01-01

    A 68 year old woman is described with persisting muscular rigidity of the left lower leg together with transient myoclonic jerking in the left quadriceps muscle. Six weeks after onset a small cell carcinoma of the lung became manifest. With radiotherapy and chemotherapy complete remission was achieved. Segmental muscular spasm improved at the same time. Necropsy revealed loss and degeneration of alpha-motor neuron cells at one side of the anterior horn of the lumbar enlargement. This case may...

  4. Changes in intraocular pressure and anterior segment morphometry after uneventful phacoemulsification cataract surgery.

    LENUS (Irish Health Repository)

    Dooley, I

    2012-02-01

    PURPOSE: To study changes in anterior segment morphometry after uneventful phacoemulsification cataract surgery, and to investigate whether there is a relationship between any observed changes and intraocular pressure (IOP) reduction after the procedure. METHODS: The anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), central corneal thickness (CCT), and IOP were measured in 101 non-glaucomatous eyes before and after uneventful phacoemulsification cataract surgery. RESULTS: After cataract surgery, the mean ACD, ACV, and ACA values increased by 1.08 mm, 54.4 mm(3), and 13.1 degrees , respectively, and the mean IOP (corrected for CCT) decreased by 3.2 mm Hg. The predictive value of a previously described index (preoperative ACD\\/preoperative IOP (corrected for CCT) or CPD ratio) for IOP (corrected for CCT) reduction after cataract surgery was confirmed, reflected in an r(2) value of 23.3% between these two parameters (P<0.001). Other indices predictive of IOP reduction after cataract surgery were also identified, including preoperative IOP\\/preoperative ACV and preoperative IOP\\/preoperative ACA, reflected in r(2) values of 13.7 and 13.7%, respectively (P<0.001 and P<0.001, respectively). CONCLUSIONS: Our study confirms the predictive value of the CPD ratio for IOP reduction after cataract surgery, and may contribute to the decision-making process in patients with glaucoma or ocular hypertension. Furthermore, two novel indices of preoperative parameters that are predictive for IOP reduction after cataract surgery were identified, and enhance our understanding of the mechanisms underlying IOP changes after this procedure.

  5. Segmental colitis associated with diverticulosis syndrome

    Institute of Scientific and Technical Information of China (English)

    Hugh James Freeman

    2008-01-01

    An inflammatory process that involves the sigmoid colonic segment associated with diverticular disease (SCAD) appears to be a distinct clinical and pathological disorder. It has been described in older adults, often presenting with rectal bleeding. Host of the patients seem to respond to treatment only with a 5-aminosalicylate, but some spontaneously resolve with no treatment. Endoscopic evaluation usually shows a non-specific inflammatory process localized in the sigmoid colon alone that may resolve completely with histologically normal colonic mucosa. Repeated symptomatic events with discrete episodes of segmental colitis may occur, but most patients have an entirely benign clinical course. Definition of the underlying molecular events that occur with SCAD may be critically important in understanding the critical elements present in a colonic inflammatory process that can completely resolve without pharmacological or biological treatment.

  6. Slowly progressive anarthria with late anterior opercular syndrome: a variant form of frontal cortical atrophy syndromes.

    Science.gov (United States)

    Broussolle, E; Bakchine, S; Tommasi, M; Laurent, B; Bazin, B; Cinotti, L; Cohen, L; Chazot, G

    1996-12-01

    We describe eight patients with slowly progressive speech production deficit combining speech apraxia, dysarthria, dysprosody and orofacial apraxia, and initially no other deficit in other language and non-language neuropsychological domains. Long-term follow-up (6-10 years) in 4 cases showed an evolution to muteness, bilateral suprabulbar paresis with automatic-voluntary dissociation and frontal lobe cognitive slowing without generalised intellectual deterioration. Most disabled patients presented with an anterior opercular syndrome (Foix-Chavany-Marie syndrome), and pyramidal or extrapyramidal signs. CT and MRI findings disclosed asymmetric (left > right) progressive cortical atrophy of the frontal lobes predominating in the posterior inferior frontal region, notably the operculum. SPECT and PET revealed a decreased cerebral blood flow and metabolism, prominent in the left posterior-inferior frontal gyrus and premotor cortex, extending bilaterally in the most advanced cases. Pathological study of two cases showed non-specific neuronal loss, gliosis, and spongiosis of superficial cortical layers, mainly confined to the frontal lobes, with no significant abnormalities in the basal ganglia, thalamus, cerebellum, brain stem (except severe neuronal loss in the substantia nigra in one case), and spinal cord. We propose to call this peculiar syndrome Slowly Progressive Anarthria (SPA), based on its specific clinical presentation, and its metabolic and pathological correlates. SPA represents another clinical expression of focal cortical degeneration syndromes, that may overlap with other similar syndromes, specially primary progressive aphasia and the various frontal lobe dementias.

  7. [Drug delivery systems to target the anterior segment of the eye: fundamental bases and clinical applications].

    Science.gov (United States)

    Behar-Cohen, F

    2002-05-01

    The development of new drug delivery systems to target the anterior segment of the eye may offer many advantages: to increase the biodisponibility of the drug, to allow the penetration of drug that cannot be formulated as solutions, to obtain constant and sustained drug release, to achieve higher local concentrations without systemic effects, to target more specifically one tissue or cell type, to reduce the frequency of instillation and therefore increase the observance and comfort of the patient while reducing side effects of frequent instillation. Several approaches are developed, aiming to increase the corneal contact time by modified formulation or reservoir systems, or by increasing the tissue permeability using iontophoresis. To date, no ocular drug delivery system is ideal for all purposes. To maximize treatment efficacy, careful evaluation of the specific pathological condition, the targeted Intraocular tissue and the location of the most severe pathology must be made before selecting the method of delivery most suitable for each individual patient.

  8. Role of anterior segment optical coherence tomogram in Descemet′s membrane detachment

    Directory of Open Access Journals (Sweden)

    Sonia Kothari

    2011-01-01

    Full Text Available Descemet′s membrane detachment (DD is a rare but serious complication of intraocular surgery. In rare cases where corneal edema is severe and we may not be able to visualize DD on slit-lamp examination, anterior segment optical coherence tomogram (AS-OCT would be helpful. We describe two patients with DD, highlighting the role of AS-OCT in early diagnosis and management of patients with DD. One of the patients had DD with rolled in edge, which could only be visualized with AS-OCT. In such a situation, AS-OCT can identify the edge of detachment and show the exact position of the rolled edge, which can allow us to plan the surgical strategy to unroll the DD.

  9. Anterior segment changes following intravitreal bevacizumab injection for treatment of neovascular glaucoma

    Directory of Open Access Journals (Sweden)

    Canut MI

    2011-05-01

    Full Text Available MI Canut1, A Alvarez2, J Nadal3, R Abreu4, JA Abreu5, JS Pulido61Glaucoma Section, 2Barraquer Ophthalmology Centre, 3Retina and Vitreous Unit, Macula Section, Institut Universitari Barraquer, Universidad Autonoma de Barcelona, Barcelona, Spain; 4Retina and Vitreous Unit, University Hospital of La Candelaria, Tenerife 5Glaucoma Section, University Hospital of the Canary Islands, Tenerife, Spain; 6Retina and Vitreous Unit, Ophthalmology Department, Mayo Clinic, Rochester, MN, USABackground: The purpose of this study was to describe anterior segment changes in a prospective, interventional, noncomparative case series of patients with neovascular glaucoma secondary to proliferative diabetic retinopathy treated with intravitreal bevacizumab.Methods: Five consecutive patients with neovascular glaucoma and a refractory, symptomatic elevation of intraocular pressure and pronounced anterior segment congestion received intravitreal bevacizumab 1.25 mg/0.05 mL. Follow-up examinations were performed at 4–16 weeks by the same specialists, with testing performed at hour 48, week 1, and months 1, 3, and 6 after intravitreal bevacizumab.Results: We observed a significant difference (P = 0.021 between initial and mean neovascularization at three months in all the quadrants. At three months, median intraocular pressure was 19 ± 5.38 (range 12–26 mmHg. In three of the five cases, diode laser cyclophotocoagulation was required, and in one case a trabeculectomy was performed. One patient showed complete synechial angle closure 48 hours after treatment which required cyclodestructive procedures to normalize intraocular pressure.Conclusion: Intravitreal bevacizumab achieves complete regression of neovascularization in neovascular glaucoma secondary to proliferative diabetic retinopathy, and this regression is stable when associated with treatment of the underlying disease and should be investigated more thoroughly as an adjunct in the management of neovascular

  10. Agreement between Gonioscopic Examination and Swept Source Fourier Domain Anterior Segment Optical Coherence Tomography Imaging

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    Mohammed Rigi

    2016-01-01

    Full Text Available Purpose. To evaluate interobserver, intervisit, and interinstrument agreements for gonioscopy and Fourier domain anterior segment optical coherence tomography (FD ASOCT for classifying open and narrow angle eyes. Methods. Eighty-six eyes with open or narrow anterior chamber angles were included. The superior angle was classified open or narrow by 2 of 5 glaucoma specialists using gonioscopy and imaged by FD ASOCT in the dark. The superior angle of each FD ASOCT image was graded as open or narrow by 2 masked readers. The same procedures were repeated within 6 months. Kappas for interobserver and intervisit agreements for each instrument and interinstrument agreements were calculated. Results. The mean age was 50.9 (±18.4 years. Interobserver agreements were moderate to good for both gonioscopy (0.57 and 0.69 and FD ASOCT (0.58 and 0.75. Intervisit agreements were moderate to excellent for both gonioscopy (0.53 to 0.86 and FD ASOCT (0.57 and 0.85. Interinstrument agreements were fair to good (0.34 to 0.63, with FD ASOCT classifying more angles as narrow than gonioscopy. Conclusions. Both gonioscopy and FD ASOCT examiners were internally consistent with similar interobserver and intervisit agreements for angle classification. Agreement between instruments was fair to good, with FD ASOCT classifying more angles as narrow than gonioscopy.

  11. Prevalence of Corneal Astigmatism and Anterior Segmental Biometry Characteristics Before Surgery in Chinese Congenital Cataract Patients.

    Science.gov (United States)

    Lin, Duoru; Chen, Jingjing; Liu, Zhenzhen; Wu, Xiaohang; Long, Erping; Luo, Lixia; Lin, Zhuoling; Li, Xiaoyan; Zhang, Li; Chen, Hui; Liu, Jinchao; Chen, Weirong; Lin, Haotian; Liu, Yizhi

    2016-02-25

    The prevalence and the distribution characteristics of corneal astigmatism (CA) and anterior segment biometry before surgery in Chinese congenital cataract (CC) patients are not completely understood. This study involved 400 CC patients from the Zhongshan Ophthalmic Center enrolled from February 2011 to August 2015. Data on CA, keratometry, central corneal thickness (CCT) and anterior chamber depth (ACD) were measured by the Pentacam Scheimpflug System. The mean age of patients was 54.27 months, and the ratio of boys to girls was 1.53:1. The mean CA was 2.03 diopters (D), and 39.25% of subjects had CA values ≥2 D. The most frequent (71.8%) diagnosis was with-the-rule astigmatism. Oblique astigmatism was present in 16.2% of cases, and 12% of cases had against-the-rule astigmatism. The mean keratometry measurement of cataractous eyes in bilateral patients was significantly larger than that in unilateral patients. Girls had a larger mean keratometry but a thinner CCT than did boys. The CA, CCT, and ACD of cataractous eyes were significantly larger than those of non-cataractous eyes in unilateral patients. The CA, mean keratometry, CCT, and ACD in CC patients varied with age, gender, and laterality. Fully understanding these characteristics may help inform guidelines and treatment decisions in CC patients.

  12. Evaluation of Descemet’s Membrane Detachment Using Anterior Segment Optical Coherence Tomography

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    Halil Hüseyin Çağatay

    2014-10-01

    Full Text Available We report the use of anterior segment optical coherence tomography (ASOCT in Descemet’s membrane detachment (DMD. A patient who developed DMD after uneventful cataract surgery with posterior chamber lens implantation is presented in this case report. At the follow-up examination after cataract surgery, slit-lamp evaluation showed stromal striae, but it was impossible to diagnose the DMD due to the corneal edema. ASOCT imaging of the cornea revealed a DMD, and the patient underwent intracameral air injection to the anterior chamber through the site which was identified as intact by ASOCT. Follow-up ASOCT imaging revealed the reattachment of the Descemet’s membrane and reduced corneal thickness. If DMD is suspected in any cases, ASOCT can be useful to document and follow the postsurgical detachment of DMD and also to determine the site, configuration, and extent of the DMD, thus guiding the treatment method and monitoring the treatment outcome. (Turk J Ophthalmol 2014; 44: 407-9

  13. Coincidence of Varicella-Zoster Virus Anterior Uveitis in a Patient with Chandler's Syndrome

    Directory of Open Access Journals (Sweden)

    Takeshi Joko

    2013-11-01

    Full Text Available Purpose: We report a patient who, based on the clinical manifestations, was originally diagnosed as having Chandler's syndrome and later developed varicella-zoster virus (VZV DNA-positive anterior uveitis. Methods: The patient with Chandler's syndrome who manifested anterior uveitis underwent a complete ophthalmologic examination. Polymerase chain reaction (PCR was used to amplify the viral DNA in the aqueous humor to determine the cause of the intraocular inflammation. Results: Slit-lamp biomicroscopy showed focal iris atrophy and peripheral anterior synechiae (PAS; specular microscopy of the corneal endothelium disclosed the hammered-silver appearance. Based on these clinical findings, we diagnosed this patient as having Chandler's syndrome. During the follow-up period, however, the inflammatory cells suddenly appeared in the anterior chamber with formation of keratic precipitates and an increased intraocular pressure (IOP. VZV DNA was displayed in the aqueous humor by PCR. Based upon the diagnosis of VZV anterior uveitis, corticosteroids and acyclovir were given topically and systemically. The inflammation subsided with these medications; however, trabeculectomy was finally needed to control the IOP due to PAS progression. Conclusion: The coincidence of VZV anterior uveitis with Chandler's syndrome may constitute an implication for the possible viral etiology of iridocorneal endothelial syndrome.

  14. Right anterior segmental hepatic duct emptying directly into the cystic duct in a living donor.

    Science.gov (United States)

    Ishiguro, Yasunao; Hyodo, Masanobu; Fujiwara, Takehito; Sakuma, Yasunaru; Hojo, Nobuyuki; Mizuta, Koichi; Kawarasaki, Hideo; Lefor, Alan T; Yasuda, Yoshikazu

    2010-08-07

    A 35-year-old mother was scheduled to be the living donor for liver transplantation to her second son, who suffered from biliary atresia complicated with biliary cirrhosis at the age of 2 years. The operative plan was to recover the left lateral segment of the mother's liver for living donor transplantation. With the use of cholangiography at the time of surgery, we found the right anterior segmental duct (RASD) emptying directly into the cystic duct, and the catheter passed into the RASD. After repairing the incision in the cystic duct, transplantation was successfully performed. Her postoperative course was uneventful. Biliary anatomical variations were frequently encountered, however, this variation has very rarely been reported. If the RASD was divided, the repair would be very difficult because the duct will not dilate sufficiently in an otherwise healthy donor. Meticulous preoperative evaluation of the living donor's biliary anatomy, especially using magnetic resonance cholangiography and careful intraoperative techniques, is important to prevent bile duct injury and avoid the risk to the healthy donor.

  15. Bilateral Anterior Opercular Syndrome With Partial Kluver–Bucy Syndrome in a Stroke Patient: A Case Report

    OpenAIRE

    Cho, Ah-Ra; Lim, Young-Ho; Chung, Sae-Hoon; Choi, Eun-Hi; Lim, Jong Youb

    2016-01-01

    Bilateral anterior opercular syndrome and partial Kluver–Bucy syndrome are associated with bilateral middle cerebral artery lesions. The combination of these two syndromes has only been reported in a child with limbic encephalitis. In this case, a 44-year-old woman with bilateral middle cerebral artery infarction, which occurred 2 years prior, could walk independently. However, she showed automatic-voluntary dissociation and anarthria with preserved writing skills. She also presented hypersex...

  16. Evaluation of Anterior Segment Parameter Changes Using the Sirius after Uneventful Phacoemulsification

    Science.gov (United States)

    Şimşek, Ali; Çapkın, Musa; Bilak, Şemsettin; Güler, Mete; Reyhan, Ali Hakim

    2016-01-01

    noncontact, noninvasive, and comfortable system for patients that is highly reliable and repeatable for anterior segment measurements. PMID:27478351

  17. Evaluation of Changes in Anterior Segment Configuration by Ultrasound Biomicroscopy after Phacoemulsification and Foldable Intraocular Lens Implantation

    Directory of Open Access Journals (Sweden)

    ilhami Salcan

    2011-08-01

    Full Text Available Purpose: To quantify the configuration changes in anterior segment structures after cataract extraction using ultrasound biomicroscopy (UBM. Material and Method: 33 eyes of 33 patients (21 male, 12 female; mean age: 69.0±8.3 years with senile or presenile cataracts undergoing cataract surgery were prospectively studied. UBM was performed for each patient before and 1 month after surgery. At each UBM examination, axial images of the anterior chamber and radial sections of the angle in four quadrants were obtained. The measurements were performed by using the calipers included in the equipment software and UBM Pro2000® software. Results: After cataract surgery, we determined statistically significant increases in anterior chamber depth and angle parameters (p=0.001. We found that the postoperative increases in anterior chamber depth, angle recess area, angle opening distance 250 and angle opening distance 500 were 1.3, 1.4, 1.7 and 1.5 times, respectively, when compared with the preoperative levels. Decreases in acceleration and increases in y-intercept were determined in 4 quadrants postoperatively by of linear regression analysis of anterior chamber angle and these were also statistically significant (p=0.001. Discussion: UBM gives both qualitative and quantitative valuable information about anterior segment structures. We think that UBM may be a useful tool for evaluation of patients with cataract and occludable and/or narrow angles undergoing cataract surgery for therapeutic purpose. (Turk J Ophthalmol 2011; 41: 200-6

  18. Stability of the Anterior Maxillary Segment and Teeth after Segmental Le Fort I Osteotomy and Postoperative Skeletal Elastic Fixation With or Without Occlusal Splint

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    Tue Lindberg

    2014-10-01

    Full Text Available Objectives: To assess the short term dental and skeletal stability of the anterior maxillary segment after segmental Le Fort I osteotomy with postoperative skeletal elastic fixation with or without occlusal splint. Material and Methods: 29 consecutive patients underwent segmental Le Fort I osteotomy and elastic skeletal fixation was applied. Patients were divided into two groups according to whether a fixed occlusal splint was used for six weeks (group A or dismounted perioperatively (group B. Changes in landmarks and reference planes between the two timepoints were estimated on lateral cephalometric radiographs. Results: Group A: The upper incisor had a mean intrusion of -0.56 mm (SD 0.77; range -2.04 to 1.08 mm and a mean posterior movement of -0.93 mm (SD 1.03; range -2.52 to 0.96 mm. The mean change in the axial inclination of the upper incisor was -0.33° (SD 2.56; range -6° to 4° (95% CI: -1.75 to 1.08°. Group B: The upper incisor had a mean intrusion of -0.13 mm (SD 1.36; range -1.92 to 3.6 mm and a mean anterior movement of 0.11 mm (SD 1.78; range -2.88 to 3.84 mm. The mean change in the axial inclination of the upper incisor was -0.07° (SD 3.05; range -5° to 5° (95% CI: -1.83 to 1.69°. There was no statistically significant difference in stability between the two groups at the P value 0.05. Conclusions: The skeletal anterior fixation with postoperative elastics for eight weeks may not compromise the early postoperative dental and skeletal stability of the anterior segment in segmental Le Fort I osteotomy.

  19. Failure of cervical arthroplasty in a patient with adjacent segment disease associated with Klippel-Feil syndrome

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    Ioannis D Papanastassiou

    2011-01-01

    Full Text Available Cervical arthroplasty may be justified in patients with Klippel-Feil syndrome (KFS in order to preserve cervical motion. The aim of this paper is to report an arthroplasty failure in a patient with KFS. A 36-year-old woman with KFS underwent two-level arthroplasty for adjacent segment disc degeneration. Anterior migration of the cranial prosthesis was encountered 5 months postoperatively and was successfully revised with anterior cervical fusion. Cervical arthroplasty in an extensively stiff and fused neck is challenging and may lead to catastrophic failure. Although motion preservation is desirable in KFS, the special biomechanical features may hinder arthroplasty. Fusion or hybrid constructs may represent more reasonable options, especially when multiple fused segments are present.

  20. Measurement of Scleral Thickness in Humans Using Anterior Segment Optical Coherent Tomography.

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    Hetal D Buckhurst

    Full Text Available Anterior segment optical coherent tomography (AS-OCT, Visante; Zeiss is used to examine meridional variation in anterior scleral thickness (AST and its association with refractive error, ethnicity and gender. Scleral cross-sections of 74 individuals (28 males; 46 females; aged between 18-40 years (27.7±5.3 were sampled twice in random order in 8 meridians: [superior (S, inferior (I, nasal (N, temporal (T, superior-temporal (ST, superior-nasal (SN, inferior-temporal (IT and inferior-nasal (IN]. AST was measured in 1mm anterior-to-posterior increments (designated the A-P distance from the scleral spur (SS over a 6mm distance. Axial length and refractive error were measured with a Zeiss IOLMaster biometer and an open-view binocular Shin-Nippon autorefractor. Intra- and inter-observer variability of AST was assessed for each of the 8 meridians. Mixed repeated measures ANOVAs tested meridional and A-P distance differences in AST with refractive error, gender and ethnicity. Only right eye data were analysed. AST (mean±SD across all meridians and A-P distances was 725±46 μm. Meridian SN was the thinnest (662±57 μm and I the thickest (806±60 μm. Significant differences were found between all meridians (p<0.001, except S:ST, IT:IN, IT:N and IN:N. Significant differences between A-P distances were found except between SS and 6 mm and between 2 and 4 mm. AST measurements at 1mm (682±48 μm were the thinnest and at 6mm (818±49 μm the thickest (p<0.001; a significant interaction occurred between meridians and A-P distances (p<0.001. AST was significantly greater (p<0.001 in male subjects but no significant differences were found between refractive error or ethnicity. Significant variations in AST occur with regard to meridian and distance from the SS and may have utility in selecting optimum sites for pharmaceutical or surgical intervention.

  1. Massage Therapy Protocol for Post–Anterior Cruciate Ligament Reconstruction Patellofemoral Pain Syndrome: A Case Report

    OpenAIRE

    2008-01-01

    Background: The intent of the present study was to determine the effectiveness of massage therapy in the rehabilitation of post–anterior cruciate ligament reconstruction patellofemoral pain syndrome. The primary complications following surgical repair of the anterior cruciate ligament—classified as patellofemoral pain syndrome—are hamstring flexion contracture and quadriceps weakness, leading to patellofemoral dysfunction and retropatellar pain. Methods: Treatment included lymphatic drainage,...

  2. Atypical presentation of popliteal artery entrapment syndrome: involvement of the anterior tibial artery.

    Science.gov (United States)

    Bou, Steven; Day, Carly

    2014-11-01

    Popliteal artery entrapment syndrome (PAES) is a rare condition that should be suspected in a young patient with exertional lower extremity pain. We report the case of an 18-year-old female volleyball player with bilateral exertional lower extremity pain who had been previously diagnosed with tendinitis and periostitis. Diagnostic studies showed entrapment of the left popliteal artery and the left anterior tibial artery. To our knowledge, there has only been 1 previous report of anterior tibial artery involvement in PAES.

  3. Anterior opercular syndrome as a first presentation of herpes simplex encephalitis.

    Science.gov (United States)

    De Kleermaeker, Floriaan G C M; Bouwmans, Angela E P; Nicolai, Joost; Klinkenberg, Sylvia

    2014-04-01

    We report a 5-year-old girl who presented with fever, drooling, dysphagia, and anarthria. Moreover, voluntary facial movements were disturbed, but the emotional facial movements were completely normal. This clinical phenomenon is known as the anterior opercular syndrome. There was a positive polymerase chain reaction for herpes simplex in the cerebrospinal fluid. The diagnosis herpes simplex encephalitis was supported by both magnetic resonance images (MRI) as by electroencephalogram (EEG). Herpes simplex encephalitis is a rare, but severe, cause of the anterior opercular syndrome that demands treatment as soon as possible in order to prevent high morbidity or mortality. The phenomenon of autonomic-voluntary dissociation, associated with other clinical and radiologic findings related to an underlying neurologic disorder, alerts clinicians to the anterior opercular syndrome as a critical diagnostic observation with time-dependent therapeutic consequences.

  4. CUBITAL TUNNEL SYNDROME: REVIEW OF 14 ANTERIOR SUBCUTANEOUS TRANSPOSITIONS OF THE VASCULARIZED ULNAR NERVE

    Directory of Open Access Journals (Sweden)

    M. Farzan

    2005-06-01

    Full Text Available Anterior transposition of the ulnar nerve is widely implemented for treatment of cubital tunnel ‎syndrome. However, preservation of the extrinsic blood supply of the ‎ulnar nerve may result in better clinical outcomes. Fourteen patients with cubital tunnel ‎syndrome, 11 ‎men and 3 women, were treated by anterior subcutaneous transposition of the ulnar nerve. The extrinsic blood supply of the ulnar nerve was ‎preserved. The average age at the time of operation was 33 years. The average follow-up period was 44 months. Post-operative outcome assessment by an independent examiner was based on the modified Bishop rating system. Nine patients had excellent or good outcomes. Five patients had a fair outcome. There ‎were no complications or recurrence of symptoms. Anterior subcutaneous ‎transposition of the vascularized ulnar nerve is an effective method of surgical ‎treatment for patients with cubital tunnel syndrome.

  5. A novel method for measuring anterior segment area of the eye on ultrasound biomicroscopic images using photoshop.

    Directory of Open Access Journals (Sweden)

    Zhonghao Wang

    Full Text Available To describe a novel method for quantitative measurement of area parameters in ocular anterior segment ultrasound biomicroscopy (UBM images using Photoshop software and to assess its intraobserver and interobserver reproducibility.Twenty healthy volunteers with wide angles and twenty patients with narrow or closed angles were consecutively recruited. UBM images were obtained and analyzed using Photoshop software by two physicians with different-level training on two occasions. Borders of anterior segment structures including cornea, iris, lens, and zonules in the UBM image were semi-automatically defined by the Magnetic Lasso Tool in the Photoshop software according to the pixel contrast and modified by the observers. Anterior chamber area (ACA, posterior chamber area (PCA, iris cross-section area (ICA and angle recess area (ARA were drawn and measured. The intraobserver and interobserver reproducibilities of the anterior segment area parameters and scleral spur location were assessed by limits of agreement, coefficient of variation (CV, and intraclass correlation coefficient (ICC.All of the parameters were successfully measured by Photoshop. The intraobserver and interobserver reproducibilities of ACA, PCA, and ICA were good, with no more than 5% CV and more than 0.95 ICC, while the CVs of ARA were within 20%. The intraobserver and interobserver reproducibilities for defining the spur location were more than 0.97 ICCs. Although the operating times for both observers were less than 3 minutes per image, there was significant difference in the measuring time between two observers with different levels of training (p<0.001.Measurements of ocular anterior segment areas on UBM images by Photoshop showed good intraobserver and interobserver reproducibilties. The methodology was easy to adopt and effective in measuring.

  6. Evaluation of anterior segment parameters using pentacam in silicone oil-injected patients after pars plana vitrectomy

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    Burcu Çalik

    2013-01-01

    Full Text Available Background: The aim of this study is to evaluate anterior segment changes with Pentacam Scheimpflug camera after pars plana vitrectomy (PPV and silicone oil injection. Materials and Methods: In all, 44 eyes of 44 patients who underwent PPV by one surgeon were evaluated with Pentacam preoperatively, first week, and first month after surgery. The patients were divided into two groups, eyes with silicone injection after PPV and eyes with PPV and no endotamponade. Main outcome measures were preoperative and postoperative anterior chamber volume (ACV, anterior chamber depth (ACD, anterior chamber angle (ACA, and central corneal thickness (CCT obtained with pentacam. Results: Each group consisted of 22 patients. In both groups no significant difference was detected among preop and postop changes in ACV and ACA values ( p > 0.05. The increase in ACD in silicone oil-injected group and the decrease in ACD in PPV group at postop 1 week were statistically significant ( p < 0.05. The increase in CCT in silicone oil-injected group at postop 1 week and then decrease in postop 1 month were also significant ( p < 0.05. Surgically induced astigmatism (SIA was 3.7 Dioptry (D in silicone oil-injected group and 2.4 D in PPV group at postop 1 week. SIA decreased to 1.7 D and 1.5 D, respectively, at postop 1 month. Changes in SIA were significant ( p < 0.05. Conclusion: PPV effects cornea and anterior segment. Changes in cornea and anterior segment after PPV seem to return to preoperative values among 1 month after surgery.

  7. The muscle pattern of the Drosophila abdomen depends on a subdivision of the anterior compartment of each segment.

    Science.gov (United States)

    Krzemien, Joanna; Fabre, Caroline C G; Casal, José; Lawrence, Peter A

    2012-01-01

    In the past, segments were defined by landmarks such as muscle attachments, notably by Snodgrass, the king of insect anatomists. Here, we show how an objective definition of a segment, based on developmental compartments, can help explain the dorsal abdomen of adult Drosophila. The anterior (A) compartment of each segment is subdivided into two domains of cells, each responding differently to Hedgehog. The anterior of these domains is non-neurogenic and clones lacking Notch develop normally; this domain can express stripe and form muscle attachments. The posterior domain is neurogenic and clones lacking Notch do not form cuticle; this domain is unable to express stripe or form muscle attachments. The posterior (P) compartment does not form muscle attachments. Our in vivo films indicate that early in the pupa the anterior domain of the A compartment expresses stripe in a narrowing zone that attracts the extending myotubes and resolves into the attachment sites for the dorsal abdominal muscles. We map the tendon cells precisely and show that all are confined to the anterior domain of A. It follows that the dorsal abdominal muscles are intersegmental, spanning from one anterior domain to the next. This view is tested and supported by clones that change cell identity or express stripe ectopically. It seems that growing myotubes originate in posterior A and extend forwards and backwards until they encounter and attach to anterior A cells. The dorsal adult muscles are polarised in the anteroposterior axis: we disprove the hypothesis that muscle orientation depends on genes that define planar cell polarity in the epidermis.

  8. Embolization for the treatment of unilateral A1 segment anterior communicating artery aneurysm: a report of 48 cases

    OpenAIRE

    Qing-dong GUO; Liu, Wei; Fu, Luo-An; Zhang, Lei; Zhang, Xue-Xi; Jing HU; Fei, Zhou

    2011-01-01

    Objective To summarize the experience and method of endovascular treatment of unilateral A1 segment anterior communicating artery aneurysm with detachable coils.Methods Forty-eight patients with unilateral A1 anterior communicating artery aneurysm(23 males and 25 females,age ranged from 32 to 72 years with mean of 53.4,hospitalized in Xijing hospital from Jan.2009 to Apr.2010) were involved in present study.All of the aneurysms were measured with rotational digital subtraction angiography(RDS...

  9. Anterior throat pain syndromes: causes for undiagnosed craniofacial pain.

    Science.gov (United States)

    Shankland, Wesley E

    2010-01-01

    It is not uncommon for practitioners who treat craniofacial pain to see patients with undiagnosed throat and submandibular pain. Usually, these patients will already have been seen by their primary care physician and frequently, several others doctors including otolaryngologists, oral and maxillofacial surgeons, and even neurologists. Far too often these patients have three common features: 1. they have endured multiple expensive diagnostic tests; 2. they have received treatment of multiple courses of antibiotics; and 3. no specific diagnosis for their pain complaints has been determined and their pain persists. In this article, five disorders, Ernest syndrome, Eagle's syndrome, carotid artery syndrome, hyoid bone syndrome and superior pharyngeal constrictor syndrome are briefly described. All five produce common symptoms, making diagnosis difficult, which is often followed by ineffective or no treatment being provided to the patient. Diagnostic criteria and suggested treatment modalities are also presented.

  10. Relationship of A1 segment hypoplasia to anterior communicating artery aneurysm morphology and risk factors for aneurysm formation.

    Science.gov (United States)

    Rinaldo, Lorenzo; McCutcheon, Brandon A; Murphy, Meghan E; Bydon, Mohamad; Rabinstein, Alejandro A; Lanzino, Giuseppe

    2016-09-30

    OBJECTIVE Hypoplasia of the A1 segment of the anterior cerebral artery is frequently observed in patients with anterior communicating artery (ACoA) aneurysms. The effect of this anatomical variant on ACoA aneurysm morphology is not well understood. METHODS Digital subtraction angiography images were reviewed for 204 patients presenting to the authors' institution with either a ruptured or an unruptured ACoA aneurysm. The ratio of the width of the larger A1 segment to the smaller A1 segment was calculated. Patients with an A1 ratio greater than 2 were categorized as having A1 segment hypoplasia. The relationship of A1 segment hypoplasia to both patient and aneurysm characteristics was then assessed. RESULTS Of 204 patients that presented with an ACoA aneurysm, 34 (16.7%) were found to have a hypoplastic A1. Patients with A1 segment hypoplasia were less likely to have a history of smoking (44.1% vs 62.9%, p = 0.0410). ACoA aneurysms occurring in the setting of a hypoplastic A1 were also found to have a larger maximum diameter (mean 7.7 vs 6.0 mm, p = 0.0084). When considered as a continuous variable, increasing A1 ratio was associated with decreasing aneurysm dome-to-neck ratio (p = 0.0289). There was no significant difference in the prevalence of A1 segment hypoplasia between ruptured and unruptured aneurysms (18.9% vs 10.7%; p = 0.1605). CONCLUSIONS Our results suggest that a hypoplastic A1 may affect the morphology of ACoA aneurysms. In addition, the relative lack of traditional risk factors for aneurysm formation in patients with A1 segment hypoplasia argues for the importance of hemodynamic factors in the formation of ACoA aneurysms in this anatomical setting.

  11. Anterior inferior iliac spine fracture: Another component of seat belt syndrome?

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    Paisal HUSSIN

    2013-04-01

    Full Text Available Seat belt syndrome occurs when seat belts are used improperly, and it is a cause of significant morbidity and mortality. The spectrum of seat belt syndrome includes spinal, intra-abdominal and vascular injury. Here, we report the case of anterior inferior iliac spine avulsion fracture in association with seat belt injuries in a 24-year old man involved in a head on motor vehicle collision. 

  12. Extensive molecular differences between anterior- and posterior-half-sclerotomes underlie somite polarity and spinal nerve segmentation

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    Keynes Roger J

    2009-05-01

    Full Text Available Abstract Background The polarization of somite-derived sclerotomes into anterior and posterior halves underlies vertebral morphogenesis and spinal nerve segmentation. To characterize the full extent of molecular differences that underlie this polarity, we have undertaken a systematic comparison of gene expression between the two sclerotome halves in the mouse embryo. Results Several hundred genes are differentially-expressed between the two sclerotome halves, showing that a marked degree of molecular heterogeneity underpins the development of somite polarity. Conclusion We have identified a set of genes that warrant further investigation as regulators of somite polarity and vertebral morphogenesis, as well as repellents of spinal axon growth. Moreover the results indicate that, unlike the posterior half-sclerotome, the central region of the anterior-half-sclerotome does not contribute bone and cartilage to the vertebral column, being associated instead with the development of the segmented spinal nerves.

  13. Biomechanical Evaluation of Different Fixation Methods for Mandibular Anterior Segmental Osteotomy Using Finite Element Analysis, Part One: Superior Repositioning Surgery.

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    Kilinç, Yeliz; Erkmen, Erkan; Kurt, Ahmet

    2016-01-01

    The aim of the current study was to comparatively evaluate the mechanical behavior of 3 different fixation methods following various amounts of superior repositioning of mandibular anterior segment. In this study, 3 different rigid fixation configurations comprising double right L, double left L, or double I miniplates with monocortical screws were compared under vertical, horizontal, and oblique load conditions by means of finite element analysis. A three-dimensional finite element model of a fully dentate mandible was generated. A 3 and 5 mm superior repositioning of mandibular anterior segmental osteotomy were simulated. Three different finite element models corresponding to different fixation configurations were created for each superior repositioning. The von Mises stress values on fixation appliances and principal maximum stresses (Pmax) on bony structures were predicted by finite element analysis. The results have demonstrated that double right L configuration provides better stability with less stress fields in comparison with other fixation configurations used in this study.

  14. Embolization for the treatment of unilateral A1 segment anterior communicating artery aneurysm: a report of 48 cases

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    Qing-dong GUO

    2011-10-01

    Full Text Available Objective To summarize the experience and method of endovascular treatment of unilateral A1 segment anterior communicating artery aneurysm with detachable coils.Methods Forty-eight patients with unilateral A1 anterior communicating artery aneurysm(23 males and 25 females,age ranged from 32 to 72 years with mean of 53.4,hospitalized in Xijing hospital from Jan.2009 to Apr.2010 were involved in present study.All of the aneurysms were measured with rotational digital subtraction angiography(RDSA and image post-processing techniques,and they were embolized with Guglielmi detachable coils(GDCs.The patency of the parent arteries was monitored by catheterization in both carotid arteries in the process of treatment.Stent-assisted,balloon remodeling,microcatheter and microwire assisted techniques were used in the treatment of wide-necked aneurysm to keep patency of parent arteries.Cerebral angiography was performed in 38 cases 6 months after the operation to observe the patency of embolized aneurysms and anterior communicating arteries.Results Of the 48 cases,total occlusion was achieved in 39(81.3%,more than 90% occlusion was achieved in 6(12.5%,and 3(6.3% with less than 90% occlusion;1 had hemorrhage during embolization,3 had anterior communicating artery occlusion,and 2 had contralateral internal carotid artery compensation after anterior communicating artery occlusion.No re-bleeding was found during the 6 months follow-up period.Cerebral angiography showed total occlusion of aneurysms and patency of anterior communicating arteries in 38 cases during re-examination.Conclusion The anterior communicating arteries should be kept patent in embolization treatment of the major unilateral blood supply anterior communicating artery aneurysms,and it is helpful to use microcatheter or microwire assisted techniques.

  15. Assessment of Anterior Segment Measurements with Swept Source Optical Coherence Tomography before and after Ab Interno Trabeculotomy (Trabectome) Surgery

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    Huang, Ping

    2016-01-01

    Purpose. To compare the changes of anterior segment parameters, assessed by swept source anterior segment optical coherence tomography (AS-OCT) after combined Trabectome-cataract surgery and Trabectome-only surgery in open angle glaucoma patients. Methods. Thirty-eight eyes of 24 patients with open angle glaucoma were scanned with swept source AS-OCT before and 4 weeks after combined Trabectome-cataract or Trabectome-only surgery. Intraocular pressure, number of medications, and AS-OCT parameters, such as angle opening distance at 500 and 750 μm from the scleral spur (AOD500 and AOD750), trabecular-iris space area at 500 and 750 mm2 (TISA500, TISA750), angle recess area at 500 and 750 mm2 (ARA500, ARA750), trabecular iris angle (TIA), anterior chamber depth (ACD), anterior chamber width (ACW), and anterior chamber volume (ACV), were obtained before the surgery. These parameters were compared to evaluate whether the outcome of the surgery differed among the patients after the surgery. The width of the trabecular cleft was also measured for both groups. Results. The reduction of IOP and number of medications was found to be statistically significant in both groups (p ACV, and angle parameters such as AOD 500/750, TISA 500/750, ARA 500/750, and TIA500 showed significantly greater changes from the preoperative values to postoperative 1st month values in combined Trabectome-cataract surgery group (p 0.05). There was no statistically significant difference between two groups for the width of the trabecular cleft (p = 0.7). Conclusion. Anterior chamber angle parameters measured with swept source AS-OCT may be useful for evaluating glaucoma patients before and after Trabectome surgery with or without cataract surgery. PMID:27795855

  16. Morphology of functioning trabeculectomy blebs using anterior segment optical coherence tomography

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    Mayuri B Khamar

    2014-01-01

    Full Text Available Purpose: To image trabeculectomy blebs using anterior segment optical coherence tomography (AS-OCT, and to correlate the bleb morphologic features at one month postoperatively with bleb function at six months. Materials and Methods: This prospective, observational study included 56 eyes undergoing trabeculectomy with MMC, followed up for minimum of six months. Postoperatively, bleb imaging was done using AS-OCT at one and six month. Bleb morphology was assessed for bleb wall reflectivity, bleb pattern in multiform reflectivity, visibility of drainage route and presence of hyper-reflectivity area. Bleb function was considered successful if IOP was <18 mmHg without medication at six month. Bleb morphology one month postoperatively was correlated with bleb function at six months. Results: At six months successful bleb function was noted in 44 (81.5% eyes. Morphology of bleb at one month showed uniform bleb wall reflectivity in 6 eyes (11% and multiform wall reflectivity in 48 eyes (89%. In eyes with multiform wall reflectivity, microcysts with multiple layers was seen in 26 eyes (48%, microcysts with subconjunctival separation in 12 eyes (22% and only microcyst in 10 eyes (19%. When bleb features at one month were correlated with the bleb function at six months, logistic regression analysis revealed that blebs with multiform reflectivity with multiple internal layers with microcysts were associated with higher chances of success (P < 0.001. Conclusion : AS-OCT demonstrated early bleb morphological features that may be used to predict the functioning of a bleb. Multiform bleb wall reflectivity with a pattern of multiple internal layers and microcysts was associated with increased chances of success of a bleb.

  17. REPERFUSION THERAPY IN ACUTE CORONARY SYNDROME WITH ST SEGMENT ELEVATION

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    A. L. Alyavi

    2016-01-01

    Full Text Available Aim. To compare effect of percutaneous balloon angioplasty (PCA and a systemic thrombolysis (STL on the central and intracardiac hemodynamics in patients with acute coronary syndrome (ACS with ST segment elevation.Material and methods. 80 patients with ACS with ST segment elevation were included in the study. Patients were split into 2 groups depending on reperfusion strategy. PCA was performed in 55 patients (first group. 25 patients of the second group had STL with Streptokinase, i/v, 1 500 000 units per hour. Echocardiography was performed in all patients at admission and after 3 and 7 days of treatment to evaluate intracardiac hemodynamics.Results. Both reperfusion methods significantly increase of ejection fraction (EF and maximal output speed of left ventricle (LV. Increase of LV EF in patients after PCA was higher than this in patients after STL. PCA improved LV diastolic function; STL did not change this characteristic. After PCA working diagnosis of ACS was transformed to the following final diagnosis: acute myocardial infarction (AMI with Q, AMI without Q and unstable angina in 37,5, 30,4 and 32,1% of patients, respectively. After STL diagnosis of AMI with Q was defined in all patients.Conclusion. PCA in patients with ACS with ST segment elevation results in fast improvement of global systolic and diastolic LV function. Besides, PCA prevents AMI with Q in a half of these patients.

  18. Anterior subcutaneous transposition of the ulnar nerve improves neurological function in patients with cubital tunnel syndrome

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    Wei Huang

    2015-01-01

    Full Text Available Although several surgical procedures exist for treating cubital tunnel syndrome, the best surgical option remains controversial. To evaluate the efficacy of anterior subcutaneous transposition of the ulnar nerve in patients with moderate to severe cubital tunnel syndrome and to analyze prognostic factors, we retrospectively reviewed 62 patients (65 elbows diagnosed with cubital tunnel syndrome who underwent anterior subcutaneous transposition. Preoperatively, the initial severity of the disease was evaluated using the McGowan scale as modified by Goldberg: 18 patients (28% had grade IIA neuropathy, 20 (31% had grade IIB, and 27 (42% had grade III. Postoperatively, according to the Wilson & Krout criteria, treatment outcomes were excellent in 38 patients (58%, good in 16 (25%, fair in 7 (11%, and poor in 4 (6%, with an excellent and good rate of 83%. A negative correlation was found between the preoperative McGowan grade and the postoperative Wilson & Krout score. The patients having fair and poor treatment outcomes had more advanced age, lower nerve conduction velocity, and lower action potential amplitude compared with those having excellent and good treatment outcomes. These results suggest that anterior subcutaneous transposition of the ulnar nerve is effective and safe for the treatment of moderate to severe cubital tunnel syndrome, and initial severity, advancing age, and electrophysiological parameters can affect treatment outcome.

  19. Anterior subcutaneous transposition of the ulnar nerve improves neurological function in patients with cubital tunnel syndrome.

    Science.gov (United States)

    Huang, Wei; Zhang, Pei-Xun; Peng, Zhang; Xue, Feng; Wang, Tian-Bing; Jiang, Bao-Guo

    2015-10-01

    Although several surgical procedures exist for treating cubital tunnel syndrome, the best surgical option remains controversial. To evaluate the efficacy of anterior subcutaneous transposition of the ulnar nerve in patients with moderate to severe cubital tunnel syndrome and to analyze prognostic factors, we retrospectively reviewed 62 patients (65 elbows) diagnosed with cubital tunnel syndrome who underwent anterior subcutaneous transposition. Preoperatively, the initial severity of the disease was evaluated using the McGowan scale as modified by Goldberg: 18 patients (28%) had grade IIA neuropathy, 20 (31%) had grade IIB, and 27 (42%) had grade III. Postoperatively, according to the Wilson & Krout criteria, treatment outcomes were excellent in 38 patients (58%), good in 16 (25%), fair in 7 (11%), and poor in 4 (6%), with an excellent and good rate of 83%. A negative correlation was found between the preoperative McGowan grade and the postoperative Wilson & Krout score. The patients having fair and poor treatment outcomes had more advanced age, lower nerve conduction velocity, and lower action potential amplitude compared with those having excellent and good treatment outcomes. These results suggest that anterior subcutaneous transposition of the ulnar nerve is effective and safe for the treatment of moderate to severe cubital tunnel syndrome, and initial severity, advancing age, and electrophysiological parameters can affect treatment outcome.

  20. Two patients with TAFRO syndrome exhibiting strikingly similar anterior mediastinal lesions with predominantly fat attenuation on chest computed tomography.

    Science.gov (United States)

    Ozawa, Yoko; Yamamoto, Hiroshi; Yasuo, Masanori; Takahashi, Hidekazu; Tateishi, Kazunari; Ushiki, Atsuhito; Kawakami, Satoshi; Fujinaga, Yasunari; Asaka, Shiho; Sano, Kenji; Takayama, Hiroshi; Imamura, Hiroshi; Hanaoka, Masayuki

    2017-03-01

    We herein report on two middle-aged men with TAFRO (thrombocytopenia, anasarca, fever, reticulin fibrosis or renal failure, and organomegaly) syndrome, a unique clinicopathological variant of multicentric Castleman׳s disease recently proposed in Japan. Strikingly similar anterior mediastinal fat swellings with soft tissue density were observed in the patients on chest computed tomography. In TAFRO syndrome, bilateral pleural effusion and slight lymph node swelling are common in the thoracic region; however, anterior mediastinal lesions have not been previously observed. Although the mechanisms of anterior mediastinal lesions have not been defined, these lesions seem to have a close relationship with TAFRO syndrome.

  1. Ceratoconjuntivite alérgica e complicações no segmento ocular anterior de pacientes Evaluation of anterior ocular segment complications in patients with allergic keratoconjunctivitis

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    Patrícia Bezerra de Menezes Botelho

    2003-01-01

    with secondary anterior segment alterations. Data collected from the charts were: age, gender, kind of allergy, time of disease, time that complication appeared after treatment in our Service, side effects and ocular complications. RESULTS: Complications of anterior segment that caused reduction in visual acuity were: shield ulcers, 5 cases; cataract, 3 cases; corneal opacity, 6 cases; ocular perforation, 2 cases and keratoconus 13 cases. There were 7 surgeries: 2 tectonic penetrating keratoplasty, 4 optic keratoplasty, 4 optic penetrating keratoplasty and one superficial keratectomy. CONCLUSION: Patients with allergic keratoconjunctivitis should be treated in order to prevent ocular complications like keratitis, keratoconus, opacities and cataract.

  2. Comparison of immersion ultrasonography, ultrasound biomicroscopy and anterior segment optical coherence tomography in the evaluation of traumatic phacoceles

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    Harikrishna Vodapalli

    2012-01-01

    Full Text Available Blunt ocular trauma in the elderly can result in anterior dislocation of the crystalline lens into the subconjunctival space (phacocele. Although rare, this presentation can be missed, especially if the patient presents several days after the injury and if the lid is not everted on examination. While a careful clinical examination is adequate in the diagnosis, imaging techniques can be put to use for the accurate location of the associated sclera rupture. We report three cases of post-traumatic phacocele wherein ultrasound biomicroscopy (UBM was compared to the anterior segment optical coherence tomography (AS-OCT and B-scan ultrasonography (B-scan, in order to establish the best imaging tool for this condition. We concluded, based on image quality, that UBM could be the imaging modality of choice to aid in the diagnosis of phacocele.

  3. Doenças do segmento anterior ocular associadas a lentes de contato Contact lens-associated ocular anterior segment diseases

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    Murilo Barreto Souza

    2008-12-01

    Full Text Available A disponibilidade de lentes de contato cada vez mais confortáveis e toleráveis favoreceu não só a ampliação das indicações, mas também o aumento do número de seus usuários. Como conseqüência deste fato as complicações associadas ao uso de lentes de contato são cada vez mais comuns, e representam um problema de grande prevalência na prática clínica. O objetivo deste estudo é revisar as principais doenças e alterações do segmento anterior e superfície ocular associadas ao uso de lentes de contato.Nowadays, contact lenses have shown a larger variety of options in order to meet the needs of different patients. They have become more frequent in the clinical practice and, consequently, the complications related to contact lenses have been more common. This review attempted to describe the main alterations and diseases of the cornea and anterior segment associated with contact lens wearers.

  4. Evaluation of anterior segment parameters and possible influencing factors in normal subjects using a dual Scheimpflug analyzer.

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    Xiaogang Wang

    Full Text Available PURPOSE: To investigate normal anterior segment parameters and analyze the possible influencing factors using a dual Scheimpflug system. SETTING: Department of Ophthalmology, Affiliated Sixth People's Hospital Shanghai Jiao Tong University, Shanghai, China. DESIGN: A prospective observational case series. METHODS: A total of 153 normal subjects (153 eyes were studied. The anterior segment parameters, including the central corneal thickness (CCT, anterior chamber depth (ACD, pupil diameter (PD, keratoconus prediction index (KPI, simulated keratometry (SimK values, anterior instantaneous curvature (AIC, posterior axial curvature (PAC, corneal eccentricity, total corneal power (TCP, axial curvature (AC, total corneal wavefront (TCW, high order aberration (HOA, and spherical aberration (SA, were determined using a dual Scheimpflug analyzer. RESULTS: The CCT and ACD were both negatively correlated with age (r = -0.203, p = 0.012; r = -0.589, p<0.001. There was no significant difference in the refractive indices of AIC and SimK. Compared with the negative correlation of HOA and SA (r = -0.358, p<0.001, a positive correlation was found between TCW and HOA (r = 0.561, p<0.001. Unlike the decreased tendency of AC, the TCP increased gradually from the center to the periphery in the central 8 mm diameter. TCP showed a significant correlation with AC in the analyzed area. CONCLUSIONS: AIC and SimK provide different information in clinic, but the refractive indices of them showed no difference in this healthy study population, and age should be considered when using CCT and ACD values.

  5. Anterior Segment Alterations and Comparative Aqueous Humor Proteomics in the Buphthalmic Rabbit (An American Ophthalmological Society Thesis)

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    Edward, Deepak P.; Bouhenni, Rachida

    2011-01-01

    Purpose To use an integrated proteohistologic approach to gain insight into the anterior segment alterations in the buphthalmic rabbit. Methods Eyes from 2- and 5-year-old buphthalmic and normal rabbits (n=20) were studied histologically. Liquid chromatography–tandem mass spectrometry (LC-MS/MS) of aqueous humor (AH) was used to determine differential protein expression between animal groups. Western blot and immunohistochemistry were performed on selected differentially expressed proteins identified by LC-MS/MS. Results The buphthalmic rabbits manifested a mild clinical phenotype with typical angle anomalies that appeared progressive by histology. Significantly thickened Descemet’s membrane (DM) and anterior lens capsule in all buphthalmic rabbits showed increased fibronectin and collagen-IV immunolabeling. LC-MS/MS applying stringent filtering criteria revealed significant differential expression of several AH proteins in these rabbits. The protein of interest in the 2-year-old group was histidine-rich glycoprotein, and those in the 5-year-old group included alpha-2-HS-glycoprotein, clusterin, apolipoprotein E, interphotoreceptor retinoid-binding protein, transthyretin, cochlin, gelsolin, haptoglobin, hemopexin, and beta-2 microglobulin. The proteomic data for selected proteins was validated by Western blot and immunohistochemistry. A wide range of functional groups were affected by the altered AH proteins. These included extracellular matrix modulation, regulation of apoptosis, oxidative stress, and protein transport. Conclusions Multiple anterior segment alterations were histologically identified in the buphthalmic rabbits that showed progressive changes with age. The differentially expressed AH proteins in these rabbits suggest a multifunctional role for AH in modulating pathologic changes in DM, anterior lens capsule, and the angular meshwork in these animals. PMID:22253484

  6. Consideration of QRS complex in addition to ST-segment abnormalities in the estimated "risk region" during acute anterior myocardial infarction

    DEFF Research Database (Denmark)

    van Hellemond, Irene E G; Bouwmeester, Sjoerd; Olson, Charles W

    2011-01-01

    a falsely low estimated total MaR if determined by using ST segment-based methods. The purpose of this study was to investigate if consideration of the abnormalities in the QRS complex, in addition to those in the ST segment, provides a more accurate estimated total MaR during anterior AMI than...

  7. Anterior Hypopituitarism and Treatment Response in Hunter Syndrome: A Comparison of Two Patients

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    Luca, Paola; Wei, Xing-Chang; Khan, Aneal

    2016-01-01

    Hypopituitarism is a clinically important diagnosis and has not previously been reported in Hunter syndrome. We contrast two cases with anatomic pituitary anomalies: one with anterior panhypopituitarism and the other with intact pituitary function. Patient 1, a 10-year-old boy with Hunter syndrome, was evaluated for poor growth and an ectopic posterior pituitary gland. Endocrine testing revealed growth hormone (GH) deficiency, secondary adrenal insufficiency, and tertiary hypothyroidism. An improvement in growth velocity with hormone replacement (GH, thyroxine, and corticosteroid) was seen; however, final adult height remained compromised. Patient 2, a 13-year-old male with Hunter syndrome, was evaluated for growth failure. He had a large empty sella turcica with posteriorly displaced pituitary. Functional endocrine testing was normal and a trial of GH-treatment yielded no significant effect. Panhypopituitarism associated with pituitary anomalies has not been previously reported in Hunter syndrome and was an incidental finding of significant clinical importance. In the setting of documented anterior hypopituitarism, while hormone replacement improved growth velocity, final height remained impaired. In patient 2 with equivocal GH-testing results, treatment had no effect on linear growth. These cases highlight the importance of careful clinical assessment in Hunter syndrome and that judicious hormone replacement may be indicated in individual cases. PMID:28018694

  8. Anterior Hypopituitarism and Treatment Response in Hunter Syndrome: A Comparison of Two Patients

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    Munier A. Nour

    2016-01-01

    Full Text Available Hypopituitarism is a clinically important diagnosis and has not previously been reported in Hunter syndrome. We contrast two cases with anatomic pituitary anomalies: one with anterior panhypopituitarism and the other with intact pituitary function. Patient 1, a 10-year-old boy with Hunter syndrome, was evaluated for poor growth and an ectopic posterior pituitary gland. Endocrine testing revealed growth hormone (GH deficiency, secondary adrenal insufficiency, and tertiary hypothyroidism. An improvement in growth velocity with hormone replacement (GH, thyroxine, and corticosteroid was seen; however, final adult height remained compromised. Patient 2, a 13-year-old male with Hunter syndrome, was evaluated for growth failure. He had a large empty sella turcica with posteriorly displaced pituitary. Functional endocrine testing was normal and a trial of GH-treatment yielded no significant effect. Panhypopituitarism associated with pituitary anomalies has not been previously reported in Hunter syndrome and was an incidental finding of significant clinical importance. In the setting of documented anterior hypopituitarism, while hormone replacement improved growth velocity, final height remained impaired. In patient 2 with equivocal GH-testing results, treatment had no effect on linear growth. These cases highlight the importance of careful clinical assessment in Hunter syndrome and that judicious hormone replacement may be indicated in individual cases.

  9. Biomechanical effects of polyaxial pedicle screw fixation on the lumbosacral segments with an anterior interbody cage support

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    Chen Hsiang-Ho

    2007-03-01

    Full Text Available Abstract Background Lumbosacral fusion is a relatively common procedure that is used in the management of an unstable spine. The anterior interbody cage has been involved to enhance the stability of a pedicle screw construct used at the lumbosacral junction. Biomechanical differences between polyaxial and monoaxial pedicle screws linked with various rod contours were investigated to analyze the respective effects on overall construct stiffness, cage strain, rod strain, and contact ratios at the vertebra-cage junction. Methods A synthetic model composed of two ultrahigh molecular weight polyethylene blocks was used with four titanium pedicle screws (two in each block and two rods fixation to build the spinal construct along with an anterior interbody cage support. For each pair of the construct fixed with polyaxial or monoaxial screws, the linked rods were set at four configurations to simulate 0°, 7°, 14°, and 21° lordosis on the sagittal plane, and a compressive load of 300 N was applied. Strain gauges were attached to the posterior surface of the cage and to the central area of the left connecting rod. Also, the contact area between the block and the cage was measured using prescale Fuji super low pressure film for compression, flexion, lateral bending and torsion tests. Results Our main findings in the experiments with an anterior interbody cage support are as follows: 1 large segmental lordosis can decrease the stiffness of monoaxial pedicle screws constructs; 2 polyaxial screws rather than monoaxial screws combined with the cage fixation provide higher compression and flexion stiffness in 21° segmental lordosis; 3 polyaxial screws enhance the contact surface of the cage in 21° segmental lordosis. Conclusion Polyaxial screws system used in conjunction with anterior cage support yields higher contact ratio, compression and flexion stiffness of spinal constructs than monoaxial screws system does in the same model when the spinal segment

  10. Progressive anterior operculum syndrome due to FTLD-TDP: a clinico-pathological investigation.

    Science.gov (United States)

    Otsuki, Mika; Nakagawa, Yoshitsugu; Mori, Fumiaki; Tobioka, Hirotoshi; Yoshida, Hideaki; Tatezawa, Yoshiharu; Tanigawa, Toshio; Takahashi, Ikuko; Yabe, Ichiro; Sasaki, Hidenao; Wakabayashi, Koichi

    2010-07-01

    Pathological investigation of progressive anterior operculum syndrome has rarely been reported. We describe clinico-pathological findings in a patient with progressive anterior operculum syndrome. A 74-year-old right-handed man had noticed speech and swallowing difficulties 1 year previously. Neurological examinations showed no abnormality other than a slight limitation of upward gaze and slow tongue movement without fibrillation. We investigated the patient using neuroimaging and neuropsychological examinations and observed him for 2 years until his death, at which point we obtained pathological findings. The patient's facial and masseteric muscles seemed hypotonic with drooling, but he could laugh and yawn normally, showing automatic voluntary dissociation. Palatal and pharyngeal reflexes were normal. Magnetic resonance imaging showed cortical atrophy in the temporal lobes bilaterally. (123)IMP single photon emission computed tomography and positron emission tomography showed decreased blood flow and activity in the frontotemporal lobes, predominantly on the left side. Neuropsychological examinations showed no aphasia, dementia or other neuropsychological abnormality. Intubation fiberscopy, laryngoscopy and video fluorography showed no abnormality. After 6 months his anarthria and dysphagia became aggravated. He died of aspiration pneumonia 2 years after onset. Postmortem examination revealed neuronal degeneration with TDP-43-positive inclusions in the frontal, temporal and insular cortices, consistent with frontotemporal lobar degeneration with TDP inclusions (FTLD-TDP). However, neuronal loss with gliosis was more prominent in the inferior part of the motor cortices, bilaterally. Progressive anterior operculum syndrome could be classified as a variant of FTLD-TDP.

  11. 白内障超声乳化摘出术后OCT测量的眼前节结构改变%The changes of ocular anterior segment configuration following phacoemulsification determined by anterior segment OCT

    Institute of Scientific and Technical Information of China (English)

    郑虔

    2016-01-01

    Cataract is a main blinding eye disease worldwide,follwed by glaucoma.Expension of lens volume occurs in early stage of age-related cataractous eyes,which is a risk factor of Primary angle-closure glaucoma,and phacoemulsification is a feasible approach to remove it.However,how to select the timing of operation and determine the prognosis is the major challenge for ophthalmologists.In order to evaluate the influence of phacoemulsification on ocular anterior segment configuration,we collected the information of 17 articles that quantitatively analyzed the ocular anterior segment parameter changes after phacoemulsification,determined by anterior segment OCT (AS-OCT).Total 866 eyes that received phacoemulsification for age-related cataract were included in the following-up duration for 6 months,and the results showed that the mean anterior chamber depth (ACD),anterior chamber volume (ACV),anterior chamber angle (ACA),angle opening distance 500 μm anterior to the scleral spur (AODS00),angle opening distance 750 μm anterior to the scleral spur (AOD750),trabecular-iris space area 500 μm from scleral spur (TISA500),trabecular-iris space area 750 μm from scleral spur(TISA750),and angle recess area 750 μm anterior to the scleral spur (ARA 750) were increased,but the mean anterior chamber width (ACW) and iris thickness measured at 750 μm (IT750) were not significantly changed,while the postoperative iris curvature (I-Curv),iris cross-sectional area and convex hull of iris segments were decreased after phacoemulsification.In addition,the postoperative ACD,TISA500 showed positive correlations to preoperative lens thickness,and the ACD and AOD500 in 3 months after operation were positively correlated to the preoperative lens value (LV).This systematic review concluded that phacoemulsification could be used for the treatment of glaucoma by relieving pupillary block,reducing the iris oppression,deepening the anterior chamber and opening anterior chamber angle.%目前,白内

  12. Anterior cervical surgery methods for central cord syndrome without radiographic spinal fracture-dislocation

    Institute of Scientific and Technical Information of China (English)

    Chengwei JING; Qin FU; Xiaojun XU

    2009-01-01

    This study was aimed to explore the anterior cervical surgery methods to treat central cord syndrome without radiographic spinal fracture-dislocation (CCSWORFD), retrospectively analyze the cases of CCSWORFD, and evaluate the curative effect of anterior cervical surgery methods for CCSWORFD. Twenty four cases of CCSWORFD (19 males and 5 females), all suffering from cervical hyperextension injury, between 45-68 (average 59) years old, were operated on by anterior cervical surgery methods. Among these, 18 cases had been followed up for 6-24 (average 15) months; 18 cases, who had anterior decompression and plate fixation with titanium mesh bone grafting or iliac bone grafting achieved reliable effects based on the Japanese Orthopedics Association (JOA) evaluation (improved scores of cases with titanium mesh bone grafting, t = 2.800, P0.05). Most of these cases had degeneration of cervical vertebra. The decompression which relieves the oppression to the spinal cord can help lessen edema of the spinal cord, and early fixation for stability of cervical vertebra is better for the recovery of spinal cord injury. Anterior operation with titanium mesh bone grafting or iliac bone grafting are both reliable curative methods for CCSWORFD, and titanium mesh bone grafting can avoid the trauma of the supplying graft. Mesh bone grafting can also shorten hospital stay.

  13. Serotonin (5-HT3 receptor antagonists for the reduction of symptoms of low anterior resection syndrome

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    Itagaki R

    2014-03-01

    Full Text Available Ryohei Itagaki, Keiji Koda, Masato Yamazaki, Kiyohiko Shuto, Chihiro Kosugi, Atsushi Hirano, Hidehito Arimitsu, Risa Shiragami, Yukino Yoshimura, Masato Suzuki Department of Surgery, Teikyo University Chiba Medical Center, Anesaki, Ichihara, Chiba, Japan Purpose: Serotonin (5-hydroxytryptamine [5-HT]3 receptor antagonists are effective for the treatment of diarrhea-predominant irritable bowel syndrome (IBS-D, in which exaggerated intestinal/colonic hypermotility is often observed. Recent studies have suggested that the motility disorder, especially spastic hypermotility, seen in the neorectum following sphincter-preserving operations for rectal cancer may be the basis of the postoperative defecatory malfunction seen in these patients. We investigated the efficacy of 5-HT3 receptor antagonists in patients suffering from severe low anterior resection syndrome. Patients and methods: A total of 25 male patients with complaints of uncontrollable urgency or fecal incontinence following sphincter-preserving operations were enrolled in this study. Defecatory status, assessed on the basis of incontinence score (0–20, urgency grade (0–3, and number of toilet visits per day, was evaluated using a questionnaire before and 1 month after the administration of the 5-HT3 antagonist ramosetron. Results: All the parameters assessed improved significantly after taking ramosetron for 1 month. The effect was more prominent in cases whose anastomotic line was lower, ie, inside the anal canal. Defecatory function was better in patients who commenced ramosetron therapy within 6 months postoperatively, as compared to those who were not prescribed ramosetron for more than 7 months postoperatively. Conclusion: These results suggest that 5-HT3 antagonists are effective for the treatment of low anterior resection syndrome, as in diarrhea-predominant irritable bowel syndrome. The improvement in symptoms is not merely time dependent, but it is related to treatment with 5

  14. Anterior segment study with the pentacam scheimpflug camera in refractive surgery candidates

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    Masih Hashemi

    2013-01-01

    Conclusions: Myopic eyes had steeper corneas than hyperopic eyes and anterior chamber measurements were significantly higher in the myopic eyes. In myopic eyes, AE max and PE max and K max measurements were higher, and ACD measurements were lower in the astigmatic groups.

  15. Imaging of a Severe Case of Acute Hydrops in a Patient with Keratoconus Using Anterior Segment Optical Coherence Tomography

    Directory of Open Access Journals (Sweden)

    Hiroki Ueno

    2012-09-01

    Full Text Available Aim: To investigate the clinical and diagnostic findings of a patient with acute hydrops using anterior segment optical coherence tomography (AS-OCT. Methods: The AS-OCT findings of a 43-year-old patient with acute hydrops associated with keratoconus were examined. At the initial examination and during follow-up, evaluation of the anterior segment was performed. Results: The patient presented with decreased visual acuity, pain, and redness in the right eye. The symptoms, clinical presentation, and topographical findings of the right eye confirmed the diagnosis of acute corneal hydrops. Changes in the stroma and Descemet’s membrane during the healing process of acute hydrops could be demonstrated by high-resolution AS-OCT. The use of contact lenses was improved at the last follow-up visit after 8 months and increased visual acuity to 20/20 with correction. Conclusions: AS-OCT is a useful tool for studying the morphologic features of acute hydrops.

  16. Trabecular-Iris Circumference Volume in Open Angle Eyes Using Swept-Source Fourier Domain Anterior Segment Optical Coherence Tomography

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    Mohammed Rigi

    2014-01-01

    Full Text Available Purpose. To introduce a new anterior segment optical coherence tomography parameter, trabecular-iris circumference volume (TICV, which measures the integrated volume of the peripheral angle, and establish a reference range in normal, open angle eyes. Methods. One eye of each participant with open angles and a normal anterior segment was imaged using 3D mode by the CASIA SS-1000 (Tomey, Nagoya, Japan. Trabecular-iris space area (TISA and TICV at 500 and 750 µm were calculated. Analysis of covariance was performed to examine the effect of age and its interaction with spherical equivalent. Results. The study included 100 participants with a mean age of 50 (±15 years (range 20–79. TICV showed a normal distribution with a mean (±SD value of 4.75 µL (±2.30 for TICV500 and a mean (±SD value of 8.90 µL (±3.88 for TICV750. Overall, TICV showed an age-related reduction (P=0.035. In addition, angle volume increased with increased myopia for all age groups, except for those older than 65 years. Conclusions. This study introduces a new parameter to measure peripheral angle volume, TICV, with age-adjusted normal ranges for open angle eyes. Further investigation is warranted to determine the clinical utility of this new parameter.

  17. Descemet’s scroll in syphilitic interstitial keratitis: a case report with anterior segment evaluation and a literature review

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    Kasetsuwan N

    2015-09-01

    Full Text Available Ngamjit Kasetsuwan,1,2 Usanee Reinprayoon,1,2 Patchima Chantaren2 1Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, 2Ophthalmology Department, King Chulalongkorn Memorial Hospital, Bangkok, Thailand Purpose: To present a case of syphilitic interstitial keratitis with Descemet’s scrolls, as well as its characteristic findings in an anterior segment investigation in relation to the histopathologic findings from a literature review. Case presentation: A case report of a 64-year-old woman with syphilitic infection presented with band keratopathy and retrocorneal scrolls. Slit-lamp photography, confocal microscopy, anterior segment optical coherence tomography (AS-OCT, and ultrasound biomicroscopy were performed. Four previous reports were reviewed to describe the pathogenesis, natural history, and histopathologic and immunohistologic findings of the Descemet’s scroll. Results: The spectacle-corrected visual acuity was 20/50 and 20/30 in the right and left eyes, respectively. The scrolls appeared as a translucent web extending from Descemet’s membrane into the anterior chamber. Confocal microscopy showed decreased endothelial cell density, pleomorphism, polymegathism, and hyperreflective fibrocellular rods with central hollow. The AS-OCT and ultrasound biomicroscopy showed rod-shaped retrocorneal scrolls. The corneal thickness was 494 microns, as measured by AS-OCT. The corneal lesion remained stable during the 6-year follow-up period without the need for keratoplasty, while the previous literature reported spontaneous and postoperative corneal decompensation. Conclusion: We present a case of syphilitic interstitial keratitis with rare Descemet’s scrolls featuring relatively good visual acuity. Although we did not obtain the corneal tissue for examination, the anterior segment investigation provides insight into the underlying histopathology and natural disease history. The central hollow and cellular component seen

  18. The long-term anterior segment configuration after pediatric cataract surgery and the association with secondary glaucoma

    Science.gov (United States)

    Chen, Ding; Gong, Xian-hui; Xie, He; Zhu, Xue-ning; Li, Jin; Zhao, Yun-e

    2017-01-01

    Secondary glaucoma constitutes major sight-threatening complication of pediatric cataract surgery, yet the etiology remains unclear. The purpose of this study was to investigate the long-term anterior segment configuration and the association with secondary glaucoma in pediatric pseudophakia. Ultrasound biomicroscopy (UBM) was performed on 40 eyes of 26 children underwent pediatric cataract surgery and intraocular lens (IOL) implantation. The anterior chamber depth (ACD), angle-opening distance at 500 μm (AOD500), trabecular-iris angle (TIA), central corneal thickness (CCT), structural abnormities, IOL position, IOP, and incidence of glaucoma were evaluated. High insertion of iris, in which the iris root is attached more anteriorly than normal, was seen in 13 eyes (32.50%). IOL was located in the capsular bag in 19 eyes and in the ciliary sulcus in 21 eyes. Logistic regression analysis identified high insertion of iris (OR 3.40, 95% CI 1.03–11.17, p = 0.03) and IOL implantation in sulcus (OR 1.39, 95% CI 1.07–4.85, p = 0.04) as independent risk factors for glaucoma. The presence of high insertion of iris and IOL implantation in ciliary sulcus may increase the long-term risk of the development of secondary glaucoma after pediatric cataract surgery. PMID:28220849

  19. Advancement of maxillary anterior segment by distraction osteogenesis for severe maxillary retrusion in cleft lip and palate

    Institute of Scientific and Technical Information of China (English)

    Gao Feng; Yang Minlie; Zhao Zhenmin; Sun Xiaomei; Yin Ningbei; Wang Yongqian; Song Tao

    2014-01-01

    Background Maxillary anterior segmental distraction osteogenesis (MASDO) is a recently used method for correction of severe maxillary retrusion in cleft lip and palate (CLP) patients.In this article,we evaluated the feasibility of MASDO using rigid external distraction (RED) and rapid orthodontic tooth movement to correct severe maxillary retrusion in CLP patients.Methods Fourteen male and five female complete CLP patients between the ages of 18 and 22 years (mean age 19.7 years) at the time of distraction,with severe maxillary retrusion,were treated with the rigid external distraction (RED) device after maxillary anterior osteotomy.Rapid orthodontic tooth movement was started one week after the MASDO.Standard profile photographic,cephalometric films were obtained preoperatively and after therapy.Sella-nasion-point A (SNA) and Sella-nasion-point B (SNB) angles were measured to reflect changes in maxillary and mandibular position,and the distance between anterior nasal spine and posterior nasal spine (ANS-PNS) was measured to represent the maxillary dental arch length.Results The SNA angle increased from an average of 74.6° (range 73.0°-78.0°),preoperatively,to 83.4° (range 78.6°-88.0°) after the RED was removed (P <0.01).All cases of severe maxillary retrusion were improved.Nine patients' profiles became harmonious after therapy.One patient had a bimaxillary protrusion deformity and needed further surgery.The regenerate alveolar crest and edentulous space on both segments was almost completely eliminated after rapid orthodontic tooth movement.Conclusion MASDO with the RED system and rapid orthodontic tooth movement is a successful way of correcting severe maxillary retrusion in CLP patients.

  20. Comparison between a New Optical Biometry Device and an Anterior Segment Optical Coherence Tomographer for Measuring Central Corneal Thickness and Anterior Chamber Depth

    Science.gov (United States)

    Huang, Jinhai; Lu, Weicong; Savini, Giacomo; Chen, Hao; Wang, Chengfang; Yu, Xinxin; Bao, Fangjun; Wang, Qinmei

    2016-01-01

    Purpose. To compare between a new optical biometer (AL-Scan, Nidek Co., Aichi, Japan) and an anterior segment optical coherence tomographer (Visante AS-OCT, Carl Zeiss Meditec, Dublin, USA) for measuring central corneal thickness (CCT), anterior chamber depth (ACD), and aqueous depth (AD). Methods. Sixty-three eyes of 63 normal subjects were examined with AL-Scan and Visante AS-OCT in this prospective study. One eye per subject was measured three times with both devices to record their CCT, ACD, and AD. All procedures were performed by the same operator. Agreement between the two devices was assessed using paired t-tests, Bland-Altman plots, and 95% limits of agreement (LoA). Results. The mean CCT, ACD, and AD measured by AL-Scan were 538.59 ± 27.37 μm, 3.70 ± 0.30 mm, and 3.16 ± 0.30 mm, respectively. The mean values obtained by the Visante OCT were 536.14 ± 26.61 μm for CCT, 3.71 ± 0.29 mm for ACD, and 3.17 ± 0.29 mm for AD. The mean CCT by the AL-Scan was higher than that obtained by the Visante AS-OCT (difference = 2.45 ± 6.07 μm, P < 0.05). The differences in ACD and AD measurements were not statistically significant. The 95% LoA of CCT, ACD, and AD were between −9.44 and 14.35 μm, −0.15 and 0.12 mm, and −0.15 and 0.12 mm, respectively. Conclusions. Since these two devices were comparable for measuring CCT, ACD, and AD, their results can be interchangeably used in the clinic. PMID:27403339

  1. Comparison between a New Optical Biometry Device and an Anterior Segment Optical Coherence Tomographer for Measuring Central Corneal Thickness and Anterior Chamber Depth

    Directory of Open Access Journals (Sweden)

    Jinhai Huang

    2016-01-01

    Full Text Available Purpose. To compare between a new optical biometer (AL-Scan, Nidek Co., Aichi, Japan and an anterior segment optical coherence tomographer (Visante AS-OCT, Carl Zeiss Meditec, Dublin, USA for measuring central corneal thickness (CCT, anterior chamber depth (ACD, and aqueous depth (AD. Methods. Sixty-three eyes of 63 normal subjects were examined with AL-Scan and Visante AS-OCT in this prospective study. One eye per subject was measured three times with both devices to record their CCT, ACD, and AD. All procedures were performed by the same operator. Agreement between the two devices was assessed using paired t-tests, Bland-Altman plots, and 95% limits of agreement (LoA. Results. The mean CCT, ACD, and AD measured by AL-Scan were 538.59±27.37 μm, 3.70±0.30 mm, and 3.16±0.30 mm, respectively. The mean values obtained by the Visante OCT were 536.14±26.61 μm for CCT, 3.71±0.29 mm for ACD, and 3.17±0.29 mm for AD. The mean CCT by the AL-Scan was higher than that obtained by the Visante AS-OCT (difference = 2.45±6.07 μm, P<0.05. The differences in ACD and AD measurements were not statistically significant. The 95% LoA of CCT, ACD, and AD were between −9.44 and 14.35 μm, −0.15 and 0.12 mm, and −0.15 and 0.12 mm, respectively. Conclusions. Since these two devices were comparable for measuring CCT, ACD, and AD, their results can be interchangeably used in the clinic.

  2. Morphological expression of the anterior spinal artery and the intracranial segment of the vertebral artery: a direct anatomic study.

    Science.gov (United States)

    Ballesteros, L; Forero, P; Quintero, I

    2013-01-01

    Given its importance for clinical diagnosis and management, the purpose of this study was to determine the morphological expression of the intracranial segment of both vertebral and spinal arteries. Ninety-five fresh cadaveric specimens autopsied at the Instituto de Medicina Legal of Bucaramanga (Colombia) were perfused with polyester resins at the vertebrobasilar vascular bed, by canalizing the proximal segment of the internal carotids and vertebral arteries. The intracranial segment of the vertebral arteries (VA) had a length of 33.2±5.2 mm and a caliber of 3.03±0.81 mm. The left vertebral artery had a caliber of 3.12±0.85 mm, this being greater than the caliber of the right artery in 59.6% of the cases. The VA junction was seen at the level of the ponto-medullary sulcus in 44.2%, above this level in 30.5%, and below it in 25.3%. The distance from the origin of the anterior spinal branches (ASBs) to the VA junction was 7.34±2.71 mm, with a greater distance corresponding to the right ASBs, a difference that did not reach statistical significance (p=0.32). The anterior spinal arteries (ASA) had a bilateral origin in 65.3% of the cases, with the caliber being balanced in 37 (39%) and dominant at the right side in 15.8%. A right unilateral origin of the ASA was observed in 13.7% and a left unilateral origin in 9.5% of the specimens. There is disagreement in the literature as to the level of the junction of the two vertebral arteries. The unilateral origin of the spinal arteries is more frequent than most prior studies have indicated.

  3. Optimal timing of coronary invasive strategy in non-ST-segment elevation acute coronary syndromes

    DEFF Research Database (Denmark)

    Navarese, Eliano P; Gurbel, Paul A; Andreotti, Felicita;

    2013-01-01

    The optimal timing of coronary intervention in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACSs) is a matter of debate. Conflicting results among published studies partly relate to different risk profiles of the studied populations....

  4. Parathyroid Adenoma Located on Anterior Mediastinum and Hungry Bone Syndrome ; Case Report

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    Ali Celik

    2013-10-01

    Full Text Available   Anterior mediastinum is a rare localization for ectopic parathyroid adenoma. This localization seen about 1-2 % in the patient that looked for primary  ypherparathyroidism etiology. On a 33 - years old male patient who had searched for primary   perparathyroidism etiology, an anterior mediastinal lesion which referred to be an ectopic parathyroid adenoma was detected via Tc-99m MIBI. After, total mass excision was performed via sternotomy, pathologic examination reported as parathyroid adenoma. In early postoperative period, hungry bone syndrome was occured. After treatment, the patient whose clinic and laboratory results was normal discharged uneventful. The ectopic paratroid adenomas and their surgical  options and postoperative management has reviewed with literature knowladge  due to this case.

  5. Anterior pituitary lobe atrophy as late complication of hemorrhagic fever with renal syndrome

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    Jovanović Dragan

    2009-01-01

    Full Text Available Introduction. Hemorrhagic fever with renal syndrome (HFRS is acute infective multisystemic disease followed by febrility, hemorrhages and acute renal insufficiency. Bleeding in the anterior pituitary lobe leading to tissue necrosis occurs in acute stage of severe clinical forms of HFRS, while atrophy of the anterior pituitary lobe with diminution of the gland function occurs after recovery stage. Case report. We presented a patient with the development of chronic renal insufficiency and hypopituitarism as complication that had been diagnosed six years after Hantavirus infection. Magnetic resonance of the pituitary gland revealed atrophy and empty sella turcica. Conclusion. Regarding frequency of this viral infection and its endemic character in some parts of our country partial and/or complete loss of pituitary function should be considered during the late stage of HFRS.

  6. Anterior Spinal Artery Syndrome: Reversible Paraplegia after Minimally Invasive Spine Surgery

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    J. Bredow

    2014-01-01

    Full Text Available Background Context. Percutaneous balloon kyphoplasty is an established minimally invasive technique to treat painful vertebral compression fractures, especially in the context of osteoporosis with a minor complication rate. Purpose. To describe the heparin anticoagulation treatment of paraplegia following balloon kyphoplasty. Study Design. We report the first case of an anterior spinal artery syndrome with a postoperative reversible paraplegia following a minimally invasive spine surgery (balloon kyphoplasty without cement leakage. Methods. A 75-year-old female patient underwent balloon kyphoplasty for a fresh fracture of the first vertebra. Results. Postoperatively, the patient developed an acute anterior spinal artery syndrome with motor paraplegia of the lower extremities as well as loss of pain and temperature sensation with retained proprioception and vibratory sensation. Complete recovery occurred six hours after bolus therapy with 15.000 IU low-molecular heparin. Conclusion. Spine surgeons should consider vascular complications in patients with incomplete spinal cord syndromes after balloon kyphoplasty, not only after more invasive spine surgery. High-dose low-molecular heparin might help to reperfuse the Adamkiewicz artery.

  7. Evaluation of anterior ocular segment complications in patients with allergic keratoconjunctivitis

    OpenAIRE

    Patrícia Bezerra de Menezes Botelho; Patrícia Marback; Luciene Barbosa de Sousa; Mauro Campos; Luiz Antonio Vieira

    2003-01-01

    INTRODUÇÃO: A alergia ocular é condição que pode ocasionar sintomas de coceira, ardor e lacrimejamento, podendo também ser ameaçadora para visão. A fisiopatologia envolve mecanismos de hipersensibilidade imunológica. Devido a fatores imunológicos, o segmento anterior destes pacientes está mais suscetível a alterações que ameaçam a acuidade visual, tais como: opacidades corneanas, ceratocone e catarata. MÉTODOS: Foram revistos, retrospectivamente, 186 pacientes com ceratoconjuntivite alérgica ...

  8. Anterior segment biometry using ultrasound biomicroscopy and the Artemis-2 very high frequency ultrasound scanner

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    Al-Farhan HM

    2013-01-01

    Full Text Available Haya M Al-Farhan, Reem N AlMutairiKing Saud University, College of Applied Medical Sciences, Department of Optometry and Vision Sciences, Riyadh, Kingdom of Saudi ArabiaPurpose: To compare the precision of anterior chamber angle (ACA and anterior chamber depth (ACD measurements taken with ultrasound biomicroscopy (UBM and the Artemis-2 Very High Frequency Ultrasound Scanner (VHFUS in normal subjects.Design: Prospective study.Methods: We randomly selected one eye from each of 59 normal subjects in this study. Two subjects dropped out of the study; the associated data were excluded from analysis. ACA and ACD measurements were obtained using the VHFUS and the UBM. The results were compared statistically using repeated-measures analysis of variance for the intraobserver repeatability, unpaired t-test, and limits of agreement.Results: The average ACA values for the UBM and the VHFUS (±standard deviation were 41.83° ± 5.03° and 33.36° ± 6.03°, respectively. The average ACD values were 2.96 ± 0.34 mm and 2.87 ± 0.31 mm. The intraobserver repeatability analysis of variance P-values for ACA and ACD measurements using UBM were 0.10 and 0.68, respectively; for the Artemis-2 VHFUS, the respective values were 0.68 and 0.09. The difference in ACA measurements was statistically significant (t = 8.41; P < 0.0001, while the difference in ACD values was not (t = 1.51; P < 0.13. The mean ACA difference was 8.50° ± 2.50°, and the limits of agreement were +13.30° to −3.60°. The mean ACD difference was 0.09 ± 0.27 mm, and the limits of agreement ranged from 0.61 mm to −0.43 mm. The mean difference percentage of ACD was 3.1% for both instruments.Conclusion: In case of the ACD, both instruments can be used interchangeably; however, with the ACA instruments, they cannot be used interchangeably.Keywords: anterior chamber angle, anterior chamber depth, Artemis-2 VHF scanner, ultrasound biomicroscope, normal eyes

  9. Genetics and aging; the Werner syndrome as a segmental progeroid syndrome.

    Science.gov (United States)

    Martin, G M

    1985-01-01

    The maximum lifespan potential is a constitutional feature of speciation and must be subject to polygenic controls acting both in the domain of development and in the domain of the maintenance of macromolecular integrity. The enormous genetic heterogeneity that characterizes our own species, the complexities of numerous nature-nurture interactions, and the quantitative and qualitative variations of the senescent phenotype that are observed suggest that precise patterns of aging in each of us may be unique. Patterns of aging may also differ sharply among species (for example, semelparous vs. multiparous mammals). Some potential common denominators, however, allow one to identify progeroid syndromes in man that could lead to the elucidation of important pathways of gene action. (The suffix "-oid" means "like"; it does not mean identity.) Unimodal progeroid syndromes (eg., familial dementia of the Alzheimer type, an autosomal dominant) can help us understand the pathogenesis of a particular aspect of the senescent phenotype of man. Segmental progeroid syndromes (eg. the Werner syndrome, an autosomal recessive) may be relevant to multiple aspects of the senescent phenotype. Some results of research on the Werner syndrome may be interpreted as support for "peripheral" as opposed to "central" theories of aging; they are consistent with the view that gene action in the domain of development (adolescence, in this instance) can set the stage for patterns of aging in the adult; they point to the importance of mesenchymal cell populations in the pathogenesis of age-related disorders; finally, they underscore the role of chromosomal instability, especially in the pathogenesis of neoplasia.

  10. Conservation, Innovation, and Bias: Embryonic Segment Boundaries Position Posterior, but Not Anterior, Head Horns in Adult Beetles.

    Science.gov (United States)

    Busey, Hannah A; Zattara, Eduardo E; Moczek, Armin P

    2016-07-01

    The integration of form and function of novel traits is a fundamental process during the developmental evolution of complex organisms, yet how novel traits and trait functions integrate into preexisting contexts remains poorly understood. Here, we explore the mechanisms by which the adult insect head has been able to integrate novel traits and features during its ontogeny, focusing on the cephalic horns of Onthophagus beetles. Specifically, using a microablation approach we investigate how different regions of the dorsal head of adult horned beetles relate to their larval and embryonic counterparts and test whether deeply conserved regional boundaries that establish the embryonic head might also facilitate or bias the positioning of cephalic horns along the dorsal adult head. We find that paired posterior horns-the most widespread horn type within the genus-are positioned along a border homologous to the embryonic clypeolabral (CL)-ocular boundary, and that this placement constitutes the ancestral form of horn positioning. In contrast, we observed that the phylogenetically much rarer anterior horns are positioned by larval head regions contained firmly within the CL segment and away from any major preexisting larval head landmarks or boundaries. Lastly, we describe the unexpected finding that ablations at medial head regions can result in ectopic outgrowths bearing terminal structures resembling the more anterior clypeal ridge. We discuss our results in the light of the developmental genetic mechanisms of head formation in holometabolous insects and the role of co-option in innovation and bias in developmental evolution.

  11. Texture analysis improves level set segmentation of the anterior abdominal wall

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Zhoubing [Electrical Engineering, Vanderbilt University, Nashville, Tennessee 37235 (United States); Allen, Wade M. [Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee 37235 (United States); Baucom, Rebeccah B.; Poulose, Benjamin K. [General Surgery, Vanderbilt University Medical Center, Nashville, Tennessee 37235 (United States); Landman, Bennett A. [Electrical Engineering, Vanderbilt University, Nashville, Tennessee 37235 and Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee 37235 (United States)

    2013-12-15

    Purpose: The treatment of ventral hernias (VH) has been a challenging problem for medical care. Repair of these hernias is fraught with failure; recurrence rates ranging from 24% to 43% have been reported, even with the use of biocompatible mesh. Currently, computed tomography (CT) is used to guide intervention through expert, but qualitative, clinical judgments, notably, quantitative metrics based on image-processing are not used. The authors propose that image segmentation methods to capture the three-dimensional structure of the abdominal wall and its abnormalities will provide a foundation on which to measure geometric properties of hernias and surrounding tissues and, therefore, to optimize intervention.Methods: In this study with 20 clinically acquired CT scans on postoperative patients, the authors demonstrated a novel approach to geometric classification of the abdominal. The authors’ approach uses a texture analysis based on Gabor filters to extract feature vectors and follows a fuzzy c-means clustering method to estimate voxelwise probability memberships for eight clusters. The memberships estimated from the texture analysis are helpful to identify anatomical structures with inhomogeneous intensities. The membership was used to guide the level set evolution, as well as to derive an initial start close to the abdominal wall.Results: Segmentation results on abdominal walls were both quantitatively and qualitatively validated with surface errors based on manually labeled ground truth. Using texture, mean surface errors for the outer surface of the abdominal wall were less than 2 mm, with 91% of the outer surface less than 5 mm away from the manual tracings; errors were significantly greater (2–5 mm) for methods that did not use the texture.Conclusions: The authors’ approach establishes a baseline for characterizing the abdominal wall for improving VH care. Inherent texture patterns in CT scans are helpful to the tissue classification, and texture

  12. Combined anterior and posterior decompression and short segment fixation for unstable burst fractures in the dorso lumbar region.

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    Ramani P

    2002-07-01

    Full Text Available The dorso lumbar segment of spine (D10 to L2 is an unstable zone between fixed dorsal and mobile lumbar spine. A combined anterior and posterior approach with short segment stabilization was found most appropriate. Thirty cases were treated over a period of 4 years and 6 months. There were 26 male and 4 female patients with mean age of 32.6 years. L1 vertebra was fractured in 17 cases, D1 in 8 cases, D11 in 4 cases and D10 in one case. 14 cases had total neurological deficit, 9 cases had partial and 7 had no neurological deficit. We have used three column classification of Denis to assess the cases. Seven patients returned to regular physical work, 5 had restricted physical work, 5 remained in full time light job and 9 patients were unable to return to original job but did some work. Most had flaccid paraplegia but 4 patients were completely disabled due to spastic paraplegia. Neurological recovery occurred in all the patients with partial paralysis, and appeared to be dependent on initial kyphosis. The overall recovery rate varied from 50% to 90%. There is no correlation between canal compromise and severity of injury. Neurological injury occured at the time of trauma, rather than as a result of pressure of fragment in the canal. No strong conclusion could be drawn to say that the results of surgery were superior to non-operative treatment.

  13. Acute Tubulointerstitial Nephritis and Anterior Uveitis (TINU Syndrome: A Report of Two Cases

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    Mortajil Fatima

    2006-01-01

    Full Text Available TINU or Dobrin syndrome is a rare oculo-renal inflammatory condition which is comprised of acute idiopathic tubulointerstitial nephritis and uveitis. We report here two female patients aged 35 and 44 years, who were admitted with severe renal failure of acute onset (serum creatinine of 607 and 310 Umol/L [Editor note: do you mean "µmol/L"?] respectively with the first patient requiring hemodialysis. The cause of acute renal failure was unclear on clinical and laboratory assessment, and a percutaneous renal biopsy was performed which showed features of acute tubulointerstitial nephritis in both cases. Both patients were started on oral steroids at a dose of 1 mg/kg/day. There was progressive improvement of their renal function. Three months later, the two patients presented with bilateral anterior uveitis requiring local corticosteroid therapy. This was followed by total resolution of the uveitis. The cause of the interstitial nephritis and the uveitis could not be identified in the two cases. The renal function was normal in these patients after 24 and 27 months of follow-up, respectively. Dobrin or TINU syndrome is rare, and must be considered in patients who present with acute tubular interstitial [Editor note: for consistency with the title, you may wish to replace this with "tubulointerstitial"] nephritis and anterior uveitis.

  14. Autosomal recessive mental retardation syndrome with anterior maxillary protrusion and strabismus: MRAMS syndrome.

    Science.gov (United States)

    Basel-Vanagaite, Lina; Rainshtein, Limor; Inbar, Dov; Gothelf, Doron; Hennekam, Raoul; Straussberg, Rachel

    2007-08-01

    We report on a family in whom the combination of mental retardation (MR), anterior maxillary protrusion, and strabismus segregates. The healthy, consanguineous parents (first cousins) of Israeli-Arab descent had 11 children, 7 of whom (5 girls) were affected. They all had severe MR. Six of the seven had anterior maxillary protrusion with vertical maxillary excess, open bite, and prominent crowded teeth. None of the sibs with normal intelligence had jaw or dental anomalies. The child with MR but without a jaw anomaly was somewhat less severely retarded, had seizures and severe psychosis, which may point to his having a separate disorder. Biochemical and neurological studies, including brain MRI and standard cytogenetic studies, yielded normal results; fragile X was excluded, no subtelomeric rearrangements were detectable, and X-inactivation studies in the mother showed random inactivation. We have been unable to find a similar disorder in the literature, and suggest that this is a hitherto unreported autosomal recessive disorder, which we propose to name MRAMS (mental retardation, anterior maxillary protrusion, and strabismus).

  15. Transient autonomic dysfunction precedes ST-segment depression in patients with syndrome X.

    Science.gov (United States)

    Ponikowski, P; Rosano, G M; Amadi, A A; Collins, P; Coats, A J; Poole-Wilson, P A; Kaski, J C

    1996-05-01

    Increased sympathetic drive has been suggested to play a role in the pathogenesis of syndrome X (angina pectoris, positive exercise testing, and angiographically normal coronary arteries). Heart rate variability (HRV) studies have shown that patients with syndrome X have an imbalance in autonomic nervous system activity (sympathetic predominance). However, it is not known if transient ST-segment depression which occurs in syndrome X during daily activities is related to this autonomic nervous system dysfunction. This study investigates the relation between the response of the autonomic nervous system, as assessed by HRV analysis, and the occurrence of transient ST-segment depression during 24-hour ambulatory electrocardiographic monitoring in 23 patients (4 men and 19 women, mean age 55 +/- 6 years) with syndrome X. The frequency-domain variables of HRV low-frequency (0.04 to 0.15 Hz) and high-frequency (0.15 to 0.40 Hz) power were measured at 6-minute intervals during the 30 minutes preceding the onset of transient ST-segment depression. Fourteen patients (61%) had > or = 1 episode of ST-segment depression in the 24 hours, whereas the remaining 9 patients (39%) had no significant ST-segment change. HRV measures differed according to whether or not ST-segment depression was associated with increased heart rate. Episodes of ST-segment depression associated with increased heart rate were preceded by a reduction of high-frequency power and an increase in the low-frequency--high-frequency ratio, whereas episodes of ST-segment depression not associated with increased heart rate showed no significant HRV changes. Low-frequency power remained unchanged irrespective of heart rate. Thus, in patients with syndrome X, a sympathovagal imbalance (sympathetic predominance due to vagal tone withdrawal) precedes episodes of ST-segment depression that are associated with an increased heart rate.

  16. Review of integrated neuromusculoskeletal release and the novel application of a segmental anterior/posterior approach in the thoracic, lumbar, and sacral regions.

    Science.gov (United States)

    Danto, Jay B

    2003-12-01

    Integrated neuromusculoskeletal release (INR) using a segmental anterior/posterior approach is an osteopathic manipulative treatment technique that is easily learned and applied. The segmental anterior/posterior approach to INR was developed as a practical osteopathic manipulative treatment procedure for the inpatient setting, but also has equal efficacy in the outpatient setting. It builds on the principles of INR and myofascial release techniques, as well as other techniques. This approach focuses on both the anterior and posterior connectivity of the body through the neuromusculoskeletal system and uses this connectivity to effectively treat somatic dysfunctions. The principles of INR are discussed, as well as the role of INR in the diagnosis and treatment of somatic dysfunctions in the thoracic, lumbar, and sacral regions.

  17. Lower extremity anterior compartment syndrome complicating bilateral mastectomy and immediate breast reconstruction: A case report and literature review.

    Science.gov (United States)

    Tashakkor, A Yashar; Macadam, Sheina A

    2012-01-01

    'Well leg compartment syndrome' refers to compartment syndrome occurring in a nontraumatic setting. This occurs most commonly in the lower limb during surgery performed with the patient in an anatomically vulnerable position. While this complication is well documented in the setting of orthopedic, urological and gynecological surgeries, it is an exceptionally rare complication in plastic surgery; only seven cases have been published on compartment syndrome complicating an operation performed on a supine patient. A case involving a 56-year-old woman who developed an anterior compartment syndrome of her right lower leg following a bilateral mastectomy with immediate breast reconstruction is presented. A detailed literature review is also included.

  18. Vitrectomy and translocation of the anterior chamber intraocular lens to the sulcus: a closed microsurgical technique for the UGH syndrome.

    Science.gov (United States)

    Gualtieri, William; Rossini, Paolo; Forlini, Cesare

    2008-01-01

    This interventional case report presents an anterior chamber intraocular lens (AC-IOL) translocation technique to manage a case of uveitis-glaucoma-hyphema (UGH) syndrome associated with posterior dislocation of nuclear fragments and vitreitis as a consequence of capsule rupture during cataract surgery. Pars plana vitrectomy followed by an AC-IOL translocation from the anterior chamber to the sulcus without additional surgical corneal incision was performed. At 12 months' follow-up, the original AC-IOL was in stable position in the posterior chamber, with binocular refractive balance and no further astigmatism and resolution of the UGH syndrome.

  19. Segmental overgrowth syndrome due to an activating PIK3CA mutation identified in affected muscle tissue by exome sequencing

    DEFF Research Database (Denmark)

    Rasmussen, Maria; Sunde, Lone; Weigert, Karen Petra;

    2014-01-01

    Mosaic PIK3CA-mutations have been described in an increasing number of overgrowth syndromes. We describe a patient with a previously unreported segmental overgrowth syndrome with the mutation, PIKCA3 c.3140A>G (p.His1047Arg) in affected tissue diagnosed by exome sequencing. This PIK3CA-associated......-associated segmental overgrowth syndrome overlaps with CLOVES syndrome and fibroadipose hyperplasia but is distinct from each of these entities....

  20. Revesz syndrome

    Directory of Open Access Journals (Sweden)

    Dayane Cristine Issaho

    2015-04-01

    Full Text Available Revesz syndrome is a rare variant of dyskeratosis congenita and is characterized by bilateral exudative retinopathy, alterations in the anterior ocular segment, intrauterine growth retardation, fine sparse hair, reticulate skin pigmentation, bone marrow failure, cerebral calcification, cerebellar hypoplasia and psychomotor retardation. Few patients with this syndrome have been reported, and significant clinical variations exist among patients. This report describes the first Brazilian case of Revesz syndrome and its ocular and clinical features.

  1. Responses of the Ocular Anterior Segment and Refraction to 0.5% Tropicamide in Chinese School-Aged Children of Myopia, Emmetropia, and Hyperopia

    Directory of Open Access Journals (Sweden)

    Ying Yuan

    2015-01-01

    Full Text Available Purpose. To investigate the changes of anterior segment after cycloplegia and estimate the association of such changes with the changes of refraction in Chinese school-aged children of myopia, emmetropia, and hyperopia. Methods. 309 children were recruited and eligible subjects were assigned to three groups: hyperopia, emmetropia, or myopia. Cycloplegia was achieved with five cycles of 0.5% tropicamide. The Pentacam system was used to measure the parameters of interest before and after cycloplegia. Results. In the myopic group, the lenses were thinner and the lens position was significantly more posterior than that of the emmetropic and hyperopic groups in the cycloplegic status. The correlations between refraction and lens thickness (age adjusted; r=0.26, P<0.01, and lens position (age adjusted; r=-0.31, P<0.01 were found. After cycloplegia, ACD and ACV significantly increased, while ACA significantly decreased. Changes in refraction, ACD, ACV, and ACA were significantly different among the three groups (P<0.05, all. Changes of refraction were correlated with changes of ACD (r=0.41, P<0.01. Conclusions. Myopia presented thinner lenses and smaller changes of anterior segment and refraction after cycloplegia when compared to emmetropia and hyperopia. Changes of anterior chamber depth were correlated with refraction changes. This may contribute to a better understanding of the relationship between anterior segment and myopia.

  2. Anterior Segment OpticalCoherence Tomography: Assisted Topographic Corneal Epithelial Thickness Distribution Imaging of a Keratoconus Patient

    Directory of Open Access Journals (Sweden)

    A. John Kanellopoulos

    2013-04-01

    Full Text Available Purpose: To evaluate safety, efficacy and ease of measurement of epithelial thickness in a keratoconic patient based on anterior segment optical coherence tomography (AS-OCT. Methods: A 25-year-old male patient, previously diagnosed with keratoconus, with highly asymmetric manifestation among the two eyes, was subjected to AS-OCT corneal epithelial imaging. We investigated epithelial thickness and epithelial topographic thickness distribution. Results: Mean epithelial thickness was 51.97 ± 0.70 for the less affected right eye (OD, and 55.65 ± 1.22 for the more affected left eye (OS. Topographic epithelial thickness variability for the OD was 1.53 ± 0.21 μm, while for the OS it was 9.80 ± 0.41 μm. Conclusions: This case further supports our previous findings with high-frequency ultrasound measurements of the increase in overall epithelial thickness in keratoconic eyes in comparison with normal eyes. AS-OCT further offers ease of use and possibly higher predictability of measurement. This case report, based on AS-OCT imaging, verifies increased overall epithelial thickness in keratoconic eyes, as introduced by a previous study [Kanellopoulos et al.: Clin Ophthalmol 2012;6:789-800], based on high-frequency scanning ultrasound biomicroscopy imaging.

  3. Bilateral anterior tarsal tunnel syndrome variant secondary to extensor hallucis brevis muscle hypertrophy in a ballet dancer: a case report.

    Science.gov (United States)

    Tennant, Joshua N; Rungprai, Chamnanni; Phisitkul, Phinit

    2014-12-01

    We present a case of bilateral anterior tarsal tunnel syndrome secondary EHB hypertrophy in a dancer, with successful treatment with bilateral EHB muscle excisions for decompression. The bilateral presentation of this case with the treatment of EHB muscle excision is the first of its type reported in the literature.

  4. Segmental reversal of the small bowel as treatment of short bowel syndrome in adults

    DEFF Research Database (Denmark)

    Burgdorf, Stefan K; Qvist, Niels; Gögenur, Ismail

    2014-01-01

    Short bowel syndrome is the result of extensive surgical resection, inherited defects or loss of functional absorbing intestine. Parenteral nutrition is associated with high economical expenses, increased morbidity and decreased quality of life. Intestinal transplantation is associated with high...... morbidity and mortality rates. Segmental reversal of the small bowel can prolong the transit time in the small bowel and in many cases permanently end parenteral nutrition dependency. Segmental reversal of the small bowel should be integrated in the surgical treatment of adults with short bowel syndrome....

  5. [Prehospital stage of medical aid to patients with acute coronary syndrome and elevated ST segment].

    Science.gov (United States)

    Vertkin, A L; Morozov, S N; Fedorov, A I

    2013-01-01

    We studied effect of time on the outcome of acute coronary syndrome and elevated ST segment at the prehospital stage. Logistic regression analysis revealed two time-dependent predictors: "symptom-needle" time and total call service time. In patients undergoing prehospital thrombolysis, these indices (88 and 85 min respectively) reliably predicted the probability of fatal outcome. Their values of 71 and 77 min respectively predicted the risk of unfavourable outcome. The total call service time may serve as an indicator of the quality of work of an ambulance crew at the prehospital stage of management of acute coronary syndrome with elevated ST segment.

  6. Boston type I keratoprosthesis-donor cornea interface evaluated by high-definition spectral-domain anterior segment optical coherence tomography

    Directory of Open Access Journals (Sweden)

    Alzaga Fernandez AG

    2012-08-01

    Full Text Available Ana G Alzaga Fernandez,* Nathan M Radcliffe,* Kimberly C Sippel, Mark I Rosenblatt, Priyanka Sood, Christopher E Starr, Jessica B Ciralsky, Donald J D'Amico, Szilárd KissDepartment of Ophthalmology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA*These authors contributed equally to this work and both are considered principal authorsBackground: The purpose of this study was to assess whether the resolution offered by two different, recently commercially available high-resolution, spectral-domain anterior segment optical coherence tomography (AS-OCT instruments allows for detailed anatomic characterization of the critical device-donor cornea interface in eyes implanted with the Boston type I permanent keratoprosthesis.Methods: Eighteen eyes of 17 patients implanted with the Boston type I keratoprosthesis were included in this retrospective case series. All eyes were quantitatively evaluated using the Cirrus HD-OCT while a subset (five eyes was also qualitatively imaged using the Spectralis Anterior Segment Module. Images from these instruments were analyzed for evidence of epithelial migration onto the anterior surface of the keratoprosthesis front plate, and presence of a vertical gap between the posterior surface of the front plate and the underlying carrier donor corneal tissue. Quantitative data was obtained utilizing the caliper function on the Cirrus HD-OCT.Results: The mean duration between AS-OCT imaging and keratoprosthesis placement was 29 months. As assessed by the Cirrus HD-OCT, 83% of eyes exhibited epithelial migration over the edge of the front plate. Fifty-six percent of the keratoprosthesis devices displayed good apposition of the device with the carrier corneal donor tissue. When a vertical gap was present (44% of eyes, the mean gap was 40 (range 8–104 microns. The Spectralis Anterior Segment Module also displayed sufficient resolution to allow for similar characterization of the device

  7. Efficacy and safety of out-of-hospital intravenous metoprolol administration in anterior ST-segment elevation acute myocardial infarction: insights from the METOCARD-CNIC trial

    OpenAIRE

    Mateos, Alonso; García Lunar, Inés; García Ruiz, José María; Pizarro, Gonzalo; Fernández Jiménez, Rodrigo; Huertas, Pilar; García Álvarez, Ana; Fernández-Friera, Leticia; Bravo, Jesús; Flores Arias, José; Barreiro, María V.; Chayán Zas, Luisa; Corral, Ervigio; Fuster, Valentín; Sánchez Brunete, Vicente

    2015-01-01

    We seek to examine the efficacy and safety of prereperfusion emergency medical services (EMS)–administered intravenous metoprolol in anterior ST-segment elevation myocardial infarction patients undergoing eventual primary angioplasty. This is a prespecified subgroup analysis of the Effect of Metoprolol in Cardioprotection During an Acute Myocardial Infarction trial population, who all eventually received oral metoprolol within 12 to 24 hours. We studied patients receiving intravenous metoprol...

  8. Assessment of Anterior Segment Changes in Pseudophakic Eyes, Using Ultrasonic Biomicroscopic Imaging, after Pars Plana Vitrectomy with Silicone Oil or Gas Tamponade

    OpenAIRE

    Erkan Ünsal; Kadir Eltutar; Belma Karini; Osman Kızılay

    2016-01-01

    Objective. To evaluate the morphological changes of the anterior segment using ultrasonic biomicroscopy (UBM) imaging in pseudophakic patients who underwent pars plana vitrectomy (PPV) with silicone oil or gas (C3F8) internal tamponade agent injection. Method. This prospective study included pseudophakic patients with planned PPV, divided into two groups according to internal tamponade agent: those in which silicone oil was used (n = 27, Group 1) and those in which gas (C3F8) was used (n = 24...

  9. Management of non ST segment elevation acute coronary syndromes: A shift in the paradigm

    Institute of Scientific and Technical Information of China (English)

    Jean-Pierre Bassand

    2008-01-01

    @@ The new European guidelines on the management of non-ST segment elevation acute coronary syndromes (NSTE-ACS) were published in June 2007, two months before the American College of Cardiology-American Heart Association (ACC-AHA) guideline update on the same topic.1'2

  10. Applications of anterior segment optical coherence tomography in ophthalmology%眼前段相干光断层成像术在眼科的应用

    Institute of Scientific and Technical Information of China (English)

    王冰松; 王宁利

    2008-01-01

    The background,technical characteristics and operation procedures of anterior segment optical coherence tomography(OCT)are introduced.The ophthalmic applications of this technique are summarized.The initial studies showed that anterior segment OCT can be a promising tool for the observation of image and analysis of the cornea,the imaging and biological measuring of the anterior chamber,the observation of image and quantitative evaluation of the anterior chamber angle,the observation of image and assessment of phakic intraocular lenses,the observation of image and evaluation of trabeculectomy blebs as well as the observation of ocular accommodation.%本文介绍了眼前段相干光断层成像术(OCT)产生的背景、技术特点及测量方法,并对其在眼科的应用进行综述.初步的研究结果显示眼前段OCT在角膜成像和分析、前房成像和活体测量、前房角成像和定量分析、有晶状体眼人工晶状体成像和位置测量、小梁切除术后滤过泡的成像和分析以及眼的调节观察等方面均具有良好的应用前景.

  11. Application of Pentacam Anterior Segment Analysis System on diagnosis of keratoconus%Pentacam眼前节分析在圆锥角膜诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    徐漫; 孙荔; 刘永珍; 卢迪; 徐艳春; 陈蕾

    2015-01-01

    Pentacam三维眼前节分析系统可合成眼前节从角膜前表面到晶状体后表面的三维图像,通过测量分析系统检测的角膜前后表面曲率、角膜前后表面高度、后表面屈光度、角膜厚度、角膜体积、角膜散光度等,在圆锥角膜,特别是早期圆锥角膜的诊断中有重要作用.%Pentacam Anterior Segment Analysis System shows a 3D image which synthesize from the front surface of the cornea to the post surface of the lens.Anterior and posterior corneal curvature, anterior and posterior corneal elevation, posterior refractive power, corneal astigmatism, corneal volume and corneal thickness measured by the Pentacam Anterior Segment Analysis System play the important roles in diagnosing keratoconus, particular in diagnosing early keratoconus.

  12. Anterior ischemic optic neuropathy associated with metabolic syndrome Neuropatia óptica isquêmica anterior associada a síndrome metabólica

    Directory of Open Access Journals (Sweden)

    Natalija Kosanovic-Jakovic

    2008-02-01

    Full Text Available PURPOSE: Metabolic syndrome denotes a common cluster of naturally connected risk factors including obesity, elevated blood pressure, insulin resistance, dyslipidemia, proinflammatory state and prothrombotic state. Anterior ischemic optic neuropathy is an acute ischaemic disorder of the optic nerve head and may lead to severe visual loss. METHODS: We considered three patients with moderate degree of diabetic retinopathy and anterior ischemic optic neuropathy. They were submitted to endocrinological examination and the diagnosis of metabolic syndrome was established. RESULTS: Cardiological examination revealed that blood pressure control was not optimal. The signs of left ventricular hypertrophy and diastolic dysfunction were confirmed by echocardiography. They are possible markers of preclinical cardiovascular disease. CONCLUSION: We observed that a variety of well-known risk factors in metabolic syndrome may be involved in serious eye and cardiological complications. The early diagnosis and treatment of these patients can not only improve visual function but also prevent cardiovascular complications.OBJETIVO: A síndrome metabólica indica um grupo comum dos seguintes achados clinicos: obesidade, hipertensão arterial, variações nos níveis de glicemia, dislipidemia, estado proinflamatório e o estado protrombótico. Neuropatia óptica isquêmica anterior é um distúrbio agudo isquêmico da cabeça do nervo óptico que pode levar à perda de visão. MÉTODOS: Consideramos três pacientes com retinopatia diabética não proliferativa moderada e neuropatia óptica isquêmica anterior. Os pacientes foram examinados por endocrinologistas e o diagnóstico de síndrome metabólica foi confirmado. RESULTADOS: O exame cardiológico revelou que o controle da pressão sangüínea não era adequado e tal anormalidade foi corrigida. A ecocardiografia confirmou os indícios de hipertrofia ventricular esquerda e disfunção diastólica. Estes são os

  13. Agreement of angle closure assessments between gonioscopy, anterior segment optical coherence tomography and spectral domain optical coherence tomography

    Institute of Scientific and Technical Information of China (English)

    Elton; Lik; Tong; Tay; Vernon; Khet; Yau; Yong; Boon; Ang; Lim; Stelson; Sia; Elizabeth; Poh; Ying; Wong; Leonard; Wei; Leon; Yip

    2015-01-01

    AIM: To determine angle closure agreements between gonioscopy and anterior segment optical coherence tomography(AS-OCT), as well as gonioscopy and spectral domain OCT(SD-OCT). A secondary objective was to quantify inter-observer agreements of AS-OCT and SD-OCT assessments.METHODS: Seventeen consecutive subjects(33 eyes)were recruited from the study hospital’s Glaucoma clinic.Gonioscopy was performed by a glaucomatologist masked to OCT results. OCT images were read independently by 2 other glaucomatologists masked to gonioscopy findings as well as each other’s analyses of OCT images.RESULTS: Totally 84.8% and 45.5% of scleral spurs were visualized in AS-OCT and SD-OCT images respectively(P <0.01). The agreement for angle closure between AS-OCT and gonioscopy was fair at k =0.31(95% confidence interval, CI: 0.03-0.59) and k =0.35(95%CI: 0.07-0.63) for reader 1 and 2 respectively. The agreement for angle closure between SD-OCT and gonioscopy was fair at k =0.21(95% CI: 0.07-0.49) and slight at k =0.17(95% CI: 0.08-0.42) for reader 1 and 2 respectively. The inter-reader agreement for angle closure in AS-OCT images was moderate at 0.51(95% CI: 0.13-0.88). The inter-reader agreement for angle closure in SD-OCT images was slight at 0.18(95% CI: 0.08-0.45).CONCLUSION: Significant proportion of scleral spurs were not visualised with SD-OCT imaging resulting in weaker inter-reader agreements. Identifying other angle landmarks in SD-OCT images will allow more consistent angle closure assessments. Gonioscopy and OCT imaging do not always agree in angle closure assessments but have their own advantages, and should be used together and not exclusively.

  14. Mutation analysis of the genes associated with anterior segment dysgenesis, microcornea and microphthalmia in 257 patients with glaucoma.

    Science.gov (United States)

    Huang, Xiaobo; Xiao, Xueshan; Jia, Xiaoyun; Li, Shiqiang; Li, Miaoling; Guo, Xiangming; Liu, Xing; Zhang, Qingjiong

    2015-10-01

    Genetic factors have an important role in the development of glaucoma; however, the exact genetic defects remain to be identified in the majority of patients. Glaucoma is frequently observed in patients with anterior segment dysgenesis (ASD), microcornea or microphthalmia. The present study aimed to detect the potential mutations in the genes associated with ASD, microcornea and microphthalmia in 257 patients with glaucoma. Variants in 43 of the 46 genes, which are associated with ASD, microcornea or microphthalmia, were available in whole‑exome sequencing. Candidate variants in the 43 genes were selected following multi‑step bioinformatic analysis and were subsequently confirmed by Sanger sequencing. Confirmed variants were further validated by segregation analysis and analysis of controls. Overall, 70 candidate variants were selected from whole‑exome sequencing, of which 53 (75.7%) were confirmed by Sanger sequencing. In total, 27 of the 53 were considered potentially pathogenic based on bioinformatic analysis and analysis of controls. Of the 27, 6 were identified in BEST1, 4 in EYA1, 3 in GDF6, 2 in BMP4, 2 in CRYBA4, 2 in HCCS, and 1 in each of CRYAA, CRYGC, CRYGD, COL4A1, FOXC1, GJA8, PITX2 and SHH. The 27 variants were detected in 28 of 257 (10.9%) patients, including 11 of 125 patients with primary open‑angle glaucoma and 17 of 132 patients with primary angle‑closure glaucoma. Variants in these genes may be a potential risk factor for primary glaucoma. Careful clinical observation and analysis of additional patients in different populations are expected to further these findings.

  15. Fusion of Adjacent Segment Degeneration after Anterior Portion Cervical Decompression%颈前路融合术后相邻节段退变120例

    Institute of Scientific and Technical Information of China (English)

    占蓓蕾; 叶舟

    2014-01-01

    目的:探讨颈椎前路减压融合术后相邻节段退变的因果关系。方法:对237例患者行前路椎间节段减压植骨融合术(87例),椎体次全切除减压植骨融合术(109例),椎间节段减压、椎体次全切除减压植骨融合术(41例)。通过影像学检查,观察不同手术方法术后相邻节段退变发生情况。结果:术后随访时间2.6~13年,平均6.8年;发生相邻节段明显退变的120例(50.6%),头侧相邻节段退变发生率明显高于尾侧邻近节段(P<0.05),其中27例(22.2%)需2次翻修手术。结论:颈椎前路融合术后可导致颈椎相邻节段的退变。%Objective To investigate the result of anterior cervical decompression and fusion of adjacent segment degeneration after causality. Methods among 237 patients(87 cases) weretreated with anterior decom-pression and interbody fusion intervertebral segments, 109cases with subtotal excision of the vertebral body with decompression and interbody fusion,and 41 cases with intervertebral segmental decompression, vertebral body subtotal resection decompression and interbody fusion.By imaging examination, different surgical methods and postoperative adjacent segment degeneration were observed. Results Postoperative follow-up at time of 2.6~13 years, averaging 6.8 years; showed significantly degeneration of adjacent segments in 120 cases (50.6%), the cranial adjacent segment degeneration rate significantly higher than that of the caudal adjacent segment (P<0.05), among them,27 cases (22.2%)needed 2 times of revision surgery. Conclusion The anterior cervical fu-sion surgery can lead to cervical vertebral adjacent segment degeneration.

  16. Nephrotic syndrome and multiple tubular defects in children: an early sign of focal segmental glomerulosclerosis.

    Science.gov (United States)

    McVicar, M; Exeni, R; Susin, M

    1980-12-01

    The nephrotic syndrome is rarely associated with renal tubular defects, and the combination has been reported only in association with advanced renal insufficiency. We report here five children with nephrotic syndrome and multiple tubular defects which evolved when glomular filtration rate ranged between 56 and 90 ml/minute/1.73 m2. The tubular defects were first noted at 3, 4, 4, 7, and 22 months after the onset of the nephrotic syndrome, and renal glycosuria was the first sign in all five children. Glycosuria was intermittent in three patients, constant in two, and ceased with loss of kidney function. Four patients had hyperaminoaciduria and renal tubular acidosis (two of four tested had distal renal tubular acidosis). Three patients had decreased tubular reabsorption of phosphorus and defective maximum concentrating capacity. All five had focal segmental glomerulosclerosis proven by renal biopsy. Over a follow-up period of seven years, all of the children have developed advanced renal insufficiency, four of the five have required dialysis or transplantation within 21 to 72 months after onset, and one has stabilized renal function at 35 ml/minute/1.73 m2. The one patient receiving a kidney transplant has had recurrence of focal segmental glomerulosclerosis in the transplanted kidney and became nephrotic with three subsequent transplants. Our experience suggests that the nephrotic syndrome associated with tubular defects in children forms a subgroup of focal segmental glomerulosclerosis, with rapid progression to renal insufficiency and the potential for recurrence of the lesion in the transplanted kidney.

  17. Optic atrophy, necrotizing anterior scleritis and keratitis presenting in association with Streptococcal Toxic Shock Syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Papageorgiou Konstantinos I

    2008-02-01

    Full Text Available Abstract Introduction We report a case of optic atrophy, necrotizing anterior scleritis and keratitis presenting in a patient with Streptococcal Toxic Shock Syndrome. Case presentation A 43-year-old woman developed streptococcal toxic shock syndrome secondary to septic arthritis of her right ankle. Streptococcus pyogenes (b-haemolyticus Group A was isolated from blood cultures and joint aspirate. She was referred for ophthalmology review as her right eye became injected and the pupil had become unresponsive to light whilst she was in the Intensive Therapy Unit (ITU. The iris appeared atrophic and was mid-dilated with no direct or consensual response to light. Three zones of sub-epithelial opacification where noted in the cornea. There where extensive posterior synechiae. Indirect ophthalmoscopy showed a pale right disc. The vision was reduced to hand movements (HM. A diagnosis of optic atrophy was made secondary to post-streptococcal uveitis. She subsequently developed a necrotizing anterior scleritis. Conclusion This case illustrates a previously unreported association of optic atrophy, necrotizing anterior scleritis and keratitis in a patient with post-streptococcal uveitis. This patient had developed Streptococcal Toxic Shock Syndrome secondary to septic arthritis. We recommend increased awareness of the potential risks of these patients developing severe ocular involvement.

  18. Assessment of Anterior Segment Changes in Pseudophakic Eyes, Using Ultrasonic Biomicroscopic Imaging, after Pars Plana Vitrectomy with Silicone Oil or Gas Tamponade.

    Science.gov (United States)

    Ünsal, Erkan; Eltutar, Kadir; Karini, Belma; Kızılay, Osman

    2016-01-01

    Objective. To evaluate the morphological changes of the anterior segment using ultrasonic biomicroscopy (UBM) imaging in pseudophakic patients who underwent pars plana vitrectomy (PPV) with silicone oil or gas (C3F8) internal tamponade agent injection. Method. This prospective study included pseudophakic patients with planned PPV, divided into two groups according to internal tamponade agent: those in which silicone oil was used (n = 27, Group 1) and those in which gas (C3F8) was used (n = 24, Group 2). UBM measurements were performed in the supine position before and one week after surgery. Results. In patients of Group 1, postoperative trabecular meshwork-ciliary process distance (T-CPD) and iris-ciliary process distance (I-CPD), according to preoperative values, were found to be statistically significantly reduced, and postoperative mean value of scleral thickness (ST) and intraocular pressure (IOP), according to preoperative value, was found to be statistically significantly increased. In patients of Group 2, postoperative mean values of anterior chamber depth (ACD), ciliary body thickness (CBT), T-CPD, I-CPD, and IOP, according to preoperative values, were found to be statistically significantly reduced. Preoperatively, in Group 2 patients, according to Group 1 patients, TIA and IOP were found to be statistically significantly increased. Preoperative and postoperative IOP between the measured parameters with UBM showed no statistically significant correlation. Conclusions. Gases cause more morphological changes in the anterior segment structures. It is thought that complications such as increased intraocular pressure can be seen more frequently for this reason.

  19. Prevalence of adjacent segment disc degeneration in patients undergoing anterior cervical discectomy and fusion based on pre-operative MRI findings.

    Science.gov (United States)

    Lundine, Kristopher M; Davis, Gavin; Rogers, Myron; Staples, Margaret; Quan, Gerald

    2014-01-01

    Anterior cervical discectomy and fusion (ACDF) is a widely accepted surgical treatment for symptomatic cervical spondylosis. Some patients develop symptomatic adjacent segment degeneration, occasionally requiring further treatment. The cause and prevalence of adjacent segment degeneration and disease is unclear at present. Proponents for motion preserving surgery such as disc arthroplasty argue that this technique may decrease the "strain" on adjacent discs and thus decrease the incidence of symptomatic adjacent segment degeneration. The purpose of this study was to assess the pre-operative prevalence of adjacent segment degeneration in patients undergoing ACDF. A database review of three surgeons' practice was carried out to identify patients who had undergone a one- or two-level ACDF for degenerative disc disease. Patients were excluded if they were operated on for recent trauma, had an inflammatory arthropathy (for example, rheumatoid arthritis), or had previous spine surgery. The pre-operative MRI of each patient was reviewed and graded using a standardised methodology. One hundred and six patient MRI studies were reviewed. All patients showed some evidence of intervertebral disc degeneration adjacent to the planned operative segment(s). Increased severity of disc degeneration was associated with increased age and operative level, but was not associated with sagittal alignment. Disc degeneration was more common at levels adjacent to the surgical level than at non-adjacent segments, and was more severe at the superior adjacent level compared with the inferior adjacent level. These findings support the theory that adjacent segment degeneration following ACDF is due in part to the natural history of cervical spondylosis.

  20. Adjacent segment disease after anterior cervical discectomy and fusion: Incidence and clinical outcomes of patients requiring anterior versus posterior repeat cervical fusion

    Directory of Open Access Journals (Sweden)

    Mohamad Bydon

    2014-01-01

    Conclusions : Patients undergoing an anterior revision surgery for ASD after ACDF have higher rates of postoperative radiculopathy and redevelopment of ASD when compared with posteriorly approached patients. Patients receiving posterior revision surgery had higher intraoperative blood loss, hospitalizations, and postoperative complications such as wound infections and discharge to rehabilitation, but had a statistically lower chance of redevelopment of ASD requiring secondary revision surgery. This may be due to the fact that posterior revision surgeries involved more levels fused. This study provides one of the longest and most comprehensive follow-ups of this challenging patient population. Prospective studies comparing surgical approaches and techniques are needed to corroborate our findings.

  1. Significant relationship between local angle at fused segments and C2-7 angle: Average duration of longer than 20 years after anterior cervical discectomy and fusion

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    T Nagata

    2011-01-01

    Full Text Available Background : The authors have focused their attention to the radiological durability of cervical sagittal alignment after anterior cervical discectomy and fusion (ACDF using autologous bone grafting. Materials and Methods : Among the patients who underwent ACDF with trans-unco-discal (TUD approach between 1976 and 1997, 22 patients (16 males and 6 females made return visits for a clinical evaluation. Patients with trauma or previously treated by anterior cervical fusion or by posterior decompression were excluded from the present study. Clinical evaluation included adjacent segment degeneration (ASD, osseous fusion, local angle at the fused segments and C2-7 angle of cervical spine. Results : The duration after ACDF ranged from 13 to 34 years with an average of 21.3 ± 7.0 years. A single level fusion was done on 8 patients, 2 levels on 11 patients, 3 levels on 2 patients, and 4 levels on 1 patient. Imaging studies indicated that 12 of the 22 patients (54.5% were graded as having symptomatic ASD. Osseous bony fusion at ACDF was recognized in all cases. None of the patients demonstrated kyphotic malalignment of the cervical spine. Average degrees of local angle at the fused segments and the C2-7 angle were 7.06 and 17.6, respectively. Statistical analysis indicated a significant relationship between the local at the fused segments and C2-7 angles. Conclusions : Sagittal alignment of the cervical spine was durable long after ACDF when the local angle at the fused segments was well stabilized.

  2. An Xpd mouse model for the combined xeroderma pigmentosum/Cockayne syndrome exhibiting both cancer predisposition and segmental progeria.

    NARCIS (Netherlands)

    Andressoo, Jaan-Olle; Mitchell, James R; Wit, Jan de; Hoogstraten, Deborah; Volker, Marcel; Toussaint, Wendy; Speksnijder, Ewoud; Beems, Rudolf B; Steeg, Harry van; Jans, Judith; Zeeuw, Chris I de; Jaspers, Nicolaas G J; Raams, Anja; Lehmann, Alan R; Vermeulen, Wim; Hoeijmakers, Jan H J; Horst, Gijsbertus T J van der

    2006-01-01

    Inborn defects in nucleotide excision DNA repair (NER) can paradoxically result in elevated cancer incidence (xeroderma pigmentosum [XP]) or segmental progeria without cancer predisposition (Cockayne syndrome [CS] and trichothiodystrophy [TTD]). We report generation of a knockin mouse model for the

  3. Anterior chamber depth and refractive change in late postoperative capsular bag distension syndrome: a retrospective analysis.

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    Min Kyu Yang

    Full Text Available To assess the characteristic findings and effects of laser capsulotomy in patients with late postoperative capsular bag distension syndrome (CBDS.Twenty patients diagnosed with late postoperative CBDS between July 2010 and August 2013 were retrospectively reviewed. Before and 1 week after capsulotomy, changes in the anterior chamber depth (ACD were assessed using ultrasound biomicroscopy. Changes in the refractive status and uncorrected visual acuity (UCVA were also measured 1 week and 1 month after capsulotomy. For patients who received bilateral cataract surgery, preoperative ACD and axial length measured by IOLMaster were compared between the two eyes.Twenty-two eyes from 20 patients who had undergone laser capsulotomy showed a mean UCVA improvement of 0.27 ± 0.24 logMAR (range, 0.00-0.90. ACD was increased by an average of +0.04 mm (95% confidence interval, +0.01 to +0.06 mm, p = 0.034, equivalent to predicted refractive change of +0.10 D. The discrepancy between actual (+1.33 D and predicted refractive change after capsulotomy suggests that refractive change may not be generated from IOL displacement in late postoperative CBDS. Preoperative ACD was deeper in the eye with late postoperative CBDS in all bilaterally pseudophakic patients (mean, 3.68 mm vs. 3.44 mm in the fellow eye, p = 0.068.Late postoperative CBDS showed refractive changes that were resolved successfully after laser capsulotomy. The convex lens effects of opalescent material in the distended capsular bag may play a major role in myopic shift. A larger preoperative ACD is possibly associated with the development of late postoperative CBDS.

  4. Segmental anhidrosis with hyporeflexia associated with congenital spinal deformity: A Ross's syndrome variant or inverse Horner's syndrome?

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    Sawhney M

    2004-01-01

    Full Text Available A 39-year-old soldier presented with anhidrosis affecting both upper extremities below the shoulders, the right side of the trunk below the third rib in front and the third vertebra on the back, and the left lower extremity below the inguinal ligament since 1992. Ten years later in 2002, he was also found to have bilateral absence of Achilles reflex and decreased right knee jerk. In addition, the patient was found to have congenital spinal abnormalities in the form of block of vertebrae C3-C4; decreased disc space C4-C5; and break in pars interarticularis L5-S1 with decreased disc space. A total of seven cases of Ross syndrome, Holmes-Adie syndrome (tonic pupil with lost tendon jerks with segmental anhidrosis, have been described in the literature. Our case, however, did not have any pupillary abnormality. A case of progressive isolated segmental anhidrosis has also been described. The association of congenital spinal abnormality, which may be pathognomonic in the causation of this progressive sudomotor degeneration, is quite interesting in our case. The distribution of anhidrosis on the right side is just below the level of sweating loss sometimes described in lesions of superior sympathetic cervical ganglion in Horner's syndrome.

  5. Changes in segmentation and setation along the anterior/posterior axis of the homonomous trunk limbs of a remipede (Crustacea, Arthropoda

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    Viacheslav N. Ivanenko

    2016-08-01

    Full Text Available This study describes the segmentation and setation at different developmental stages of the homonomous trunk limbs of the remipede Speleonectes tulumensis Yager, 1987 collected in anchialine caves of the Yucatan Peninsula. Most homonomous trunk limbs originate ventrolaterally and are composed of two protopodal segments, three exopodal segments and four endopodal segments; contralateral limb pairs are united by a sternal bar. However, the last few posterior limbs originate ventrally, are smaller sized, and have regressively fewer segments, suggesting that limb development passes through several intermediate steps beginning with a limb bud. A terminal stage of development is proposed for specimens on which the posterior somite bears a simple bilobate limb bud, and the adjacent somite bears a limb with a protopod comprised of a coxapod and basipod, and with three exopodal and four endopodal segments. On each trunk limb there are 20 serially homologous groups of setae, and the numbers of setae on different limbs usually varies. These groups of setae are arranged linearly and are identified based on the morphology of the setae and their position on the segments. The number of setae in these groups increases gradually from the anterior homonomous limb to a maximum between limbs 8–12; the number then decreases sharply on the more posterior limbs. Changes in the number of setae, which reach a maximum between trunk limbs 8–12, differ from changes in segmentation which vary only over the last few posterior trunk limbs. Following a vector analysis that identified a spatial pattern for these 20 groups of setae among the different homonomous limbs, the hypothesis was confirmed that the number of setae in any given group and any given limb is correlated with the group, with the position of the somite along the body axis, and with the number of somites present on the specimens. This is the first vector analysis used to analyze a pattern of developmental

  6. Bacteria in milk from anterior and posterior mammary glands in sows affected and unaffected by postpartum dysgalactia syndrome (PPDS

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    Gerjets Imke

    2009-06-01

    Full Text Available Abstract Background The performance of piglet weight gain is strongly dependent on the sow's ability to meet the demand for adequate milk. Postparturient disorders, especially those subsumed under the term postpartum dysgalactia syndrome (PPDS, can alter or reduce the milk production sensitively, resulting in starving piglets. The aim of this study was to gather further information about the prevalence of different bacterial species in the anterior and posterior mammary glands of sows with respect to the clinical appearance of PPDS. Methods In this study, the health status of 56 sows after farrowing was determined with special regard to mastitis and dysgalactia. Pooled milk samples from anterior and posterior glands were taken from both affected and non-affected animals and analysed bacteriologically for the presence of a wide spectrum of different pathogens. Results Mainly Escherichia coli, staphylococci and streptococci were detected in high percentages but without significant differences in healthy and diseased animals and anterior and posterior glands. However, the large percentages of coliform bacteria suggested a transmission route via faecal contamination. Conclusion In this study, the prevalence of different bacteria in anterior and posterior glands in PPDS positive and negative sows was analysed. No significant differences in bacteria of healthy and diseased sows were assessed. Therefore, the development of clinical PPDS and actual infection seems to be largely dependant on individual resistance in single sows.

  7. Inter-Segmental Coordination Pattern in Patients with Anterior Cruciate Ligament Deficiency during a Single-Step Descent.

    Science.gov (United States)

    Nematollahi, Mohammadreza; Razeghi, Mohsen; Mehdizadeh, Sina; Tabatabaee, Hamidreza; Piroozi, Soraya; Rojhani Shirazi, Zahra; Rafiee, Ali

    2016-01-01

    Anterior cruciate ligament injury is a debilitating pathology which may alter lower limb coordination pattern in both intact and affected lower extremities during activities of daily living. Emerging evidence supports the notion that kinematic variables may not be a good indicator to differentiate patients with anterior cruciate ligament deficiency during step descent task. The aim of the present study was to examine alterations in kinematics as well as coordination patterns and coordination variability of both limbs of these patients during a single step descent task. Continuous relative phase technique was used to measure coordination pattern and coordination variability between a group of anterior cruciate ligament deficient (n = 23) and a healthy control group (n = 23). A third order polynomial Curve fitting was utilized to provide a curve that best fitted to the data points of coordination pattern and coordination variability of the healthy control group. This was considered as a reference to compare to that of patient group using nonlinear regression analysis. The results of the present study demonstrated an altered coordination pattern of the supporting shank-thigh and the stepping foot-shank couplings in anterior cruciate ligament deficient subjects. It was further noticed that there was an increased coordination variability in foot-shank and shank-thigh couplings of both supporting and stepping legs. There was no significant difference in the hip, knee and ankle joints kinematics in either side of these patients. Anterior cruciate ligament deficient individuals showed altered strategies in both intact and affected legs, with increased coordination variability. Kinematic data did not indicate any significant difference between the two groups. It could be concluded that more sophisticated dynamic approach such as continuous relative phase would uncover discrepancies between the healthy and anterior cruciate ligament deficient individuals.

  8. Unilateral anterior persistent fetal vasculature in a child with blepharophimosis-ptosis-epicanthus inversus syndrome: A surgical challenge

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    Vasudha Kemmanu

    2016-01-01

    Full Text Available Blepharophimosis-ptosis-epicanthus inversus syndrome (BPES is a rare autosomal dominant genetic disease. It is clinically characterized by four major features; blepharophimosis, ptosis, epicanthus inversus, and telecanthus. We report a case of a 1-year-old female with BPES with unilateral anterior persistent fetal vasculature (PFV. On examination, she was found to have all the clinical features of BPES, along with calcified and partially absorbed cataract with elongated ciliary processes in her left eye. B-scan of left eye showed attached retina with no evidence of posterior PFV. Systemic examination was normal. She underwent cataract surgery with primary posterior capsulotomy with intraocular lens implantation under general anesthesia. Literature search did not reveal any previous reports of unilateral anterior PFV and BPES. The clinical features, other associations, and the difficulties in the surgical management of this condition are discussed.

  9. Unilateral anterior persistent fetal vasculature in a child with blepharophimosis-ptosis-epicanthus inversus syndrome: A surgical challenge

    Science.gov (United States)

    Kemmanu, Vasudha; Rathod, Pragnya; Anaspure, Hemant; Yadav, Naresh K

    2016-01-01

    Blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) is a rare autosomal dominant genetic disease. It is clinically characterized by four major features; blepharophimosis, ptosis, epicanthus inversus, and telecanthus. We report a case of a 1-year-old female with BPES with unilateral anterior persistent fetal vasculature (PFV). On examination, she was found to have all the clinical features of BPES, along with calcified and partially absorbed cataract with elongated ciliary processes in her left eye. B-scan of left eye showed attached retina with no evidence of posterior PFV. Systemic examination was normal. She underwent cataract surgery with primary posterior capsulotomy with intraocular lens implantation under general anesthesia. Literature search did not reveal any previous reports of unilateral anterior PFV and BPES. The clinical features, other associations, and the difficulties in the surgical management of this condition are discussed. PMID:27488160

  10. Comparison of anterior subcutaneous and submuscular transposition of ulnar nerve in treatment of cubital tunnel syndrome: A prospective randomized trial

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    Abolghassem Zarezadeh

    2012-01-01

    Full Text Available Background: This study was designed to compare two methods of surgery, anterior subcutaneous transposition (ASCT and anterior submuscular transposition (ASMT of the ulnar nerve in treatment of cubital tunnel syndrome. Materials and Methods: This randomized trial study was conducted from October 2008 to March 2009 in the Department of Orthopedic Surgery at University Hospital. Forty-eight patients with confirmed cubital tunnel syndrome were randomized in two groups, and each patient received one of two different surgical treatment methods, either ASCT (n = 24 or ASMT (n = 24. In the ASCT technique, the ulnar nerve was transposed and retained in the subcutaneous bed, whereas in the ASMT, the nerve was retained deep in the transected muscular complex, near the median nerve. Patient outcomes, including pain, sensation, muscle strength, and muscle atrophy were compared between groups. Results: The two groups were similar in baseline characteristics. However, those treated with ASMT had a statistically significant reduction in their pain levels compared with ASCT (21 (87.5% vs 8 (33.3%, P 0.05. Conclusions: Our results indicate that ASMT are more efficient than ASCT for managing cubital tunnel syndrome. In patients who had ASMT, there were significant reductions of pain compared with ASCT.

  11. Consideration of QRS complex in addition to ST-segment abnormalities in the estimation of the "risk region" during acute anterior or inferior myocardial infarction.

    Science.gov (United States)

    Vervaat, F E; Bouwmeester, S; van Hellemond, I E G; Wagner, G S; Gorgels, A P M

    2014-01-01

    The myocardial area at risk (MaR) is an important aspect in acute ST-elevation myocardial infarction (STEMI). It represents the myocardium at the onset of the STEMI that is ischemic and could become infarcted if no reperfusion occurs. The MaR, therefore, has clinical value because it gives an indication of the amount of myocardium that could potentially be salvaged by rapid reperfusion therapy. The most validated method for measuring the MaR is (99m)Tc-sestamibi SPECT, but this technique is not easily applied in the clinical setting. Another method that can be used for measuring the MaR is the standard ECG-based scoring system, Aldrich ST score, which is more easily applied. This ECG-based scoring system can be used to estimate the extent of acute ischemia for anterior or inferior left ventricular locations, by considering quantitative changes in the ST-segment. Deviations in the ST-segment baseline that occur following an acute coronary occlusion represent the ischemic changes in the transmurally ischemic myocardium. In most instances however, the ECG is not available at the very first moments of STEMI and as times passes the ischemic myocardium becomes necrotic with regression of the ST-segment deviation along with progressive changes of the QRS complex. Thus over the time course of the acute event, the Aldrich ST score would be expected to progressively underestimate the MaR, as was seen in studies with SPECT as gold standard; anterior STEMI (r=0.21, p=0.32) and inferior STEMI (r=0.17, p=0.36). Another standard ECG-based scoring system is the Selvester QRS score, which can be used to estimate the final infarct size by considering the quantitative changes in the QRS complex. Therefore, additional consideration of the Selvester QRS score in the acute phase could potentially provide the "component" of infarcted myocardium that is missing when the Aldrich ST score alone is used to determine the MaR in the acute phase, as was seen in studies with SPECT as gold

  12. Ultrasund biomicroscopy diagnosis of anterior segment tumors%超声生物显微镜诊断眼前节肿瘤

    Institute of Scientific and Technical Information of China (English)

    杨文利; 胡士敏; 朱晓青; 王兰; 郑邦和

    2000-01-01

    目的 了解跟前节常见肿瘤的超声生物显微镜表现特点.方法 应用超声生物显微镜对55例常见眼前节肿瘤~虹膜囊、虹膜色素痣、睫状体肿瘤进行观察.结果 超块生物显微镜表现:虹膜囊肿为边界清晰的圆形或椭圆形囊样病变,内部为无回声区;虹膜色不痣为边界清晰的局限隆起,可为梭形、半球形等,内部回声均匀且与虹膜组织基本相同;睫状体肿瘤表现为睫状体局限隆起,可为半球形或蘑茹显微镜对虹膜肿瘤可明确鉴别实性或囊性,睫状体肿瘤的基底中亦可详尽观察,超声生物显微镜是一种新的无创评估眼前节肿瘤的诊断方法.%Objective To investigate the character of anterior segment tumor by ultrasound biomicroscopy (UBM).Methods UBM was used to diagnose 55 patients of anterior segment tumors,such as iris cyst ,iris nevi and ciliary bdy tumors.Results UBM showed iris cyst was circular or ellipse with Smooth surface and thin wall,but no renectivify.iris nevus was of anteriorly convex shape in fusifarm or semicircles ,its superficaial layer can rcoeCtS as Snne 3s ihs.Ciliary body tumors was of anteriorly convex shape in semircle or mushroom,its renectivlty was not even,namely the reflectivity gets stronger near the probeand nice versa, and may be associated with iris cyst and supcraciliary cffusion.Conclusions Diffexentiation between solid and cystic lesion was easily achicvcd by UBM,the margins of ciliary body tumors could be roofe accurately defined UBN, proved a new noninvasive technique in the evaluation of anterior tumors.

  13. Biometry of anterior segment of human eye on both horizontal and vertical meridians during accommodation imaged with extended scan depth optical coherence tomography.

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    Lin Leng

    Full Text Available To determine the biometry of anterior segment dimensions of the human eye on both horizontal and vertical meridians with extended scan depth optical coherence tomography (OCT during accommodation.Twenty pre-presbyopic volunteers, aged between 24 and 30, were recruited. The ocular anterior segment of each subject was imaged using an extended scan depth OCT under non- and 3.0 diopters (D of accommodative demands on both horizontal and vertical meridians. All the images were analyzed to yield the following parameters: pupil diameter (PD, anterior chamber depth (ACD, anterior and posterior surface curvatures of the crystalline lens (ASC and PSC and the lens thickness (LT. Two consecutive measurements were performed to assess the repeatability and reproducibility of this OCT. They were evaluated by calculating the within-subject standard deviation (SD, a paired t-test, intra-class correlation coefficients (ICC and the coefficient of repeatability/reproducibility (CoR.There were no significant differences between two consecutive measurements on either horizontal or vertical meridians under both two different accommodative statuses (P>0.05. The ICC for all parameters ranged from 0.775 to 0.998, except for the PSC (0.550 on the horizontal meridian under the non-accommodative status. In addition, the CoR for most of the parameters were excellent (0.004% to 4.89%. In all the parameters, only PD and PSC were found different between the horizontal and vertical meridians under both accommodative statuses (P<0.05. PD, ACD, ASC and PSC under accommodative status were significantly smaller than those under the non-accommodative status, except that the PSC at the vertical meridian did not change. In addition, LT was significantly increased when accommodation.The extended scan depth OCT successfully measured the dimensions of the anterior eye during accommodation with good repeatability and reproducibility on both horizontal and vertical meridians. The asymmetry

  14. Guyon's canal syndrome due to tortuous ulnar artery with DeQuervain stenosing tenosynovitis, ligamentous injuries and dorsal intercalated segmental instability syndrome, a rare presentation: a case report

    OpenAIRE

    Zeeshan, Muhammad; Ahmed, Farhan; Kanwal, Darakhshan; Khalid, Qazi Saad Bin; Ahmed, Muhammad Nadeem

    2009-01-01

    The Guyon's canal syndrome is a well known clinical entity and may have significant impact on patient's quality of life. We report a case of 43-year-old male who presented with complaints of pain and numbness in right hand and difficulty in writing for past one month. On imaging diagnosis of Guyon's canal syndrome because of tortuous ulnar artery was made with additional findings of DeQuervain's stenosing tenosynovitis and dorsal intercalated segmental instability syndrome with ligamentous in...

  15. Assessment of Anterior Segment Changes in Pseudophakic Eyes, Using Ultrasonic Biomicroscopic Imaging, after Pars Plana Vitrectomy with Silicone Oil or Gas Tamponade

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    Erkan Ünsal

    2016-01-01

    Full Text Available Objective. To evaluate the morphological changes of the anterior segment using ultrasonic biomicroscopy (UBM imaging in pseudophakic patients who underwent pars plana vitrectomy (PPV with silicone oil or gas (C3F8 internal tamponade agent injection. Method. This prospective study included pseudophakic patients with planned PPV, divided into two groups according to internal tamponade agent: those in which silicone oil was used (n=27, Group 1 and those in which gas (C3F8 was used (n=24, Group 2. UBM measurements were performed in the supine position before and one week after surgery. Results. In patients of Group 1, postoperative trabecular meshwork-ciliary process distance (T-CPD and iris-ciliary process distance (I-CPD, according to preoperative values, were found to be statistically significantly reduced, and postoperative mean value of scleral thickness (ST and intraocular pressure (IOP, according to preoperative value, was found to be statistically significantly increased. In patients of Group 2, postoperative mean values of anterior chamber depth (ACD, ciliary body thickness (CBT, T-CPD, I-CPD, and IOP, according to preoperative values, were found to be statistically significantly reduced. Preoperatively, in Group 2 patients, according to Group 1 patients, TIA and IOP were found to be statistically significantly increased. Preoperative and postoperative IOP between the measured parameters with UBM showed no statistically significant correlation. Conclusions. Gases cause more morphological changes in the anterior segment structures. It is thought that complications such as increased intraocular pressure can be seen more frequently for this reason.

  16. Progressive non-infectious anterior vertebral fusion in a baby with Saethre-Chotzen-acrocephalosyndactyly type III syndrome

    OpenAIRE

    2015-01-01

    We report on a 3-months old baby of Austrian origin and product of non-consanguineous parents. Abnormal craniofacial contour was the main deformity. The overall clinico-radiographic features were consistent with Saether-Chotzen-acrocephalosyndactyly type III syndrome. Bi-directional sequencing of the exon 8 and of the FGFR3-genes, exons 7 of FGFR3 (Fibroblast growth factor receptor3) genes, the exon 5 of the FGFR1 gene, revealed no mutations. Sagittal MRI imaging of the spine showed anterior ...

  17. Progressive non-infectious anterior vertebral fusion in a baby with Saethre-Chotzen-acrocephalosyndactyly type III syndrome

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    Али Аль-Каисси

    2015-09-01

    Full Text Available We report on a 3-months old baby of Austrian origin and product of non-consanguineous parents. Abnormal craniofacial contour was the main deformity. The overall clinico-radiographic features were consistent with Saether-Chotzen-acrocephalosyndactyly type III syndrome. Bi-directional sequencing of the exon 8 and of the FGFR3-genes, exons 7 of FGFR3 (Fibroblast growth factor receptor3 genes, the exon 5 of the FGFR1 gene, revealed no mutations. Sagittal MRI imaging of the spine showed anterior vertebral fusion along the thoraco-lumbar vertebrae compatible with the non-infectious type.

  18. Acute thrombosis during left main stenting using tap technique in a patient presenting with non-ST-segment elevation acute coronary syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Natarajan, Deepak, E-mail: deepaknatarajan@me.com

    2015-06-15

    This case reports the sudden development of large burden of thrombi in the left anterior descending coronary artery immediately following distal left main stenting using TAP technique in a middle aged man who presented with non ST-segment elevation acute coronary syndrome despite having been administered 7,500 units of unfractionated heparin and being given 325 mg of aspirin and 60 mg of prasugrel prior to the procedure. The thrombi were managed effectively by giving an intra-coronary high bolus dose of tirofiban (25 mcg/kg) without the need for catheter thrombus extraction. Tirofiban intra-venous infusion was maintained for 18 hours, and the patient was discharged in stable condition on the third day. Importantly there is no controlled study on upstream administration of glycoprotein IIb/IIIa inhibitors in addition to the newer more potent anti-platelet agents in patients with unprotected distal left main disease presenting with non ST-segment elevation acute coronary syndrome, nor is there any data on safety and efficacy of mandatory usage of injectable anti-platelet agents at the start of a procedure in a catheterization laboratory in such a setting.

  19. The role of a high pull headgear in counteracting side effects from intrusion of the maxillary anterior segment.

    Science.gov (United States)

    van Steenbergen, E; Burstone, C J; Prahl-Andersen, B; Aartman, I H A

    2004-08-01

    Intrusion of incisors is often the preferred treatment of a deep overbite. This study focuses on deep overbite correction by intrusion of maxillary incisors. The purpose of this study is to determine whether high-pull headgear wear can prevent steepening of the buccal segment, extrusion of the buccal segment, maintain arch width, and increase the rate of incisor intrusion. The number of patients needed for this study was calculated to be 20. Patients were between nine and 14 years of age and assigned to one of two groups. In each group, intrusion of maxillary incisors was performed. Patients in one group wore a high-pull headgear at night, and patients in the other group did not. For each patient, a lateral head film, impressions with a wax bite in centric occlusion, and intraoral photographs were taken at the beginning and end of intrusion. This study demonstrated that high-pull headgear had no effect on steepening and extrusion of the buccal segments or on the rate of intrusion but did have an effect on narrowing of the buccal segments. By performing intrusion as described in this study, no statistically significant side effects were observed in the buccal segments, whereas a statistically significant amount of incisor intrusion of 2.24 mm in the no-headgear group and 2.37 mm in the headgear group was observed.

  20. Adjacent segment disease after anterior cervical decompression and fusion: analysis of risk factors on X-ray and magnetic resonance imaging

    Institute of Scientific and Technical Information of China (English)

    Zhao Yanbin; Sun Yu; Zhou Feifei; Wang Shaobo; Zhang Fengshan; Pan Shengfa

    2014-01-01

    Background Adjacent segment disease (ASD) is common after cervical fusion.The aim of this study was to evaluate the risk factors for ASD on X-ray and magnetic resonance imaging (MRI).Methods Patients included in this study had received revision surgeries after developing symptomatic ASD following anterior decompression and fusion.A control group that had not developed ASD was matched 1:1 by follow-up time and fusion segments.Plate-to-disc distances (PDDs),developmental cervical canal stenosis on X-ray,cervical disc degeneration grading,and cervical disc bulge impingements on preoperative MRI were measured and compared between the ASD group and the control group.Results Thirty-four patients with complete radiographic data were included in the ASD group.The causative segments of ASD included nine cases of C3-4,18 cases of C4-5,three cases of C5-6,and four cases of C6-7.The ASD occurred at the upper adjacent segments in 26 patients and at the lower adjacent segments in eight patients.PDD distributions were similar between the ASD group and the control group.Developmental cervical canal stenosis was a risk factor for ASD,with an odd ratio value of 2.88.Preoperative cervical disc degenerations on MRI were similar between the ASD group and the control group.In the upper-level ASD group,the disc bulge impingement was (19.7±9.7)%,which was significantly higher than that of the control group of (11.8±4.8)%.Conclusions ASD was more likely to develop above the index level of fusion.Developmental cervical canal stenosis and greater disc bulge impingement may be risk factors for the development of ASD.

  1. Biomechanical Evaluation of Different Fixation Methods for Mandibular Anterior Segmental Osteotomy Using Finite Element Analysis, Part Two: Superior Repositioning Surgery With Bone Allograft.

    Science.gov (United States)

    Kilinç, Yeliz; Erkmen, Erkan; Kurt, Ahmet

    2016-01-01

    In this study, the biomechanical behavior of different fixation methods used to fix the mandibular anterior segment following various amounts of superior repositioning was evaluated by using Finite Element Analysis (FEA). The three-dimensional finite element models representing 3 and 5 mm superior repositioning were generated. The gap in between segments was assumed to be filled by block bone allograft and resignated to be in perfect contact with the mandible and segmented bone. Six different finite element models with 2 distinct mobilization rate including 3 different fixation configurations, double right L (DRL), double left L (DLL), or double I (DI) miniplates with monocortical screws, correspondingly were created. A comparative evaluation has been made under vertical, horizontal and oblique loads. The von Mises and principal maximum stress (Pmax) values were calculated by finite element solver programme. The first part of our ongoing Finite Element Analysis research has been addressed to the mechanical behavior of the same fixation configurations in nongrafted models. In comparison with the findings of the first part of the study, it was concluded that bone graft offers superior mechanical stability without any limitation of mobilization and less stress on the fixative appliances as well as in the bone.

  2. Knee kinetic pattern during gait and anterior knee pain before and after rehabilitation in patients with patellofemoral pain syndrome.

    Science.gov (United States)

    Claudon, B; Poussel, M; Billon-Grumillier, C; Beyaert, C; Paysant, J

    2012-05-01

    Patellofemoral pain is likely due to compressive force acting on the patella related in turn to knee extension moment. The latter variable was assumed to be (i) reduced during short-distance free walking in case of patellofemoral pain syndrome and (ii) increased after therapeutic pain reduction. Peak knee extension moment at beginning of stance phase was recorded by three-dimensional gait analysis in 22 controls and in 23 patients with patellofemoral pain syndrome before and after rehabilitation of knee extensors and flexors to reduce the pain. Pain would occur mainly in stressful activities such as stair negotiation or squatting and was quantified by the anterior knee pain scale. Peak knee extension moment was significantly reduced in all the patients before treatment (n=23) compared to controls, although no one had pain during free walking. In the 17 patients who experienced significant post-rehabilitation pain reduction in their stressful activities, the peak knee extension moment was significantly reduced before treatment compared to controls and significantly increased after treatment, reaching values similar to control values. The peak knee extension moment during free walking appears to be a good kinetic variable related to a compensatory mechanism limiting or avoiding anterior knee pain and may be of interest in assessing knee dynamics alteration in patients with PFPS.

  3. Endovascular repair of ruptured aneurysm arising from fenestration of the horizontal segment of the anterior cerebral artery: case report.

    Science.gov (United States)

    Yoshida, Masahiro; Ezura, Masayuki; Sasaki, Kazuto; Chonan, Masashi; Mino, Masaki

    2012-01-01

    A 50-year-old man presented with an aneurysm arising from a fenestration of horizontal portion (A(1)) of the anterior cerebral artery manifesting as subarachnoid hemorrhage. Coil embolization was conducted and the aneurysm was occluded easily. Most reported cases of these types of aneurysms underwent direct surgery. Aneurysm arising from the A(1) fenestration is rare, but the present case shows that coil embolization can be an effective treatment modality. Three-dimensional rotational angiography and aneurysmography were helpful to characterize this complicated vascular structure.

  4. Guyon's canal syndrome due to tortuous ulnar artery with DeQuervain stenosing tenosynovitis, ligamentous injuries and dorsal intercalated segmental instability syndrome, a rare presentation: a case report.

    Science.gov (United States)

    Zeeshan, Muhammad; Ahmed, Farhan; Kanwal, Darakhshan; Khalid, Qazi Saad Bin; Ahmed, Muhammad Nadeem

    2009-12-23

    The Guyon's canal syndrome is a well known clinical entity and may have significant impact on patient's quality of life. We report a case of 43-year-old male who presented with complaints of pain and numbness in right hand and difficulty in writing for past one month. On imaging diagnosis of Guyon's canal syndrome because of tortuous ulnar artery was made with additional findings of DeQuervain's stenosing tenosynovitis and dorsal intercalated segmental instability syndrome with ligamentous injury and subsequently these were confirmed on surgery.Although it is a rare syndrome, early diagnosis and treatment prevents permanent neurological deficits and improve patient's quality of life.

  5. Anterior interosseous nerve syndrome diagnosis and intraoperative findings: A case report

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    Abdulla Aljawder

    2016-01-01

    Conclusion: Clinical suspicion should arise in the presence of isolated paralysis of the AIN-supplied muscles. MRI and electrodiagnostic studies will confirm the diagnosis and identify the etiology. The optimal treatment of AIN syndrome has not been established. We recommend surgical intervention in confirmed AIN syndrome from compression neuropathy, refractive to conservative therapy.

  6. Síndrome compartimental em perna após reconstrução de ligamento cruzado anterior: relato de caso Leg's compartment syndrome after reconstruction of the anterior cruciate ligament: case report

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    Jorge Sayum Filho

    2011-01-01

    Full Text Available Os autores apresentam o relato de caso de um paciente que foi submetido à cirurgia de reconstrução de ligamento cruzado anterior e reparo de ligamento colateral medial de joelho esquerdo e que evoluiu com síndrome de compartimento de perna.The authors report a case of a patient that was submitted to a surgery of reconstruction of anterior cruciate ligament and collateral medial ligament repair of the left knee that complicated to a compartment syndrome.

  7. Effect of Elbow Position on Short-segment Nerve Conduction Study in Cubital Tunnel Syndrome

    Institute of Scientific and Technical Information of China (English)

    Zhu Liu; Zhi-Rong Jia; Ting-Ting Wang; Xin Shi; Wei Liang

    2016-01-01

    Background:The appropriate elbow position of short-segment nerve conduction study (SSNCS) to diagnose cubital tunnel syndrome (CubTS) is still controversial.The goal of this study was to determine the effect of different elbow positions at full extension and 70° flexion on SSNCS in CubTS.Methods:In this cross-sectional study,the clinical data of seventy elbows from 59 CubTS patients between September,2011 and December,2014 in the Peking University First Hospital were included as CubTS group.Moreover,thirty healthy volunteers were included as the healthy group.SSNCS were conducted in all subjects at elbow lull extension and 70° elbow flexion.Paired nonparametric test,bivariate correlation,Bland-Altman,and Chi-squared test analysis were used to compare the effectiveness of elbow full extension and 70° flexion elbow positions on SSNCS in CubTS patients.Results:Data of upper limit was calculated from healthy group,and abnormal latency was judged accordingly.CubTS group's latency and compound muscle action potential (CMAP) of each segment at 70° elbow flexion by SSNCS was compared with full extension position,no statistically significant difference were found (all P > 0.05).Latency and CMAP of each segment at elbow full extension and 70° flexion were correlated (all P < 0.01),except the latency of segment of 4 cm to 6 cm above elbow (P =0.43),and the latency (P =0.15) and the CMAP (P =0.06) of segment of 2 cm to 4 cm below elbow.Bivariate correlation and Bland-Altman analysis proved the correlation between elbow full extension and 70° flexion.Especially in segments across the elbow (2 cm above the elbow and 2 cm below it),latency at elbow full extension and 70° flexion were strong direct associated (r =0.83,P < 0.01; r =0.55,P < 0.01),and so did the CMAP (r =0.49,P < 0.01; r =0.72,P < 0.01).There was no statistically significant difference in abnormality of each segment at full extension as measured by SSNCS compared with that at 70° flexion (P > 0

  8. Comparative Study of Anterior Eye Segment Measurements with Spectral Swept-Source and Time-Domain Optical Coherence Tomography in Eyes with Corneal Dystrophies

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    Anna K. Nowinska

    2015-01-01

    Full Text Available Purpose. To compare anterior eye segment measurements and morphology obtained with two optical coherence tomography systems (TD OCT, SS OCT in eyes with corneal dystrophies (CDs. Methods. Fifty healthy volunteers (50 eyes and 54 patients (96 eyes diagnosed with CD (epithelial basement membrane dystrophy, EBMD = 12 eyes; Thiel-Behnke CD = 6 eyes; lattice CD TGFBI type = 15 eyes; granular CD type 1 = 7 eyes, granular CD type 2 = 2 eyes; macular CD = 23 eyes; and Fuchs endothelial CD = 31 eyes were recruited for the study. Automated and manual central corneal thickness (aCCT, mCCT, anterior chamber depth (ACD, and nasal and temporal trabecular iris angle (nTIA, tTIA were measured and compared with Bland-Altman plots. Results. Good agreement between the TD and SS OCT measurements was demonstrated for mCCT and aCCT in normal individuals and for mCCT in the CDs group. The ACD, nTIA, and tTIA measurements differed significantly in both groups. TBCD, LCD, and FECD caused increased CCT. MCD caused significant corneal thinning. FECD affected all analyzed parameters. Conclusions. Better agreement between SS OCT and TD OCT measurements was demonstrated in normal individuals compared to the CDs group. OCT provides comprehensive corneal deposits analysis and demonstrates the association of CD with CCT, ACD, and TIA measurements.

  9. Anterior Subcutaneous versus Submuscular Transposition of the Ulnar Nerve for Cubital Tunnel Syndrome: A Systematic Review and Meta-Analysis.

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    Chun-Hua Liu

    Full Text Available To pool reliable evidences for the optimum anterior transposition technique in the treatment of cubital tunnel syndrome by comparing the clinical efficacy of subcutaneous and submuscular anterior ulnar nerve transposition.A comprehensive search was conducted in PubMed MEDLINE, Cochrane Library, EMBASE, Web of Science, OVID AMED, EBSCO and potentially relevant surgical archives. Risk of bias of each included studies was evaluated according to Cochrane Handbook for Systematic Reviews of Interventions. The risk ratio (RR and 95% confidence intervals (CI were calculated for the clinical improvement in function compared to baseline. Heterogeneity was assessed across studies, and subgroup analysis was also performed based on the study type and follow-up duration.Three studies with a total of 352 participants were identified, and the clinically relevant improvement was used as the primary outcomes. Our meta-analysis revealed that no significant difference was observed between two comparison groups in terms of postoperative clinical improvement in those studies (RR 1.04, 95% CI 0.86 to 1.25, P = 0.72. Meanwhile, subgroup analyses by study type and follow-up duration revealed the consistent results with the overall estimate. Additionally, the pre- and postoperative motor nerve conduction velocities were reported in two studies with a total of 326 patients, but we could not perform a meta-analysis because of the lack of concrete numerical value in one study. The quality of evidence for clinical improvement was 'low' or 'moderate' on the basis of GRADE approach.Based on small numbers of studies with relatively poor methodological quality, the limited evidence is insufficient to identify the optimum anterior transposition technique in the treatment of cubital tunnel syndrome. The results of the present study suggest that anterior subcutaneous and submuscular transposition might be equally effective in patients with ulnar neuropathy at the elbow. Therefore

  10. Adjacent segment degeneration after single-level anterior cervical decompression and fusion: disc space distraction and its impact on clinical outcomes.

    Science.gov (United States)

    Li, Jia; Li, Yongqian; Kong, Fanlong; Zhang, Di; Zhang, Yingze; Shen, Yong

    2015-03-01

    The purpose of this study was to find whether excessive distraction of the disc space for cage insertion was a risk factor for adjacent segment degeneration (ASD) after anterior cervical decompression and fusion (ACDF). One hundred and sixteen consecutive patients who underwent ACDF for single-level cervical disc herniation between June 2006 and November 2008 were retrospectively reviewed. Preoperative, postoperative and final follow-up disc height (DH), sagittal segmental alignment (SSA), and sagittal alignment of the cervical spine (SACS) were measured and compared between the ASD group and non-ASD group. In 116 patients, ASD was radiographically proven in 28 (24.1%) patients. The clinical outcomes were significantly improved compared to the preoperative scores in both groups. However, the postoperative and final follow-up DH of the ASD group were significantly higher than in the non-ASD group (p<0.05). In addition, the postoperative DH was significantly correlated with the postoperative or final follow-up SSA (p<0.05). However, postoperative DH was not found to significantly correlate with postoperative or final follow-up SACS (p=0.072 and p=0.096, respectively). Multivariate analysis showed that postoperative DH was the most significant risk factor for ASD. The clinical outcomes of ACDF for single-level degenerative cervical disc disease were satisfactory. Postoperative DH (the distracted distance) had the greatest impact on the incidence of ASD. Excessive disc space distraction is a considerable risk factor for the development of radiographic ASD.

  11. Acute coronary syndromes without persistent st-segment elevation: advances in surgical revascularization.

    Science.gov (United States)

    Zoffoli, Giampaolo; Nicolini, Francesco; Beghi, Cesare; Budillon, Alessandro Maria; Agostinelli, Andrea; Borrello, Bruno; Cagnoni, Giovanni; Frassetto, Guido; Fragnito, Claudio; Gherli, Tiziano

    2005-09-01

    Coronary artery bypass grafting (CABG) still plays a fundamental role in the management of acute coronary syndromes. The aim of this study is to report the experience of our center in the treatment of patients with acute coronary sindromes without persistent ST elevation urgently operated on with CABG, and to discuss surgical problems related. Two-hundred and six patients were urgently operated on for CABG for acute coronary syndromes without persistent ST-segment elevation from January 2001 to February 2003. The majority of them had three vessel coronary disease (72%) and left main stem disease occurred in 20% of the patients. Mean LVEF (left ventricular ejection fraction) was 54 +/- 12% whereas 9% of the patients had a LVEF < 40%. Twenty-one patients (10%) received glycoprotein IIb/IIIa receptor inhibitors and 35 (17%) received intravenous heparin therapy before surgery. Mean interval time between the onset of symptoms and surgery was 16 +/- 10 days (range 4-50). In-hospital mortality was 2% (4 patients). Perioperative AMI (acute myocardial infarction) occurred in 4% (8 patients) and a transient low cardiac output syndrome in 27 patients (13%). Bleeding requiring surgery occurred in 1% of the patients. Transient respiratory insufficiency was present in 12 patients (6%) and acute renal failure in 8 patients (4%). Mean I.C.U. time was 2.4 days (1-17). Urgent CABG for acute coronary syndromes shows a low risk for in-hospital mortality and morbidity. In acute patients arterial grafts are not detrimental for the outcome, but are recommended in the absence of contraindications to improve long-term results. In spite of recent developments in cardioplegic cardiac arrest, optimal myocardial protection against perioperative myocardial infarction still remains a challenge.

  12. Anastomotic leak management after a low anterior resection leading to recurrent abdominal compartment syndrome: a case report and review of the literature

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    Toutouzas Kostas

    2009-11-01

    Full Text Available Abstract Introduction Low anterior resection is usually the procedure of choice for rectal cancer, but a series of complications often accompany this procedure. This case report describes successful management of an intricate anastomotic leak after a low anterior resection. Case presentation A 66-year-old Caucasian man was admitted to our hospital and diagnosed with a low rectal adenocarcinoma. He underwent a low anterior resection but subsequently developed fecal peritonitis due to an anastomotic leak. He was operated on again but developed abdominal compartment syndrome, multi-organ failure and sepsis. He was aggressively treated in the intensive care unit and in the operating room. Overall, the patient underwent four laparotomies and stayed in the intensive care unit for 75 days. He was discharged after 3 months of hospitalization. Conclusion Abdominal compartment syndrome may present as a devastating complication of damage control laparotomy. Prompt recognition and goal-directed management are the cornerstones of treatment.

  13. Pentacam System for the Measurement of the Anterior Segment of Myopia Eye%Pentacam系统对近视人群眼部前节的测量

    Institute of Scientific and Technical Information of China (English)

    盛豫; 黄一飞; 关娟; 王大江

    2012-01-01

    [Objective] To analyze the data of ocular anterior segment of myopia eye obtained by Pentacam system. [Methods]The anterior segment of 436 myopia eyes were measured by Pentacam system and the data were obtained. The coefficient of variation(CV) was calculated. According to the data of spherical equivalent(SE) , the subjects were divided into super-high myopia group, high myopia group, moderate myopia group and mild myopia group. One-way ANOVA was used to analyze the data. The data from the groups with different sex or different side of eyes were analyzed by using 2 independent samples tests (rank test). [Results] The change of the data from anterior tissues and eye tissues near the axis was little, While the change of the data from posterior and periphery tissues was larger. The anterior angle in the super-high myopia group was narrower than that in other groups, and there was significant difference ( P <0. 05=. There was no significant difference in thinnest corneal thickness, corneal volume and the diameter of pupil between male data and female data( P >0. 05). There was no significant difference in the data between left side and right side of eyes( P >0. 05). [Conclusion] Pentacam system for the examination of eyes is fast, useful and easy to operate, and can obtain the data at the first time. The result of the data accords with the characteristics of human anatomy and physiological change. Therefore, Pentacam system has better clinical application value.%[目的]对Pentacam系统获得的近视眼的前节各部位数据进行分析.[方法]应用Pentacam系统对436只近视眼球进行检测并获取数据,计算各部位数据的变异系数(Coefficient of variation,CV).按等效球镜数据,将人群分为超高近视组、高度近视组、中度近视组和低度近视组,数据采用单因素方差分析法(One-way ANOVA)进行分析.按性别分组及眼别分组的数据,采用两独立样本非参数检验法分析(秩和检验).[结果]眼前

  14. 角膜塑形术后眼前节形态及调节功能%Anterior segment biometry and accommodative function after orthokeratology

    Institute of Scientific and Technical Information of China (English)

    朱伟根; 张莎莎; 邵一磊; 袁一民; 沈梅晓; 瞿佳

    2016-01-01

    Objective To investigate the changes in accommodative response and anterior segment biometry during accommodation in young progressive myopes who wear overnight orthokeratology lenses.Methods Eighteen children (age:14.4±2.6 years) were enrolled in this prospective experimental study and were tested before wearing orthokeratology (OK) lenses and after wearing them for three months.Using a Badal optical system,the refractive error of each subject was corrected before and after lens wear,and then accommodative stimuli of 3 D and 5 D were presented.A custom-built optical coherence tomographer (OCT) with a long scan depth was used to image the entire anterior segment through the pupil,and to obtain the anterior segment biometry including pupil diameter (PD),anterior chamber depth (ACD),lens thickness (LT) and the lens anterior surface's radius of curvature (LAC).An auto-refractometer (WAM-5500) was used to measure ocular refraction during accommodation,which was used to calculate the accommodative response.The measurements of anterior segment biometry and accommodative response were repeated twice under each accommodative state.Results After wearing orthokeratology lenses for one to three months,an improvement in the accommodative response was evident under both the 3 D (1.72±0.59 D vs.2.42±0.84 D) and 5 D (3.09±0.63 D vs.3.61±0.86 D) accommodative states (paired t-test,t=2.84,2.12,P<0.05).During accommodation,△PD,△ACD,△LT,and △LAC changed obviously.Compared with baseline (before wearing OK lenses),accommodation-related changes in △ACD (3 D:-0.11±0.04 mm vs.-0.16±0.06 mm,t=3.88,P<0.01;5 D:-0.15±0.05 mm vs.-0.20±0.07 mm,t=2.37,P<0.05),△LAC (3 D:-2.60±0.79 mm vs.-3.81±1.08 mm,t=3.96,P<0.01;5 D:-3.57±1.14 mm vs.-4.32±1.36 mm,t=2.08,P<0.05) and △LT (3 D:0.22±0.13 mm vs.0.27±0.06 mm,t=-1.94,P<0.05;5 D:0.26± 0.09 mm vs.0.30±0.10 mm,t=-1.99,P<0.05) showed statistically significant increases.Conclusion After wearing orthokeratology

  15. Segmental small bowel necrosis associated with antiphospholipid syndrome: a case report.

    Science.gov (United States)

    Wang, Qun-Ying; Ye, Xiao-Hua; Ding, Jin; Wu, Xiao-Kang

    2015-04-07

    Antiphospholipid syndrome is a multi-system disease characterized by the formation of thromboembolic complications and/or pregnancy morbidity, and with persistently increased titers of antiphospholipid antibodies. We report the case of a 50-year-old, previously healthy man who presented with fever and new-onset, dull abdominal pain. A contrast-enhanced computed tomography scan showed segmental small bowel obstruction, for which an emergency laparotomy was performed. Histopathologic examination of resected tissues revealed multiple intestinal and mesenteric thromboses of small vessels. Laboratory tests for serum antiphospholipid (anticardiolipin IgM) and anti-β2-glycoprotein I antibodies were positive. Despite proactive implementation of anticoagulation, steroid, and antibiotic therapies, the patient's condition rapidly deteriorated, and he died 22 d after admission. This case highlights that antiphospholipid syndrome should be suspected in patients with unexplainable ischemic bowel and intestinal necrosis presenting with insidious clinical features that may be secondary to the disease, as early diagnosis is critical to implement timely treatments in order to ameliorate the disease course.

  16. Establishing Age-Adjusted Reference Ranges for Iris-Related Parameters in Open Angle Eyes with Anterior Segment Optical Coherence Tomography.

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    Jeffrey R Peterson

    Full Text Available Define criteria for iris-related parameters in an adult open angle population as measured with swept source Fourier domain anterior segment optical coherence tomography (ASOCT.Ninety-eight eyes of 98 participants with open angles were included and stratified into 5 age groups (18-35, 36-45, 46-55, 56-65, and 66-79 years. ASOCT scans with 3D mode angle analysis were taken with the CASIA SS-1000 (Tomey Corporation, Nagoya, Japan and analyzed using the Anterior Chamber Analysis and Interpretation software. Anterior iris surface length (AISL, length of scleral spur landmark (SSL to pupillary margin (SSL-to-PM, iris contour ratio (ICR = AISL/SSL-to-PM, pupil radius, radius of iris centroid (RICe, and iris volume were measured. Outcome variables were summarized for all eyes and age groups, and mean values among age groups were compared using one-way analysis of variance. Stepwise regression analysis was used to investigate demographic and ocular characteristic factors that affected each iris-related parameter.Mean (±SD values were 2.24 mm (±0.46, 4.06 mm (±0.27, 3.65 mm (±0.48, 4.16 mm (±0.47, 1.14 (±0.04, 1.51 mm2 (±0.23, and 38.42 μL (±4.91 for pupillary radius, RICe, SSL-to-PM, AISL, ICR, iris cross-sectional area, and iris volume, respectively. Both pupillary radius (P = 0.002 and RICe (P = 0.027 decreased with age, while SSL-to-PM (P = 0.002 and AISL increased with age (P = 0.001. ICR (P = 0.54 and iris volume (P = 0.49 were not affected by age.This study establishes reference values for iris-related parameters in an adult open angle population, which will be useful for future studies examining the role of iris changes in pathologic states.

  17. Selective preservation of anterior pituitary functions in patients with Sheehan′s syndrome

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    Bashir Ahmad Laway

    2011-01-01

    Full Text Available Background: Sheehan′s syndrome manifests as hypopituitarism following a child birth usually preceded by postpartum hemorrhage. The symptoms range from vague feelings of ill health to symptoms of a full blown panhypopituitarism. A large series of such patients is not described in the literature. Materials and Methods: We present the details of ten women with partial Sheehan′s syndrome. They presented with post-partum hemorrhage and lactation failure. Results: After delivery, seven out of ten patients had regular menstrual cycles indicating preservation of gonadotroph function. Lactotroph, thyrotroph, and somatotroph failure were present in all and corticotrophs preservation was documented in four out of ten patients. The hypophysial magnetic resonance imaging (MRI confirmed empty sella in all. Conclusion: lactotroph, somatotroph and thyrotroph failure are common in patients with Sheehan′s syndrome. In addition to known preservation of gonadotroph axis, corticotroph axis may be preserved in some of these patients arguing against the universal treatment of these patients with glucocorticoids.

  18. An unusual variant of the common trunk of the fronto-orbital and frontopolar arteries associated with a ruptured aneurysm of the A1 segment of the anterior cerebral artery

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    Kenta Aso

    2015-01-01

    Full Text Available Background: The common trunk of the fronto-orbital artery (FOA and frontopolar artery (FPA arising from the A1 segment of the anterior cerebral artery (ACA associated with a ruptured aneurysm (AN, is rare. Case Description: The patient was a 52-year-old man who suffered from subarachnoid hemorrhage. Three-dimensional computed tomography angiography revealed an elongated and tortuous left A1 segment of the ACA and a saccular AN arising from the left A1 segment of the ACA at the origin of the cortical branch, defining its location just on the midline and behind the anterior communicating artery. This vessel had two branches. One branch ran along the inferior surface of the ipsilateral frontal lobe, and the other branch ran anteriorly and medially along the surface of the left hemisphere toward the frontal pole. The anomalous artery was interpreted as a common trunk of the FOA and FPA. Bifrontal craniotomy was performed. The anomalous artery arose from the A1 segment of the ACA at the origin of the AN, and the recurrent artery of Heubner branched off the anomalous artery. The AN was successfully obliterated, clipping with a bayonet-shaped Yasargil titanium clip. Complete AN occlusion and patency of both the A1 and the common trunk of the FOA and FPA, were confirmed intraoperatively by indocyanine green angiography. Conclusions: Recognizing this variant preoperatively, could be helpful in preventing the complications of surgery.

  19. 采用眼前段光学相干断层扫描仪检测的健康人眼前段结构相关参数间的关系%Relationship among related parameters of healthy human eye anterior segment structure detected by anterior segment optical coherence tomography

    Institute of Scientific and Technical Information of China (English)

    曾阳发; 刘杏; 王涛; 钟毅敏; 李媚; 何明光

    2009-01-01

    Objective To analyze the relationship among parameters of healthy human eye anterior segment structure detected by anterior segment optical coherence tomography (AS-OCT), and to explore the effect of age on these parameters. Methods AS-OCT was performed in 211 healthy people (211 eyes) to measure the parameters of anterior segment structure, including anterior chamber depth (ACD), anterior chamber horizontal diameter (ACHD), anatomy anterior chamber depth (AACD), lens thickness (LT), ciliary band length (CBL) , lens position (LP) and iris thickness (IT). These parameters were compared between men and women. Relationship among the parameters was analyzed, and effect of age on anterior segment structure biometric values was evaluated. Results The values of ACD, ACHD, AACD, CBL, IT and LP were significantly higher in male than those in female[ACD: (2.87±0.38) mm vs (2.66±0.40) mm; ACHD: (11.73±0.43) mm vs (11.53±0.36) mm;AACD: (3.09±0.19) mm vs (3.00±0.19) mm;CBL: (0.20± 0.09) mm vs (0.17±0.09) mm;iT: (0.36±0.08) mm vs (0.34±0.08) mm; LP: (5.11±0.26) mm vs (4.91± 0.28) ram; all P0.05). ACHD was negatively correlated with age (r=-0.148, P=0.032). LT was positively correlated with age (r=0.646, P=0.000). LT was negatively correlated with ACD (r=-0.714, P=0.000). LT had no significant effect on LP using regression analysis. Conclusions The anterior segments biometric structure of female is narrower than that of male. With aging, the narrowing of ACD is resulted from LT increment. And LP of healthy eyes does not change with aging and LT increment.%目的 采用眼前段光学相干断层扫描仪(AS-OCT)测量健康人的眼前段各参数,并分析参数间的关系以及年龄对其的影响.方法 采用AS-OCT扫描211例健康人(211只眼)眼前段结构,并测量前房深度(ACD)、前房横径(ACHD)、解剖前房深度(AACD)、晶状体厚度(LT)、睫状体带长度(CBL)、晶状体位置(LP)和虹膜厚度(IT).对各参数进行性别间的比较,

  20. Prefrontal and anterior cingulate cortex abnormalities in Tourette Syndrome: evidence from voxel-based morphometry and magnetization transfer imaging

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    Dengler Reinhard

    2009-05-01

    Full Text Available Abstract Background Pathophysiological evidence suggests an involvement of fronto-striatal circuits in Tourette syndrome (TS. To identify TS related abnormalities in gray and white matter we used optimized voxel-based morphometry (VBM and magnetization transfer imaging (MTI which are more sensitive to tissue alterations than conventional MRI and provide a quantitative measure of macrostructural integrity. Methods Volumetric high-resolution anatomical T1-weighted MRI and MTI were acquired in 19 adult, unmedicated male TS patients without co-morbidities and 20 age- and sex-matched controls on a 1.5 Tesla neuro-optimized GE scanner. Images were pre-processed and analyzed using an optimized version of VBM in SPM2. Results Using VBM, TS patients showed significant decreases in gray matter volumes in prefrontal areas, the anterior cingulate gyrus, sensorimotor areas, left caudate nucleus and left postcentral gyrus. Decreases in white matter volumes were detected in the right inferior frontal gyrus, the left superior frontal gyrus and the anterior corpus callosum. Increases were found in the left middle frontal gyrus and left sensorimotor areas. In MTI, white matter reductions were seen in the right medial frontal gyrus, the inferior frontal gyrus bilaterally and the right cingulate gyrus. Tic severity was negatively correlated with orbitofrontal structures, the right cingulate gyrus and parts of the parietal-temporal-occipital association cortex bilaterally. Conclusion Our MRI in vivo neuropathological findings using two sensitive and unbiased techniques support the hypothesis that alterations in frontostriatal circuitries underlie TS pathology. We suggest that anomalous frontal lobe association and projection fiber bundles cause disinhibition of the cingulate gyrus and abnormal basal ganglia function.

  1. CONGENITAL ANTERIOR TIBIOFEMURAL SUBLUXATION

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    A. Shahla

    2008-06-01

    Full Text Available Congenital anterior tibiofemoral subluxation is an extremely rare disorder. All reported cases accompanied by other abnormalities and syndromes. A 16-year-old high school girl referred to us with bilateral anterior tibiofemoral subluxation as the knees were extended and reduced at more than 30 degrees flexion. Deformities were due to tightness of the iliotibial band and biceps femuris muscles and corrected by surgical release. Associated disorders included bilateral anterior shoulders dislocation, short metacarpals and metatarsals, and right calcaneuvalgus deformity.

  2. 前节OCT在瞳孔残膜诊治中的应用%The Value of Anterior Segment Optical Coherence Tomography in Persistent Pupillary Membrane

    Institute of Scientific and Technical Information of China (English)

    玛琮

    2013-01-01

    Objective:To analyze the value of anterior segment optical coherence tomography when diagnose and treat persistent pupillary membrane.Method:12 cases(24 eyes)of persistent pupillary membrane were underwent anterior segment optical coherence tomography examination both with or without the irradiation of light.Summarize the character of all the result.Design the treatment for the patients according to the results of examination as well as patient's age,visual acuity and the character of the membrane.Result:It showed a active reflect signal of the patients underwent the AS-OCT examination. It could detect the changes of the membrane under the condition of dark and light. The membranes showed no interfere effect on the movement of the pupils and no contact to the surface of lens. 8 cases(16 eyes)were treated of membrane resection,and 4 cases(8 eyes)underwent radiation treatment. Most of the patients received a better acuity or quantity of visual.Conclusion:AS-OCT can detect the shape of the membranes under the condition of dark and light,and provides information to determine the best chose for the patients in clinical practice.%  目的:探讨前节 OCT 在瞳孔残膜诊治中的应用价值。方法:采用光照射与暗光下对12例(24只眼)瞳孔残膜患者进行前节OCT 检查,总结其特点,根据检查结果,结合患者年龄、视力、残膜致密形态及致密程度制定治疗方案。结果:瞳孔残膜在 OCT 检查中表现为高信号,通过光照射与暗光下 OCT 检查结果的对比,12例(24只眼)瞳孔残膜与晶状体表面均无粘连,8例(16只眼)采用手术切除,4例(8只眼)行激光治疗,治疗后大部分患者视力或视觉质量有不同程度提高。结论:前节 OCT 能清楚显示瞳孔残膜,根据光照射与暗光下 OCT 检查可以进一步了解残膜与晶状体表面有无粘连,为治疗方案的选择提供依据,具有一定的临床实用价值。

  3. Causes of death in patients ≥75 years of age with non-ST-segment elevation acute coronary syndrome.

    Science.gov (United States)

    Morici, Nuccia; Savonitto, Stefano; Murena, Ernesto; Antonicelli, Roberto; Piovaccari, Giancarlo; Tucci, Daniele; Tamburino, Corrado; Fontanelli, Alessandro; Bolognese, Leonardo; Menozzi, Mila; Cavallini, Claudio; Petronio, Anna Sonia; Ambrosio, Giuseppe; Piscione, Federico; Steffenino, Giuseppe; De Servi, Stefano

    2013-07-01

    The causes of death within 1 year of hospital admission in patients with non-ST-segment elevation acute coronary syndromes are ill defined, particularly in patients aged ≥75 years. From January 2008 through May 2010, we enrolled 645 patients aged ≥75 years with non-ST-segment elevation acute coronary syndromes: 313 in a randomized trial comparing an early aggressive versus an initially conservative approach, and 332, excluded from the trial for specific reasons, in a parallel registry. Each death occurring during 1 year of follow-up was adjudicated by an independent committee. The mean age was 82 years in both study cohorts, and 53% were men. By the end of the follow-up period (median 369 days, interquartile range 345 to 391), 120 patients (18.6%) had died. The mortality was significantly greater in the registry (23.8% vs 13.1%, p = 0.001). The deaths were classified as cardiac in 94% of the cases during the index admission and 68% of the cases during the follow-up period. Eighty-six percent of the cardiac deaths were of ischemic origin. In a multivariate logistic regression model that included the variables present on admission in the whole study population, the ejection fraction (hazard ratio 0.95, 95% confidence interval 0.94 to 0.97; p segment elevation acute coronary syndromes, most deaths in patients aged ≥75 years have a cardiac origin, mostly owing to myocardial ischemia.

  4. Predictors of outcome in patients with acute coronary syndromes without persistent ST-segment elevation. Results from an international trial of 9461 patients. The PURSUIT Investigators

    NARCIS (Netherlands)

    W.C. Chang; K.L. Lee (Kerry); K.M. Akkerhuis (Martijn); M.L. Simoons (Maarten); R.A. Harrington (Robert Alex); E.J. Topol (Eric); P.W. Armstrong (Paul); R.M. Califf (Robert); A.M. Lincoff (Michael); K.S. Pieper (Karen); E.W. Steyerberg (Ewout); R.G. Wilcox (Robert); J.W. Deckers (Jaap); H. Boersma (Eric)

    2000-01-01

    textabstractBACKGROUND: Appropriate treatment policies should include an accurate estimate of a patient's baseline risk. Risk modeling to date has been underutilized in patients with acute coronary syndromes without persistent ST-segment elevation. METHODS AND RESULTS: We analyzed

  5. 颈椎间盘置换及前路椎间融合治疗单节段颈椎间盘突出症:谁更多影响邻近节段发生退变?%Anterior cervical disc replacement and anterior cervical decompression and fusion for treating single segment cervical disc herniation:which has greater effects on adjacent segment degeneration?

    Institute of Scientific and Technical Information of China (English)

    刘威; 盛伟斌; 张健; 邓强; 郭海龙

    2016-01-01

    背景:有研究表明,颈椎间盘置换及前路固定融合治疗颈椎病可以取得较好的临床效果,但是哪种术式在避免邻近节段退变方面更具优势尚无定论。目的:比较颈椎间盘置换与前路固定融合治疗单节段颈椎间盘突出症对邻近节段的近期影响。方法:收集2009年1月至2012年12月以“颈椎间盘突出症”为诊断收入院并行单节段颈椎间盘置换或颈前路椎间盘切除融合患者178例的临床资料,进行回顾性分析,其中前路固定融合组116例,颈椎间盘置换组62例。结果与结论:①评价:两组患者末次随访时目测类比评分、日本骨科协会评估治疗评分、颈椎功能障碍指数均较治疗前明显改善(P 0.05)。前路固定融合组术后3个月时手术节段基本融合,活动度丧失,末次随访时邻近上位节段活动度与邻近下位节段活动度明显增加,且上位节段活动度增加的度数较下位节段大(P 0.05). At 3 months after surgery, in the anterior cervical decompression and fusion group, surgical segment was confluent, and range of motion lost. During final fol ow-up, range of motion of adjacent upper segment and adjacent lower segment was significantly increased, and the increased range of motion in the upper segment was bigger than that of the lower segment (P < 0.05). (3) During final fol ow-up, X-ray films and MRI images revealed the number of degenerated adjacent segment was more in the anterior cervical decompression and fusion group than in the anterior cervical disc replacement group (P <0.05). The number of degenerated middle and upper segments was more than that of the lower segment in both groups (P < 0.05). (4) The findings confirmed that anterior cervical disc replacement or anterior cervical decompression and fusion for treating cervical disc herniation could effectively relieve nerve symptoms of patients. However, compared with the anterior cervical disc

  6. Assessment of Anterior Cingulate Cortex (ACC) and Left Cerebellar Metabolism in Asperger's Syndrome with Proton Magnetic Resonance Spectroscopy (MRS)

    Science.gov (United States)

    Goji, Aya; Ito, Hiromichi; Mori, Kenji; Harada, Masafumi; Hisaoka, Sonoka; Toda, Yoshihiro; Mori, Tatsuo; Abe, Yoko; Miyazaki, Masahito; Kagami, Shoji

    2017-01-01

    Purpose Proton magnetic resonance spectroscopy (1H MRS) is a noninvasive neuroimaging method to quantify biochemical metabolites in vivo and it can serve as a powerful tool to monitor neurobiochemical profiles in the brain. Asperger’s syndrome (AS) is a type of autism spectrum disorder, which is characterized by impaired social skills and restrictive, repetitive patterns of interest and activities, while intellectual levels and language skills are relatively preserved. Despite clinical aspects have been well-characterized, neurometabolic profiling in the brain of AS remains to be clear. The present study used proton magnetic resonance spectroscopy (1H MRS) to investigate whether pediatric AS is associated with measurable neurometabolic abnormalities that can contribute new information on the neurobiological underpinnings of the disorder. Methods Study participants consisted of 34 children with AS (2–12 years old; mean age 5.2 (±2.0); 28 boys) and 19 typically developed children (2–11 years old; mean age 5.6 (±2.6); 12 boys) who served as the normal control group. The 1H MRS data were obtained from two regions of interest: the anterior cingulate cortex (ACC) and left cerebellum. Results In the ACC, levels of N-acetylaspartate (NAA), total creatine (tCr), total choline-containing compounds (tCho) and myo-Inositol (mI) were significantly decreased in children with AS compared to controls. On the other hand, no significant group differences in any of the metabolites were found in the left cerebellum. Neither age nor sex accounted for the metabolic findings in the regions. Conclusion The finding of decreased levels of NAA, tCr, tCho, and mI in the ACC but not in left cerebellar voxels in the AS, suggests a lower ACC neuronal density in the present AS cohort compared to controls. PMID:28060873

  7. Quantitative changes of anterior segment before and after implantable collamer lens implantation for high myopia with Pentacam anterior segment system%Pentacam评估高度近视有晶状体眼人工晶状体植入术前后眼前节形态的改变

    Institute of Scientific and Technical Information of China (English)

    周远香

    2015-01-01

    目的:通过眼前节全景分析仪( Pentacam)量化分析高度近视患者行ICL植入术手术前后眼前节形态的改变,评估手术的安全性、有效性。  方法:收集我院2011-09/2013-02高度近视眼行ICL植入手术的患者21例39眼,术后随访6~12mo。通过Pentacam分别测量术前;术后1wk;1,6mo的中央前房深度( ACD)、前房角度(ACA)、前房容积(ACV);记录术后1wk;1,6mo的ICL拱高(ICL-vault);记录术前裸眼视力(pre-UCVA)、最佳矫正视力( BCVA)、术后裸眼视力( post-UCVA)以及眼压值。使用SPSS18.0统计软件分析各项指标,术前、术后的资料均采用配对t检验进行统计学分析。  结果:术前;术后1wk;1,6mo 的ACD分别是3.27±0.22,3.02±0.33,2.98±0.31,2.98±0.32mm, ACA分别是(40.39±5.40)°,(26.70±4.47)°,(26.96±4.48)°,(26.95±4.45)°, ACV分别是207.74±25.43,122.87±17.58,128.05±17.84, ;128.64±17.50mm 3。术后1wk;1,6mo的拱高分别是0.49±0.13,0.46±0.13,0.46±0.14mm。术前与术后3个不同时段的ACD,ACA,ACV的值相比,其均存在统计学差异( P  结论:通过眼前节全景分析仪( Pentacam)分析发现ICL术后前房变浅,房角变窄,前房容积变小,但人工晶状体与透明晶状体之间仍拥有安全的间隙,ICL植入术治疗高度近视眼安全、有效,但远期疗效有待进一步观察。%•AlM: To analyze the quantitative changes of anterior segment by Pentacam anterior segment system and to evaluate the safety and effectiveness after implantable collamer lens ( lCL) implantation for high myopia. •METHODS:Twenty- one patients with 39 eyes were implanted lCL in our hospital from September 2011 to February 2013. The follow-up was 6 ~ 12mo. Central anterior chamber depth ( ACD ) , anterior chamber angle ( ACA) , anterior chamber volume ( ACV) were measured by Pentacam preoperatively, 1wk, 1 and 6mo postoperatively. The distance between crystal lens and lOL ( lCL- vault ) were measured at

  8. Evaluation of Filtering Bleb Function after Trabeculectomy with Mitomycin C Using Biomicroscopy, Anterior Segment Optical Coherence Tomography and In Vivo Confocal Microscopy

    Directory of Open Access Journals (Sweden)

    Suzan Güven Yılmaz

    2015-08-01

    Full Text Available Objectives: To analyze and assess compatibility of trabeculectomy filtering bleb characteristics and appearances using biomicroscopy, anterior segment optical coherence tomography (AS-OCT and in vivo confocal microscopy (IVCM. Materials and Methods: Twenty-eight eyes of 28 patients who underwent glaucoma filtering surgery with mitomycin C in our clinic between 2009 and 2013 were evaluated. Morphological appearances of the blebs on slit-lamp biomicroscopy were defined according to the Moorfields bleb classification system. For the internal tissue assessment of blebs, AS-OCT and IVCM were performed. Bleb biometric parameters such as length, height and bleb wall thickness were assessed by AS-OCT; conjunctival epithelial-stromal cyst, structural network of conjunctival stroma and vascularisation were examined with IVCM. The relation between biomicroscopic morphological staging and bleb characteristics detected on AS-OCT and IVCM were assessed. Results: The mean age of the 28 patients (16 male, 12 female was 57.2±15.9 (19 to 79 years. The mean time elapsed between surgery and examination was 29.2±19.2 (6 to 68 months. According to biomicroscopic appearance, 17 (60.7% blebs were functional (13 diffuse, 4 microcystic, whereas 11 (39.3% blebs were non-functional (9 flat, 2 encapsulated. In the comparison of non-functional and functional blebs, functional blebs were found to be superior in terms of biometric parameters on AS-OCT assessment (p<0.05. Higher number of epithelial and stromal cysts and less vascularisation were detected by IVCM in functional blebs when compared with non-functional blebs (p<0.05. Conclusion: Biomicroscopic appearances and characteristics on AS-OCT and IVCM of filtration blebs are consistent with each other. Besides biomicroscopic examination, which is an easy and practical method for determining bleb morphology, cross-sectional images obtained by AS-OCT and IVCM provide objective data regarding internal structure and

  9. Computer navigation-assisted spinal fusion with segmental pedicle screw instrumentation for scoliosis with rett syndrome:a case report

    Directory of Open Access Journals (Sweden)

    Nishida,Keiichiro

    2009-12-01

    Full Text Available Scoliosis is a common clinical manifestation of Rett syndrome, a neurodevelopmental disorder that almost exclusively affects females. The spinal curve in patients with Rett syndrome is typically a long C curve of a neuromuscular type. As the onset of the scoliosis is very early and shows rapid progression, early surgical intervention has been recommended to prevent a life-threatening collapsing spine syndrome. However, there are high perioperative risks in Rett syndrome patients who undergo spinal surgery, such as neurological compromise and respiratory dysfunction due to rigid spinal curve. We herein report the surgical result of treating severe rapid progressive thoracic scoliosis in a 16-year-old girl with Rett syndrome. Posterior segmental pedicle screw fixation was performed from T1 to L3 using a computer-assisted technique. Post-operative radiography demonstrated a good correction of the curve in both the sagittal and coronal alignment. There were no postoperative complications such as neurological compromise. The patient had maintained satisfactory spinal balance as of the 3-year follow-up examination.

  10. Zebrafish-a new animal models of anterior segment embryonic development and diseases basic reserch%斑马鱼在眼前节胚胎发育和疾病研究中的应用进展

    Institute of Scientific and Technical Information of China (English)

    郝永娜; 魏瑞华; 赵少贞

    2012-01-01

    In recent years,zebrafish has become ideall animal models of human disease with its unique characteristics,such as small body,fecundity,fast development and growth,embryo transparency,and so on.Furthermore,the structure and gene of zebrafish eye are highly conservative with human eye,which make ophthalmologists to pay close attention to zebrafish.This review focus on the studies and applications on zebrafish embryonic development of anterior segment,including the morphogenesis of cornea,lens and anterior chamber,and diseases of anterior segment (corneal diseases,cataract,glaucoma).%近年来,斑马鱼凭借其体型小、繁殖力强、生长发育快、胚胎透明等独特的生物学特性,成为人类疾病动物模型的理想选择,加之与人类眼部结构和基因的高度保守性,使斑马鱼受到眼科学领域工作者的关注.本文主要对斑马鱼在眼前节胚胎发育,包括角膜、晶状体和前房的形态发生,以及眼前节疾病(角膜病、白内障、青光眼等)方面的研究和应用作一综述.

  11. Research progress on anterior segment optical coherence tomography in glaucoma%眼前节相干光断层扫描在青光眼中的研究进展

    Institute of Scientific and Technical Information of China (English)

    赵黎; 李青松; 柯梅青; 张兴儒

    2014-01-01

    Glaucoma is the second blindness disease in the world, and there are more primary angle closed glaucoma in China.The anatomy changes of the anterior chamber have close relationships with the development of glaucoma. Anterior segment optical coherence tomography ( AS-OCT) has the advantages of fast, non-contact, high resolution and accurate quantitative measurement, which provides a kind of important method for finding the pathogenesis of primary angle closed glaucoma, for early diagnosis and treatment of glaucoma, and for the postoperative evaluation of glaucoma.%青光眼是世界第二位致盲性眼病,我国以原发性闭角型青光眼较多。前房解剖结构的改变与青光眼的发展有密切的关系。眼前段光学相干断层成像技术( anterior segment optical coherence tomography , AS-OCT )具有检查快速、非接触、高分辨率、精确定量化测量等特点,为原发闭角型青光眼房角关闭的发病机制、早期诊断和治疗、青光眼术后评价等方面提供了一种重要的方法。

  12. A tomografia de córnea e segmento anterior na propedêutica do exame complementar na avaliação de ectasia Simplifying ectasia screening with corneal and anterior segment tomography

    OpenAIRE

    Bruno de Freitas Valbon; Rodrigo Teixeira Santos; Isaac Ramos; Ana Laura Canedo; Leonardo Nogueira; Renato Ambrósio Jr

    2013-01-01

    Descrevemos a importância da tomografia de córnea e segmento anterior na propedêutica do exame complementar na avaliação de ectasia. Esta descrição da interpretação clínica dos índices da tomografia de córnea e segmento anterior (Pentacam - Oculus, Wetzlar, Germany) neste relato de caso, demonstra a relevância de uma nova tecnologia na avaliação da córnea e segmento anterior na suspeita de ceratocone. O diagnóstico de ceratocone foi excluído pela análise dos índices tomográficos de ectasia. D...

  13. AS-OCT测量眼前节虹膜参数可重复性研究%Reproducibility of iris parameters measurements with anterior segment optical coherence tomography

    Institute of Scientific and Technical Information of China (English)

    郑策; 谢晓玲; 陈文霞; 张铭志

    2015-01-01

    Objective To determine the repeatability and reproducibility of anterior segment optical coherence tomography (AS-OCT) on the measurement of iris parameters.Methods In this cross-sectional study,105 consecutive subjects,mean age was 48.5 years (range:24-67),(50 normal open angle subjects and 55 angle-closure subjects) were recruited.One eye from each subject was randomly selected for imaging by AS-OCT using anterior segment single protocol.For intraobserver and interobserver reproducibility,a single observer acquired two sets of images followed by a third set of images acquired by a second observer.AS-OCT images were measured using custom software to determine iris parameters,including iris thickness,iris area and iris curvature.The intraclass correlation coefficient (ICC),limits of agreement (LOA;mean of differences± 1.96SD of differences),and coefficient of variation (CV) were calculated as items of intraobserver and interobserver reproducibility.Results The mean and standard deviation of iris thickness,iris area and iris curvature,in open angle group,were 0.40±0.05mm,1.67±0.24 mm2 and 0.18±0.12 mm,respectively;and in angle-closure group,were 0.42±0.04 mm,1.62±0.25 mm2 and 0.25±0.11 mm,respectively.In open angle group,ICC of intraobserver and interobserver measurement was from 0.865 to 0.982.In angle-closure group,the range of ICC was from 0.875 to 0.948.Conclusions The reproducibility of iris parameters measurements with the AS-OCT is good in both open angle and angle closure eyes.%目的 评估使用眼前节光学相干断层成像术(AS-OCT)定量测量虹膜参数的可重复性.方法 横断面研究.对2013年1月至2015年1月在汕头国际眼科中心共纳入受试者105名,平均年龄48.5岁(24~67岁).分为房角开放(50名受试者)和房角关闭(55名受试者)两组.采用AS-OCT的眼前节单线扫描模式,使用自编程图像处理软件定量测量AS-OCT影像的虹膜参数,包括虹膜厚度,虹膜体积和虹膜曲度.先由

  14. Comparison of ultrasound biomicroscopy and CT in diagnosis of anterior segment intraocular foreign body%超声活体显微镜和CT诊断眼前段异物的对比分析

    Institute of Scientific and Technical Information of China (English)

    李舒茵; 史大鹏

    2008-01-01

    Objective To report the appearance of anterior segment intraocular foreign body in ultrasound biomicroscopy(UBM)and CT. To investigate the advantage and disadvantage of these two imaging methods and to evaluate the value of combining application of these methods in the diagnosis of anterior segment intraocular foreign body. Methods It was a comparative study. Forty-four cases of suspected anterior segment intraoeular foreign body were simultaneously examined by UBM and CT from July 2000 to Mav 2007,the results were compared with the operation results.Results In 44 cases examined by CT,foreign bodies in 40 cases showed high density shadows,including iron,copper,stone and other foreign bodies:2 cases showed slightly high density shadow,which were identified as plastics;in 2 cases,the foreign bodies could not be detected by CT,which were bamboo pick and Chinese chestnut sting. It wasdifficuItv to locate the foreign body exactly and to detect the complications of anterior segment intraocular foreign body by using CT.All 44 cases of anterior segment intraocular foreign body showed strong echo spot with acoustic shadow in the UBM.UBM could provide the exact location of foreign body and could detect all complications. But the examining procedure of UBM was complicated,the examining screen was relativelynarrow and the examination was time-consuming. Condusion In suspected anterior segment intraocular foreign body,CT examination should be performed first to detect the position and the nature of foreign body,then UBM could be used to obtain the exact position of foreign body and to detect the complications.(Chin J Ophthalmol,2008,44:229-232)%目的 探讨超声活体显微镜(UBM)和CT两种不同成像方法 对眼前段异物诊断的优缺点及联合应用的价值.方法 为比较研究,收集2000年7月至2007年5月共44例疑诊为眼前段异物的患者同时行UBM和CT检查的资料,并与其手术结果 相对照.结果 CT扫描发现其中40例表现为高密

  15. A novel fibrillin-1 mutation in an egyptian marfan family: A proband showing nephrotic syndrome due to focal segmental glomerulosclerosis

    Directory of Open Access Journals (Sweden)

    Mohammad Al-Haggar

    2017-01-01

    Full Text Available Marfan syndrome (MFS, the founding member of connective tissue disorder, is an autosomal dominant disease; it is caused by a deficiency of the microfibrillar protein fibrillin-1 ( FBN1 and characterized by involvement of three main systems; skeletal, ocular, and cardiovascular. More than one thousand mutations in FBN1 gene on chromosome 15 were found to cause MFS. Nephrotic syndrome (NS had been described in very few patients with MFS being attributed to membranoproliferative glomerulonephritis secondary to infective endocarditis. Focal segmental glomerulosclerosis (FSGS had been reported in NS in conjunction with MFS without confirming the diagnosis by mutational analysis of FBN1. We hereby present an Egyptian family with MFS documented at the molecular level; it showed a male proband with NS secondary to FSGS, unfortunately, we failed to make any causal link between FBN dysfunction and FSGS. In this context, we review the spectrum of renal involvements occurring in MFS patients.

  16. 眼前节相干光断层扫描在原发性闭角型青光眼诊治中的应用%Anterior segment optical coherence tomography for the evaluation of primary angle closure glaucoma

    Institute of Scientific and Technical Information of China (English)

    刘杏; 李媚

    2013-01-01

    眼前节相干光断层扫描(AS-OCT)是继超声生物显微镜(UBM)后又一种眼前段成像检测手段,其为无创性、非接触性,分辨率较UBM高.可测量包括角膜、前房、前房角、虹膜、晶状体等多个眼前段结构参数.本文评价了AS-OCT在原发性闭角型青光眼(PACG)诊治中利用AS-OCT了解PACG和正常人眼前段生物学参数的差异,了解周边虹膜切开(或切除)术后、小梁切除术后、白内障手术后PACG的眼前段结构性参数的变化,以及对小梁切除术后滤过泡功能进行评估等,强调AS-OCT在PACG的诊断、发病机制、治疗观察中具有重要的临床应用价值.%Anterior segment optical coherence tomography (AS-OCT) is an imaging instrument developped after ultrasound biomi-croscopy (UBM). Moreover, AS-OCT is a non-invasive and non-contact instrument with a higher resolution than UBM. AS-OCT offers anterior segment images of the cornea, anterior chamber, anterior chamber angle, iris and lens. In this article, the value of AS-OCT is e-valuated in the diagnosis and treatment of primary angle closure glaucoma (PACG), including the application of AS-OCT in observing the differences between PACG and normal controls, the changes in anterior segment configuration after peripheral iridectomy/trabeculec-tomy/ cataract surgery in PACG, and the morphology of filtering blebs after trabeculectomy. The present study showed that AS-OCT would play an important role in the diagnosis, treatment choice and pathogenesis study of PACG.

  17. Age-Related Change and Gender Difference in Ocular Anterior Segment Parameters%眼前段生物结构参数的年龄相关性改变与性别差异研究

    Institute of Scientific and Technical Information of China (English)

    苏鹏; 孔祥斌; 晏世刚; 黄玉娟

    2016-01-01

    目的:比较30岁以上正常人不同年龄段眼前段生物结构参数的变化及性别差异,为闭角型青光眼的发病机制提供证据。方法选择474例眼科门诊检查正常者为研究对象,均30岁以上,其中男213例,女261例。采用眼前段光学相干断层扫描仪,获取眼前段水平图像,用中山房角分析软件进行图片分析获得眼前段结构参数[包括房角宽度(angle open distance,AOD500)、虹膜面积、前房深度及前房容积],按年龄、性别进行分组,采用 stata12.0进行数据处理及分析。结果各年龄段 AOD500、前房深度、前房容积及虹膜面积比较差异均有统计学意义(P <0.001);男性 AOD500、前房深度、前房容积及虹膜面积均显著高于女性(P <0.001)。30~55岁年龄段,AOD500变化最大,而55岁后 AOD500变化相对平缓;男性前房容积在50岁前变化相对明显,50岁后变化相对平缓,而女性前房容积变化明显且均匀。结论30以上正常人 AOD500、前房深度、前房容积均随年龄增加呈递减趋势,而虹膜面积随年龄增加呈递增趋势;女性较男性更易患闭角型青光眼。%Objective To investigate the age-related change and gender difference in ocular an-terior segment parameters in persons older than 30 years,and to provide evidence for the patho-genesis of angle-closure glaucoma.Methods A total of 474 normal subjects older than 30 years (213 males and 261 females)were selected in this study.The anterior segment optical coherence tomography(AS-OCT)was performed to obtain the anterior segment images,and the Zhongshan Angle Assessment Program was used to obtain the ocular anterior segment parameters,including angle opening distance at 500 μm(AOD500),iris area,anterior chamber depth and anterior cham-ber volume.These subjects were divided into different age and gender groups.Data were analyzed using Stata12.0.Results There were significant

  18. Cervicoplastia anterior Anterior cervicoplasty

    Directory of Open Access Journals (Sweden)

    Lucas Gomes Patrocínio

    2004-10-01

    Full Text Available Muitos pacientes buscam correção estética da frouxidão da pele do pescoço, depósito de gordura na região submentoneana ou bandas de platisma. Em grande parte dos casos a ação medial, via cervicoplastia anterior é necessária. OBJETIVO: Demonstrar a casuística e avaliar os resultados e complicações com a técnica de cervicoplastia anterior no Serviço de Otorrinolaringologia da Universidade Federal de Uberlândia. FORMA DE ESTUDO: Relato de série. PACIENTES E MÉTODOS: Quarenta e dois pacientes, entre 39 e 65 anos de idade, sendo 40 (95,2% do sexo feminino e 2 (4,8% do masculino, foram submetidos a cervicoplastia anterior. Retrospectivamente foram avaliados resultados e complicações. RESULTADOS: Destes, 34 apresentaram resultados satisfatórios, 4 apresentaram déficit estético notado somente pelo cirurgião, 3 apresentaram déficit estético notado somente pelo paciente e 1 apresentou déficit estético necessitando cirurgia revisional. Ao estudo fotográfico, todos os pacientes apresentaram melhora do perfil cervical, redução das bandas de platisma e da frouxidão da pele, estabilização da musculatura cervical e acentuação do ângulo cervicomental, em graus variados. Houve complicação em 2 casos (discreto serohematoma e cicatriz um pouco alargada. CONCLUSÃO: A cervicoplastia, associada ou não à tração lateral pela ritidoplastia, é uma técnica que produz resultados satisfatórios na grande maioria dos casos.Many patients look for aesthetic correction of the laxity of neck skin, submandibular fat deposit or platisma bands. In a large part of the cases, medial action, through anterior cervicoplasty is necessary. AIM: To demonstrate the casuistic and to evaluate the results and complications with anterior cervicoplasty technique in the Otorhinolaryngology Service of the Federal University of Uberlândia. STUDY DESIGN: Serie report. PATIENTS AND METHODS: Forty-two patients, between 39 and 65 years of age, being 40 (95

  19. Subcutaneous Versus Submuscular Anterior Transposition of the Ulnar Nerve for Cubital Tunnel Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Observational Studies.

    Science.gov (United States)

    Liu, Chun-Hua; Wu, Shi-Qiang; Ke, Xiao-Bin; Wang, Han-Long; Chen, Chang-Xian; Lai, Zhan-Long; Zhuang, Zhi-Yong; Wu, Zhi-Qiang; Lin, Qin

    2015-07-01

    Subcutaneous and submuscular anterior ulnar nerve transposition have been widely used in patients with cubital tunnel syndrome. However, the reliable evidence in favor of 1 of 2 surgical options on clinical improvement remains controversial. To maximize the value of the available literature, we performed a systematic review and meta-analysis to compare subcutaneous versus submuscular anterior ulnar nerve transposition in patients with ulnar neuropathy at the elbow. PubMed, Cochrane Library, and EMBASE databases were searched for randomized and observational studies that compared subcutaneous transposition with submuscular transposition of ulnar nerve for cubital tunnel syndrome. The primary outcome was clinically relevant improvement in function compared to the baseline. Randomized and observational studies were separately analyzed with relative risks (RRs) and 95% confidence intervals (CIs). Two randomized controlled trials (RCTs) and 7 observational studies, involving 605 patients, were included. Our meta-analysis suggested that no significant differences in the primary outcomes were observed between comparison groups, both in RCT (RR, 1.16; 95% CI 0.68-1.98; P = 0.60; I2= 81%) and observational studies (RR, 1.01; 95% CI 0.95-1.08; P = 0.69; I2 = 0%). These findings were also consistent with all subgroup analyses for observational studies. In the secondary outcomes, the incidence of adverse events was significantly lower in subcutaneous group than in submuscular group (RR, 0.54; 95% CI 0.33-0.87; P = 0.01; I2 = 0%), whereas subcutaneous transposition failed to reveal more superiority than submuscular transposition in static two-point discrimination (MD, 0.04; 95% CI -0.18-0.25; P = 0.74; I = 0%). The available evidence is not adequately powered to identify the best anterior ulnar nerve transposition technique for cubital tunnel syndrome on the basis of clinical outcomes, that is, suggests that subcutaneous and submuscular anterior transposition might be equally

  20. 超声生物显微镜观察弹性开放襻前房型人工晶状体对眼前段结构的影响%The influence of flexible open-loop anterior chamber intraocular lens on the structure of ocular anterior segment

    Institute of Scientific and Technical Information of China (English)

    陈伟蓉; 刘奕志; 陈秀琦; 程冰; 刘玉华

    2001-01-01

    Objective To evaluate the therapeutic effects and safety offlexible open-loop anterior chamber intraocular lens (FOAC-IOL). Methods By ultrasound biomicroscopy, the positions of the haptics of FOAC-IOL in 20 patients (20 eyes) and the relationships of the haptics with iris and anterior chamber angle structures were observed postoperatively to evaluate the impact of these lenses on the structures of ocular anterior segment. Follow-up duration was from 6 to 20 months. Results Among 40 IOL′s haptics, twenty-six haptics were fixed at the recess of the chamber angle ;and other fourteen haptics penetrated the iris and invaded into the ciliary stroma, which caused recurrent uveitis. There was 1 eye with eccentric lens. There were 8 eyes with anterior synechiae of iris, which were related to the haptics of intraocular lens. Conclusions Ultrasound biomicroscopy works well in dynamic observation of the influence of intraocular lens on ocular anterior segment. The haptics of flexible open-loop anterior chamber intraocular lens should be modified.%目的 评价弹性开放襻一体型前房型人工晶状体(anterchamberintraocularlens,AC-IOL)植入术的疗效及其安全性。方法 应用超声生物显微镜观察20例(20只眼)弹性开放襻一体型AC-IOL植入术后患者IOL襻的位置,以及其与虹膜及房角结构的关系,从而评价IOL对眼前段结构的影响。随访时间6~20个月。结果 40个IOL襻中,26个襻固定于房角隐窝;14个襻(8只眼)穿过虹膜侵入至睫状体实质内,并伴有反复发作的葡萄膜炎。术后8只眼虹膜前粘连与IOL襻有关。结论超声生物显微镜检查是动态了解IOL对眼前段结构影响的有效方法。AC-IOL襻的设计有待进一步改进。

  1. Combined anterior and posterior segment surgery in the treatment of penetrating eye injuries with small intraocular foreign body%眼球穿孔伤并眼内小异物眼前后段联合手术

    Institute of Scientific and Technical Information of China (English)

    石芊; 彭秀军; 刘百臣; 王桂琴

    2015-01-01

    目的:探讨眼球穿孔伤并眼内小异物早期行眼前后段联合手术治疗的临床效果。方法22例(22眼)眼球穿孔伤并眼内小异物,清创缝合术后2~4 d行前后段联合手术,根据病情,选择不同术式。前段手术:前房成形、虹膜裂伤缝合、白内障摘出、人工晶状体植入;后段手术:玻璃体切除术、异物摘出、视网膜损伤部位周围激光光凝、玻璃体腔C3 F8气体或硅油填充。术后随访3~12个月。其中硅油填充眼于术后4~5个月取出硅油,观察手术效果及并发症。结果所有患者均一次手术摘出了眼内异物,一期植入人工晶状体,未发生感染性眼内炎、人工晶状体移位、葡萄膜炎、视网膜脱离、脉络膜脱离或继发性青光眼等并发症。手术前最佳矫正视力为光感~0.1,术后随访最佳矫正视力为0.05~0.8,全组22眼视力均有不同程度提高。结论眼球穿孔伤并眼内小异物早期行眼前后段联合手术治疗可取得良好的临床效果。%Objective To investigate the clinical efficacy of combined anterior and posterior segment surgery in early treatment of penetrating eye injuries with small intraocular foreign body. Methods Twenty-two eyes of 22 patients suffered penetrating eye injuries with small intraocular foreign bodies underwent the combined operations of anterior and posterior eye segment 2-4 days after emergent debridement and suturing and according to their conditions different surgical procedures were preformed. Anterior segment surgery included anterior chamber forming, iris suture laceration, cataract extraction and intraocular lens implantation and posterior segment surgery included vitrectomy, foreign body removal, retinal laser photocoagulation around the injury site and C3 F8 gas or silicone oil tamponade. The surgery efficacy and the complications were analyzed from 3months to 12 months. Silicone oil was removed 4-5month after operation. Results Intraocular foreign

  2. 25G玻璃体切割系统在眼前节手术中的应用进展%25-gauge vitrectomy system for the surgery of eye anterior segment

    Institute of Scientific and Technical Information of China (English)

    张影影; 张立贵

    2012-01-01

    25 G经结膜无缝合玻璃体切割系统的出现,标志着微创玻璃体切割手术取得了突破性进展,该系统在一些眼底疾病的治疗中已取得令人满意的疗效,随着对其不断改进,目前已逐步应用到眼前节手术中,尤其在儿童白内障手术中经角巩膜缘或扁平部行后囊膜切开联合前段玻璃体切割术更突显其微创优势.本文就25 G玻璃体切割系统的工作原理和优点、在眼前节手术中的临床应用及其潜在并发症等作一综述.%One of the most revolutionary developments in vitreoretinal surgery is 25-gauge transconjunctival sutureless vitrectomy.Its use in the treatment of retina diseases has achieved signifcant effects.With the improvement of surgical technique,it has been developed for application to the operation of eye anterior segment,especially for pediatric cataract surgery,during which posterior capsulotomy and anterior vitrectomy are performed via a corneoscleral limbal or pars plana approach with it.This paper summaries the principle,advantages,indications and the potential accomplications of 25-gauge transconjunctival sutureless vitrectomy system for the surgery of eye anterior segment.

  3. [Anterior cervical hypertrichosis: case report].

    Science.gov (United States)

    Orozco-Gutiérrez, Mario H; Sánchez-Corona, José; García-Ortiz, José E; Castañeda-Cisneros, Gema; Dávalos-Rodríguez, Nory O; Corona-Rivera, Jorge R; García-Cruz, Diana

    2016-10-01

    The non-syndromic anterior cervical hypertrichosis (OMIM N° 600457) is a genetic disorder characterized by a patch of hair at the level of the laryngeal prominence. We present a 12-year-old boy with anterior cervical hypertrichosis and mild generalized hypertrichosis. He has no neurological, ophthalmological or skeletal anomalies. The clinical follow up is 10 years.

  4. Abdominoplastia por plicatura anterior longitudinal na síndrome de prune belly: experiência inicial do hospital municipal Jesus Abdominoplasty by longitudinal anterior plicature in prune belly syndrome: preliminary experience in hospital municipal Jesus

    Directory of Open Access Journals (Sweden)

    Lisieux Eyer de Jesus

    2001-06-01

    patients 1, 2 and 3, respectivelly. We could demonstrate that anterior longitudinal abdominoplasty is a safe and easily performed surgical technique, with good aesthetic results and significant psychological and social improvement. Chronic constipation, aerobic capacity and postural changes are also ameliorated. Regarding urodynamic repercussions we think that a longer period of observation is necessary to reach any definitive conclusions. CONCLUSIONS: Anterior longitudinal abdominoplasty is an effective and safe technique to treat prune belly syndrome patients and ameliorates functions of the abdominal parietes. It has urodynamic consequences that need long-term follow-up.

  5. 光学相干断层扫描技术在眼前节结构应用的新进展%Progression in application of optical coherence tomography in ocular anterior segment examination

    Institute of Scientific and Technical Information of China (English)

    张鹏

    2014-01-01

    光学相干断层扫描技术(OCT)是一种利用光的干涉原理来成像眼部结构的方法,最初用于眼后节的测量和检查,但随着OCT技术的进展,目前已广泛用于眼前节各组织的测量和检查.眼前节光学相干断层扫描技术(AS-OCT)可将角膜、前房、瞳孔、虹膜等眼前节组织结构显示于一张图像上,并可用于准分子激光角膜原位磨镶术术后角膜前后表面情况和角膜曲率的测定,青光眼患者房角、虹膜、睫状体的观察,抗青光眼术后功能性滤过泡的动态变化以及眼外伤患者的眼前节组织结构变化等.AS-OCT检测具有非接触、分辨率高、检测快捷、可定量分析等特点,因此是眼前节组织的检测的有力工具.就AS-OCT技术在眼科的临床应用、优缺点及展望进行综述.%Optical coherence tomography (OCT) is a technology that imaging the ocular structure by the interference of light.OCT is invented and applied in the examine and measure of the retina and choroid.However,the development of spectrum domain make the study of ocular anterior segment structure possible.Anterior segment OCT (AS-OCT) can image the tissue structures of the cornea,anterior chamber,pupil,iris,etc.on the same picture.Also,AS-OCT can be used to measure the corneal surface and curvature after excimer laser in situ keratomileusis,the examination of the angle,iris,ciliary body in glaumatous eyes,the observation of dynamic alteration of the filtering bleb following antiglaucoma surgery and the evaluation of ocular anterior segment tissue after eye trauma.AS-OCT examined at a non-contact,non-invasive way with higher resolution and higher speed.In addition,AS-OCT offers the quantitative analysis of the ocular anterior segment.The clinical application,advantages and disadvantages,prospect of AS-OCT in ophthalmology were reviewed in this paper.

  6. Fenestration of the anterior cerebral artery

    Energy Technology Data Exchange (ETDEWEB)

    Ito, J.; Washiyama, K.; Hong, K.C.; Ibuchi, Y.

    1981-08-01

    Three cases of angiographically demonstrated fenestration of the anterior cerebral artery are reported. Fenestration occurred at the medial half of the horizontal segment of the anterior cerebral artery in all cases. Its embryology and clinical significance are briefly discussed, and the anatomical and radiological literature on fenestration of the anterior cerebral artery is reviewed.

  7. Immediate versus deferred coronary angioplasty in non-ST-segment elevation acute coronary syndromes

    NARCIS (Netherlands)

    Riezebos, R.K.; Ronner, E.; ter Bals, E.; Slagboom, T.; Smits, P.C.; ten Berg, J.M.; Kiemeneij, F.; Amoroso, G.; Patterson, M.S.; Suttorp, M.J.; Tijssen, J.G.P.; Laarman, G.J.

    2009-01-01

    BACKGROUND: The field of acute coronary syndromes is characterised by an increasing tendency towards early invasive catheter-based diagnostics and therapeutics-a practice based on observational and retrospective data. OBJECTIVE: To compare immediate versus deferred angioplasty in patients with non-S

  8. Very Long-Term Prognostic Role of Admission BNP in Non-ST Segment Elevation Acute Coronary Syndrome

    Directory of Open Access Journals (Sweden)

    Fernando Bassan

    2016-01-01

    Full Text Available Abstract Background: BNP has been extensively evaluated to determine short- and intermediate-term prognosis in patients with acute coronary syndrome, but its role in long-term mortality is not known. Objective: To determine the very long-term prognostic role of B-type natriuretic peptide (BNP for all-cause mortality in patients with non-ST segment elevation acute coronary syndrome (NSTEACS. Methods: A cohort of 224 consecutive patients with NSTEACS, prospectively seen in the Emergency Department, had BNP measured on arrival to establish prognosis, and underwent a median 9.34-year follow-up for all-cause mortality. Results: Unstable angina was diagnosed in 52.2%, and non-ST segment elevation myocardial infarction, in 47.8%. Median admission BNP was 81.9 pg/mL (IQ range = 22.2; 225 and mortality rate was correlated with increasing BNP quartiles: 14.3; 16.1; 48.2; and 73.2% (p 72 years (OR = 3.79, 95% CI = 1.62-8.86, p = 0.002, BNP ≥ 100 pg/mL (OR = 6.24, 95% CI = 2.95-13.23, p < 0.001 and estimated glomerular filtration rate (OR = 0.98, 95% CI = 0.97-0.99, p = 0.049 were independent late-mortality predictors. Conclusions: BNP measured at hospital admission in patients with NSTEACS is a strong, independent predictor of very long-term all-cause mortality. This study allows raising the hypothesis that BNP should be measured in all patients with NSTEACS at the index event for long-term risk stratification.

  9. Use of platelet glycoprotein IIb/IIIa inhibitors in diabetics undergoing PCI for non-ST-segment elevation acute coronary syndromes: impact of clinical status and procedural characteristics

    NARCIS (Netherlands)

    T. Bauer (Timm); H. Möllmann (Helge); F. Weidinger (Franz); U. Zeymer (Uwe); R. Seabra-Gomes (Ricardo); F.R. Eberli (Franz Robert); P.W.J.C. Serruys (Patrick); A. Vahanian (Alec); S. Silber (Sigmund); W. Wijns (William); M. Hochadel (Matthias); H.M. Nef (Holger); C.W. Hamm (Christian); J. Marco (Jean); A.K. Gitt (Anselm)

    2010-01-01

    textabstractBackground: The most recent ESC guidelines for percutaneous coronary intervention (PCI) recommend the use of glycoprotein IIb/IIIa inhibitors (GPI) in high risk patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS), particularly in diabetics. Little is known about th

  10. Nephrotic syndrome; is rituximab the light at the end of the tunnel in the treatment of adult steroid-dependent minimal change disease and focal segmental glomerulosclerosis?

    Science.gov (United States)

    Kronbichler, Andreas; Mayer, Gert

    2014-01-01

    Implication for health policy/practice/research/medical education: Reports on patients with steroid-dependent nephrotic syndrome and underlying minimal change disease or focal segmental glomerulosclerosis have shown promising results. There is a strong need for more trials conducted in a prospective, controlled manner to clearly recommend rituximab therapy in this indication on a regular basis.

  11. The application of ocular anterior segment optical coherence tomography after operation of ocular penetraing injury%眼前段OCT在眼球穿孔伤术后的运用

    Institute of Scientific and Technical Information of China (English)

    李娟娟; 盛智超; 胡竹林

    2011-01-01

    Objective To evaluat the application of anterior segment optical coherence tomography (ASOCT) in the imaging of postoperative ocular penetrating injuries. Methods Thirty-six successive cases (36 eyes) with ocular penetrating injury in our hospital were examined by ASOCT after surgery to observe and analyze stuctural changes of cornea and anterior chamber angle by anterior segment biomicroscopy. Results The results of ASOCT showed that swollen and cloudy corneas with disordered stroma and irregular surfaces in 21 eyes, lacerated chamber angles in 5 eyes, synechial and closed chamber angles in 12 eyes, iris adhered to the wounds in 8 eyes, broken anterior lens capsules and overflowed cortices in 12 eyes and shallow cyclodialyses in 3 eyes. Conclusion ASOCT has good clinical value in evaluating injury degree in postoperative penetrating injury eyeballs and predicating the prognosis for recovery.%目的 评估眼前段OCT在眼球穿孔伤术后的应用价值.方法 连续收集我院所收治的眼球穿孔伤36例(36眼),术后进行眼前段裂隙灯显微镜检查,观察分析角膜,前房角等组织结构的变化.结果 眼前段OCT显示出:21眼角膜水肿浑浊,实质层结构紊乱,表面不规则;5眼房角撕裂,12眼房角粘连关闭;8眼虹膜粘连于伤口;2眼晶状体前囊破裂,皮质溢出;3眼睫状体浅脱离.结论 眼前段OCT对眼球穿孔伤术后评估眼球损伤程度,预后恢复等有较好的临床应用价值.

  12. 抗VEGF药物在眼前节疾病围手术期研究及应用%Anti VEGF drugs for Eye anterior segment disease in perioperative research and application

    Institute of Scientific and Technical Information of China (English)

    郭红林

    2015-01-01

    Objective: To investigate the effect of anti VEGF drugs in the perioperative period of the patients with anterior segment disease.Methods: According to different treatment methods, 90 patients with anterior segment disease were divided into observation group and control group (45 cases). The patients in the two groups were treated by operation, and the observation group was treated with anti VEGF drugs, and the clinical efficacy of the two groups were compared.Results: After treatment, the two groups of IOP were significantly lower than before treatment, and the observation group after treatment, 30d, 90d, 7d were significantly lower than the control group,P<0.05. The effective rate of the observation group was 98%, significantly higher than the control group of 88.46%, P<0.05.Conclusion: The use of anti VEGF drugs in the treatment of patients with anterior segment disease can effectively inhibit the generation and proliferation of new blood vessels in the retina and iris.%目的:探讨抗VEGF药物在眼前节疾病围术期中的应用效果。方法根据治疗方法的不同,将90例眼前节疾病患者分为观察组和对照组(每组45例),两组患者均行手术治疗,观察组在此基础上加用抗VEGF药物,比较两组患者的临床疗效。结果治疗后,两组的眼压水平均较治疗前显著降低,且观察组治疗后7d、30d、90d的眼压水平均显著低于对照组,P<0.05。观察组治疗有效率为98.0%,显著高于对照组的88.46%,P<0.05。结论对行手术治疗的眼前节疾病患者应用抗VEGF药物,能够有效抑制视网膜及虹膜上新生血管的生成与增殖,提高手术疗效。

  13. A new osteophyte segmentation method with applications to an anterior cruciate ligament transection rabbit femur model via micro-CT imaging

    Science.gov (United States)

    Liang, G.; Elkins, J. M.; Coimbra, A.; Duong, L. T.; Williams, D. S.; Sonka, M.; Saha, P. K.

    2010-03-01

    Osteophyte is an additional bony growth on a normal bone surface limiting or stopping motion in a deteriorating joint. Detection and quantification of osteophytes from CT images is helpful in assessing disease status as well as treatment and surgery planning. However, it is difficult to segment osteophytes from healthy bones using simple thresholding or edge/texture features in CT imaging. Here, we present a new method, based on active shape model (ASM), to solve this problem and evaluate its application to ex vivo μCT images in an ACLT rabbit femur model. The common idea behind most ASM based segmentation methods is to first build a parametric shape model from a training dataset and during application, find a shape instance from the model that optimally fits to target image. However, it poses a fundamental difficulty for the current application because a diseased bone shape is significantly altered at regions with osteophyte deposition misguiding an ASM method that eventually leads to suboptimum segmentation results. Here, we introduce a new partial ASM method that uses bone shape over healthy regions and extrapolate its shape over diseased region following the underlying shape model. Once the healthy bone region is detected, osteophyte is segmented by subtracting partial-ASM derived shape from the overall diseased shape. Also, a new semi-automatic method is presented in this paper for efficiently building a 3D shape model for rabbit femur. The method has been applied to μCT images of 2-, 4-, and 8-week post ACLT and sham-treated rabbit femurs and results of reproducibility and sensitivity analyses of the new osteophyte segmentation method are presented.

  14. Prognostic Value of Plasma Intermedin Level in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome.

    Science.gov (United States)

    Li, Pengyang; Shi, Lin; Han, Yalei; Zhao, Yuntao; Qi, Yongfen; Wang, Bin

    2016-04-01

    Intermedin (IMD), an autocrine/paracrine biologically active peptide, plays a critical role in maintaining vascular homeostasis. Recent research has shown that high plasma levels of IMD are associated with poor outcomes for patients with ST-segment elevation acute myocardial infarction. However, the prognostic utility of IMD levels in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) has not yet been investigated. We hypothesized that the level of plasma IMD would have prognostic value in patients with NSTE-ACS. Plasma IMD was determined by radioimmunoassay in 132 NSTE-ACS patients on admission to hospital and 132 sex- and age-matched healthy-control subjects. Major adverse cardiovascular events (MACEs), including death, heart failure, hospitalization, and acute myocardial infarction, were noted during follow-up. In total, 23 patients suffered MACEs during the follow-up period (mean 227 ± 118 days, range 2-421 days). Median IMD levels were higher in NSTE-ACS patients than control [320.0 (250.9/384.6) vs. 227.2 (179.7/286.9) pg/mL, P variables and NT-proBNP showed that the risk of MACEs increased by a factor of 12.96 (95% CI, 3.26-49.42; P <0.001) with high IMD levels (at the cut-off value). IMD has potential as a prognostic biomarker for predicting MACEs in patients with NSTE-ACS.

  15. Clinical observation and analysis of adjacent segment degeneration after anterior cervical fusion%颈椎前路融合术后相邻节段退变的临床观察与分析

    Institute of Scientific and Technical Information of China (English)

    王义生; 邓俊森

    2012-01-01

    [Objective] To study whether the anterior cervical fusion inevitably lead to the adjacent segment degeneration (ASD) . [Methods] From 1986.1 to 1999. 12, a total of 346 patients with cervical degenerative disease underwent the surgery of enlarged decompression with circular saw and auto iliac bone grafting. Among them there were 1 segment in 55 patients, 2 segments in 223 patients and 3 segments in 68 patients. The two motion segments adjacent to the fused segment and interval from the fused segment were evaluated respectively for imaging changes and divided the results into groups for statistical test. [Results] The patients were followed up for 13. 5 (4.1 ~ 18) years on average. Total 156 cases (45. 1% ) had obvious adjacent segment degeneration, 23 cases (6. 6% ) had obvious interval segment degeneration. The interval segment degeneration was less than that of adjacent segment degeneration, and the comparative differences had statistically significance (P 0.05 ) . [ Conclusion] The anterior cervical fusion accelerated the occurrence of ASD. The incidence of cephalic adjacent segment ASD was higher than that of tail side adjacent segments. The incidences of postoperative ASD in single segment and several segment fusion have no significant differences.%[目的]研究颈椎前路融合术是否必然导致邻近节段退变(adjacent segment degeneration,ASD).[方法]1986~1999年,共346例采用“环锯法前路扩大脊髓减压+椎体间植骨内固定术”治疗颈椎退变性疾病,其中,1个间隙55例,2个间隙223例,3个间隙68例.分别评定融合节段头、尾侧相邻间隙及间隔间隙的影像学表现,对结果分组进行统计学检验.[结果]术后随访13.5 (4.1 ~18)年,发生邻近节段明显退变的156例(45.1%),间隔节段明显退变的23例(6.6%).间隔节段退变明显少于邻近节段退变,两者比较差异有统计学意义(P<0.05).单纯头侧邻近节段发生ASD 84例,单纯尾侧邻近节段发生ASD 27例,头

  16. Analysis of adjacent segment degeneration of patients with anterior cervical discectomy and fusion%颈椎前路减压植骨融合术后邻近节段退变情况分析

    Institute of Scientific and Technical Information of China (English)

    邓志龙; 张晓星; 王令; 李邦春

    2011-01-01

    目的 分析颈椎前路减压植骨融合术后融合椎体邻近节段退变的影响因素.方法 选取250例行颈椎前路减压植骨融合内固定手术治疗的患者作为研究对象,观察术后邻近节段退变的发生情况,对退变患者组与无退变患者组各项观察指标进行统计学比较.结果 共72例(75个节段)(28.8%)发生术后邻近节段退变,椎间盘退变程度按评分,1分48例,2分21例,3分3例;退变组术前D值(1.26±1.30)mm、术后D值(3.76±3.10)mm,明显小于无退变组的(1.90±1.30)mm与(5.85±3.04)mm(P0.05).结论 颈椎前路减压植骨融合术后融合椎体邻近节段退变发生率较高;颈椎前凸程度较小、且手术对颈椎前凸程度改善较小是导致邻近节段退变发生的重要影响因素.%Objective To analyze the influeneing factors of adjacent segment degeneration of patients with anterior cervical discectolny and fusion. Methods Totally 250 cases of anterior cervical discectolny and fusion were selected for study. The incidence of adjacent segment degeneration was observed and the indexes of degeneration group and non-degeneration group were compared statistically. Results There were 72 cases (75 segment) of adjacent segment degeneration( 28.8% ) ,including 48 cases of degradation score of 1, 21 cases of degradation score of 2,3 cases of degradation score of 3. The preoperative D value of degradation group was ( 1.26 ± 1.30 ) mm, while ( 3.76 + 3.10) mm after operation, indicating significantly lower than that of non-degradation group ( P < 0.05 ).The postoperative D value of degradation group increased by ( 2.5 + 3.21 ) mm,notably lower than that of non-degradation group (3.95 ± 3.13) mm ( P < 0.05 ) . The age, gender distribution, JOA score and Cobb' s angle of the two groups had no statistical difference( P < 0.05). Conclusion The incident rate of adjacent segment degeneration in patients with anterior cervical diseectolny and fusion is high. The small degree of

  17. Lifespan extension by dietary intervention in a mouse model of Cockayne syndrome uncouples early postnatal development from segmental progeria.

    Science.gov (United States)

    Brace, Lear E; Vose, Sarah C; Vargas, Dorathy F; Zhao, Shuangyun; Wang, Xiu-Ping; Mitchell, James R

    2013-12-01

    Cockayne syndrome (CS) is a rare autosomal recessive segmental progeria characterized by growth failure, lipodystrophy, neurological abnormalities, and photosensitivity, but without skin cancer predisposition. Cockayne syndrome life expectancy ranges from 5 to 16 years for the two most severe forms (types II and I, respectively). Mouse models of CS have thus far been of limited value due to either very mild phenotypes, or premature death during postnatal development prior to weaning. The cause of death in severe CS models is unknown, but has been attributed to extremely rapid aging. Here, we found that providing mutant pups with soft food from as late as postnatal day 14 allowed survival past weaning with high penetrance independent of dietary macronutrient balance in a novel CS model (Csa(-/-) | Xpa(-/-)). Survival past weaning revealed a number of CS-like symptoms including small size, progressive loss of adiposity, and neurological symptoms, with a maximum lifespan of 19 weeks. Our results caution against interpretation of death before weaning as premature aging, and at the same time provide a valuable new tool for understanding mechanisms of progressive CS-related progeroid symptoms including lipodystrophy and neurodysfunction.

  18. [Ruptured aneurysm at the anterior wall of the internal carotid artery in a patient with systemic lupus erythematosus and secondary antiphospholipid syndrome].

    Science.gov (United States)

    Chonan, Masashi; Fujimura, Miki; Inoue, Takashi; Tominaga, Teiji

    2011-07-01

    A 60 year-old woman, who had a 45-year history of systemic lupus erythematosus (SLE) and secondary antiphospholipid syndrome, presented with subarachnoid hemorrhage due to a ruptured aneurysm at the anterior wall of the non-branching site of the right internal carotid artery. She underwent radical surgery on the day of onset. In light of the possibility of arterial dissection, we performed extracranial-intracranial bypass prior to careful exploration of the aneurysm. Based on the finding of saccular aneurysm, she ultimately underwent neck clipping of the aneurysm without complication. Postoperative course was uneventful, and she did not suffer from cerebral vasospasm. We recommend early surgical intervention in patients with aneurysmal SAH associated with SLE, while intrinsic pathologies of SLE such as fragile vascular structure and the risk for ischemic complication should be considered.

  19. Propranolol and prednisolone combination for the treatment of segmental haemangioma in PHACES syndrome.

    Science.gov (United States)

    Gnarra, M; Solman, L; Harper, J; Batul Syed, S

    2015-07-01

    Posterior fossa malformations-haemangiomas-arterial anomalies-cardiac defects-eye abnormalities-sternal cleft and supraumbilical raphe syndrome (also known as PHACES syndrome) is a rare neurocutaneous disorder. Children presenting with these manifestations need careful ophthalmological, cardiac and neurological assessment. They may have one or more of these extracutaneous manifestations, the most common being cerebral and cardiovascular anomalies. There is controversy about treating these children with propranolol especially if they have cerebrovascular involvement with narrow, dysplastic or absent blood vessels. The concern with propranolol is that hypotension may lead to reduced cerebral blood flow and neurological consequences. Prior to propranolol the systemic treatment for haemangiomas was prednisolone and then the concern was the opposite, namely hypertension. Our proposal was whether a combination of these two drugs would provide a safer and faster recovery. We report three retrospective cases of PHACES syndrome, each of whom received treatment with a combination of propranolol and prednisolone: two children were started on prednisolone and propranolol was added because the haemangiomas failed to respond adequately; the third child was started on propranolol and developed peripheral ischaemia and ulceration necessitating a reduction in dose addition of a low dose of prednisolone. All three patients, who failed on the one treatment, responded well to combination therapy without any significant complications. These outcomes suggest that for some patients with PHACES syndrome the use of combination treatment with propranolol and prednisolone could be advantageous, potentially allowing for the introduction of low doses of each with an enhanced combined effect. The doses can be increased gradually depending on the magnetic resonance imaging findings.

  20. False aneurysm of the interosseous artery and anterior interosseous syndrome - an unusual complication of penetrating injury of the forearm: a case report

    Directory of Open Access Journals (Sweden)

    Garavaglia Guido

    2009-12-01

    Full Text Available Abstract Background Palsies involving the anterior interosseous nerve (AIN comprise less than 1% of all upper extremity nerve palsies. Objectives This case highlights the potential vascular and neurological hazards of minimal penetrating injury of the proximal forearm and emphasizes the phenomenon of delayed presentation of vascular injuries following seemingly obscure penetrating wounds. Case Report We report a case of a 22-year-old male admitted for a minimal penetrating trauma of the proximal forearm that, some days later, developed an anterior interosseous syndrome. A Duplex study performed immediately after the trauma was normal. Further radiologic investigations i.e. a computer-tomographic-angiography (CTA revealed a false aneurysm of the proximal portion of the interosseous artery (IA. Endovascular management was proposed but a spontaneous rupture dictated surgical revision with simple excision. Complete neurological recovery was documented at 4 months postoperatively. Conclusions/Summary After every penetrating injury of the proximal forearm we propose routinely a detailed neurological and vascular status and a CTA if Duplex evaluation is negative.

  1. Podocin inactivation in mature kidneys causes focal segmental glomerulosclerosis and nephrotic syndrome.

    Science.gov (United States)

    Mollet, Géraldine; Ratelade, Julien; Boyer, Olivia; Muda, Andrea Onetti; Morisset, Ludivine; Lavin, Tiphaine Aguirre; Kitzis, David; Dallman, Margaret J; Bugeon, Laurence; Hubner, Norbert; Gubler, Marie-Claire; Antignac, Corinne; Esquivel, Ernie L

    2009-10-01

    Podocin is a critical component of the glomerular slit diaphragm, and genetic mutations lead to both familial and sporadic forms of steroid-resistant nephrotic syndrome. In mice, constitutive absence of podocin leads to rapidly progressive renal disease characterized by mesangiolysis and/or mesangial sclerosis and nephrotic syndrome. Using established Cre-loxP technology, we inactivated podocin in the adult mouse kidney in a podocyte-specific manner. Progressive loss of podocin in the glomerulus recapitulated albuminuria, hypercholesterolemia, hypertension, and renal failure seen in nephrotic syndrome in humans. Lesions of FSGS appeared after 4 wk, with subsequent development of diffuse glomerulosclerosis and tubulointerstitial damage. Interestingly, conditional inactivation of podocin at birth resulted in a gradient of glomerular lesions, including mesangial proliferation, demonstrating a developmental stage dependence of renal histologic patterns of injury. The development of significant albuminuria in this model occurred only after early and focal foot process effacement had progressed to diffuse involvement, with complete absence of podocin immunolabeling at the slit diaphragm. Finally, we identified novel potential mediators and perturbed molecular pathways, including cellular proliferation, in the course of progression of renal disease leading to glomerulosclerosis, using global gene expression profiling.

  2. Podocin Inactivation in Mature Kidneys Causes Focal Segmental Glomerulosclerosis and Nephrotic Syndrome

    Science.gov (United States)

    Mollet, Géraldine; Ratelade, Julien; Boyer, Olivia; Muda, Andrea Onetti; Morisset, Ludivine; Lavin, Tiphaine Aguirre; Kitzis, David; Dallman, Margaret J.; Bugeon, Laurence; Hubner, Norbert; Gubler, Marie-Claire; Esquivel, Ernie L.

    2009-01-01

    Podocin is a critical component of the glomerular slit diaphragm, and genetic mutations lead to both familial and sporadic forms of steroid-resistant nephrotic syndrome. In mice, constitutive absence of podocin leads to rapidly progressive renal disease characterized by mesangiolysis and/or mesangial sclerosis and nephrotic syndrome. Using established Cre-loxP technology, we inactivated podocin in the adult mouse kidney in a podocyte-specific manner. Progressive loss of podocin in the glomerulus recapitulated albuminuria, hypercholesterolemia, hypertension, and renal failure seen in nephrotic syndrome in humans. Lesions of FSGS appeared after 4 wk, with subsequent development of diffuse glomerulosclerosis and tubulointerstitial damage. Interestingly, conditional inactivation of podocin at birth resulted in a gradient of glomerular lesions, including mesangial proliferation, demonstrating a developmental stage dependence of renal histologic patterns of injury. The development of significant albuminuria in this model occurred only after early and focal foot process effacement had progressed to diffuse involvement, with complete absence of podocin immunolabeling at the slit diaphragm. Finally, we identified novel potential mediators and perturbed molecular pathways, including cellular proliferation, in the course of progression of renal disease leading to glomerulosclerosis, using global gene expression profiling. PMID:19713307

  3. The preliminary research of normal structure of ocular anterior segment with 20.0 MHz ultrasound%20.0 MHz超声对正常活体眼前节结构检测的初步研究

    Institute of Scientific and Technical Information of China (English)

    陈琴; 刘薇; 成仲夏

    2000-01-01

    目的 探讨高频超声对眼前节结构的检测价值,为进一步研究眼前节组织疾病奠定基础.方法 用20.0 MHz高频探头对30例正常人眼的眼前节结构进行测量.结果 20.0 MHz高频超声能清楚地观察角膜、虹膜、晶状体、睫状体、前房等结构.角膜呈一条弧形的高回声,中央厚度为(O·383±O.031)mm:前房为无回声,前房深度为(2.241±0.256)mm;虹膜呈短条状高回声,厚度为(O.419±O.044)mm;晶状体前囊膜呈弧形高回声,晶状体内部为无回声,晶状体厚度为(3.533±0.185)mm;睫状体为类似三角形的中高回声,最厚处厚度为(1.131±0.094)mm.结论 20.0 MHz高频超声可无创性、清晰地观察正常眼的眼前节结构,对青光眼、角膜、巩膜、虹膜、晶状体、睫状体疾病的诊断有较大价值.%Objective To investigate the normal structure of ocular anterior segment with 20.0MHz ultrasound.Methods The structres of ocular anterior segment in thirty normal humen were measured with 20.0MHz high frequency ultrasound probe.Results The conea,iris,lens,ciliary body, and the anterior chambet was clearly viewed and measured with 20.0 MHz high frequency ultrasound.An intense curving echo was seen in the conea, which central thickness was(0.383±0.031)mm. No echo was seen in the anterior chamber, which death was(2.241±0.256)mm.A short strip echo was seen in the iris, which thickness was(0.419±O.044) mm.The intense curving echo was seen in the whole lens.No echo was seen in the interior part of the lens. The thickness of the 1ens was(3.533±0.185)mm. A medium triangularlike echo was seen in the ciliary body. The most thickest pan was(1.131±0.094)mm. Conclusions The normal structure of ocular anterior segment can be clearly Observed by 20.0 MHz high frequency ultrasound without injury.The method is very valuable in the diagnosis of diseases ocular diseases, such as glaucoma, conea, sclera, iris, lense and the ciliary body.

  4. Non-fusion segment disease after the anterior cervical arthrodesis:a retrospective study%颈椎前路融合术后非融合节段退变性疾病的回顾性研究

    Institute of Scientific and Technical Information of China (English)

    郭炳路; 宋科冉; 陈巧灵; 陈增海; 王大鹏; 王慧; 金培; 唐家广

    2016-01-01

    Objective To investigate the incidence and causes of non-fusion segment disease ( NFSD ), both adjacent and non-adjacent to the fused segment, after the anterior cervical arthrodesis.Methods This is a retrospective cohort study. Between January 1998 and January 2011, 171 patients who had anterior cervical decompression and fusion for the intervertebral disc herniation and cervical spondylosis were followed clinically. There were 97 males and 74 females, and the average age at the operation was ( 51.90 ± 9.28 ) years ( range: 31 - 72 years ). We evaluated the correlation between the incidence of symptomatic non-fusion segment disease and the following clinical parameters ( age at the operation, fusion levels ) and radiological parameters ( preoperative and postoperative cervical spine alignment, Pavlov’s ratio at the C5 level, and preoperative existence of a non-fusion segment degeneration on magnetic resonance imaging ).Results Of the 171 patients reviewed, 16 patients had non-fusion segment disease ( 9.36% ), 12 patients had adjacent segment disease and 4 had non-adjacent segment disease. Postoperative cervical lordosis in the non-fusion segment disease group was signiifcantly smaller than that of the disease-free group [ ( 7.38 ± 12.37 ) ° vs. ( 17.26 ± 9.75 ) °,P < 0.001 ]. Fusion levels in the NFSD group were 1.63 whereas 2.27 in disease-free group (P = 0.002 ). The incidence of disc degeneration in non-fused segments was more severe in the NFSD group than in the disease-free group [ ( 2.63 ± 0.62 )vs. ( 1.62 ± 0.99 ), P = 0.008 ].Conclusions The incidence of symptomatic non-fusion segment disease after the anterior cervical arthrodesis has multifactorial causes. Postoperative cervical lordosis, disc degeneration in non-fusion segments, and the number of fusion levels are all factors in the incidence of NFSD.%目的:探讨颈椎前路减压融合术后非融合节段病变( non-fusion segment disease,NFSD )的发生率和

  5. Anterior segment changes during accommodation in myopia with OCT%OCT测量近视眼在不同调节状态下眼前段结构变化

    Institute of Scientific and Technical Information of China (English)

    周少博; 李辉; 谭娟; 洪海峰

    2013-01-01

    AIM: To evaluate anterior segment changes during accommodation in different degree of myopia with OCT.METHODS: Sixty myopes with the age from 18 to 39 years were enrolled in this study and were divided into two groups: low to moderate myopia group (>-6. 0D), and high myopia group (≤-6. OD). Anterior segment measurements were performed by anterior segment optic coherence tomography ( OCT) under three different accommodative state of relax (0.0 D), 3. 00D and 5. 00D. The posterior corneal curvature (PCC), anterior chamber depth (ACD), lens thickness (LT), pupil diameter (PD) were compared at different accommodative state using repeated measures ANOVA.RESULTS:Low to moderate myopia group comprised 32 myopes with the mean age 29. 34 ± 4. 65 years, mean spherical equivalent -3. 72± 1. 05D; High myopia group comprised 28 myopes with the mean age 29. 57 ± 5. 89 years, mean spherical equivalent -7.05±0.85D; With the accommodation relaxed (0D), there was no difference between the low to moderate myopia group and high myopia group both in PCC and LT, ACD was 2. 92 ± 0.23mm in high myoia and 2. 67 ± 0. 19mm in low to moderate myopia (t=-4. 637, P=0.000). Pupil diameter was 6.21 ±0. 56mm in low to moderate myopia and 5.95± 0.42mm in high myopia (t= 2. 011, P= 0. 049). With the accommodation increased, ACD decreased significantly,LT increased significantly, and PD decreased significantly in both groups(all P 0.05).CONCLUSION: Anterior segment OCT can find the alteration of ACD, LT and PD with accommodation. During accommodation, the cornea is stable. However, with the accommodation increased, ACD, greater changes happened in LT and PD using anterior segment OCT.%目的:探讨不同程度近视眼在不同调节状态下OCT(optic coherence tomography,OCT)测量的眼前段结构的变化.方法:招募60例近视患者,年龄:18~39岁,按近视程度分为轻中度近视组和高度近视组,用眼前段OCT对测试眼分别在调节放松(0D)、诱发3.00D和5.00D

  6. Radical surgery for Budd-Chiari syndrome through exposure of the entire inferior vena cava of the hepatic segment

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xiao-ming; LI Qing-Le

    2007-01-01

    Background Several kinds of radical surgery for the treatment of Budd-Chiari syndrome (BCS) have been devised. We have described preliminary efforts to treat BCS using a novel radical resection technique to expose the entire inferior vena cava (IVC) of the hepatic segment.Methods Sixty patients with BCS were treated by radical resection, including 46 men and 14 women. BCS patients ranged in age from 11 to 62 years, with 3 months to 11 years since the BCS diagnosis. The lesions included membrane occlusion of the IVC in 16 patients, double membranes within the IVC in 2 patients, double membranes within the IVC and the hepatic vein (HV) in 3 patients, IVC membrane with distal thrombosis in 10 patients, long segment thrombosis of the IVC in 5 patients (organized thrombosis in 2 patients, fresh thrombosis in 3 patients), occlusion of the outlet of the HVs due to mural thrombosis in 2 patients, segmental occlusion of the IVC in 3 patients, membranes within the HV with IVC stenosis due to protrusion of HV stent in 1 patient, HV membranes in 11 patients, extensive occlusion of HVs in 1 patient, the whole IVC tumor thrombus with tumor thrombus of 2/3 right atrium resulting from a posterior peritoneum tumor in 1 patient, IVC leiomyosarcoma in 2 patients, IVC leiomyosarcoma with tumor thrombus into 1/2 right atrium in 1 patient, IVC thrombosis extending into right atrium in 1 patient, compression of supra-hepatic segment of IVC due to fiber trabs in 1 patient.Results All lesions were successfully resected under direct supervision. Three procedures were performed under extracorporeal circulation, 52 patients with catheterization of the right atrium, 4 patients with a cell saver, and one patient with auto-retrieval of blood. The retrieved blood was from 300 ml to 4000 ml. Transfusion of banked blood was from 400 ml to 2000 ml for 14 patients. For the other patients no transfusion of banked blood was required. One patient died of renal failure peri-operatively. Newly formed IVC

  7. Adult onset segmental cavernous hemangioma, varicose veins and limb atrophy (klippel-trenaunay-Weber syndrome variant

    Directory of Open Access Journals (Sweden)

    Sawhney MPS

    1990-01-01

    Full Text Available A 22 year-old woman presented with multiple soft, compressible, protuberant, bluish cutaneous lesions as well as firm, non-compressible, subcutaneous masses and varicose veins affecting the right upper limb of three years duration. There was atrophy of soft tissue of forearm by 2.5 cm. X-ray showed soft tissue densities, multiple phleboliths and hypoplastic forearm bones. Histopathological examination from cutaneous lesions revealed cavernous hemangioma. Adult onset cavernous hemangioma involving one upper limb and breast with multiple phleboliths and limb atrophy is a very unusual presentation of Klippel-Trenaunay-Weber syndrome.

  8. Iliotibial band friction syndrome after anterior cruciate ligament reconstruction using the transfix device: report of two cases and review of the literature.

    Science.gov (United States)

    Pelfort, Xavier; Monllau, Joan C; Puig, Lluís; Cáceres, Enric

    2006-06-01

    The use of hamstrings is increasing as a treatment for anterior cruciate ligament (ACL) injuries. There are a lot of new devices and techniques that try to fix the graft without causing further injury or increased morbidity. We report two cases in relation to the transfix device for reconstructing the ACL. The first case is a 38-year-old female who was treated with an autologous hamstring graft for chronic ACL instability brought on by a sport trauma. The patient developed iliotibial band friction syndrome 3 months after the operation. MRI showed incorrect positioning and a rupture of the femoral bio-absorbable cross-pin. The hamstring graft always had good fixation and did not produce instability of the knee. We removed the cross-pin fragment in a second surgery and the patient returned to her daily lifestyle after 3 weeks. The second case is a 52-year-old female with a painful and unstable knee due to a previous lateral meniscectomy and failure of an ACL reconstruction. We performed an ACL reconstruction with an autologous hamstring graft and a lateral meniscus transplantation. Some months after the procedure she also developed this syndrome. MRI showed the same features as shown in the first case and a second surgery was needed. To our knowledge this clinical and technical problem has not been previously described.

  9. Comparison of anterior segment parameters with Lenstar 900 and Sirius system%Sirius系统与Lenstar 900测量眼前节参数的比较研究

    Institute of Scientific and Technical Information of China (English)

    赵艳; 韦伟; 张长宁

    2014-01-01

    目的:比较两种非接触眼生物测量仪Lenstar 900( LS900)和Sirius眼前节分析系统测量眼前节有关参数的异同。  方法:对近视患者54例87眼分别采用LS900及Sirius系统测量角膜中央厚度( central corneal thickness, CCT)、前房深度(aqueous depth, ACD)、角膜平K(flat keratometry, FK)、角膜陡 K(steep keratometry,SK)、白到白(white to white, WTW)。采用配对 t 检验、Pearson 相关和 Bland-Altman图分析和评估。  结果:Sirius系统检测的CCT和ACD大于LS900,而FK、SK和 WTW 小于 LS900,差值的均值分别为-6.11±6.32μm;-0.09±0.07 mm;0.18±0.25 D;0.21±0.36 D 和0.25±0.39mm,差异有统计学意义(P  结论:LS900和Sirius系统对眼前节参数的检测具有良好的相关性和一致性,但也存在一定差异。这可能与Lenstar和Sirius测量方式并不一致有关,因此还有待进一步研究。%AlM: To compare the anterior segment measurements derived from optical low coherence reflectometer ( Lenstar LS900 ) and combined Scheimpflug - Placido disk topographer ( Sirius) . METHODS: ln this study, we enrolled healthy myopic subjects 54 ( 87 eyes ) . The central corneal thickness (CCT), anterior chamber depth (ACD), flat keratometry ( FK) readings , steep keratometry ( SK ) readings and white to white ( WTW ) were measured by LS900 and Sirius. Evaluation and analysis were performed using paired t tests, the Pearson correlation, and Bland-Altman analyses. RESULTS: The CCT and ACD measurements were significantly lower whereas FK, SK and WTW measurements were higher with LS900 (P CONCLUSlON: Anterior segment parameters evaluated with LS900 and Sirius systemare correlated well and achieve good agreement. However, there are significantly statistical differences which may be caused by the different measurement modes, so they may not be interchangeable use under certain clinical circumstances.

  10. 大脑前动脉A1段形态学特点与前交通动脉瘤的关系%The relationship between the morphological features of A1 segment of anterior cerebral artery and anterior communicating artery aneurysms

    Institute of Scientific and Technical Information of China (English)

    冯文峰; 张龙; 李伟光; 张国忠; 何小艳; 王刚; 李明洲; 漆松涛

    2012-01-01

    Objective To improve the predictability of surgical clipping and guide the steam shaping of mi-crocatheters in endovascular embolization by analyzing the association of morphological features of A1 segment of anterior cerebral artery (ACA) with formation and classification of anterior communicating artery aneurysms (ACoAA). Methods Digital subtraction angiography data of 264 cases of ACoAA and 296 cases of other cerebral vascular diseases were analyzed retrospectively. The morphology of A1 segment of ACA was divided into four different patterns including "arc" pattern (type Ⅰ a; convex shape, type Ⅰ b: concave shape), "S" pattern (type Ⅱ a: inverse lateral "s" shape, type Ⅱ b: lateral "s" shape), approximate straight-line shape (type Ⅲ ) and non-development. According to the direction of aneurysm protrusion, the ACoAA were divided into 5 types including anterior-inferior type, anterior-superior type, posterior-superior type, posterior-inferior type and complicated type. Results Among 264 ACoAA patients, the morphology of A1 segment of ACA was type I a in 158 sides, type Ⅰ b in 11, type Ⅱ a in 35, type lib in 87, type Ⅲ in 171 and absence in 66. The morphology of A1 segment of ACA in 296 patients with other cerebral vascular diseases was type Ⅰ a in 195 sides, type Ⅰ b in 20, type Ⅱ a in 47, type Ⅱ b in 74, type Ⅲ in 217 and absence in 39. The no-visualization of Al segment of ACA occurred was more frequent in the ACoAA group than in control group (x2 = 11.482, P = 0.001). The direction of ACoAA in 264 patients were anterior-superior type in 121 cases, anterior-inferior type in 105, complicated type in 16, posterior-inferior type in 12 and posterior-superior type in 10. The correlation between the morphology of dominant A1 segment of ACA and direction of ACoAA was significant x2 = 221.859, P = 0.000; C - 0.619, P = 0.000). The direction of ACoAA was downward at the type Ⅰ a/ type Ⅱ a, upward at type Ⅰ b/ type Ⅱ b, upward or downward

  11. The Role of the Reactive Oxygen Species and Oxidative Stress in the Pathomechanism of the Age-Related Ocular Diseases and Other Pathologies of the Anterior and Posterior Eye Segments in Adults

    Science.gov (United States)

    Nita, Małgorzata; Grzybowski, Andrzej

    2016-01-01

    The reactive oxygen species (ROS) form under normal physiological conditions and may have both beneficial and harmful role. We search the literature and current knowledge in the aspect of ROS participation in the pathogenesis of anterior and posterior eye segment diseases in adults. ROS take part in the pathogenesis of keratoconus, Fuchs endothelial corneal dystrophy, and granular corneal dystrophy type 2, stimulating apoptosis of corneal cells. ROS play a role in the pathogenesis of glaucoma stimulating apoptotic and inflammatory pathways on the level of the trabecular meshwork and promoting retinal ganglion cells apoptosis and glial dysfunction in the posterior eye segment. ROS play a role in the pathogenesis of Leber's hereditary optic neuropathy and traumatic optic neuropathy. ROS induce apoptosis of human lens epithelial cells. ROS promote apoptosis of vascular and neuronal cells and stimulate inflammation and pathological angiogenesis in the course of diabetic retinopathy. ROS are associated with the pathophysiological parainflammation and autophagy process in the course of the age-related macular degeneration. PMID:26881021

  12. 频域眼前段光学相干断层扫描对周边虹膜切除术前后前房角的研究%Evaluation of the anterior chamber angle before and after iridectomy by spectral domain-anterior segment optical coherence tomography

    Institute of Scientific and Technical Information of China (English)

    袁永刚; 梁纳; 马胜生; 郑东健

    2014-01-01

    目的 应用频域眼前段光学相干断层扫描(OCT)分析周边虹膜切除术前后前房角的变化.方法 原发性前房角关闭者32例(40只眼)行周边虹膜切除术,术前、术后2d、2个月使用频域眼前段OCT进行前房角测量,比较500 μm/750 μm前房角角度(ACA500/ACA750)和500 μm/750μm前房角开放距离(AOD500/AOD750)等指标.结果 各指标在术前、术后差异有统计学意义,术后2d、2个月相应指标差异无统计学意义.结论 原发性前房角关闭行周边虹膜切除术后前房角增宽,可缓解瞳孔阻滞,预防前房角进一步关闭,频域眼前段OCT可进行术前术后的非接触检查,实现前房的生物统计学测量.%Objective To evaluate the change of the anterior chamber angle before and after iridectomy by spectral domain-anterior segment optical coherence tomography(SD-AS OCT).Methods The clinical trial was carried out in 40 eyes of 32 cases with primary angle closure(PAC).500μm/750μm anterior chamber angle (ACA500/ACA750) and 500μm/750μm angle opening distance (AOD500/AOD750) were imaged with SD-AS OCT before and after iridectomy.Results There were statistical significant differences between preoperation and post-operation in ACAS00/ACA750 and AODS00/AOD750.No significant differences of above indexes were found between 2 days and 2 months after surgery.Conclusion The anterior chamber angle becomes wider in PAC patient after iridectomy.This improvement can relieve pupil block and prevent further chamber angle closure.SD-AS OCT can be used to carry out a noncontact biometrical measurement of anterior chamber before and after surgery.

  13. 高速枪击伤后兔眼前节组织结构改变%Morpholoigical changes in the anterior segment of rabbits' eyes injured by high-speed bullets

    Institute of Scientific and Technical Information of China (English)

    聂闯; 陈穗桦; 李俊杰; 杨丽萍

    2011-01-01

    目的 研究眼钝挫伤的损伤机制的实验动物模中多以重力为主要致伤因素,文中以高速枪弹击伤制作兔眼眼前节动物损伤模型,探讨高速枪弹钝挫伤损伤机制. 方法 实验组12只新西兰兔用汽步枪以90m/s的速度射发TB弹(平均质量0.20122g)击中左眼角膜中央区,对照组2只新西兰兔不致伤(单眼处理).裂隙灯下观察伤后3h、6h、1d、3d、7d、14d6个时相点眼前节组织的病理改变. 结果 致伤后球结膜水肿逐渐加重,第3天开始缓解;角膜损伤严重,雾状混浊2周后才稍有好转,同时,周边可见大量新生血管长入;前房可见大量新鲜出血,实验结束时仍未吸收;瞳孔呈外伤性散大,10只实验兔眼出现不可逆的瞳孔变形;晶体浑浊. 结论 高速枪弹钝挫伤可对眼前节造成严重的损伤.%Objective Most researchers study the mechanism of contusion injury by building animal trial models, particularly the gravity-injury animal model. Clinical samples show that the gravity of projection is not the most critical factor of injury. Thus, we built an animal model of high-speed bullet injury in rabbits to observe the damage and changes in the anterior segment and investigate the mechanism of high-speed contusion injury. Methods A total of 14 eyes of 14 healthy New Zealand rabbits weighing 2.0 - 3.0 kg were included in this study. Contusion injury was inflicted upon 12 left eyes of the rabbits with plastic bullets (mean weight 0.20122 g) from an air rifle at a speed of 90 m/s. The other 2 of the control group were not injured and received unilateral treatment. Pathological changes in the anterior segment were observed under the slit-lamp at 3h,6h, 1 d, 3 d, 7 d, and 14 d after the injury. Results Gradual deterioration of bulbar conjunctiva edema was observed after the injury, and alleviation began at 3 d. The corneal was damaged seriously and improved slightly only at 14 d, with obvious peripheral neovascularization

  14. Anterior Nutcracker syndrome as a rare cause of hematuria in an 8 year old boy: A case report

    Directory of Open Access Journals (Sweden)

    Prashant S Patil

    2016-09-01

    Full Text Available Nutcracker syndrome is caused by a compression of the left renal vein between the aorta and the superior mesenteric artery. It results in left renal venous hypertension, and the subsequent development of venous varicosities of the renal pelvis, ureter, and gonadal vein. We report a rare case in an 8-year-old boy who presented with a history of intermittent episodes of hematuria leading to anemia and left flank pain. Ultrasound examination of abdomen revealed bulky left kidney and features of subacute medical renal disease. Computed tomography of abdomen showed compressed left renal vein between aorta and superior mesenteric artery. Authors report the successful operative management of this rare syndrome in a pediatric patient.

  15. Ultrasound biomicroscopy in the comparison of the anterior segment morphometry before and after pars plana vitrectomy Biomicroscopia ultra-sônica na comparação da morfometria do segmento anterior antes e após vitrectomia "pars plana"

    Directory of Open Access Journals (Sweden)

    Flavio de Andrade Marigo

    2006-12-01

    Full Text Available PURPOSE: To determine if pars plana vitrectomy induces long-term changes in the anterior segment anatomy by means of ultrasound biomicroscopy. METHODS: A prospective case series study was undertaken of consecutive patients referred to a tertiary eye care centre for pars plana vitrectomy as the only procedure. Twenty eyes of 20 patients undergoing pars plana vitrectomy alone were studied by ultrasound biomicroscopy. Silicone oil or scleral buckle was not used in any of the included cases. The following morphometric parameters were compared before and after 3 months of surgery: anterior chamber depth, angle-opening distance at 500 µm from the scleral spur, trabecular-ciliary process distance, ciliary body thickness at 1, 2 and 3 millimeters from the scleral spur and measurement of the supraciliary space thickness, when fluid was detected. RESULTS: No statistically significant differences were found between the preoperative and the postoperative morphometric parameters. CONCLUSION: Uncomplicated pars plana vitrectomy does not induce any long-term change on anterior segment morphometry. Based on these findings, the normal long-term pattern to be expected after pars plana vitrectomy is the conservation of the preoperative morphometry.OBJETIVOS: O objetivo do presente estudo foi determinar, por meio da biometria ultra-sônica (UBM, se a vitrectomia via "pars plana" pode induzir alterações permanentes na anatomia do segmento anterior. MÉTODOS: Foi realizado estudo prospectivo, analisando-se uma série consecutiva de pacientes, encaminhados para um centro de referência terciário para serem submetidos a vitrectomia via "pars plana" como único procedimento. Vinte olhos de 20 pacientes a serem submetidos a vitrectomia como único procedimento foram estudados pela biomicroscopia ultra-sônica. Óleo de silicone ou introflexão escleral não foram usados em nenhum dos casos incluídos. Os seguintes parâmetros morfométricos foram comparados antes e

  16. 基于谱域OCT图像的人眼前节生物学参数自动测量%Automated biometry of human ocular anterior segment based on spectral domain optical coherence tomography

    Institute of Scientific and Technical Information of China (English)

    陈思思; 朱德喜; 马庆凯; 沈梅晓

    2016-01-01

    ocular anterior segment.However,the measurement of the dimension of anterior segment from the OCT image with high speed and precision is a challenge at present.The software of automatic data processing is still lack in analyzing spectral domain OCT.Objective This study was to perform the automatic biometry and data processing of human ocular anterior segment OCT image by using self-developed automatic detection software and evaluate the accuracy and repeatability of this method.Methods Twenty eyes of 10 normal subjects were included in Eye Hospital of Wenzhou Medical University from June to July 2013.The OCT image of anterior eye segments were obtained with custom-made ultra-long scan depth OCT under the informed consent.Anautomatic software algorithm was developed for the biometric measurement on these OCT images,including boundary segmentation,image registration and optical correction of OCT images.The boundary segmentation algorithm utilized the axial gradient information of OCT images and the shortest path search principal based on the dynamic programming to optimize edge finding.Central corneal thickness (CCT),anterior chamber depth (ACD),pupil diameter (PD),lens thickness (LT),radius of lens anterior curvatures (LAC) and radius of lens of posterior curvatures (LPC) were automatically and manually measured,and the validity of automatic detection algorithm was assessed by calculating the intraclass correlation coefficient (ICC) between the automatic and manual measurements,and the repeatability was validated by calculating the coefficient of repeatability (COR) between repeated measurement.This study was approved by the Ethic Committee of Wenzhou Medical University and informed consent was obtained from all subjects.Results There were no significant differences in the results of CCT,ACD,PD,LT,LAC and LPC between the automatic and manual measurements (P =0.205,0.167,0.285,0.127,0.102,0.074).The results were consistent between automatic and manual measurements (all at

  17. The clinical practice of pars plana anterior vitreous aspiration in sundenly positive vitreous pressure during intraocular operation of ocular anterior segment%经睫状体平坦部穿刺抽吸玻璃体液在眼前节内眼术中突发玻璃体正性压力下应用

    Institute of Scientific and Technical Information of China (English)

    李兴育; 马千丽; 杨新光; 张璐; 陈曦

    2013-01-01

    Objective To summary the clinical practice experience of pars plana anterior vitreous aspiration during intraocular operation of ocular anterior segment,to give suggestion to ophthalmologist in front of positive vitreous pressure.Methods A retrospective clinical study.The data of 24 patients (25 cases) who received pars plana anterior vitreous aspiration during intraocular operation of ocular anterior segment from December 2010 to March 2012 in Xi' an NO.4 hospital were collected.One of them had this practice in two time operations.Analysis the patients' sex,average age,preoperative diagnosis,operation mode,preoperative and postoperative intraocular pressure,puncture time,puncture related complications.Results The ratio of male and female was 1:2; average age was 60.0±10.4; in all cases,the first diagnosis was glaucoma in 21 cases,4 cases was cataract;the operation mode included:14 cases with glaucoma surgery,3 cases underwent phacoemulsification,4 cases underwent phacoemulsification combined with anterior vitrectomy,1 case underwent phacoemulsification combined with pars plana vitretomy,3 cases underwent anti-glaucoma and phacoemulsification combined with anterior vitrectomy; the average intraocular pressure of those cases with maximum drugs was 32.50±13.41mmHg,average intraocular pressure was 21.95±10.69 mmHg within the first day of postoperative; par plana anterior vitreous aspiration was likely to practice in any operation steps; two cases had complication,one was little vitreous hemorrhage,one was posterior capsular rupture.Conclusions Positive vitreous pressure is an occasionally thorny issue during intraocular operation in ocular anterior segment.Pars plana anterior vitreous aspiration can be quickly relieved clinical symptoms,make operation turn the comer.The clinical practice have some risk,ophthalmic should pay attention to operation and reduce complications.%目的 研究总结经睫状体平坦部穿刺抽吸玻璃体液在眼前节内眼手术中

  18. 前路减压植骨融合术后颈椎相邻节段生物力学变化%Biomechanical changes of the adjacent segments after anterior cervical decompression and fusion

    Institute of Scientific and Technical Information of China (English)

    尹飞; 郭丽; 朱庆三; 赵东旭; 巩固; 李然; 赵昆池; 王迎智

    2013-01-01

    Objective To study the biomechanical changes of the adjacent segments after anterior cervical decompression and fusion (ACDF).Methods EB composite resin was used to mimic the fuion effect after anterior cervical decompression.The motion range and biomechanical changes of the adjacent segments were measured.Results Under the same torque of 2.0 Nm,the motion range of the adjacent segments was from 4.3 to 8.0 degrees,which was not significantly different from that before fusion (P >0.05).Increasing the torque gradually to let the samples reach their normal range of motion,the range of motion of the adjacent segments increased significantly.There are significant differences of them after and before fusion (P < 0.05).Conclusion If people keep the normal range of motion of cervical spine after ACDF,their adjacent segment's movement will increase significantly.This might be the main cause of the degeneration after fusion.By limiting the neck movement can reduce,or even avoid postoperative degeneration.%目的 观察颈椎前路减压植骨融合术后相邻节段生物力学变化.方法 采用EB复合树脂黏合的方法模拟颈椎前路减压植骨术后融合的效果,检测颈椎融合前、后相邻节段运动范围及生物力学的变化.结果 在2.0 Nm力矩不变的情况下,融合节段相邻间隙的运动范围为4.3°~8.0°,与融合前比较差异无统计学意义(P>0.05);加大力矩使融合后的颈椎尽量达到术前正常运动范围时融合节段相邻间隙运动范围明显增加,与融合前比较差异有统计学意义(P<0.05).结论 颈椎融合术后如果仍要达到术前正常的运动范围,其相邻节段的运动范围明显增加,这可能是造成其退变的主要原因.限制颈部术后活动可以减少、甚至避免术后退变的发生.

  19. Duration of symptomatology and median segmental sensory latency in 993 carpal tunnel syndrome hands (668 cases

    Directory of Open Access Journals (Sweden)

    KOUYOUMDJIAN JOAO ARIS

    1999-01-01

    Full Text Available According to median sensory nerve action potential onset-latency to index finger in a 140 mm fixed distance, 993 carpal tunnel syndrome (CTS hands from 668 patients were grouped into MIld (3.0 to 3.5 ms, 384 hands, MOderate (3.6 to 4.4 ms, 332 hands, SEvere (> 4.4 ms, 135 hands and UNrecordable (142 hands and correlated with CTS symptomatology duration. All patients have sensory antidromic median-radial latency difference (MRD e > or = 1.0 ms without any doubt about CTS diagnosis. Patients with systemic disease, trauma or previous surgery were excluded. There is a remarkable cumulative percentage increase from 1 to 12 months in group UN (3.5% to 38.7%, 11 folds, much less than the group MI (13.8% to 54.6%, 3.9 folds. There is also a remarkable non-cumulative percentage increase in group UN, from 1 to 4-12 months; the group MI had a relatively uniform distribution in all symptomatic duration groups from 1 to > 60 months. The conclusion is that median nerve compression at carpal tunnel can lead to unrecordable potentials in a relatively short period from 1 to 12 months of evolution, suggesting acute/subacute deterioration. Electrophysiological evaluation must be done periodically in patients that underwent clinical treatment, since cumulative 38.7% of group UN was found in 12 months period.

  20. 经前路颈椎椎体次全切除钛网置入融合后相邻节段的退变%Adjacent segment degeneration after anterior cervical corpectomy and fusion

    Institute of Scientific and Technical Information of China (English)

    翟鹏飞; 刘伟; 孙志明; 张学利

    2016-01-01

    BACKGROUND:In recent years, the researchers have studied the adjacent segment degeneration after cervical fusion. Several studies concerned the adjacent segment degeneration after anterior cervical corpectomy and fusion. OBJECTIVE:To evaluate the correlative factors of adjacent segment degeneration after anterior cervical corpectomy and fusion. METHODS:122 patients were included in the study from 126 patients who underwent anterior cervical corpectomy and fusion that operated by the same treatment team and involved a single vertebral body and the two plates between February 2009 and February 2012. The final fol ow-up period was 3 years. According to the degeneration progress of adjacent segment degeneration, these patients were divided into non-progression group and progression group. The gender, age, preoperative adjacent segment degeneration, cervical range of motion, upper and lower vertebral range of motion, surgical segment, titanium mesh subsidence, plate-to-disc distance, and cervical curvature index were compared between two groups. Logistic regression analysis was applied to analyze the correlative factors of adjacent segment degeneration. RESULTS AND CONCLUSION:(1) There were significant differences in preoperative adjacent segment degeneration, postoperative cervical range of motion, postoperative upper and lower vertebral range of motion, and postoperative cervical curvature index (P  目的:探讨经前路椎体次全切除钛网椎间置入融合后相邻节段退变的相关因素。  方法:纳入2009年2月至2012年2月行经前路椎体次全切除钛网椎间置入融合的患者共126例,其中资料完整的122例纳入研究。均由同一治疗组完成,且手术均涉及单个椎体及2个间盘。终末随访期为3年。根据术前及术后相邻节段退变程度,分为非相邻节段退变进展组和相邻节段退变进展组,比较2组患者的性别、年龄、术前相邻节段退变、颈椎活动度、术椎

  1. 青光眼暗室激发试验的眼前节相关因素分析%The correlative factors of darkroom provocative test in anterior segment parameters

    Institute of Scientific and Technical Information of China (English)

    王忠浩; 李媚; 蔡小于; 梁轩伟; 刘杏

    2013-01-01

    目的 分析房角狭窄患者暗室激发试验阳性者的相关眼前节结构参数.方法 回顾性系列病例研究.分析260例房角狭窄患者的暗室试验结果和超声生物显微镜(UBM)眼前节结构参数.其中男性36例,女性224例,平均年龄(59.6±9.3)岁.眼前节结构参数包括前房深度(ACD)、瞳孔直径(PD)、晶状体矢高(LV)、周边虹膜厚度(IT)、虹膜膨隆度(IC)、房角开放距离(AOD)、小梁网睫状突夹角(TCPA)及房角接触性关闭的象限数(NPAC).用单因素和多因素Logistic回归分析青光眼暗室激发试验阳性的相关因素.结果 260例房角狭窄者青光眼暗室激发试验的阳性率为27.3% (71/206),男性阳性率(41.7%,15/36)大于女性(25.0%,56/224),差异有统计学意义(x2=4.340,P=0.037).单因素分析表明,男性(OR =2.14)、AOD(OR=0.98)、IT(OR=1.68)、NPAC(OR=2.24)是暗室试验阳性的相关因素;多因素Logistic回归分析表明,IT(OR=1.47)、NPAC(OR=1.70)是暗室试验阳性的独立相关因素.结论 房角和虹膜参数与房角狭窄者的青光眼暗室激发试验阳性结果相关,IT和NPAC是暗室激发试验阳性的独立相关因素.%Objective To investigate the correlative anterior segment parameters of positive darkroom provocative test in patients with narrow anterior chamber angles.Methods It was a retrospective case series study.Two hundred and sixty patients [36 males and 224 females,mean age (59.6 ± 9.3) years] with narrow anterior chamber angles underwent darkroom provocative test and UBM scan were analyzed retrospectively.Anterior segment parameters including anterior chamber depth (ACD),pupil diameter (PD),lens vault (LV),peripheral iris thickness (IT),iris convex (IC),anterior chamber angle open distance (AOD),trabecular-meshwork ciliary process angle (TCPA) and the number of appositional angle closure (NPAC) were quantitatively analyzed.Correlative factors of positive results were analysis by both single factor and multiple

  2. What is a segment?

    Science.gov (United States)

    Hannibal, Roberta L; Patel, Nipam H

    2013-12-17

    Animals have been described as segmented for more than 2,000 years, yet a precise definition of segmentation remains elusive. Here we give the history of the definition of segmentation, followed by a discussion on current controversies in defining a segment. While there is a general consensus that segmentation involves the repetition of units along the anterior-posterior (a-p) axis, long-running debates exist over whether a segment can be composed of only one tissue layer, whether the most anterior region of the arthropod head is considered segmented, and whether and how the vertebrate head is segmented. Additionally, we discuss whether a segment can be composed of a single cell in a column of cells, or a single row of cells within a grid of cells. We suggest that 'segmentation' be used in its more general sense, the repetition of units with a-p polarity along the a-p axis, to prevent artificial classification of animals. We further suggest that this general definition be combined with an exact description of what is being studied, as well as a clearly stated hypothesis concerning the specific nature of the potential homology of structures. These suggestions should facilitate dialogue among scientists who study vastly differing segmental structures.

  3. 可植入胶原聚合透镜植入术后早期眼前段观察%Observation of anterior segment after implantation of implantable collamer lens in early stage

    Institute of Scientific and Technical Information of China (English)

    栗静; 刘磊; 李新宇; 王虎杰

    2014-01-01

    Objective To observe the anterior segment after implantation of implantable collamer lens (ICL) in early stage.Methods 65 eyes of 37 patients with high myopia who accepted ICL implantation were enrolled in this study.Anterior chamber volume (ACV),anterior chamber depth (ACD),iridocorneal angle,intraocular pressure (IOP) and endothelial cell density were measured at pre-operation,1 month and 6 months after surgery,and measurements were analyzed by statistical analysis.Results After surgeries,the ACD,iridocorneal angles and ACV decreased statistically significantly,and there were no statistical differences between measurements of 1 month and 6 months after surgery; the IOP measured at postoperative 1 month was lower than before and achieved stable state during postoperative 6 months; The endothelial cell density decreased about 4.75% and 6.87% respectively at postoperative 1 month and 6 months (P < 0.05) ; The mean central vault were (412.61 ± 192.94) μm and (365.69 ± 179.75) μm respectively at postoperative 1 month and 6 months,the ICLs had no contact with lens.Conclusion In the early period after implantation of ICL,the anterior segment morphology changed significantly,but these indexes were stable and no closure of iridocorneal angle or increasing of IOP were observed in the follow-up 6 months,therefore,long time follow-up is still required.%目的 观察有晶状体眼可植入胶原聚合透镜(ICL)植入术后早期的眼前段形态.方法 随机选取接受ICL植入术的高度近视37例(65只眼),测量患者术前、术后1个月和6个月的前房深度、前房角、前房容积、眼压和角膜内皮细胞密度,并对测量结果进行统计学分析.结果 术后前房深度、前房角和前房容积均较术前显著减小,术后1个月和术后6个月相比差异无统计学意义.术后1个月时眼压较术前稍有降低,术后6个月时恢复至术前水平;术后1个月和6个月患眼角膜内皮细胞密度较术前分别降低4

  4. Moyamoya disease associated with antiphospholipid syndrome

    Directory of Open Access Journals (Sweden)

    Mahmut Abuhandan

    2011-12-01

    Full Text Available Moyamoya (MMD is a disease that often involves the vascular structures of anterior cerebral circulation, particularly the proximal segments of anterior and middle cerebral arteries. The etiology of the disease is unknown. MMD often presents with cerebral ischemia and rarely with cerebral hemorrhage. The pathology is termed Moyamoya syndrome (MMS when the pathological cerebral angiography findings are accompanied by meningitis, neurofibromatosis, neoplasm, Down syndrome or polycystic kidney disease. Autoimmune diseases including Graves’ disease, Behcet’s disease and antiphospholipid syndrome might also lead to the development of MMS. In this manuscript, we presented an interesting case of MMD associated with antiphospholipid syndrome, which is quite a rare cause of acute cerebral infarction in childhood

  5. Comparison of anterior segment changes resulted from accommodation before and after LASIK in myopia%近视眼LASIK手术前后调节所致眼前段结构变化的比较

    Institute of Scientific and Technical Information of China (English)

    周少博; 李辉; 洪海峰; 谭娟

    2014-01-01

    目的 探索近视眼LASIK手术前后调节致眼前段结构变化的差异.方法 临床病例系列研究.对2010年3~8月在广州医学院第一附属医院眼科就诊的60例年龄在18~39岁近视患者,按近视程度分为轻中度近视组和高度近视组,统一行标准的LASIK手术,分别于术前、术后1周、1、3个月用眼前段OCT对非主导眼进行不同调节状态下眼前段扫描分析,测量该眼在调节放松(0.0 D)和诱发3.0 D调节两种状态下的眼前段参数术后变化,包括角膜后表面曲率、前房深度、晶状体厚度和暗瞳直径的大小.结果 60例患者,轻中度近视组32例,高度近视组28例.两组患者在调节放松状态下(0.0 D),角膜后表面曲率、前房深度、晶状体厚度和瞳孔直径在手术前后各时期的差异比较均无统计学意义(P>0.05).在诱发3.0 D调节时,轻中度近视组与高度近视组,角膜曲率、前房深度和瞳孔直径在术前和术后1周、1、3个月的变化差异比较无统计学意义(P>0.05);但晶状体厚度在各时期的变化差异比较有统计学意义(F轻中度近视组=3.595,P =0.025;F高压近视组=3.310,P=0.046),轻中度近视组术后1周晶状体的变化量较术前减少,高度近视组晶状体的变化量术后3个月较术前增大.结论 近视眼LASIK手术前后调节所致的眼前段改变,不同程度近视和不同部位在不同时期有所差异,调节所致的角膜后表面曲率和瞳孔直径变化在手术前后无明显差异;术后早期(1周)调节所致的晶状体改变量均低于术前,术后1个月可以恢复至术前水平,术后远期(3个月),高度近视调节所致晶状体的变化量甚至高于术前水平.%Objective To evaluate the difference of anterior segment changes resulted from accommodation before and after LASIK in myopia.Methods Sixty myopic patients with the age from 18 to 39 years who were going to undergo standard LASIK were enrolled in this study and were

  6. 20G 23G玻璃体切除术后眼前节形态学变化临床研究%Morphologic changes in the anterior segment after 20-, 23-G pars plana vitrectomy

    Institute of Scientific and Technical Information of China (English)

    禹海; 王颖; 李鹤一; 曹蕾; 张沈夏; 高明宏

    2015-01-01

    Objective To evaluate morphologic changes in anterior segment and the influencing factors for the changes after 20-, 23-G pars plana vitrectomy (PPV) by Ultrasound biomicroscope (UBM).Methods One hundred and thirty-one patients (133 eyes) who underwent primary PPV and 3 months follow-up after surgery in our hospital from January 2013 to February 2014 were enrolled in this prospective study.The patients were divided in 20-G group and 23-G group.UBM was applied to determine the tomographic features of anterior segment before and 1 week and 3 months after the surgery.The pre-and postoperative intraocular pressure (IOP), anterior chamber depth (ACD),parameters of anterior chamber angle, iris and ciliary body in 2 groups were assessed.Results The morphologic changes in anterior segment after surgery included: (1) ciliary body detachment (CBD) (2) anterior chamber angle closure (3) vitreous incarceration (4) anterior hyaloids proliferation (5) ciliary body atrophy.Forty-six of 86 eyes in 20G group presented morphologic changes after surgery compared with 22 of 47 eyes in 23G group.Vitreous incarceration was significantly higher in 23Ggroup (P =0.003).The proportion of CBD in 23G group was also higher than that in 20G, but there are no statistical significance within two groups (P =0.062).The other morphologic changes between 2 group were not statistical difference (P =0.098, 0.172, 1.000).The postoperative ACD of 20G group were deeper than that of 23G group, but the statistical difference were not significant (P =0.162, 0.301).The postoperative IOP of 20G group were significantly higher than that of 23G group in lweek (P =0.05) and sustained higher till 3 months after surgery.The incidence of CBD was significant difference among different diseases (P =0.041), CBD most frequently occurred in eyes of patients with proliferation diabetic retinopathy (PDR) or retinal vascular obstructive diseases (RVO).PDR was an influencing factor for postoperative CBD (Spearman analysis, r

  7. 改进的上颌前部骨切开术矫治上颌前突及其术后的美学评价%Esthetic evaluation after modified anterior segmental osteotomy on maxillary protrusion

    Institute of Scientific and Technical Information of China (English)

    吴中兴; 李祖兵; 东耀峻; 叶翁三杰; 杨学文; 李智

    2009-01-01

    Objective The main goals of orthognathic surgery are to achieve funetional occlusion and improve patient's profile.The unintended nasal change in association with anterior maxillary osteotomy is always a challenging.The purpose of this study was to improve the anterior maxillary segmental osteotomy resulting in less post-operative unintended nasal change.Methods Thirty-two patients with maxillary protrusion underwent modified anterior subapical maxillary osteotomy.The design of the modified approach was based on the anterior mandibular subapical osteotomy.The horizontal osteotomy connecting the vertical osteotomy lines on both right and left sides was performed inferior to the piriform aperture and 3 mm over the apex.The integrity of piriform aperture was maximally preserved.Lateral cephalograms,lateral and frontal photographs taken pre-and post-operatively were analyzed.All the patients were followed up for at least 6 months.Results All thirty-two patients were satisfied with esthetic outcome.The upper lip protrusions and tooth exposure improved significantly.Cephalometric and photograph analysis showed that the ratio of upper lip to maxillary ineisor retractionwas 0.64:1.00,and the nasolabial angle and philtrum length were significantly increased(P<0.05)while vermilion length was decreased.The height of nasal tip and nasal width(alarbase to alarbase)were not significantly changed.Conclusion The modified anterior subapical maxillary osteotomy is a simple procedure leading to no significant postoperative nasal change.It provides a promising alternative in the treatment of maxillary protrusion.%目的 探讨矫治上颌前突的改进术式,以避免传统术式往往发生的继发鼻部形态改变,并可保证美容效果.方法 改进方式是根据下颌前部根尖下骨切开术的原则,在梨状孔下缘下方的前颌骨面、沿各上前牙根尖上3 mm做切骨标志点,将其相连即水平骨切开线,线两端与左右垂直骨切开线相连,呈"

  8. 正常人眼前段组织与房角开放度数的关系%Relationship between Structure of Anterior Segment Tissue and Open Angle in Normal Subjects

    Institute of Scientific and Technical Information of China (English)

    曾阳发; 刘杏; 王涛; 李媚; 李彬彬; 何明光

    2009-01-01

    [Objective] To study the relationship between structure of anterior segment tissues and open angle(AA) in normal subjects.[Methods] A total of 211 eyes from 211 normal subjects were enrolled,whose anterior chambers and lens were scanned using anterior segment optical coherence tomography (AS-OCT).The measuring items included AA,anterior chamber depth (ACD),anterior chamber horizontal diameter (ACHD),anatomical anterior chamber depth (AACD),ciliary band length (CBL),iris thickness (IT),lens thickness (LT),lens position (LP) and lens anterior apex position (LAAP).The relationship between the 8 biometric parameters and AA was analyzed using linear correlation,respectively.[Results] The mean of AA was (40 ± 17)°,with (44 ± 18)° in male,and (37 ± 16)° in female.The difference of AA between male and female was statistically significant (t = 2.893,P = 0.004).There was significant correlation between AA and ACD (r = 0.721,P = 0.000),LT (r = -0.545,P = 0.000),CBL (r = 0.615,P = 0.000),LAAP (r = -0.717,P = 0.000),LP (r = 0.557,P = 0.000),and ACHD (r = 0.175,P = 0.011).There was no significant correlation between AA and AACD (r = 0.130,P = 0.059),IT (r = 0.129,P = 0.061).[Conclusion] The AA of females was narrower than that of males.In normal subjects,the most important factors which determine AA are the lens,the location of the peripheral iris and ciliary body.%[目的] 分析正常人房角开放度数(AA)与眼前段结构的关系. [方法] 收集211例(211只眼)正常人,采用眼前段光学相干断层扫描仪(AS-OCT)扫描其前房和晶状体,并测量前房深度(ACD)、前房横径(ACHD)、解剖前房深度(AACD)、睫状体带长度(CBL)、虹膜厚度(IT)、晶状体厚度(LT)、晶状体位置(LP)以及晶状体前极的位置(LAAP).采用直线相关分析这8个参数与AA的关系. [结果] AA的均值为(40 ± 17)°,男性(44 ± 18)°,女性(37 ± 16)°,比较差异有统计学意义(t = 2.893,P = 0.004).AA

  9. Patterns of prefrontal dysfunction in alcoholics with and without Korsakoff's syndrome, patients with Parkinson's disease, and patients with rupture and repair of the anterior communicating artery.

    Science.gov (United States)

    Dirksen, Courtney L; Howard, Julie A; Cronin-Golomb, Alice; Oscar-Berman, Marlene

    2006-09-01

    This study compared patterns of frontal-lobe dysfunction in alcoholics with Korsakoff's syndrome (KS: n = 9), non-Korsakoff alcoholics (AL: n = 28), patients with Parkinson's disease (PD: n = 18), and patients with rupture and repair of the anterior communicating artery (ACoA: n = 4) relative to healthy non-neurological control (NC) participants (n = 70). The tests administered were sensitive to functions of dorsolateral prefrontal and orbito-frontal subsystems. Measures included perseverative errors on the Wisconsin Card Sorting Test (WCST-pe), errors on object alternation (OA), errors on Trails B, number of words generated on the Controlled Oral Word Association Test (COWAT), and number of categories completed on the WCST (WCST-cc). KS patients were as impaired as AL participants on orbitofrontal measures and, on dorsolateral prefrontal measures, were impaired relative to AL participants, whose performance did not differ from controls. Patients with PD also were impaired on tests of orbitofrontal and dorsolateral prefrontal functioning but to a lesser extent than the KS patients. Moreover, most of the PD deficits were driven by the impaired performance of patients whose initial symptoms were on the right side of the body. The ACoA patients were significantly impaired on tests of orbitofrontal but not dorsolateral prefrontal functioning relative to the control group. Together, the results confirm different patterns of frontal-system impairments in patient groups having compromised frontal lobe functioning consequent to varying etiologies.

  10. Adjacent segment degeneration after anterior cervical discectomy and fusion follow-up%颈椎前路融合术后邻近节段退变情况的研究

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

      目的通过观察分析前路颈椎间盘切除融合术(anterior cervical discectomy and fusion,ACDF)术后随访患者的影像学资料,探讨邻近节段病变的发生时间和发生率。方法分析2008年以来本科收治的94例施行 ACDF 手术并获得完整随访的患者,其中男性51例,女性43例;年龄28~70岁,平均50.5岁。融合节段:单节段42例,上节段30例,三节段22例。术前均常规行颈椎正、侧位 X 线、MRI 检查。术后评定患者神经功能恢复情况,根据 Kellgren 分级标准对临近节段颈椎间盘退变情况进行 X 线评价。结果94例患者随访时间12~45个月,平均随访时间为29.1月。术后患者神经功能改善明显,JOA 评分较术前提高5.8,改善率为64.3%,有效率为100%。临近节段颈椎间盘退变情况的 X 线评估显示,有19例发生临近节段的退变,其中12例有轻度退变表现,7例出现较严重退变表现,邻近节段退变发生率为20.2%。退变发生时间为术后5~40个月,平均为18.7±4.79个月。结论 ACDF 治疗颈椎间盘退行性疾病有良好的疗效,术后邻近节段发生退变时间为18.7±4.79月,随访29.1个月邻近节段退变发生率为20.2%。%Objective To study the clinical efficacy of anterior cervical discectomy and fusion(ACDF) for cervical spondylosis , also the rate and occurrence time of adjacent segment degeneration.Methods 94 cases (male: 51, female: 43, average age: 50.5, ranging from 28 to 70)of cervical spondylosis admitted to our department since 2008 were analyzed in this study.42 patients were performed with single-level ACDF, 30 patients with double-level ACDF,and 22 patients with three-level ACDF. The cervical anterior-posterior and lateral X-ray and MRI examination were performed before the operation.Neurological functional recovery was assessed after operation. X -ray was used to evaluate the degree of adjacent segment degeneration according to

  11. Patterns of prefrontal dysfunction in alcoholics with and without Korsakoff’s syndrome, patients with Parkinson’s disease, and patients with rupture and repair of the anterior communicating artery

    OpenAIRE

    Dirksen, Courtney L; Howard, Julie A.; Cronin-Golomb, Alice; Oscar-Berman, Marlene

    2006-01-01

    This study compared patterns of frontal-lobe dysfunction in alcoholics with Korsakoff’s syndrome (KS: n = 9), non-Korsakoff alcoholics (AL: n = 28), patients with Parkinson’s disease (PD: n = 18), and patients with rupture and repair of the anterior communicating artery (ACoA: n = 4) relative to healthy non-neurological control (NC) participants (n = 70). The tests administered were sensitive to functions of dorsolateral prefrontal and orbito-frontal subsystems. Measures included perseverativ...

  12. A modified HEART risk score in chest pain patients with suspected non-ST-segment elevation acute coronary syndrome

    Institute of Scientific and Technical Information of China (English)

    Chun-Peng MA; Xiao WANG; Qing-Sheng WANG; Xiao-Li LIU; Xiao-Nan HE; Shao-Ping NIE

    2016-01-01

    ObjectiveTo validate a modified HEART [History, Electrocardiograph (ECG), Age, Risk factors and Troponin] risk score in chest pain patients with suspected non-ST-segment elevation acute coronary syndrome (NSTE-ACS) in the emergency department (ED).Methods This retrospective cohort study used a prospectively acquired database and chest pain patients admitted to the emergency department with suspected NSTE-ACS were enrolled. Data recorded on arrival at the ED were used. The serum sample of high-sensitivity cardiac Troponin I other than conventional cardiac Troponin I used in the HEART risk score was tested. The modified HEART risk score was calculated. The end point was the occurrence of major adverse cardiac events (MACE) defined as a composite of acute myocardial infarction (AMI), percu-taneous intervention (PCI), coronary artery bypass graft (CABG), or all-cause death, within three months after initial presentation.Results A total of 1,300 patients were enrolled. A total of 606 patients (46.6%) had a MACE within three months: 205 patients (15.8%) were diag-nosed with AMI, 465 patients (35.8%) underwent PCI, and 119 patients (9.2%) underwent CABG. There were 10 (0.8%) deaths. A progres-sive, significant pattern of increasing event rate was observed as the score increased (P < 0.001 byχ2 for trend). The area under the receiver operating characteristic curve was 0.84. All patients were classified into three groups: low risk (score 0–2), intermediate risk (score 3–4), and high risk (score 5–10). Event rates were 1.1%, 18.5%, and 67.0%, respectively (P < 0.001).ConclusionsThe modified HEART risk score was validated in chest pain patients with suspected NSTE-ACS and may complement MACE risk assessment and patients triage in the ED. A prospective study of the score is warranted.

  13. Discussion on application of optical coherence tomography for anterior segment imaging%光学相干断层扫描技术眼前节成像的应用探讨

    Institute of Scientific and Technical Information of China (English)

    董静; 吴强; 王晓刚

    2015-01-01

    It is very important for ophthalmic clinical diagnosis and research to obtain anterior segment information by non-invasive means. With the progress of science and technology, the application of optical coherence tomography ( OCT ) on clinical practice and scientific research of ophthalmology has been widely accepted . It not only can achieve precise imaging of an organization structure, but also can do some quantitative analysis for the assessment of clinical treatment and follow-up as an irreplaceable information.%通过无创性手段获得眼前节组织结构信息,对于眼科临床诊断及科研尤为重要。随着科技的进步,光学相干断层扫描技术( optical coherence tomography,OCT)在眼科临床及科研的应用已经得到广泛认可。目前不仅可以实现组织结构的精细成像,并可以进行对应的量化分析,为临床治疗的评估、随访观察提供不可替代的信息。

  14. 飞秒激光制瓣LASIK术后眼前节参数的变化%Changes of the parameters of anterior segment of eyes after femtosecond laser LASIK

    Institute of Scientific and Technical Information of China (English)

    胡正再; 张薇; 王志军

    2016-01-01

    Objective To analyze the changes of the parameters of anterior segment of eyes after femtosecond laser LASIK.Methods In this prospective clinic study,50 eyes of 25 patients who underwent femtosecond laser laser in situ keratomileusis (LASIK) were included.The corneal endothelium density,anterior chamber depth,anterior chamber angle width,posterior corneal surface height (4 mm diameter),distance between pupil center and corneal vertex,pupil diameter under light and dark environment were compared before and 6 months or more after surgery.Distance between pupil center and corneal vertex using absolute value.Data were analyzed using paired t test.Results After surgery,comeal endothelium density (2 829.7±227.2 cells/mm2 vs.2 716.4±255.2 cells/mm2),anterior chamber depth(3.18±0.19 mm vs.3.08±0.21 mm),anterior chamber angle width (39.39°±3.90°,37.92° ±3.76°) decreased (t=3.077,11.079,5.241,P<0.01).The differences of posterior corneal surface height (4 mm diameter),pupil diameter under light and dark environment before and after surgery were insignificant.The distance between pupil center and corneal vertex on X axis increased (0.11±0.10 mm vs.0.14±0.12 mm,t=-3.318,P<0.01).The distance between pupil center and corneal vertex on Y axis increase (0.11±0.08 mm vs.0.15±0.11 mm,t=-4.157,P<0.01).Conclusion The parameters of anterior segment of eyes after femtosecond laser LASIK changed obviously,especially for the distance between pupil center and corneal vertex.Maybe this change is important in guiding the following surgery.%目的 分析飞秒激光制瓣LASIK术后眼前节各参数(前房深度、前房角宽度、4 mm范围角膜后表面最高值、瞳孔中心与角膜顶点距离)的变化.方法 前瞻性临床研究.接受飞秒制瓣LASIK手术的患者25例(50眼),记录并分析术前和术后6个月以上中央角膜内皮细胞计数、前房深度、前房角宽度、4 mm范围角膜后表面最高值、瞳孔中心与角膜顶点距离、明

  15. The changes of inflammatory cytokines and their clinical significance in patients of inferior ST-segment elevation acute myocardial infarction with anterior ST-segment depression%急性下壁ST段抬高性心肌梗死合并前壁导联ST段压低患者炎性因子改变及临床意义

    Institute of Scientific and Technical Information of China (English)

    叶明; 曾玉杰

    2014-01-01

    目的 分析炎性因子水平与急性下壁心肌梗死有无前壁导联ST段压低之间的相关性及其临床意义.方法 选取北京安贞医院2007年5月至2012年9月急诊危重症中心因急性下壁ST段抬高性心肌梗死入院的患者360例,所有患者均急诊行PCI治疗,并观察罪犯血管以外冠脉病变的情况.所有患者根据有无前壁导联ST压低分为对照组180例和前壁ST段压低组180例.所有患者均于入院即刻取静脉血8ml,分离血浆,通过生物化学和ELISA方法检测血浆超敏C反应蛋白(Hs-CRP)、纤维蛋白原(Fib)、白细胞介素6(IL-6)、肿瘤坏死因子(TNF-α)、丙二醛(MDA)、过氧化物岐化酶(SOD)的变化,并分析血浆炎性因子水平与有无前壁ST段压低急性下壁心肌梗死相关性.结果 与对照组比较,前壁导联ST段压低患者双支病变、3支病变的比例更高(P<0.01);血浆Hs-CRP、Fib、IL-6、TNF-α水平升高更显著(P<0.01),脂质过氧化产物MDA含量更高(P<0.01),抗氧化物质SOD含量更低(P<0.01).结论 血浆炎症因子及脂质过氧化程度可在一定程度上反映冠脉病变的程度,对疾病的严重程度具有一定的预测价值.%Objective To investigate the level of Hs-CRP,Fib,IL-6,TNF-α,MDA,SOD,and analyse the correlation between the level of plasma inflammatory cytokines and clinical significance in patients with anterior ST-segment depression.Methods We choosed 360 patients with inferior ST Segment elavation acute myocardial infarction from May 2007 to Sep 2012 in rescue Center of Anzhen Hospital,in Anzhen Hospital,and all the patients received percutaneous coronary intervention treatment and the vascular lesions besides culprit vessel were observed.All the patients were divided into two groups:control group(n =180) and anterior ST-segment depression group (n =180).8ml venous blood was obtained from all the patients,and then plasma were separated.The level of plasma Hs-CRP,Fib,IL-6,TNF

  16. Anterior cervical discectomy combined with corpectomy treatment of multi-segmental cervical spondylotic myeiopathy%颈椎前路两种手术方式治疗多节段脊髓型颈椎病

    Institute of Scientific and Technical Information of China (English)

    巩陈; 申才良; 董福龙; 郑军; 汪卫兵

    2011-01-01

    Objective To evaluate of two different anterior cervical surgical treatment of multilevel cervical spondylotic myelopathy clinical efficacy. Methods Selected three or more segments accumulated of the spinal cord-type cervical spondylosis of 36 patients, of which 18 cases were treated with a single sub-segment corpectomy internal fixation + other disc excision alone bone graft and internal fixation( A group ), which was segmental decompression and bone graft fixation; 18 patients with two or more vertebral bodies and fusion with subtotal long segment plate fixation( B group ), which was long segment decompression and bone graft fixation. Two groups were compared with operative time , operative blood loss, hospital stay, fusion rate, neurological improvement rate and cervical physiological curvature of the situation. Results Operation time, blood loss, hospital stay in A group were lower than those in B group( P <0. 05 ). Internal fixations of both groups had not problem postoperative. Cobb’s angle compared with preoperative improvement between the two groups was statistically significant( P < 0. 05 ) ; B group anglec loss rate of postoperative follow-up was higher than that in A group( P <0. 05 ); Bone graft fusion occurred after 6 months in two groups, JOA scores had improvement in the two groups and there was no statistically significant ( P >0. 05 ). Conclusion Both methods attain good clinical results; Anterior cervical discectomy combined with corpectomy treatment of multi-segmental cervical spondylotic myeiopathy , with relatively less blood loss, shorter operative time,less trauma, retain more vertebral bone.which is a good operation method.%目的 评价颈椎前路分节段减压植骨内固定术和长节段减压植骨固定术治疗多节段脊髓型颈椎病的临床疗效.方法 选择累及≥3个节段的脊髓型颈椎病患者36例,其中18例采用分节段单个椎体次全切除植骨内固定+其它椎间盘单独切除植骨内固

  17. Chromosome 18q22.2-->qter deletion and a congenital anomaly syndrome with multiple vertebral segmentation defects.

    OpenAIRE

    Dowton, S B; Hing, A V; Sheen-Kaniecki, V; Watson, M. S.

    1997-01-01

    Multiple vertebral segmentation defects occur in a group of conditions variably associated with anomalies of other organ systems. This report describes a female child in whom a deletion of chromosome 18 (18q22.2-->qter) is associated with congenital anomalies including multiple vertebral segmentation defects resembling sporadic spondylocostal dysplasia. The child also has unilateral renal agenesis and unilateral fibular aplasia. The association of severe multiple vertebral segmentation defect...

  18. Presentation of a case with Wellens syndrome

    Directory of Open Access Journals (Sweden)

    Luis A. Rodríguez López

    2016-06-01

    Full Text Available This case report is about a 56-year-old male, farm worker with a history of being a smoker and suffering from high blood pressure, who was admitted at the Cardiology Care Department with the diagnosis of coronary artery disease –unstable angina–, because of chest pain related to physical effort and changes in the appearance threshold. Rest-electrocardiogram, painless, shows deep, symmetric negative T waves in anterior wall, without enzyme elevation; but during admission the patient evolves quickly, clinically and electrically, to an extensive anterior wall acute myocardial infarction, without responding to the fibrinolytic reperfusion therapy, and showing a ventricular tachycardia degenerating into ventricular fibrillation. There was no response to the maneuvers of cardiovascular resuscitation, thus, he dies. It is diagnosed postmortem as a Wellens syndrome, because necropsy showed severe atherosclerotic disease of the proximal segment of the left anterior descending coronary artery with extensive anterior transmural infarction.

  19. Chromosome 18q22.2-->qter deletion and a congenital anomaly syndrome with multiple vertebral segmentation defects.

    Science.gov (United States)

    Dowton, S B; Hing, A V; Sheen-Kaniecki, V; Watson, M S

    1997-05-01

    Multiple vertebral segmentation defects occur in a group of conditions variably associated with anomalies of other organ systems. This report describes a female child in whom a deletion of chromosome 18 (18q22.2-->qter) is associated with congenital anomalies including multiple vertebral segmentation defects resembling sporadic spondylocostal dysplasia. The child also has unilateral renal agenesis and unilateral fibular aplasia. The association of severe multiple vertebral segmentation defects with 18q- in this patient suggests the possibility that a gene important for somite formation or vertebral differentiation maps to this segment of chromosome 18.

  20. The anterior cingulate cortex

    Directory of Open Access Journals (Sweden)

    Pavlović D.M.

    2009-01-01

    Full Text Available The anterior cingulate cortex (ACC has a role in attention, analysis of sensory information, error recognition, problem solving, detection of novelty, behavior, emotions, social relations, cognitive control, and regulation of visceral functions. This area is active whenever the individual feels some emotions, solves a problem, or analyzes the pros and cons of an action (if it is a right decision. Analogous areas are also found in higher mammals, especially whales, and they contain spindle neurons that enable complex social interactions. Disturbance of ACC activity is found in dementias, schizophrenia, depression, the obsessive-compulsive syndrome, and other neuropsychiatric diseases.

  1. Pentacam of the anterior segment after implantation of iris-fixated lens%应用Pentacam三维眼前段分析仪对虹膜夹型人工晶状体植入术后的研究

    Institute of Scientific and Technical Information of China (English)

    汤欣; 邢晓杰

    2008-01-01

    目的 应用Pentacam术后追踪测量虹膜夹型有晶状体眼人工晶状体(PIOL)中央和周边部与角膜内皮和自然晶体之间的距离,倾斜度、偏心值以及前房深度的变化,评价其在前房的位置.方法 收集自2006年1月以来接受虹膜夹型人晶状体植入术的22例33只眼.术后6个月全部患者行Pentacam检查,测量VRSM50和VRSM60两组不同类型虹膜夹型PIOL中央和周边部与角膜内皮和自然晶体之间的距离,并测量术后1d、1、3及6个月人工晶状体的偏心量、倾斜度及前房深度值.结果 角膜内皮至PIOL光学部前表面距离为(1.94±0.36)mm.PIOL后表面与自然晶状体间的距离为(0.76±0.12)mm.分别比较各组在不同时期的平均偏心量与平均倾斜度,差异无统计学意义(P>0.05).在术后1d、1、3及6个月,比较2组的平均偏心量与平均倾斜度,差异无统计学意义(P>0.05).结论 Pentacam三维眼前段分析仪为PIOL植入术后提供高质量的Scheimpflug摄像,可以为有晶状体眼前房型人工晶状体提供精确的眼内定位,在这一方面具有重要的临床应用价值.%Objective To evaluate intraocular dimensions of the anterior segment and examine decentration,tilt and anterior chamber depth (ACD)of myopic phakic eyes after implantation of iris-fixated lenses.Methods Thirty-three myopic eyes that received a iris-fixated phakic intraocular lens (PIOL) were assessed.The eyes were randomized into VRSM50 and VRSM60 2 groups based on PIOL type.Distances between the cornea and the PIOL-optic edge and between the PIOL optic and the crystalline lens were evaluated using Scheimpflug photography 6 months postoperatively.The degree of IOL decentration, tilt and ACD was measured 1 day and 1,3and 6 months after surgery.Results The average postoperative distance between the central corneal endothelium and the anterior surface of the PIOL wasl.94±0.36 mm.The distance between the crystalline lens and posterior surface of the PIOL

  2. 应用25G玻璃体切除术治疗白内障术后眼前段拥挤征%25-Gauge transconjunctival sutureless vitrectomy for crowded anterior segment after cataract surgery.

    Institute of Scientific and Technical Information of China (English)

    李雯; 荣翱

    2012-01-01

    Objective To investigate the application of 25-gauge transconjunctival sutureless vitrectomy system(25GTSV)on the treatment of crowded anterior segment(CAS)after phacoemulsification and intraocular lens implantation.Methods 15 cases(15 eyes)of CAS after cataract surgery were treated with posterior capsulotomy and anterior segment vitrectomy with 25GTSV.The follow-up periods were 6 ~ 12months[(8.0 ± 1.5)months].The visual acuity,intraocular pressure(IOP)and the depth of anterior chamber were recorded,the condition of cornea,pupil,intraocular lens and complication were observed.Results All operations were successful.The visual acuity of all cases were improved in different degree after treatment.The best corrected visual acuity before treatment,1 week after treatment and at the end of the followup period was(0.05 ± 0.02),(0.2 ± 0.1)and(0.4 ± 0.1)respectively.There were significant difference before and after treatment(t =0.00,P =0.00).The mean IOP 1 week after treatment and at the end of the follow-up period was(17.3 ± 1.8)mmHg and(16.5 ± 1.3)mmHg respectively.They were lower obviously than the mean IOP before surgery which was(40.1 ± 7.5)mmHg.There were significant difference between them(t =0.00,P =0.00).The mean depth of anterior chamber before treatment,1 week after treatment and at the end of the follow-up period was(0.69 ±0.17)mm,(2.7 1 ±0.43)mm and(2.85 ±0.52)mm respectively.There were significant difference before and after treatment(t =0.00,P =0.00).After surgery,the edema of cornea disappeared,the pupil is round and a round hyalomere with diameter of 3.0 ~ 4.0 mmwas formed at the center of lens ' posterior capsule in all eyes.No obvious complications were observed intraoperatively and postoperatively.Conclusion 25GTSV with micro-incision can release and cure CAS after cataract surgery effectively and safely.%目的 评价25G经结膜无缝合玻璃体切除手术系统(25G TSV)在白内障行超声乳化联合人工晶状体植入术后眼前

  3. CASE OF BILATERAL ANTERIOR SEGMENT TUBERCULOSIS

    Directory of Open Access Journals (Sweden)

    Gopal Kishan

    2015-04-01

    Full Text Available Tuberculosis is an important cause of uveitis in our country. India has been declared the country with the highest tuberculosis burden with 25 % of the cases . (1 This is especially true in Andhra Pradesh and Telangana which have a high percentage of affected patients. However , tuberculous uveitis is usually a unilateral presen tation. We report a case of bilateral uveitis of tuberculous origin in a 55 year old woman. She presented with different tuberculous manifestations in the two eyes. While the RE showed non granulomatous uveitis with sclerosing keratitis , the LE showed gran ulomatous uveitis with mutton fat keratic precipitates. Systemic examination revealed an enlarged lymph node which was positive for tuberculosis on biopsy. She was hence diagnosed as extra pulmonary tuberculosis and was treated with ATT regimen. In this pa tient , uveitis was the initial manifestation and resulted in a systemic diagnosis.

  4. The Ophthalmic Anomalies in Children with Down Syndrome in Split-Dalmatian County

    OpenAIRE

    Karlica, Dobrila; Skelin, Siniša; Culic, Vida; Galetović, Davor; Znaor, Ljubo; Karlica, Hana; Pavelić, Jasminka

    2011-01-01

    Our aim was to present the ophthalmic anomalies in patients with Down syndrome in Split-Dalmatia County born from 1992 until 2009 year. It was a cross-sectional study. 153 children with Down syndrome aged 0–18 years from the Split-Dalmatia County were examined. One hundred twelve participants were borne in Split,13 in Vrgorac,16 in Makarska, 12 in Sinj. All enrolled children underwent a complete ophthalmological examination (anterior segment, ocular motility, refractive status, fu...

  5. Multiple segmental uniparental disomy associated with abnormal DNA methylation of imprinted loci in Silver-Russell syndrome

    NARCIS (Netherlands)

    R.P. Dias (Renuka); I. Bogdarina (Irina); J.-B. Cazier (Jean-Baptiste); C. Buchanan (Charles); M.C. Donaldson (Magruder); L. Johnston (Linda); A.C.S. Hokken-Koelega (Anita); A.J. Clark (Adrian)

    2012-01-01

    textabstractBackground: Silver-Russell syndrome (SRS; online inheritance in man 180860) is a low-birth-weight syndrome characterized by postnatal growth restriction and variable dysmorphic features. Although maternal uniparental disomy (UPD) of chromosome 7 and hypomethylation of H19 have been repor

  6. Therapy of non-ST-segment elevation acute coronary syndromes%非ST段抬高急性冠状动脉综合征治疗进展

    Institute of Scientific and Technical Information of China (English)

    刘广彬

    2011-01-01

    Non-ST-segment elevation acute coronary syndromes have become the main reason for emergency and admission, studies on the anti-platelet, anticoagulation, lipid-lowering and intervention are considered to be of utmost importance for the improvement of survival rates and quality of life of the patients. This article updates the developments in new drugs, treatment choices, the timing of intervention and treatments for special groups in recent years.%非ST段抬高急性冠状动脉综合征(non-ST-segment elevation acute coronary syndromes,NSTEACS)已成患者急诊和入院的主要原因,其抗血小板、抗凝、调脂、介入治疗等方面研究对提高患者的生存率及生存质量有重要意义.近年来,关于新的治疗药物、治疗方法的选择、介入治疗的时机及特殊人群的处理等方面都有一些新的进展.

  7. The observation of anterior segment morphological changes in eyes with primary angle closure after LPI by using UBM%原发性前房角关闭行LPI后眼前节形态学的UBM观察

    Institute of Scientific and Technical Information of China (English)

    吴杨杨; 宋胜仿; 刘世纯; 李春华; 张永烨; 吕莎

    2014-01-01

    观察原发性前房角关闭(primary angle closure, PAC)行YAG激光周边虹膜切除术(laser peripheral iridotomy, LPI)后眼前节形态学的变化。方法:选择2012年3月至2013年3月在我院诊断为PAC并行LPI的患者28例(48眼)为研究对象,应用超声生物显微镜(ultrasound biomicroscopy, UBM),观察LPI术前及术后1天、1周、1个月及3个月各时间点颞上、正上、正下、颞侧、鼻侧共5个位点的房角开放距离(angle opening distance, AOD500)、小梁虹膜夹角(trabecu-lar-iris angle, TIA)、小梁睫状体距离(trabecular ciliary process distance, TCPD)、虹膜睫状体距离(iris ciliary process distance , ICPD)、虹膜晶体夹角(iris lens angle, ILA)、虹膜晶体接触距离(iris lens process distance, ILCD)、虹膜厚度1(iris thickness, ITl)、IT2、IT3以及中央前房深度(cental depth distance, ACD)的变化。结果:AOD500、TIA:术后较术前均增大(P<0.05);术后1周大于术后其余时间点(P>0.05)。TCPD:除个别位点较术前增加(P>0.05),其余时间点相应位点较术前增加(P<0.05);术后1周大于术后其余时间点(P>0.05)。ILA:术后较术前均减小(P<0.05);术后1天至术后3个月逐渐增大(P>0.05)。ILCD:术后较术前均增大(P<0.05),术后1天至术后3个月逐渐减小(P>0.05);IT1、IT2、IT3:术后较术前均减小(P<0.05);术后各时间点间比较(P>0.05)。ACD:术后较术前增加(P>0.05)。 LPI术前及术后各时间点平均ILA与平均ILCD的相关性显示二者呈高度负相关。结论:PAC患者行LPI术后周边前房明显加深,虹膜膨隆和瞳孔阻力减轻,但术后3个月内眼前节形态并不稳定,个别参考值有不同程度的回退,LPI术后有必要进行长期随访观察。%Objective To evaluate the changes in the anterior segment morphology by using ultrasound biomicroscopy (UBM) after YAG laser

  8. Lenstar LS900与IOLMaster测量眼前节生物参数及人工晶状体度数的比较%Comparison of anterior segment biometry and intraocular lens power measured by Lenstar LS900 and IOLMaster

    Institute of Scientific and Technical Information of China (English)

    叶向彧; 纪建丽; 张广斌; 王乐; 毛益辉; 何雪洪

    2011-01-01

    目的 精确的眼生物测量对人工晶状体(intraocular lens,IOL)度数计算至关重要,尤其是眼轴及角膜曲率的测量.本研究将对比新一代光学低相干反射生物测量仪Lenstar LS900 (Haag-Streit)与IOLMaster对眼前节参数及IOL测算的差异.方法 应用Lenstar LS900和IOLMaster分别对30例(60眼)老年性白内障患者进行眼轴长度、前房深度、角膜曲率和散光轴方面的测量比较;分别利用2种设备计算IOL度数,均选用SRK/T计算公式和SA60AT(Alcon)IOL,在确定同一度数的前提下比较目标屈光度的差异.结果 Lenstar LS900和IOLMaster测量眼轴长度、前房深度、平均角膜曲率、陡峭轴角膜曲率之间差异均无统计学意义(均为P>0.05),且均具有良好的相关性(相关系数分别为0.999、0.955、0.936、0.845),而两种设备测得陡峭轴之间相关欠佳(r =0.579).Lenstar LS900和IOLMaster所获得的术后目标屈光度值分别为(-0.02±0.17)D和(-0.07±0.23)D,差异无统计学意义(P>0.05).Bland-Altman分析显示,2种设备获得的目标屈光值具有良好的一致性.结论 Lenstar LS900和IOLMaster两种设备测量眼前节参数及IOL度数具有良好的一致性.同时,Lenstar LS900还可以快速、准确的为白内障患者和屈光医师提供更多的眼生物参数.%Objective To compare the difference of anterior segment biometry and intraocular lens (IOL) power measured by a new noncontact optical biometer Lenstar LS9O0 (Haag-Streit) using optical low-coherence reflectometry and IOLMaster. Methods Biometry measurements in 60 eyes of 30 patients scheduled for cataract surgery by the same examiner with Lenstar LS900 and IOLMaster, the axial length (AL) .anterior chamber depth (ACD) and keratometric (K) were compared,IOL power for AcrySof SA60AT( Alcon) measure by two devices using SRK/T formulas was calculated, and the difference of targeted diopter under same IOL power was compared. Results There was no statistical

  9. Effect of aspirin plus clopidogrel on inflammatory markers in patients with non-ST-segment elevation acute coronary syndrome

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Background Aspirin can inhibit inflammatory reactions and platelet aggregation, but little is known about the effects of the combination of aspirin plus clopidogrel, a new antiplatelet agent, on inflammation. The purpose of this study was to determine whether aspirin plus clopidogrel can further suppress inflammation in patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). Methods One hundred and fifteen patients with NSTEACS were randomized into two groups: group A (aspirin alone, n=58) and group B (aspirin plus clopidogrel, n=57). Patients in group A received a loading dose of 300 mg aspirin, then 100 mg per day. The patients in group B received a loading dose of 300 mg aspirin and 300 mg clopidogrel, then 100 mg aspirin and 75 mg clopidogrel per day. Serum high sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor-α(TNF-α) were measured in all patients at baseline prior to any drug treatment after admission, and at 7 and 30 days after beginning drug treatment. Thirty healthy volunteers on no medications were enrolled as controls (group C).Results Baseline levels of hs-CRP and TNF-αin group A and group B were significantly higher than those in group C. Seven days after administration, the levels of hs-CRP in both group A and group B decreased significantly [Group A: (6.15 ± 1.39) mg/L vs (9.18 ± 1.62) mg/L, P <0.01; Group B:(4.99 ± 1.62) mg/L vs (10.29 ± 1.47) mg/L, P<0.01]. Similarly, levels of TNF-αin both groups decreased at 7 days compared to baseline [Group A: (90.99 ± 28.91) pg/ml vs (117.20 ± 37.13) pg/ml, P <0.01; Group B: (74.32± 21.83) pg/ml vs (115.27 ± 32.11) pg/ml, P <0.01]. Thirty days after administration, the levels of hs-CRP in both group A and group B decreased further to (3.49 ± 1.53) mg/L, and (2.40 ± 1.17) mg/L respectively (P <0.01 for both comparisons). Levels of TNF-αin groups A and B also decreased significantly between 7 and 30 days, to 63.28 ± 29.01 pg/ml (group A) and (43.95 ± 17.10) pg

  10. Prevalence of first-pass myocardial perfusion defects detected by contrast-enhanced dual-source CT in patients with non-ST segment elevation acute coronary syndromes

    Energy Technology Data Exchange (ETDEWEB)

    Schepis, Tiziano; Achenbach, Stephan; Marwan, Mohamed; Muschiol, Gerd; Ropers, Dieter; Daniel, Werner G.; Pflederer, Tobias [University of Erlangen, Department of Internal Medicine 2 (Cardiology), Erlangen (Germany)

    2010-07-15

    To investigate the prevalence and diagnostic value of first-pass myocardial perfusion defects (PD) visualised by contrast-enhanced multidetector computed tomography (MDCT) in patients admitted for a first acute coronary syndrome (ACS). Thirty-eight patients with non-ST segment elevation myocardial infarction (NSTEMI) or unstable angina (UA) and scheduled for percutaneous coronary intervention underwent dual-source CT immediately before catheterisation. CT images were analysed for the presence of any PD by using a 17-segment model. Results were compared with peak cardiac troponin-I (cTnI) and angiography findings. PD were seen in 21 of the 24 patients with NSTEMI (median peak cTnI level 7.07 ng/mL; range 0.72-37.07 ng/mL) and in 2 of 14 patients with UA. PD corresponded with the territory of the infarct-related artery in 20 out of 22 patients. In a patient-based analysis, sensitivity, specificity, negative and positive predictive values of any PD for predicting NSTEMI were 88%, 86%, 80% and 91%. Per culprit artery, the respective values were 86%, 75%, 80% and 83%. In patients with non-ST segment elevation ACS, first-pass myocardial PD in contrast-enhanced MDCT correlate closely with the presence of myocardial necrosis, as determined by increases in cTnI levels. (orig.)

  11. A Narrow Segment of Maternal Uniparental Disomy of Chromosome 7q31-qter in Silver-Russell Syndrome Delimits a Candidate Gene Region

    Science.gov (United States)

    Hannula, Katariina; Lipsanen-Nyman, Marita; Kontiokari, Tero; Kere, Juha

    2001-01-01

    Maternal uniparental disomy of chromosome 7 (matUPD7), the inheritance of both chromosomes from only the mother, is observed in ∼10% of patients with Silver-Russell syndrome (SRS). It has been suggested that at least one imprinted gene that regulates growth and development resides on human chromosome 7. To date, three imprinted genes—PEG1/MEST, γ2-COP, and GRB10—have been identified on chromosome 7, but their role in the etiology of SRS remains uncertain. In a systematic screening with microsatellite markers, for matUPD7 cases among patients with SRS, we identified a patient who had a small segment of matUPD7 and biparental inheritance of the remainder of chromosome 7. Such a pattern may be explained by somatic recombination in the zygote. The matUPD7 segment at 7q31-qter extends for 35 Mb and includes the imprinted gene cluster of PEG1/MEST and γ2-COP at 7q32. GRB10 at 7p11.2-p12 is located within a region of biparental inheritance. Although partial UPD has previously been reported for chromosomes 6, 11, 14, and 15, this is the first report of a patient with SRS who has segmental matUPD7. Our findings delimit a candidate imprinted region sufficient to cause SRS. PMID:11112662

  12. 颈前路螺钉矢状角对相邻节段影响的生物力学研究%A biomechanical study of effects of anterior cervical screw sagittal angle on adjacent segments

    Institute of Scientific and Technical Information of China (English)

    陆兆华; 赵峰; 苏维成; 赵晓勇; 赵彦涛; 李忠海

    2015-01-01

    目的:采用三维有限元方法分析颈前路螺钉矢状角( sagittal screw angle,SSA )对相邻节段生物力学的影响,判断 SSA 是否是引起邻近节段病的危险因素。方法基于健康成年男性 C3~7节段 CT 图像建立颈椎有限元模型。模拟颈前路 C5椎体次全切除、C4~6钢板内固定术,按照 SSA (0°,0°)(5°,5°)(10°,10°)分别建模,计算在不同的 SSA 下,C4上终板、C6下终板以及钢板的应力变化情况。结果 C4上终板在前屈时前方区域所受应力最大,随着 SSA 的增加,C4上终板整体所受的最大应力逐渐减小,SSA 增大10°后,C4上终板前方区域的最大应力减小12.67%。C6下终板在前屈时前方区域所受应力最大,随着 SSA 的增加,C6下终板整体所受的最大应力逐渐减小,SSA 增大10°后,C6下终板前方区域的最大应力减小7.99%。钢板在前屈和后伸时其最大应力均较集中于中部区域,并且显著高于上部及下部区域,随着 SSA 的增加,钢板受到的应力会逐渐增加。结论在颈椎前路融合内固定手术中,增大 SSA,可增加钢板承受的应力,同时降低邻近节段终板的应力,从而减少邻近节段病的发生。%Objective To analyze effects of different screw sagittal angles ( SSA ) on the stress of adjacent levels, and determine whether SSA is a risk factor of adjacent segment disease ( ASD ).Methods A three-dimensional ifnite element ( FE ) model of intact C3-7 segments was developed and validated based on healthy males. C5 anterior corpectomy and allograft interbody fusion with a rigid anterior screw-plate construction was created from C4 to C6. Three additional FE models were developed from the fusion model corresponding to 3 different combinations of SSA: ( 0°, 0° ), ( 5°, 5° ), and ( 10°, 10° ). Von Mises stress on the C4 superior end-plate, C6 inferior end-plate and screw-plate were analyzed.Results The largest stress

  13. Care of children with anterior uveitis.

    Science.gov (United States)

    Kanski, J J

    1981-09-01

    The clinical features of 290 children with anterior uveitis are presented. The vast majority suffered from chronic uveitis. Specific uveitis entities in children include the syndrome of 'chronic iridocyclitis' in girls, heterochromic cyclitis, and pars planitis. Systemic associations include sarcoidosis, the Vogt-Harada-Koyanagi syndrome, and the seronegative arthritides (juvenile chronic arthritis, juvenile ankylosing spondylitis, psoriatic arthritis, and rarely Reiter's and Beçet's syndromes). Children with a pauciarticular onset of juvenile chronic arthritis, especially when combined with positive findings for antinuclear antibody, are at particular risk of developing chronic anterior uveitis. Most cases of chronic anterior uveitis can be controlled with topical corticosteroids. Those that are resistant to both topical and systemic corticosteroids may have to be treated with chlorambucil. The operation of lensectomy is a great advance in the management of complicated cataract. Secondary glaucoma is the most devastating complication of chronic anterior uveitis in children and responds poorly to therapy.

  14. Intraocular lens movement in anterior segment imaging system and pseudoaccommodation in eyes after phacoemulcification%人工晶体在前节OCT中的位移表现与伪调节力的研究

    Institute of Scientific and Technical Information of China (English)

    王飞; 卢奕; 汪琳

    2008-01-01

    目的 分析人工晶状体植入后生理状态下,在眼内的前后位移度及其和伪凋节力的关系.方法 选择病人46例(46只眼)行白内障超声乳化联合单焦点一体式折叠人工晶状体植入术,检测和分析术后人工晶状体在眼前节OCT图像中的位移表现,记录不同度数镜片附加时的前房深度和瞳孔直径变化值,测量患者术眼的伪凋节力,并进行相关性分析.平均随访(5.2±1.6)个月.结果 78.26%(36/46)术眼屈光矫正后近视力≥Jr5;患者术眼术后平均伪凋节力为(1.08±0.71)D.眼前节OCT图像显示附加负值镜片时人工晶状体向前位移,前房变浅,附加正值镜片时人工晶状体向后位移,前房变深,前房深度变化值为(0.26±0.09)mm;不同度数镜片附加时瞳孔直径变化值为(0.58±0.28)mm.伪凋节力与前房深度变化呈正相关(r=0.8267,P<0.01),与瞳孔直径变化亦呈正相关(r=0.6724,P<0.01).结论 白内障术后人工晶状体在生理状态下位置可前后移动,视近时睫状肌收缩、人工晶状体向前移动,是IOL眼产生伪凋节力的重要机制之一;瞳孔收缩也可部分补偿调节力.%Objective To evaluate the relationship between the position shift of posterior chamber in traocular lenses (PC IOLs) in physical condition and the amplitude of pseudoaccommodation in eyes after pacoemulcification.Methods This study analyzed 46 eyes of 46 patients after cataract surgery and PC IOLs implantation 3 months after surgery. The position shift of the IOL and radius of pupil were measured by anterior segment imaging system with different diopter spectacle plus. Pseudoaccommodation amplitude was also calculated. The relationship among pseudoaccommodation.IOL movement and pupil radius was analyzed. Results There were 78.26%(36/46 ) patients whose near visual acuity with best distance correction ≥ Jr5.With negative spectacles, IOLs moved forwards, with positive spectacles, IOLs moved backwards. The mean ACD

  15. 眼前节内眼模拟手术诱发血眼屏障破坏的大鼠动物模型%Rat model of blood-ocular barrier breakdown induced by anterior segment intraocular analogic surgery

    Institute of Scientific and Technical Information of China (English)

    谢茂松; 郑永征; 徐国兴

    2012-01-01

    目的 建立眼前节内眼模拟手术诱发血眼屏障破坏的大鼠动物模型.方法 清洁级健康成年雄性Sprague-Dawley大鼠150只,随机分为对照组和模型组,每组75只.按1 ml/kg的剂量腹腔注射盐酸氯胺酮-盐酸甲苯噻嗪混合液麻醉大鼠.磷酸盐缓冲液灌注袋连接三通管.三通管一端连接24G静脉留置针,手术显微镜下在3点时钟位从角巩缘前透明角膜30°斜行穿刺入前房,退出针头,留置套管;另一端连接24G静脉留置针套管,与测压计相连测量大鼠眼压.大鼠眼压波动于0~12 mm Hg(1 mm Hg=0.133 kPa)之间,波动30次/min,重复60次.采用氧氟沙星滴眼液滴眼.建模后第1、2、3、5、7天,采用免疫组织化学法检测大鼠白蛋白;定量检测大鼠房水、视网膜中伊凡思蓝(EB)浓度.结果 免疫组织化学染色结果显示,建模后第1、2、3、5、7天对照组白蛋白阳性染色均局限于虹膜和视网膜血管内,脉络膜弥漫性着色.建模后第1天,模型组白蛋白阳性染色主要位于虹膜和视网膜神经层血管周围;建模后第2、3天,阳性染色扩散到虹膜和视网膜全层;建模后第5、7天,阳性染色主要局限于虹膜和视网膜血管内.模型组房水中EB浓度在建模后第1、2、3、5天,均较对照组高(t=25.781,37.433,25.150,19.171;P<0.01);建模后第7天,与对照组接近(t=1.303,P=0.209).模型组视网膜EB浓度在建模后第1、2、3天,均较对照组高(t=11.997,14.622,23.014;P<0.01);建模后第5、7天,与对照组接近(t=2.027,0.756; P=0.058,0.459).结论 通过模拟眼前节内眼手术损伤因素,可建立内眼手术诱发的血眼屏障破坏的大鼠动物模型.%Objective To establish a rat model of blood ocular barrier breakdown induced by anterior segment intraocular analogic surgery. Methods One hundred and fifty healthy adult male rats were randomly divided into control group and model group,75 rats in each group.The rats were

  16. Automatic Measurement of Central Cornea Thickness of Eye Anterior Segment Optical Coherence Tomography Image%眼前节光学相干层析图像中央角膜厚度自动测量

    Institute of Scientific and Technical Information of China (English)

    舒鹏; 孙延奎; 田小林

    2012-01-01

    为了自动获取所需医学参数,辅助医生诊断,提出了一种基于边缘检测和随机抽样一致性的中央角膜厚度自动测量方法.采用边缘检测算子获得眼前节组织光学相干层析图像中的初始边缘,然后利用随机抽样一致性算法对初始中央角膜上边缘进行圆弧拟合,进一步提取中央角膜下边缘并采用相同方法进行圆弧拟合,根据得到的中央角膜上下边缘计算中央角膜厚度.实验结果表明,该算法能排除图像中时常出现的中央亮线干扰,实时而准确地提取中央角膜上下边缘,得到的中央角膜厚度计算结果与人工分析基本一致,具有良好的应用价值和商业前景.%To obtain quantitative parameters automatically and help medical diagnosis, automatic measurement of central cornea thickness based on edge detection and random sample consensus (RANSAC) is employed. The initial edge in the eye anterior segment optical coherence tomography (OCT) image is obtained with an edge detector. Upper and lower edges of the central cornea are extraxted using the RANSAC circle fitting method. The central cornea thickness is then computed based on the edges. Experiments show that the proposed method can avoid the effect of light beam crossing, and good results comparable to manual analysis can be obtained in real time, indicating that the method has potential applications in the future.

  17. Perawatan Ortodontik Gigi Anterior Berjejal dengan Tulang Alveolar yang Tipis

    Directory of Open Access Journals (Sweden)

    Miesje K. Purwanegara

    2015-09-01

    Full Text Available Anterior teeth movement in orthodontic treatment is limited to labiolingual direction by very thin alveolar bone. An uncontrolled anterior tooth movement to labiolingual direction can cause alveolar bone perforation at its root segment. This case report is to remind us that alveolar bone thickness limits orthodontc tooth movement. A case of crowded anterior teeth with thin alveolar bone in malocclusion I is reported. This case is treated using adgewise orthodontic appliance. Protraction of anterior teeth is anticipated due to thin alveolar bone on the anterior surface. The conclusion is although the alveolar bone surrounding the crowded anterior teeth is thin, by controlling the movement the teeth reposition is allowed.

  18. Evaluation the value of Pentacam anterial segment analysis system in the study of anterior segment of the eye before and after laser periphery iridectomy%Pentacam眼前节分析系统在激光周边虹膜切除术前后眼前节结构评估中的应用

    Institute of Scientific and Technical Information of China (English)

    吴慧娟; 任泽钦; 鲍永珍; 侯宪如; 胡亦文

    2010-01-01

    Objective To evaluate the anterior segment parameters in early primary angle-closure glaucoma (PACG) and primary angle closure (PAC) eyes before and after neodymium: yttrium aluminum garnet (Nd:YAG) laser periphery iridectomy (LPI) by using Pentacam system. Methods Self-coutrol study. Sixty one eyes of 33 patients were recruited into this study. The images of the anterior segment of the eye were captured and the parameters[I.e. The anterior chamber ( AC ) volume, the central AC depth, the peripherial AC depth, the peripherial AC angle and the pupil size]were measured by the Pentaeam system pre-operatively and 1 week after laser treatment. Results The Pentacam system clearly showed the structure changes of the anterior segment after LPI ( I. E. The convex configuration of the iris was flattened and the peripherial AC depth was deepened). The average AC volume( t = 15. 928 ), the peripherial AC depth( t =- 17. 399, - 10. 629, - 12. 576, - 14. 474 ) and the peripherial AC angle( t = - 5. 087 ) were increased significantly (P <0. 01 ) after LPI. The AC volume was (74. 10 ± 16.35 ) mm3 before LPI and (94. 10 ±18.42) mm3 after LPI, and the increases of peripherial AC depth were 0. 17 mm (nasal) and 0. 29 mm (temporal). There was no statistical significant changes in the AC depth before and after LPI. Conclusion In patients with PACG and PAC, the changes of AC after LPI can be demonstrated by the Pentacam qualitatively and quantitatively.%目的 评价Pentacam 眼前节分析系统的临床应用价值.方法 自身对照研究.33例(61只眼)原发性闭角型青光眼和原发性房角关闭患者,在接受掺钕钇铝石榴石激光周边虹膜切除术前及术后,应用Pentacam眼前节分析系统进行眼前节摄像和图像分析,同时分别测定患者眼前房相关量化指标.激光周边虹膜切除术前后各检测参数的变化比较采用配对t检验.结果 Pentacam眼前节分析系统能够清晰显示激光治疗前后眼前节结构变化,如

  19. Segmental Orthodontics for the Correction of Cross Bites

    Science.gov (United States)

    Mathur, Rinku

    2011-01-01

    ABSTRACT Cross bite is a condition where one or more teeth may be abnormally malposed buccally or lingually or labially with reference to the opposing tooth or teeth. Cross bite correction is highly recommended as this kind of malocclusion do not diminish with age. Uncorrected cross bite may lead to abnormal wear of lower anteriors and cuspal interference, mandibular shift resulting in mandibular asymmetry and temporomandibular joint dysfunction syndrome. There are several methods for treating this type of malocclusion. In this article, segmental orthodontics has been highlighted by using 2 × 4 appliance therapy and lingual button with cross elastics. This appliance offers many advantages as it provides complete control of anterior tooth position, is extremely well tolerated, requires no adjustment by the patient and allows accurate and rapid positioning of teeth. PMID:27616858

  20. Changes of anterior segment after early implantation of posterior chamber phakic intraocular lens for correction of high myopia%ICL植入术治疗高度近视术后早期眼前节形态的变化

    Institute of Scientific and Technical Information of China (English)

    黎冬平; 刘磊; 李新宇; 栗静; 王虎杰; 杨硕

    2014-01-01

    目的:我们应用眼前节全景分析仪( Pentacam)测量有晶状体眼后房型人工晶状体( ICL )植入术手术前后前节形态指标,评价有晶状体眼后房型人工晶状体植入术的安全性及稳定性。  方法:选取行有晶状体眼后房型人工晶状体植入术治疗的高度近视患者48例90眼,术后随访6mo。 Pentacam眼前节全景分析仪测量各时间点的中央前房深度( ACD)、3∶00位前房角( ICA)、角膜像差( CA)、角膜曲率( K)和角膜厚度(CCT)等指标。使用SPSS 19.0统计软件,描述术前术后各指标的分布特征,采用配对t检验对各指标进行手术前后的差异性比较。  结果:所有观察指标各时间点均呈正态分布。 ACD、3∶00位ICA较术前降低( P<0.05)。 CA中,总像差( CTA )及低阶像差( CLOA)较术前无统计差异( P>0.05),高阶像差(CHOA)则较术前有所增加(P<0.05);K略有减小(P<0.05)。 CCT较术前比较均无统计学差异( P>0.05)。对于术后有统计学意义变化的指标,均在术后1 mo时即达到稳定状态。  结论:应用眼前节全景分析仪( Pentacam )观察有晶状体眼后房型人工晶状体植入术眼前节形态的变化主要有ICA变窄, ACD变小, CHOA增加, K减小,尚在安全范围内,6 mo随访中各值均保持稳定,未出现并发症,但远期效果需进一步随访观察。%AIM:To evaluate safety and stability of ICL implantation treatment of high myopia through the observation of anterior segment parameters such as ACD and ICA over time pre-and post-operation changes by Pentacam. METHODS:According to the proposed inclusion criteria, 90 eyes (48 patients) with high myopia who accepted ICL implantation treatment were selected.The mean follow-ups are 6 months.Anterior segment parameters such as ACD, ICA ( 3'clock ) , corneal aberration ( CA ) , K-value and CCT were

  1. THE COMPARATIVE ASSESSMENT THE EFFECTIVENESS OF TREATMENT THE NERVE ROOT COMPRESS SYNDROME USING THE ANTERIOR AND POSTERIOR APPROACHES OF PATIENTS WITH COMBINED LATERAL LUMBAR STENOSIS

    Directory of Open Access Journals (Sweden)

    Ye. B. Kolotov

    2013-01-01

    Full Text Available Objective: to compare the therapeutic possibility of the decompressiveviedecompressive with stabilization surgeries using the standard posterior and anterior retroperitoneal approaches in patients with combination of inherent and obtaining lateral stenosis and to demonstrate the adequacy of using. At the main group we removed the herniated disc with stabilization using anterior and posterior approaches – 82 patients. The control group was treated by standard microdiscectomy – 40 patients. More excellent and good results were in the main group where decompression was combined with stabilization, and at the same group were less negative results. The decompressive-stabilizing surgery with anterior interbody fusion is a pathogenetic and technically adequate treatment for combined lateral stenosis.

  2. Safety, tolerability, and initial efficacy of AZD6140, the first reversible oral adenosine diphosphate receptor antagonist, compared with clopidogrel, in patients with non-ST-segment elevation acute coronary syndrome: primary results of the DISPERSE-2 trial

    DEFF Research Database (Denmark)

    Cannon, Christopher P; Husted, Steen; Harrington, Robert A;

    2007-01-01

    OBJECTIVES: Our goal was to compare the safety and initial efficacy of AZD6140, the first reversible oral adenosine diphosphate receptor antagonist, with clopidogrel in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS). BACKGROUND: AZD6140 achieves higher mean levels of p...

  3. Anterior Eye Imaging with Optical Coherence Tomography

    Science.gov (United States)

    Huang, David; Li, Yan; Tang, Maolong

    The development of corneal and anterior segment optical coherence tomography (OCT) technology has advanced rapidly in recently years. The scan geometry and imaging wavelength are both important choices to make in designing anterior segment OCT systems. Rectangular scan geometry offers the least image distortion and is now used in most anterior OCT systems. The wavelength of OCT light source affects resolution and penetration. An optimal choice of the OCT imaging wavelength (840, 1,050, or 1,310 nm) depends on the application of interest. Newer generation Fourier-domain OCT technology can provide scan speed 100-1000 times faster than the time-domain technology. Various commercial anterior OCT systems are available on the market. A wide spectrum of diagnostic and surgical applications using anterior segment OCT had been investigated, including mapping of corneal and epithelial thicknesses, keratoconus screening, measuring corneal refractive power, corneal surgery planning and evaluation in LASIK, intracorneal ring implantation, assessment of angle closure glaucoma, anterior chamber biometry and intraocular lens implants, intraocular lens power calculation, and eye bank donor cornea screening.

  4. In-hospital prognosis in non-ST-segment elevation acute coronary syndrome derived using a new risk score based on electrocardiographic parameters obtained at admission.

    Science.gov (United States)

    Jiménez-Candil, Javier; González Matas, José Manuel; Cruz González, Ignacio; Hernández Hernández, Jesús; Martín, Ana; Pabón, Pedro; Martín, Francisco; Martín-Luengo, Cándido

    2010-07-01

    Several electrocardiographic variables are of prognostic value in non-ST-segment elevation acute coronary syndrome (NSTEACS). From observations in 427 patients, we developed a new risk score (the ECG-RS) based on admission ECG findings that can be used to determine the likelihood of death or recurrent ischemia during hospitalization, which occurred in 36% of patients. Logistic regression analysis, which considered seven electrocardiographic variables and variables from the Thrombolysis in Myocardial Infarction (TIMI) risk score, identified the following significant predictors: corrected QT interval (QTc) > or =450 ms (odds ratio 4.2, Psegment depression >0.5 mm (odds ratio 2.7, P or =450 ms, 2 points for ST-segment depression >0.5 mm, and 1 point for left atrial enlargement. When patients were divided into three groups on the basis of their ECG-RSs (i.e. or =4), the risk of death or recurrent ischemia was significantly different between the groups, at 11%, 27% and 58%, respectively (P< .001). In conclusion, the new ECG-RS provides a simple, rapid and accurate means of determining prognosis in patients with NSTEACS.

  5. ANTERIOR OSTEOPHYTE IDENTIFICATION IN CERVICAL VERTEBRAE

    Directory of Open Access Journals (Sweden)

    A. T. Chougale

    2011-06-01

    Full Text Available Radiologist always examines X-ray to determine abnormal changes in cervical, lumbar & thoracic vertebrae. Osteophyte (bony growth may appear at the corners of vertebrae so that vertebral shape becomes abnormal. This paper presents the idea from Image processing techniques such as customised Hough transform which will be used for segmentation which should be independent of rotation, scale, noise & shape. This segmented image will be then used for computing size invariant, convex hull based features to differentiate normal cervical vertebrae from cervical vertebrae containing anterior osteophyte. This approach effectively finds anterior osteophytes in cervical vertebrae.

  6. The imaging characteristics and comparative analysis of 1310 nm study of real-time Fourier-domain anterior segment OCT%1310 nm傅里叶域眼前节OCT的成像特点及与其他两种OCT的对比分析

    Institute of Scientific and Technical Information of China (English)

    王飞; 赵镇南; 李喜琪; 姜春晖; 孙兴怀; 史国华; 钱韶红

    2012-01-01

    Objective To discuss the imaging ability of different anterior optical coherence tomography (OCT) systems.Methods It was a cross-sectional study.Six normal volunteers (12 eyes,24 directions) were involved in this cross-sectional study.Three different OCT systems were used to acquire images of their eyes.The important structures:scleral spur,Schlemm's canal,anterior segment angle recess and Schwalbe line were defined.The trabecular-iris angle (TIA500),angle opening distance at 500 μm (AOD500),the area of the trabeculo-iris space at 500 μm (TISA500),the widest diameter of Schlemm's canal,and the area and circumference of Schlemm's canal were measured if possible.Results Using real-time Fourier-domain anterior segment OCT,the scleral spur,Schlemm's canal,anterior segment angle recess and the Schwalbe line were defined in 8 eyes (67%) 13 positions (54%),12 eyes (100%) 22 positions (92%),12 eyes (100%) 24 positions (100%),and 6 eyes (50%) 9 positions (38%),respectively.Using RTV-ue 100 OCT,Schlemm's canal and the Schwalbe line could be defined in 8 eyes (67%) 8 positions (33%) and 10 eyes (83%) 19 positions (79%),respectively.The scleral spur and anterior segment angle recess could not be seen.The scleral spur and anterior segment angle recess were defined in 12 eyes (100%) 21 positions (88%) and 12 eyes (100%) 24positions (100%),respectively using Visante OCT,but Schwalbe's line and Schlemm's canal could not be defined.There was a significant difference in their ability to define important structures (scleral spur,P<0.01; Schlemm's canal,P<0.01; anterior segment angle recess,P<0.01; and Schwalbe line,P<0.01).The TIA500,AOD500 and TISA500 measured by Real-time Fourier-domain anterior segment OCT and Visante OCT were similar,and the area and widest diameter of Schlemm's canal measured by Real-time Fourier-domain anterior segment OCT and RTV-ue 100 OCT were also similar.The differences were not significant.Conclusion All three

  7. 应用临时人工角膜行前后节联合手术治疗严重眼外伤%Combined anterior and posterior segments surgery using temporary keratoprosthesis for severe ocular injuries

    Institute of Scientific and Technical Information of China (English)

    王兴荣; 温莹; 毕宏生

    2008-01-01

    Objective To compare the effectiveness of combined vitrectomy with penetrating keratoplasty using temporary keratoprosthesis for different types of severe ocular injuries. Method 20cases (21eyes) including 11 ocular explosive injuries and 9 ocular penetrating injuries were underwent combined surgery .The preoperative visual acuity was from light perception to hand movement. With temporary keratoprosthesis pars plana vitrectomy, cataract excision, foreign body removal ,reattachment of retina and partial penetrating keratoplasty was performed .The follow-up period was from 3~36 months, the mean follow-up time was 17 months. Analysis was focused on visual acuity (VA), intraocular pressure, anatomic results and complications. Result 19 eyes including 100% ocular explosive injuries and 78% ocular penetrating injuries retained anatomic integrity of eyeball. 11 cases (52%) got the final postoperative VA 0.05 or better, 9 eyes were explosive injuries, the other 2 eyes were penetrating injuries. The severe complications including intraocular hypotension and retinal redetachment were all occurred in the cases with ocular penetrating injuries. Conclusion Temporary keratoprosthesis used in the combined surgeries of anterior and posterior ocular segments is proved to be an unique effective method for treatment of severe ocular injuries.Prognosis of ocular explosive injuries is better than ocular penetrating injuries.%目的 比较应用临时人工角膜行玻璃体切割联合穿透性角膜移植术治疗不同类型严重眼外伤的临床效果.方法 对伴有严重角膜混浊的眼外伤患者20例(21只眼),包括爆炸伤11例(12只眼)、眼球穿通伤9例(9只眼).术前视力为光感~眼前手动,采用临时人工角膜代替病变角膜完成闭合式玻璃体切割、白内障切除、球内异物取出、视网膜复位等眼内操作后,再用新鲜供体角膜置换人工角膜.术后随访3~36个月,平均17月,随访视力、眼压、眼球解

  8. The Effectiveness of Non-ECG-Gated Contrast-Enhanced Computed Tomography for the Diagnosis of Non-ST Segment Elevation Acute Coronary Syndrome.

    Science.gov (United States)

    Watanabe, Tomomi; Furuse, Yoshiyuki; Ohta, Yasutoshi; Kato, Masahiko; Ogawa, Toshihide; Yamamoto, Kazuhiro

    2016-09-28

    Non-ST segment elevation acute coronary syndrome (NSTE-ACS) can be difficult to diagnose accurately, especially in the hyper-acute phase. Non-ECG-gated contrast-enhanced computed tomography (non-ECG-gated CE-CT) has been used in many institutions for screening acute chest pain. Although early defects (EDs) observed in non-ECG-gated CE-CT have been reported as a sign of acute myocardial ischemia, the precise diagnostic value of this sign for acute coronary syndrome has not been fully elucidated. We investigated the usefulness of non-ECG-gated CE-CT for the diagnosis of NSTE-ACS. We retrospectively reviewed 556 patients who were hospitalized for acute-onset chest pain and who underwent emergent coronary angiography. Non-ECG-gated CE-CT was performed in 23 of these patients. Two readers independently analyzed CT images using a 5-point scale. Of the 23 patients, 13 were diagnosed with NSTE-ACS. The remaining 10 patients were diagnosed with other conditions. The sensitivity, specificity, positive predictive value, and negative predictive value, respectively, of EDs on non-ECG-gated CE-CT to detect NSTE-ACS were 84.6%, 90%, 91.7%, and 81.8%. The identification of EDs was consistent between the two readers. Non-ECG-gated CE-CT may be useful not only to triage patients with chest pain by ruling out other conditions, but also to accurately diagnose NSTE-ACS.

  9. 骨间前神经卡压的解剖学研究及临床分析%Anatomic study and clinical analysis of anterior interosseous nerve compression syndrome

    Institute of Scientific and Technical Information of China (English)

    刘志刚; 刘宏君; 刘彬

    2009-01-01

    目的 探讨骨间前神经卡压的解剖学因素及临床疗效.方法 对12侧新鲜尸体上肢标本进行解剖学研究,观察骨间前神经在走行过程中存在的卡压因素.1997年5月-2007年12月,对15例骨间前神经卡压者进行治疗.其中1例行保守治疗;14例行骨间前神经松解,并切除对其形成卡压的腱性组织,其中7例同时结扎卡压在骨间前神经上的血管.15例获得6个月至4年的随访.结果 12侧解剖学研究发现,旋前圆肌深头的腱性组织出现率为91.7%(11侧),骨间前神经几乎均被旋前圆肌两头骑跨;示、中指指浅屈肌腱腱弓出现率为41.7%(5侧);拇长屈肌副头出现率为58.3%(7侧);骑跨于正中神经和骨间前神经之上的异常血管出现率为66.7%(8侧).14例手术者中,7例同时行血管结扎者,术后疗效优于单纯松解骨间前神经和切断腱性组织者.结论 骨间前神经卡压是多因素共同作用的结果,手术彻底解除其走行路径的全部卡压因素是获得满意疗效的关键.%Objective To investigate the anatomic factors that cause anterior interosseous nerve entrapment and analyze the clinical results of decompression. Methods Twelve fresh cadaver upper limb specimens were dissected. The anatomic characteristics of the anterior interosseous nerve and the possible compression factors along its course were observed. Fifteen cases of anterior interosseous nerve compression syndrome were treated between May 1997 and December 2007. One underwent conservative treatment and 14 had surgical decompression of the anterior interosseous nerve. The tendinous structures that compressed the nerve were resected. In 7 cases the vessels that run across the nerve were ligated. Postoperative fo].low up time ranged from 6 months to 4 years. Results Anatomic studies in the dissected 12 specimens showed 91.7% occurrence ( 11specimens) of tendinous structures of the deep head of pronator teres. The anterinor interosseous nerve was

  10. Using of Strain-Sounterstrain method in the physical therapy of patients with myofascial pain syndrome of lumbosacral spine segment.

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    Lytovka M.V.

    2011-07-01

    Full Text Available The article examines the influence of physiotherapy measures on sacrolumbal myofascial pain syndrome management in combination with Strain-Counterstrain method. Two groups of patients aged 35-55 years old took part in the experiment with 10 people in each group. In the experimental group besides classical methods of physiotherapy Strain-Counterstrain method was used. It proved to be efficient and appropriate for acute pain management during the first days of therapy.

  11. Regionalization of ST-segment elevation acute coronary syndromes care: putting a national policy in proper perspective.

    Science.gov (United States)

    Rathore, Saif S; Epstein, Andrew J; Nallamothu, Brahmajee K; Krumholz, Harlan M

    2006-04-04

    A uniform policy for regionalization of ST-segment elevation myocardial infarction (STEMI) care raises several concerns. Transferring all STEMI patients to obtain primary percutaneous coronary intervention (PCI) may be less effective than transferring only high-risk STEMI patients. Delays in time to treatment >60 min associated with transferring patients for primary PCI may result in increased mortality for the average patient as compared with providing immediate fibrinolytic therapy at their initial hospital; yet more than 95% of patients transferred for primary PCI in the U.S. exceed this 60-min benchmark. Superior outcomes associated with treatment at higher-volume regional STEMI centers are inconsistent among centers, and there is no direct evidence that patients will benefit by a transfer to a high-volume hospital from a low-volume hospital. Published data suggest as many as 800 PCI patients would need to be transferred to a high-volume PCI hospital to avoid a single death at a low-volume PCI hospital. Although European randomized trial data suggest transferring patients with STEMI for primary PCI may be superior to immediate fibrinolytic therapy, these findings are unlikely to generalize to the U.S. health care system given size, geography, and organization. ST segment elevation myocardial infarction care regionalization would require a massive redistribution of health care resources, depriving several hospitals of advanced cardiac care facilities, expertise, and associated revenue. Clearer evidence of the benefits and discussion of potential harms are needed before adopting a national STEMI regionalization policy.

  12. Congestive myelopathy (Foix-Alajouanine Syndrome) due to intradural arteriovenous fistula of the filum terminale fed by anterior spinal artery: Case report and review of literature.

    Science.gov (United States)

    Krishnan, Prasad; Banerjee, Tapas Kumar; Saha, Manash

    2013-07-01

    Spinal arteriovenous fistulas are rare entities. They often present with congestive myelopathy but are infrequently diagnosed as the cause of the patients' symptoms. Only one such case has been described previously in Indian literature. We describe one such case who presented to us after a gap of 3 years since symptom onset and following a failed laminectomy where the cause was later diagnosed to be an intradural fistula in the filum terminale fed by the anterior spinal artery and review the available literature.

  13. Comparatire study of anterior segment parameters measurement by OCT, Orbscan, and A-scan ultrasound%眼前节相干光断层扫描仪与Orbscan Ⅱ及超声法眼前节生物测量对比研究

    Institute of Scientific and Technical Information of China (English)

    庞辰久; 宋晓虹; 王丽娅

    2009-01-01

    Objective To compare the accuracy of anterior segment OCT with Orbscan and A ultra-sound in measuring anterior segment parameters.Methods Anterior segment parameters in 66 eyes of 33 my-opic patients were measured with OCT, Orbscan and A-scan ultrasound.The central corneal thickness (CCT), anterior chamber depth (ACD)were acquired by the three methods, corneal diameter( W to W ), anterior cham-ber width,pupil diameter,and anterior chamber angle were measured by OCT and Orbscan.Results The CCTs were (532.32±35.26)μm,(538.45±38.31 )μm,and (555.82±37.63)μm,measured by AS-OCT, Orbscan,and A-scan ultrasound.There were significant differences between each of them (P <0.01 ),and also positive correlations were found.The ACD were ( 3.19±0.21 )mm, ( 3.08±0.24 )mm, and( 3.27±0.23 )mm, re-spectively measured by OCT, Orbcan and ultrasound.There were significant differences between each of them. Pupil diameterwere(5.5±0.93)mm,and(4.5±0.75)mm measured by OCT and Orbscan, The difference was(-1.00±0.68)mm,asignificantdifferencewasfound(t=1195,P=0.000),95%CI(0.84,1.17). Thedifferenceofanteriorcham-beranglewere 1.58° inposition 180° (P=0.119)and 2.89° in position 0° (P<0.01)measure by OCT and Orbscan.Conclusion The CCT was thinner obtained by OCT than by Orbscan and A-scan ultrasound,ACD was deeper than by Orbscan and more close to A-scan ultrasound.The anterior chamber angle were similar in both instruments. AS-OCT provide noncontact,rapid,simple and accurate anterior segment parameters and furthermore a clear ante-rior segment image.It is a useful instrument in measuring anterior segment parameters.%目的 比较眼前节相干光断层扫描仪(AS-OCT)与Orbscan Ⅱ以及超声法眼的节生物测量结果,为临床应用提供参考:方法对33例(66只眼)近视眼患者分别行AS-OCT,Orbscan Ⅱ以及A型超声测量仪(DGH550和DGH4000)进行眼前节生物测量,获取角膜中央厚度(CCT),前房深度(ACD),角膜直径,瞳孔直径以及前房角

  14. Brugada syndrome: a case report of an unusual association with vasospastic angina and coronary myocardial bridging.

    Science.gov (United States)

    Imazio, Massimo; Ghisio, Aldo; Coda, Luisella; Tidu, Massimo; Belli, Riccardo; Trinchero, Rita; Brusca, Antonio

    2002-04-01

    This report describes a case of an unusual association between vasospastic angina, coronary myocardial bridging, and Brugada syndrome. The patient complained of chest pain followed by rhythmic palpitation and syncope. Brugada syndrome ECG markers were documented with transient ST-segment elevation in lateral leads. A coronary angiogram showed a myocardial bridging in the left anterior descending artery and coronary vasospasm was reproduced after intracoronary ergonovine injection in the circumflex coronary artery. Ventricular fibrillation was induced by programmed electrical stimulation. The described association can be important because interaction between ischemia and Brugada syndrome electrophysiological substrate could modulate individual susceptibility to life-threatening ventricular tachyarrhythmias.

  15. Anterior internal impingement of the shoulder in rugby players and other overhead athletes

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    Siddharth R. Shah, MBBS, MSc Sports Medicine (UK, MRCS-Ed

    2017-04-01

    Conclusion: This series of anterior internal impingement, which we believe is the largest in the literature to date, demonstrates the value of an to assess and successfully treat overhead athletes with anterior impingement syndrome.

  16. 人工颈椎间盘置换与前路颈椎间盘切除融合后邻近节段椎间盘应力分布的有限元对比%Comparison of stress distribution of adjacent segments after artificial cervical disc replacement versus anterior cervical discectomy and fusion:a finite element analysis

    Institute of Scientific and Technical Information of China (English)

    刘雅普; 侯秀伟; 吴广良; 夏虹

    2016-01-01

    背景:通过前期的临床随访研究发现,前路颈椎融合后邻近节段椎间盘退变速度要快于人工颈椎间盘置换,人工颈椎间盘置换相较于前路颈椎融合可以保持良好的置换节段活动度,是否置换后邻近椎间盘的应力情况与融合之间存在着差异需要进一步研究。目的:对比人工颈椎间盘置换与前路颈椎间盘切除融合后邻近节段椎间盘的应力分布情况。方法:选择1名30岁健康男性志愿者,人工颈椎间盘和颈椎前路钢板实物进行薄层CT扫描,通过Mimics 10.01及Geomagic Studio.v11软件重建出三维图像,将以上三维数据导入Abaqus 6.9有限元分析软件中进行网格划分、赋值、应力分析。利用有限元方法分析模拟人工颈椎间盘置换及前路颈椎间盘切除融合后邻近节段椎间盘的应力变化。结果与结论:①在相同的预载荷条件下,前屈、后伸、侧屈等运动状态时前路颈椎间盘切除融合后邻近节段椎间盘的应力明显大于正常人相应节段椎间盘应力;而人工椎间盘植入后与正常人相比,在前屈、后伸、侧屈等运动状态时邻近节段椎间盘的应力差异无显著性意义;②前路颈椎间盘切除融合组与人工颈椎间盘置换组相比较,融合组术后邻近节段椎间盘的应力较置换组增大10.3%-51.6%;③有限元分析方法发现,前路颈椎间盘切除融合后邻近节段椎间盘应力大于人工颈椎间盘置换组,随着随访时间的延长,相较于传统前路减压融合,人工颈椎间盘置换可能将更好地发挥其对邻近节段椎间盘的保护作用。%BACKGROUND:Previous clinical fol ow-up study showed that disc degeneration of adjacent segment after anterior cervical discectomy and fusion was faster than that of artificial cervical disc replacement. Compared with the anterior cervical discectomy and fusion, artificial cervical disc replacement can maintain a

  17. Wellens' syndrome

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    Franco Lai

    2007-12-01

    Full Text Available We report a case of quite rare cause of thoracic pain suspected by emergency physician as Wellens’ syndrome. Wellens’ syndrome is a pattern of electrocardiographic T-wave changes associated with critical, proximal left anterior descending artery (LAD. This syndrome is about 10-15% of all unstable angina in emergency department (ED. The cardiologic consult was obtained in ED and it was not conclusive for a Wellens’ syndrome, so that the diagnostistic planning was wrong. The authors point out the importance of this syndrome in ED and the necessity of an urgent angiographic study as every acute coronary syndrome presented in ED. We remark the importance in ED to recognize these changes associated with critical LAD obstruction and the high risk for anterior wall myocardial infarction.

  18. Virtual histology study of atherosclerotic plaque composition in patients with stable angina and acute phase of acute coronary syndromes without ST segment elevation

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    Ivanović Miloš

    2013-01-01

    Full Text Available Introduction. Rupture of vulnerable atherosclerotic plaques is the cause of most acute coronary syndromes (ACS. Postmortem studies which compared stable coronary lesions and atherosclerotic plaques in patients who have died because of ACS indicated high lipid-core content as one of the major determinants of plaque vulnerability. Objective. Our primary goal was to assess the potential relations of plaque composition determined by IVUS-VH (Intravascular Ultrasound - Virtual Histology in patients with stable angina and subjects in acute phase of ACS without ST segment elevation. Methods. The study comprised of 40 patients who underwent preintervention IVUS examination. Tissue maps were reconstructed from radio frequency data using IVUS-VH software. Results. We analyzed 53 lesions in 40 patients. Stable angina was diagnosed in 24 patients (29 lesions, while acute phase of ACS without ST elevation was diagnosed in 16 patients (24 lesions. In the patients in acute phase of ACS without ST segment elevation IVUS-VH examination showed a significantly larger area of the necrotic core at the site of minimal lumen area and a larger mean of the necrotic core volume in the entire lesion comparing to stable angina subjects (1.84±0.90 mm2 vs. 0.96±0.69 mm2; p<0.001 and 20.94±15.79 mm3 vs. 11.54±14.15 mm3; p<0.05 respectively. Conclusion. IVUS-VH detected that the necrotic core was significantly larger in atherosclerotic lesions in patients in acute phase of ACS without ST elevation comparing to the stable angina subjects and that it could be considered as a marker of plaque vulnerability.

  19. New Lmna knock-in mice provide a molecular mechanism for the 'segmental aging' in Hutchinson-Gilford progeria syndrome.

    Science.gov (United States)

    Jung, Hea-Jin; Tu, Yiping; Yang, Shao H; Tatar, Angelica; Nobumori, Chika; Wu, Daniel; Young, Stephen G; Fong, Loren G

    2014-03-15

    Lamins A and C (products of the LMNA gene) are found in roughly equal amounts in peripheral tissues, but the brain produces mainly lamin C and little lamin A. In HeLa cells and fibroblasts, the expression of prelamin A (the precursor to lamin A) can be reduced by miR-9, but the relevance of those cell culture studies to lamin A regulation in the brain was unclear. To address this issue, we created two new Lmna knock-in alleles, one (Lmna(PLAO-5NT)) with a 5-bp mutation in a predicted miR-9 binding site in prelamin A's 3' UTR, and a second (Lmna(PLAO-UTR)) in which prelamin A's 3' UTR was replaced with lamin C's 3' UTR. Neither allele had significant effects on lamin A levels in peripheral tissues; however, both substantially increased prelamin A transcript levels and lamin A protein levels in the cerebral cortex and the cerebellum. The increase in lamin A expression in the brain was more pronounced with the Lmna(PLAO-UTR) allele than with the Lmna(PLAO-5NT) allele. With both alleles, the increased expression of prelamin A transcripts and lamin A protein was greater in the cerebral cortex than in the cerebellum. Our studies demonstrate the in vivo importance of prelamin A's 3' UTR and its miR-9 binding site in regulating lamin A expression in the brain. The reduced expression of prelamin A in the brain likely explains why children with Hutchinson-Gilford progeria syndrome (a progeroid syndrome caused by a mutant form of prelamin A) are spared from neurodegenerative disease.

  20. Semi-automated segmentation and quantification of adipose tissue in calf and thigh by MRI: a preliminary study in patients with monogenic metabolic syndrome

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    Walcarius Rhonda

    2006-08-01

    Full Text Available Abstract Background With the growing prevalence of obesity and metabolic syndrome, reliable quantitative imaging methods for adipose tissue are required. Monogenic forms of the metabolic syndrome include Dunnigan-variety familial partial lipodystrophy subtypes 2 and 3 (FPLD2 and FPLD3, which are characterized by the loss of subcutaneous fat in the extremities. Through magnetic resonance imaging (MRI of FPLD patients, we have developed a method of quantifying the core FPLD anthropometric phenotype, namely adipose tissue in the mid-calf and mid-thigh regions. Methods Four female subjects, including an FPLD2 subject (LMNA R482Q, an FPLD3 subject (PPARG F388L, and two control subjects were selected for MRI and analysis. MRI scans of subjects were performed on a 1.5T GE MR Medical system, with 17 transaxial slices comprising a 51 mm section obtained in both the mid-calf and mid-thigh regions. Using ImageJ 1.34 n software, analysis of raw MR images involved the creation of a connectedness map of the subcutaneous adipose tissue contours within the lower limb segment from a user-defined seed point. Quantification of the adipose tissue was then obtained after thresholding the connected map and counting the voxels (volumetric pixels present within the specified region. Results MR images revealed significant differences in the amounts of subcutaneous adipose tissue in lower limb segments of FPLD3 and FPLD2 subjects: respectively, mid-calf, 15.5% and 0%, and mid-thigh, 25.0% and 13.3%. In comparison, old and young healthy controls had values, respectively, of mid-calf, 32.5% and 26.2%, and mid-thigh, 52.2% and 36.1%. The FPLD2 patient had significantly reduced subcutaneous adipose tissue compared to FPLD3 patient. Conclusion Thus, semi-automated quantification of adipose tissue of the lower extremity can detect differences between individuals of various lipodystrophy genotypes and represents a potentially useful tool for extended quantitative phenotypic

  1. Double anterior chamber in a patient with glaucoma and microspherophakia

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    Hamid Khakshoor

    2011-01-01

    Full Text Available We report the case of a 16-year-old woman with microspherophakia and secondary open angle glaucoma. The patient presented with a membrane dividing the anterior chamber into two segments without edema or Descemet′s membrane detachment. Slit lamp biomicroscopy, Pentacam, and specular microscopy images were obtained. Double anterior chamber is primarily found in patients with anterior chamber anomalies when there is no history of surgery or trauma.

  2. Tratamento da síndrome do túnel cubital pela técnica de transposição anterior subcutânea: será este método seguro e eficaz? Subcutaneous anterior transposition for treatment of cubital tunnel syndrome: is this method safe and effective?

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    Sara Lima

    2012-01-01

    Full Text Available OBJETIVO: Avaliar os resultados da transposição anterior subcutânea do nervo cubital no tratamento da síndrome do túnel cubital (STC e a influência de fatores de prognóstico, tais como o estádio de McGowan pré-operatório, a idade e a duração dos sintomas. MÉTODOS: Foram avaliados 36 doentes com STC submetidos à transposição anterior subcutânea do nervo cubital entre 2006 e 2009, com um tempo médio de follow-up de 28 meses. A idade média foi de 41,6 anos. Nove doentes foram incluídos no estádio I de McGowan, 18 no estádio II e nove no estádio III. RESULTADOS: Obteve-se melhoria estatisticamente significativa dos défices motores e sensitivos. 78% dos doentes com neuropatia severa melhoraram após a cirurgia. Segundo a escala de Bishop modificada, obtiveram-se 21 (58,3% resultados excelentes, sete (19,4% bons, seis (16,7% satisfatórios e dois maus (5.55%. A taxa de satisfação foi de 86% e 72% dos doentes recuperaram as atividades diárias sem limitações. CONCLUSÕES: A gravidade da neuropatia e a duração pré-operatória dos sintomas, mas não a idade, tiveram uma influência negativa no outcome. A transposição anterior subcutânea do nervo cubital é segura e eficaz no tratamento da STC com diversos graus de gravidade. Tendo em conta os principais fatores de prognóstico identificados, o tratamento cirúrgico deve ser aconselhado logo que a perda axonal se torne clinicamente evidente.OBJECTIVE: To evaluate the results from subcutaneous anterior transposition of the cubital nerve for treating cubital tunnel syndrome (CTS and the influence of prognostic factors such as preoperative McGowan stage, age and duration of symptoms. METHODS: 36 patients with CTS who underwent subcutaneous anterior transposition of the cubital nerve between 2006 and 2009 were evaluated after an average follow-up of 28 months. Their mean age was 41.6 years. Nine patients were in McGowan stage I, 18 in stage II and nine in stage III. RESULTS

  3. Congestive myelopathy (Foix-Alajouanine Syndrome due to intradural arteriovenous fistula of the filum terminale fed by anterior spinal artery: Case report and review of literature

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    Prasad Krishnan

    2013-01-01

    Full Text Available Spinal arteriovenous fistulas are rare entities. They often present with congestive myelopathy but are infrequently diagnosed as the cause of the patients′ symptoms. Only one such case has been described previously in Indian literature. We describe one such case who presented to us after a gap of 3 years since symptom onset and following a failed laminectomy where the cause was later diagnosed to be an intradural fistula in the filum terminale fed by the anterior spinal artery and review the available literature.

  4. Segmental Colitis Complicating Diverticular Disease

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    Guido Ma Van Rosendaal

    1996-01-01

    Full Text Available Two cases of idiopathic colitis affecting the sigmoid colon in elderly patients with underlying diverticulosis are presented. Segmental resection has permitted close review of the histopathology in this syndrome which demonstrates considerable similarity to changes seen in idiopathic ulcerative colitis. The reported experience with this syndrome and its clinical features are reviewed.

  5. 颈椎前路融合致邻近节段椎间盘退变的原因探讨%Causes of adjacent segments disc degeneration caused by anterior cervical fusion

    Institute of Scientific and Technical Information of China (English)

    张克非; 刘伟; 于长水; 袁绍辉; 潘琦

    2011-01-01

    目的 探讨颈椎前路融合后邻近节段椎间盘退变的原因及其防治办法.方法 对实施颈椎前路融合术的126例颈椎间盘突出症患者进行回顾性分析,归纳可能导致颈椎前路融合术后临近椎间盘退变突出的原因.结果 随访时间最短10个月,最长10年,平均7.8年.37例颈椎间盘突出症患者发生临近节段椎间盘退变加重,其中7例患者再次手术.结论 颈椎前路融合后邻近节段椎间盘退变的原因可能为临近节段原有退变加重,椎间融合后生物力学改变,临近节段应力集中.%To investigate the causes of the adjacent intervertebral disc degeneration after anterior decompression and interbody fusion of C-spine and search for the way of prevention.Methods A retrospective study was given to 126 patients who underwent an anterior decompression and interbody fusion of C-spine, the causes of the adjacent intervertebral disc degeneration after anterior decompression and interbody fusion of C-spine were analyzed. Results The follow-up time was from 10 months to 10 years, average 7.8 years. Thirty-seven patients occurred the aggravation of adjacent intervertebral discs degeneration, in which 7 patients underwent reoperation. Conclusion The possible causes of the adjacent intervertebral disc degeneration after anterior decompression and interbody fusion of C-spine is that the aggravation of original degeneration of adjacent intervertebral disc, the alteration of biomechanics after anterior decompression and interbody fusion of C-spine induces the stress concentration of the adjacent intervertebral disc.

  6. 原发性急性闭角型青光眼周边虹膜切除和滤过性手术前后眼前段结构参数对比分析%Anterior segment optical coherence tomography changes after iridectomy or trabeculectomy in angle-closure glaucoma

    Institute of Scientific and Technical Information of China (English)

    李媚; 刘杏; 钟毅敏; 曹丹; 杨晔; 曾阳发

    2011-01-01

    Objective To evaluate the changes in antenor segment configuration after peripheral iridectomy (PD or trabeculectomy (Trab) in acute primary angle closure glaucoma (APACG). Methods FiRy-seven eyes of 57 patients with APACG were successive collected. PI was performed to those patients with the clock hours of peripheral anterior synechiae (PAS) 6, while Trab was performed to those patients with the clock hours of PAS >6. Anterior segment optical coherence tomography (AS-OCT) examination was performed before and 3 months after PI/Trab to compare central anterior chamber depth (ACD), angle opening distance (AOD), trabecular iris area (TISA), angle recess area (ARA), anterior chamber width (ACW), anterior chamber volume (ACV) and crystalline lens rise (CLR). Results There were no differences in mean age (P 0.862) and male/female ratio (P=0.380) between the 2 groups. After surgery, AOD, TISA, ARA, ACA and ACV increased significantly (P <0.001~0.044), while no changes were found in ACD, ACW and CLR (P=0.102~0.609) in PI group. In Trab group, ACV increased significantly postoperation (P <0.001) while other parameters shown no changes. Conclusions Both surgery of PI and Trab can increase ACV; PI can improve the anterior angle parameters in APACG, but Trab surgery shows no changes of those parameters.%目的 观察原发性急性闭角型青光眼(acute primary angle closure glaucoma,APACG)周边虹膜切除(peripheral iridectomy,PI)和小梁切除术(Trabeculectomy,Trab)手术前后眼前段结构参数的改变.方法 临床病例对照研究.对2009年6~12月在中山大学眼科中心连续性收集57例57只眼APACG患者,周边虹膜粘连(peripheral anterior synechiae,PAS)范围≤6个钟点者行PI术,PAS范围>6个钟点者行小梁切除术,术前及术后3月行眼前段光学相干断层扫描仪(anterior segment optical coherence tomograph,AS-OCT)眼前段扫描.比较两组组内及组间术前及术后的中央前房深度(central anterior chamber

  7. [Pharmacological Tests for Horner Syndrome - Case Report].

    Science.gov (United States)

    Skorkovská, K

    2016-01-01

    The case report presents a patient, who was examined at our department due to anisocoria that was present for more than one year. Besides the anisocoria the patient had no other pathological symptoms. The pupil on the right eye was larger than on the left eye by more than 1mm. Photoreaction was present on both eyes with a dilatation deficit on the left eye. There was also a slight ptosis on the left. The anterior and posterior eye segment was normal, only the iris of the left eye was slightly decoloured. The ophthalmological finding was pointing to Horner syndrome on the left side. The cause of the syndrome was not found. The case report discusses current problems of pharmacological pupillary tests used in Horner syndrome. Alternatives to the standard cocaine test are proposed, with respect to substances currently available in the Czech Republic.

  8. Clinical Effectiveness and Influence on Adjacent Segments Degeneration after Single-level Anterior Cervical Fusion%单节段颈椎前路减压融合术对邻近节段退变的影响及疗效观察

    Institute of Scientific and Technical Information of China (English)

    郑兆君; 邱玉金; 刘文华; 李军磊; 曹亮波

    2013-01-01

    Objective To evaluate the clinical effectiveness and influence on adjacent segments degenera-tion after single-level anterior cervical fusion.Methods A retrospective study was given to 40 patients who underwent single-level anterior cervical fusion from Aug.2007 to Dec.2010 and 40 patients with cervical spondylosis of the same age for the same period(imaging showed only a single segment lesions ) underwent conservative therapypatient .The disc degeneration were evaluated using intervertebral disc height and disc Pfirrmann MRI degeneration score .The clinical ef-fectiveness were evaluated using cervical JOA score ,the neck disability index(NDI) .Results The surgical group and conservative group had a statistically significant difference (P0.05) in cervi-cal JOA score and NDI than 1 week after that.Conclusion Anterior cervical discectomy and fusion can lead to degener-ation at the adjacent segment,but the clinical effectiveness are worthy of recognition .%  目的探讨单节段颈椎前路减压融合术对邻近节段退变的影响及手术疗效.方法回顾性分析2007年8月~2010年12月我科收治的40例行单节段颈椎前路减压融合术患者及同期同年龄段颈椎病(影像学显示仅单节段病变)且行保守治疗的患者资料.采用椎间隙高度及椎间盘Pfirrmann MRI退变评分作为评价椎间盘退变指标;采用颈椎JOA评分、颈椎功能障碍指数(NDI)作为手术疗效评价指标.结果术后24个月时,与对照组相比,手术组邻近节段椎间隙高度明显降低,差异有统计学意义(P0.05).结论颈椎前路减压融合术后邻近节段易发生退变,但疗效值得肯定.

  9. Study design and rationale of a comparison of prasugrel and clopidogrel in medically managed patients with unstable angina/non-ST-segment elevation myocardial infarction: the TaRgeted platelet Inhibition to cLarify the Optimal strateGy to medicallY manage Acute Coronary Syndromes (TRILOGY ACS

    DEFF Research Database (Denmark)

    Chin, Chee Tang; Roe, Matthew T; Fox, Keith A A;

    2010-01-01

    Practice guidelines recommend dual antiplatelet therapy with aspirin and clopidogrel for patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) regardless of in-hospital management strategy. Prasugrel-a thienopyridine adenosine diphosphate receptor antagonist that provides...

  10. The application of AS-OCT in the quantification study of anterior segment changes in patients with early stage PACG following LPI%原发性闭角型青光眼早期干预后眼前段结构改变定量研究

    Institute of Scientific and Technical Information of China (English)

    方敏; 葛坚; 王梅; 林明楷; 卓业鸿; 凌运兰; 张秀兰; 蔡小于; 金陈进

    2009-01-01

    目的 应用光学成像系统一前段OCT(Anterior Segment Optical Coherence Tomographv.AS-OCT)量化评价原发性闭角犁青光眼患者(Primary Angle Closure Glaucoma,PACG)早期干预后眼前段结构的改变.方法 对确诊的早期PACG患者36例(60只眼)予以激光周边虹膜切开术(Laser Peripheral Iri-dotomy,LPI)进行早期干预;采用AS-OCT量化评价干预后眼前段结构的改变.对视力、眼压、房角开放情况及眼前段结构包括AOD500(巩膜突前500μm的房角开放距离)、前房轴深、晶状体厚度等进行观察,随访时间3个月.结果 术后视力无明显变化,术后眼压较术前下降,差异有统计学意义(t=3.506,P<0.01).术后房角增宽,AOD500增加,差异有统计学意义(t=-8.34,P<0.01),术后前房轴深加深,差异有统计学意义,(t-2.909,P<0.01),术后晶状体厚度增加,差异有统计学意义(t-3.701,P<0.01 o结论AS-OCT的精确定量能够发现LPI术后眼前段结构的细微改变,是研究原发性闭角型青光眼早期于预的有力辅助工具.%Objeetive To quantify the clinical features and the anatomical changes following laser pe-ripheral iridotomy(LPI)in early stage PACG with AS-OCT.Methods 36 early stage PACG patients(60 eyes) were evaluated using gonioscopy and AS-OCT.Anterior segment configuration including angle opening dis-tance at 500 micron anterior to the scleral spur, AOD500,anterior chamber depth,ACD,lens thickness, LT were determined.The following-up was 3 months.Results After LPI, visual acuity changed little after LPI, in-traocular pressure reduced(t =3.506, P <0.01 ), AODS00 became wider(t =-8.34, P <0.01 ), ACD deepened(t =-2.909,P <0.01 )and the lens became thicker(t =-3.701 ,P <0.01 ).Conclusions AS-OCT can make precise quantifying discriminations in the anterior segment changes in early stage PACG patients following LPI, AS-OCT can be a useful high quality instrument in PACG study.

  11. Impact of Frailty and Other Geriatric Syndromes on Clinical Management and Outcomes in Elderly Patients With Non-ST-Segment Elevation Acute Coronary Syndromes: Rationale and Design of the LONGEVO-SCA Registry.

    Science.gov (United States)

    Alegre, Oriol; Ariza-Solé, Albert; Vidán, María T; Formiga, Francesc; Martínez-Sellés, Manuel; Bueno, Héctor; Sanchís, Juan; López-Palop, Ramón; Abu-Assi, Emad; Cequier, Àngel

    2016-07-01

    The incidence of acute coronary syndromes (ACS) is high in the elderly. Despite a high prevalence of frailty and other aging-related variables, little information exists about the optimal clinical management in patients with coexisting geriatric syndromes. The aim of the LONGEVO-SCA registry (Impacto de la Fragilidad y Otros Síndromes Geriátricos en el Manejo y Pronóstico Vital del Anciano con Síndrome Coronario Agudo sin Elevación de Segmento ST) is to assess the impact of aging-related variables on clinical management, prognosis, and functional status in elderly patients with ACS. A series of 500 consecutive octogenarian patients with non-ST-segment elevation ACS from 57 centers in Spain will be included. A comprehensive geriatric assessment will be performed during the admission, assessing functional status (Barthel Index, Lawton-Brody Index), frailty (FRAIL scale, Short Physical Performance Battery), comorbidity (Charlson Index), nutritional status (Mini Nutritional Assessment-Short Form), and quality of life (Seattle Angina Questionnaire). Patients will be managed according to current recommendations. The primary outcome will be the description of mortality and its causes at 6 months. Secondary outcomes will be changes in functional status and quality of life. Results from this study might significantly improve the knowledge about the impact of aging-related variables on management and outcomes of elderly patients with ACS. Clinical management of these patients has become a major health care problem due to the growing incidence of ACS in the elderly and its particularities.

  12. The study of the prognostic value scales of assessing the risk of adverse coronary events in patients with acute coronary syndrome without ST-segment elevation in combination with comorbid conditions

    Directory of Open Access Journals (Sweden)

    Dorokhova O.V.

    2014-12-01

    Full Text Available Objective: to identify the most prognostically significant scale risk assessment of patients with acute coronary syndrome without ST-segment elevation in combination with diabetes mellitus type 2, chronic renal failure, multifo-cal coronarocardiosclerosis, dyscirculatory encephalopathy. Material and methods. 260 patients with acute coronary syndrome without ST-segment elevation were divided into 4 groups according to the presence of severe concomitant diseases: patients with diabetes mellitus type 2 (71 people, chronic renal failure (49, multifocal lesions of the coronary arteries (76 and patients with dyscirculatory encephalopathy of grade 2-3, including ischemic stroke (64. All patients were stratified by major scales risk: TIMI, GRACE, PURSUIT. The development of negative coronary events was assessed in hospital and during the year after discharge. On the basis of the results, all scales were studied using the criterion of Mann-Whitney and identified the most predictably significant groups of patients with specific comorbid conditions. Results. It is revealed that the significance of the scales TIMI and GRACE in the study of distant forecast (up to 6 months is the most reliable with acute coronary syndrome without ST-segment elevation in combination with diabetes mellitus type 2. For the patients with combination with chronic renal insufficiency the best prognostic significance was obtained by the GRACE scale in the study of hospital risk and forecast up to 6 months. TIMI and GRACE scales in the study of hospital risk and forecast up to 6 months had the greatest prognostic significance for the patients with acute coronary syndrome without ST-segment elevation on the background of multifocal lesions of the coronary arteries. For the patients with dyscirculatory encephalopathy of the 2nd and 3rd grades, the greatest prognostic significance was obtained by stratification of risk on PURSUIT and GRACE scales in the study of hospital risk and

  13. Novel occurrence of axenfeld: Rieger syndrome in a patient with blepharophimosis ptosis epicanthus inversus syndrome.

    Science.gov (United States)

    Shah, Bhavin M; Dada, Tanuj; Panda, Anita; Tanwar, Mukesh; Bhartiya, Shibal; Dada, Rima

    2014-03-01

    Blepharophimosis ptosis epicanthus inversus syndrome (BPES) is a complex eyelid malformation characterized by the classical tetrad of blepharophimosis, telecanthus, ptosis, and epicanthus inversus. It has been reported to be associated with other ocular anomalies such as euryblepharon, strabismus, nystagmus, amblyopia, microphthalmos, lacrimal drainage apparatus abnormality, extra ocular muscle abnormalities, microcornea, trabecular dysgenesis, optic nerve hypoplasias, and colobomas of the optic disk. We describe a case of BPES with Axenfeld-Rieger syndrome, a neurocristopathy characterized by maldevelopment of the anterior segment with predisposition to development of glaucoma. Interestingly, both syndromes are caused by mutations in the same class of genes, namely the winged-helix/forked transcription factors (FOX) involved in a variety of developmental processes.

  14. Novel occurrence of axenfeld: Rieger syndrome in a patient with blepharophimosis ptosis epicanthus inversus syndrome

    Directory of Open Access Journals (Sweden)

    Bhavin M Shah

    2014-01-01

    Full Text Available Blepharophimosis ptosis epicanthus inversus syndrome (BPES is a complex eyelid malformation characterized by the classical tetrad of blepharophimosis, telecanthus, ptosis, and epicanthus inversus. It has been reported to be associated with other ocular anomalies such as euryblepharon, strabismus, nystagmus, amblyopia, microphthalmos, lacrimal drainage apparatus abnormality, extra ocular muscle abnormalities, microcornea, trabecular dysgenesis, optic nerve hypoplasias, and colobomas of the optic disk. We describe a case of BPES with Axenfeld-Rieger syndrome, a neurocristopathy characterized by maldevelopment of the anterior segment with predisposition to development of glaucoma. Interestingly, both syndromes are caused by mutations in the same class of genes, namely the winged-helix/forked transcription factors (FOX involved in a variety of developmental processes.

  15. Inhibitory Effect of Clopidogrel on Release of Soluble CD40 Ligand by ADP-activated Platelet in Patients With Non-ST-segment elevation Acute Coronary Syndromes

    Institute of Scientific and Technical Information of China (English)

    Wei Wei; Chufan Luo; Zhimin Du

    2008-01-01

    Objectives To investigate the inhibitory effect of clopidogrel on release of soluble CD40 ligand (sCD40L) by ADP-activated platelet in patients with non-ST-segment elevation acute coronary syndromes(NSTEACS).Methods Forty-two patients with NSTEACS were treated with clopidogrel for 6~8 days.In order to obtain platelet rich plasma (PRP) samples,the venous blood was drawn before and after treatment,respectively.The platelets were activated by adenosine diphosphate (ADP),thus releasing sCD4OL,sCD40L levels were determined by enzyme-linked immunosorbent assay (ELISA) at different time of the reaction.Results Plasma sCD40L concentration before treatment was (0.199±0.155 ) ng/mL,and (0.190±0.176) ng/mL after treatment (P>0.05).Before treatment the PRP sCD40L level at 20-minute of platelet activation was (4.34±2.51 )ng/mL,and decreased to (2.79±1.93 ) ng/mL after treatment (P<0.001).The corresponding level at 40-minute of platelet activation was (5.29±3.13 ) ng/mL before treatment and (2.87±1.59 ) ng/mL after treatment(P<0.001 ).Conclusions Short-term clopidogrel administration might inhibit the release of sCD40L by ADP-activated platelet in patients with NSTEACS,suggesting that,in addition to its antiplatelet potency,clopidogrel may still have an anti-inflammatory effect.

  16. Urinary IgG and α2-Macroglobulin Are Powerful Predictors of Outcome and Responsiveness to Steroids and Cyclophosphamide in Idiopathic Focal Segmental Glomerulosclerosis with Nephrotic Syndrome

    Directory of Open Access Journals (Sweden)

    Claudio Bazzi

    2013-01-01

    Full Text Available Objective. To assess whether high-molecular-weight proteins excretion predicts outcome and therapy-responsiveness in patients with FSGS and nephrotic syndrome. Research Design and Methods. Thirty-eight patients measured at biopsy fractional excretion of IgG (FEIgG and urinary α2-macroglobulin/creatinine ratio (α2m/C. Low and high risk groups were defined by cutoffs assessed by ROC analysis. In all patients first-line therapy was with steroids alone or in combination with cyclophosphamide. Results. α2m/C and FEIgG were correlated with segmental sclerosis (r=0.546; r=0.522. Twenty-three patients (61% entered Remission and 9 (24% progressed to ESRD. Comparing low and high risk groups, by univariate analysis remission was predicted by FEIgG (77% versus 25%, P=0.016 and α2m/C (81% versus 17%, P=0.007 and ESRD at best by FEIgG (0% versus 75%, P<0.0001 and α2m/C (4% versus 67%, P<0.0001. By multivariate analysis FEIgG was the only independent predictor of remission and α2m/C the most powerful predictor of ESRD. Low and high risk groups of FEIgG and α2m/C in combination had very high predictive value of sustained remission and ESRD in response to therapy. Conclusions. FEIgG and α2m/C are powerful predictors of outcome and responsiveness to steroids and cyclophosphamide; their predictive value, if validated in prospective studies, may be useful in clinical practice suggesting first-line alternative treatments in high risk patients.

  17. The sugery for adjacent segment degenerative disease after previous anterior cervical corpectomy and fusion%颈前路椎体次全切除融合术后邻近节段病的手术治疗

    Institute of Scientific and Technical Information of China (English)

    张海龙; 贺石生; 丁悦; 顾广飞; 李忠海; 溪铁胜

    2012-01-01

    颈前路椎体次全切除融合术(anterior cervical corpectomy and fusion,ACCF)是治疗神经根及脊髓型颈椎病的有效方法,但随之而来的邻近节段退变问题成为广泛关注的焦点.既往文献报告引起症状的邻近节段退变的发生率达7%~17%,部分患者需要手术干预[1].1997年8月~2007年8月对42例ACCF后邻近节段退变性疾病患者行再手术治疗,总结如下.

  18. Anterior chest wall examination reviewed

    Directory of Open Access Journals (Sweden)

    F. Trotta

    2011-09-01

    Full Text Available Anterior chest wall involvement is not infrequently observed within inflammatory arthropaties, particularly if one considers seronegative spondiloarthritides and SAPHO syndrome. Physical examination is unreliable and conventional X-rays analysis is an unsatisfactory tool during diagnostic work-up of this region. Scintigraphic techniques yield informations both on the activity and on the anatomical extent of the disease while computerized tomography visualize the elementary lesions, such as erosions, which characterize the process. Moreover, when available, magnetic resonance imaging couple the ability to finely visualize such lesions with the possibility to show early alterations and to characterize the “activity” of the disease, presenting itself as a powerful tool both for diagnosis and follow-up. This review briefly shows the applications of imaging techniques for the evaluation of the anterior chest wall focusing on what has been done in the SAPHO syndrome which can be considered prototypical for this regional involvement since it is the osteo-articular target mainly affected by the disease.

  19. Association among leukocyte count, mortality, and bleeding in patients with non-ST-segment elevation acute coronary syndromes (from the Acute Catheterization and Urgent Intervention Triage StrategY [ACUITY] trial).

    Science.gov (United States)

    Palmerini, Tullio; Généreux, Philippe; Mehran, Roxana; Dangas, George; Caixeta, Adriano; Riva, Diego Della; Mariani, Andrea; Xu, Ke; Stone, Gregg W

    2013-05-01

    Although inflammation is involved in the pathogenesis of acute coronary syndromes, the extent of inflammation is not routinely assessed, and its prognostic implications in patients with non-ST-segment elevation acute coronary syndrome have not been investigated in depth. We analyzed the prognostic implications of an elevated white blood cell count (WBCc) in patients with moderate and high-risk non-ST-segment elevation acute coronary syndrome undergoing an early invasive strategy in the large-scale Acute Catheterization and Urgent Intervention Triage StrategY trial. The WBCc at admission was available for 13,678 of 13,819 patients (98.9%). The patients in the upper tertile of the WBCc had an increased risk of 30-day major bleeding, 1-year mortality, and definite/probable stent thrombosis compared to those in the mid or lower tertiles. On multivariate analysis, the WBCc was an independent predictor of 30-day major bleeding and 1-year cardiac, noncardiac, and all-cause mortality. The association between the WBCc and cardiac mortality was present in multiple prespecified subgroups, with no significant interaction between the WBCc and age, gender, diabetes, smoking, renal dysfunction, elevated baseline biomarkers, antithrombotic therapy, revascularization, and Thrombolysis In Myocardial Infarction risk score. The WBCc remained an independent predictor of mortality after adjusting for bleeding, C-reactive protein level, and angiographic variables, including left ventricular ejection fraction, Thrombolysis In Myocardial Infarction flow, and number of diseased vessels. The WBCc significantly improved the prognostic accuracy of the Thrombolysis In Myocardial Infarction risk score, with a net reclassification improvement of 11% (p segment elevation acute coronary syndrome, an elevated admission WBCc was an independent predictor of 30-day major bleeding, and 1-year cardiac, noncardiac, and all-cause mortality.

  20. Pseudoexfoliation syndrome in various ethnic population of Nepal.

    Science.gov (United States)

    Shakya, S; Dulal, S; Maharjan, I M

    2008-09-01

    Pseudoexfoliation syndrome is an ocular condition characterized by a distinctive deposition of fibrillar material in the anterior segment of the eye. Pseudoexfoliation syndrome is frequently associated with glaucoma. Though it is seen in all the population, prevalence varies considerably in different races. A hospital based study done in Nepal by our group showed that Gurung population is frequently affected by this disease than any others. To determine the fact a larger population based study was necessary. Thus a research was designed to survey the various populations in the community. Different population from Kathmandu valley, Kavrepalanchowk, Pokhara, and Ghandruk were evaluated in two different phases to include major ethnic population living in Nepal. Household surveys done to bring all the targeted population to base hospital and detail examination including anterior segment evaluation after dilatation of pupil, optic disc evaluation, intraocular pressure measurement, gonioscopy, visual field recording and photographic documentation was done. Total of4430 population surveyed while only 2135 fulfilled the criteria for inclusion. Gurungs irrespective of their place of residence showed higher prevalence of Pseudoexfoliation syndrome accounting for 7.8% in Kathmandu valley while 12.0% in Ghandruk. Tamangs were affected very rarely by this disease accounting only for 0.3%. Gurungs are at higher risk of developing Pseudoexfoliation syndrome than any others in Nepal.

  1. Structural and functional changes in a synthetic S5 segment of KvLQT1 channel as a result of a conserved amino acid substitution that occurs in LQT1 syndrome of human.

    Science.gov (United States)

    Verma, Richa; Ghosh, Jimut Kanti

    2010-03-01

    Mutations in various voltage gated cardiac ion channels are the cause of different forms of long QT syndrome (LQTS), which is an inherited arrhythmic disorder marked as a prolonged QT interval on electrocardiogram. Of these LQTS1 is associated with mutations in the gene encoding KCNQ1 (KvLQT1) channel. One responsible mutation, G269S, in the S5 segment of KvLQT1, that affects the proper expression and function of channel protein leads to LQTS1. Our objective was to study how G269S mutation interferes with the structure and function of a synthetic S5 segment of KvLQT1 channel. One wild type 22-residue peptide and another mutant peptide of the same length with G269S mutation, derived from the S5 segment were synthesized and labeled with fluorescent probes. The mutant peptide exhibited lower affinity towards phospholipid vesicles as compared to the wild type peptide and showed impaired assembly and localization onto the lipid vesicles as evidenced by membrane-binding, energy transfer and proteolytic cleavage experiments. Loss in the helical content of S5 mutant peptide in membrane-mimetic environments was observed. Furthermore, it was observed that G269S mutation significantly inhibited the ability of S5 peptide to permeabilize the lipid vesicles. The present studies show the basis of change in function of the selected S5 segment as a result of G269S mutation which is associated with LQT1 syndrome. We speculate that the structural and functional changes related to the glycine to serine amino acid substitution in the S5 segment may also influence the activity of the whole KvLQT1 channel.

  2. Segmentation: Identification of consumer segments

    DEFF Research Database (Denmark)

    Høg, Esben

    2005-01-01

    origin in other sciences as for example biology, anthropology etc. From an economic point of view, it is called segmentation when specific scientific techniques are used to classify consumers to different characteristic groupings. What is the purpose of segmentation? For example, to be able to obtain...... a basic understanding of grouping people. Advertising agencies may use segmentation totarget advertisements, while food companies may usesegmentation to develop products to various groups of consumers. MAPP has for example investigated the positioning of fish in relation to other food products...... and analysed possible segments in the market. Results show that the statistical model used identified two segments - a segment of so-called "fish lovers" and another segment called "traditionalists". The "fish lovers" are very fond of eating fish and they actually prefer fish to other dishes...

  3. Anterior opercular cortex lesions cause dissociated lower cranial nerve palsies and anarthria but no aphasia: Foix-Chavany-Marie syndrome and "automatic voluntary dissociation" revisited.

    Science.gov (United States)

    Weller, M

    1993-01-01

    Anarthria and bilateral central facio-linguovelo-pharyngeo-masticatory paralysis with "automatic voluntary dissociation" are the clinical hallmarks of Foix-Chavany-Marie syndrome (FCMS), the corticosubcortial type of suprabulbar palsy. A literature review of 62 FCMS reports allowed the differentiation of five clinical types of FCMS: (a) the classical and most common form associated with cerebrovascular disease, (b) a subacute form caused by central nervous system infections, (c) a developmental form probably most often related to neuronal migration disorders, (d) a reversible form in children with epilepsy, and (e) a rare type associated with neurodegenerative disorders. Bilateral opercular lesions were confirmed in 31 of 41 patients who had CT or MRI performed, and by necropsy in 7 of 10 patients. FCMS could be attributed to unilateral lesions in 2 patients. The typical presentation and differential diagnosis of FCMS provide important clues to lesion localization in clinical neurology. FCMS is a paretic and not an apraxic disorder and is not characterized by language disturbances. Its clinical features prove divergent corticobulbar pathways for voluntary and automatic motor control of craniofacial muscles. Precise clinico-neuroradiological correlations should facilitate the identification of the structural substrate of "automatic voluntary dissociation" in FCMS.

  4. Lenstar、Pentacam与Sirius测量白内障患者眼前节生物参数的比较%Comparison of anterior ocular segment measurements for cataracts using Lenstar, Pentacam and Sirius

    Institute of Scientific and Technical Information of China (English)

    黄锦海; 李坚; 鲁伟聪; 程丹; 邓军; 王勤美

    2014-01-01

    Objective To assess the differences and agreements among measurements of cataractous eyes using Lenstar LS900 biometer,Pentacam rotating Scheimpflug photography and a Sirius Scheimpflug-Placido disc topographer.The following measurements were taken:central corneal thickness (CCT),anterior chamber depth from the corneal endothelium to the anterior lens capsule (ACDendo),anterior chamber depth from the corneal epithelium to the anterior lens capsule (ACDepi) and mean keratometry (Kin).Methods In this prospective clinical study,CCT,ACD (including ACDendo and ACDepi) and the Km of 40 eyes were randomly obtained by Lenstar,Pentacam and Sirius.All measurements included the 3 methods which were compared using a repeated-measures analysis of variance (ANOVA),with a Bonferroni multiple comparison correction.Bland-Altman analyses were used to evaluate the agreement between the devices.Results The mean CCTs obtained by Lenstar,Pentacam and Sirius were 528.18±29.12 μm,533.21±27.02 μm and 534.48±26.15 μm,respectively.The mean ACDendo obtained by Lenstar,Pentacam and Sirius were 2.54±0.41 mm,2.54±0.43 mm and 2.57±0.43 mm,respectively.The mean ACDepi obtained by Lenstar,Pentacam and Sirius were 3.07±0.41 mm,3.08±0.42 mm and 3.10±0.43 mm,respectively.The mean Km obtained by Lenstar,Pentacam and Sirius were 44.05±1.69 D,43.99±1.65 D and 43.93±1.63 D,respectively.There were significant differences among the results of these three methods in CCT (F=11.641,P<0.01),ACDendo (F=9.961,P<0.01),ACDepi (F=12.539,P<0.01),and Km (F=4.186,P<0.05).The Bland-Altman plot analyses showed that the three devices had comparable results for CCT,ACD and Km.For the maximum absolute values of 95% limits of agreement (LoA) were 26.41 μm,0.12 mm,0.12 mm and 0.61 D respectively.Conclusion Lenstar,Pentacam and Sirius demonstrated high agreement for CCT,ACD and corneal curvature measurements in cataractous eyes.%目的 评估新型光学低相干反射仪Lenstar、Pentacam眼前节

  5. Visual outcome after phacoemulsification with intraocular lens implantation in patients with anterior lenticonus due to Alport syndrome%超声乳化联合IOL植入治疗前圆锥晶状体伴有Alport综合征的视觉效果

    Institute of Scientific and Technical Information of China (English)

    Mohammad Ali Zare; Mohammad Taher Rajabi; Syed Jafar Oskouee; Mohammad Nili

    2006-01-01

    · AIM: We describe visual improvement after phacoemulsification with intraocular lens (IOL) implantation in 7 eyes with anterior lenticonus secondary to Alport syndrome.· METHODS: 7 eyes from 4 patients with Alport syndrome underwent phacoemulsification with IOL implantation due to anterior lenticonus.· RESULTS: All of the patients resumed excellent visual acuity after surgery.· CONCLUSION: We recommend the phacoemulsification with IOL implantation as a safe procedure in anterior lenticonus due to Alport syndrome.%目的:观察超声乳化联合IOL植入治疗7眼前圆锥晶状体伴有Alport综合征患者的手术效果.方法:Alport综合征患者4例,7眼因前圆锥晶状体行超声乳化联合IOL植入手术.结果:所有患者的术后视力均有明显提高.结论:我们认为对于前圆锥晶状体伴有Alport综合征患者采用超声乳化联合IOL植入手术治疗,是一种安全的疗法.

  6. Nonnecrotizing anterior scleritis mimicking orbital inflammatory disease

    Directory of Open Access Journals (Sweden)

    Lynch MC

    2013-08-01

    Full Text Available Michelle Chen Lynch,1 Andrew B Mick21Optometry Clinic, Ocala West Veterans Affairs Specialty Clinic, Ocala, FL, USA; 2Eye Clinic, San Francisco VA Medical Center, San Francisco, CA, USABackground: Anterior scleritis is an uncommon form of ocular inflammation, often associated with coexisting autoimmune disease. With early recognition and aggressive systemic therapy, prognosis for resolution is good. The diagnosis of underlying autoimmune disease involves a multidisciplinary approach.Case report: A 42-year-old African American female presented to the Eye Clinic at the San Francisco Veteran Affairs Medical Center, with a tremendously painful left eye, worse on eye movement, with marked injection of conjunctiva. There was mild swelling of the upper eyelid. Visual acuity was unaffected, but there was a mild red cap desaturation. The posterior segment was unremarkable. The initial differential diagnoses included anterior scleritis and orbital inflammatory disease. Oral steroid treatment was initiated with rapid resolution over a few days. Orbital imaging was unremarkable, and extensive laboratory work-up was positive only for antinuclear antibodies. The patient was diagnosed with idiopathic diffuse, nonnecrotizing anterior scleritis and has been followed for over 5 years without recurrence. The rheumatology clinic monitors the patient closely, as suspicion remains for potential arthralgias including human leukocyte antigen-B27-associated arthritis, lupus-associated arthritis, seronegative rheumatoid arthritis, recurrent juvenile idiopathic arthritis, and scleroderma, based on her constitutional symptoms and clinical presentation, along with a positive anti-nuclear antibody lab result.Conclusion: Untreated anterior scleritis can progress to formation of cataracts, glaucoma, uveitis, corneal melting, and posterior segment disease with significant risk of vision loss. Patients with anterior scleritis must be aggressively treated with systemic anti

  7. 超声乳化白内障吸出术对急性原发性闭角型青光眼眼前段的影响%Effects of anterior segment after phacoemulsification in patients with acute primary angle closure glaucoma

    Institute of Scientific and Technical Information of China (English)

    李乃洋; 赵岐; 钟兴武

    2011-01-01

    目的 使用Pentacam三维前房分析仪和眼前段光学相干断层扫描仪(AS-OCT)观察超声乳化白内障吸出术对急性原发性闭角型青光眼(APACG)患者眼前段的影响.方法 收集2010年7月至12月于中山大学附属中山医院眼科就诊的伴有白内障APACG的病例共39例(39眼).常规行超声乳化白内障吸出联合人工晶体(IOL)植入术.术前和术后3个月使用Pentacam和AS-OCT测量眼前段参数.结果 术后3个月,APACG患者眼压由术前(33.08±5.21)mm Hg降至(16.36±3.44)mm Hg(1mm Hg=0.133 kPa,t=20.644,P=0.000),中央前房深度由(1.79±0.20)mm增至(3.41±0.38) mm (t=36.191,P=0.000),周边前房深度由(0.82±0.12) mm加深至(1.81 ±0.20) mm (t=40.732,P=0.000),前房容积自(74.10±9.94) mm增加至(149.72± 17.12) mm (t=54.921,P=0.000),下方前房角自(24.03±3.50).加宽至( 43.29±3.92).(t=55.489,P=0.000),鼻侧前房角自(23.02±2.96)°加宽至(42.36±4.61).(t=43.291,P=0.000),上方前房角自(21.62±3.04).加宽至(39.66±3.53).( t=43.511,P=0.000),颞侧前房角自(22.88±2.87).加宽至(41.21±3.81).(t=44.930,P=0.000).瞳孔直径由术前(3.06±1.32)mm缩小至术后的(3.00±1.21)mm,但差异无统计学意义(t=1.177,P=0.247).结论 超声乳化白内障吸出术可改善APACG患者眼前段结构的狭窄.Pentacam和AS-OCT可简便快捷和非接触地观察眼前段,有良好的应用前景.%Objective To investigate the morphological changes of anterior segment in patients with acute primary angle closure glaucoma (APACG) after phacoemulsification using the Pentacam three-dimension anterior chamber analysis system and anterior segment optical coherence tomography (AS-OCT).Methods Thirty- nine APACG patients (39 eyes) accompanied with cataract were treated with phacoemulsification from July 2010 to December 2010 in Zhongshan Hospital.All the patients were examined by Pentacam and AS-OCT preoperation and 3 months postoperation.Outcomes included intraocular pressure (IOP

  8. An Unusual Course of Segmental Renal Artery Displays a Rare Case of Hilar Nutcracker Phenomenon

    Science.gov (United States)

    Sawant, Devendra A.; Moore, Thomas F.

    2015-01-01

    Nutcracker phenomenon or renal vein entrapment is classically seen as a compression of renal vein in between abdominal aorta and superior mesenteric artery with patients being asymptomatic or clinically manifested in the form of nutcracker syndrome as proteinuria, hematuria, flank pain, pelvic congestion in women, and varicocele in men. In this report, we are presenting a case of rare variant of nutcracker phenomenon along with brief review of anatomy, pathophysiology, public health, and clinical significance of nutcracker syndrome. On a routine dissection of an adult male cadaver, we noticed an unusual arrangement of the structures at the hilum of the left kidney showing entrapment of renal vein between left anterior inferior and posterior segmental renal arteries. The variation in the course of left anterior inferior segmental renal artery leads to compression of left renal vein at renal hilum. Therefore, we have named this rare abnormal anatomical entity as hilar nutcracker phenomenon. The structures in the right renal hilum are normal. The objective of this paper is to report an unusual but important variant of nutcracker phenomenon and also give collective knowledge of such anatomical variations in renal vasculature that will help in diagnosing and treating such rare renal disorder. PMID:26448765

  9. An Unusual Course of Segmental Renal Artery Displays a Rare Case of Hilar Nutcracker Phenomenon

    Directory of Open Access Journals (Sweden)

    Devendra A. Sawant

    2015-01-01

    Full Text Available Nutcracker phenomenon or renal vein entrapment is classically seen as a compression of renal vein in between abdominal aorta and superior mesenteric artery with patients being asymptomatic or clinically manifested in the form of nutcracker syndrome as proteinuria, hematuria, flank pain, pelvic congestion in women, and varicocele in men. In this report, we are presenting a case of rare variant of nutcracker phenomenon along with brief review of anatomy, pathophysiology, public health, and clinical significance of nutcracker syndrome. On a routine dissection of an adult male cadaver, we noticed an unusual arrangement of the structures at the hilum of the left kidney showing entrapment of renal vein between left anterior inferior and posterior segmental renal arteries. The variation in the course of left anterior inferior segmental renal artery leads to compression of left renal vein at renal hilum. Therefore, we have named this rare abnormal anatomical entity as hilar nutcracker phenomenon. The structures in the right renal hilum are normal. The objective of this paper is to report an unusual but important variant of nutcracker phenomenon and also give collective knowledge of such anatomical variations in renal vasculature that will help in diagnosing and treating such rare renal disorder.

  10. The Primary Study of Changes of the Structure of Ocular Anterior Segment after Trabeculectomy with Ultrasound Biomicroscopy%超声生物显微镜对原发性闭角型青光眼小梁切除手术前后眼前节结构改变的初步研究

    Institute of Scientific and Technical Information of China (English)

    潘雪; 李平华

    2009-01-01

    目的 应用超声生物显微镜(UBM)分别观察急、慢性原发性闭角型青光眼小梁切除手术前后眼前节结构的改变.方法 对26例33眼急性闭角型青光眼和25例37眼慢性闭角型青光眼分别于小梁切除手术前和手术后1个月应用UBM进行眼前节结构的测量.结果 急性闭角型青光眼房角开放距离 (AOD)、房角开放度数 (AA)、虹膜晶状体接触距离(ILCD)、虹膜晶体夹角(θ2)、虹膜悬韧带距离(IZD)手术前后比较有统计学差异(P<0.05),术前3眼发现睫状体脱离.慢性闭角型青光眼ILCD、θ2、IZD手术前后比较有统计学差异(P<0.05).结论 UBM对原发性闭角型青光眼患者小梁切除手术后眼前节结构的改变能进行精确测量,对探讨青光眼发病机制、防止并发症发生、判断手术预后均有较大的实用价值.%Objective To observe the changes of the structure of ocular anterior segment after trabeculectomy with ultrasound biomicroscopy(UBM) in acute angle-closure glaucoma(ACAG) and chronic angle-closure glaucoma(CACG).Methods 26 patients(33 eyes)of acute angle-closure glaucoma and 25 patients(37 eyes)of chronic angle-closure glaucoma were underwent trabeculectomy.The structure of ocular anterior segment were separately observed and measured by using UBM before and after surgery.Results In ACAG patients,there were statistically significant differences between the preoperative and postoperative angle opening distance(AOD),open angle(AA),iris-lens contact distance(ILCD),iris-lens angle(θ2),iris-zonular distance(IZD) (P<0.05),and there were 3 eyes with ciliary body detachment before surgery.In CACG patients,there were statistically significant differences between the preoperative and postoperative ILCD,θ2,IZD(P<0.05).Conclusions UBM is an exactly tool to mea-sure the changes of the structure of ocular anterior segment after trabeculectomy.It posses higher diagnostic value in discussing mechanism of glaucoma

  11. Neuroimaging features of Cornelia de Lange syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Whitehead, Matthew T. [Department of Radiology, Washington, DC (United States); Nagaraj, Usha D. [Department of Radiology, Washington, DC (United States); Cincinnati Children' s Hospital, Department of Radiology, Cincinnati, OH (United States); Pearl, Phillip L. [Department of Radiology, Washington, DC (United States); Boston Children' s Hospital, Department of Neurology, Boston, MA (United States)

    2015-08-15

    Cornelia de Lange syndrome is a rare genetic disease characterized by distinctive facial dysmorphia and dwarfism. Multiple organ system involvement is typical. Various central nervous system (CNS) aberrations have been described in the pathology literature; however, the spectrum of neuroimaging manifestations is less well documented. To present neuroimaging findings from a series of eight patients with Cornelia de Lange syndrome. The CT/MR database at a single academic children's hospital was searched for the terms ''Cornelia'', ''Brachmann'' and ''de Lange.'' The search yielded 18 exams from 16 patients. Two non-CNS and six exams without available images were excluded. Ten exams from eight patients were evaluated by a board-certified neuroradiologist. All patients had skull base dysplasia, most with an unusual coronal basioccipital cleft (7/8). All brain MR exams showed microcephaly, volume loss and gyral simplification (5/5). Six patients had an absent massa intermedia. Four patients had small globe anterior segments; three had optic pathway hypoplasia. Basilar artery fenestration was present in two patients; vertebrobasilar hypoplasia was present in one patient. The inner ear vestibules were dysplastic in two patients. One patient had pachymeningeal thickening. Spinal anomalies included scoliosis, segmentation anomalies, endplate irregularities, basilar invagination, foramen magnum stenosis and tethered spinal cord. Typical imaging manifestations of Cornelia de Lange syndrome include skull base dysplasia with coronal clival cleft, cerebral and brainstem volume loss, and gyral simplification. Membranous labyrinth dysplasia, anterior segment and optic pathway hypoplasia, basilar artery fenestration, absent massa intermedia and spinal anomalies may also be present. (orig.)

  12. Anterior Cruciate Ligament (ACL) Injuries

    Science.gov (United States)

    ... Week of Healthy Breakfasts Shyness Anterior Cruciate Ligament (ACL) Injuries KidsHealth > For Teens > Anterior Cruciate Ligament (ACL) ... and Recovery Coping With an ACL Injury About ACL Injuries A torn anterior cruciate ligament (ACL) is ...

  13. Kounis syndrome secondary to amoxicillin use in an asthmatic patient.

    Science.gov (United States)

    Viana-Tejedor, Ana; Espinosa, M Ángeles; Cuesta, J; Núñez, A; Bueno, H; Fernández-Avilés, F

    2011-08-04

    A sixty-four year old man with a past history of hypercholesterolemia, asthma, food allergy, epilepsy and myocardial infarction was admitted to the emergency department because of a generalized erythema, nausea, vomiting, and chest pain after taking an oral dose of amoxicillin. Electrocardiography showed ST segment elevation in anterior leads. After coronary angiography, type 2 variant of Kounis syndrome was diagnosed. We present the first case of oral amoxicillin induced Kounis syndrome in an asthmatic patient with severe anaphylactic shock. The present report also shows that atopic people expressing an amplified mast cell degranulation may have more serious hemodynamic decompensation during hypersensitivity reactions. Case selective mast cell surface membrane stabilization should be considered a potential therapeutic strategy for people with food induced allergy, for atopic patients and for patients who have already experienced a first Kounis syndrome.

  14. Gene expression suggests double-segmental and single-segmental patterning mechanisms during posterior segment addition in the beetle Tribolium castaneum.

    Science.gov (United States)

    Janssen, Ralf

    2014-01-01

    In the model arthropod Drosophila, all segments are patterned simultaneously in the blastoderm. In most other arthropods, however, posterior segments are added sequentially from a posterior segment addition zone. Posterior addition of single segments likely represents the ancestral mode of arthropod segmentation, although in Drosophila, segments are patterned in pairs by the pair-rule genes. It has been shown that in the new model insect, the beetle Tribolium, a segmentation clock operates that apparently patterns all segments in pairs as well. Here, I report on the expression of the segment polarity gene H15/midline in Tribolium. In the anterior embryo, segmental stripes of H15 appear in pairs, but in the posterior of the embryo stripes appear in a single-segmental periodicity. This implies that either two completely different segmentation-mechanisms may act in the germ band of Tribolium, that the segmentation clock changes its periodicity during development, or that the speed in which posterior segments are patterned changes. In any case, the data suggest the presence of another (or modified), yet undiscovered, mechanism of posterior segment addition in one of the best-understood arthropod models. The finding of a hitherto unrecognized segmentation mechanism in Tribolium may have major implications for the understanding of the origin of segmentation mechanisms, including the origin of pair rule patterning. It also calls for (re)-investigation of posterior segment addition in Tribolium and other previously studied arthropod models.

  15. The reproducibility of mechanism categories of angle closure using ultrasound biomicroscopy and anterior segment optical coherence tomography%根据超声生物显微镜和眼前节OCT图像对房角关闭机制进行分型的一致性研究

    Institute of Scientific and Technical Information of China (English)

    张烨; 唐炘; 王宁利

    2016-01-01

    Background Angle closure is the pathological basis of primary angle-closure disease (PACD).Understanding different types of angle closure mechanisms is significant for evaluation of risk factors,prevention,diagnosis and treatment of PACD.Ultrasound biomicroscopy (UBM) is commonly used for investigating the types of angle closure mechanisms in clinical works.However,UBM is a contact examination,which limits its application.Anterior segment optical coherence tomography (AS-OCT) is a non-contact examination of anterior segment imaging,through which qualitative and quantitative evaluations of the anterior chamber angle can be made.Objective This study was to investigate the reproducibility of mechanism categories of angle closure based on AS-OCT images and UBM images.Methods Cross-sectional study was performed.PACD outpatients from September to October in 2013 in Beijing Tongren Hospital were enrolled and received both UBM and AS-OCT examinations.UBM images were obtained in superior,inferior,nasal and temporal quadrants of the anterior chamber.AS-OCT images were obtained in the "anterior segment quadrant" mode at 0-180,45-225,90-270,and 135-315 degree meridians.UBM and ASOCT images were categorized into three dominant angle closure mechanisms:pupil block,anterior located ciliary body and thick peripheral iris roll,separately.And the same mechanism of at least two UBM/AS-OCT images of one eye was defined as the angle closure mechanism of this eye.If both eyes of one PACD patient were eligible for inclusion,the right eye was selected for analysis.The reproducibility of two examinations was evaluated by Kappa coefficients.Results Finally 40 PACD patients (40 eyes,27 right eyes and 13 left eyes) were enrolled for analysis.Based on UBM images,12 eyes (30.0%) were classified as pupil block,23 eyes (57.5%) as anterior located ciliary body and 5 eyes (12.5%) as thick peripheral iris roll.Based on AS-OCT,12 eyes (30.0%) were classified as pupil block,21 eyes (52.5

  16. Fingerprint Segmentation

    OpenAIRE

    Jomaa, Diala

    2009-01-01

    In this thesis, a new algorithm has been proposed to segment the foreground of the fingerprint from the image under consideration. The algorithm uses three features, mean, variance and coherence. Based on these features, a rule system is built to help the algorithm to efficiently segment the image. In addition, the proposed algorithm combine split and merge with modified Otsu. Both enhancements techniques such as Gaussian filter and histogram equalization are applied to enhance and improve th...

  17. Down's syndrome: a ten-year group study.

    Science.gov (United States)

    Gaynon, M W; Schimek, R A

    1977-12-01

    Thirty individuals with the clinical diagnosis of Down's syndrome received ophthalmologic examination periodically over 10 years at a state school for exceptional children. External examination, retinoscopy, anterior segment evaluation, ophthalmoscopy, and tonometry were usually done. The ages at present range from 10 to 50 years. The sex ratio was 80% male and 20% female. Three subjects died during the course of the study. The most frequent ocular anomalies were oblique fissures, refractive error, blepharoconjunctivitis, epicanthus, and Brushfield's spots. All of these occurred in 50% or more of the subjects.

  18. Comparison of anterior cervical discectomy and fusion and anterior cervical corpectomy and fusion for the treatment of multi-segmental cervical spondylotic myelopathy%前路椎间盘切除减压融合与椎体次全切除减压融合治疗多节段颈椎病疗效比较

    Institute of Scientific and Technical Information of China (English)

    吴畏; 朱天亮

    2014-01-01

    目的:比较前路椎间盘减压融合( ACDF)与前路椎体次全切除减压融合( ACCF)治疗多节段颈椎病的效果。方法将138例多节段脊髓型颈椎病患者按照治疗方式的不同分为观察组(行ACDF治疗)和对照组(行ACCF治疗),比较两组手术时间、术中出血量、术后住院时间、术前与术后6个月颈椎总活动度、颈椎曲度、颈椎节段性高度及JOA评分。结果手术时间:观察组(128.3±32.4)min,对照组(163.2±43.6)min;术中出血量:观察组(161.4±122.5)ml,对照组(319.2±308.7)ml;以上指标观察组均少于对照组(P0.05)。术后颈椎曲度:观察组23.5°±7.4°,对照组16.1°±7.2°;椎间节段性高度:观察组5.6°±0.4°,对照组4.7°±0.8°;以上指标两组比较差异有统计学意义(P0. 05 ) . Postoperative cervical curvature: the observation group was 23. 5° ± 7. 4°, the control group was 16. 1° ± 7. 2°;intervertebral segmental height:observation group was 5. 6° ± 0. 4°, the control group was 4. 7° ± 0. 8°; between these indicators there were statistically significant differences between groups ( P <0. 05 ) . Conclusions Compared with ACCF, ACDF has shorter operative time, less blood loss, cervical physiological curvature and height of intervertebral segment recovered well, but there is no statistically significant differences on postoperative hospital stay time, postoperative JOA score and cervical total activity.

  19. 单侧A1优势前交通动脉瘤的栓塞治疗(附48例报告)%Embolization for the treatment of unilateral A1 segment anterior communicating artery aneurysm: a report of 48 cases

    Institute of Scientific and Technical Information of China (English)

    郭庆东; 刘伟; 付洛安; 张磊; 张学析; 胡晶; 费舟

    2011-01-01

    目的 总结使用可脱弹簧圈栓塞治疗48例单侧A1优势前交通动脉瘤的经验和方法.方法 2009年1月-2010年4月西京医院收治的单侧A1优势前交通动脉瘤患者48例,其中男23例,女25例,年龄32~72岁,平均53.4岁.全部动脉瘤均在术中应用旋转成像图像后处理技术,并采用弹簧圈进行动脉瘤内栓塞治疗,采用双侧颈动脉置管技术监测栓塞术中载瘤动脉通畅情况.对宽颈动脉瘤采用支架辅助技术,球囊辅助瘤颈重塑形技术,微导管、微导丝辅助技术保持载瘤动脉通畅.其中38例术后6个月复查全脑血管造影,了解已栓塞动脉瘤及前交通动脉通畅情况.结果 48例患者中动脉瘤致密栓塞39例(81.25%),90%以上栓塞6例(12.50%),90%以下栓塞3例(6.25%);术中出血 1例(2.08%),前交通动脉闭塞3例(6.25%),前交通动脉闭塞后对侧代偿2例(4.17%).随访均无再出血,38例复查全脑血管造影见动脉瘤栓塞致密、前交通动脉血流通畅.结论 单侧主供血前交通动脉瘤栓塞治疗术中应注意保持前交通动脉通畅,使用微导管或微导丝置于瘤颈处辅助栓塞有一定帮助.%Objective To summarize the experience and method of endovascular treatment of unilateral A1 segment anterior communicating artery aneurysm with detachable coils. Methods Forty-eight patients with unilateral Al anterior communicating artery aneurysm (23 males and 25 females, age ranged from 32 to 72 years with mean of 53.4, hospitalized in Xijing hospital from Jan. 2009 to Apr. 2010) were involved in present study. All of the aneurysms were measured with rotational digital subtraction angiography (RDSA) and image post-processing techniques, and they were embolized with Guglielmi detachable coils (GDCs). The patency of the parent arteries was monitored by catheterization in both carotid arteries in the process of treatment Stent-assisted, balloon remodeling, microcatheter and microwire assisted techniques were used

  20. Anterior cervical plating

    Directory of Open Access Journals (Sweden)

    Gonugunta V

    2005-01-01

    Full Text Available Although anterior cervical instrumentation was initially used in cervical trauma, because of obvious benefits, indications for its use have been expanded over time to degenerative cases as well as tumor and infection of the cervical spine. Along with a threefold increase in incidence of cervical fusion surgery, implant designs have evolved over the last three decades. Observation of graft subsidence and phenomenon of stress shielding led to the development of the new generation dynamic anterior cervical plating systems. Anterior cervical plating does not conclusively improve clinical outcome of the patients, but certainly enhances the efficacy of autograft and allograft fusion and lessens the rate of pseudoarthrosis and kyphosis after multilevel discectomy and fusions. A review of biomechanics, surgical technique, indications, complications and results of various anterior cervical plating systems is presented here to enable clinicians to select the appropriate construct design.

  1. 急性闭角型青光眼对侧眼与可疑原发房角关闭眼的前节参数比较%Comparison of anterior segment parameters between fellow eyes of unilateral acute angle closure glaucoma and primary angle closure suspects

    Institute of Scientific and Technical Information of China (English)

    郭竞敏; 许小兰; 张虹; 王军明

    2015-01-01

    目的:探讨原发闭角型青光眼单侧急性发作( acute angle closure glaucoma,AACG)的对侧眼、可疑原发房角关闭眼(primary angle closure suspects,PACS)和正常眼的前节生物学参数差异。  方法:采用光学相干断层扫描( optical coherence tomography,OCT)和 Pentacam 三维眼前节分析诊断系统(pentacam scheimpflug system,Pentacam)完成26例26眼AACG对侧眼及与之年龄、性别匹配的28例28眼PACS和34例34眼正常眼的前节扫描。采用Pentacam获得以下参数:中央角膜厚度( CCT)、角膜容积( CV)、瞳孔直径( PD)、中央前房深度( CACD)、周边前房深度( PACD)、前房容积( CV )和房角度数( ACA )。应用图像处理软件和OCT测量虹膜厚度(IT750,IT2000),面积(IS)、体积(IV)和房角开放距离500( AOD500)进行。  结果:角膜参数(CCT,CV),PD、虹膜参数(IT750,IT2000, IS,IV)无统计学差异( P>0.05)。与 AACG 对侧眼和PACS比较,正常人CACD和PACD更深, ACV更大, ACA和AOD500更宽敞( P0.05)。以AACG对侧眼作为房角关闭好发的诊断标准,上述前房参数的受试者工作特征曲线下面积均小于0.7。  结论:AACG对侧眼和PACS的前节生物学参数无显著差异,以此作为房角关闭好发的诊断精准度较低。%AIM: To explore the differences of anterior segment parameters in the patients with fellow eyes of unilateral acute angle-closure glaucoma ( AACG ) , primary angle-closure suspects ( PACS) and normal group. METHODS: Twenty-six eyes of 26 patients with fellow eyes of AACG, 28 eyes of 28 age- and gender-matched PACS and 34 normal eyes were imaged using optical coherence tomography ( OCT) and pentacam scheimpflug system ( Pentacam ) . Anatomical parameters including central corneal thickness ( CCT ) , corneal volume ( CV ) , pupillary diameter ( PD ) , central anterior chamber depth ( CACD ) , peripheral anterior chamber depth ( PACD ) , anterior chamber volume ( ACV ) and anterior chamber angle

  2. Comparative analysis on biological measurement of anterior segment structure in some Fuzhou colleges and primary students%福州市部分大学生和小学生眼前节结构生物测量对比分析

    Institute of Scientific and Technical Information of China (English)

    孙堂胜; 过贵元; 吴生泉; 薛建设

    2012-01-01

    Objective To investigate relation between the part of the anatomy structure of the anterior segment and age in some Fuzhou students. Methods The ciliary body, iris, anterior chamber angle and other relevant data of 54 primary school students and 51 college students in Fuzhou were detected with an ultrasound biomicroseopy (UBM),and statistical analysis was underwent. Results The data in primary students group were CPD (160.53 ±17. 78),CT (90.01 ±34. 30),ICPD (23. 11 ±3. 33), IDt (35.95 ±6. 60),ID2 (52.81 ±9.94),θ3 (39.23 ±7.46) ,θ4 (56.02 ±6.75), and TCPD (151.27 ±23. 11) respectively. The data in college students group were CPD (214. 64 ± 15. 25), CT (99. 13 ±17. 80),ICPD (27.92 ±9.00),IDl (40.72±6.43),ID2 (56.57 ±9. 13),θ3 (43.73 ±6. 93),θ4 (60. 15 ±10.48),and TCPD (176.82 ± 28.06 ) respectively. There were highly significant differences in CPD, ID1,θ3, TCPD (P < 0. 01) between the primary and college students. Conclusion Significant changes occur in the development process of anterior segment and ciliary body structure,which closely related to the occurrence and development of myopia.%目的 探讨福州市部分大学生和小学生眼前节部分解剖结构随年龄增长的发展趋势.方法 采用美国产超声生物显微镜(ultrasound biomicroscopy,UBM)检测福州市54名小学生及51名大学生的睫状体、虹膜及房角等相关数据,并进行统计学分析.结果 小学生组:CPD值(160.53±17.78),CT值(90.01±34.30),ICPD值(23.11±3.33),ID1值(35.95±6.60),ID2值(52.81±9.94),θ3值(39.23±7.46),θ4值(56.02±6.75),TCPD值(151.27±23.11);大学生CPD值(214.64±15.25),CT值(99.13±17.80),ICPD值(27.92±9.00),ID1值(40.72±6.43),ID2值(56.57±9.13),θ3值(43.73±6.93),θ4值(60.15±10.48),TCPD值(176.82+28.06).其中在大学生和小学生之间,CPD、ID1、θ3、和TCPD指标均存在极显著性差异(P均<0.01).结论 在人体发育过程中,与睫状体相关的眼前节结构部分指标改变明显,这些指

  3. Clinical research on segmental invisible technique with mini-implant for en-masse retraction of maxillary anterior teeth%片段隐形矫治器结合微种植体内收上前牙的临床研究

    Institute of Scientific and Technical Information of China (English)

    金丽飞; 黄一慧; 弓国梁; 林新平

    2016-01-01

    Objective To evaluate the clinical efficiency of segmental invisible technique with mini-implant for en-masse retraction of maxillary anterior teeth on the aspect of vertical and torque in the treatment of bimaxillary protrusion. Methods Twelve subjects with upper dental alveolar bone protrusion were selected for this study. Arch-dimension variables were evaluated by cephalometric and dental models before and after orthodontic retraction. All data were analyzed by SPSS 20. 0 software. Results For vertical control, U1E-PP was increased by 0. 78 mm, U1AP-PP was decreased by 0. 29 mm, while the change of U1CR-PP showed no significant difference ( P>0. 05). For sagittal control, all the anterior teeth showed a decreased torque with canine displaying uprighting. Conclusion Segmen-tal invisible technique with mini-implant is efficient in the vertical and torque control of anterior teeth in the treatment of bimaxillary protrusion, and it can demonstrate invisible and aesthetic orthodontic effects.%目的:评估片段隐形矫治器结合微种植体矫治前突患者时对上前牙垂直向和转矩方面的控制效果。方法选取12例双牙槽前突患者,通过测量治疗前后X线头颅定位侧位片上颌前牙矢状向与垂直向的变化值,以及模型上的转矩变化值,使用SPSS 20.0软件进行统计分析。结果治疗后上切牙切缘至腭平面距离U1E-PP增加0.78 mm,上切牙根尖点至腭平面距离U1AP-PP减小0.29 mm,上切牙阻抗中心至腭平面距离U1CR-PP的变化无统计学差异(P>0.05),上切牙阻抗中心的位置基本不变;治疗后的上前牙转矩值减少,尖牙出现直立趋势。结论片段隐形矫治技术治疗前突患者对其上前牙的垂直向和转矩控制较好,总体获得了良好的治疗效果,并且在治疗期间充分发挥了隐形、美观的矫治效果。

  4. 闭角型青光眼合并白内障患者人工晶状体植入术后眼前节变化的观察%The change in the ocular anterior segment of patients with angle-closure glaucoma combined with cataract after IOL implantation

    Institute of Scientific and Technical Information of China (English)

    王泽飞; 何锐; 方爱武

    2013-01-01

    Objective To observe the changes in the anatomical structure of the ocular anterior segment in patients with primary angle-closure glaucoma (PACG) combined with cataract pre-and post-operatively using four different types of measurements,and to evaluate the clinical application value of the those equipments.Methods Thirty eyes of 26 patients that fit the inclusion criteria with typical PACG combined with cataract were selected.Cataract phacoemulsification with IOL implantation was performed.Measurements of the ocular anterior segment were taken pre-and 3 months post-operatively with UBM,Visante OCT,Pentacam and IOL-Master.The changes of the parameters of the anterior segment obtained by these types of instruments pre-and post-operatively were analyzed,and compared the differences among the four different measuring systems.The SPSS 16.0 statistical software was used for the data process and analysis,P <0.05 indicating statistical significance.Results 1.The four different types of measuring methods showed that all patients had a significant increase in the central anterior chamber depth (ACD) post-operatively compared with that pre-operatively (t =-29.583,t =-28.478,t =-27.588,t =-24.075,P <0.01); statistical significance also existed in the difference among the four types of methods (F =20.036,P <0.01; F =20.012,P <0.01).2.Statistically significant difference existed in the AOD500 (Angle Open Distance 500) preand 3 months post-operatively measured by UBM and Visante OCT (t =-17.781,P <0.01;t =-18.313,P <0.01),with no significant difference between the measurement of the two measuring system either per-or post-operatively (t =-1.252,P =0.221; t =-0.059,P =0.953).3.Statistically significant difference existed in the Trabecular-Iris Angle at 500μm (TIA500) pre-and post-operatively measured by UBM and Visante OCT (t =-17.623,P <0.01; t =-17.016,P <0.01; t =-14.688,P <0.01),the angle degree was also statistically significantly different pre-and post

  5. Posterior single segment anterolateral decompression and anterior column reconstruction for type Denis B thoracolumbar burst fractures%后路单节段侧前方减压前柱重建术治疗Denis B型胸腰椎爆裂骨折

    Institute of Scientific and Technical Information of China (English)

    高志朝; 王梅; 张妙林; 孟永俊; 祝卫民; 张春

    2011-01-01

    Objective To investigate the feasibility and clinical effect of the posterior single segment anterolateral decompression and anterior column reconstruction in the treatment of thoracolumbar burst fractures. Methods A retrospective study was done on 21 patients with type Denis B thorocalumbar burst fractures who were treated by posterior approach minimal incision pedicle SCreW fixation,single segment anterolateral decompression and titanium mesh and bone graft from August 2007 to August 2009.There were 15 males and six males at mean age of 35.6 years(range,23-50 years).The involved segments included T12 in six patients,L1 in 11,L2 in three,and L3 in one.The preoperative spinal canal enemachment rate was 62.5%and the anterior-middle vertebral compression of all patients was less than 50%.CT scanning showed normal vertebral body and inferior endplate structure.The fracture reduction,graft fusion,neurological function recovery,correction loss,lumbar activities and adjacent lumbar disc degeneration were observed through preoperative,immediate postoperative and final follow up X-ray,CT and neurological examinations. Results The operation duration was 1.5-3.2 hours(average 2.1hours),with the bleeding of 350-1 000 ml(average 580 ml).All the patients were followed up for 4-26months(average 10.3 months),which showed that the vertebral fusion time was 4-6 months,with no loss of the vertebral height,implant breakage,loosening or extrusion.The nerve function was improved for 1-2 grades. Conclusions With correct selection of the indications,the posterior single segment anterolateral decompression and anterior column reconstruction is a reliable fixation,for it takes advantages of simple operation,minor trauma,less fusion segments and fast recovery.%目的 探讨后路小切口单节段侧前方减压前柱重建术治疗Denis B犁胸腰椎爆裂骨折的可行性及临床疗效.方法 回顾性分析2007年8月-2009年8月采用经后路小切口椎弓根钉内同定、单间

  6. 颈椎前路减压人工颈椎间盘置换术与融合术治疗单节段颈椎间盘突出症的短期疗效比较%Clinical outcome of Discover artificial cervical disc replacement versus anterior cervical decompression and fusion for single segment cervical disc herniation

    Institute of Scientific and Technical Information of China (English)

    卡哈尔·艾肯木; 楚戈; 王振斌; 陈继征; 顾文飞; 胡雅斌; 涂来勇; 赵疆; 项泽文

    2014-01-01

    Background: The curative effect of anterior cervical discectomy and fusion (ACDF) is satisfactory for the patients with symptomatic cervical disc herniation. However, it can result in stress increase in adjacent segments and speed up the degen-eration of adjacent segments. Artificial cervical disc replacement (ACDR), a typical non-fusion surgical treatment, may be an alternative to ACDF for cervical disc herniation. Objective:To compare the clinical outcomes between ACDR and ACDF for single segmental cervical disc herniation. Methods:From January 2009 to February 2012, 61 patients with single segmental cervical disc herniation were treated in our hospital. Of them, 26 received Discover ACDF (arthroplasty group) and 35 underwent single-level ACDF (fusion group). Visual analogue scale (VAS) neck/arm pain score, Japanese Orthopedics Association (JOA) score and flexion-exten-sion range of motion of operative and adjacent segments were evaluated preoperatively and 1 week and 3, 6, 12, and 24 months postoperatively. Complications and secondary treatment were recorded. Results:A total of 52 patients (29 in arthroplasty group and 23 in fusion group) were followed up. The average follow-up pe-riod was 15.3 months (range, 12-24 months). The VAS scores of neck pain and upper limb pain and JOA score were signifi-cantly improved during follow up as compared with preoperative ones in all patients (P0.05). In arthroplasty group, there was no significant difference in range of motion of opera-tive and adjacent segments before and after treatment (P>0.05). The rate of fusion achievement was 90.5%. In arthroplasy group, prosthesis antedisplacement (<3 mm) in 2 patients at 6 months after surgery, and cerebrospinal fluid leakage oc-curred 1 patient. In fusion group, adjacent segment disease occurred in one patient who underwent secondary operation. Conclusions:Discover cervical disc replacement is a feasible alternative to ACDF for patients with persistent symptomatic cervical disc

  7. Influence of renal function on the efficacy and safety of fondaparinux relative to enoxaparin in non ST-segment elevation acute coronary syndromes

    DEFF Research Database (Denmark)

    Fox, Keith A A; Bassand, Jean-Pierre; Mehta, Shamir R;

    2007-01-01

    . Limitations: Subgroup analyses warrant caution; the study was powered to detect noninferiority at 9 days. Fondaparinux is not approved for use in patients with ACS in the United States. CONCLUSIONS: The benefits of fondaparinux over enoxaparin when administered for non-ST-segment elevation ACS are most marked...... the risk for major bleeding. OBJECTIVE: To compare the efficacy and safety of fondaparinux and enoxaparin over the spectrum of renal dysfunction observed in the OASIS 5 trial. DESIGN: Subgroup analysis of a randomized, controlled trial. SETTING: Patients presenting to the hospital with non-ST-segment...

  8. Fascia Wrapping Technique: A Modified Method for the Treatment of Cubital Tunnel Syndrome

    Directory of Open Access Journals (Sweden)

    Hyun Ho Han

    2014-01-01

    Full Text Available Variations of the anterior transposition of the ulnar nerve for cubital tunnel syndrome include subcutaneous, submuscular, intramuscular, and subfascial methods. We introduce a modification of subfascial transposition, which is designed to facilitate nerve gliding by wrapping the nerve with fascia. Twenty patients with wrapping surgery following the diagnosis of cubital tunnel syndrome were reviewed retrospectively. Preoperative electrodiagnostic studies were performed in all patients and all of them were rechecked postoperatively. The preoperative mean value of motor conduction velocity (MCV was 37.1±6.7 m/s within the elbow segment and this result showed a decrease compared to the result of MCV with 53.9±6.9 m/s in the below the elbow-wrist segment with statistical significance (P<0.05. Postoperative mean values of MCV were improved in all of 20 patients to 47.6±5.5 m/s (P<0.05. 19 patients of 20 (95% reported good or excellent clinical outcomes according to a modified Bishop scoring system. The surgical treatment methods for cubital tunnel syndrome have their own advantages and disadvantages, and the preferred method differs depending on the surgeon. The wrapping method of anterior transposition is a newly designed alternative method modified from subfascial transposition. This method could be an alternative option to treat cubital tunnel syndrome.

  9. Evaluation the value of Pentacam segment analysis system in the study of eye anterior segment before and after prophylactic laser periphery iridotomy%Pentacam眼前节分析系统在预防性激光虹膜周边切除评估中的应用

    Institute of Scientific and Technical Information of China (English)

    章玉群; 田琳璐; 章翼; 赵东升

    2013-01-01

    目的:以首次发作急性闭角型青光眼的对侧眼为研究对象,采用Pentacam眼前节分析系统观察预防性激光虹膜周边切除(laser peripheral iridotomy,LPI)前后眼前节结构变化,评估LPI的有效性和安全性.方法:急性原发性闭角型青光眼50例50眼的对侧眼行氩激光联合Nd:YAG激光预防性激光周边虹膜切除,检查治疗前及治疗后1d;6mo的眼内压(intraocular pressure,IOP),以Pentacam测量中央角膜厚度(central corneal thickness,CCT)、中央前房深度(central anterior chamber depth,CACD)、周边前房深度(peripheral anterior chamber depth,PACD)、前房容积(anterior chamber volume,ACV)、前房角(anterior chamber angle,ACA)、瞳孔直径(pupil diameter,PD)、晶状体厚度(lens thickness,LT),IOL-Master测量眼轴长度(axial length,AL),并估算晶状体在眼内的相对位置(relative position of the lens,RPL).结果:Pentacam 图像清晰显示凸出的虹膜变平坦,前房角加深.治疗前与治疗后1d;6mo的眼压无显著变化.CCT值分别为548.02 ±20.22,549.32±21.78,551.34±26.37mm.CACD值分别为1.65±0.28,1.72±0.31,1.71±0.23mm.PD值分别为2.32±0.55,2.20±0.39,2.38±0.40mm.LT值分别为1.90±0.55,1.82±0.39,1.98±0.40mm.眼AL分别为23.08±1.05,22.91±1.12,22.94±0.96.RPL值分别为0.118±0.035,0.126±0.041,0.121±0.028.治疗前后均无统计学差异.PACD值分别为颞侧(0.88±0.31,1.19±0.25,1.17±0.30mm),上方(0.83±0.32,1.01±0.42,1.02±0.36mm),鼻侧(0.80±0.42,0.95±0.21,0.94±0.24mm),下方(0.83 ±0.34,1.13 ± 0.14,1.12± 0.25mm);ACV值分别为57.06±18.43,80.65±20.02,81.43 ±17.21mm3;ACA值分别为27.02° ±6.65°,30.41°±5.87°,31.52°±6.98°,治疗前与治疗后均有统计学差异,治疗后1d与6mo无统计学差异.结论:LPI能明显增加急性闭角型青光眼对侧眼的周边前房深度和前房容积.Pentacam眼前节分析系统能直观定量反映LPI对于急性闭角型青光眼对侧眼的眼前节三维结构变化.

  10. Cervical instability in Klippel-Feil syndrome:case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Aaron Wessell; Peter DeRosa; Abraham Cherrick; Jonathan H.Sherman

    2015-01-01

    Background: The authors present a case of cervical myelopathy and radiculopathy in the setting of multiple Klippel-Feil syndrome abnormalities treated surgically with a single-level C3-C4 anterior cervical discectomy and fusion.We discuss the clinical presentation, radiographic findings, and various treatment options for cervical spine abnormalities in Klippel-Feil syndrome.Case Presentation: This 22-year-old female with Klippel-Feil syndrome presented with intermittent neck pain, left upper extremity weakness, and paresthesias.Preoperative MRI, CT, and X-rays of the cervical spine revealed anterolisthesis at C3/4 with unstable movement on flexion and extension imaging.In addition, there were multiple segmental fusion abnormalities including hemivertebrae and other congenital fusion abnormalities.A C3-C4 anterior cervical discectomy and fusion was performed with intervertebral disc spacer.Adequate decompression was achieved with postoperative resolution of the patient's symptoms and improvement in neurological exam.Conclusions: Single-level anterior cervical discectomy and fusion can be utilized for treatment of cervical myelopathy and radiculopathy in the setting of multiple congenital Klippel-Feil syndrome abnormalities.

  11. 玻璃体切割联合眼内全视网膜光凝对 PDR合并虹膜新生血管的视网膜供血影响%Retinal blood supply changes after vitrectomy combined with panretinal photocoagulation in PDR patients with anterior segment neovascularization

    Institute of Scientific and Technical Information of China (English)

    王勇; 石兴东; 胡博杰; 边领斋; 李筱荣

    2016-01-01

    AIM: To investigate hemodynamic alterations of retrobulbar vessels in proliferative diabetic retinopathy ( PDR) patients with anterior segment neovascularization, before and 3mo after vitrectomy combined with panretinal photocoagulation and to explore the clinical significance. ●METHODS: Color Doppler flow imaging ( CDFl ) was used for measurement of blood flow velocities and resistive indexes ( Rl ) of the ophthalmic artery ( OA ) , short posterior ciliary arteries ( sPCA ) and central retinal artery ( CRA ) in 21 eyes of 21 PDR patients with anterior segment neovascularization. CDFl parameters were obtained before and 3mo after vitrectomy combined with panretinal photocoagulation ( PRP) . ● RESULTS: Peak systolic velocity ( PSV ) and end diastolic velocity ( EVD ) of CRA were significantly increased after surgeries, Rl were decreased significantly (P0. 05). ●CONCLUSION: Vitrectomy combined with panretinal photocoagulation might increase the velocity of CRA, decrease Rl and improve ocular blood supply postoperatively. lt may delay or prevent the process of neovascular glaucoma.%目的:探讨玻璃体切割联合眼内全视网膜光凝对增殖性糖尿病视网膜病变( proliferative diabetic retinopathy,PDR)合并虹膜新生血管( iris neovascularization,NVI)患者视网膜供血的影响及其临床价值。  方法:采用彩色多普勒超声血流显像技术( color doppler flow imaging,CDFI)检测21例21眼PDR合并NVI患者行玻璃体切割联合眼内光凝术前、术后3 mo视网膜中央动脉( central retinal artery, CRA )、睫状后短动脉( shot posterior ciliary artery, sPCA )、眼动脉( ophthalmic artery, OA)的收缩期峰值流速( peak systolic velocity,PSV)、舒张末期血流速度( end diastolic velocity, EDV )、阻力指数( resistance index,RI)的变化。  结果:玻璃体切割联合眼内全视网膜光凝术后3 mo CRA的PSV、EDV较术前明显升高,而RI值下降,有统计学差异( P0.05)。  结

  12. Proposal for the use in emergency departments of cardiac troponins measured with the latest generation methods in patients with suspected acute coronary syndrome without persistent ST-segment elevation

    Directory of Open Access Journals (Sweden)

    Ivo Casagranda

    2013-10-01

    Full Text Available The purpose of this document is to develop recommendations on the use of the latest generation of cardiac troponins in emergency room settings for the diagnosis of myocardial infarction in patients with suspected acute coronary syndrome without persistent ST-segment elevation (NSTE-ACS. The main points which have been addressed reaching a consensus are: i suitability and appropriateness of the terminology; ii appropriateness of the request; iii confirmation of the diagnosis of myocardial infarction (rule-in; iv exclusion of the diagnosis of myocardial infarction (rule-out. Each point has been analyzed by taking into account the evidence presented in medical publications. Recommendations were developed using the criteria adopted by the European Society of Cardiology and the American Heart Association/American College of Cardiology. Each point of the recommendation was submitted for validation to an external audit by a Group of Experts (named above.

  13. Safety and efficacy of enoxaparin vs unfractionated heparin in patients with non-ST-segment elevation acute coronary syndromes who receive tirofiban and aspirin: a randomized controlled trial

    NARCIS (Netherlands)

    Blazing, M.A.; Lemos, J.A. de; White, H.D.; Fox, K.; Verheugt, F.W.A.; Ardissino, D.; DiBattiste, P.M.; Palmisano, J.; Bilheimer, D.W.; Snapinn, S.M.; Ramsey, K.E.; Gardner, L.H.; Hasselblad, V.; Pfeffer, M.A.; Lewis, E.F.; Braunwald, E.; Califf, R.M.

    2004-01-01

    CONTEXT: Enoxaparin or the combination of glycoprotein IIb/IIIa inhibitor tirofiban with unfractionated heparin independently have shown superior efficacy over unfractionated heparin alone in patients with non-ST-elevation acute coronary syndromes (ACS). It is not clear if combining enoxaparin with

  14. Anterior Segment Findings in Vitamin A Deficiency: A Case Series

    Science.gov (United States)

    Rubino, Pierangela; Mora, Paolo; Ungaro, Nicola; Gandolfi, Stefano A.; Orsoni, Jelka G.

    2015-01-01

    Vitamin A deficiency is a rare but vision threatening disorder in the developed world, which can lead to blindness for severe keratomalacia with cornea scarring and perforation or night blindness due to impaired dark adaptation. Conversely, the disease is quite common in developing countries, as a consequence of chronic malnutrition. The correct diagnosis and therapy with prompt vitamin A supplementation avoid blindness. We report a series of 3 local cases with different age and causes for vitamin A deficiency. The diagnostic workup, therapy, and prognosis are discussed. PMID:26509090

  15. [Segmental neurofibromatosis].

    Science.gov (United States)

    Zulaica, A; Peteiro, C; Pereiro, M; Pereiro Ferreiros, M; Quintas, C; Toribio, J

    1989-01-01

    Four cases of segmental neurofibromatosis (SNF) are reported. It is a rare entity considered to be a localized variant of neurofibromatosis (NF)-Riccardi's type V. Two cases are male and two female. The lesions are located to the head in a patient and the other three cases in the trunk. No family history nor transmission to progeny were manifested. The rest of the organs are undamaged.

  16. Pathogenesis and electrodiagnosis of cubital tunnel syndrome

    Institute of Scientific and Technical Information of China (English)

    贾志荣; 石昕; 孙相如

    2004-01-01

    Background Cubital tunnel syndrome is a well-recognized clinical condition and is the second most common peripheral compression neuropathy. This study was designed to investigate the causes of cubital tunnel syndrome by surgical means and to assess the clinical value of the neurophysiological diagnosis of cubital tunnel syndrome. Methods Twenty-one patients (involving a total of 22 limbs from 16 men and 5 women, aged 22 to 63, with a mean age of 49 years) with clinical symptoms and signs indicating a problem with their ulnar nerve underwent motor conduction velocity examinations at different sites along the ulnar nerve and examinations of sensory conduction velocity in the hand, before undergoing anterior transposition of the ulnar nerve.Results Electromyographic abnormalities were seen in 21 of 22 limbs [motor nerve conduction velocity (MCV) range (15.9-47.5) m/s, mean 32.7 m/s] who underwent motor conduction velocity examinations across the elbow segment of the ulnar nerve. Reduced velocity was observed in 13 of 22 limbs [MCV (15.7-59.6) m/s, mean 40.4 m/s] undergoing MCV tests in the forearms. An absent or abnormal sensory nerve action potential following stimulation was detected in the little finger of 14 of 22 limbs. The factors responsible for ulnar compression based on observations made during surgery were as follows: 15 cases involved compression by arcuate ligaments, muscle tendons, or bone hyperplasia; 2 involved fibrous adhesion; 3 involved compression by the venous plexus or a concurrent thick vein; 2 involved compression by cysts. Conclusions Factors inducing cubital tunnel syndrome include both common factors that have been reported and rare factors, involving the venous plexus, thick veins, and cysts. Tests of motor conduction velocity at different sites along the ulnar nerve should be helpful in diagnosis cubital tunnel syndrome, especially MCV tests indicating decreased velocity across the elbow segment of the ulnar nerve.

  17. An Approach with Hybrid Segmental Mechanics.

    Science.gov (United States)

    Mishra, Harsh Ashok; Maurya, Raj Kumar

    2016-06-01

    Present case report provides an insight into the hybrid segmental mechanics with treatment of 13-year-old male, considering the side effects of sole continuous arch wire sliding mechanics. Patient was diagnosed as a case of skeletal class I jaw relationship, low mandibular plane angle, class II molar relation on right and class I molar relation on left side, anterior cross bite, crowding of 12mm in upper, 5mm in lower arch. He also had proclined upper and lower anteriors by 2mm, convex profile and incompetent lips. Total treatment duration was 20 months, during which segmental canine retraction was performed with TMA (Titanium, Molybdenum, Aluminum) 'T' loop retraction spring followed by consolidation of spaces with continuous arch mechanics. Most of the treatment objectives were met with good intraoral and facial results within reasonable framework of time. This approach used traditional twin brackets, which offered the versatility to use continuous arch-wire mechanics, segmental mechanics and hybrid sectional mechanics.

  18. SAPHO syndrome associated spondylitis

    OpenAIRE

    Takigawa, Tomoyuki; Tanaka, Masato; Nakanishi, Kazuo; Misawa,Haruo; Sugimoto, Yoshihisa; Takahata, Tomohiro; Nakahara, Hiroyuki; Nakahara, Shinnosuke; Ozaki, Toshifumi

    2008-01-01

    The concept of synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome has been well clarified, after Chamot et al. suggested this peculiar disorder in 1987. The most commonly affected site in SAPHO syndrome is the anterior chest, followed by the spine. However, the clinical course and taxonomic concept of SAPHO spinal lesions are poorly understood. This study was performed to analyze: (1) the detailed clinical course of spinal lesions in SAPHO syndrome, and (2) the relationship ...

  19. Impact of graft height on zygapophyseal joint pressure and range of motion adjacent to segment following cervical anterior fusion%颈椎前路融合术中植骨块的高度对邻近节段关节突压力及椎间位移的影响

    Institute of Scientific and Technical Information of China (English)

    罗春山; 欧阳北平; 梁栋柱; 陆廷盛; 姚书耽; 赵国权

    2016-01-01

    Objective To discuss impact of graft height on zygapophyseal joint pressure and range of motion of adjacent segments following the cervical anterior fusion and to guide the choice of optimal graft height in clinic. Methods Eight fresh-frozen human cadaveric cervical spines were used in this series, specimens were tested in five conditions, normal(specimens with intact discs)and different graft height(120%, 140%,160%of mean height) after Smith-Robinson discectomy between the fifth and sixth cervical vertebrae. Each specimens were subjected to flexion-extension. Lateral bending and axial rotation in material test system (BOSE ELECTROFORCE) were adopted to measure zygapophyseal joint pressure and rotation of the fourth to fifth segments and the sixth to seventh segments. Finally, The data for each state was used to determine the statistical significance of differences. Results The height of bone graft had little effect on the zygapophysial joints pressure values in neutral position with no statistical significance noted among each groups(P>0.05); The zygapophysial joints pressure value was the highest increase in extension position,but 120%M increased minimum of zygapophysial joints pressure value, and statistical significance were noted among each groups(P0.05), and statistical significance were noted in others groups(P0.05). Conclusion The appropriate graft height after single discectomy may be 120%mean height.%目的:探讨颈椎前路融合术中植骨块的高度对邻近节段关节突压力及活动度的影响,为临床上选择适宜的植骨高度提供依据。方法采用8例新鲜成人尸体颈椎标本,对完整状态,C5/6节段椎间隙减压术后(100%M、120%M、140%M、160%M)5组,于BOSE机加载下行三维运动,并测量颈C4/5,C6/7关节突压力值及C4/5,C6/7三维运动范围;最后将结果行多重比较分析。结果中立位状态下,关节突压力值各组无显著差异,P>0.05;后伸状态下,关节突压力

  20. Anterior crucate ligament (ACL) injury

    Science.gov (United States)

    ... An anterior cruciate ligament injury is the over-stretching or tearing of the anterior cruciate ligament (ACL) ... may be injured. This is a medical emergency. Prevention Use proper techniques when playing sports or exercising. ...

  1. Interferon Induced Focal Segmental Glomerulosclerosis

    Science.gov (United States)

    Bayram Kayar, Nuket; Alpay, Nadir; Hamdard, Jamshid; Emegil, Sebnem; Bag Soydas, Rabia; Baysal, Birol

    2016-01-01

    Behçet's disease is an inflammatory disease of unknown etiology which involves recurring oral and genital aphthous ulcers and ocular lesions as well as articular, vascular, and nervous system involvement. Focal segmental glomerulosclerosis (FSGS) is usually seen in viral infections, immune deficiency syndrome, sickle cell anemia, and hyperfiltration and secondary to interferon therapy. Here, we present a case of FSGS identified with kidney biopsy in a patient who had been diagnosed with Behçet's disease and received interferon-alpha treatment for uveitis and presented with acute renal failure and nephrotic syndrome associated with interferon. PMID:27847659

  2. Facetas em dentes anteriores

    OpenAIRE

    Veloso, Helena Rafaela Lourenço Martins

    2015-01-01

    Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária A presente revisão bibliográfica aborda as facetas estéticas em dentes anteriores, pela crescente valorização de um sorriso esteticamente agradável, facto que faz com que as pessoas procurem cada vez mais alternativas de tratamento para melhorar a aparência do seu sorriso. Os dentes anteriores são decisivos na aparência estética e, c...

  3. Quantitative observation on changes of anterior segment by ultrasound biomicroscopy after posterior chamber phakic intraocular lens implantation%UBM量化观察有晶状体眼后房型人工晶状体植入术前后眼前节形态的变化

    Institute of Scientific and Technical Information of China (English)

    王瑞娜; 郑广瑛; 王松田; 王洁; 赵建国; 郭红亮; 赵丽君

    2011-01-01

    ObjectiveThe objective is to study the safety and effectiveness of implantation of posterior chamber phakic intraocular contact lens (ICL) by observing the changes in anterior segment using ultrasound biomicroscopy (UBM). Methods It was a perspective study. The study sampled 30 high myopia patients (30 eyes) who were treated with posterior chamber phakic ICL implant. Central anterior chamber depth (ACD), trabecular-iris angle (TIA), angle opening distance (AOD500), trabecular-ciliary processes distance (TCPD) and iris-ciliary processes distance (ICPD) were measured using UBM preoperatively,3 months and 1 year postoperatively. The distance from ICL to the central surface of lens and peripheral lens and intra-ocular pressure were measured postoperatively and examined using slit-lamp biomicroscope. Oneway ANOVA was used to analyze the distance between peripheral surface of ICL and the lens. One-way repeated measures ANOVA and Bonferroni were conducted. Results Preoperatively, 3 months and 1 year postoperatively, ACD were(3. 16 ± 0. 08 ) mm, ( 2. 76 ± 0. 13 ) mm, (2. 74 ± 0. 14) mm; AOD500 were (0.45 + 0.04) mm, (0.41 ± 0.04) mm, (0.41 ±0.03) mm; TIA were (35.00 ±3. 24)°, (32.47 ±3.56) °, (32. 40 ± 3. 23 ) °, respectively. There were significant difference in TIA, ACD and AOD ( P <0. 05) between preoperative and postoperative data. There was no significant difference between the two postoperative periods tested. TCPD and ICPD showed no significant difference between various time points ( F =0. 49, F =0. 57 ; P > 0. 05 ). Conclusions The decrease in ACD depth and correction in TIA and AOD were the noticeable changes observed in morphological structure of the ocular anterior segment after the ICL treatment. The incidence of complication did not increase as the result of the minor changes in morph structure during the course of the study. However, the long-term effects would require further long-term observation.%目的 应用超声生物显微镜(UBM)对

  4. 经前路椎体次全切钛笼置入锁定钢板螺丝钉内固定治疗相邻两节段脊髓型颈椎病%Adjacent Two Segments Anterior Subtotal Titanium Cage into the ;Locking Plate Screw Fixation for the Treatment of Cervical Spondylotic Myelopathy

    Institute of Scientific and Technical Information of China (English)

    青祖宏; 刘明; 高巍; 何蔚; 刘杨; 李永焕

    2013-01-01

    Objective To summarize the clinical efficacy of the anterior corpectomy cut with titanium cage and locking plate screw fixation for the treatment of two adjacent cervical spondylotic myelopathy.Method August 2010~December 2012,Anterior corpectomy cut with titanium cage and locking plate screw fixation for the treatment of adjacent two segments cervical spondylotic myelopathy 25 cases,including 18 men and 7 women patients,aged 33~75 years,mean 56.5 years.In 25 patients with varying degrees of symptoms of spinal cord compression. There are 9 cases(C4/C5). There are 15 cases(C5/C6).There are 1 case(C6/C7).Observed lateral cervical spine,cervical hyperextension flexion X-rays and cervical MR, before and after surg ery and follow-up phase,so as to learn spinal cord compression,cervical stability and postoperative cervical height,curvature,titanium cage plate screw position and cervical fusion. Compared preoperative to postoperative and follow-up,pain visual analog scale (VAS) and the Japan Orthopaedics Association (JOA) pain score.Results Operative time (120±30) min,blood loss (150±50)ml.The surgery does not appear related complications.The followed up time are 2~24 months (mean 12.5 months). Nerve function significantly improved.JOA score increased from preoperative 6.2±1.1 to the last follow-up 14.3±1.5,with an average improvement rate was (82.3±11.4)%.VAS average score is 2.1 points.The follow-up period is not found that the titanium cage shift,loose screws and lesion spinal cord compression phenomenon.Conclusion Anterior corpectomy cut with titanium cage and locking plate screw fixation for the treatment of two adjacent segments of cervical spondylotic myelopathy,effectively relieve nerve compression of the spinal cord,quickly restored cervical curvature and height,reconstruction of spinal stability,shorter operative time,less bleeding, and less damage.It has created favorable conditions for the rehabilitation of neurological function in patients,which is an

  5. Involuntary masturbation and hemiballismus after bilateral anterior cerebral artery infarction.

    Science.gov (United States)

    Bejot, Yannick; Caillier, Marie; Osseby, Guy-Victor; Didi, Roy; Ben Salem, Douraied; Moreau, Thibault; Giroud, Maurice

    2008-02-01

    Ischemia of the areas supplied by the anterior cerebral artery is relatively uncommon. In addition, combined hemiballismus and masturbation have rarely been reported in patients with cerebrovascular disease. We describe herein a 62-year-old right-handed man simultaneously exhibiting right side hemiballismus and involuntary masturbation with the left hand after bilateral infarction of the anterior cerebral artery territory. Right side hemiballismus was related to the disruption of afferent fibers from the left frontal lobe to the left subthalamic nucleus. Involuntary masturbation using the left hand was exclusively linked to a callosal type of alien hand syndrome secondary to infarction of the right side of the anterior corpus callosum. After 2 weeks, these abnormal behaviours were completely extinguished. This report stresses the wide diversity of clinical manifestations observed after infarction of the anterior cerebral artery territory.

  6. Intradural anterior transpetrosal approach.

    Science.gov (United States)

    Ichimura, Shinya; Hori, Satoshi; Hecht, Nils; Czabanka, Marcus; Vajkoczy, Peter

    2016-10-01

    The standard anterior transpetrosal approach (ATPA) for petroclival lesions is fundamentally an epidural approach and has been practiced for many decades quite successfully. However, this approach has some disadvantages, such as epidural venous bleeding around foramen ovale. We describe here our experience with a modified technique for anterior petrosectomy via an intradural approach that overcomes these disadvantages. Five patients with petroclival lesions underwent surgery via the intradural ATPA. The intraoperative hallmarks are detailed, and surgical results are reported. Total removal of the lesions was achieved in two patients with petroclival meningioma and two patients with pontine cavernoma, whereas subtotal removal was achieved in one patient with petroclival meningioma without significant morbidity. No patient experienced cerebrospinal fluid leakage. The intradural approach is allowed to tailor the extent of anterior petrosectomy to the individually required exposure, and the surgical procedure appeared to be more straightforward than via the epidural route. Caveats encountered with the approach were the temporal basal veins that could be spared as well as identification of the petrous apex due to the lack of familial epidural landmarks. The risk of injury to the temporal bridging veins is higher in this approach than in the epidural approach. Intradural approach is recommended in patients with a large epidural venous route, such as sphenobasal and sphenopetrosal vein. Navigation via bone-window computed tomography is useful to identify the petrous apex.

  7. Optical Coherence Tomography Findings in Anterior Chamber Ointment Globule after Phacoemulsification

    Directory of Open Access Journals (Sweden)

    Ahmad M. Mansour

    2015-12-01

    Full Text Available We present 2 cases of anterior chamber ointment with evidence of progressive endothelial cell loss. In both cases, an anterior segment optical coherence tomography (OCT was similar to an OCT of a tobramycin-dexamethasone ointment placed on a pen tip. An anterior segment OCT also demonstrated the direct contact of the globule with the corneal endothelium. A gas chromatography/mass spectrometry analysis documented the similarity to tobramycin-dexamethasone ointment in 1 case. Anterior segment OCT can help in confirming the diagnosis. Corneal endothelial injury is a continuous process, and its clinical manifestation is related to the size of the globule, the initial endothelium count, and the duration of ointment contact, which is related to supine positioning. It is advisable to avoid ointments in the immediate postoperative period, especially in corneal wounds larger than 3 mm.

  8. Segmentation of knee injury swelling on infrared images

    Science.gov (United States)

    Puentes, John; Langet, Hélène; Herry, Christophe; Frize, Monique

    2011-03-01

    Interpretation of medical infrared images is complex due to thermal noise, absence of texture, and small temperature differences in pathological zones. Acute inflammatory response is a characteristic symptom of some knee injuries like anterior cruciate ligament sprains, muscle or tendons strains, and meniscus tear. Whereas artificial coloring of the original grey level images may allow to visually assess the extent inflammation in the area, their automated segmentation remains a challenging problem. This paper presents a hybrid segmentation algorithm to evaluate the extent of inflammation after knee injury, in terms of temperature variations and surface shape. It is based on the intersection of rapid color segmentation and homogeneous region segmentation, to which a Laplacian of a Gaussian filter is applied. While rapid color segmentation enables to properly detect the observed core of swollen area, homogeneous region segmentation identifies possible inflammation zones, combining homogeneous grey level and hue area segmentation. The hybrid segmentation algorithm compares the potential inflammation regions partially detected by each method to identify overlapping areas. Noise filtering and edge segmentation are then applied to common zones in order to segment the swelling surfaces of the injury. Experimental results on images of a patient with anterior cruciate ligament sprain show the improved performance of the hybrid algorithm with respect to its separated components. The main contribution of this work is a meaningful automatic segmentation of abnormal skin temperature variations on infrared thermography images of knee injury swelling.

  9. Spontaneous Scleral Perforation of an Anterior Chamber Intraocular Lens

    Directory of Open Access Journals (Sweden)

    Oriel Spierer

    2016-05-01

    Full Text Available A routine eye examination of a 69-year-old man revealed a scleral perforation of one of the haptics of the anterior chamber intraocular lens (AC IOL which had been implanted many years ago. The patient was asymptomatic with good visual acuity. His history was negative for any trauma, eye rubbing, topical corticosteroid use, or autoimmune disease. The horizontal and vertical white-to-white diameters of the cornea in the right eye were 11.5 and 10.5 mm, respectively. Anterior segment optical coherence tomography showed the anterior chamber length to be 12.28 mm horizontally and 10.63 mm vertically. The patient underwent an IOL exchange, and the length of the explanted AC IOL was measured to be 12 mm. We speculate that the AC IOL, which was vertically aligned, was oversized. This case demonstrates the need for proper sizing and positioning of an AC IOL. In complex cases where AC IOL may be used, measuring the horizontal and vertical lengths of the anterior chamber by anterior segment optical coherence tomography prior to surgery may be useful.

  10. Spontaneous Scleral Perforation of an Anterior Chamber Intraocular Lens

    Science.gov (United States)

    Spierer, Oriel; O'Brien, Terrence P.

    2016-01-01

    A routine eye examination of a 69-year-old man revealed a scleral perforation of one of the haptics of the anterior chamber intraocular lens (AC IOL) which had been implanted many years ago. The patient was asymptomatic with good visual acuity. His history was negative for any trauma, eye rubbing, topical corticosteroid use, or autoimmune disease. The horizontal and vertical white-to-white diameters of the cornea in the right eye were 11.5 and 10.5 mm, respectively. Anterior segment optical coherence tomography showed the anterior chamber length to be 12.28 mm horizontally and 10.63 mm vertically. The patient underwent an IOL exchange, and the length of the explanted AC IOL was measured to be 12 mm. We speculate that the AC IOL, which was vertically aligned, was oversized. This case demonstrates the need for proper sizing and positioning of an AC IOL. In complex cases where AC IOL may be used, measuring the horizontal and vertical lengths of the anterior chamber by anterior segment optical coherence tomography prior to surgery may be useful. PMID:27462251

  11. Spontaneous Scleral Perforation of an Anterior Chamber Intraocular Lens.

    Science.gov (United States)

    Spierer, Oriel; O'Brien, Terrence P

    2016-01-01

    A routine eye examination of a 69-year-old man revealed a scleral perforation of one of the haptics of the anterior chamber intraocular lens (AC IOL) which had been implanted many years ago. The patient was asymptomatic with good visual acuity. His history was negative for any trauma, eye rubbing, topical corticosteroid use, or autoimmune disease. The horizontal and vertical white-to-white diameters of the cornea in the right eye were 11.5 and 10.5 mm, respectively. Anterior segment optical coherence tomography showed the anterior chamber length to be 12.28 mm horizontally and 10.63 mm vertically. The patient underwent an IOL exchange, and the length of the explanted AC IOL was measured to be 12 mm. We speculate that the AC IOL, which was vertically aligned, was oversized. This case demonstrates the need for proper sizing and positioning of an AC IOL. In complex cases where AC IOL may be used, measuring the horizontal and vertical lengths of the anterior chamber by anterior segment optical coherence tomography prior to surgery may be useful.

  12. Segmental anterior cervical decompression with fusion for treating multilevel cervical myelopathy: Comparison of fusion rates among three methods%颈前路分节段减压植骨融合术治疗多节段颈椎病:3种方法移植骨融合率的比较

    Institute of Scientific and Technical Information of China (English)

    袁文; 徐盛明; 王新伟; 张涛; 刘百峰

    2007-01-01

    院时间均明显少于/短于长节段减压组(P<0.05),平均住院费用明显高于长节段减压组(P<0.05).分节段减压组、三间隙减压组和长节段减压组术后JOA评分提高分数和植骨融合率相近(P>0.05).结论:综合植骨融合率、神经功能恢复情况、手术时间、术中出血量、住院时间多种因素,3种术式中以颈前路分节段减压植骨融合术为治疗多节段颈椎病的手术方式较佳方案.%BACKGROUND:As a traditional treatment for multilevel cervical myelopathy,nterior long-segmental decompression has the shortcomings of great operative trauma,high difficulty,low fusion rate,etc.,which can affect the postoperative efficacy.OBJ ECTIVE:To evaluate the clinical effects of three different anterior surgeries on multilevel cervical myelopathy.DESIGN:A comparative observation.SETTING:Department of Orthopaedics,Changzheog Hospital,the Second Military Medical University of Chinese PLA.PARTICIPANTS:Thirty-six patients with multilevel cervical myelopathy of 3 consecutive segments,who were surgically treated,were selected from the Department of Orthopaedics,Changzheng Hospital,the Second Military Medical University of Chinese PLA from June 1999 to June 2003,including 25 males and 11 females,35-62 years of age,the disease course ranged from 3 to 26 months. According to the clinical manifestations and imaging esults,they were diagnosed as multilevel cervical myelopathy,and they were not suffering from consecutive ossification of posterior longitudinal ligament and ossification of ligamenta flava. Informed contents were obtained from all the patients and their relatives.METHODS:All the patients were grafted with utologous bone. Autologous ilium or cancellous bone excluding vertebral body was filled into titan net or Cage,which were made of titan and characterized by high intensity,tolerance to decay,good biocompatibility,etc. According to the operative manner,the patients were divided into 3 groups:① two

  13. Ocular Munchausen Syndrome; Self Introduction of Clay and Glass Parts to Conjunctival Fornix

    Directory of Open Access Journals (Sweden)

    Sadullah Keles

    2014-04-01

    Full Text Available In this study we aimed to introduce two cases presented to our clinic with a complaint of foreign bodies in eyes, followed in our clinic and diagnosed with Ocular Munchausen syndrome. In the first case; a 10 year old male patient had complained out of soil from each eye. In the patient%u2019s biomicroscopic examination; reminiscent of the wet soil material was observed in the conjunctival fornix and caruncle in both eyes. Patient%u2019s both eye anterior segment and fundus examination, orbital and lacrimal gland ultrasound were normal. Sample from the eyes of the patient was reported to be soil material content with quite high organic matter. Patient was consulted with Child and Adolescent Psychiatry Clinic and diagnosed with Ocular Munchausen Syndrome. In the other case; 24 year old male patient presented to our clinic with the diagnosis of %u2018foreign body in the right eye%u2019. 3 pieces of glass were removed from the upper fornix in the patient%u2019s right eye examination. Patient%u2019s anterior segment, fundus examination and B-scan USG were normal. Patient was admitted again with similar complaints after 1 week and 2 pieces of glass were removed from the upper fornix in the patient%u2019s right eye examination. Patient was consulted to psychiatry clinic and diagnosed with Ocular Munchausen Syndrome.

  14. Blind loop syndrome

    Science.gov (United States)

    ... part of the stomach) and operations for extreme obesity As a complication of inflammatory bowel disease Diseases such as diabetes or scleroderma may slow down movement in a segment of the intestine, leading to blind loop syndrome.

  15. Silent ST segment elevation myocardial infarction with multi-segmental renal infarction: an unusual presentation.

    Science.gov (United States)

    Chang, Hung-Yu; Yang, Yung-Nien

    2011-01-01

    A 36-year-old diabetic man came to our institution presenting with constant left flank pain. Left renal embolic infarction was found by abdominal computed tomography. Silent ST segment elevation myocardial infarction was noted on 12-lead electrocardiogram. Emergent coronary angiography revealed large thrombus burdens with complete occlusion at the left anterior descending artery ostium, which may be the embolic origin. Silent ST segment elevation myocardial infarction with acute flank pain and multiple segmental renal infarction is an unusual presentation. High vigilance may prevent delay of the "golden hour" to treat acute myocardial infarction.

  16. Axenfeld-Rieger syndrome and spectrum of PITX2 and FOXC1 mutations

    DEFF Research Database (Denmark)

    Tümer, Zeynep; Bach-Holm, Daniella

    2009-01-01

    Axenfeld-Rieger syndrome (ARS) is a rare autosomal dominant disorder, which encompasses a range of congential malformations affecting the anterior segment of the eye. ARS shows genetic heterogeneity and mutations of the two genes, PITX2 and FOXC1, are known to be associated with the pathogenesis....... There are several excellent reviews dealing with the complexity of the phenotype and genotype of ARS. In this study, we will attempt to give a brief review of the clinical features and the relevant diagnostic approaches, together with a detailed review of published PITX2 and FOXC1 mutations....

  17. 新型三维眼前节分析仪Sirius和Pentacam测量准分子激光角膜原位磨镶术后眼前节参数的对比研究%Comparison of anterior segment measuring parameters in myopia after laser in situ keratomileusis between Sirius and Pentacam

    Institute of Scientific and Technical Information of China (English)

    徐真; 黄锦海; 成拾明; 冯一帆; 王勤美

    2013-01-01

    者的结果一致性欠佳,95%CI为-27.70~6.20 mm3. 结论 Sirius和Pentacam测量LASIK术后眼前房参数结果的重复性和稳定性好,此外两种方法测量的角膜曲率、角膜厚度和ACD具有很好的一致性,两种测量结果的差异在临床上可以接受,二者可以互相替代使用,但在测量角膜最薄点位置及ACV时两种方法的测量结果差异较大,临床上相互替代使用时需谨慎.%Background Sirius system,a new Scheimpflug camera combined with Placido topography,improved the capability of imaging the anterior eye segment significantly.However,the study of assessing the repeatability and agreement between Sirius and Pentacam is still lack up to now.Objective This study was to evaluate the repeatability and agreement of the anterior ocular segment measuring parameters by Sirius and Pentacam in myopia received laser in situ keratomileusis (LASIK).Methods Thirty-five myopic eyes of 35 patients received LASIK were included in School of Optometry and Ophthalmology Eye Hospital from 2010 May through 2010 July.Corneal power flat keratometry (Kf),step keratometry (Ks),mean keratometry (Km),thinnest corneal thickness(TCT),the location of TCT,anterior chamber depth (ACD) and anterior chamber volume (ACV) were measured by Sirius and Pentacam in all the eyes,respectively.The repeatability of the measuring results were evaluated using intraclass correlation coefficients (ICC) and Cronbach's coefficient alpha (CoA),and the agreement of measuring parameters between Sirius and Pentacam was analyzed using Bland-Altman plot.Results Both Sirius and Pentacam demonstrated high intraobserver repeatability,with all ICC and CoA more than 0.90.No significant differences were found in Kf values and Ks values between the two methods (t =-1.533,-1.750,P>0.05).Km value was (39.14 ± 1.95) D by Sirius measurement,which was sígnificantly higher than (39.05 ± 1.91) D by Pentacam measurement (t =3.572,P =0.001).The TCT was (457.6 ± 40.9) μm by Sirius method,showing a

  18. Expression of engrailed-family genes in the jumping bristletail and discussion on the primitive pattern of insect segmentation.

    Science.gov (United States)

    Nakagaki, Yasutaka; Sakuma, Masashi; Machida, Ryuichiro

    2015-09-01

    It has been shown that segmentation in the short-germ insects proceeds by a two-step mechanism. The anterior region is simultaneously segmented in a manner similar to that in Drosophila, which is apparently unique to insects, and the rest of the posterior region is segmented sequentially by a mechanism involving a segmentation clock, which is derived from the common ancestor of arthropods. In order to propose the evolutionary scenario of insect segmentation, we examined segmentation in the jumping bristletail, the basalmost extant insect. Using probes for engrailed-family genes for in situ hybridization, we found no sign of simultaneous segmentation in the anterior region of the jumping bristletail embryos. All segments except the anteriormost segment are formed sequentially. This condition shown in the jumping bristletail embryos may represent the primitive pattern of insect segmentation. The intercalating formation of the intercalary segment is assumed to be a synapomorphic trait shared among all insects after the branching of the jumping bristletail.

  19. Síndrome do disco adjacente à fusão (Síndrome de Transição na coluna cervical: resultados segundo critérios clínicos e radiológicos Síndrome del disco adyacente a la fusión (Síndrome de Transición en la columna cervical Adjacent segment disease (Transitional Syndrome in cervical spine: clinical and radiological results

    Directory of Open Access Journals (Sweden)

    Alexandre Meluzzi

    2010-03-01

    adyacente, se mostraron como los grandes factores de riesgo para el seguimiento.OBJECTIVE: the objective of this study was to identify the occurrence of adjacent disc syndrome secondary to intervertebral fusion in the cervical segment, and the predictors of outcome. METHODS: the medical records and imaging studies of 209 patients undergoing surgical treatment of cervical degenerative disease, with 169 cases treated through anterior approach and 40 cases through the posterior approach, at the HC-FMUSP from March 1993 to January 2007. Clinical evaluation was quantified by the scale of Japanese Orthopaedic Association (JOA, with an average follow-up of 80 months. The radiological analysis was based on the criteria of instability by White and Panjabi in all cases. The degeneration was measured by the scale of Kellgren before and after surgery. RESULTS: overall, the syndrome of adjacent disc was diagnosed in 30 cases (17.75%, with a mean time interval of incidence of 28.5 months after the merger, or 2.9 cases per year. There was an increase in degenerative changes in X-rays at levels adjacent to anterior fusion in 41.42% and 52.5% for the posterior without fusion, evaluated by the scale of Kellgren, the degeneration rate of 6.7% per annum, with no correlation with clinical changes. CONCLUSIONS: changes in physiological sagittal alignment of the spine and their severity predispose to the development of the syndrome. There was no incidence of the syndrome in cases of pseudoarthrosis or methacrylate, therefore, where there was a merger. The use of decompression and fusion, anterior, is associated with the possibility of developing a new framework for myeloradiculopathy in the postoperative period. Merger at a level that involve the fifth or sixth cervical vertebra, fixation with plates and pre-existing radiographic evidence of disc degeneration adjacent were factors of high risk for its emergence.

  20. Schizophrenia as segmental progeria

    Science.gov (United States)

    Papanastasiou, Evangelos; Gaughran, Fiona; Smith, Shubulade

    2011-01-01

    Schizophrenia is associated with a variety of physical manifestations (i.e. metabolic, neurological) and despite psychotropic medication being blamed for some of these (in particular obesity and diabetes), there is evidence that schizophrenia itself confers an increased risk of physical disease and early death. The observation that schizophrenia and progeroid syndromes share common clinical features and molecular profiles gives rise to the hypothesis that schizophrenia could be conceptualized as a whole body disorder, namely a segmental progeria. Mammalian cells employ the mechanisms of cellular senescence and apoptosis (programmed cell death) as a means to control inevitable DNA damage and cancer. Exacerbation of those processes is associated with accelerated ageing and schizophrenia and this warrants further investigation into possible underlying biological mechanisms, such as epigenetic control of the genome. PMID:22048679

  1. Spectral domain optical coherence tomography study of pearl-like lesions in the anterior chamber

    Directory of Open Access Journals (Sweden)

    Soliman W

    2012-06-01

    Full Text Available Wael Soliman*, Ehab I Wasfi*, Omar M AliDepartment of Ophthalmology, Assiut University Hospital, Assiut University, Assiut, Egypt*These authors contributed equally to this workAim: To study the morphological pattern of pearl-like lesions in the anterior chambers of children before and after management using anterior segment spectral domain optical coherence tomography (SD-OCT.Patients and methods: This was a prospective, observational cross-sectional study of patients presenting with peculiar pearl-like lesions in the anterior chamber of their eyes. 1 mL of betamethasone sodium phosphate (2 mg/mL and betamethasone dipropionate (5 mg/mL was injected subconjunctivally. Follow-ups of all patients were conducted for a period of 6 weeks. Anterior segment imaging was done using SD-OCT and also photo slit lamp before and after management.Results: Twelve eyes of 12 patients were included in this study. These patients presented with pearl-like lesions in the anterior chamber with signs of anterior uveitis. There was no history of ocular injury or tuberculosis in any patients. Six weeks after subconjunctival steroid injection, all patients achieved mean best-corrected visual acuity, which changed from 0.2 (range 0.1–0.4 to 0.5 (range 0.4–0.8, and the severity of iritis decreased. SD-OCT showed that the lesions at presentation appeared as a globular noncystic mass attached to the back of the cornea, encroaching on the angle of the eye, and attached to the anterior surface of the iris at some points.Conclusion: SD-OCT for imaging the anterior segment allowed us to exclude the cystic nature of this pearly lesion. Some similarities may exist between these pearly lesions and superficial phlyctenular keratitis, which may support the immunological and inflammatory origin of these lesions.Keywords: pearl-like lesions, anterior chamber, phlycten, anterior segment OCT

  2. Mitochondrial encephalopathy with lactic acidosis and stroke-like episodes syndrome with hypothyroidism and focal segmental glomerulosclerosis in a paediatric patient.

    Science.gov (United States)

    Lau, Keith K; Yang, Samuel P; Haddad, Maha N; Butani, Lavjay; Makker, Sudesh P

    2007-01-01

    Herein, we report on a paediatric patient with mitochondrial encephalopathy, lactic acidosis and stroke-like episodes (MELAS) who was hospitalized for acute on chronic renal insufficiency, seizures and deterioration of the level of consciousness. She also had hypertension, hypothyroidism and nephrotic range proteinuria. Kidney biopsy revealed many sclerotic glomeruli and focal segmental glomerulosclerosis (FSGS). Glomerulopathy is rare in patients with MELAS, and FSGS has been reported only in a few patients. The histopathological features of the renal biopsy suggested that the aetiology of the FSGS may have been secondary to chronic renal injury rather than from a primary immunologic cause. Moreover, our case is unique in that, the coexistence of MELAS, hypothalamic hypothyroidism and FSGS has not been reported in the past. The purpose of this report is to increase the awareness of health-care professionals, especially in the fields of paediatrics, neurology, endocrinology and nephrology, regarding the manifestations and complications of MELAS.

  3. Endogenous growth hormone and insulin after interposition of a reversed jejunal segment in short bowel syndrome. An experimental study on pigs

    Directory of Open Access Journals (Sweden)

    Papamichail Michail

    2012-08-01

    Full Text Available Abstract Background Interposition of a reversed jejunal loop in short bowel sydrome has previously been investigated in human along with animal models and seemed able to facilitate intestinal adaptation. However, it is unclear if growth hormone and insulin, well known for their implication in short bowel pathophysiology, intervene on this effect. Findings Porcine models were randomly allocated to two cohorts: (1 short bowel (SB group (n = 8 and (2 short bowel reverse jejunal segment (SB-RS group (n = 8. Amongst other parameters serum growth hormone and insulin were measured at baseline, as well as on postoperative day 30 and 60. Conclusion Both endogenous hormones failed to demonstrate significant difference in respect to potential direct effect to mechanisms of enhanced intestinal adaptation in reversed group

  4. Anterior knee pain

    Energy Technology Data Exchange (ETDEWEB)

    LLopis, Eva [Hospital de la Ribera, Alzira, Valencia (Spain) and Carretera de Corbera km 1, 46600 Alzira Valencia (Spain)]. E-mail: ellopis@hospital-ribera.com; Padron, Mario [Clinica Cemtro, Ventisquero de la Condesa no. 42, 28035 Madrid (Spain)]. E-mail: mario.padron@clinicacemtro.com

    2007-04-15

    Anterior knee pain is a common complain in all ages athletes. It may be caused by a large variety of injuries. There is a continuum of diagnoses and most of the disorders are closely related. Repeated minor trauma and overuse play an important role for the development of lesions in Hoffa's pad, extensor mechanism, lateral and medial restrain structures or cartilage surface, however usually an increase or change of activity is referred. Although the direct relation of cartilage lesions, especially chondral, and pain is a subject of debate these lesions may be responsible of early osteoarthrosis and can determine athlete's prognosis. The anatomy and biomechanics of patellofemoral joint is complex and symptoms are often unspecific. Transient patellar dislocation has MR distinct features that provide evidence of prior dislocation and rules our complication. However, anterior knee pain more often is related to overuse and repeated minor trauma. Patella and quadriceps tendon have been also implicated in anterior knee pain, as well as lateral or medial restraint structures and Hoffa's pad. US and MR are excellent tools for the diagnosis of superficial tendons, the advantage of MR is that permits to rule out other sources of intraarticular derangements. Due to the complex anatomy and biomechanic of patellofemoral joint maltracking is not fully understood; plain films and CT allow the study of malalignment, new CT and MR kinematic studies have promising results but further studies are needed. Our purpose here is to describe how imaging techniques can be helpful in precisely defining the origin of the patient's complaint and thus improve understanding and management of these injuries.

  5. Evaluation of the Effects of Menstrual Cycle on Anterior Chamber Parameters as Measured with Pentacam

    Directory of Open Access Journals (Sweden)

    Arzu Seyhan Karatepe

    2013-01-01

    Full Text Available Pur po se: To evaluate the effects of endogenous gonadotropic hormones (follicle-stimulating hormone, luteinizing hormone and sex steroids (progesterone, estrogen to anterior segment parameters. Ma te ri al and Met hod: Thirty healthy females who had a menstrual cycle of 28±1 day and with a mean age of 36.5±7.56 (range, 20 – 46 years were included in the study. Starting from the first day of their cycle, Pentacam Scheimpflug camera measurements were performed on the 1st, 3rd, 7th, 12th, 16th, 21st, 26th, and 28th days. The central corneal thickness, anterior chamber depth, anterior segment volume, keratometric values, anterior chamber angle value, and pupilla diameter of both eyes were evaluated. Repeated measures analysis of variance test was used for statistical analysis. Re sults: No difference that reaches statistical significance was found in the means of central corneal thickness, anterior chamber volume, keratometric values, anterior chamber angle, and pupilla diameter between the days. Mean anterior chamber depth measurement of the right eyes on the 1st day was 2.72±0.44 mm, whereas it was 2.77±0.46 mm on the 26th day. Mean anterior chamber depth measurement of the left eyes on the 1st day was 2.74±0.42 mm, whereas it was 2.80±0.43 mm on the 26th day. This increment of anterior chamber depth value from the 1st to the 26th days was found to be statistically significant (p≤0.05. Dis cus si on: Progesterone and estrogen that rise in the second half of the menstrual cycle might have a deepening effect on the anterior chamber. These findings should be further investigated with more profound studies that also evaluate the hormonal values and their correlations with anterior segment parameters. (Turk J Ophthalmol 2013; 43: 15-8

  6. Analysis of the invasive strategy decision in patients with acute coronary syndrome without ST-segment elevation in a real-world setting.

    Science.gov (United States)

    De Abreu, Maximiliano; Mariani, Javier A; Silberstein, Alejandro; Guridi, Cristian; Hecht, Gabriela; Gagliardi, Juan A; Doval, Hernán C; Tajer, Carlos D

    2014-06-15

    Observational studies have reported a marked discrepancy between the risk estimated by scores and the use of an invasive strategy in patients with acute coronary syndromes. The objective is to describe the criteria used to decide an early invasive strategy and to determine the differences between those criteria and the thrombolysis in myocardial infarction risk score (TRS). Patients entered to the Epi-Cardio registry with a diagnosis of non-ST-elevation acute coronary syndrome were analyzed. A logistic regression model including variables associated with an early invasive strategy was developed and validated in 2 consecutive cohorts. The association between the TRS and the clinical decision model with an early invasive strategy was evaluated by receiver operating characteristic (ROC) curves. We included a total of 3,187 patients. In the derivation cohort, variables associated with an early invasive strategy were previous angioplasty (odds ratio [OR] 1.63), hypercholesterolemia (OR 1.36), ST changes (OR 1.49), elevated biomarkers (OR 1.42), catheterization laboratory availability (OR 1.7), recurrent angina (OR 3.45), age (OR 0.98), previous coronary bypass (OR 0.65), previous heart failure (OR 0.40), and heart rate at admission (OR 0.98). The areas under the ROC curves to predict invasive strategy were 0.55 for the TRS and 0.69 for the clinical decision model, p variables not completely included in risk scores. The clinical, evolutionary, and structural variables included in the model can explain, partially, the discordance existing between risk stratification and medical strategies.

  7. 前后段联合手术及硅油填充治疗高度近视黄斑孔视网膜脱离的疗效观察%The therapeutic effect of combined surgery of anterior and posterior segment and silicon oil tamponade on macular hole retinal detachment in eyes with high myopia

    Institute of Scientific and Technical Information of China (English)

    陈伟奇; 张责华; 胡一骏; 郑建龙

    2009-01-01

    Objective To observe the therapeutic effect of combined surgery of anterior and posterior segment and silicon oil tamponade on macular hole retinal detachment in eyes with high myopia. Methods The clinical data of 48 high myopia patients (48 eyes) with macular hole retinal detachment were retrospectively analyzed. Retinal detachment was mainly at the posterior pole; macular hole was confirmed by non-contact Hruby lens and optical coherence tomography (OCT). Phacoemulsification combined with pars plana vitrectomy and silicon oil tamponade were performed to all patients, of which 41 had undergone internal limiting membrane peeling, and 23 had intraocular lens implanting. The oil had been removed 3.5-48.0 months after the first surgery and OCT had been performed before the removal. The follow-up period after the removal of the silicon oil was more than 1 year. Results The edge of the macular hole could not be seen under the non-contact Hruby lens 1 week after the surgery in all but 5 patients, and the visual acuity improved. The silicon oil had been removed in all of the 48 patients; the OCT scan before the removal showed that the closed macular holes can be in U shape (8 eyes), V shape (6 eyes) or W shape (23 eyes). About 13-38 months after the oil removal, retinal detachment recurred in 2 patients with the W-shaped holes. At the end of the follow-up period, 16 patients (33.3%) had U or V-shaped macular holes, and 32 patients (66.7%) had W-shaped macular holes. The rate of retinal reattachment was 100%. Conclusion Combined surgery of anterior and posterior segment and silicon oil tamponade is effective on macular hole retinal detachment in eyes with high myopia.%目的 观察前后段联合手术及硅油充填治疗高度近视黄斑孔视网膜脱离临床疗效.方法 回顾分析前后段联合手术及硅油充填治疗高度近视黄斑孔视网膜脱离患者48例48只眼的临床资料.患者均有高度近视史,视网膜脱离以后极部为主.裂隙灯

  8. THERAPY OF FIBRINOUS PLASTIC ANTERIOR UVEITIS

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    A. L. Onishchenko

    2015-01-01

    Full Text Available Aim. To analyze the efficacy of modified pupillary massage technique using cycloplegic agent Appamide Plus in the treatment of anterior uveitis. Patients and methods. 45 patients (25 men and 20 women aged 21‑69 with endogenous uveitis (51 eyes were enrolled in the study. Etiology of uveitis was identified in 57.7 % of cases: herpes simplex virus (22.2 %; systemic disorders — rheumatoid arthritis, Reiter syndrome, Bechterew’s disease, psoriasis (17.7 %; local infection — purulent periodontitis or sinusitis (11 %. Patients were divided into two groups. Group I received basic therapy in combination with traditional pupillary massage. Group II received basic therapy in combination with modified pupillary massage using Appamide Plus (muscarinic receptor antagonist and alpha adrenergic agonist and plasma exchange with cell mass ozonation. Results. Inflammation of the uveal tract was prevented in all patients. In group I (traditional pupil massage, posterior synechiae persisted in 26 % of cases. In group II (pupil massage using Appamide Plus, anterior chamber humor was transparent, posterior synechiae were broken, normal pupillary response was re-established. Additionally, inflammatory exudate in the anterior chamber and endothelial precipitates resolved by 3.3 days earlier than in group I (р < 0.05. Visual outcomes were also better in Appamide Plus group. T cell-mediated immunity study revealed initial CD3+ cell and T cell subpopulation deficiency. Relative and absolute references of T cells and their subpopulations tended to decrease even when uveitis signs reduced. Conclusions. T cell-mediated immunity depression is probably due to pharmacotherapy. Appamide Plus eye drops are highly effective for therapeutic mydriasis and pupillary massage in the course of anterior uveitis treatment to prevent synechiae formation in enlarged or small pupil.

  9. Novel approach to evaluation of medical care quality delivered to patients with ST-segment elevation acute coronary syndrome: course to clinical result

    Directory of Open Access Journals (Sweden)

    Posnenkova О.М.

    2014-09-01

    Full Text Available The purpose was to implement system analysis of clinical cases for development of healthcare quality indicators for STe-ACS patients, aimed at achievement of clinical result — decrease of in-hospital mortality. Mathehal and Methods. National recommendations on diagnostic and treatment of patients with myocardial infarction with ST-segment elevation on ECG (2007 were used to determine clinical result of treatment and key measures of medical care. To reveal major causes of clinical result non-achievement fishbone diagram was used. Results. Early reperfusion and optimal medical therapy were determined as the key measures of medical care delivered to patients with STe-ACS. The following indicators were developed to control these measures: «Primary reperfusion», «Thrombolysis in 30 minutes», «Primary percutaneous coronary intervention in 90 minutes», «Dual antiplatelet therapy in hospital», «Beta-blockers administration», «ACE-is/ARBs administration». The major causes of in-hospital mortality were separated. Indicators for assessment the major causes of clinical result non-achievement were proposed. Principal stages of performance measures creation were posed. Conclusion. Recommendation-based and clear definition of clinical result of treatment and key measures of the result achievement combined with methods of systems analysis allows development of evidence-based measures for assessment the quality of care delivered to patients with STe-ACS.

  10. Multidisciplinary management of anterior diastemata

    DEFF Research Database (Denmark)

    Furuse, Adilson Yoshio; Herkrath, Fernando José; Franco, Eduardo Jacomino

    2007-01-01

    Anterior diastemata may compromise the harmony of a patient's smile. Consideration of etiologic factors, previous gingival conditioning, and individual treatment planning are essential in the proper management of anterior diastemata. An integrated orthodontic-restorative approach may enhance...... the aesthetic results when orthodontic therapy itself is not feasible. This article presents integrated orthodonticrestorative solutions of anterior diastemata, associated with the conditioning of the gingival tissue with composite resin, and discusses the most relevant aspects related to their etiology...

  11. Correlation of segmental carpal tunnel pressures with changes in hand and wrist positions in patients with carpal tunnel syndrome and controls.

    Science.gov (United States)

    Luchetti, R; Schoenhuber, R; Nathan, P

    1998-10-01

    We investigated pressures at 1 cm intervals along the carpal tunnel in 39 patients with carpal tunnel syndrome (CTS) and 12 controls. Pressures were measured for relaxed and gripping hand positions in combination with neutral, extended, and flexed wrist positions. Patient pressures exceeded control pressures, were below the previously reported 30 mmHg threshold for four of five locations in the relaxed neutral position and were typically greater in extension than in flexion. In the neutral position, both patient and control pressures were slightly above threshold levels just distal to the tunnel. Maximum intratunnel pressures were generally found in the central part of the tunnel and minimum pressures in the distal tunnel. Gripping hand pressures in the tunnel were lowest with the wrist flexed. In both controls and CTS patients, only in the neutral wrist and relaxed hand positions were pressures highest at the point where nerve conduction studies have indicated the nerve is most likely to be compromised (in the midpalm just distal to the distal margin of the carpal tunnel).

  12. Homozygosity mapping of the gene for Chediak-Higashi syndrome to chromosome 1q42-q44 in a segment of conserved synteny that includes the mouse beige locus (bg)

    Energy Technology Data Exchange (ETDEWEB)

    Fukai, Kazuyoshi; Oh, Jangsuk; Karim, M.A. [Univ. of Wisconsin Medical School, Madison, WI (United States)] [and others

    1996-09-01

    Chediak-Higashi syndrome (CHS) is an autosomal recessive disorder characterized by hypopigmentation or oculocutaneous albinism and severe immunologic deficiency with neutropenia and lack of natural killer (NK) cell function. Most patients die in childhood from pyogenic infections or an unusual lymphoma-like condition. A hallmark of the disorder is giant inclusion bodies seen in all granule-containing cells, including granulocytes, lymphocytes, melanocytes, mast cells, and neurons. Similar ultrastructural abnormalities occur in the beige mouse, which thus has been suggested to be homologous to human CHS. High-resolution genetic mapping has indicated that the bg gene region of mouse chromosome 13 is likely homologous to the distal portion of human chromosome 1q. Accordingly, we carried out homozygosity mapping using markers derived from distal human chromosome 1q in four inbred families or probands with CHS. Our results indicate that the human CHS gene maps to an 18.8-cM interval in chromosome segment 1q42-q44 and that human CHS therefore is very likely homologous to mouse bg. 43 refs., 2 figs.

  13. Antithrombotic treatment advance of non-ST-segment elevation acute coronary syndrome%非 ST 段抬高型急性冠状动脉综合征抗栓治疗的研究进展

    Institute of Scientific and Technical Information of China (English)

    韦晓(综述); 尹瑞兴(审校)

    2014-01-01

    The antithrombotic treatment advance on non-ST-segment elevation acute coronary syndrome in re-cent several years was reviewed in this paper .There are two kinds of antithrombotic drugs , antiplatelet and anticoagu-lant drugs.The antiplatelet agents include aspirin , adenosine monophosphate (ADP) receptor antagonist and platelet membrane glycoprotein ( GPⅡb/Ⅲa) antibody antagonist .The anticoagulant drugs consist of heparin , low molecular weight heparin , anti factor Xa inhibitors and the direct thrombin inhibitor etc .%该文综述近年来非ST段抬高型急性冠状动脉综合征抗栓治疗的研究进展。抗栓药物包括抗血小板药和抗凝药,其中抗血小板药有阿司匹林、磷酸腺苷( ADP)受体拮抗剂和血小板膜糖蛋白( GPⅡb/Ⅲa)受体拮抗剂等;抗凝药有普通肝素和低分子肝素、抗Xa因子抑制药和直接凝血酶抑制剂等。

  14. Triple procedure in posterior segment intraocular foreign body

    Directory of Open Access Journals (Sweden)

    Azad Rajvardhan

    1998-01-01

    Full Text Available Three patients with intraocular foreign bodies and traumatic cataracts underwent single stage pars plana lensectomy with anterior capsule preservation, vitrectomy, removal of the foreign body, and intraocular lens implantation. The preserved anterior capsule permitted support for the placement of an intraocular lens in the posterior chamber in the ciliary sulcus. The procedure enabled early visual rehabilitation. This procedure seems useful in the management of posterior segment intraocular foreign body associated with cataract.

  15. Misdiagnosis induced intraocular lens dislocation in anterior megalophthalmos

    Institute of Scientific and Technical Information of China (English)

    WANG Qi-wei; XU Wen; ZHU Ya-nan; LI Jin-yu; ZHANG Li; YAO Ke

    2012-01-01

    Anterior megalophthalmos (AM) is an uncommon developmental anomaly of the anterior segment of the eye with a constellation of findings that includes enlarged cornea,deep anterior chamber,posterior positioning of the iris and lens,iris stroma atrophy,hypoplasia of iris dilator,pupil displacement,large capsular bag,lens subluxation,prematurely cataract and the tendency to retinal detachment.AM,especially when symptoms are mild,is not an easy disease to diagnose.We present 3 AM cases that were misdiagnosed as congenital cataract with weak zonule and megalocornea.Intraocular lenses (IOLs) dislocated after standard cataract surgeries and subsequent surgery (replacing the dislocated IOLs with iris-claw intraocular lenses) achieved satisfactory outcome.Although rare,AM should be included in the differential diagnosis of enlarged cornea and we recommend implanting Artisan lens in AM patients.

  16. Ectopic corticotroph syndrome

    Directory of Open Access Journals (Sweden)

    Penezić Zorana

    2004-01-01

    Full Text Available INTRODUCTION Endogenous Cushing's syndrome is a clinical state resulting from prolonged, inappropriate exposure to excessive endogenous secretion of Cortisol and hence excess circulating free cortisol, characterized by loss of the normal feedback mechanisms of the hypothalamo-pituitary-adrenal axis and the normal circadian rhythm of cortisol secretion [2]. The etiology of Cushing's syndrome may be excessive ACTH secretion from the pituitary gland, ectopic ACTH secretion by nonpituitary tumor, or excessive autonomous secretion of cortisol from a hyperfunctioning adrenal adenoma or carcinoma. Other than this broad ACTH-dependent and ACTH-independent categories, the syndrome may be caused by ectopic CRH secretion, PPNAD, MAH, ectopic action of GIP or catecholamines, and other adrenel-dependent processes associated with adrenocortical hyperfunction. CASE REPORT A 31 year-old men with b-month history of hyperpigmentation, weight gain and proximal myopathy was refereed to Institute of Endocrinology for evaluation of hypercortisolism. At admission, patient had classic cushingoid habit with plethoric face, dermal and muscle atrophy, abdominal strie rubrae and centripetal obesity. The standard laboratory data showed hyperglycaemia and hypokaliemia with high potassium excretion level. The circadian rhythm of cortisol secretion was blunted, with moderately elevated ACTH level, and without cortisol suppression after low-dose and high-dose dexamethason suppression test. Urinary 5HIAA was elevated. Abdominal and sellar region magnetic resonance imaging was negative. CRH stimulation resulted in ACTH increase of 87% of basal, but without significant increase of cortisol level, only 7%. Thoracal CT scan revealed 14 mm mass in right apical pulmonary segment. A wedge resection of anterior segment of right upper lobe was performed. Microscopic evaluation showed tumor tissue consisting of solid areas of uniform, oval cells with eosinophilic cytoplasm and centrally

  17. [Fuchs uveitis syndrome--heterochromia is no "conditio sine qua non"].

    Science.gov (United States)

    Becker, M D; Zierhut, M

    2005-07-01

    Fuchs uveitis syndrome (FUS) is typically a unilateral, chronic, low-grade inflammation of the anterior segment which manifests in young adulthood. It is underdiagnosed because of its variable clinical spectrum. Although it can mimic various forms of anterior uveitis, it is important to make the correct diagnosis, based on clinical grounds, because both the management and prognosis differ from those of other uveitides. While its etiology remains unknown, it is possible that the disease has multiple causes that lead through different pathogenic mechanisms to the same clinical entity. Although many patients do not require treatment, it is not a benign condition, as often perceived. The high incidence of glaucoma makes it mandatory that all patients with FUS should be screened at regular intervals, even if they are not being actively treated and are relatively asymptomatic.

  18. Study design and rationale of a comparison of prasugrel and clopidogrel in medically managed patients with unstable angina/non-ST-segment elevation myocardial infarction: the TaRgeted platelet Inhibition to cLarify the Optimal strateGy to medicallY manage Acute Coronary Syndromes (TRILOGY ACS

    DEFF Research Database (Denmark)

    Chin, Chee Tang; Roe, Matthew T; Fox, Keith A A;

    2010-01-01

    Practice guidelines recommend dual antiplatelet therapy with aspirin and clopidogrel for patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) regardless of in-hospital management strategy. Prasugrel-a thienopyridine adenosine diphosphate receptor antagonist that provides...... higher and less variable levels of platelet inhibition than clopidogrel-has demonstrated benefit when used to treat ACS patients undergoing percutaneous coronary intervention. However, the optimal approach to antiplatelet therapy for high-risk, medically managed NSTE ACS patients remains uncertain...

  19. Coloboma típico associado à síndrome de clivagem de câmara anterior e microcórnea: descrição de um caso Typical coloboma associated with anterior chamber cleavage syndrome, and microcornea: description of one case

    Directory of Open Access Journals (Sweden)

    Ana Regina Cruz Vlainich

    2004-02-01

    Full Text Available Os autores descrevem associação rara bilateral de coloboma da íris, coróide, retina e cabeça do nervo óptico, microcórnea e deficiência de clivagem de câmara anterior. Fazem também uma abordagem quanto à embriologia e à dificuldade de identificar se a causa da queda contínua e insidiosa da visão é devida ao próprio coloboma ou a outra doença associada, como o glaucoma. Os exames subsidiários disponíveis como campo visual, fundoscopia e tonometria, são de pouca confiabilidade devido ao nistagmo e à baixa acuidade visual.The authors describe a rare association of bilateral typical coloboma, microcornea and anterior chamber cleavage deficience. They also discuss the embriology and the difficulties to identify if the continuous and insidious vision impairment is due to coloboma or to other associated disease, like glaucoma. Supplementary tests, such as visual field, ophthalmoscopy, and tonometry are not reliable because of the presence of nistagmus and low visual acuity.

  20. [Familial Focal Segmental Glomerulosclerosis, a vademecum for clinical nephrologist].

    Science.gov (United States)

    Caridi, Gianluca; Lugani, Francesca; Bonanni, Elisa; Rossi, Roberta; Carrea, Alba; Ghiggeri, Gian Marco

    2015-01-01

    The new genomic technologies (Next Generation Sequencing, NGS) are opening a new era in Genomic Medicine. This simple guide gives a state-of-the-art description of the genes that cause Focal Segmental Glomerulosclerosis and nephrotic syndrome.

  1. Significance of lead aVR in acute coronary syndrome

    Institute of Scientific and Technical Information of China (English)

    Akira; Tamura

    2014-01-01

    The 12-lead electrocardiogram(ECG)is a crucial tool in the diagnosis and risk stratification of acute coronary syndrome(ACS).Unlike other 11 leads,lead aVR has been long neglected until recent years.However,recent investigations have shown that an analysis of ST-segment shift in lead aVR provides useful information on the coronary angiographic anatomy and risk stratification in ACS.ST-segment elevation in lead aVR can be caused by(1)transmural ischemia in the basal part of the interventricular septum caused by impaired coronary blood flow of the first major branch originating from the left anterior descending coronary artery;(2)transmural ischemia in the right ventricular outflow tract caused by impaired coronary blood flow of the large conal branch originating from the right coronary artery;and(3)reciprocal changes opposite to ischemic or non-ischemic ST-segment depression in the lateral limb and precordial leads.On the other hand,ST-segment depression in lead aVR can be caused by transmural ischemia in the inferolateral and apical regions.It has been recently shown that an analysis of T wave in lead aVR also provides useful prognostic information in the general population and patients with prior myocardial infarction.Cardiologists should pay more attention to the tracing of lead aVR when interpreting the12-lead ECG in clinical practice.

  2. The NEtherlands Cervical Kinematics (NECK Trial. Cost-effectiveness of anterior cervical discectomy with or without interbody fusion and arthroplasty in the treatment of cervical disc herniation; a double-blind randomised multicenter study

    Directory of Open Access Journals (Sweden)

    van den Akker Elske

    2010-06-01

    Full Text Available Abstract Background Patients with cervical radicular syndrome due to disc herniation refractory to conservative treatment are offered surgical treatment. Anterior cervical discectomy is the standard procedure, often in combination with interbody fusion. Accelerated adjacent disc degeneration is a known entity on the long term. Recently, cervical disc prostheses are developed to maintain motion and possibly reduce the incidence of adjacent disc degeneration. A comparative cost-effectiveness study focused on adjacent segment degeneration and functional outcome has not been performed yet. We present the design of the NECK trial, a randomised study on cost-effectiveness of anterior cervical discectomy with or without interbody fusion and arthroplasty in patients with cervical disc herniation. Methods/Design Patients (age 18-65 years presenting with radicular signs due to single level cervical disc herniation lasting more than 8 weeks are included. Patients will be randomised into 3 groups: anterior discectomy only, anterior discectomy with interbody fusion, and anterior discectomy with disc prosthesis. The primary outcome measure is symptomatic adjacent disc degeneration at 2 and 5 years after surgery. Other outcome parameters will be the Neck Disability Index, perceived recovery, arm and neck pain, complications, re-operations, quality of life, job satisfaction, anxiety and depression assessment, medical consumption, absenteeism, and costs. The study is a randomised prospective multicenter trial, in which 3 surgical techniques are compared in a parallel group design. Patients and research nurses will be kept blinded of the allocated treatment for 2 years. The follow-up period is 5 years. Discussion Currently, anterior cervical discectomy with fusion is the golden standard in the surgical treatment of cervical disc herniation. Whether additional interbody fusion or disc prothesis is necessary and cost-effective will be determined by this trial

  3. [Despite medication, overdrive pacing is required to stabilize the electrical storm associated with acute coronary syndrome: a case report].

    Science.gov (United States)

    Umeda, Masanobu; Morimoto, Atsushi; Yokoyama, Kaori; Tateishi, Emi; Makino, Kanako; Yamamoto, Kazuo; Nakagawa, Yoko; Fukuhara, Shinya; Takase, Eiji

    2007-10-01

    A 75-year-old female complained of severe chest pain and was emergently admitted to our hospital because of anterior acute myocardial infarction. Emergent coronary angiography was performed and revealed occlusion in segment 7, so a stent was implanted. Lidocaine, carvedilol, amiodarone, magnesium, and nifekalant were administered successively because non-sustained ventricular tachycardia (NSVT) frequently appeared like an electrical storm. After nifekalant administration, QTc was significantly prolonged and torsades de pointes was induced. Overdrive pacing was performed and finally the NSVT was completely controlled. If fatal arrhythmias such as NSVT show resistance to medication, overdrive pacing should be considered to stabilize the arrhythmia associated with acute coronary syndrome.

  4. Endoscopic anterior decompression in cervical disc disease

    Directory of Open Access Journals (Sweden)

    Yad Ram Yadav

    2014-01-01

    Full Text Available Background: Although microscopic anterior cervical discectomy with or without fusion are common surgical procedures for treatment of cervical herniated discs, loss of disc height, pseudarthrosis, and adjacent disc degeneration are some of the problems associated with it. This study is aimed to evaluate results of endoscopic microforaminotomy in cervical disc diseases. Materials and Methods: A prospective study of 50 patients of mono segmental soft or hard disc causing myeloradiculopathy was undertaken. A visual analogue scale (VAS for neck and arm pain and functional outcomes using the Nurick grading system were assessed. There were 28, 12, 8, and 2 patients at C5-6, C6-7, C4-5, and C3-4 levels disc diseases, respectively. Patients with two or more level disc, instabilities, disc extending more than half vertebral body height, and previous operation at the same segment were excluded. Results: Age ranged from 21 to 67 years. Average postoperative reduction in disc height, operating time, and blood loss was 1.1 mm, 110 minutes, and 30 ml, respectively. Average pre-operative VAS score for arm pain and Nurick grading was 7.6 and 2.7, which improved to 1.9 and 0.82, respectively. All patients improved; 1, 2, 3 grade improvement was seen in 10, 27, and 10 patients, respectively. There was no significant complication or any mortality. Conclusion: Although longer follow up of large number of patients is required, endoscopic microforaminotomy is a safe and an effective alternative to microscopic anterior discectomy with or without fusion.

  5. Inestabilidad Anterior de Hombro

    Directory of Open Access Journals (Sweden)

    Pablo David Flint Kuran

    2013-11-01

    Full Text Available In­tro­duc­ción La luxación recidivante de hombro es una patología frecuente en pacientes jóvenes, laboralmente activos. Existen numerosas técnicas quirúrgicas para la inestabilidad glenohumeral. La técnica de Bristow, discutida por no ser anatómica y por sus complicaciones, continúa vigente debido al bajo índice de reluxaciones. Los objetivos fueron determinar el índice de recidiva, alteraciones funcionales e índice de consolidación del injerto. Materiales­ y­ Métodos Se evaluaron 24 pacientes del sexo masculino, de entre 19 y 40 años, operados por luxación anterior recidivante de hombro según la técnica de Bristow, entre enero de 2003 y agosto de 2011. Se evaluó la tasa de reluxación, la función articular según el puntaje de Constant y el posicionamiento del injerto con respecto a la superficie articular con tomografía y radiografías para evaluar la consolidación del injerto. Se registraron las complicaciones quirúrgicas. Resultados ­Todos los pacientes eran hombres, con rango de edad de 19 a 40 años. La causa fue traumática en 24 pacientes. Dieciséis pacientes presentaron más de 3 episodios de luxación prequirúrgicos. Según la escala de Constant, 21 obtuvieron entre 96 y 100 puntos, y los restantes, entre 90 y 95 puntos. No hubo nuevos episodios de luxaciones. La tomografía mostró la consolidación en todos los casos. Un paciente tuvo una imagen osteolítica alrededor del tornillo, sin compromiso funcional del hombro. Conclusión La técnica de Bristow para tratar la luxación anterior recidivante de hombro provocó un bajo índice de complicaciones, con resultados funcionales entre excelentes y buenos. No hubo episodios de reluxación y se logró la consolidación del injerto óseo en todos los casos.

  6. 微螺钉结合片段弓技术内收上前牙的临床研究%Micro-screw with Segmental Arch Technique for En-masse Retraction of Maxillary Anterior Teeth:A Clinical Cephalometric Study

    Institute of Scientific and Technical Information of China (English)

    张燕琴; 林新平

    2013-01-01

    目的:评估微螺钉结合片段弓技术内收上前牙对上切牙垂直向和转矩控制的效果.方法:选取16例上颌前突患者分为实验组(微螺钉结合片段弓技术)和对照组(微螺钉全牙弓).测量治疗前后的X线头颅定位侧位片相关指标,使用SPSS17.0软件分析.结果:实验组上切牙切缘至RL(通过翼上颌裂点作腭平面的垂线)距离U1E-RL减小7.26 mm,阻抗中心至RL距离U1CR-RL减小3.72 mm,根尖至RL距离U1AP-RL减小1.23 mm,切缘至腭平面的距离U1E-PP增加0.49 mm,阻抗中心至腭平面的距离U1CR-PP减小0.19 mm,根尖至腭平面的距离U1AP-PP减小0.25 mm,上切牙长轴与腭平面交角U1-PP减小11.65°;对照组U1E-RL减小6.18mm,U1CR-RL减小2.94 mm,减小U1AP-RL 0.47 mm,U1E-PP增加0.53 mm,U1CR-PP增加0.27 mm,U1 AP-PP增加0.28 mm,U1-PP减小16.31°.结论:微螺钉结合片段弓技术内收上前牙对上切牙的转矩和垂直向控制较好.%Objective:To evaluate the efficiency of micro-screw with segmental arch technique for en-masse retraction of maxillary anterior teeth.Methods:Sixteen subjects with upper dental alveolar bone protrusion were selected for this study.They were divided into two groups:experimental group (micros-crew with sectional arch technique) and control group (micro-screw with the whole arch).Torque and vertical of the central incisor were evaluated cephalometrically before and after orthodontic retraction.All data were analyzed by SPSS17.0 software.Results:Experimental group:U1E-RL was decreased by 7.26mm,U1CR-RL was decreased by 3.72mm,U1AP -RL was decreased by 1.23mm,U1E-PP was increased by 0.49mm,U1CR-PP was decreased by 0.19mm,U1AP-PP was decreased by 0.25mm,U1-PP was decreased by 11.65°; control group:U1E-RL was decreased by 6.18mm,U1CR-RL was decreased by 2.94mm,U1AP-RL was decreased by 0.47mm,U1E-PP was increased by 0.53mm,U1CR-PP was increased by 0.27mm,U1AP-PP was increased by 0.28mm,U1-PP was decreased by 16.31

  7. 节段性神经肌肉疗法治疗肌筋膜痛综合征临床疗效观察%Observations on the Therapeutic Effect of Segmental Neuromyotherapy on Myofascial Pain Syndrome

    Institute of Scientific and Technical Information of China (English)

    邓磊; 郑敏

    2012-01-01

    目的:观察节段性神经肌肉疗法(Segmental Neuromyotherapy,SNMT)治疗肌筋膜痛综合征的疗效。方法:选取36例肌筋膜痛综合征患者,所有患者进行SNMT治疗。每例患者在SNMT治疗前、后及治疗后1个月、3个月进行0~10数字分级量表(Numeric Rating Scale,NRS)评定。结果:SNMT治疗前NRS评分平均为8.12±1.21分,治疗后即刻降至3.62±1.64分,与治疗前比有显著性差异(P=0.000);治疗后1个月为3.36±1.78分,与治疗前比有显著性差异(P=0.044);治疗后3个月为3.28±1.42分,与治疗前比有显著性差异(P=0.044)。结论:SNMT对肌筋膜痛综合征所致神经肌肉骨骼性疼痛具有明显改善作用,疗效持久。%Purpose: To study the effect of segmental neuromyotherapy(SNMT) on myofascial pain syndrome patients(MPS).Methods: 36 MPS patients were involved in this study.All the patients received SNMT therapy.0~10 Numeric Rating Scale(NRS) were valued by the patients before and after SNMT therapy,and 1 month、3 months after the treatment.Results: The average NRS marks were 8.12±1.21分before SNMT therapy and 3.62±1.64 immediately after,3.36±1.78 1 months after,3.28±1.42 3 months after.All of the latter changed significantly to the marks before SNMT therapy(P=0.000 and 0.044 seperately).All of the latter changed significantly(P=0.001 and 0.000 seperately).Conclusions: SNMT can help to reduce the pain of MPS,and has immediate and long-term effects on MPS.

  8. Prognostic value of clinical variables at presentation in patients with non-ST-segment elevation acute coronary syndromes: results of the Proyecto de Estudio del Pronóstico de la Angina (PEPA).

    Science.gov (United States)

    López de Sá, Esteban; López-Sendón, José; Anguera, Ignasi; Bethencourt, Armando; Bosch, Xavier

    2002-11-01

    Patients with suspected non-ST-segment elevation acute coronary syndromes (NSTEACS) constitute a heterogeneous population with variable outcomes. Risk stratification in this population of patients is difficult due to the complexity in patient risk profile. We conducted this study to characterize the value of clinical and electrocardiographic variables for risk stratification in an unselected population of consecutive patients with NSTEACS on admission. Thirty-five clinical and electrocardiographic variables at presentation in the emergency room of 18 hospitals were prospectively analyzed in 4,115 patients with NSTEACS and related with the outcomes at 90 days. We also developed a risk score using the variables found to be independent predictors of ischemic events to facilitate risk stratification. Cardiovascular mortality was 4.3% and the rate for the outcome of either cardiovascular death or nonfatal myocardial infarction was 6.9%. The only independent predictors of mortality were age, diabetes, peripheral vascular disease, postinfarction angina, Killip class > or = 2, ST-segment depression, and elevation of cardiac markers. A risk profile using the variables found to be independent predictors of events was calculated for cardiovascular mortality and for the combination of either death or nonfatal myocardial infarction. Event rates increased significantly in all subgroups of patients based on the number of independent risk factors as the risk score increased. Using these factors, 90-day mortality ranged from as low as 0.4% in patients with no risk factors to 21.1% for those with more than 4 risk factors. In conclusion, simple clinical and electrocardiographic data obtained at hospital admission allow an accurate risk stratification of patients with NSTEACS. In the PEPA registry, simple variables easy to obtain at admission appear to be a valuable tool in discerning between patients at very low and very high risk according to the cluster of factors for each patient

  9. [Aneurysm of the anterior inferior cerebellar artery: case report].

    Science.gov (United States)

    Adorno, Juan Oscar Alarcón; de Andrade, Guilherme Cabral

    2002-12-01

    The intracranial aneurysms of the posterior circulation have been reported between 5 and 10% of all cerebral aneurysms and the aneurysms of the anterior inferior cerebellar artery (AICA) are considered rare, can cause cerebello pontine angle (CPA) syndrome with or without subarachnoid hemorrhage. Since 1948 few cases were described in the literature. We report on a 33 year-old female patient with subarachnoid hemorrhage due to sacular aneurysm of the left AICA. She was submitted to clipage of the aneurysm without complications.

  10. Congenital heart defects in two siblings in an Axenfeld-Rieger syndrome family.

    Science.gov (United States)

    Akkus, Mehmet Necdet; Argin, Atilla

    2010-04-01

    Axenfeld-Rieger syndrome is a genetically heterogeneous, autosomal dominant disorder characterized by anomalies of the anterior segment of the eye, face, teeth, and umbilicus. Many other extraocular findings, including congenital heart defects, have been reported in association with this syndrome. It has been suggested by some investigators that the coexistence of Axenfeld-Rieger syndrome and congenital heart defects is not a chance event but it represents a distinct entity. We report a family in which four members in three generations have typical ocular features of Axenfeld-Rieger syndrome. Two of them, who are siblings, also have congenital heart defects. The congenital heart defect was bicuspid aortic valve anomaly with severe stenosis and mild regurgitation in one sibling and ostium secundum atrial septal defect in the other. To our knowledge, the combination of congenital heart defects with Axenfeld-Rieger syndrome in siblings has not been reported previously. Our observation further strengthens the notion that Axenfeld-Rieger syndrome associated with congenital heart defects is not a chance event.

  11. Segmentation Similarity and Agreement

    CERN Document Server

    Fournier, Chris

    2012-01-01

    We propose a new segmentation evaluation metric, called segmentation similarity (S), that quantifies the similarity between two segmentations as the proportion of boundaries that are not transformed when comparing them using edit distance, essentially using edit distance as a penalty function and scaling penalties by segmentation size. We propose several adapted inter-annotator agreement coefficients which use S that are suitable for segmentation. We show that S is configurable enough to suit a wide variety of segmentation evaluations, and is an improvement upon the state of the art. We also propose using inter-annotator agreement coefficients to evaluate automatic segmenters in terms of human performance.

  12. SAPHO syndrome associated spondylitis.

    Science.gov (United States)

    Takigawa, Tomoyuki; Tanaka, Masato; Nakanishi, Kazuo; Misawa, Haruo; Sugimoto, Yoshihisa; Takahata, Tomohiro; Nakahara, Hiroyuki; Nakahara, Shinnosuke; Ozaki, Toshifumi

    2008-10-01

    The concept of synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome has been well clarified, after Chamot et al. suggested this peculiar disorder in 1987. The most commonly affected site in SAPHO syndrome is the anterior chest, followed by the spine. However, the clinical course and taxonomic concept of SAPHO spinal lesions are poorly understood. This study was performed to analyze: (1) the detailed clinical course of spinal lesions in SAPHO syndrome, and (2) the relationship between SAPHO syndrome with spinal lesions and seronegative spondyloarthropathy. Thirteen patients with spondylitis in SAPHO syndrome were analyzed. The features of spinal lesions were a chronic onset with a slight inflammatory reaction, and slowly progressing non-marginal syndesmophytes at multi spinal levels, besides the coexistence of specific skin lesions. SAPHO syndrome, especially spinal lesions related to palmoplantar pustulosis, can be recognized as a subtype of seronegative spondyloarthropathy.

  13. 非ST段抬高型急性冠状动脉综合征抗栓治疗进展%Antithrombotic Treatment Advance on non-ST-segment Elevation Acute Coronary Syndrome

    Institute of Scientific and Technical Information of China (English)

    韦晓(综述); 尹瑞兴(审校)

    2014-01-01

    The treatment of non-ST-segment elevation acute coronary syndromes includes medical treat-ment,percutaneous coronary intervention and coronary artery bypass grafting,and antithrombotic therapy sig-nificantly reduces mortality in patients and the incidence of myocardial infarction and disability rate,and im-proving the quality of life of patients. There are two kinds of antithrombotic drugs,antiplatelet and anticoagu-lant drugs. The antiplatelet agents include aspirin,adenosine monophosphate receptor antagonist and platelet membrane glycoprotein antibody antagonist. The anticoagulant drugs consist of heparin,low molecular weight heparin,anti factor Ⅹa inhibitors and the direct thrombin inhibitor etc.%非ST段抬高急性冠状动脉综合征的治疗包括药物治疗、经皮腔内冠状动脉介入治疗和冠状动脉旁路移植术,而抗栓药物治疗大大减少了患者的病死率、心肌梗死发生率及致残率,同时提高患者生活质量。抗栓药物包括抗血小板和抗凝药。其中抗血小板药有阿司匹林、磷酸腺苷受体拮抗剂和血小板膜糖蛋白抗体拮抗剂等;抗凝药有普通肝素和低分子肝素、抗Ⅹa因子抑制药和直接凝血酶抑制剂等。

  14. STUDY ON VARIATIONS OF INFERIOR SEGMENTAL BRANCH OF RENAL ARTERY

    Directory of Open Access Journals (Sweden)

    Chandragirish S

    2014-11-01

    Full Text Available Background: The segmental arteries of the kidney supply the organ in such a way that, each renal pole receives its own artery while, the anterior portion between the poles is supplied by an upper and lower segmental vessel. These two arteries also include in their territory the lateral edge of the kidney and adjacent to the strip of parenchyma on the dorsal or posterior aspect of the organ. The knowledge of inferior segmental branch of renal artery is very important for surgeries in its distribution area in kidney. Materials and Methods: 100 kidneys (Fifty pairs intact with abdominal aorta were collected from department of Forensic medicine, JSS Medical College and Mysore Medical College. For study of segmental variation Corrosion cast technique method was used. The variations of inferior segmental branch of renal artery were observed and recorded. Results: In present study type I inferior segmental branch of renal artery were found in - 59% cases, type II in - 6% cases, type III in - 28% cases, type IV in - 2% cases. Conclusion: The inferior segmental artery from the anterior division of the renal artery is the commonest event –arising in 59%. This is Type I, the normal type. It arises from the renal artery (28% or from the posterior division (6% or from the aorta (2%. The knowledge of inferior segmental branch of renal artery helpful in kidney transplantation and renal surgery because these type of surgeries success mainly depends on arterial ligations.

  15. Thoracolumbar kyphoscoliosis with unilateral subluxation of the spine and postoperative lumbar spondylolisthesis in Hunter syndrome.

    Science.gov (United States)

    Roberts, Simon B; Tsirikos, Athanasios I

    2016-03-01

    Surgical correction for kyphoscoliosis is increasingly being performed for patients with mucopolysaccharidosis (MPS). Reported case series have predominantly included patients with Type I (Hurler) and Type IV (Morquio) MPS. To their knowledge, the authors describe the first case report of surgical management of thoracolumbar kyphoscoliosis in Hunter syndrome (MPS Type II) and the rare occurrence of lumbar spondylolisthesis following surgical stabilization. A 12-year-old boy with Hunter syndrome presented with severe thoracolumbar kyphoscoliosis and no associated symptoms. Spinal radiographs demonstrated kyphosis of 48° (T11-L3) and scoliosis of 22° (T11-L3) with an anteriorly hypoplastic L-1 vertebra. The deformity progressed to kyphosis of 60° and scoliosis of 42° prior to surgical intervention. Spinal CT scans identified left T12-L1 facet subluxation, causing anterior rotatory displacement of the spine proximal to L-1 and bilateral L-5 isthmic spondylolysis with no spondylolisthesis. A combined single-stage anterior and posterior instrumented spinal arthrodesis from T-9 to L-4 was performed. Kyphosis and scoliosis were corrected to 4° and 0°, respectively. Prolonged ventilator support and nasogastric feedings were required for 3 months postoperatively. At 2.5 years following surgery, the patient was asymptomatic, mobilizing independently, and had achieved a solid spinal fusion. However, he had also developed a Grade II spondylolisthesis at L4-5; this was managed nonoperatively in the absence of symptoms or further deterioration of the spondylolisthesis to the 3.5-year postoperative follow-up visit. Satisfactory correction of thoracolumbar kyphoscoliosis in Hunter syndrome can be achieved by combined anterior/posterior instrumented arthrodesis. The risk of developing deformity or instability in motion segments adjacent to an instrumented fusion may be greater in patients with MPS related to the underlying connective tissue disorder.

  16. Segment lengths influence hill walking strategies.

    Science.gov (United States)

    Sheehan, Riley C; Gottschall, Jinger S

    2014-08-22

    Segment lengths are known to influence walking kinematics and muscle activity patterns. During level walking at the same speed, taller individuals take longer, slower strides than shorter individuals. Based on this, we sought to determine if segment lengths also influenced hill walking strategies. We hypothesized that individuals with longer segments would display more joint flexion going uphill and more extension going downhill as well as greater lateral gastrocnemius and vastus lateralis activity in both directions. Twenty young adults of varying heights (below 155 cm to above 188 cm) walked at 1.25 m/s on a level treadmill as well as 6° and 12° up and downhill slopes while we collected kinematic and muscle activity data. Subsequently, we ran linear regressions for each of the variables with height, leg, thigh, and shank length. Despite our population having twice the anthropometric variability, the level and hill walking patterns matched closely with previous studies. While there were significant differences between level and hill walking, there were few hill walking variables that were correlated with segment length. In support of our hypothesis, taller individuals had greater knee and ankle flexion during uphill walking. However, the majority of the correlations were between tibialis anterior and lateral gastrocnemius activities and shank length. Contrary to our hypothesis, relative step length and muscle activity decreased with segment length, specifically shank length. In summary, it appears that individuals with shorter segments require greater propulsion and toe clearance during uphill walking as well as greater braking and stability during downhill walking.

  17. [Atypical form of tako-tsubo cardiomyopathy in a patient with atrial fibrillation in Wolff-Parkinson-White syndrome complicated with ventricular fibrillation: the diagnostic problems].

    Science.gov (United States)

    Kukla, Piotr; Stec, Sebastian; Karbarz, Dariusz; Wrzosek, Bożena; Jastrzębski, Marek; Kluczewski, Maciej; Kurdzielewicz, Wojciech

    2013-01-01

    Atypical form of tako-tsubo cardiomyopathy (TTC) is associated with regional wall motion abnormalities in basal and/or middle segments or only middle segments with sparing of apical segments or apical and basal segments. We described a case of47-year-old female with atypical form of TTC due to fast atrial fibrillation that converted into ventricular fibrillation in WPW syndrome. The echocardiogram made after direct current cardioversion revealed decreased left ventricular ejection fraction (LVEF 35%) with akinesis of inferior and posterior walls and anterior part of interventricular septum in the middle and the basal segments with hyperkinesis of apical segments. The biochemistry blood samples revealed elevated both troponin T- 0.35 ng/mL and NT-proBNP - 3550 pg/mL plasma level. The ECG showed sinus rhythm 62 bpm, shortened PQ interval 100 ms, widened QRS duration - 115 ms with delta wave, prolonged QT interval - 520 ms, QS in leads: II, III, aVF. NegativeT waves in leads: I, aVL and positive, symmetrical T waves in leads V1-V6. The coronarography revealed normal coronaryarteries. The control echocardiography after 10 days showed normal LVEF 70%, without any wall motion abnormalities. TTC was recognised based on: history of sudden stress situation before, ischaemic ECG changes, positive markers of myocardial injury, transient segmental wall motion abnormalities and normal coronary arteries. The ablation of right postero-septal accessory pathway was successfully performed.

  18. Carotid-anterior cerebral artery anastomosis on MR angiography: a university hospital-based study

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, Akira; Saito, Naoko; Okada, Yoshitaka; Inoue, Kaiji [Saitama Medical University International Medical Center, Department of Dia