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American Journal of Ophthalmology Jun 2022To compare prostaglandin E2 (PGE-2) levels in the aqueous and pupil diameter in patients undergoing low-pulse energy femtosecond laser-assisted cataract surgery (LCS)... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
To compare prostaglandin E2 (PGE-2) levels in the aqueous and pupil diameter in patients undergoing low-pulse energy femtosecond laser-assisted cataract surgery (LCS) without non-steroidal anti-inflammatory (NSAID) pretreatment with either fragmentation or capsulotomy performed first.
DESIGN
Prospective, randomized, fellow-eye controlled comparison.
METHODS
This study was undertaken at the Department of Ophthalmology, Medical University of Vienna. The population consisted of 140 eyes of 70 patients with bilateral age-related cataract. Bilateral same-day LCS with either anterior capsulotomy before lens fragmentation (Caps-First) in one eye or vice versa (Frag-First) in a random sequence were performed. Aqueous was tapped 5 minutes after LCS and PGE-2 concentration was analyzed. Pupil diameters were recorded immediately before and after femtosecond laser pretreatment. The main outcome measure was PGE-2 concentrations in picograms/milliliter and pupil diameter in millimeters.
RESULTS
Mean PGE-2 concentrations were 42.0 ± 63.7 pg/mL in the Caps-First group versus 71.8 ± 160.7 pg/mL with the Frag-First group (P = .186). Mean pupil diameters before and after pretreatment were 7.6 ± 0.8 mm and 7.6 ± 0.8 mm, respectively (P = .871). Mean PGE-2 concentrations and pupil diameters did not show any significant difference between time points or groups.
CONCLUSIONS
Low-energy femtosecond laser pretreatment did not increase PGE-2 levels in the absence of NSAID pretreatment. This was independent of whether capsulotomy or fragmentation was performed first. Moreover, no pupillary miosis was observed.
Topics: Anti-Inflammatory Agents, Non-Steroidal; Cataract; Cataract Extraction; Humans; Laser Therapy; Lasers; Phacoemulsification; Premedication; Prospective Studies; Prostaglandins; Prostaglandins E
PubMed: 35033540
DOI: 10.1016/j.ajo.2022.01.002 -
Neural Regeneration Research May 2024Microvasculature of the retina is considered an alternative marker of cerebral vascular risk in healthy populations. However, the ability of retinal vasculature changes,...
Microvasculature of the retina is considered an alternative marker of cerebral vascular risk in healthy populations. However, the ability of retinal vasculature changes, specifically focusing on retinal vessel diameter, to predict the recurrence of cerebrovascular events in patients with ischemic stroke has not been determined comprehensively. While previous studies have shown a link between retinal vessel diameter and recurrent cerebrovascular events, they have not incorporated this information into a predictive model. Therefore, this study aimed to investigate the relationship between retinal vessel diameter and subsequent cerebrovascular events in patients with acute ischemic stroke. Additionally, we sought to establish a predictive model by combining retinal veessel diameter with traditional risk factors. We performed a prospective observational study of 141 patients with acute ischemic stroke who were admitted to the First Affiliated Hospital of Jinan University. All of these patients underwent digital retinal imaging within 72 hours of admission and were followed up for 3 years. We found that, after adjusting for related risk factors, patients with acute ischemic stroke with mean arteriolar diameter within 0.5-1.0 disc diameters of the disc margin (MAD) of ≥ 74.14 μm and mean venular diameter within 0.5-1.0 disc diameters of the disc margin (MVD) of ≥ 83.91 μm tended to experience recurrent cerebrovascular events. We established three multivariate Cox proportional hazard regression models: model 1 included traditional risk factors, model 2 added MAD to model 1, and model 3 added MVD to model 1. Model 3 had the greatest potential to predict subsequent cerebrovascular events, followed by model 2, and finally model 1. These findings indicate that combining retinal venular or arteriolar diameter with traditional risk factors could improve the prediction of recurrent cerebrovascular events in patients with acute ischemic stroke, and that retinal imaging could be a useful and non-invasive method for identifying high-risk patients who require closer monitoring and more aggressive management.
PubMed: 37862222
DOI: 10.4103/1673-5374.382863 -
Expert Review of Medical Devices Jun 2020To assess the repeatability of ocular biometric parameters using a high-resolution imaging device.
PURPOSE
To assess the repeatability of ocular biometric parameters using a high-resolution imaging device.
METHODS
74 healthy right eyes were included in this study. Five-repeated measurements were taken with ANTERION high-resolution swept-source optical coherence tomographer (SS-OCT) to measure: corneal thickness (central and at 2, 4 and 6-mm diameters), aqueous depth (AD), lens thickness (LT), anterior chamber volume (ACV), axial length (AL), and pupil (diameter and position). The intrasubject standard deviation (S), coefficient of repeatability (CoR) and intraclass correlation coefficient (ICC) were calculated. Bland-Altman method was applied to analyze the difference between the first and the last measurement. The average and the difference between both measurements were calculated for all parameters.
RESULTS
We have not found statistically significant differences between repeated measurements (p > 0.05). The mean difference for corneal thickness was between -0.08 and 0.28 μm. For AD and LT was 0.004 and -0.004 μm, respectively. ACV mean difference was -0.03 mm and for AL was 0.001 mm. Pupil diameter and position mean differences ranged between -0.008 and 0.009 mm. Overall, most ocular parameters had a S <1 and a CoR <2 in their respective units, and an ICC >0.92.
CONCLUSIONS
The ANTERION high-resolution SS-OCT device provides good repeatability for different ocular biometric measurements.
Topics: Adult; Aged; Anterior Chamber; Biometry; Eye; Female; Humans; Lens, Crystalline; Male; Middle Aged; Pupil; Reproducibility of Results; Tomography, Optical Coherence; Young Adult
PubMed: 32425075
DOI: 10.1080/17434440.2020.1772050 -
Cureus Sep 2022The anthropometry of the proximal femur holds great clinical significance in designing implants and prostheses for proximal femoral fractures and hip joint...
The anthropometry of the proximal femur holds great clinical significance in designing implants and prostheses for proximal femoral fractures and hip joint arthroplasties. Surgical fixation with a properly matched prosthesis plays a crucial role in improving long-term treatment outcomes and preventing post-operative complications such as osteolysis with aseptic loosening and increased load. The femur is also one of the most commonest used bones for stature estimation. Often during forensic investigations, only fragmented remains of femur are found available from which femoral length is estimated by application of linear regression equations. The estimated femoral length thus obtained is used for stature estimation of the unidentified individual. This study has measured nine bony parameters from the proximal femur in a total of 96 dry femora. These measurements include the vertical head diameter, neck diameter, neck thickness, neck length, neck shaft angle, the transverse diameter of the fovea, longitudinal diameter of the fovea, foveal depth, and the intertrochanteric line length. In addition, the total length of the femur was also measured. The results were tabulated and statistically analyzed using SPSS software, version 25. The mean femoral head diameter was observed to be 41.59±3.25 mm, mean foveal depth was found to be 2.95±0.75 mm, mean foveal transverse and longitudinal diameters were observed to be 11.38±2.35 mm and 15.94±3.37 mm, respectively. The mean neck diameter was 29.45±3.33 mm. Mean neck length and neck thickness were observed to be 36.06±4.94 mm and 27.61±2.71 mm, respectively. Neck shaft angle was noted to range from 109° to 128°, with a mean of 119.08°±5.18°. The mean length of the inter-trochanteric line was measured to be 41.92±3.9 mm. The mean femoral length was observed to be 42.11±2.91 cm. Significant positive correlations were found between the various measured proximal morphometric parameters of the femur. The length of the femur showed a maximum positive correlation with the vertical head diameter, followed by the neck diameter, thickness, and foveal depth. The findings of this study can throw further light on the existing data. They can serve as a guideline for designing better-matched prostheses and implants for hip surgeries in the eastern Uttar Pradesh population.
PubMed: 36225441
DOI: 10.7759/cureus.28780 -
Annals of Plastic Surgery Aug 2017One of the clinical aspects characterizing gynecomastia is the enlargement of the nipple-areolar complex (NAC) due to hypertrophic breast glands, and the excessive fatty...
BACKGROUND
One of the clinical aspects characterizing gynecomastia is the enlargement of the nipple-areolar complex (NAC) due to hypertrophic breast glands, and the excessive fatty tissue underneath.
OBJECTIVE
The purpose of this study was to quantify the reduction of the areolar diameter after ultrasound-assisted liposuction (UAL) of the male breast.
METHODS
The horizontal diameters of the NACs of 30 men who underwent UAL were measured before surgery, 1 month after surgery and 6 months after surgery in a standard fashion. Those patients with surgical gland removals of any kind were not included in this study.
RESULTS
The mean age of the patients was 27.9 years, and all of the patients had bilateral grade I, II, or III gynecomastia. The mean diameter of the NACs before surgery was 35.36 mm (range, 26-55 mm), and after surgery, the mean diameter of the NACs was initially reduced to 28.8 mm (range, 23-44 mm) and later to 28.57 mm (range, 23-42 mm). The mean volume of breast tissue aspirated was 382 mL per breast, and the percentage of reduction was 17.3%. The reduction of areola diameter was statistically significant after first month. A significant positive correlation was identified between the liposuction volume and areolar diameter reduction.
CONCLUSIONS
In cases of gynecomastia, the removal of the glandular and fatty tissue underneath the areola releases the expanding forces and pressure that enlarge it. In many cases of gynecomastia, UAL alone is effective in reducing the size of the NAC and allows the surgeon to avoid placing scars on the breast.
Topics: Adolescent; Adult; Follow-Up Studies; Gynecomastia; Humans; Lipectomy; Male; Middle Aged; Nipples; Treatment Outcome; Ultrasonography, Interventional; Young Adult
PubMed: 28252545
DOI: 10.1097/SAP.0000000000000994 -
Khirurgiia 2023To study functional anatomy of the right gastroepiploic artery (RGEA), its gastric and omental branches and practical significance of these anatomical features.
OBJECTIVE
To study functional anatomy of the right gastroepiploic artery (RGEA), its gastric and omental branches and practical significance of these anatomical features.
MATERIAL AND METHODS
We analyzed 20 cadaveric organ complexes (11 men and 9 women, aged 49-85 years) between 2018 and 2019. The organ complexes consisted of the stomach, proximal duodenum and large omentum. RGEA catheterization at the level of pylorus was followed by selective real time angiography. We assessed the following parameters of RGEA: total length, diameter at the level of pylorus, number and diameter of gastric and omental branches. To objectify the study, we visually divided RGEA into 5 equal segments between pylorus and the last branch arising from this artery.
RESULTS
The RGEA looks like a gradually and evenly narrowing tube. Mean diameter of the artery at the level of pylorus was 2.2±0.68 mm, mean length - 23.6±3.7 cm. Mean number of gastric and omental branches was 16.2±4.8 and 8.6±2.6, respectively. The number of gastric branches in the distal part of the RGEA increased, while the diameters of the gastric branches did not significantly differ. The number of gastric branches in distal RGEA increased, while diameters of gastric branches were similar. The greatest number of omental branches with the largest diameter was observed in the 2 and 3 segments of the artery. Considering these data, we formulated the equation for RGEA hemodynamics and developed the technique for optimal blood supply to proximal part of the gastric transplant during esophagogastroplasty.
CONCLUSION
Anatomical features of the right gastroepiploic artery can be used in reconstructive surgery of abdominal cavity and chest.
Topics: Male; Humans; Female; Gastroepiploic Artery; Coronary Artery Bypass; Stomach; Hepatic Artery; Hemodynamics
PubMed: 37850889
DOI: 10.17116/hirurgia202304112 -
Journal of Medical Ultrasound 2021High intra- and interobserver variability in the follicular assessment using two-dimensional (2D) ultrasound (US) is still a concern. To solve this issue, we have...
BACKGROUND
High intra- and interobserver variability in the follicular assessment using two-dimensional (2D) ultrasound (US) is still a concern. To solve this issue, we have developed a novel software solution, which automatically provides follicles' count and their diameters using 2D US images obtained by a manual sweep of an ovary. The primary objective of this study was to compare the result of the automated solution with a manual 2D US-based assessment.
METHODS
In the first phase, multiple follicular US sweeps were collected from 54 subjects; these sweeps were used to develop the software. In the second phase, data from 10 subjects were collected for validation of the developed solution. During each phase, for follicles ≥5 mm, their count and diameters were recorded by the sonologist using 2D US.
RESULTS
For the total follicle count, a high correlation (0.787) was observed between the solution and manual assessment. The 95% limits of agreement between the two methods were in the range of 4.232 to -4.258. The two methods had an excellent correlation (0.817) for the measurement of mean follicular diameter. However, the solution had a tendency to underestimate the mean diameter by an average of 1.725 mm (±2.16 mm). The limits of agreement between the two methods for mean diameter measurement were from 2.508 to -5.960 mm.
CONCLUSION
This study validates the feasibility of our solution for automatic assessment of follicle count and diameter with accuracy comparable to the 2D US-based manual assessment. We further observed that the solution's performance is better than known intra- and interobserver variability of the manual assessment. We recommend further validation of the solution to confirm these initial results and potential time gain with an automated assessment.
PubMed: 35127406
DOI: 10.4103/JMU.JMU_149_20 -
Children (Basel, Switzerland) Oct 2022(1) Background: Contrary to a tenet of the funnel-shaped pediatric larynx with the cricoid level being narrowest, recent studies show the glottis and subglottis as the...
(1) Background: Contrary to a tenet of the funnel-shaped pediatric larynx with the cricoid level being narrowest, recent studies show the glottis and subglottis as the narrowest levels. To locate the functionally narrowest level of the larynx, we reported normal laryngeal dimensions and their croup-related changes in young children. (2) Methods: We reviewed normal plain neck radiographs recorded for the evaluation of minor trauma or foreign bodies in 504 children aged ≤4 years who visited the emergency department from 2016 through 2021. Using computed tomography-based localization of the glottis, we radiographically defined the subglottis and cricoid. At these levels, we measured diameters and calculated cross-sectional areas (CSAs) on the radiographs. The values were compared to the equivalent values of a 1:1 age-matched population with croup. (3) Results: In the study population (n = 401), the narrowest diameter and CSA were observed in the glottis. In detail, the mean anteroposterior/transverse diameters were 9.8/3.4 mm at the glottis, 8.5/5.6 mm at the subglottis, and 7.4/6.8 mm at the cricoid (p < 0.001), respectively. In the same order, the mean CSAs were 26.5, 38.1, and 40.5 mm2 (p < 0.001). All dimensions were narrower in the croup population (p < 0.001). We found croup-related narrowing, namely reductions in the transverse diameter and CSA that were more severe closer to the glottis (p < 0.001), without differences per level in the anteroposterior diameter. (4) Conclusions: This study confirms the glottis as the narrowest level of the larynx in young children. In addition, level-based differences in croup-related narrowing suggest some point between the glottis and subglottis as the functionally narrowest level.
PubMed: 36291468
DOI: 10.3390/children9101532 -
Lymphatic Research and Biology Jun 2021Until now, lymphatic ultrasound was performed with the patients in the prone position. The aim of this study was to evaluate the change in the lymphatic diameter in...
Until now, lymphatic ultrasound was performed with the patients in the prone position. The aim of this study was to evaluate the change in the lymphatic diameter in different body positions. We performed a retrospective study. We performed indocyanine green (ICG) lymphography and lymphatic ultrasound as a pre-operative examination for lymphaticovenous anastomosis (LVA). ICG was injected at three lymphosomes per limb (the saphenous lymphatics, lateral thigh lymphatics, and lateral calf lymphatics). For the lymphatic ultrasound, a commonly used ultrasound device with an 18 MHz linear probe was employed. We measured the lymphatic diameter in the designed LVA sites in prone, sitting, and upright position. We investigated 61 limbs of 31 female patients with lower limb lymphedema. The mean age was 62.0 (range: 42-86) years. We measured the lymphatic diameter at 78 sites in the thigh and 76 sites in the lower leg. In the thigh, the mean lymphatic diameters in the supine and upright positions were 0.43 ± 0.02 mm and 0.40 ± 0.02 mm, respectively, with no significant difference ( = 0.10). In the lower leg, the mean lymphatic diameters in the supine, sitting, and upright positions were 0.68 ± 0.04 mm, 0.63 ± 0.04 mm, and 0.63 ± 0.04, respectively. A significant decrease was noted between the supine and sitting positions ( = 0.02). The lymphatic diameter in the lymphedematous lower limbs tended to decrease when the patients changed their body position from supine to the sitting or upright positions.
Topics: Female; Humans; Indocyanine Green; Lymphatic Vessels; Lymphedema; Lymphography; Middle Aged; Retrospective Studies
PubMed: 33058749
DOI: 10.1089/lrb.2020.0081 -
Journal of Vascular and Interventional... Sep 2019To describe the prostatic microvasculature anatomy and to measure the diameter of the intraprostatic vessels from human cadaveric specimens.
PURPOSE
To describe the prostatic microvasculature anatomy and to measure the diameter of the intraprostatic vessels from human cadaveric specimens.
MATERIAL AND METHODS
The prostates of 18 white males (35-68 years of age; mean prostate volume, 60.11 mL) were fixed in a solution of phosphate-buffered 10% formaldehyde and processed histologically with hematoxylin and eosin stain, Masson trichrome stain, immune peroxidase, and immunofluorescence. Fluorescence-conjugated antibodies (anti-CD34 and anti-actin smooth muscle) were used to mark the endothelium and the fibromuscular stroma, respectively. Each slide was digitally scanned and photographed under microscopy to measure the intraprostatic arterial diameters using image analysis software.
RESULTS
In 28 hemipelvises (77.8%) a single dominant prostate artery was found (mean diameter, 1.96 mm). The microvasculature study identified 3 types of intraprostatic arterial distributions: internodal (IT), perinodal (PN), and intranodal (IN). The IT arteries are located at the trabeculae of the hyperplastic stroma between the nodules. The PN arteries were located at the periphery of each hyperplastic nodule before entering into it. The IN vessels were located inside the hyperplastic nodules as terminal arteries to the glands. The mean IT artery diameter was 317 μm (min-max range, 155-555 μm), mean PN artery diameter was 150 μm (min-max range, 59-266 μm), and the mean IN artery was 56 μm (min-max range, 24-104 μm). The diameters of intraprostatic arteries did not correlate with prostate volume (IT arteries, P = .303; PN arteries, P = .686; and IN arteries, P = .413).
CONCLUSIONS
The description of the prostate microvasculature anatomy, as described by this cadaveric study, may provide useful information for prostate artery embolization.
Topics: Adult; Aged; Arteries; Cadaver; Embolization, Therapeutic; Humans; Male; Microvessels; Middle Aged; Prostate
PubMed: 31371136
DOI: 10.1016/j.jvir.2019.03.021