Computer-aided system for morphometric mandibular index computation (Using dental panoramic radiographs)

Objective: We propose and validate a computer—aided system to measure three different mandibular indexes: cortical width, panoramic mandibular index and, mandibular alveolar bone resorption index. Study Design: Repeatability and reproducibility of the measurements are analyzed and compared to the manual estimation of the same indexes. Results: The proposed computerized system exhibits superior repeatability and reproducibility rates compared to standard manual methods. Moreover, the time required to perform the measurements using the proposed method is negligible compared to perform the measurements manually. Conclusions: We have proposed a very user friendly computerized method to measure three different morphometric mandibular indexes. From the results we can conclude that the system provides a practical manner to perform these measurements. It does not require an expert examiner and does not take more than 16 seconds per analysis. Thus, it may be suitable to diagnose osteoporosis using dental panoramic radiographs. Key words:Osteoporosis, panoramic mandibular index, cortical width, mandibular alveolar bone resorption index.     

The influence of posterior capsular opacification removal on anterior segment birefringence parameters as measured by scanning laser polarimetry

PURPOSE: To determine the effect of posterior capsular opacification (PCO) removal on anterior segment birefringence (ASB) and its influence on peripapillary retinal nerve fibre layer (RNFL) retardation measurements obtained by means of scanning laser polarimetry. METHODS: In this prospective interventional study, scanning laser polarimetry was performed using GDx variable corneal compensation on 26 eyes of 26 patients who developed clinically significant PCO (after uncomplicated cataract surgery and with no other ocular pathology) both before and between 1 and 4 weeks after Nd:YAG capsulotomy. Best-corrected visual acuity (BCVA), intraocular pressure, corneal polarization axis (CPA), corneal polarization magnitude (CPM) were compared using the Student t-test and Wilcoxon signed ranks test. Spearman correlations between changes (differences between values after and before capsulotomy) in the CPA, CPM, BCVA and RNFL data were also performed. RESULTS: PCO removal is associated with a shift in CPA (from 10.86 to 15.03 degrees, P = 0.004) and CPM (from 28.54 to 37.92 nm, P = 0.004). Significant correlations were found between changes in the parameters of ASB and BCVA. Furthermore, RNFL measurements (nerve fibre indicator, temporal-superior-nasal-inferior-temporal average and superior average) were also well related to the CPA and CPM shifts. CONCLUSIONS: PCO induces an inaccurate compensation of ASB which affects RNFL assessment. Thus, it is necessary to recompensate ASB after posterior capsulotomy.     

A rare transthyretin mutation (Asp18Glu) associated with vitreous amyloid

Amyloidosis is a term to describe extracellular deposition of insoluble beta-fibrillar proteins. Here we describe a patient who was confirmed to have amyloidosis after right heart biopsy and was found to have DNA change 114T > A (codon change D18E). Ophthalmic examination showed increasing vitreous sheet-like opacities in the left eye and she subsequently underwent vitrectomy. The vitrectomy specimen was confirmed to have amyloid involvement. To our knowledge this is the first report of vitreous involvement of a patient with the Asp18Glu mutation of the transthyretin (TTR) gene with DNA change 114T > A.     

Reelin expression is upregulated following ocular tissue injury

Purpose Reelin is important in the guidance of neuronal stem cells in the central nervous system during normal development. We wished to determine whether reelin is expressed in the retina and cornea after injury. Methods Mice underwent laceration of their retina as well as corneal epithelial debridement. The mice were sacrificed at 3 days, and eyes were fixed and stained for reelin expression and reelin messenger ribonucleic acid (mRNA). Results In normal eyes, reelin was expressed only at very low levels in the ganglion cell layer of the retina and the endothelial cell layer of the cornea. In injured eyes, there was marked expression in reelin immunoreactivity in the retina and cornea. Reelin gene expression was seen in the retina and cornea. Conclusions Reelin is expressed during normal retinogenesis. This study shows that reelin is also upregulated following injury to the retina and cornea. The expression of reelin following injury suggests that reelin may play an important role in regulating stem cell trafficking in neuronal and nonneuronal tissues following injury similar to its role in normal organogenesis. For consideration of publication in Graefe’s Archive for Clinical and Experimental Ophthalmology.     

Comparison between LASEK and LASIK for the correction of low myopia

PURPOSE: To compare the refractive results of laser epithelial keratomileusis (LASEK) and laser in situ keratomileusis (LASIK) for the correction of low myopia. METHODS: A prospective, interventional, non-randomized, observer-masked study was performed of patients with myopia of < or = -2.50 diopters (D) (cylinder < or = 1.50 D) who had undergone either LASEK or LASIK. Refractive analysis was performed by a masked observer preoperatively and 1 day, 1 week, and 1 and 3 months postoperatively. RESULTS: Seventy-nine eyes that fulfilled the inclusion criteria in each group were included in the study. No statistically significant differences were noted in age, gender, or preoperative refractive error between groups. Postoperative uncorrected visual acuity (UCVA) was significantly lower in LASEK eyes 1 and 7 days postoperatively (P = .0001). At 1 and 3 months postoperatively, no significant differences were noted between the groups in UCVA (P = .07), but best spectacle-corrected visual acuity 3 months postoperatively was significantly better in LASEK eyes (P = .01). The refractive error was similar in both groups (P = .3). CONCLUSIONS: Visual improvement after LASEK for low myopia is significantly slower than after LASIK. Visual outcomes at 3 months postoperatively were similar with both techniques for the correction of low myopia.     

念珠菌生物膜体外抗真菌药物敏感性研究

随着医疗技术的不断进步，各种体内装置的应用明显增加，如静脉插管、人工心脏瓣膜、关节置换术等。这些装置均可作为微生物的附着物而形成一种由单层或多层细胞粘附到这些生物材料基质的表面生长的生物膜结构犤１犦。生长在生物膜中的念珠菌在其表型上与悬浮的念珠菌有着很大的不同，其中最主要的特点是对许多抗真菌药物的敏感性降低甚至产生耐药犤２犦。本文介绍一种快速，简单的９６孔微量培养皿方法形成念珠菌生物膜的体外模型，用分光光度计通过测定甲基四氮盐XTT狖２，３－二（２－甲氧－４－硝基－５－硫苯基）－５－犤（氨苯基）…     

Anterior Myocardial Pseudoinfarction in a patient with Diabetic Ketoacidosis: a case report

Background: Patients with Diabetic Ketoacidosis are prone to various life-threatening complications. This case presents a rare presentation of pseudoinfarction in a patient presenting with DKA.rnCase: 47-year old female with diabetes presented to the hospital with a three-day course of worsening nausea and vomiting. Initial electrocardiogram demonstrated ST elevations on leads V1-V3 concerning for anterior myocardial infarction. She underwent emergent left heart catheterization. During the procedure, the patient was found to have a blood glucose of 985 mg/dL, potassium of 6.7mmol/L, bicarbonate of 8 mmol/L, anion gap of 35 and the diagnosis of diabetic ketoacidosis was made. Cardiac catheterization demonstrated non-obstructive coronary artery disease. Left ventricular end-diastolic pressure obtained concerning for severe dehydration and left vetriculogram noted preserved ejection fraction. She later underwent management for DKA in the medical intensive care unit, including insulin therapy and fluid replacement. One hour afterwards, serum glucose level had improved (613 mg/dL) and the hyperkalemia had resolved (potassium 4.6 mmol/L). Repeat EKG showed normal sinus rhythm with no ST elevations. rnDecision-Making: Early detection of myocardial infarction is imperative to reduce mortality from this entity. ST segment elevation does not always equal myocardial infarction as demonstrated in this case. An EKG pattern mimicking myocardial infarction with worrisome confounding co-morbid condition such as diabetic ketoacidosis can subject patients to unnecessary invasive management.rnConclusion: Hyperkalemia, metabolic acidosis or other metabolic abnormalities and hyperosmolar blood present in DKA can lead to ST segment elevations mimicking a myocardial infarction pattern on EKG. Diabetic Ketoacidosis in 4% of cases may predispose patients to developing acute myocardial infarction and should be considered as a confounding factor in medical or invasive management.     

中心性浆液性脉络膜视网膜病变眼底自发荧光影像的特点

目的：研究急性和慢性特发性中心性浆液性脉络膜视网膜病变眼底自发荧光影像模式及眼底荧光血管造影相关性发现。

方法：观察性研究案例。回顾性分析中心性浆液性脉络膜视网膜病变患者临床数据,眼底荧光血管造影及眼底自发荧光影像,并对其调查结果进行比较。

结果：该研究共纳入17例25眼。确诊为急性中心性浆液性脉络膜视网膜病变5眼,慢性疾病或复发性慢性疾病20眼。急性病例眼底自发荧光影像显示低荧光点与荧光血管造影检测出的荧光渗漏点位置相同。慢性特发性中心性浆液性脉络膜视网膜病变眼底荧光血管造影为视网膜色素上皮弥漫性萎缩区域,可透视荧光。眼底自发荧光影像的低荧光区域的形态和位置与眼底荧光血管造影的高荧光区域相对应,然而眼底荧光血管造影的低荧光区域与眼底自发荧光影像的高荧光区域相对应。在急性病例中,低自发荧光点不能准确指出视网膜色素上皮的渗漏点。

结论：中心性浆液性脉络膜视网膜病变眼底自发荧光影像模式能够描述疾病不同阶段的特征,具有无风险和可再生性,可替代荧光素血管造影术治疗中心性浆液性脉络膜视网膜病变。