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131.
132.
Valentín Tinguaro Díaz-Alemán Francisco José Fumero Batista Silvia Alayón Miranda Denisse Ángel-Pereira Víctor Javier Arteaga-Hernández José Francisco Sigut Saavedra 《Archivos de la Sociedad Espa?ola de Oftalmología》2021,96(4):181-188
ObjectiveTo determine and compare the diagnostic precision in glaucoma of two deep learning models using infrared images of the optic nerve, eye fundus, and the ganglion cell layer (GCL).MethodsWe have selected a sample of normal and glaucoma patients. Three infrared images were registered with a spectral-domain optical coherence tomography (SD-OCT). The first corresponds to the confocal scan image of the fundus, the second is a cut-out of the first centered on the optic nerve, and the third was the SD-OCT image of the GCL. Our deep learning models are developed on the MatLab platform with the ResNet50 and VGG19 pre-trained neural networks.Results498 eyes of 298 patients were collected. Of the 498 eyes, 312 are glaucoma and 186 are normal. In the test, the precision of the models was 96% (ResNet50) and 96% (VGG19) for the GCL images, 90% (ResNet50) and 90% (VGG19) for the optic nerve images and 82% (ResNet50) and 84% (VGG19) for the fundus images. The ROC area in the test was 0.96 (ResNet50) and 0.97 (VGG19) for the GCL images, 0.87 (ResNet50) and 0.88 (VGG19) for the optic nerve images, and 0.79 (ResNet50) and 0.81 (VGG19) for the fundus images.ConclusionsBoth deep learning models, applied to the GCL images, achieve high diagnostic precision, sensitivity and specificity in the diagnosis of glaucoma. 相似文献
133.
Kyung-Woo Kwak Min-Su Kim Chul-Hoon Chang Seong-Ho Kim 《Journal of Korean Neurosurgical Society》2011,49(2):139-141
Compression of the ulnar nerve in Guyon''s canal can result from repeated blunt trauma, fracture of the hamate''s hook, and arterial thrombosis or aneurysm. In addition, conditions such as ganglia, rheumatoid arthritis and ulnar artery disease can rapidly compress the ulnar nerve in Guyon''s canal. A ganglion cyst can acutely protrude or grow, which also might compress the ulnar nerve. So, clinicians should consider a ganglion cyst in Guyon''s canal as a possible underlying cause of ulnar nerve compression in patients with a sudden decrease in hand strength. We believe that early decompression with removal of the ganglion is very important to promote complete recovery. 相似文献
134.
135.
Sangeetha Srinivasan Cirous Dehghani Nicola Pritchard Katie Edwards Anthony W. Russell Rayaz A. Malik Nathan Efron 《Journal of diabetes and its complications》2018,32(1):67-74
Aims
To investigate the role of ophthalmic imaging markers – namely retinal thickness measures and corneal nerve morphology – in predicting four-year development and worsening of diabetic retinopathy (DR) in type 1 diabetes (T1DM).Methods
126 eyes of 126 participants with T1DM were examined at baseline and after four years. Diabetic retinopathy (DR) was graded using the Early Treatment Diabetic Retinopathy Study scale. HbA1c, nephropathy, neuropathy, cardiovascular factors, and retinal thickness using optical coherence tomography (OCT) and corneal nerve fiber length (CNFL) using corneal confocal microscopy at baseline were assessed by univariate and step-wise multiple logistic regression, and their diagnostic capabilities for single and combined measures.Results
Four-year development of DR was 19% (13 of 68 without DR at baseline). Worsening of DR was seen in 43% (25 of 58 with DR at baseline). When adjusted for potential confounders, a lower CNFL (AUC = 0.637, p = 0.040, 64% sensitivity and 64% specificity at 14.9 mm/mm2 cut-off), higher triglycerides (AUC = 0.669, p = 0.012, 64% sensitivity, 62% specificity at 0.85 mmol/L) and an elevated vibration threshold (AUC = 0.708, p = 0.002, 96% sensitivity, 40% specificity at 3.55 Hz) were significant predictors for four-year worsening of DR.Conclusions
Reduced CNFL, elevated vibration perception threshold and higher triglycerides can predict future worsening of DR. 相似文献136.
Mohammad Hossein Anbardar Bita Geramizadeh Hamid Reza Foroutan 《Iranian journal of pediatrics.》2015,25(2)
Background:
Hirschsprung’s disease (HD) is a congenital intestinal motility disorder with absence of ganglion cells in the colonic wall. Diagnosis of the disease is mainly based on the identification of the lack of ganglion cells in the pathology sections of the colon which is very difficult and time consuming and also needs several serial cut sections. There are many proposed markers in this field in the literature but none of them has been satisfactory. Calretinin immunohistochemistry (IHC) has been introduced as a new diagnostic marker to overcome the problems in diagnosis of this disease about 5 years ago. However there are few studies regarding the benefits and pitfalls of this marker.Objectives:
The aim of this study is to determine the diagnostic value of calretinin IHC in detecting aganglionosis (HD).Patients and Methods:
27 HD patients and 28 non-Hirschsprung’s disease (NHD) patients were collected in a prospective study and calretinin IHC was performed on 31 aganglionic and 51 normoganglionic full wall thickness sections of colectomies (some of the cases had more than 1 section). The IHC slides were evaluated by two pathologists and the diagnostic value was calculated in comparison with gold standard which is the presence or absence of ganglion cells in serial Hematoxylin and Eosin (HE) stained sections of the colectomies.Results:
There was great concordance between the final diagnosis of both pathologists and gold standard (k > 0.9). Calretinin immunostaining showed 100% specificity and positive predictive value and more than 90% sensitivity and negative predictive value. High agreement was present between the two pathologists (k > 0.9).Conclusions:
Calretinin IHC is a very convenient, useful and valuable method to demonstrate aganglionosis in HD patients. Loss of calretinin immunostaining in lamina propria and submucosa is characteristic of HD. 相似文献137.
Context
Ganglion cell complex is damaged early in glaucoma. Does this loss of GCC help in early diagnosis of glaucoma.Aims
To compare the RNFL thickness and ganglion cell complex (GCC) in diagnosed patients of glaucoma, pre-perimetric glaucoma and normal controls.Settings and design
Case controlled, observational study.Methods and material
33 glaucoma patients, 45 pre-perimetric glaucoma, and 30 controls were enrolled in the study. ONH parameters on cirrus HD OCT like CD ratio, para papillary RNFL thickness and GCC were calculated for each case.Statistical analysis used
ANOVA test to analyse differences between groups. ROC for ganglion cell layer.Results
RNFL thickness was 71.6 μ and GCC was 69.19 μ in glaucoma patients. RNFL thickness was 77.31 μ and GCC was 71 μ in pre-perimetric glaucoma and 99.6 μ and 85.16 μ in controls respectively. The difference of mean for RNFL and GCC by ANOVA was statistically significant for controls, glaucoma patients and pre-perimetric glaucoma patients. RNFL (p < 0.001) and GCC (p < 0.001). Receiver operating characteristic curve for GCC was 0.83 (p < 0.000).Conclusions
The RNFL analysis is increasingly being used as newer tool in diagnosis of glaucoma. In addition, GCC can be used as a supplementary tool in picking up cases of pre-perimetric glaucoma as loss is significant in pre-perimetric glaucoma also. 相似文献138.
The purpose of our study was to review the clinical features and determine the results following surgical excision of a flexor
tendon sheath ganglion. A retrospective analysis of 24 consecutive patients (25 ganglions) who underwent excision of a painful
flexor tendon sheath ganglion by the same surgeon was performed. The patient’s medical and operative records were reviewed.
Each patient was invited to return for an evaluation, which consisted of a clinical interview, completion of a questionnaire,
and physical examination. Those patients that were unable to return underwent a detailed telephone interview. Sixteen patients
returned for a clinical evaluation, while eight patients underwent a telephone interview. There were 15 women and nine men,
with an average age of 43 years (range, 21–68 years). The dominant hand was involved in 15 patients. The long finger was most
commonly involved (11 cases). The ganglion arose from the A1 pulley in 13 cases, between the A1 and A2 pulleys in three cases,
and from the A2 pulley in nine cases. At an average follow-up of 18.5 months (range, 5–38 months), all of the patients were
satisfied with their final result. No patient developed a recurrence and all returned to their previous functional level.
There were two minor complications that resolved uneventfully; one patient experienced mild incisional tenderness, while an
additional patient experienced transient digital nerve paresthesias. We conclude that surgical excision is a simple, safe,
and effective method for treating a painful ganglion of the digital flexor tendon sheath. 相似文献
139.
Denis MH Dudrap E Courville P Auquit-Auckbur I Joly P Milliez PY 《Annales de chirurgie plastique et esthétique》2007,52(1):28-34
AIM: Thirty-five cases of lymphadenectomy carried out in the context of positive sentinel lymph node for malignant melanoma have been reviewed to assess the prognostic value of certain metastatic charachteristics. We have checked wether the type (macro or micrometastasis) and localisation (subcapsular or intraparenchymal) in the sentinel lymph node had predictive value for the lymphadenectomy outcome and evolution of the case. MATERIAL AND METHODS: The retrospective study relates to 35 cases (with an average 2 years history) taken from a total of 87 sentinel lymph node protocols; average age 46.5 years, Breslow 2.5 mm with an history of 25 months. RESULTS: Among the 35 positive sentinel lymph nodes we have 19 cases (54.2%) of micrometastasis. Among the 35 lymphadenectomy 5 cases (14.28%) turned out positive, 3 of which concerned micrometastatic sentinel lymph nodes. In our cohort the micrometastatic nature of sentinel lymph nodes did not have statistically significant impact upon the lymphadenectomy result but showed more favourable short-term evolution with 68.42% metastatic free evolution as against 43.75% in case of initial macrometastasis. The subcapsular localisation of micrometastasis equally represents a factor of improved prognosis (69.2% of metastatic free evolution against of 30.8% in the case of intraparenchymal localistion). CONCLUSION: Unfortunately, none of the studied criteria justifies a modification of our present clinical attitude whereby a systematic lymphadenectomy in cases of positive sentinel lymph nodes is performed, whatever the type or localisation of the relevant metastases. 相似文献
140.