bluuebunny/crossref_metadata_2025 huggingface dataset:
Solubility of Root Canal Sealers: A Comparative Study
Authors: Poggio Claudio , Arciola Carla Renata , Dagna Alberto , Colombo Marco , Bianchi Stefano , Visai Livia
Published: January 2018

Introduction

Root canal sealers used in odontological applications are capable of providing an apical seal, thus inhibiting potential bacterial penetration into the periradicular tissues. Since insolubility is the ideal characteristic for a root canal sealer material, in dentistry the sealability of the material depends on its solubility.

Purpose

This study tested the solubility of six different root canal sealers: two ZnOE-based sealers (Endomethasone C and Argoseal), two calcium hydroxide-containing sealers (Bioseal Normal and Acroseal), and two resin-based sealers (AH Plus and MM Seal).

Methods

Ten specimens of each material were prepared using stainless steel ring molds with the same internal diameter and the same height in order to obtain similar samples, and immersed in water. Solubility was determined by using sample weight loss (%) after 24 hours and after 2 months. The test was performed according to the International Standards Organization 6876 standard and the American Dental Association specifications No. 30 and No. 57. Data were statistically analyzed with a one-way analysis of variance test (ANOVA).

Results

The ANOVA test showed significant differences between the various groups. The post-hoc test showed that resin-based root canal sealers had significantly lower solubility percentages than other groups (p<0.05), and showed no difference between them (p>0.05).

Conclusions

All the materials fulfilled the requirements of International Standard 6876 and ANSI/ADA specifications demonstrating a weight loss of less than 3%. Under the conditions of the present study, all root canal sealers were of low solubility, but the lowest solubility percentages were recorded in resin-based root canal sealers, which can be considered virtually insoluble, and thanks to this physical property, ideal for use as endodontic sealer.
Blocking of matrix metalloproteinases-13 responsive peptide in poly(urethane urea) for potential cartilage tissue engineering applications
Authors: Wu Gang , Wang Huan , Xiao Jiangwei , Wang Lilu , Ke Yu , Fang Liming , Deng Chunlin , Liao Hua
Published: January 2018

The matching of scaffold degradation rate with neotissue growth is required for tissue engineering applications. Timely provision of proper spaces especially for cartilage tissue engineering plays a pivotal role in chondrocyte cluster formation. In this study, poly(urethane urea) was synthesized using conventional two-stage method by extending the isocyanate group terminated prepolymers with different amounts of GPLGLWARK peptide, which responses the degrading induced by matrix metalloproteinase 13, the main proteinase for cartilage matrix degradation. The Fourier transform infrared spectrometer with the attenuated total reflection and 1H nuclear magnetic resonance spectra revealed that the peptides were introduced to poly(urethane urea) according to the characteristic absorption bands of the peptide and the newly formed urea bonds. The ultraviolet–visible spectroscopy spectra showed that the weight percentages of the peptide in the three poly(urethane urea) were 25%, 32%, and 35%. Atomic force microscopy images revealed that phase separation occurred in all poly(urethane urea) samples and became increasingly apparent with increasing amount of peptides introduced. Mechanical tests showed that the poly(urethane urea) strength increased with increasing amount of peptides in poly(urethane urea). Poly(urethane urea) proteolysis in matrix metalloproteinase 13 solution was more rapid than hydrolysis in aqueous buffer, and proteolysis rate was dependent on the amount of peptides in poly(urethane urea). Cell proliferation on the material surface in vitro displayed nontoxicity for all synthesized poly(urethane urea). In vivo subcutaneous implantation evaluation revealed the presence of local foreign body reactions triggered by poly(urethane urea) but was not due to peptide in poly(urethane urea). Moreover, the synthesized poly(urethane urea) with significant phase separation did not degrade under the matrix metalloproteinase 13 free subcutaneous environment, but poly(urethane urea) with minimal phase separation was degraded by attacking of the enzymes adsorbed on the hydrophobic surface through non-specific adsorption.
Long breathing lean NOx trap regeneration with supplemental n-butanol
Authors: Aversa Christopher , Yu Shui , Jeftić Marko , Bryden Geraint , Zheng Ming
Published: January 2018

This paper evaluates a long breathing strategy of lean NO x trap for achieving ultra-low nitrogen oxide (NO x) emissions, with an aim to reduce the associated fuel penalty. The fuel impacts on the long breathing strategy of lean NO x trap operation are examined on a heated flow bench with diesel and n-butanol as the reductants. Engine tests are performed to identify suitable working regions for the lean NO x trap strategies. For a very low engine-out NO x emission level of ~30 ppm, the long breathing adsorption of the lean NO x trap shows a significant improvement in NO x storage efficiency compared to a conventional lean NO x trap operational strategy for a moderate level of NO x emissions. The use of n-butanol fuel in diesel engines produces much lower NO x and particulate matter emissions, which is deemed advantageous for operating the long breathing lean NO x trap strategy. As a reductant for lean NO x trap regeneration, n-butanol is found to be more effective in terms of regeneration effectiveness, NO x conversion efficiency, and potential hydrogen (H2) yield compared to using diesel fuel in the after-treatment. A fuel penalty analysis is conducted for the selected cases with combinations of different combustion modes and lean NO x trap strategies. Given a low level of NO x emissions from n-butanol combustion, the long breathing lean NO x trap strategy can potentially achieve ultra-low NO x emissions with a minimum fuel penalty.
The spatial correlation between track roughness and ground-penetrating radar inferred ballast degradation
Authors: Scanlan Kirk M , Hendry Michael T , Martin C Derek , Schmitt Douglas R
Published: January 2018

Ballast degradation is considered to be a primary factor that contributes to the development of track roughness, and as such it is important to develop efficient techniques to assess the condition of the ballast. Ground-penetrating radar is one method that has been applied in a variety of railway foundation studies including those attempting to non-destructively assess ballast degradation. However, there has yet to be a large-scale study that attempts to correlate the ground-penetrating radar-based estimates of ballast degradation with the observed track roughness. This study investigates this correlation along a 335 km-long heavy-haul railway subdivision in Alberta, Canada. Track roughness is quantified from repeated track alignment and surface measurements spanning 15 months prior to the ground-penetrating radar data acquisition. Three sets of 400 MHz ground-penetrating radar measurements were performed in August 2012, one along each ballast shoulder and one along the track centreline. The results of this study reveal that significant correlations between the observed track roughness and the ground-penetrating radar-based interpretation of ballast degradation are rare and only exist when the data are compared at very small spatial scales. The absence of significant correlations between track roughness and the estimates of ballast degradation is primarily interpreted as being the result of ambiguous ground-penetrating radar data caused by local-scale variations in the track foundation unrelated to ballast degradation. To address these issues, potential improvements in the application of ground-penetrating radar as a ballast degradation detection tool are proposed.
Electoral Violence and the Challenge of Democratic Consolidation in Nigeria
Authors: Ashindorbe Kelvin
Published: January 2018

Elections are the hallmarks of democracy; they also serve the purpose of peaceful change in government and confer political legitimacy on the government. Viewed from this prism, elections represent the expression of the sovereign will of the people. However, the conduct of elections in a plural society like Nigeria is often fraught with animosities and violence. Failing is the process to satisfy the test of popular participation and legitimacy. At the core of this bitter contest is the struggle for power by factional elite groups perceived as representing ethno religious and regional interest. Electoral seasons more than anytime else reveals the fragility and soft underbelly of the Nigerian state. The country’s electoral history is replete with narratives of flawed and disputed elections that have turned violent, resulting in numerous fatalities and reversing previous attempts at democratic consolidation. The 2015 general election was unprecedented in the annals of the country because for the first time an entrenched and incumbent party was defeated at the polls, and the country witnessed a peaceful alternation of power between contending political parties thereby fulfilling one of the preconditions for democratic consolidation. A tensed pre-election political atmosphere occasioned by the activities of the terrorist group, Boko Haram, that then controlled a large swath of Nigeria’s territory and a fragmented elite divided along ethno-religious and regional lines foreshadowed the election. Shuttle diplomacy by the United States secretary of state and the constitution of body called ‘National Peace Committee’ comprised of Kofi Anan, the immediate past secretary general of the United Nations, past presidents of Nigeria and leading clergymen and the postponement of the election date by six weeks before the electoral management body could deliver an election whose outcome was accepted by the contending political parties and averting the prediction of an apocalyptic endgame. This study seeks to engage the factors that make conduct of elections in Nigeria to be violent prone and undermine attempts at institutionalising a democratic tradition. The methodology is qualitative in approach, relying on secondary data from books, journal articles and newspaper commentaries.
Clinical Toxicology of Yew Poisoning
Authors: Labossiere Alexander W. , Thompson Dennis F.
Published: January 2018

Objectives: Yew plant materials contain highly toxic taxine alkaloids. Serious ingestions can result in life-threatening toxicity. The purpose of this article is to summarize the literature on the treatment of acute yew poisoning. Data Sources: PubMed (January 1946 to November 2017) was searched using the search terms “taxus/po”. EMBASE (1980 to November 2017) was searched using the search terms “taxus/to” and “yew.mp.” Web of Science (1945 to November 2017) was searched using the text words taxus, taxine, and yew. Study Selection and Data Extraction: Available English language articles involving case reports, epidemiology, treatment, and outcomes were included. Data Synthesis: Although not uncommon, unintentional yew poisoning rarely results in significant morbidity or mortality. A total of 26 case reports of yew poisoning were evaluated along with 4 case series articles (totaling 22 additional cases). Only 4 of the 48 total cases (8%) were accidental poisonings, the rest being deliberate ingestions. In 20 patients (42%), it resulted in fatalities. Severe, acute yew poisoning results in symptomatology largely resistant to pharmacotherapy intervention. Conclusions: Most nonintentional ingestions of yew plant constituents are asymptomatic and require little intervention. Severe poisoning can result in life-threatening cardiac toxicity and require aggressive supportive care. Therapeutic interventions, such as sodium bicarbonate, digoxin immune fab, and hemodialysis that have been utilized in case studies and case series in the literature have little proven benefit. Extracorporeal life support should be considered in severe yew poisoning.
Efficacy and Safety of Subcutaneous Neostigmine for Ileus, Acute Colonic Pseudo-obstruction, or Refractory Constipation
Authors: Kram Bridgette , Greenland Maegan , Grant Mollie , Campbell Michael E. , Wells Charlotte , Sommer Courtney
Published: January 2018

Background: Neostigmine is traditionally administered intravenously for treatment of acute colonic pseudo-obstruction (ACPO), though use is associated with administration constraints and adverse effects. Objective: To evaluate whether an alternative route of administration for neostigmine via subcutaneous (SQ) delivery is safe and effective in a broad cohort of medical and surgical patients. Methods: This multicenter, retrospective observational study included adult patients administered SQ neostigmine for ileus, ACPO, or refractory constipation. Efficacy indicators were time to first bowel movement (BM) following initiation of the medication, total SQ neostigmine dose administered to produce a BM, and administration of a rescue intervention to produce a BM. Safety events evaluated were cardiac arrest, bradycardia, bronchospasm requiring intervention, nausea requiring intervention, or severe salivation, lacrimation, or diarrhea. Results: A total of 182 patients were eligible for inclusion. The most commonly utilized dosing strategy of neostigmine was 0.25 mg SQ 4 times daily. The median time to first BM following initiation of SQ neostigmine was 29.19 hours (interquartile range = 12.18-56.84) with a median dose administered before first BM of 1.25 mg. Three patients (1.65%) experienced an adverse drug event leading to drug discontinuation, with 2 developing bradycardia that resolved with drug discontinuation alone. Conclusions: SQ neostigmine may be reasonable for management of ileus, ACPO, or refractory constipation, though use should be avoided in patients with new-onset heart block, a history of second-degree heart block, or following bowel resection with primary anastomosis. Despite the low incidence of adverse drug events observed, monitoring for bradycardia with telemetry may be considered.
Biologic-Induced Infections in Inflammatory Bowel Disease: The TNF-α Antagonists
Authors: McConachie Sean M. , Wilhelm Sheila M. , Bhargava Ashish , Kale-Pradhan Pramodini B.
Published: January 2018

Objective: To review the mechanism and association of infectious risk among the tumor-necrosis factor α (TNF-α) antagonists used in inflammatory bowel disease. Data Sources: A PubMed literature search was performed using the following search terms: infliximab, adalimumab, certolizumab, golimumab, inflammatory bowel disease, crohn’s, ulcerative colitis, adverse effects, adverse events, safety, and infection. Study Selection and Data Extraction: Meta-analyses and cohort studies with outcomes pertaining to quantitative infectious risk were reviewed. Case reports and case series describing association between TNF-α inhibitors and infection were also reviewed. Data Synthesis: A total of 7 recent meta-analyses of randomized trials demonstrate inconclusive association of infection with TNF-α antagonists. Registry data suggest that medications carry an independent risk of opportunistic infections. Risk factors for infection include older age, malnutrition, diabetes, and possibly combination therapy. Reported infections vary widely but include intracellular and granulomatous bacteria, viruses, and fungi. Conclusion: TNF-α antagonists are associated with an increased risk of opportunistic infection, although this risk has not been demonstrated conclusively in randomized controlled trials. Knowledge of concomitant risk factors, mechanism of infectious risk, and available treatment options can improve patient care in the clinical setting.
Polymorphisms of F2, PROC, PROZ, and F13A1 Genes are Associated With Recurrent Spontaneous Abortion in Chinese Han Women
Authors: Xu Zuying , Zhang Ying , Liu Wei , Liu Yunyun , Su Yezhou , Xing Qiong , He Xiaojin , Wei Zhaolian , Cao Yunxia , Xiang Huifen
Published: January 2018

Mutations of hemostasis/coagulation-related genes have been speculated to cause recurrent spontaneous abortion (RSA). This study investigated the genetic association between the polymorphisms of factor V (F5), factor II (F2), antithrombin (SERPINC1), protein C (PROC), protein S (PROS1), protein Z (PROZ), factor XIII (F13A1), and carboxypeptidase B2 (CPB2) genes and RSA. The 426 patients with RSA and 444 controls were recruited in this study, and single-nucleotide polymorphisms (SNPs) were analyzed by using SNPscan technology. Genotype and allele frequencies of rs3136520 in F2, rs3024731 in PROZ, and rs1050782 in F13A1 showed statistically significant differences between the 2 groups. TT genotype of rs3136520 ( P = .031, odds ratio [OR] = 0.986, 95% confidence interval [CI] = 0.976-0.997) and AA genotype of rs2069906 in PROC ( P = .021, OR = 0.114, 95% CI = 0.014-0.902) in their recessive models and AG + GG variants of rs1050782 ( P = .007, OR = 0.681, 95% CI = 0.516-0.899) in the dominant model might be associated with the reduced risk of RSA. AT + TT variants of rs3024731 ( P = .010, OR = 1.479, 95% CI = 1.098-1.994) may increase disease susceptibility in dominant model. Haplotype analysis of rs3024731 and rs3024735 in PROZ displayed that the AA and TG haplotype were inclined to decrease and increase the risk of RSA, respectively. These results suggested that rs3136520, rs2069906, rs3024731, and rs1050782 may have a significant association with the genetic susceptibility of RSA in Chinese Han women.
Dynamic force reconstruction techniques from incomplete measurements
Authors: Jayalakshmi V. , Lakshmi K. , Mohan Rao A. Rama
Published: January 2018

We present two time-domain algorithms derived from the popular Newmark’s time integration algorithm, to reconstruct the input force excitation from the vibration measurements. While the first method uses a direct formulation of the time integration algorithm, the second one uses a regularization tool to solve the associated inverse problem. A modified regularization technique is employed to improve the accuracy of the identification problem. Numerical studies with limited measurements, with measurement noise, multiple load identification etc., are presented to investigate the practical applicability of the two methods. Studies have clearly favored the inverse algorithm with modified regularization technique. Finally modeling errors associated with force reconstruction are investigated and a technique is proposed to identify the system parameters simultaneously while reconstructing the input dynamic force, using a recently developed quantum particle swarm optimization algorithm developed by the authors. The numerical simulation studies presented clearly indicate that the force, as well as the system parameters, can be identified accurately using the proposed algorithm.
Gender Differences in Hospital CEO Compensation: A National Investigation of Not-for-Profit Hospitals
Authors: Song Paula H. , Lee Shoou-Yih Daniel , Toth Matthew , Singh Simone R. , Young Gary J.
Published: January 2018

Gender pay equity is a desirable social value and an important strategy to fill every organizational stratum with gender-diverse talent to fulfill an organization’s goals and mission. This study used national, large-sample data to examine gender difference in CEO compensation among not-for-profit hospitals. Results showed the average unadjusted annual compensation for female CEOs in 2009 was $425,085 compared with $581,121 for male CEOs. With few exceptions, the difference existed across all types of not-for-profit hospitals. After controlling for hospital- and area-level characteristics, female CEOs of not-for-profit hospitals earned 22.6% less than male CEOs of not-for-profit hospitals. This translates into an earnings differential of $132,652 associated with gender. Explanations and implications of the results are discussed.
Comparison of Analgesia and Akinesia after Retrobulbar Injections at Different Speeds
Authors: Krause M. , Baldus A. , Spang S. , Weindler J. , Ruprecht K.W.
Published: January 2018

Purpose

To assess how the speed of injection of local anesthetic solutions affected pain of injection, bulbar akinesia and analgesia with retrobulbar anesthesia (RBA).

Methods

70 patients undergoing RBA for cataract surgery were enrolled in a prospective masked trial. They were allocated randomly to receive 5 ml anesthetic solution injected either within 20 seconds (group A) or within 60 seconds (group B). Additionally, akinesia of the orbicularis muscle was created according to O'Brien's technique. The pain of injection was registered on an ordinal analogue scale immediately before and after RBA. The following data were collected before and 20 minutes after retrobulbar injection: eye motility (Kestenbaum test), and corneal sensitivity (0: no sensitivity; 1: sensitivity remaining). Data were also collected on age, sex, and bulbar length, and any side effects of the intervention.

Results

Injection pain did not differ in the two groups. After RBA horizontal and vertical eye motility was slightly lower in group A than group B. Persistent motility was found in 18 patients in group A and 16 in group B. Median horizontal and vertical motility was 0 mm in both groups. Four patients in group A and five in group B had corneal sensitivity persisting after RBA.

Conclusions

This comparison of different injection velocities brought to light no significant differences regarding bulbar analgesia and akinesia after RBA.
Effect of Xyfoglucan (Tamarind Seed Polysaccharide) on Conjunctival Cell Adhesion to Laminin and on Corneal Epithelium Wound Healing
Authors: Burgalassi S. , Raimondi L. , Pirisino R. , Banchelli G. , Boldrini E. , Saettone M. F.
Published: January 2018

Purpose

TO explore the role of a natural polysaccharide extracted from tamarind seed (xyloglucan, or tamarind seed polysaccharide, TSP) on the integrin-substrate recognition system and on repair of corneal wounds.

Methods

a) Cultured human conjunctival cells were labeled by addition of a tritiated amino acid mixture. Their adhesion to laminin-coated culture wells in the absence or presence of TSP was checked by radioactivity count, b) The corneal epithelium of albino rabbits was damaged by applying a paper disc soaked with n-heptanol. The eyes were then treated with TSP, with a hyaluronate reference formulation and with normal saline solution (controls). The diameter of corneal wounds was measured daily, after fluorescein staining.

Results

Compared to hyaluronate, TSP slighthly but significantly increased the wound healing rate, TSP 1.0% exerted a positive influence on cell adhesion to laminin, up to a certain laminin concentration.

Conclusions

The ability of the polysaccharide to promote corneal wound healing might depend on its influence on the integrin recognition system.
Visual Acuity and Color Vision Deficiency in Amblyopia
Authors: Koçak-Altintas A.G. , Satana B. , Koçak I. , Duman S.
Published: January 2018

Purpose

To investigate color vision and its relation with the type of amblyopia and visual acuity of amblyopic eyes.

Methods

In this prospective study, 67 amblyopic eyes of 64 patients, aged from 4 to 13 years (mean 6.8 ± 2.1) and 26 eyes of 13 control subjects aged from 5 to 13 years (mean 7.3 ± 1.6) were examined with the Farnsworth-Munsell 100 Hue Test (FM-100). Amblyopic eyes were grouped as strabismic (21 eyes) and anisometropic (46 eyes). Each group was subdivided according to their visual acuity, as less than 5/10 and 6/10 or better. The total errors, blue-yellow (B-Y) and red-green (R-G) partial error scores were obtained for each group. One-way ANOVA was used to assess differences between groups.

Results

The error scores of all axes were lower in the control group than the amblyopic groups (p<0.001), but the differences within amblyopic groups were not significant (p>0.05).

Conclusions

Deficient color vision in the amblyopic eyes was not related to the visual acuity and type of amblyopia.
Posterior Sub-Tenon Triamcinolone for Refractory Diabetic Macular Edema: A Randomized Clinical Trial
Authors: Entezari M. , Ahmadieh H. , Dehghan M.H. , Ramezani A. , Bassirnia N. , Anissian A.
Published: January 2018

Purpose

To evaluate the effect of posterior sub-tenon triamcinolone acetonide (TA) injection on clinical, angiographic, and optical coherence tomographic (OCT) parameters in refractory diabetic macular edema (DME).

Methods

In a double-masked placebo-controlled clinical trial, 64 eyes were randomly assigned to two groups. The treatment group (32 eyes) received 40 mg posterior sub-tenon injection of TA and the placebo group (32 eyes) received subconjunctival injection of a placebo. The injections were repeated after 2 months in both groups. Complete ophthalmologic examination, fluorescein angiography, and OCT were performed before intervention and after 4 months. Quantitative measurement of angiographic variables such as the amount of hard exudates (HE), size of foveal avascular zone (FAZ), and leakage severity was performed by computer, using Photoshop software.

Results

Initial best-corrected visual acuity (VA) was 0.93±0.39 logMAR in the placebo group and 0.75±0.38 logMAR in the treatment group. At 4 months, corrected VA was 0.88±0.48 logMAR in the controls versus 0.71±0.42 logMAR in the cases. Mean central macular thickness measured by OCT before and 4 months after injection was 392 and 377 microns in the treatment group and 388 and 357 microns in the placebo group, respectively. No statistically significant difference was detected between the two groups. The difference was also not significant in HE, FAZ, and leakage in the angiograms.

Conclusions

Two injections of posterior sub-tenon TA had no therapeutic effect on refractory DME.
Topographic Angiography and Optical Coherence Tomography: A Correlation of Imaging Characteristics
Authors: Ahlers C. , Michels S. , Elsner H. , Birngruber R. , Pruente C. , Schmidt-erfurth U.
Published: January 2018

Purpose

Topographic angiography (TAG) using confocal scanning laser angiography and optical coherence tomography (OCT) are new imaging modalities that have been introduced during recent years. OCT and TAG imaging were compared to specify the characteristics of each imaging modality.

Methods

TAG using fluorescein angiography (FA) provides a three-dimensional profile of the vascular structures based on the analysis of a set of 32 confocal images over a depth of 4 mm. OCT provides cross-sectional images of the neurosensory retina and the retinal pigment epithelium-choriocapillary complex (RPE-CC). The authors compared and evaluated both modalities in 10 patients with predominantly classic choroidal neovascularization (CNV), 10 patients with serous pigment epithelial detachment (PED), and 10 patients with geographic RPE atrophy, all secondary to age-related macular degeneration (ARMD).

Results

In patients with classic CNV, TAG detected neovascular structures and delineated their configuration. In PEDs pooling of extravascular fluid is demonstrated, and in geographic RPE atrophy TAG showed reduced choroidal perfusion. Classic CNV was demonstrated by OCT as a hyperreflective band at the level of the RPE-CC, and PED showed a dome-shaped RPE detachment. In geographic RPE atrophy, OCT imaged loss of the RPE band and had an increased depth resolution.

Conclusions

TAG and OCT are useful imaging modalities in the evaluation of ARMD cases. TAG visualizes the vascular configuration and dynamic perfusion and leakage changes. OCT is able to document intra-, subretinal, and sub-RPE fluid accumulation secondary to CNV. Both modalities may provide further valuable insight into ARMD pathogenesis, enhance diagnostic quality, and improve the assessment of therapeutic effects.
Utilization of Mathematical Processing of Retinal Images with Use of Adaptive Contrast Control (ACC) Method to Detect Quantity of Vascular Endings
Authors: Kolar P. , Starha P. , Vlkova E.
Published: January 2018

Purpose

The authors investigated whether the method of mathematical processing of retinal images with the use of a computer can be used to evaluate ocular background figures of patients with physiologic retinal findings. This method is based on identification of vascular endings in an examined retinal area. When the authors mention vascular endings, they do not refer to factual endings, but recognizable vascular endings; there are no endings in a vascular system.

Methods

Adaptive contrast control (ACC) method was used to determine a number of vascular endings. The method is based on mathematical processing of a digitized retina picture with the use of a computer. On a digitized retinal picture, the vascular system is identified with the use of the conditional erosion methodology, and the number of vascular endings is then determined. The ACC method was used to process a file of retinal pictures of 38 patients (76 eyes) with physiologic retinal findings.

Results

Based on the results of statistical analysis, the authors detected that the number of vascular endings showed a normal curve (Gaussian distribution, p=0.05). A tight correlation between quantities of vascular endings in the right and the left eyes was also detected, which means that the quantity of vascular endings in the right and the left eyes is in a very close correlation (p=0.05).

Conclusions

The authors highlight that the curve of the number of vascular endings of patients with physiologic retinal findings shows a Gaussian distribution.
Retinal Angiomatous Proliferation Treated with a Combination of Intravitreal Triamcinolone Acetonide and Photodynamic Therapy with Verteporfin
Authors: Mantel I. , Ambresin A. , Zografos L.
Published: January 2018

Purpose

Retinal angiomatous proliferation (RAP) is a particularly aggressive form of exudative age-related macular degeneration. Response to laser photocoagulation or to photodynamic therapy (PDT) alone is often disappointing. The purpose of this study was to determine whether intravitreal triamcinolone acetonide (TA) injections followed by PDT in eyes with early stage RAP may be effective.

Methods

Prospective uncontrolled study, enrolling 11 patients (11 eyes) with stage 2 RAP, treated with intravitreal TA injection followed by PDT. Patients with large pigment epithelium detachment, RAP stage 3, or pre-existing glaucoma and known steroid responders were excluded. All patients underwent a complete ophthalmic examination including fluorescein and indocyanine green (ICG) angiography and optical coherence tomography (OCT-3) at baseline and at 1, 3, 6, and 12 months. Informed consent was obtained from all patients.

Results

Mean follow-up was 14.9 months (range 6–21 months). Mean age was 82 years. In four patients a small pigment epithelium detachment was found on tomography. Initial visual acuity (VA) ranged from 0.1 to 0.6 on the Snellen scale. After calculating the logarithmic values the authors found an initial mean VA of logMAR 0.61, which improved by 1.5, 0.9, and 0.9 log lines after 3, 6, and 12 months, respectively. Although the VA gain from baseline tended to decrease with time, only 2 patients (18%) had an actual loss of acuity (≥3 lines). Retreatment was required in 5 eyes.

Conclusions

In this prospective pilot study examining the use of intravitreal TA followed by PDT with verteporfin in eyes with stage 2 RAP, without a large pigment epithelium detachment, the authors found a potential benefit in terms of stabilization or even improvement of vision.
Idiopathic Macular Hypoplasia: A Report of Four Cases and Refinement of the Phenotype of So-Called Ateliotic Macula
Authors: El Annan J. , Marcotty A. , Mitchell P. , Traboulsi E.I.
Published: January 2018

Purpose

To refine the phenotype of idiopathic macular hypoplasia, also referred to as ateliotic macula, by describing a series of cases with this diagnosis.

Methods

A review of the clinical characteristics of four patients as documented in medical records with regard to refractive error, visual acuity, anterior segment examination, retinal findings, and ancillary tests such as electroretinography (ERG).

Results

All patients had oval circumscribed or diffuse areas in the posterior pole where the retina appeared not to have developed normally; the fovea was involved in three patients with reduced visual acuity, and one patient had parafoveal lesions with preserved visual acuity. There were three males and one females. Patients’ age ranged from 4 to 16 years. Errors of refraction ranged from severe myopia to hypermetropia and mild astigmatism. The anterior segment was normal in all patients. Three patients had strabismus and two had nystagmus. ERG was normal in the one patient in whom it was performed. One patient was mosaic for trisomy of chromosome 9.

Conclusions

The term idiopathic macular hypoplasia can be applied to a spectrum of abnormalities in which a localized area of the posterior pole has a primordial or underdeveloped appearance. Lesions involving the fovea result in poor acuity. Generalized retinal dysfunction is absent. At least one of the genes involved in macular development may be located on chromosome 9.
Microincisional Cataract Surgery (MICS) with Pulse and Burst Modes
Authors: Baykara M. , Ercan Í. , Ozcetin H.
Published: January 2018

Purpose

To compare the amount of ultrasound (US) energy and balanced solution (BS) required for burst mode and pulse mode during bimanual phacoemulsification surgery.

Methods

One hundred cases were divided into two groups (the pulse mode Group 1 [50 eyes], the burst mode Group 2 [50 eyes]). One surgeon (M.B.) performed phaco emulsification procedures using topical anesthesia with the AMO Sovereign in all patients. The technique was based on the nuclear hardness and surgeon's criteria and performed bimanually The surgery time, total ultrasound time (UST) and effective US power (USP), and used balanced solution (BS) were retrospectively compared.

Results

The mean surgery time, mean UST, and mean used BS volume were not statistically different in both groups (p>0.05). The mean EPT was statistically highly different in both groups (p>0.001). There was a slight tendency toward more surgery time in Group 2 than in Group 1, although the difference was not significant (p=0.146). Statistically significant higher results (Group 1: r=0,889, p<0.001 and Group 2: r=0,834, p<0.001) were seen in Group 1 when both groups were evaluated for the surgery time and used BS volume. When UST and used BS volume were evaluated in Groups 1 and 2, significant relation was seen in both but the correlation is statistically higher in Group 1 (Group 1: r=0,765, p<0.001, and Group 2: r=0,544, p<0.001).

Conclusions

The very low energy modes with the WhiteStar technology are suitable for bimanual cataract surgery.
Prevalence of Congenital Optic Disc Pits in Adult Chinese: The Beijing Eye Study
Authors: Wang Y. , Xu L. , Jonas J.B.
Published: January 2018

Purpose

To determine the prevalence of optic disc pits in the elderly Chinese population.

Methods

The Beijing Eye Study, a population-based, cross-sectional cohort study, included 4439 subjects out of 5324 subjects invited to participate (response rate 83.4%) with an age of 40+ years. The present study included 4027 (90.7%) subjects for whom readable optic disc photographs were available.

Results

A pit of the optic nerve head was detected in one (0.02%) patient. Prevalence was 0.02 ± 1.58% (95% confidence interval: −0.02, 0.07).

Conclusions

A congenital optic disc pit was found in one subject of the present population-based study in mainland China. In a mathematical sense, the calculated prevalence of optic disc pits in the whole population would be 0.02 ± 1.58% (95% confidence interval: −0.02, 0.07) or about 1:4.000 subjects. From a statistical point of view, however, population-based studies with about 10,000 subjects are necessary to confirm this finding.
Prevalence of Retinitis Pigmentosa in Urban and Rural Adult Chinese: The Beijing Eye Study
Authors: Xu L. , Hu L. , Ma K. , Li J. , Jonas J.B.
Published: January 2018

Purpose

To determine the prevalence of retinitis pigmentosa in the elderly Chinese population.

Methods

The Beijing Eye Study is a population-based, cross-sectional cohort study and included 4439 subjects out of 5324 subjects invited to participate (response rate 83.4%) with an age of 40+ years. Readable fundus photographs were available for 4027 (90.7%) subjects. Diagnostic criteria for retinitis pigmentosa were visual field defects on frequency doubling perimetry, typical ophthalmoscopic abnormalities such as retinal pigment deposits, retinal arteriole attenuation, and pigment epithelial atrophy, and no other reason for perimetric defects and fundus abnormalities.

Results

Retinitis pigmentosa was diagnosed in four subjects (all men). Its prevalence was 0.099±3.15% (95% CI: 0.00, 0.2).

Conclusions

Retinitis pigmentosa with typical fundus appearance and functional loss may be present in about 1 out of 1000 elderly Chinese in Northern China. Calculated for the whole population in China, the figure would be 1.3 million patients with retinitis pigmentosa.
Expression of Proteins Associated with Cell-Matrix Adhesion in Proliferative Vitreoretinopathy Designed by Dispase Model
Authors: Isiksoy S. , Basmak H. , Kasapoglu dundar E. , Ozer A.
Published: January 2018

Purpose

During recent years, the interaction of cell surface molecule, extracellular matrix proteins, and cytoskeletal elements has been a topic for research for the purpose of understanding the mechanisms of pathologic conditions. This study aims to evaluate the expression of CD44, as a cell surface adhesion molecule; fibronectin (FN), as an extracellular and a cell surface protein; vinculin and actin/α-smooth muscle actin (α-SMA), as cytoskeletal elements; and the interactions of these proteins in the microenvironment of proliferative vitreoretinopathy (PVR).

Methods

This experimental study was designed by the intravitreal Dispase model in rabbits and proteins' expression were evaluated via immunohistochemical staining.

Results

As a cell surface protein, CD44 expression was determined in only four eyes focally and weakly, but in a small number of cells. Among the cytoskeletal proteins, vinculin expression was the most extensive and the strongest in intensity in epi- and subretinal membranes. Alpha-SMA expression was mostly present within small foci of cells. Fibronectin expression was determined in some of the eyes only faintly.

Conclusions

Vinculin seems to be involved in PVR pathogenesis. Variability in co-distribution of the expression of vinculin, FN, and α-SMA reflects the dynamic interactions evolving between cell and extracellular matrix during the epi- and subretinal membrane formations. The results of this study were determined not to be in support of the assumption that CD44 has a functional role in the pathogenesis of PVR. (Eur J Ophthalmol 2007; 17: 89–103)
Orbital Cellulitis following Implantation of Aqueous Drainage Devices
Authors: Chaudhry I.A. , Shamsi F.A. , Morales J.
Published: January 2018

Purpose

Orbital cellulitis (OC) as a complication of implanted aqueous drainage devices (ADD) for glaucoma is an uncommon phenomenon. The authors report two cases of infectious OC in patients with a history of congenital glaucoma and placement of ADD.

Methods

Clinical records of two patients with ADD who subsequently developed OC were reviewed for presenting symptoms, signs, medical and surgical management, and final outcome.

Results

In the first case, an 11-year-old girl was found to have evidence of OC 9 days after the implantation of a Krupin-Denver valve. In the second case, a 14-month-old girl presented with similar findings 8 months following the implantation of an Ahmed valve. In both cases, ultrasonography demonstrated evidence of orbital inflammation and in one patient computed tomography scan was consistent with OC. In both cases, prompt institution of systemic antibiotics resulted in resolution of the clinical signs. In the first case, diagnosis was made early and the patient was promptly treated with systemic antibiotics, resulting in resolution of her symptoms without the need for implant removal. Because of the delayed presentation in the second case, an infected implant had to be removed to achieve resolution in addition to aggressive treatment with antibiotics.

Conclusions

Although rare, infectious OC may occur following implantation of ADD. Early recognition and intervention may be required to achieve resolution of the infection. (Eur J Ophthalmol 2007; 17: 136–40)
Comparison of Swedish Interactive Threshold Algorithm and Full Threshold Algorithm for Glaucomatous Visual Field Loss
Authors: Aoki Y. , Takahashi G. , Kitahara K.
Published: January 2018

Purpose

To compare the prevalence of visual field loss, the sensitivity distribution, and the size and depth of glaucomatous visual field defects using the standard full threshold (FT) and the Swedish interactive threshold algorithm (SITA) standard (SS) procedures in patients with early or suspected glaucoma.

Methods

Automated perimetry findings were retrospectively evaluated in 53 patients (105 eyes) with early or suspected glaucoma.

Results

The number of eyes judged to have glaucomatous visual field loss by SS (48 eyes) was significantly larger than what was found with FT (35 eyes), and 70 eyes were classified as pre-perimetric glaucoma. In these 70 eyes, there were many locations where the sensitivity was significantly higher with SS than with FT (intrasubject difference), and SS had less intersubject variability than FT at most locations. The cumulative decibel scores at the region of glaucomatous defects were larger with SS (206.2±103.3 dB) than with FT (162.1±87.5 dB) (p=0.02), which indicated that the depth of defects measured by SS was shallower than that by FT. The sizes of defects were significantly larger with SS (11.2±5.6) than with FT (9.7±5.1) (p<0.05).

Conclusions

Glaucomatous defects were measured as being significantly shallower and larger with SS than with FT. In addition, the prevalence of visual field defect was higher with SS according to some of the criteria for glaucomatous visual field defects. These results might be related to the fact that SS strategy has a lower variability and to the Bayesian statistical properties of the SITA algorithm. (Eur J Ophthalmol 2007; 17: 196–202)
Intravitreal Bevacizumab Therapy for Choroidal Neovascularization Secondary to Age-Related Macular Degeneration: 6-Month Results of an Open-Label Uncontrolled Clinical Study
Authors: Giansanti F. , Virgili G. , Bini A. , Rapizzi E. , Giacomelli G. , Donati M.C. , Verdina T. , Menchini U.
Published: January 2018

Purpose

To investigate the 6-month safety and clinical outcomes of intravitreal injections of bevacizumab administered to treat choroidal neovascularization secondary to age-related macular degeneration.

Methods

Twenty-seven patients underwent 1.25 mg intravitreal injections of bevacizumab at baseline. A similar intravitreal injection was administered to all eyes at 1 and 2 month follow-up visits. At baseline and at each follow-up visit (1, 2, 3, and 6 months), patients underwent best-corrected visual acuity (BCVA) measurement, fluorescein angiography, indocyanine green angiography, and optical coherence tomography. Laboratory testing, visual field analyses, and endothelial cell counts were performed at baseline and third and sixth months.

Results

At 3 months, the mean BCVA remained substantially stable at 20/100. Mean central retinal thickness (CRT) decreased from 373 to 279 μm (p<0.01). Mean lesion greatest linear dimension (GLD) decreased from 4087 to 3782 microns (p<0.01). At 6 months, mean BCVA slightly decreased from 20/100−1 to 20/125−3 (not significant, p=0.40). Mean CRT was still inferior to baseline (305 μm, p<0.01). Mean lesion GLD was 4186 μm, not different from baseline values (p=0.59), but superior to 3-month mean GLD (p<0.01). Significant visual field defects or endothelial cell losses were not detected at 3 and 6 months. Laboratory testing did not reveal any clinically significant deviations compared to baseline values.

Conclusions

Intravitreal therapy using bevacizumab over 6 months showed stabilization of visual acuity and choroidal neovascularization activity; the safety data were convincing. (Eur J Ophthalmol 2007; 17: 230–7)
Long-Term Clinical Outcomes and Therapeutic Benefits of Triamcinolone-Assisted Pars Plana Vitrectomy for Proliferative Vitreoretinopathy: A Case Study
Authors: Ueno A. , Enaida H. , Hata Y. , Hisatomi T. , Nakamura T. , Mochizuki Y. , Sakamoto T. , Ishibashi T.
Published: January 2018

Purpose.

To investigate intraoperative visibility and long-term clinical outcome following triamcinolone acetonide (TA)-assisted pars plana vitrectomy (PPV) for proliferative vitreoretinopathy (PVR).

Methods.

A retrospective interventional noncomparative clinical study was carried out on 21 eyes from 21 patients with more than grade C2 PVR, all of whom underwent TA-assisted PPV. Two of the specimens were observed with an electron microscope. After treatment, outcome measures, including changes in best-corrected visual acuity (BCVA), intraocular pressure (IOP) elevation, corneal pathology, and occurrence of endophthalmitis, were recorded. Patient follow-up time was >36 months (mean ± standard deviation = 47.3 ± 6.7 months).

Results.

TA improved the intraoperative visualization of the epiretinal membrane (ERM), allowing it to be easily removed together with the partially internal limiting membrane (ILM) using microforceps. The excised tissue consisted of proliferative cells and an extracellular matrix underlying the ILM. After the operation, 71.4% of the eyes had improved BCVA. Three of the eyes showed sustained IOP elevation (14.3%); two of these cases were controlled by the administration of eyedrops, while the third required filtering surgery. In two cases, an absorption delay of the TA granule on the retinal surface was observed. One eye developed corneal stromal opacity. No other severe complications occurred during the observation period.

Conclusions.

TA-assisted PPV offers improved visualization during the surgical management of PVR, and allows surgeons to excise the ERM safely and effectively without the risk of serious complications.
Macular Hole and Intravitreal Injection of Triamcinolone Acetonide for Macular Edema Due to Central Retinal Vein Occlusion
Authors: Lattanzio R. , Ramoni A. , Scotti F. , Introini U.
Published: January 2018

Purpose.

To report a case of macular hole progression after intravitreal injection of triamcinolone acetonide (IVTA) for chronic macular edema secondary to nonischemic central retinal vein occlusion (CRVO).

Methods.

A 33-year-old woman with massive macular edema after CRVO underwent IVTA. Optical coherence tomography (OCT) and fluorescein angiography were performed before and after the procedure.

Results.

At the 1-week IVTA injection control, the patient's best-corrected visual acuity improved from 20/400 to 20/200 and OCT detected a progression of macular hole stage.

Conclusions.

IVTA steroid injection may provide a significant improvement in macular edema, but injection-related complications may occur such as this uncommon macular reaction resulting in permanent visual loss.