bluuebunny/crossref_metadata_2025 huggingface dataset:
Early responders within seven days of dupilumab treatment for severe asthma evaluated by patient-reported outcome: a pilot study
Authors: Tani Nozomi , Kataoka Nobutaka , Kunimatsu Yusuke , Tachibana Yusuke , Sugimoto Takumi , Sato Izumi , Ogura Yuri , Hirose Kazuki , Takeda Takayuki
Published: March 2021

Background: The management of severe asthma-associated symptoms is essential since they are distressing to the affected patients, and also greatly impair their quality of life. Dupilumab, a monoclonal antibody, blocks interleukin (IL)-4 and IL-13 signaling, both of which are crucial in acquired and innate immunity pathways through fast signal transduction, leading to an early response to treatment. Although rapid improvement within 1–3 days after dupilumab treatment was observed in moderate-to-severe atopic dermatitis, an early response within 7 days of dupilumab treatment in severe asthma has not been reported. Methods: Twelve consecutive patients with severe asthma who were newly treated with dupilumab between July 2019 and April 2020 were retrospectively investigated. We evaluated the early response (within 7 days) of patients with severe asthma receiving dupilumab therapy. Asthma control test (ACT) and the daily ACT, which was modified from the ACT to evaluate daily symptoms associated with asthma, were adopted as patient-reported outcomes (PROs) at week 8 and within 7 days, respectively. Patients were stratified into early responders (7 days), late responders (week 8), and non-responders without significant improvement in PROs. Descriptive statistics were adopted due to the limited number of patients.Results: Four of these 12 patients were early responders, with the following baseline characteristics: body mass index, <25 kg/m2; without depression; baseline forced expiratory volume in 1 second, <1.50 L; and more than one exacerbation in 1 year. On the other hand, five were late responders, and 44.4% of the nine responders were early responders. The higher the eosinophilic count and/or FeNO did not show any relationship between the early responder and nonresponder.Conclusions: The effect of dupilumab on severe asthma in patients with atopic features could be started earlier than 2 weeks, similar to atopic dermatitis. Daily ACT may be useful in monitoring the early efficacy of dupilumab in treating severe asthma.
The pioneers of modern lymphology in the early 20th century
Authors: Macciò Alberto
Published: March 2021

We can state that modern lymphology was born from the pioneering work of the physicians of the first quarter of the 20th century. The turning point was definitely linked to the huge and precise work of the anatomists of the previous centuries and above all to the fine anatomical studies that resulted from the works of the second half of the 19th century. In the following decades, the possibility of specifically highlighting and studying lymphatic vessels and their physiology allowed the foundational step towards their clinical application and therefore the real understanding of pathologies and the first rudimentary therapeutic approaches. After the work of Von Recklingausen (1863) and Sappey (1876), after the technical completion of the then modern Gerota staining (1896) and the postulates on the physiology of the microcirculation put forward by Starling (1894), three centuries after the intuitions of Aselli (1626), we saw the definitive emancipation of Lymphology as an independent medical subject.
Environmental cracking tests on 18% Ni maraging steel used in the FHE 400 hydrofoil
Authors: Biefer G J , Olivier B G
Published: March 2021

"Bent-strip" environmental cracking tests in 3.5% NaCL solution indicated that air-melt 18% Ni maraging steel from the failed centre foil of the FHE 400 Hydrofoil Craft was much more susceptible to hydrogen embrittlement cracking (HEC) than was
vacuum-melt material. Tests on air-melt maraging steel from another source indicated equal susceptibility to HEC for a steel that had been given a heat-treatment designed to bring about thermal embrittlement and for the same steel given a standard heat treatment. Under free corrosion conditions,
however, the standard material appeared to be more resistant than the thermally embrittled material. The results of a few exploratory tests on maraging steel specimens which had been neoprene-coated, in some instances over a cadmium metal undercoat, are detailed.
Strength and durability of concrete made with modified type II cement
Authors: Malhotra V M , Zoldners N G
Published: March 2021

Les auteurs ont étudié, en comparaison du ciment de type I normal, les propriétés de résistance et de durabilité de bétons faits, séparément et mêlés, de trois différentes marques de ciment portland du
type II modifié à faible chaleur de prise. Les résultats de l'essai de résistance à la compression à long terme indiquent que le ciment de type II modifié présente des caractéristiques de résistance satisfaisantes. Quoiqu'il soit plus lent à
acquérir de la résistance au début, cette résistance atteint celle du béton fait de ciment portland de type I normal en 90 jours et lui est supérieure après un an. Les études sur la durabilité des trois marques de ciment de type Il indiquent que les
poutres de béton à moyenne et haute résistance (3 ½ sur 4 sur 16 pouces) qui ont servi dans cette essai se comportaient bien la fin d'environ 800 cycles de gel et de dégel, mais que les échantillons à moyenne résistance ont perdu beaucoup de leur
résistance à la flexion. La plus basse résistance résiduelle à la flexion obtenue après 781 cycles a été de 45.2 p. 100 de la résistance d'une poutre de référence traitée normalement.
COVID-19
Authors: Jadhav Rajashree Dhananjay , Gachake Arti Rajaram , Swami Vasanthi V. , Jadhav Abhishek Dhananjay
Published: March 2021

The current global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated coronavirus disease (COVID-19), has grasped the attention of entire international community and has caused widespread public health concerns. All the efforts taken globally to curtail the novel COVID-19; the outbreak is still on a rise owing to the community spread pattern of this infection. COVID-19 is a zoonotic infection that, like other coronavirus infections, is believed to have been originated in bats and pangolins, and later transmitted to humans. Once in the human body, this coronavirus (SARS-CoV-2) is abundantly present in nasopharyngeal and salivary secretions of affected patients and its spread is predominantly thought to be respiratory droplet in nature. Dental professionals may soon encounter patients with suspected or confirmed SARS-CoV-2 infection and will have to act carefully not only to provide care but at the same time prevent spread of infection. Thus, the aim of this article is to provide a brief overview of the epidemiology, symptoms and routes of spread of the novel COVID-19 infection. In addition to this, specific recommendations for dental practice are prescribed for patient screening, infection control strategies, and patient management protocol.
Effect of cavity design and material type on fracture resistance and failure pattern of molars restored by computer-aided design/computer-aided manufacturing inlays/onlays
Authors: Alassar Roqaia Mohammad , Samy Amira Mohammad , Abdel-Rahman Fatma Mahmoud
Published: March 2021

Background:

The maximum conservation of tooth structure and the use of restorative materials with elastic modulus close to the dental structure may promote greater longevity of the tooth/restoration complex. This study was conducted to evaluate the effect of cavity design and material type on fracture resistance and failure pattern of molars restored by computer-aided design/computer-aided manufacturing (CAD/CAM) inlays/onlays.

Materials and Methods:

In this in vitro study, 55 human maxillary molars were embedded in resin blocks and divided into control group (CG) and five main groups: Group 1: Inlay, Group 2: Conventional onlay/mesiobuccal (MB), Group 3: Conservative onlay/MB, Group 4: Conventional onlay/MB and distobuccal (DB), and Group 5: Conservative onlay/MB and DB. Then, each group was divided into two subgroups: (A) CeraSmart (CS) and (B) Katana Zirconia (KZ). Restorations were cemented by RelyX Ultimate and then thermocycled. The universal testing machine was used to measure fracture loads. Failure was determined using a magnifying lens. Data were statistically analyzed using ANOVA followed by Tukey's post hoc test (P < 0.05).

Results:

Group 5 showed the highest significant fracture load, whereas the least significant value was recorded in Group 2. KZ recorded higher significant fracture loads than CS in all tested groups. Groups 1, 2, and 3 restored by CS showed lower fracture load than CG, but the difference was insignificant with Group 1. CS restorations showed restorable failure, while unrestorable pattern was predominant in KZ restorations (P < 0.05).

Conclusion:

KZ inlays and onlays can be used safely in terms of fracture resistance as both have values exceed the physiologic requirements. CS inlays and onlays/MB and DB are of fracture resistance comparable to intact teeth. The use of conservative onlay design with more cusp coverage guarantees better resistance of CS restorations. Being force absorbing material, the predominant failure of teeth restored by CS was restorable.
Canalicular adenoma of the hard palate
Authors: Khodaei Milad , Amani Masoomeh , Mirinezhad Sina , Rafieyan Sona
Published: March 2021

Canalicular adenoma (CA) is a rare, benign salivary gland tumor that has special tendency to occur in the upper lip. Buccal mucosa is the second most common site. It occurs more often in older patients with peak prevalence in the seventh decade of life. A definitive female predominance has been reported. According to the latest English published literature, 531 cases of CA have been reported. We present a case of CA of the hard palate that presented in a 29-year-old female patient. The histopathological and immunohistochemical findings showed typical features of CA and intense expression of pan-cytokeratin and S-100 protein. We also review its differential diagnosis from other salivary gland tumors.
The effect of Remin Pro on the microhardness of initial enamel lesions in primary teeth
Authors: Nourolahian Homa , Parisay Iman , Mir Fatemeh
Published: March 2021

Background:

Remineralization is currently considered a treatment option for many clinicians. The present study was conducted to compare the effect of three remineralizing agents on microhardness of initial caries lesions in primary teeth.

Materials and Methods:

In this in vitro study, 96 enamel samples were prepared. Microhardness was first measured for all the samples using the Vickers microhardness test. After developing the initial caries lesions, the microhardness of all the demineralized samples was measured, and the samples were then divided into four groups (n = 24). Casein phosphopeptide–amorphous calcium phosphate in Group 1, Remin Pro in Group 2, and acidulated phosphate fluoride gel in Group 3 were placed on the samples for 4 min. The control group received no treatments. The microhardness of the samples was measured again following a pH cycle of 5 days. The data were analyzed by ANOVA and the post hoc test at the significance level of P < 0.05.

Results:

The mean microhardness reduced significantly in all the groups following the development of initial caries lesions and after the pH cycle of 3 days (P < 0.001). After the remineralization and pH cycle of 5 days, the mean microhardness was significantly lower in the control group compared to the other three groups (P < 0.001) and had increased in the three treated groups. The microhardness recovery rate also increased in the treated groups compared to the control group, but no significant differences were observed between the three groups themselves (P > 0.05).

Conclusion:

Remin Pro can be used as an effective substance for preventing tooth caries in children.
Effect of Er
Authors: Moosavi Horieh , Ahrari Farzaneh , Zanjani Maryam
Published: March 2021

Background:

This study investigated the influence of erbium-doped: yttrium aluminum garnet (Er:YAG) laser on the pull-out fracture load of fiber-reinforced composite (FRC) posts luted to dentin with different resin cements.

Materials and Methods:

In this in vitro experimental study, 90 premolars were endodontically treated. The post spaces were prepared, and the teeth were divided into three groups dependent on the cement applied for luting FRC posts: Group 1: An etch-and-rinse system, Group 2: A self-etch cement, and Group 3: A self-adhesive cement. After 6 months' storage and thermocycling, each group was divided into three subgroups (n = 10) according to the treatment applied for removing the posts; subgroup 1: Control, subgroup 2: Treatment with Er:YAG laser at 250 mJ, 20 Hz, and subgroup 3: Treatment by Er:YAG laser at 300 mJ, 10 Hz. The pull-out load was recorded in Newton. The data were analyzed by two-way ANOVA at P < 0.05.

Results:

The fracture load was significantly affected by the cementation group (P = 0.005) and treatment subgroup (P = 0.008). The pull-out load of self-etch cement was significantly greater than that of the self-adhesive and etch-and-rinse systems (P < 0.05). Treatment with Er:YAG laser caused a significant reduction in pull-out load of FRC posts (P < 0.05).

Conclusion:

The fracture load of fiber posts is influenced by the type of cement and treatment applied. Post removal would be less challenging when using a self-adhesive or conventional etch-and-rinse cement or using Er:YAG laser at the FRC-resin interface.
A new teaching model with artificial teeth containing simulated pulpal tissue
Authors: Razavian Hamid , Hanjani Kimia
Published: March 2021

Background:

This study aimed to evaluate the use of artificial teeth for endodontic training for dental students.

Materials and Methods:

The following aspects of the artificial teeth were approved by the endodontists in Isfahan University of Medical Science: internal and external anatomy; coronal pulp chambers regarding their size, shape, and canal path; the root canals regarding their size, shape, and position; filling the pulp chamber and root canals by considering the texture, quantity, color, and ease of handling; and resin hardness and visualization of the radiographic image.

Results:

The results showed favorable opinions regarding the internal and external anatomy, coronal pulp chamber, root canal (s), handling, and radiographic imaging. The contents of the pulp space and hardness of the teeth were satisfactory.

Conclusion:

The artificial teeth tested have the potential to replace the natural teeth in preclinical training.
Expression of p53 and Ki-67 proteins in patients with increasing severity and duration of pterygium
Authors: Mahesh Mood , Mittal Sanjeev K , Kishore Sanjeev , Singh Anupam , Gupta Neeti , Rana Rimpi
Published: March 2021

Purpose:

Pterygium is a triangular fibrovascular subepithelial ingrowth of degenerative bulbar conjunctival tissue over the cornea. It is now considered to be a result of uncontrolled cellular proliferation as overexpression of p53 protein and Ki-67 nuclear protein was found in the epithelium. This study was done to find the expression of p53 and Ki-67 with the severity and duration of the pterygium to explain the etiopathogenesis.

Methods:

Data were analyzed from 43 Indian participants of all age groups. All patients were divided according to the severity of pterygium (mild, moderate, and severe groups) and according to the duration of pterygium (<4 years and >4 years). The samples were studied by immunohistochemistry by using antibodies against p53 and Ki-67 proteins considering >5% expression as significant.

Results:

Of 43 cases, p53 and Ki-67 expression were positive in 33 cases. In mild, moderate, and severe cases p53 positivity was 33.3%, 78.4%, 100%, respectively. P53 expression increased with duration, 79.3% positive in <4 years, and 92.9% positive in >4 years. With increasing severity of pterygium, mild, moderate, and severe cases, Ki-67 positivity was 66.7%, 78.37%, 66.7%, respectively. Ki-67 expression with duration, 79.3% positive in <4 years, and 85.7% positive in >4 years of the duration of pterygium with no statistical significance.

Conclusion:

Our study revealed that with increasing duration and severity of pterygium, p53 expression was observed to be increasing. Ki-67 expression increased with the duration of pterygium but not with the severity.
Functional evaluation of the macular area in early glaucoma using microperimetry
Authors: Phuljhele Swati , Angmo Dewang , Aalok Lalit , Parwal Sandeep , Azad Raj Vardhan , Gupta Viney , Sihota Ramanjit
Published: March 2021

Purpose:

To evaluate the central visual field by microperimetry (MP), in early glaucoma.

Methods:

Consecutive perimetrically experienced patients with a single nasal step or arcuate scotoma and 14 control eyes underwent MP. Retinal sensitivity on MP was mapped for frequency and depth of loss in the central 10° around fixation.

Results:

Twenty-one eyes had a single nasal step and 19 eyes with single arcuate scotoma on standard automated perimetry (SAP), with central 10° being normal on 30–2 and 10–2 perimetry. The average mean sensitivity on MP, in glaucomatous and control eyes was 11.8 ± 3.9 dB and 16.6 ± 1.2 dB, respectively, P = 0.0004. The average mean defect on MP-1, in glaucomatous and control eyes was - 6.5 ± 2.0 dB and - 3.0 ± 1.2 Db, respectively, P = 0.05. The corresponding retinal hemisphere showed significant defects in MP. In eyes with single nasal steps, an absolute scotoma was seen in 14–28% of eyes 8–10° off fixation, moderate to mild defects were seen in 10–52% eyes, and 10% eyes showed involvement up to 4° from the fixation. Eyes with arcuate scotoma had an absolute scotoma on MP in 95% of eyes, 6–10° from fixation, with extension up to 2° from fixation in 21%. In glaucomatous eyes, the normal hemisphere on SAP showed a mild defect on MP in 43%. Control eyes did not show any defect in SAP or MP.

Conclusion:

A significant loss of central retinal sensitivity is recorded on MP in early glaucomatous neuropathy as compared to SAP. Paramacular absolute defects were seen at 6–10° from fixation.
Comparative evaluation of Octopus semi-automated kinetic perimeter with Humphrey and Goldmann perimeters in neuro-ophthalmic disorders
Authors: Bhaskaran Karthika , Phuljhele Swati , Kumar Pawan , Saxena Rohit , Angmo Dewang , Sharma Pradeep
Published: March 2021

Purpose:

The aim of this study was to compare the performance of Octopus 900(OVF) kinetic module with Goldmann perimeter (GVF) and Humphrey 750i (HVF) perimeters in neuro-ophthalmic disorders.

Methods:

During this prospective observational cross-sectional study, 17 patients (26 eyes) with neuro-ophthalmic disorders underwent visual field examination on the three perimeters. Field defects on OVF were matched with HVF and GVF for the number of quadrants involved. An unmasked observer, and a masked observer (unaware of the clinical diagnosis) were made to separately diagnose the type of field defects on all three fields for the same patient. The pattern of field defect on OVF was compared with GVF and HVF field defects for both observers.

Results:

When OVF was compared with HVF and GVF, 88% eyes correctly matched for normal or abnormal visual fields, while quadrant-matching was 80% and 89% respectively. For the unmasked observer, the pattern of field defects on OVF was similar to HVF and GVF in 58% and 65% eyes respectively while for a masked observer, it was 54% and 62%. Central and paracentral scotomas showed unmatched fields when OVF was compared with HVF and GVF. When these patients were excluded, sensitivity of OVF increased to 95%.

Conclusion:

Clinical correlation aids in better characterisation of a field defect. All 3 perimeters are concurrent in the pattern of field defects for non-central defects. However, the default protocol on OVF may not be enough to demarcate the central and para-central scotomas. Development of a customised protocol for the assessment of central and centrocecal field defects increases the accuracy of OVF.
Agreement of findings of glaucoma screening between trained vision center technicians and glaucoma specialists at a tertiary hospital in South India
Authors: Rengappa Ramakrishnan , Chandrashekharan Shivkumar , Gunaselvi Ranitha , Maheshwari Devendra , Kader Mohideen Abdul , Chakrabarty Sabyasachi
Published: March 2021

Purpose:

To study the agreement of findings of glaucoma screening between trained vision center (VC) technicians and glaucoma specialists in patients referred from VC to the glaucoma services of a tertiary eye care hospital in south India.

Methods:

This was a retrospective study comparing the findings of the VC technicians and the specialists of the glaucoma services in the base hospital, in patients referred from 13 VCs between January and June 2019. Medical records of 277 referred patients (out of 533 referrals) who attended the glaucoma clinic were analyzed.

Results:

Of the 277 patients, 111 (40%) were confirmed having glaucoma, 133 (48%) were suspects, 29 (10.4%) were normal, and four (1.4%) had other pathology. The mean age of the patients was 59.7 ± 13 years and 60.6% were females. There was no statistically significant difference between the mean intraocular pressure (IOP) measured (17 ± 7.2 mmHg at the VC and 18 ± 8.7 mmHg at the clinic, p = 0.16) and the cup-to-disc ratio (CDR) (0.7 ± 0.13 at the VC and 0.6 ± 0.18 at the clinic, p = 0.57). Bland–Altman plots with 95% limits of agreement supported that mean differences were close to zero, and the intraclass correlation coefficient at 95% CI showed good consistency between the measurement of IOP (0.78 [0.74 to 0.81]) and CDR (0.90 [0.88 to 0.92]) at the base hospital and vision center.

Conclusion:

There is good agreement between the findings of VC technicians and glaucoma specialists. VC technicians can help in detecting glaucoma in the community.
Habitual visual acuity in a large urban cohort of Western India and factors influencing poor habitual vision
Authors: Kumar Nishant , Dhingra Deepika , Bhartiya Shibal , Wadhwani Meenakshi
Published: March 2021

Purpose:

The aim of this study was to determine habitual visual acuity (HVA) in a large urban cohort in western India and identify factors associated with poor HVA.

Methods:

This was a prospective study conducted over 10 days in September 2018 to assess the HVA in individuals attending a 10-day festival in Western India. Participants who volunteered to undergo vision screening and also filled the questionnaire form pertaining to demographic information including their age, gender, address, income, and educational status were included in this study. HVA was recorded with the distance correction that the participants were wearing when they attended the screening. The study evaluated the prevalence of visual acuity 6/6 or <6/6, 6/12, and 6/18 and the factors associated with lower visual acuity.

Results:

Of the 6300 participants, 1660 (26.3%) were females. Majority of the participants were from urban background (6084, 96.6%) and were of younger age group (18–40 years––3786, 60.1%; 41–60 years––2187, 34.7%; >60 years––327, 5.2%). HVA was recorded as 6/6 both eyes in 4136 (65.6%), at least 6/12 both eyes in 5691 (90.3%), and at least 6/18 both eyes in 5974 (94.8%) individuals. Only 11 patients (0.17%) had VA worse than 6/60 with only 3 patients (0.003%) having bilateral VA <6/60. Older age, female sex, lower education status, and low annual income were significant risk factors for poor HVA.

Conclusion:

Poor education, lower income, female gender, and old age are significantly associated with poor HVA even in urban Western India despite relatively easy access to affordable eye care facilities.
Posterior optic buttonholing of intraocular lens implantation through posterior capsulorrhexis margin
Authors: Mohan Amit , Sen Pradhnya , Jain Richa , Shah Chintan , Jain Elesh , Sen Alok
Published: March 2021

This study aimed to evaluate the intra- and postoperative complications of intraocular lens (IOL) implantation with posterior optic buttonholing (POBH) in children that had undergone phacoemulsification irrigation/aspiration for congenital/developmental cataract and experienced complication of anterior capsulorrhexis extension (ACE). A total of 25 eyes of 21 patients were included in the study. A foldable three-piece IOL was implanted into the bag/ciliary sulcus with primary posterior capsulorrhexis and POBH. The visual acuity improved from 2.12 ± 0.69 log MAR to 1.38 ± 0.49 log MAR at 6 months follow-up. Postoperative complications included heightened postoperative inflammation in three patients and temporary corneal edema in two patients. Only one patient had developed posterior capsular opacification (PCO) at 6 months follow-up with mild tilt, while the rest 24 eyes had no PCO formation and adequate IOL centration. The results of this study indicate that a three-piece foldable IOL implantation with POBH is a feasible option for children who experienced ACE during pediatric cataract surgery, as it results in satisfactory surgical outcomes and very few ocular complications.
Thygeson‘s superficial punctate keratopathy
Authors: Priyadarshini Smruti Rekha , Roy Aravind , Das Sujata
Published: March 2021

Thygeson‘s superficial punctate keratitis (TSPK) is a chronic disorder with episodes of exacerbations and remissions which span over years to decades. Typical features of the disease include multiple, grayish white, intraepithelial corneal lesions with minimal or no conjunctival involvement. The exact etiopathogenesis of this entity is unknown. However, it may have a genetic association with HLA-DR3, an antigen proved to be associated with immunogenic responses. Treatment of the disease consists of artificial tears, topical corticosteroids, topical cyclosporine, topical tacrolimus, or usage of soft contact lenses. TSPK should be considered as a diagnosis of exclusion in cases of bilateral superficial punctate keratopathy of long duration. Thirteen patients of TSPK were examined during the last 6 years (2014–2019) at our Institute. Visual acuity was 20/20 to 20/30 in majority cases. All patients required lubricants.
Anatomical and functional outcomes one year after vitrectomy and retinal massage for large macular holes
Authors: Chakraborty Debdulal , Sengupta Sabyasachi , Mukherjee Angshuman , Majumdar Saptorshi
Published: March 2021

Purpose:

The aim of this study was to report results of macular hole closure, visual benefit and longitudinal changes in foveal architecture over 1 year following macular hole surgery with retinal massage.

Methods:

Records of patients with full thickness macular hole (FTMH) with minimum basal diameter of 550 μ who underwent vitrectomy, internal limiting membrane (ILM) peeling and retinal massage were drawn up. Retinal massage was performed after dye assisted ILM peeling, using a 27G flute needle with a long and soft silicone tip under air in a centripetal direction around the FTMH. At the end, 10% C3F8 gas was used as tamponade. The foveal contour at 1 year follow up was recorded based on its cross sectional appearance on OCT and was classified into U, V and irregular types of closure as previously described.

Results:

Forty-one eyes of 41 patients with a mean age of 70.4 ± 6.9 years were included. The mean preoperative vision was 0.99 ± 0.07 logMAR and mean maximum basal diameter of the FTMH was 835 ± 208 μ. Macular hole closure was seen in all patients at 1-month follow up. The BCVA improved to 0.5 ± 0.1 log MAR at 6 months (P < 0.001) and then stabilized. The U shaped closure was the commonest pattern (n = 22, 54%), followed by V-shaped closure (n = 16, 39%) while irregular closure was seen in 3 eyes (7%).

Conclusion:

Retinal massage after ILM peeling is a very simple, and as yet under-utilized manoeuvre that may improve hole closure rates and lead to potentially greater improvement in vision compared to existing techniques for large holes.
Contrast, visibility, and color balance between the microscope versus intracameral illumination in cataract surgery using a 3D visualization system
Authors: Kim Young Jae , Kim Yu Jeong , Nam Dong Heun , Kim Kwang Gi , Kim Seong-Woo , Chung Tae-Young , Lee Sung Jin , Park Kyu-Hyung
Published: March 2021

Purpose:

To compare image resolution and depth between the microscope versus intracameral illumination images during 3D heads-up cataract surgery.

Methods:

We collected 25 consecutive patients who had cataract surgery using the 3D viewing system. Based on bright, contrast, visibility, and color balance, the digital images (RGB color and three monochromes) extracted at the same point of the procedures were compared between the two illuminations.

Results:

Contrast values of green and blue channels except for red channel and visibility values of all three channels were higher in the intracameral illumination images than in the microscope images (P < 0.001, t-test). Color balance values of both green/red and blue/red were higher in the intracameral illumination images than in the microscope images (P < 0.001, t-test).

Conclusion:

The digital images in the digitally assisted cataract surgery were enhanced by using the intracameral illumination. Considering the contrast and color balance in the 3D cataract surgery, the intracameral illumination may be better than the microscope illumination.
Removal of full-thickness vertical corneal stromal wooden foreign bodies
Authors: Sharma Ashok , Sharma Rajan
Published: March 2021

A 28-year-old male presented with three full-thickness stromal wooden foreign bodies vertically oriented in the left cornea. An innovative intracameral approach was used. Paracentesis was done and healon was injected into the anterior chamber. Iris repositor was introduced into the anterior chamber and the area of foreign bodies was pushed up to compress the stroma. The wooden foreign body projected above the corneal surface and were picked up one by one using McPherson forceps. One of the foreign bodies has penetrated through the Descemet‘s membrane resulting a corneal perforation. A corneal perforation was confirmed by observing egress of the irrigating solution, injected into the anterior chamber through the paracentesis opening. The corneal perforation was sealed with corneal glue. He achieved 6/9 BCVA (OS) at 8 weeks and maintained it during18 months follow-up.
Acute graft rejection in a COVID-19 patient
Authors: Singh Garima , Mathur Umang
Published: March 2021

A 32-year-old man with a clear and compact graft following a penetrating keratoplasty 6 years back, developed an episode of acute graft rejection, coinciding with the COVID-19 disease. Subsequent to the infection with the novel coronavirus, he developed symptoms of acute graft rejection concurrent with the development of respiratory distress and peak systemic symptoms. This was the phase of cytokine storm as evidenced by the raised inflammatory markers in his blood tests. Such a case of acute corneal graft rejection coinciding with SARS-CoV-2 infection has been reported only once in the literature and this unique association needs to be researched further.
The anterior and posterior biometric characteristics in primary angle-closure disease
Authors: Huang Wenbin , Li Xingyi , Gao Xinbo , Zhang Xiulan
Published: March 2021

Purpose:

Obtaining a better understanding of the pathogenesis of primary angle-closure disease (PACD) still requires studies that provide measurements of anterior and posterior biometric characteristics together and that assess the relationship between them.

Methods:

In total, 201 eyes were enrolled in this cross-sectional study: 50 normal controls, 49 primary angle-closure suspect (PACS), 38 primary angle closure (PAC), and 64 primary angle-closure glaucoma (PACG) eyes. The anterior and posterior structural features were measured by anterior segment optical coherence tomography and swept-source optical coherence tomography.

Results:

All PACD groups had smaller anterior chamber depth (ACD), anterior chamber area (ACA), anterior chamber volume (ACV), angle opening distance at 750 μm from the scleral spur (AOD750), trabecular–iris space area at 750 μm from the scleral spur (TISA750), and angle recess area (ARA), as well as a larger lens vault (LV), than controls (all P < 0.001). The PACS and PAC groups had thicker iris thickness at 750 μm from the scleral spur (IT750) than controls (P = 0.017 and P = 0.002, respectively). Choroidal thickness (CT) was not statistically different among normal, PACS, PAC, and PACG eyes. Univariate and multivariate linear regression analysis revealed a significant association between thinner IT750 and increased CT in PACD eyes (P = 0.031, univariate analysis; P = 0.008, multivariate analysis).

Conclusion:

Thinner iris thickness was associated with increased CT in PACD eyes; however, the underlying mechanism needs further investigation.
Helmet shielding effect in mandibular fractures during road traffic accident
Authors: Singh R. K. , Kumar Virendra , Ganguly Roop , Patel Jatin , Daga Dipti
Published: March 2021

Objective:

The objectives of this study are to evaluate the proportion of helmeted and nonhelmeted patients sustaining mandibular fractures.

Materials and Methods:

A retrospective study was conducted on 200 patients reporting to oral and maxillofacial surgery (OMFS) unit, trauma center, and department of OMFS. A predesigned questionnaire was used to collect the necessary data. Patients were evaluated for age, gender, mode of transport (2/4 wheeler), presence of safety measure at the time of accident (helmet/seatbelt), maxillofacial injury in two wheeler (with helmet and without helmet), type of impact, and its association to maxillofacial fractures, particularly site of maxillofacial fractures. The association between mode of injury, presence of safety measures, impact type, and site of maxillofacial injuries was assessed using the Chi-square test. P < 0.5 was considered statistically significant.

Results:

The mean age of patients was 30 years, and approximately 92.5% of accidents patients were male. In this study, 35% nonhelmeted riders were reported head injury and 5% of the helmeted rider reported head injury. 54.5% of the patients suffered frontal impact, 28% collision, and 17.5% lateral slide collision. Head injuries are the main cause of death among the riders of all two wheelers. Lateral sliding collision injuries (17.5%) resulted 60.6% of the fractures mandible, 24.2% midface injury, and associated injury (15.15%).

Conclusion:

The use of helmet is strongly recommended to prevent head injuries and facial injuries. In the nonhelmeted riders in motorcycle accidents, the incidence of mandible fractures increases proportionally.
A meta analysis for evaluation of marginal bone level changes at dental implants
Authors: Kumar Varun , Arya Geeta , Singh Pranshu , Chauhan Pallavi
Published: March 2021

Aim:

The aim of this study was to assess the marginal bone level changes at dental implants after 1 year in function.

Methods:

Detailed searches from PubMed databases were made. A MEDLINE search (PubMed) published in the English language from 1980 to December 2018 was included in this study.

Results:

The electronic database research (MEDLINE) produced 166 corresponding articles. One hundred and twenty studies were excluded on the basis of abstract while the 46 researches were used chosen for full-text examination after the title and abstract testing, and 41 studies were excluded that did not meet the requirements of our inclusion and exclusion criteria. A total of 5 studies for a quantitative analysis were taken into account.

Conclusion:

Within the limits of the study, the mean marginal bone loss (MBL) was found to be 0.56 mm. A statistically significant difference in the MBL was found between the various studies.
Management of parotid fistula and Frey's syndrome with Botulinum neurotoxin type A
Authors: Chowdhury Ripon , Roy Dev , Roy Abhimanyu
Published: March 2021

The common cause of parotid fistula is parotid gland surgery and is frequently due to injury to the gland rather than to the duct. The frequency of postparotidectomy fistula is 14%. Other causes include facial trauma, congenital anomalies of the parotid gland, malignancies originating from the parotid gland and infections. Although there are several options for the treatment of parotid fistula and Frey's syndrome, very few treatment options are deemed optimal. The use of Botulinum A neurotoxin as a conservative method of treatment for parotid fistula and Frey's syndrome is a recent and evolving concept.
Bilateral sagittal split osteotomy a versatile approach for correction of facial deformity
Authors: Prasad Veerendra , Kumar Sanjay , Pradhan Harsha , Siddiqui Rehan , Ali Iqbal
Published: March 2021

Poor facial cosmesis resultant from dysgnathias usually accounts for a range of these individuals' psychological and social problems. Disturbances of both esthetics and function are caused by jaw deformity and associated structures' deformity such as malocclusion. The correction of these deformities is one of the most challenging and intriguing aspects of maxillofacial surgery. Despite having become routine only relatively recently, rigid internal fixation has advanced rapidly, its results are consistent and predictable and thus, its knowledge applies in orthognathic surgery besides other areas of maxillofacial surgery. The bilateral sagittal split osteotomy (BSSO) is a common orthognathic procedure performed on the mandible. First described by Trauner and Obwegeser in 1957, modified by Dal Pont and refined by Epker, several modifications of the BSSO have been introduced aiming to enhance surgical convenience, minimize morbidity, and maximize stability. The aim of this article is to review the literature of this technique from the historical perspective and to present a standard operation technique.
The Effect of Adipose Stromal Vascular Fraction on the Viability of Transverse Rectus Abdominis Myocutaneous Flap after Abdominoplasty
Authors: Coskun Erhan , Özkan Burak , Terzi Aysen , Özer Eda Özturan , Uysal Çagri Ahmet , Borman Huseyin , Ertas Nilgün Markal
Published: March 2021

Introduction:

A prior abdominoplasty is considered as an absolute contraindication to transverse rectus abdominis musculocutaneous (TRAM) flap surgery. The aim of this study is to investigate the effect of nonexpanded adipose stromal vascular fraction (ASVF) on the viability of TRAM flap after abdominoplasty.

Materials and Methods:

Thirty-five male Sprague Dawley rats were divided into five groups. Reverse abdominoplasty model was used in all groups except Group 1. TRAM flap was performed 2 weeks after abdominoplasty in Groups 2 and 4 and 4 weeks after in Groups 3 and 5. ASVF cells were injected during abdominoplasty in Groups 4 and 5. The viable flap area (VFA) percentage and newly formed perforators were assessed. Capillary density and fibrosis gradient and plasma vascular endothelial growth factor (VEGF) levels were measured.

Results:

The mean VFA to total flap area was measured as 82.90% ± 7.59%, 3.31% ± 3.29%, 9.40% ± 6.18%, 31.92% ± 9.29%, and 64.98% ± 10.95% in Group 1, Group 2, Group 3, Group 4, and Group 5, respectively (P < 0.05). The number of newly formed musculocutaneous perforating arteries was 0.29 ± 0.49, 1.14 ± 0.69, and 2 ± 0.82 for Groups 3, 4, and 5, respectively (P < 0.05). The mean capillary density was 6.86 ± 0.50, 0.67 ± 0.13, 2.79 ± 0.53, 3.71 ± 0.47, and 7.01 ± 0.70 in Groups 1, 2, 3, 4, and 5, respectively (P < 0.05). There was a statistically significant increase between the baseline VEGF values and the second VEGF values in Groups 4 and 5.

Conclusions:

The study showed that local injection of ASVF increases the viability of TRAM flap after abdominoplasty.
Arthroscopic Removal of Synovial Chondromatosis of the First Carpometacarpal Joint
Authors: Yildiran Gokce , Tosun Zekeriya
Published: March 2021

Synovial chondromatosis or loose body is frequently encountered in the knee, elbow, and shoulder joints. However, hand is a rare localization. It is aimed to present the arthroscopic excision of the loose body inside the first carpometacarpal (CMC) joint. A 47-year-old female patient presented with pain in the left thumb root. The grind test was positive in the patient; however, there were no signs of arthritis in the first CMC joint. Tomography revealed the loose bodies inside the joint. Under traction, CMC joint was palpated, two portals were opened, dry and wet arthroscopy was performed, and loose bodies were extracted. Synovial chondromatosis is a disorder that can be solved arthroscopically and should be kept in mind in hand and wrist pain, which reminds osteoarthritis of the hand and wrist where there are no signs of osteoarthritis in the physical examination and direct radiographs.
Fusion of Attentional and Traditional Convolutional Networks for Facial Expression Recognition
Authors: Trung Nguyen Tin , Hoang Le Thai
Published: March 2021

INTRODUCTION: The facial expression classification problem has been performed by many researchers. However, it is still a difficult problem to effectively classify facial expressions in highly challenging datasets. In recent years, the self-weighted Squeeze-and-Excitation block (SE-block) technique has evaluated the importance of each feature map in the Convolutional Neural Networks (CNNs) model, corresponding to the output of the Convolution layer, that has shown high efficiency in many practical applications.OBJECTIVES: In this paper, with the aim of balancing speed and accuracy for the problem of facial expression classification, we proposed two novel model architectures to solve these problems.METHODS: Two models proposed in this paper is: (1) a SqueezeNet model combined with a Squeeze-and- Excitation block, (2) SqueezeNet with Complex Bypass combined with a Squeeze-and-Excitation block. These models will have experimented with complex facial expression datasets. Furthermore, the ensemble learning method has also been evidenced to be effective in combining models. Therefore, in order to improve the efficiency of facial expression classification, and aim to compare with the state-of-the-art methods, we use more of the Inception-Resnet V1 model (3). Next, we combine three models (1),(2), and (3) for the classification of facial expressions.RESULTS: The proposed model gives out high accuracy for datasets: namely, with The Extended Cohn-Kanade (CK+) dataset, there are seven basic types of emotions, reaching 99.10 % (using the last 3 frames), 94.20% for the Oulu-CASIA dataset (from 7th frame) with six basic types of emotions, 74.89% for FER2013.CONCLUSION: Experimental results on highly challenging data sets (The Extended Cohn-Kanade, FER2013, Oulu-CASIA) show the effectiveness of the technique of combining three models and two proposed models.
Ferroportin and FBXL5 as Prognostic Markers in Advanced Stage Clear Cell Renal Cell Carcinoma
Authors: Park Cheol Keun , Heo Jayoon , Ham Won Sik , Choi Young-Deuk , Shin Sang Joon , Cho Nam Hoon
Published: March 2021

PurposeAdvanced stage clear cell renal cell carcinoma (ccRCC) involves a poor prognosis. Several studies have reported that dysfunctions in iron metabolism‒related proteins may cause tumor progression and metastasis of this carcinoma. In this study, we investigated the impact of the expression of iron metabolism‒related proteins on patient prognoses in advanced stage ccRCCs. Materials and MethodsAll of 143 advanced stage ccRCC specimens were selected following validation with double blind reviews. Several clinicopathological parameters including nuclear grade, perirenal fat invasion, renal sinus fat invasion, vascular invasion, necrosis, and sarcomatoid/rhabdoid differentiation were compared with the expression of ferroportin (FPN), and F-Box and leucine rich repeat protein 5 (FBXL5), by immunohistochemistry. FPN and FBXL5 mRNA level of ccRCC from The Cancer Genome Atlas database were also analyzed for validation.ResultsFPN and FBXL5 immunohistochemistry showed membrane and cytoplasmic expression, respectively. Based on the H-score, cases were classified as low or high expression with a cutoff value of 20 for FPN and 15 for FBXL5, respectively. Low expression of FPN and FBXL5 were significantly associated with patient death (p=0.022 and p=0.005, respectively). In survival analyses, low expression of FPN and FBXL5 were significantly associated with shorter overall survival (p=0.003 and p=0.004, respectively). On multivariate analysis, low expression of FBXL5 (hazard ratio, 2.001; p=0.034) was significantly associated with shorter overall survival.ConclusionFPN and FBXL5 can be used as potential prognostic markers and therapeutic targets for advanced stage ccRCC.
Nonparametric adaptive inference of birth and death models in a large population limit
Authors: Boumezoued Alexandre , Hoffmann Marc , Jeunesse Paulien
Published: March 2021

Motivated by improving mortality tables from human demography databases, we investigate statistical inference of an age-evolving population model alimented by time inhomogeneous mortality and fertility. Asymptotics are taken as the size of the population grows within a fixed time horizon: the observation gets closer to the solution of the McKendrick–Von Foerster equation, and the difficulty lies in controlling simultaneously the stochastic approximation to the limiting PDE in a suitable sense together with an appropriate parametrisation of the anisotropic solution. In this setting, we prove a concentration inequality that enables us to implement the Goldenshluger–Lepski algorithm and derive oracle inequalities. We obtain minimax optimality and adaptation over a range of anisotropic Hölder smoothness classes.
Matrix metalloproteinases and chronic rhinosinusitis with nasal polyposis. Unravelling a puzzle through a systematic review
Authors: Lygeros S. , Danielides G. , Grafanaki K. , Riga M.
Published: March 2021

BACKGROUND: The expression of metalloproteinases (MMPs) in chronic rhinosinusitis with nasal polyposis (CRSwNP) was reviewed in order to investigate their possible use as therapeutical targets and/or biomarkers. METHODOLOGY: The differences between CRSwNP and normal controls or CRS without NP, as well as the effects of various treatments on MMPs, tissue inhibitors of MMPs (TIMPs) and MMP/TIMP ratios were considered as primary outcomes. Additional factors reported to affect MMP expression levels were noted as secondary outcomes. Data regarding inflammatory subtypes, patients’ clinical characteristics, controls, laboratory method(s) and origin of samples were also pooled. Studies on 10 or fewer patients or on specimens other than nasal and serum were excluded. RESULTS: Forty-three studies were included. Tissue sample origin, allergic rhinitis, smoking, infection, medication intake and primary or recurrent disease should be considered as confounding factors for MMP levels. MMP-1 and -7 were consistently found to be significantly higher in CRSwNP patients than controls. CRSwNP endotypes with distinctly different inflammation patterns seem to present similar MMP-related remodelling patterns. CONCLUSIONS: The existing literature has revealed several population and methodology related confounding factors and remains inconclusive regarding the roles of MMPs in CRSwNP pathophysiology and their possible clinical usefulness as biomarkers and therapeutical targets.