bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Reliability of Categorical and Continuous Scales for Radiographic Assessments of Bone Infill Following Secondary Alveolar Bone Grafting
Authors: Fowler Peter V. , Al-Ani Azza H. , Thompson John M. D. 
Published: January 2018

Objectives: To investigate examiner reliability of scoring intraoral radiographs of bone infill following secondary bone grafting using a categorical scale (modified Kindelan Index) and a 10-cm visual analog scale (VAS). To investigate the level of clinical experience on the reliability of these assessments. Design: Retrospective study involving 10 clinicians of varying clinical experience who were blind to the patient’s identity. Setting: All grafting was carried out within the New Zealand public hospital service. Patients: Fifty-eight grafts (48 UCLP and 5 BCLP) were assessed with 14 duplicated radiographs randomly added to the sample, making a total of 72 radiographs for assessment. Main Outcome Measures: Weighted kappa was used for intra- and interrater examiner reliability for the categorical scale and correlations for the VAS. Results: Relatively poor intrarater examiner agreement for categorical scoring (median 0.46) was found. Clinicians with greater experience generally recording higher intrarater weighted kappa. The intrarater correlations for the continuous scale (median 0.89) suggest better consistency regardless of the level of experience. The interrater relationships were generally low, with an average of weighted kappa of 0.25 while the overall average VAS correlation was 0.49. For the majority of scorers, there was a relationship between the VAS and the Kindelan Index, with lower VAS scores related to worse Kindelan scores. Conclusions: The use of a VAS produced better intra- and interexaminer reliability than the categorical Kindelan Index and was more consistent despite the level of clinical experience. Further evaluation of the validity of the VAS for the assessment of bone infill is warranted.
Lingual Pressure During Dingman-Assisted Cleft Palate Repair
Authors: Sherif Rami D. , Sanati-Mehrizy Paymon , Taub Peter J. 
Published: January 2018

Background: A variety of palatoplasty techniques are used for cleft palate repair, almost all involving a device called the Dingman-Grabb mouth gag (“Dingman”) to push the tongue and cheeks out of the way of the operating field. There have been numerous case reports of complications hypothesized to be due to the gag, such as lingual edema and airway obstruction. The purpose of this study is to introduce a technique for monitoring lingual pressure during Dingman-assisted palatoplasty and present preliminary data from a small series. Methods: Patients with a cleft palate who underwent palatoplasty with the assistance of a Dingman-Grabb retractor at the Mount Sinai Hospital were eligible. Patients underwent a palatoplasty while having their lingual pressure monitored using a 23-gauge needle inserted into the tongue and connected to a pressure monitor. Results: Three patients were included. Patients 1 and 2 experienced a rapid rise in lingual pressure over the course of the first 45 minutes of the palatoplasty before plateauing until the conclusion of the operation when the Dingman was released. Patient 3 plateaued almost immediately by minute 1 and then had a rise in lingual pressure during the latter half of the operation, reaching a peak pressure immediately before the end of the operation. Conclusions: The present study describes an easy method to monitor lingual pressure that succeeded in measuring such changes throughout 3 palatoplasties and confirming the acute rise in lingual pressure and the potential danger posed to the tongue and the airway through the use of the Dingman.
Quantitative and Qualitative Assessment of the Relative Arterial Contributions to the Calcaneus
Authors: Donders Johanna C. E. , Klinger Craig E. , Shaffer Andre D. , Lazaro Lionel E. , Thacher Ryan R. , Dyke Jonathan P. , Wellman David S. , Helfet David L. , Lorich Dean G. 
Published: January 2018

Background: The purpose of this study was to quantitatively and qualitatively assess relative arterial contributions to the calcaneus. Method: Fourteen cadaveric ankle pairs were used. In each specimen, the posterior tibial artery, peroneal artery, and anterior tibial artery were cannulated and used for contrast-enhanced magnetic resonance imaging (MRI) and computed tomography (CT). Quantitative MRI analysis of the pre- and postcontrast MRI scans facilitated assessment of relative arterial contributions. In addition, postcontrast MRIs were used to measure all perfused arterial entry points and scaled to a 3-dimensional calcaneus model. Contrast-enhanced CT imaging was assessed to further delineate the extraosseous arterial course. Two pairs underwent infusion of diluted BaSO4 through a constant-pressure pump using extended infusion duration. Results: Quantitative MRI findings indicated the peroneal artery provided 52.6% of the calcaneal arterial supply, 31.6% from the posterior tibial artery, and 15.8% from the anterior tibial artery. The cortical entry points were found in fairly consistent patterns along calcaneal cortical surfaces. All specimens demonstrated intraosseous anastomoses between lateral and medial entry points at common locations. Conclusions: The peroneal artery was found to provide the largest calcaneal arterial contribution, followed by the posterior tibial artery and anterior tibial artery. A rich anastomotic arterial network was found supplying the calcaneus. Clinical Relevance: This study provides quantitative and qualitative findings of the relative arterial contribution of the calcaneus. This knowledge can help expand our understanding of calcaneal vascularization, demonstrate the vascular impact of calcaneal fracture and surgery, and facilitate future research on the arterial anatomy of the calcaneal soft tissue envelope.
Antithrombin III Activity in Subretinal Fluid
Authors: Malukiewicz-Wiśniewska G. , Kotschy M. 
Published: January 2018

Purpose To evaluate antithrombin III (AT III) activity in subretinal fluid (SRF) and blood plasma. Methods Prospective study of 32 patients, aged from 20 to 77 years (mean 53.8 years), undergoing retinal detachment surgery. Patients with vein or arterial disease or any other factors that could affect the parameters evaluated were excluded. Subretinal samples were obtained at the time of routine drainage during retinal detachment surgery. Venous blood samples were taken from the cubital vein into sodium citrate solution (9:1) immediately after induction of anesthesia but before surgery. AT III activity in citrated plasma and in SRF and its relations to patients' age, sex, duration and extent of retinal detachment and degenerative changes of the retina, were evaluated. Results The median level of AT III activity in 32 SRF samples was 16.5% (lower quartile 8.5% and upper quartile 23%). The mean level of AT III activity in plasma was 105% (SD 24%). AT III levels in SRF were significantly lower than in plasma (p < 0.0001). We found no correlation between AT III activity in SRF and plasma, and age, sex, the degree of myopia, the duration and extent of retinal detachment, or retinal degenerative changes. Conclusions In this study we detected AT III activity in all 32 SRF samples.
Vascularized Pigment Epithelial Detachment in Adult-Onset Foveomacular Vitelliform Dystrophy
Authors: Parodi M. Battaglia , Di Crecchio L. , Ravalico G. 
Published: January 2018

Purpose To report a case showing adult-onset foveomacular vitelliform dystrophy (AOFVD), associated with vascularized pigment epithelial detachment. Case Report A 72-year-old female affected by AOFVD complained with blurred vision and metamorphopsia in her right eye, seven months after a routinary clinical examination. Visual acuity in right eye dropped from 0.6 to 0.3, and biomicroscopic fundus examination revealed a serous pigment epithelial detachment arising from the temporal margin of the pseudovitelliform lesion. Fluorescein angiography showed an uneven filling of the pigment epithelial detachment, suggesting the presence of a subfoveal choroidal neovascularisation, which was confirmed by indocyanine green angiography. Discussion The association between AOFVD and vascularized pigment epithelial detachment, supports the hypothesis that AOFVD may be a different subgroup of age-related macular degeneration with specific genetic predisposition.
Immunohistochemical Demonstration of Metallothionein in Eyes with Choroidal Melanomas
Authors: Tuccari G. , Fedele F. , Giuffrè G. , Trombetta C.J. , Barresi G. 
Published: January 2018

Purpose The since immunohistochemically detectable metallothionein (MT) overexpression has been described in a variety of human tumours, including skin melanomas, in relation to different stages of tumour development and progression. Materials and Methods We used a monoclonal antibody to investigate the distribution of MT in 18 formalin-fixed, paraffin-embedded, surgically enucleated eyes with choroidal melanomas, from 18 patients (8 male, 10 female; age range 30–83 years, mean 58.7). Clinico-pathological details and follow-up data (2–124 months, mean 36.1) were also available. MT immunoreactivity was recorded and the percentage of stained cells was graded for semiquantitative purposes. Correlations between immunohistochemical data and morphological characteristics of melanomas were investigated using non-parametric methods; survival analysis was done by the Kaplan-Meier method and the survival curves were compared by the Mantel-Cox logrank test. Results MT immunoexpression was found in 15/18 cases (83.3%) with staining scores from 1 to 3; MT staining varied in intensity and was mainly localized in the cytoplasm, although a combined nuclear/cytoplasmic reactive pattern was seen in neoplastic elements. No differences in MT immunostaining were seen in relation to age or sex, tumour size, histotype and amount of pigment; univariate analysis of survival data showed no prognostic significance regarding MT expression. Conclusions The immunohistochemical evidence of MT in neoplastic elements could be related to the production of this scavenging protein in the tumour for cell defense mechanisms against hydroxyl free radicals, and to act as a Zn donor, since Zn is required for the synthesis of DNA and DNA-repair enzymes.
Alterations in Antithrombin III Activity and other Blood Coagulation Parameters after Retinal Detachment Surgery
Authors: Malukiewicz-Wiśniewska G. , Kotschy M. 
Published: January 2018

Purpose To evaluate perioperative changes in blood coagulation in patients undergoing retinal detachment surgery. Materials Prospective study of 56 patients, aged from 19 to 82 (mean ± S.D. 53 ± 16.8) years, undergoing retinal detachment surgery (encirclement with scleral buckling) under general anesthesia. Excluded were patients with venous or arterial disease and any other factors that could affect the parameters under consideration. Methods Blood was sampled from the cubital vein one day before surgery, immediately after induction of anesthesia but before surgery, immediately after completion of the operation but before the termination of anesthesia and on days 1 and 4 after the operation. We measured antithrombin III activity (AT III), platelet count, fibrinogen concentration, activated partial thromboplastin time (aPTT) and prothrombin time (PT). Results Intraoperative AT III activity and platelet count were significantly lower, aPTT was shortened and PT prolonged, although all values remained within the normal range. These results indicate moderate activation of coagulation during retinal detachment surgery. On the first postoperative day coagulation activity was reduced, with increases in AT III activity, fibrinogen concentration and platelet count and prolongation of aPTT. Conclusions During retinal detachment surgery there is moderate activation of coagulation in the systemic circulation.
High Performance Liquid Chromatography Analysis of Tear Protein Patterns in Diabetic and Non-Diabetic Dry-Eye Patients
Authors: Grus F.-H. , Augustin A.J. 
Published: January 2018

Purpose To analyze and compare the high performance liquid chromatography (HPLC) runs of tear proteins from diabetic (DIDRY) and non-diabetic (DRY) dry-eye patients, and healthy subjects (CTRL). The patterns were analyzed using multivariate statistical methods. Methods Tears (total 56 eyes: CTRL: n=16, DIDRY: n=21, and DRY: n=19) were analyzed by HPLC, using a size-exclusion column with an eluent of 0.5 M sodium phosphate buffer. The patients were primarily grouped according to the results of the basic secretory test (BST) in combination with subjective symptoms such as burning, foreign body sensations, tearing, and “dryness” of the eyes. Patients with BST values ≤ 10 mm/5 min plus two subjective symptoms were grouped as dry-eye patients. Before statistical analysis, each HPLC run was quantitatively analyzed using ScanPacK software (ScanPacK, Göttingen, Germany), and a data set was created from each HPLC run. The data were then analyzed by multivariate analysis of discriminance. Results The HPLC patterns of CTRL, DIDRY and DRY were significantly different (Wilks' lambda: 0.0209; p<0.01). The area of the sIgA peak was significantly smaller (p<0.05) in dry-eye tears than controls. There was a good correlation between the extent of separation in the multivariate analysis and the BST value (r = −0.71). Classification of all samples resulted in 98% correct assignments. Conclusions The analysis of HPLC patterns and subsequent statistical evaluation are useful for the detection of dry eyes. The HPLC method and the statistical routines described allow a shorter analysis time than electrophoresis. HPLC analysis in combination with statistical analysis can be used as a diagnostic tool for the detection of dry eyes, and also improves the quality of analysis of disease-associated tear proteins in clinical research.
Chondroid Syringomas of the Eyelid: Two Cases
Authors: Mencía-Gutiérrez E. , Bonales-Daimiel J.A. , Gutiérrez-Díaz E. , Santos-Briz A. , Madero-García S. 
Published: January 2018

Purpose We report two new cases of chondroid syringoma (CS) of the eyelid. Until 1961, this entity was known as pleomorphic adenoma or benign mixed tumour of the skin of salivary glands type. This tumour occurs most commonly in the head and neck regions. Case Reports We describe two cases of CS with rapid growth, in the upper right eyelid, with no relation with the palpebral lobe of the lacrimal gland. Results Treatment consists of wide local surgical excision with its capsule, in its entirety. Conclusions These tumours of the ocular adnexa are exceedingly rare. Malignant transformation is possible.
Treatment of Multiple Evanescent white Dot Syndrome with Cyclosporine
Authors: Figueroa M.S. , Ciancas E. , Mompean B. , Quereda C. 
Published: January 2018

Purpose To report the seven-year follow-up of a patient with multiple evanescent white-dot syndrome (MEWDS). Methods Case report: A 46-year-old woman presented recurrent episodes of bilateral MEWDS. Results During the seven-year follow-up there were nine episodes of MEWDS. After four bouts in the first two, cyclosporine therapy was started. During two years of treatment there were no recurrences except when the dose was reduced or discontinued. Conclusions The etiology of MEWDS is still unknown but the absence of new episodes during cyclosporine treatment and the recurrence immediately after decreasing or discontinuing the drug suggests an autoimmune origin, with the involvement of cellular immunity in the pathogenic process.
Exudative Retinal Detachment following Grid Laser Photocoagulation in a Patient with Hemiretinal Vein Occlusion
Authors: Ozerdem U. , Freeman W.R. 
Published: January 2018

Purpose To report a patient with unilateral hemiretinal vein occlusion and macular edema who developed exudative macular detachment after grid laser application. Methods Clinical examinations, fundus photography and fluorescein angiography. Results Severe macular edema and exudation. Conclusions This case illustrates a previously unreported complication of grid laser application for macular edema in retinal vein occlusion.
Corneal Topographical Study of the Effect of Lacrimal Punctum Occlusion on Corneal Surface Regularity in Dry Eye Patients
Authors: Özkan Y. , Bozkurt B. , Gedík Ş. , Írkeç M. , Orhan M. 
Published: January 2018

Purpose To compare topographic indices of surface regularity in dry eye patients and in normal subjects (controls) and to investigate the short-term effect of lacrimal punctal plugs on these indices in dry eye patients. Methods The surface regularity index (SRI) and surface asymmetry index (SAI) of the TMS-2 corneal topographic modelling system were used to evaluate corneal surface regularity in 20 eyes of 10 dry eye patients before and after the insertion of Herrick silicon lacrimal plugs (Lacrimedics, Rialto, CA, USA) and in 24 eyes of 12 normal subjects as controls. Results SRI and SAI were significantly lower in controls than dry eye patients (p=0.00). Median SRI was 1.72 in dry eye patients before punctal occlusion and 0.525 in the control group. Median SAI was 1.305 in dry eye patients and 0.240 in controls. After lacrimal punctal occlusion, Schirmer test results and fluorescein breakup time increased in nine patients and remained the same in one patient. After occlusion, the SRI decreased in 9 eyes, and increased in 11 (p=0.970); SAI decreased in 13 eyes and increased in 7 (p=0.135). Conclusions No significant change in topographic indices of corneal surface irregularity could be detected in severe dry eye patients with lacrimal punctal plugs in the short-term follow-up.
Nerve Fiber Layer Assessment with Scanning Laser Polarimetry in Glaucoma Patients and Glaucoma Suspects
Authors: Özdek Ş.C. , Önol M. , Hasanreísoğlu B. 
Published: January 2018

Purpose To investigate whether scanning laser polarimeter can differentiate glaucoma and suspected glaucoma patients from normals. Methods Polarimetric measurements were obtained using the nerve fiber analyzer (NFA)-I from 80 eyes of patients with glaucoma with mostly moderate glaucomatous optic nerve damage (37 eyes with primary open angle glaucoma, 21 with normal tension glaucoma, 17 with pseudoexfoliative glaucoma, 3 with angle closure glaucoma, and 2 with juvenile glaucoma), 53 eyes of patients suspected of glaucoma based on disc appearance, and from age-matched healthy volunteers as control groups. Ratios (superior/nasal, inferior/nasal, superior/inferior) were used for assessing nerve fiber layer (NFL) thickness. Student's t-test and linear regression analysis were used for statistical analysis. Results Both the glaucoma patients and glaucoma suspects had significantly lower NFL ratios (mean S/N 2.34 ± 0.47, I/N 2.46 ± 0.52, S/I 0.94 ± 0.18) than the control groups (respectively 2.88 ± 0.48, 2.88 ± 0.48, 1.00 ± 0.13) (p<0.05). There was an ample overlap between the patient groups and the normals. The superior and inferior NFL ratios in glaucoma patients gradually decreased as the mean defect in visual field increased (linear regression analysis, p<0.05). Conclusions The NFL of glaucomatous eyes and eyes suspected of glaucoma based on disc appearance was significantly less thick than normals. NFA-I detects pathological abnormalities in some patients with glaucomatous optic nerve damage and normal visual fields as measured by conventional achromatic computerized perimetry. NFA-I, however, is unable to distinguish these patients from normals, at least using these parameters, because of the considerable overlap.
Flap Complications in Our Learning Curve of Laser in Situ Keratomileusis Using the Hansatome Microkeratome
Authors: Yildirim R. , Devranoglu K. , Ozdamar A. , Aras C. , Ozkiris A. , Ozkan S. 
Published: January 2018

Purpose To determine the incidence and the type of flap complications in our initial series of eyes undergoing laser in situ keratomileusis and the impact of microkeratome-related complications on best spectacle-corrected visual acuity. Methods We reviewed the charts of the 630 consecutive eyes operated in the Refractive Surgery Department of Cerrahpasa Medical School, University of Istanbul, Turkey using the Hansatome microkeratome and the Summit, SVS Apex Plus excimer laser between March 1998 and November 1999. The mean follow-up was 12.6 months. Results The incidence of total flap complications was 19.8 %. Flap folds (5%) were the most common complication. The incidence of epithelial ingrowth was 3.3%. Diffuse lamellar keratitis was encountered in 20 cases (3.17%). Displaced flaps were seen shortly after the procedure in 8 eyes (1.26%) and repositioned immediately. Improper keratectomy occurred in 14 eyes (2.2%) and incomplete keratectomy in four procedures (0.63%). The presence of interface debris and hemorrhage was each 1.9%. We observed one interface abscess, which was culture-negative and cured with fortified antibiotics, and one free flap. Conclusions Although the LASIK procedure with the Hansatome had an easy learning curve without any of the serious complications that frequently occur in this phase, we still observed flap related complications that affected visual outcome
Von Willebrand Factor in Subretinal Fluid
Authors: Malukiewicz-Wiśniewska G. , Kotschy M. 
Published: January 2018

Purpose To measure the vWF antigen concentration (vWF Ag) in subretinal fluid (SRF) and blood plasma. Methods Prospective study of 30 patients, aged from 15 to 78 years (mean 52.7 years), undergoing retinal detachment surgery. Excluded were patients with venous or arterial disease or any other factors that could affect the parameters evaluated. Subretinal samples were obtained at the time of routine drainage during retinal detachment surgery. Venous blood samples were taken from the cubital vein into sodium citrate solution (9:1) immediately after induction of anesthesia but before surgery. VWF in plasma and in SRF and its relation to patients' age, sex, the duration and extent of retinal detachment, number of retinal tears, and cryopexy application were evaluated. Results The median level of vWF Ag in 30 samples of SRF was 6.3%. The median level of vWF Ag in blood plasma was 70.34%. The levels of vWF Ag in SRF were significantly lower than in blood plasma (p<0.00001). We found no correlation between the vWF Ag concentration in plasma or in SRF and sex, the degree of myopia, the duration and extent of retinal detachment, number of retinal tears and the use of cryopexy. Conclusions Determination of vWF Ag showed that this factor in SRF is unrelated to patients', sex, the degree of myopia, the duration and extent of retinal detachment, number of retinal tears and use of cryopexy.
Local Anaesthesia for Vitreoretinal Surgery: An Audit of Patient and Surgical Experience
Authors: Knight H.M.L. , Newsom R.B. , Canning C.R. , Luff A.J. , Wainwright A.C. 
Published: January 2018

Purpose Local anaesthesia for vitreoretinal surgery is little used as these procedures are deemed to be too long and uncomfortable for patients to tolerate. In this unit anterior intraconal local anaesthesia is used for most routine surgery. We undertook an audit to ensure that surgical standards and patient acceptability were not compromised. Methods A prospective observational audit was performed. Audit data included: Grade of anaesthetist and surgeon; details of anaesthetic and operation; compliance of patient; operating conditions and pain scores. Anaesthesia was provided with a combined peribulbar and intraconal anaesthetic, using bicarbonate buffered lignocaine and bupivacaine 50:50 mixture. Results 135 (76%) had local anaesthesia alone, 13 (7%) had local anaesthesia with sedation and 29 (16%) had general anaesthesia. 96.4% of patients were compliant and 98.8% of operating conditions were good or excellent. The mean perioperative pain score was 0.1 (range of 0–1), 97% said they would choose local anaesthesia again. Conclusions LA for vitreoretinal surgery is a useful and flexible method of anaesthesia, which has been shown to have excellent patient tolerance.