Extent Of Defect Research Articles

CHARACTERIZING RETINAL–CHOROIDAL ANASTOMOSIS IN MACULAR TELANGIECTASIA TYPE 2 WITH OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY

To characterize structural and angiographic findings in macular telangiectasia Type 2 (MacTel 2) and examine associations with visual acuity. MacTel 2 patients with complete ophthalmologic examination, including fundus photography, autofluorescence, spectral-domain optical coherence tomography, and projection-resolved optical coherence tomography angiography, were retrospectively evaluated. There were 43 eyes of 22 patients with a mean age 63.9 (±10.3) years. Six patients had diabetes. Twenty-one eyes (48.8%) had retinal-choroidal anastomoses (RCAs) without any evidence of neovascularization extending laterally in a plane above or below the retinal pigment epithelium. None of the eyes had hemorrhage, lipid, or signs of subretinal exudation. When present, an average of 55 (±33.7) individual RCAs were clustered primarily in temporal juxtafoveal region of involved eyes. Right-angle veins were seen in all 21 eyes with RCAs, and hyperpigmentation was present in 18 (P < 0.001 for both). A conical collection of hyperreflective material spanning from Bruch membrane past external limiting membrane of ≥200-μm basal diameter was found in 21 eyes and labeled outer retinal hyperreflective lesion. Retinal-choroidal anastomoses occurred in clusters, often within the outer retinal hyperreflective lesion. This lesion colocalized with focal thinning of the outer nuclear layer and was surrounded by a larger defect in the ellipsoid zone. The presence of diabetes (P = 0.015), outer retinal hyperreflective lesion (P = 0.006), RCA (P = 0.005), and ellipsoid zone defect extent (P < 0.001) were associated with decreased visual acuity. Retinal-choroidal anastomoses occur in eyes with MacTel 2 without signs of exudation. Retinal-choroidal anastomoses occur in numerous clusters particularly in the temporal juxtafoveal macula. Diabetes, ellipsoid zone defect extent, RCAs, and the outer retinal hyperreflective lesion predict poorer vision in MacTel 2.

An Efficient Software Error Prediction and Recommend System

This present paper proposes the while its beginning, and past years software testing has been involved. Modern technology in software is using Artificial Intelligent and machine learning for advancing the technology. According to software engineering various techniques are analysed depending on the required predictions. Here in order to give the importance for the development of software defect prediction technique helps foe testers to focus on modules that defect prone. Depending on the development aspect the literature survey states various techniques based on features that are mostly captured for the prediction of defects. So in this paper we give a novel machine learning technique which is the foremost objective for finding prospective areas defects by considering various parameters like system testing metrics and unique parameters called ‘Component Dependency Score’. By applying element determination method we can reduce the words present in defect information and also there will be an expansion in precision so that both systems can build the additional qualities like precision and reducing defect reports or words. Depending on this new technique we can reduce the defect information sets for getting 71.8 percent exactness for reducing the request. The present issue reducing information to defect and increase the information set of defect in two viewpoints such as all the while diminish the sizes of defect extent and the word extent and to enhance the precision of defect triage. So we propose a mix way for dealing with of attention of issuing for reducing information. This is viewed as an example for purpose of choice highlighting in defecting store house. So we construct a parallel categoriser for expecting the request in determination of applying example and highlighting choices. Here the request for applying occurrence in highlighting the choices is not yet related to the research space.

Segmented retinal layer analysis of chiasmal compressive optic neuropathy in pituitary adenoma patients.

To evaluate changes in the segmented retinal layers of pituitary adenoma (PA) patients and to identify the relationship between these changes and visual function. A total of 47 (PA patients) and 22 (healthy subjects) eyes were reviewed from the medical records. The PA patients performed a visual field (VF) test before surgery and 1month after surgery. By optical coherence tomography scanning, eight retinal layers were measured: retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer, outer nuclear layer, retinal pigment epithelium, and photoreceptor layer. The PA group showed reduced RNFL, GCL, and IPL thicknesses (p = 0.004,< 0.001,< 0.001) and thicker INL thickness (p = 0.012) than did the controls. The mean deviation of preoperative VF in the PA group was positively correlated with RNFL, GCL, and IPL thicknesses (R = 0.664, 0.720, 0.664; p < 0.001,< 0.001,< 0.001) and negatively correlated with the INL thickness (R = -0.400; p = 0.010). Among the 47 eyes, 32 eyes (68%) were included for subgroup analysis. Preoperative RNFL, GCL, and IPL thicknesses were thicker in the postoperatively improved VF group (p = 0.019, 0.009, 0.005). The preoperative cutoff values for visual recovery were 23.6μm for RNFL thickness, 30.6μm for GCL thickness, and 28.9μm for IPL thickness. During chiasmal compression, the thickening of the INL has presented in addition to thinning of the inner retinal layers. Also, changes in retinal anatomical structures are related to the extent of VF defect and can be used as a predictor of postoperative visual recovery.

Is the extent of obstetric anal sphincter injury correlated with the severity of fecal incontinence in the long term?

Obstetric anal sphincter injury is the most frequent cause of fecal incontinence (FI) in young women. However, the relationship between the extent of anal sphincter defects and the severity of long-term FI (at least 1 year after delivery) has been poorly studied. The aim of the present study was to determine if, in the long term, the extent of anal sphincter defects graded at anal endosonography was linked with the severity of FI. A retrospective study was conducted on women with a history of vaginal delivery, who presented with FI and had three-dimensional anorectal high-resolution manometry and endoanal ultrasound in our center from January 2015 to 2016. The detailed clinical history of each patient was obtained from the institutional database. The severity of FI was assessed with the Jorge and Wexner continence scale. There were 250 women with a mean age of 60 ± 14years. Seventy-six (30.4%) had an isolated defect of the internal anal sphincter, 21 (8.4%) had an isolated defect of the external anal sphincter, and 150 (60%) had both internal and external sphincter defects. The extent of IAS and EAS defects was proportionally correlated with the decrease in mean resting anal pressure (p < 0.01) and the decrease in mean squeeze pressure (p = 0.013) measured by 3DHRAM. No significant correlation was found between the extent and location of the defect (IAS, EAS or both) on endoanal ultrasound and the severity of FI. Menopause was the only independent factor significantly associated with the severity of FI. In our study, no significant correlation was observed between the extent of the anal sphincter defect and the severity of FI. Menopause was the only identified and independent risk factor for FI. These data confirm that, in the long-term, FI is often multifactorial.

Rehabilitation after partial mandibulectomy - Clinical Report

Purposes: The rehabilitation of oral function impairments secondary to acquired defects following segmental mandibulectomy continues to be a major challenge. The success in rehabilitating patients who had undergone tumour resection depends upon the nature and extent of the surgical defect, treatment plan, type of prothesis and patient co-operation. Removable dentures supported by remaining teeth and/or gum are often unstable and rarely satisfactory. However, given the recent advances in maxillofacial prosthetics and reconstructive surgery, it is possible to restore most individuals to nearly normal anatomy and function with immediate vascularized bone graft reconstruction followed by rehabilitation with removable or fixed implant-supported prosthesis. Case report: This case report emphasises the truly multidisciplinary approach, as it describes the prosthodontic rehabilitation of a patient with history of a segmental mandibulectomy that involved the use of a vascularized bone graft, to reconstruct the mandible, and an implant-supported fixed partial denture to restore oral function. ​Conclusions: Prosthetic rehabilitation with dental implants and fixed implant-supported prosthesis is a valid tool advocated by several authors as they provide stability with enhanced masticatory efficiency as well as aesthetics, hence providing the best dental rehabilitation with a stabilized or immobilized prothesis.

A KHDC3L mutation resulting in recurrent hydatidiform mole causes genome-wide DNA methylation loss in oocytes and persistent imprinting defects post-fertilisation

BackgroundMaternal effect mutations in the components of the subcortical maternal complex (SCMC) of the human oocyte can cause early embryonic failure, gestational abnormalities and recurrent pregnancy loss. Enigmatically, they are also associated with DNA methylation abnormalities at imprinted genes in conceptuses: in the devastating gestational abnormality biparental complete hydatidiform mole (BiCHM) or in multi-locus imprinting disease (MLID). However, the developmental timing, genomic extent and mechanistic basis of these imprinting defects are unknown. The rarity of these disorders and the possibility that methylation defects originate in oocytes have made these questions very challenging to address.MethodsSingle-cell bisulphite sequencing (scBS-seq) was used to assess methylation in oocytes from a patient with BiCHM identified to be homozygous for an inactivating mutation in the human SCMC component KHDC3L. Genome-wide methylation analysis of a preimplantation embryo and molar tissue from the same patient was also performed.ResultsHigh-coverage scBS-seq libraries were obtained from five KHDC3Lc.1A>G oocytes, which revealed a genome-wide deficit of DNA methylation compared with normal human oocytes. Importantly, germline differentially methylated regions (gDMRs) of imprinted genes were affected similarly to other sequence features that normally become methylated in oocytes, indicating no selectivity towards imprinted genes. A range of methylation losses was observed across genomic features, including gDMRs, indicating variable sensitivity to defects in the SCMC. Genome-wide analysis of a pre-implantation embryo and molar tissue from the same patient showed that following fertilisation methylation defects at imprinted genes persist, while most non-imprinted regions of the genome recover near-normal methylation post-implantation.ConclusionsWe show for the first time that the integrity of the SCMC is essential for de novo methylation in the female germline. These findings have important implications for understanding the role of the SCMC in DNA methylation and for the origin of imprinting defects, for counselling affected families, and will help inform future therapeutic approaches.

CoTiO3/NrGO nanocomposites for oxygen evolution and oxygen reduction reactions: Synthesis and electrocatalytic performance

Oxygen evolution reaction (OER) and oxygen reduction reaction (ORR) catalysts play an important role in energy conversion and storage devices, but highly active and robust nonprecious metal catalysts are required to address the cost and durability issues. In this work, a modified gel methodology has been used to obtain nanocomposites of perovskite CoTiO3 and N-doped reduced graphene oxide (NrGO). Moreover, the influence of the annealing extent in the synthesis has been studied. The composites show higher activity in oxygen evolution and reduction reactions in alkaline environment compared to sole ilmenite, which is related to a strong interaction between cobalt titanate and NrGO carbon matrix. The annealing duration appears as a key variable to modulate the physicochemical properties and the electrochemical behavior. The composite prepared at the largest duration (3 h) exhibit enhanced bifunctional properties for ORR and OER, with onset potentials of 0.93 V and 1.53 V vs. RHE respectively, which is mainly attributed to higher concentration of nitrogen, larger extent of defects and/or the presence of more oxidized Co species in the nanocomposite.

Dyspnea Postpulmonary Embolism From Physiological Dead Space Proportion and Stroke Volume Defects During Exercise

Many patients with pulmonary embolism (PE) report dyspnea on exertion following long-term treatment. Increased physiological dead space proportion (VD/VT) and decreased cardiac stroke volume reserve may distinguish persistent effects of PE itself from symptoms reflecting comorbid conditions or deconditioning. This retrospective study analyzed a consecutive series of incremental symptom-limited cardiopulmonary exercise tests that had been ordered to evaluate persistent dyspnea on exertion following long-term treatment for acute PE. Physiological VD/VT was determined at anaerobic threshold from exhaled CO2 and transcutaneous Pco2 (validated against Paco2 measurements). Cardiac stroke volume reserve was estimated at rest and at anaerobic threshold by using oxygen consumption/pulse and previously validated estimates of the arteriovenous oxygen content difference. Cardiopulmonary exercise tests were performed on 40 patients with post-PE dyspnea. In 65.0%(95%CI, 50.2-79.8), VD/VT at anaerobic threshold was abnormally elevated, stroke volume reserve was decreased, or both defects occurred. VD/VT at anaerobic threshold was abnormally elevated (≥ 0.27) in 35.0%(95%CI, 20.2-49.8). VD/VT at anaerobic threshold significantly correlated with the extent of unmatched perfusion defects on subsequent ventilation-perfusion scans (P= .0085). In 55.0%(95%CI, 39.6-70.4), stroke volume reserve at anaerobic threshold was abnormally decreased (≤ 128%of the resting value). Both defects were present in 25.0%(95%CI, 11.6-38.4). Increased VD/VT at anaerobic threshold and decreased stroke volume reserve during exercise are common among patients with dyspnea on exertion after long-term treatment of PE. The defects can be disclosed noninvasively by using cardiopulmonary exercise testing.

Mitoautophagy: A Unique Self-Destructive Path Mitochondria of Upper Motor Neurons With TDP-43 Pathology Take, Very Early in ALS.

Mitochondrial dysfunction is one of the converging paths for many neurodegenerative diseases, including amyotrophic lateral sclerosis (ALS), and TDP-43 pathology is the most common proteinopathy detected in ALS and ALS/Frontotemporal lobar degeneration (ALS/FTLD). We recently identified mitochondrial problems in corticospinal motor neurons (CSMN) and in Betz cells of patients with TDP-43 pathology. However, the timing and the extent of mitochondrial defects, and their mode of degeneration have not been revealed. Because it is important to reveal when problems first begin to emerge and whether they are shared or unique, we investigated the health and integrity of mitochondria in CSMN of prpTDP-43A315T, PFN1G118V, and hSOD1G93A mice at P15 (post-natal day 15)—a very early age in mice without any sign of cellular degeneration.Utilization of immuno-coupled electron microscopy for a detailed surveillance of mitochondria in CSMN and other non-CSMN cells revealed presence of a novel self-destructive path of mitochondrial degeneration, which we named mitoautophagy. Mitoauthopgy is different from mitophagy, as it does not require autophagosome-mediated degradation. In contrast, in this novel path, mitochondria can clear themselves independently. We find that even at this early age, all diseased CSMN begin to display mitochondrial defects, whereas mitochondria in non-CSMN cells are healthy. Our findings not only reveal mitoautophagy as a novel path of mitochondrial clearance that occurs prior to neuronal vulnerability, but it also highlights that it is present mainly in the upper motor neurons of prpTDP-43A315T and PFN1G118V mice, which mimic many aspects of the disease in patients with TDP-43 pathology.

Preventing esophageal strictures with steroids after endoscopic submucosal dissection in superficial esophageal neoplasm.

This study aimed to investigate the efficacy of prophylactic steroid administration in preventing post-endoscopic submucosal dissection (ESD) esophageal stricture and to determine risk factors for these strictures. Patients who underwent ESD for superficial esophageal neoplasms with a mucosal defect affecting >75% of the esophageal circumference between January 2011 and August 2016 were eligible. Patients were classified into three groups, including ESD-alone group (n = 22), oral steroid group (n = 25) and intralesional steroid injection group (n = 6). Univariate and multivariate logistic regression analyses were performed to evaluate the risk factors for esophageal stricture. The stricture rate was 50.0%, 20.0% and 33.3% in the ESD-alone group, oral steroid group and steroid injection group, respectively. Patients treated with steroids had a significantly lower stricture rate than the ESD-alone group (22.6% vs 50.0%, P = 0.046). Additionally, oral steroid group had a significantly lower stricture rate than the ESD-alone group (P = 0.037). Multivariate analysis revealed that the extent of the circumferential mucosal defect was a significant risk factor for post-ESD strictures (odds ratio [OR] 13.015, 95% confidence interval [CI] 2.257-76.077, P = 0.004). The administration of steroids (OR 0.108, 95% CI 0.020-0.578, P = 0.009), specifically oral steroids (OR 0.109, 95% CI 0.019-0.622, P = 0.013), was associated with prevention of post-ESD strictures. Oral steroid prophylaxis appears to be a safe and effective treatment in preventing post-ESD stricture and improving patients' quality of life.

Location of the Glenoid Defect in Shoulders With Recurrent Posterior Glenohumeral Instability

Background: Posterior glenoid bone deficiency is an increasingly recognized entity in the setting of recurrent posterior shoulder instability; however, little is known about the subject. Due to the paucity of literature on posterior bone loss, historical comparisons with anterior bone loss may not be fully accurate. Purpose: To systematically describe the morphology of posterior bone defects in the setting of recurrent posterior shoulder instability based on several quantitative parameters, including the mean location, orientation, and extent of bone loss on a clockface model, as well as the angle of the defect relative to the long axis of the glenoid. Study Design: Cross-sectional study; Level of evidence, 4. Methods: Three-dimensional reconstructed computed tomography scans of serially collected patients with a history of recurrent posterior shoulder instability were evaluated by 3 separate reviewers. The posterior glenoid bone defect was characterized using the following measures: (1) the mean lesion location and orientation based on a clockface model with 6 o’clock denoted as inferior and 9 o’clock as directly posterior for all patients; (2) the total extent of the posterior bone defect based on the clockface; and (3) the average angle of the bone loss relative to the long axis of the glenoid. Results: A total of 70 male patients and 1 female patient with a mean age of 29.3 years (range, 24.4-35.1 years) were included in the analysis. The mean clockface location of the posterior glenoid defect originated at 6:44 (range, 4:16-8:12) and extended to a mean of 9:28 (range, 7:02-10:38). The mean extent of the posterior glenoid defect was 2:43 (range, 1:08-4:50), which corresponds to a mean total bone loss arc of 81.5° (range, 34.2°-144.9°), nearly 1 quadrant of the glenoid. Posterior bone loss occurred in a posteroinferior direction at a mean angle of 30.7° (range, 8.0°-80.0°) relative to the long axis of the glenoid. Conclusion: Posterior bone defects in the setting of posterior shoulder instability most commonly occur in the posteroinferior quadrant of the glenoid and extend on average from 6:44 to 9:28 (81.5° total degrees of arc) on a clockface model. Posterior bone loss occurs at a mean of 30° off the long axis of the glenoid in a posteroinferior direction, which is historically different from anterior bone loss, which occurs parallel to the long axis of the glenoid. This study serves to highlight the location and orientation of bone loss that one can expect in a patient with recurrent posterior shoulder instability, although additional work is needed to assess why this develops.

Analysis of Carbon-Based Microelectrodes for Neurochemical Sensing.

The comprehensive microscopic, spectroscopic, and in vitro voltammetric analysis presented in this work, which builds on the well-studied properties of carbon-based materials, facilitates potential ways for improvement of carbon fiber microelectrodes (CFMs) for neuroscience applications. Investigations by both, scanning electron microscopy (SEM) and confocal Raman spectroscopy, confirm a higher degree of structural ordering for the fibers exposed to carbonization temperatures. An evident correlation is also identified between the extent of structural defects observed from SEM and Raman results with the CFM electrochemical performance for dopamine detection. To improve CFM physico-chemical surface stability and increase its mechanical resistance to the induced compressive stress during anticipated in vivo tissue penetration, successful coating of the carbon fiber with boron-doped diamond (BDD) is also performed and microspectroscopically analyzed here. The absence of spectral shifts of the diamond Raman vibrational signature verifies that the growth of an unstrained BDD thin film was achieved. Although more work needs to be done to identify optimal parameter values for improved BDD deposition, this study serves as a demonstration of foundational technology for the development of more sensitive electrochemical sensors, that may have been impractical previously for clinical applications, due to limitations in either safety or performance.

Assessing the effectiveness of an electrical stunning and chilling protocol for the slaughter of Atlantic mackerel (Scomber scombrus).

Inducing unconsciousness in fish using electrical stunning prior to slaughter may improve fish welfare and fillet quality if such practises can be disseminated into wild capture fisheries. The objectives of this study were to: 1) evaluate if an established slaughter protocol consisting of dry electrical stunning (using a coupled AC/DC current at ≈ 110 Vrms) followed by chilling could be used to stun the wild captured species Atlantic mackerel (Scomber scombrus) unconscious within 0.5 s; 2) determine if death could be induced without consciousness recovery by longer duration stunning (5 s) combined with chilling in an ice/water slurry for 6 min; and 3) examine the extent of quality defects arising from the applied slaughter protocol. We determined consciousness by examination of behavioural responses in a standardised vitality assessment. Out of a sample of 10 mackerel, 9 were assumed to be rendered unconscious by the 0.5 s stun, as determined by the presence of tonic and/or clonic muscle cramping consistent with a general epileptic insult. Assumed unconsciousness was maintained throughout chilling treatment in all fish (n = 25) following a full stun of 5 s. All fish were assumed to have died as a result of the protocol. There was no evidence of spinal damage or haematoma quality defects post filleting. These results suggest that the examined protocol is effective at slaughtering mackerel in a manner consistent with good welfare and without inducing quality defects, but further research is required to verify the unconscious condition via electroencephalogram (EEG) and before the procedure can be applied in wild capture fisheries.

10‐year prospective cohort study of immediate extraction implants placed in 3 clinical situations

Background It is an established practice to place implants in immediate extraction sockets with or without periapical pathology, and though studies present high implant survival rates, it has been observed that human studies are limited to a small number of cases or if the sample size is larger, the study was for a short duration of time. The current study bridges the gap by analyzing large data for immediate extraction implants over a 10-year period in 3 different clinical situations Aim/Hypothesis To classify data based on the reason for extraction and its assessment for overall survival rate over a 10-year period thus establishing norms for case selection, favourable surgical techniques and maintenance protocol for long term implant success in immediate extraction implant cases. Material and Methods Data of Xive implants placed in fresh extraction sockets in a single dental practice with a follow-up of 10 years was obtained. Based on the reason for tooth extraction the data was classified as non-restorable teeth with healthy periodontium (Group A-control), periodontally involved teeth with no periapical infection (Group B- experimental) and teeth with chronic periapical infection non-treatable by endodontic therapy (Group C- experimental). These data were further screened and filtered based on the size of implant placed post-surgery, the use of membrane and extent of bone defect. Marginal bone levels, pocket probing depth and bleeding on probing were measured at 12–15 months, 4.5 to 5 years and 10 to 11 years post-cementation. Patient satisfaction for function was assessed. Results 179 implants were taken up for assessments. 57 implants from group A+ 62 implants from group B+ and 60 implants from group C. Mean bone loss comparisons between group A and Group B was statistically significant (0.5319 mm for 12–15 months, 0.6173 mm for 4.5 to 5 years and 0.6557 mm for 10–11 years), mean bone loss comparisons between group A and Group C was statistically significant (0.4996 mm for 12–15 months, 0.6015 mm for 4.5 to 5 years and 0.6692 mm for 10–11 years), whereas, mean bone loss comparisons between group B and Group C was statistically insignificant (0.0323 mm for 12–15 months, 0.0158 mm for 4.5 to 5 years and 0.0135 mm for 10–11 years). Pocket depth, because of its methodology of measurement gave non-conclusive statistics. Number of cases of mucositis and periimplantitis across all 3 groups and over 10-year observation period was statistically insignificant. Conclusion and Clinical Implications With surgical protocols used in the study, implants placed into fresh extraction sites for replacement of teeth with pre-existing infected lesion or pre-existing periodontal infection show higher bone loss as compared to those without infection, however overall, success rate of all these implants is comparable to one another over a 10-year period.

Outcome Analysis of Non-Vascularized Bone Graft and Fibula Free Flap in Reconstruction of Mandible

Mandibular reconstruction is frequently performed to fix segmental defects of the mandible. Vascularized fibula free flap (FF) is considered the gold standard, while nonvascularized bone graft (NVBG) is commonly indicated to a smaller defect. However, the use of FF is limited by high costs, a long procedure time, morbidity, and the need for specialized surgical staff.1 Additionally, studies have shown that the extent of defect does not limit the use of NVBG.2 The aims of this study were to assess the outcomes of NVBG and FF in mandibular reconstruction, to assess the variables that affect the outcomes of each technique, and to evaluate the variables that may indicate the use of either technique.

Complete Free-breathing Adenosine Stress Cardiac MRI Using Compressed Sensing and Motion Correction: Comparison of Functional Parameters, Perfusion, and Late Enhancement with the Standard Breath-holding Examination.

To compare free-breathing (FB) stress cardiac MRI examinations with the reference standard breath-holding (BH) examination. A total of 40 consecutive patients were enrolled prospectively and were examined with 3-T MRI. Functional imaging, perfusion, and late gadolinium enhancement (LGE) sequences were performed in BH and FB by using compressed sensing and in-line motion correction. Left ventricle (LV) and right ventricle (RV) functional parameters in BH and FB examinations were compared by using Bland-Altman plots and linear mixed models. Subjective image quality was assessed with a five-point scale (1 = nondiagnostic, 5 = very good). For perfusion and LGE imaging, diagnostic confidence was rated with a three-point scale (1 = low, 3 = high), and image quality was rated with a five-point scale (1 = nondiagnostic, 5 = very good). The Wilcoxon test was used to compare image quality and diagnostic confidence. Bland-Altman plots showed good agreement for LV and RV functional parameters in BH and FB sequences. Subjective image quality was significantly better with the BH sequences in the LV (P < .01) but was comparable in the RV (P > .99). Scanning time was 218 seconds (range, 130-385 seconds) for cine BH and 16 seconds (range, 11-27 seconds) for cine FB. Extent of perfusion defects, LGE, and diagnostic confidence was comparable between groups. Scanning time was 371 seconds (range, 239-502 seconds) for the LGE BH sequence and 189 seconds (range, 122-286 seconds) for the LGE FB sequence. FB adenosine stress cardiac MRI delivers diagnostic image quality and could represent an alternative for use in patients who are unable to meet the demands of multiple BHs and long examination times.© RSNA, 2019.

Retinoschisis in eyes with pachychoroid and retinal pigment epithelial atrophy.

To describe the clinical characteristics and courses for eyes with retinoschisis associated with pachychoroid. A retrospective interventional case series study. Twenty-one eyes (18 patients) with pachychoroid that showed retinoschisis without evidence of neovascularization that had been followed for 1year were included. Multimodal imaging, including fundus photography, spectral-domain optical coherence tomography (OCT) with an enhanced depth protocol, fluorescein angiography (FA), and indocyanine green angiography (ICGA), was provided and treatment outcomes were analyzed. Focal RPE atrophy was present below or adjacent to the schisis in all eyes, and the mean atrophy area was 1.38 ± 1.37mm2. Intraretinal fluids of the schisis originated from the atrophy area and involved the retinal layer which was correlated with the extent of outer retinal defect. Dilated Haller layer vessel and choroidal vascular hyperpermeability were observed under the area with atrophy in all eyes. After 1year of treatment, 11 eyes (52%) still had fluid and 7 of them had fluid at the macula. Nonetheless, the mean central macular thickness decreased (144.4 to 121.8, P < 0.001), visual acuity improved (0.65 to 0.47, P = 0.026), and subfoveal choroidal thickness decreased (442.2μm to 394.9μm, P < 0.001). Atrophy of RPE can cause retinoschisis in eyes with pachychoroid. The intraretinal fluid that originated from underlying choroid and choroidal thickness decreased as intraretinal fluid diminished.

Research progress of surgical treatment for anterior shoulder dislocation and combined injuries

To summarize the research progress of surgical treatment for anterior shoulder dislocation and combined injuries. The related literature was reviewed, and the surgical treatment options for the anterior shoulder dislocation and its combined injuries were summarized. Anterior shoulder dislocation can combine with anteroinferior capsular ligament complex injury (Bankart injury), bony Bankart defect, and Hill-Sachs lesion. For Bankart and bony Bankart injuries, arthroscopic repair or coracoid osteotomy combined with bony graft reconstruction can be performed. For Hill-Sachs lesion, conservative treatment, soft tissue repair, or bony reconstruction should be selected based on the extent of the bone defect. For bipolar injury, the Bankart repair, Remplissage, or arthroplasty should be selected based on the extent of the glenoid defect. With the development of arthroscopy and the improvement of the surgical concept, there is a complete set of surgical options for various injuries of the anterior shoulder dislocation. When choosing a surgical procedure, the patient's specific injury and age, exercise level, and other relating factors should be comprehensively assessed in order to achieve the best results.

Clinical experience with flap reconstruction of post tumor excision head &amp; neck defects

Introduction: Soft tissue reconstruction of defects after excision of head &amp; neck malignancies is one of the difficult tasks for plastic surgeons and it has always been a challenge for plastic surgeons to seek options which are safe &amp; with less morbidity and good functional and aesthetic outcomes.1 Multiple options are available for reconstruction purpose, ranging from simpler options in the form of primary closure and skin grafting, to more complex reconstruction with flaps. Flap coverage is more reliable over simpler options, in terms of functional and aesthetic outcome for the management of head and neck malignancies.2 Objectives: The purpose of this study is to determine the role of different types of flaps for the soft tissue reconstruction in the management of head and neck malignancies, and reliability of local flap coverage in the management of head and neck malignancies. Material and Methods:… Study Design: Retrospective case series. Setting: This study was conducted at the department of Plastic and Reconstructive Surgery, Shaikh Zayed Postgraduate Medical Institute, Lahore. Period: 5 years from 2009 to 2013. Subject and Methods: A total of 63 patients, with diagnosis of head and malignancies, were studied retrospectively over a period of 5 years from June 2009 to June 2013. Age ranged from 18 to 80 years (mean: 59.17 years). There were 30 males (47.61%) and 33 females (52.38%). Soft tissue reconstruction was done with different types of local and distant flaps. Results: A total of 65 different types of flaps were done for the reconstruction purpose. Local flaps were done in 42 (68%) cases, regional flaps were done in 15 (23%) cases and in 6 (9%) cases, free tissue transfer was done. In two cases more than one flap were used for reconstruction. Neck dissection was done in 13(21.74%) of the cases. Good results were achieved in all cases with respect to functional and aesthetic outcome. Conclusion: Despite of the intricate anatomy of head and neck region and the challenging reconstruction, flap reconstruction is a reliable option with good functional and aesthetic outcome and most of the soft tissue reconstruction can be achieved with different local flaps, depending on the extent of soft tissue defect.

Investigation of the Correlation Between Track Geometry Defect Occurrence and Wood Tie Condition

This paper presents the results of a statistical correlation analysis between the occurrence of track geometry defects and tie condition as measured by an automated tie inspection system on a major US Class 1 railroad. This activity focuses on tie condition, as defined by the automated tie inspection system and calibrated to railroad standards, its frequency and distribution, and corresponding track geometry condition as defined by FRA and railroad standards. In this paper, multiple correlation analyses are presented to include basic correlation analyses, Wilcoxon rank-sum test, cluster dendrogram, cumulative tie segments analysis (greater than defined tie condition), and development of mixed distribution models. There was evidence of a correlation between tie condition and the occurrence of several, but not all, of the track geometry defect categories. While there was some variation between the different analyses results, in general, the following geometry defect categories were found to have a defined relationship to tie condition: Cant, CLIM (Cross-Level Index Modified, a parameter that examines the extent of multiple sequential cross-level defects.), Wide Gage, Tight Gage, Warp 62, Profile, and Crosslevel. Overall, the study showed that there is strong evidence of a correlation between tie condition and the occurrence of certain classes of track geometry defects.