Normal Width Research Articles

Prenatal Evaluation for Detection of Anorectal Atresia: Value of Ultrasound.

To investigate the applicability and value of ultrasound (US) in the diagnosis of anorectal atresia. Between January 2008 and January 2016, we prospectively evaluated 63,101 fetuses (gestational age, 20-38 weeks), including low- and high-risk populations using 2-dimensional US scans. An abnormal imaging finding was defined as an anal canal diameter of less than the 95% confidence interval (small anal canal) of the normal range or the absence of an anal canal and rectum. Imaging findings were considered normal on detection of an anal canal with a normal width and the absence of abnormalities. Prenatal imaging findings were confirmed by a postnatal or postmortem examination. Among the investigated fetuses, 28 showed evidence of anorectal atresia on US scans, and 22 of those with anorectal atresia had additional anomalies. Six cases of isolated anorectal atresia were successfully detected during the preclusive prenatal US scans. Four cases of a low imperforate anus (including 2 covered anuses) yielded false-negative results, indicating a diagnostic rate of 87.5% (28 of 32). The normal appearance of the fetal rectum and anal canal ruled out anorectal atresia in 30 fetuses with a dilated colon. Additionally, there were 3 false-positive cases, in which a narrow anal canal was observed. Identifying the abnormal appearance or absence of the fetal anal canal and rectum on preclusive US anomaly scans is useful for prenatal diagnosis or exclusion of anorectal atresia, which may help improve the detection of isolated anorectal atresia. Furthermore, a combined evaluation of the longitudinal and axial appearances of the fetal anal canal and rectum can improve diagnostic accuracy.

Abundance, color pattern variation, life cycle, and reproduction of the triploid parthenogenetic lizard Aspidoscelis uniparens (Squamata: Teiidae) in Chihuahua, Mexico

Abundance, color pattern variation, life cycle, and reproduction of the triploid parthenogenetic lizard Aspidoscelis uniparens (Squamata: Teiidae) in Chihuahua, Mexico. We have observed the triploid parthenogenetic lizard Aspidoscelis uniparens in syntopy with many congeners, as well as allopatric to them, within a distribution area in parts of Arizona, New Mexico, and Texas (USA), and Chihuahua and Sonora (Mexico). In July 2000, we discovered arrays (= groups) of A. uniparens with distinctive dorsal color patterns, allopatric to congeners, at a cluster of three sites in northwestern Chihuahua. These arrays were distinguishable based on strikingly different dorsal color patterns. Thus, we designated specimens from two mapped sites in the Municipality of Casas Grandes and from one nearby mapped site in the Municipality of Nuevo Casas Grandes as vividly striped lizards (VSL). Specimens from other mapped sites were designated normally striped lizards (NSL). We observed that the three VSL sites along the base of foothills of the eastern slope of the Sierra Madre Occidental were ecologically different from NSL sites such as El Sueco and Pradera de Janos in central and northwestern Chihuahua, respectively. All VSL specimens possessed wider and more vividly hued primary stripes, whereas the stripes were of normal width and low-contrast color hues in samples NSL-1 and NSL-2. We used samples NSL-1, NSL-2, and VSL for statistical comparisons of means ± 1 SE for the following characters: snout‒vent length (the three arrays had similar maximum SVL measurements and mean differences attributable to the year-class structure of samples); number of granular scales between the paravertebral stripes at midbody (revealing signifcant differences between some samples); percent of granular scales around midbody situated between the paravertebral stripes at midbody (revealing signifcant differences between all samples); percent of the vertebral feld with a vertebral stripe (revealing signifcant differences between some samples); and clutch size (revealing signifcant differences between some samples). We concluded that qualitative characters diagnostic of the VSL sample of A. uniparens were not accompanied by unique quantitative characters.

An adhesive wear prediction method for double helical gears based on enhanced coordinate transformation and generalized sliding distance model

An adhesive wear prediction method for double helical gears is proposed according to enhanced coordinate transformation and generalized sliding distance model in conjunction with Archard's wear equation. To describe transient contact ellipse and identify the contact point pairs conveniently, a transform coordinate plane is set in coincidence with the plane of action and a coordinate axe parallels to the contact line. The contact pressure distribution is determined by contact line length, contact width and normal force, and a modified sliding distance model is proposed by generalized moving distance replacement of Hertz contact width. As the wear coefficient, contact pressure and sliding distance are given, the tooth wear depths are predicted by a developed numerical procedure. Effects of major geometrical and working parameters on the wear depth are investigated. The results show that the wear depth becomes smaller, which is mainly determined by the contact force per unit length, equivalent curvature radius and sliding distance as normal module, normal pressure angle, helix angle, tooth width or transmission ratio increases. However, the wear depth becomes larger when input torque is improved. It is indicated that rational parameters match in gear design and uniform wear distribution are beneficial for wear resistance.

Standardizing the Prearthritic Hip Joint Space Width: An Analysis of 994 Hips

The purposes of this study were (1) to define a normal prearthritic hip joint space width (JSW) in symptomatic and asymptomatic patients with various degrees of acetabular coverage based on the lateral center edge angle (LCEA) and (2) to determine predictors of JSW using patient-specific variables. In a consecutive series of patients presenting to a hip preservation clinic between July 2012 and April 2016, a standard weight-bearing anteroposterior pelvic view was obtained. JSW was defined as the distance between the bony contour of the acetabular rim and femoral head in 2 locations (lateral and medial weight-bearing zone). Hips with severe anatomic deformity, a Tönnis grade >0, or a lateral or medial JSW <2.5mm were excluded. A linear mixed model analysis was performed in order to determine which variables (age, sex, side, height, weight, symptomatic/asymptomatic, LCEA, and clinical diagnosis) were significantly related to JSW. A total of 994 hips were included. LCEA was found to be a significant predictor of both the lateral and medial JSW, with a decreased JSW associated with increasing degrees of acetabular bony coverage (P < .02). A mean 0.9mm (20%) difference in medial JSW was found between patients with frank dysplasia (LCEA <20°) compared with those with pincer-type FAI (LCEA ≥40°). There was no difference between symptomatic and asymptomatic hips, either for lateral (asymptomatic: 4.51 ± 0.83mm; symptomatic: 4.52 ± 0.85mm; P= .58) or medial JSW (asymptomatic: 4.02±0.96mm; symptomatic: 3.97 ± 0.84mm; P= .49). The LCEA is a significant predictor of hip JSW, with the mean JSW decreasing with increasing degrees of acetabular bony coverage. Joint space is not a major factor in symptomatology in adults with prearthritic hip pain. Level III, retrospective comparative study.

The role of red cell distribution width in the locoregional recurrence of laryngeal cancer

IntroductionAlthough the red cell distribution width has been reported as a reliable predictor of prognosis in several types of cancer, to our knowledge few reports have focused on the prognostic value of red cell distribution width in laryngeal carcinoma. ObjectiveWe aimed to explore whether the pretreatment red cell distribution width predicted recurrence in laryngeal cancer patients is a simple, reproducible, and inexpensive prognostic biomarker. MethodsAll laryngeal cancer patients who underwent curative surgery (n=132) over a 7 year study period were evaluated. Data on demographics, primary tumor site, T-stage, N-stage, histological features (differentiation; the presence of perineural/perivascular invasion), treatment group (total laryngectomy or partial laryngectomy) or adjuvant therapy (chemotherapy/radiotherapy); laboratory parameters (complete blood count, including the pre-operative red cell distribution width), and disease-free survival rates were retrospectively reviewed. All cases were divided into three groups by the red cell distribution width tertile [<13% (25th percentile) (n=31), 13–14.4% (50th percentile) (n=72), and >14.4% (75th percentile) (n=29)]. ResultsHigh-red cell distribution width group included more patients of advanced age, and more of those with recurrent and metastatic tumors (p=0.005, 0.048, and 0.043, respectively). Individuals with red cell distribution width >14.4% (75th percentile) had lower disease free survival rates than did those with red cell distribution width <13% (25th percentile) (p=0.014). Patients with red cell distribution width >14.4% at diagnosis were at a higher risk of locoregional recurrence (hazard ratio=5.818, 95% confidence interval (95% CI) 1.25–26.97; p=0.024) than patients with a normal red cell distribution width (<13%). ConclusionWe found that the pretreatment red cell distribution width was independently prognostic of disease free survival rate in patients with laryngeal cancer and may serve as a new, accurate, and reproducible means of identifying early-stage laryngeal cancer patients with poorer prognoses.

Fabrication of a helical detonation channel: Effect of initial pressure on the detonation propagation modes of ethylene/oxygen mixtures

The effect of the initial gas mixture pressure on curved detonation propagation modes has been extensively investigated in the present study using a stoichiometric ethylene–oxygen mixture in a new experimental facility consisting of a straight channel section joined to a helical channel section. Flame propagation through the helical channel was observed by high-speed CCD camera, and the trajectories of triple points on the detonation waves were obtained using a soot-deposition plate. The results clearly identify three detonation propagation modes, namely, a stabilized propagation mode, critical mode, and non-stabilized propagation mode, that vary according to the ratio of the radius of curvature of the inside wall ri to the normal detonation cell width λ. For the stabilized propagation mode (ri/λ > 27), the detonation velocity at the inner wall in the curved section asymptotically approaches the detonation velocity in the straight section with increasing initial pressure due to competition between the weakening and strengthening effects characteristic of the curved channel geometry. A definite flame shape, which is perpendicular to the inner wall of the channel, is observed. For the critical mode (16 ≤ ri/λ ≤ 27), the shape of the flame front is observed to be more irregular and unstable than that of the stabilized propagation mode. This mode can be considered as a transition zone, where the stabilized propagation mode transits to the non-stabilized propagation mode with decreasing initial pressure. For the non-stabilized propagation mode (ri/λ < 16), two types of periodic detonation propagation behavior are observed. The first is analogous to single-headed spinning detonation in a circular tube, which is observed in an initial pressure range of 5.5–11 kPa. Soot-coated foil records show that the cellular structure has specific features of the periodic variation, such as re-generation, decrease, and partial disappearance of detonation near the inner wall. The angular interval of consecutive cycles for sinning-like detonation decreases with increasing initial pressure. The second is galloping detonation near the detonation propagation limit. In one cycle of galloping detonation, a change from multi-headed to single-headed cellular structure is observed. However, as the galloping detonation further decays to the low velocity phase of the galloping cycle, the cellular structure vanishes. The angular interval of consecutive cycles for galloping detonation is observed to be random. Although both spinning-like and galloping detonations periodically undergo the process of re-generation, decrease, and failure, they exhibit two different propagation behaviors. The former partially fails near the inner wall, and is re-initiated by transverse detonation from the outer wall, while the latter fails completely, and re-generates by local explosion at the outer wall.

Normal width of the inter-recti distance in pregnant and postpartum primiparous women

Study DesignLongitudinal descriptive exploratory study. ObjectivesEvaluate the normal width of the linea alba in first-time pregnant women during pregnancy and postpartum. BackgroundThere are normative values on the width of the linea alba for nulliparous women, but limited knowledge about the normal width of the inter-rectus distance (IRD) in pregnant and postpartum women. MethodsUltrasound images were recorded in 84 primiparous women, at 3 locations on the linea alba (2 cm below the umbilicus, and 2 and 5 cm above the umbilicus) and at 4 time points (gestational weeks 35–41 and 6th to 8th, 12th to 14th, and 24th to 26th weeks postpartum). The 20th and 80th percentiles were used to define the normal width of the linea alba. ResultsDuring pregnancy, the 20th and the 80th percentile corresponded to 49–79 mm below the umbilicus, 54–86 mm at 2 cm above the umbilicus and 44–79 mm at 5 cm above the umbilicus. At 6 months postpartum, the 20th and the 80th percentile corresponded to 9–21 mm at 2 cm below the umbilicus, from 17 to 28 mm at 2 cm above the umbilicus and from 12 to 24 mm at 5 cm above the umbilicus. ConclusionDifferent normative values for the width of the linea alba were found at different locations of the anterior abdominal wall. In primiparous women, the IRD may be considered “normal” up to values wider than in nulliparous.

A Pacing Strategy to Avoid Potential Complications of Right Ventricular Pacing

Right ventricular (RV) pacing leads can result in damage to the tricuspid valve structure and function. In addition, RV perforation is a potentially catastrophic complication, and has a reported incidence of 0.1–0.4%. Predisposing factors include advanced age, female sex, left bundle branch block, worsening heart failure symptoms, and low body mass index. His-bundle pacing has received exponential interest in recent years, owing to its ability to preserve normal intrinsic QRS width and normalise bundle branch block. As the lead does not usually cross the tricuspid valve, the potential complications related to disrupting the integrity of the tricuspid valve architecture and RV perforation are mitigated.

Reflectory cough. The causes, diagnostics and the possibilities for the combined treatment

The main cause of reflectory cough is neurogenic hyperventilation. The clinical signs of reflectory cough include its dry and back-breaking character, the gradual increase and abrupt beginning, impossibility to stop the coughing fit, and the feeling of shortness of breath. The triggers of a coughing attack can be a deep breath, a talk, physical and/or psycho-emotional stress, fatigue, and other sensations. The typical laryngological signs of the condition in question include the broad glottal aperture (up to 20 mm and more in contrast to its normal maximum width of 15 mm) and the spasm of the vocal cords in response to inspiration. The clinic of Diseases of Ear, Throat and Nose affiliated with I.M. Sechenov First Moscow State Medical University has gained the extensive experience with the treatment of more than 500 patients presenting with reflectory cough. All these patients received the combined treatment including 10 procedures for intracutaneous novocaine blockade of the Zakhar'in-Geda zones in the larynx in the combination with auricular reflexotherapy and respiratory gymnastics intended to eliminate hyperventilation and sedative medications and myorelaxants to remove the pathologically enhanced muscle tone as well as calcium-containing preparations if indicated.

Dental arch dimensions and palatal height in children with Turner syndrome

Introduction: A complete or partial absence of an X chromosome in girls with Turner syndrome (TS) has an impact on dental archmorphology. The aim of this study was to analyze the sizes of dental arches as well as the height of the palatal vault in patients withTS, and to determine the influence of various karyotypes on the study variables.Materials and methods: The study population sample consisted of 40 TS female patients, aged 9.2 to 18 years, and 40 healthy females aged 9.3 to 18 years, as the control group. The TS patients were subdivided according to karyotype (monosomy X, mosaic, andisochromosome). Dental arch width and length, and palatal height were measured directly on plaster dental casts.Results: The results showed differences in the dental arch dimensions between TS and control groups. The maxillary dental arch was narrower and shorter, but the mandibular arch was shorter and of normal width in the TS group. The palate in TS patients were normal in height and did not differ from those of the control subjects. Although the dental arch dimensions and palatal height were slightly reduced in mosaic and isochromosome karyotypes compared with those in 45,X females, the investigation revealed nosignificant differences between the karyotypes.Conclusions: Our findings indicate that the reduction of X chromosomal genetic material in Turner syndrome females results inthe reduction of dental arch dimensions, which is further reflected in the increased frequency of malocclusion in these individuals. Importantly, this study demonstrates that palatal height is normal, contrary to some reports in the literature. It is further significantthat the TS karyotype does not affect dentoalveolar morphology and palatal height.

Angle-to-Angle Mandibular Defect Reconstruction With Fibula Flap by Using a Mandibular Fixation Device and Surgical Navigation.

Although free fibula flaps are widely used for mandibular reconstruction, 3-dimensional (3D) position is difficult to control in angle-to-angle mandibular defects. The present study describes a revised approach for angle-to-angle mandibular reconstruction with fibula flaps by using mandibular fixation device and surgical navigation. Preoperative maxillofacial and fibular computed tomography (CT) scans were acquired, and CT data were imported into ProPlan CMF software. Virtual mandibulectomy was performed, and 3D fibula image was superimposed on the mandibular defect. The fibula flap was shaped according to virtual parameters and the stereo model. Surgical navigation was used to check and correct shaped segments. Position of the osteotomy lines and relevant parameters regarding the shape of the fibula flap were provided to the surgeon. A mandibular fixation device (Cibei, China) was fixed to bilateral mandibular ramus before mandibulectomy, which maintained normal mandibular width. Under computer navigation guidance, the fibula flap was accurately positioned in 3D direction, and the defect could be precisely reconstructed despite the lack of stable occlusal relationship after osteotomy. Postoperative CT and 3D error analysis revealed that osteotomy lines and reconstruction contour matched well with preoperative planning. Using our method, we precisely recovered the original configuration of the mandible. Bilateral condyles were located in the temporomandibular joint fossae, and normal mandibular width was maintained. Compared with preoperative positions, the average shift on the remaining mandible was 0.803 ± 0.502 mm (largest, 1.886 mm). Average shift in the reconstructed mandible was 0.281 ± 0.300 mm, largest being 2.441 mm. We describe a novel method for angle-to-angle mandibular reconstruction with free fibula flap. A mandibular fixation device combined with computer-assisted techniques involving surgical navigation improved clinical outcomes of this procedure.

Healing of root and surrounding periodontium after root damage with miniscrew implants: a histomorphologic study in dogs.

The main purpose of this study was to investigate the detailed healing process of the roots and surrounding periodontium [cementum, periodontal ligament (PDL), and bone] at different time points after intentional root damage with miniscrew implants (MSIs). After cone-beam computed tomography examination and measurement, a total of 78 premolar and molar roots from five beagle dogs were intentionally damaged by implanting miniscrews in the interradicular region. MSIs were immediately removed, and the histological morphology was observed at days 0 and 3 and at weeks 1, 2, 3, 4, 6, 8, and 12 after root injury using haematoxylin and eosin and fluorescence stainings (fluorescence staining was performed at days 28 and 56). An early new attachment of PDL adhering on to the damaged root surface was found at week 2 after root injury. Tissue differentiation of newly formed bone tissue, PDL, and cementum began at week 3. Moreover, the newly formed cementum and bone were constantly forming and mineralising at weeks 4, 6, 8, and 12, and the width of PDL gradually narrowed until close to the normal width at week 12. This study demonstrated the complete healing process of the roots and surrounding periodontium after root damage with MSIs in dogs when the damage was limited to the cementum or dentin. The findings of this study may help provide a better understanding of the detailed healing process in roots and PDLs damaged by MSIs.

Medial external fixation for staged treatment of closed calcaneus fractures: Surgical technique and case series.

The derangement in calcaneal morphology after a fracture can be significant and is often associated with severe soft tissue envelop problems. Medial calcaneal external fixation is useful for early restoration of calcaneal morphology and the corresponding soft tissue envelop. When performed in a stepwise fashion, external fixation can successfully restore normal calcaneal height, length, width, and coronal plane alignment. For severely displaced joint depression and broken tongue-type calcaneus fractures where open treatment is the preferred strategy, early external fixation restores the normal soft tissue tension, allows a stable environment for soft tissue recovery, and facilitates the definitive operation by restoring and maintaining overall calcaneal architecture. We describe the stepwise approach to calcaneal reduction and external fixation and report a case series demonstrating this method is safe and effective for staged management of severely displaced calcaneus fractures.

СРАВНИТЕЛЬНЫЙ АНАЛИЗ МОРФОФУНКЦИОНАЛЬНОГО И ПСИХОФИЗИОЛОГИЧЕСКОГО СОСТОЯНИЯ ТУВИНСКИХ ЮНОШЕЙ С РАЗЛИЧНОЙ ДВИГАТЕЛЬНОЙ АКТИВНОСТЬЮ

Aim. To reveal morphofunctional and psychophysiological indicators in Tuvan boys with different levels of motor activity. Materials and Methods. Forty boys with a low level and 115 boys with a high level of motor activity (practicing general physical conditioning (n = 45), freestyle wrestling (n = 35), and volleyball (n = 35)) aged 17?21 were recruited as participants of the study. Anthropometric, physiometric, and functional parameters in the subjects were assessed using standard methods. Psychophysiological indicators including short-term memory span and attention skills were estimated with the help of complex assessment of physical and mental health. Results. Volleyball players and wrestlers had a normal weight, physical fitness above average, and brachyskelia; along with that, volleyball players had a narrow chest while wrestlers had a normal chest width. Volleyball players had high indicators of the functional status of respiratory organs and attention skills. Boys practicing general physical conditioning had a normal weight along with a higher muscle mass, the highest strength indicators, higher functional status of respiratory organs, and fine semantic memory and attention capacity. Conclusion. Motor activity level and sports specialization have a significant effect on morphological, functional, and psychophysiological indicators in boys. General physical conditioning due to non-specific exercises having different levels of loads and difficulty and targeting different groups of muscles harmonize morphofunctional and psychophysiological status in boys.

High-speed maskless nanolithography with visible light based on photothermal localization

High-speed maskless nanolithography is experimentally achieved on AgInSbTe thin films. The lithography was carried out in air at room temperature, with a GaN diode laser (λ = 405 nm), and on a large sample disk of diameter 120 mm. The normal width of the written features measures 46 ± 5 nm, about 1/12 of the diffraction allowed smallest light spot, and the lithography speed reaches 6 ~ 8 m/s, tens of times faster than traditional laser writing methods. The writing resolution is instantaneously tunable by adjusting the laser power. The reason behind the significant breakthrough in terms of writing resolution and speed is found as the concentration of light induced heat. Therefore, the heat spot is far smaller than the light spot, so does the size of the written features. Such a sharp focus of heat occurs only on the selected writing material, and the phenomenon is referred as the photothermal localization response. The physics behind the effect is explained and supported with numerical simulations.

The contribution of 3D quantitative meniscal and cartilage measures to variation in normal radiographic joint space width—Data from the Osteoarthritis Initiative healthy reference cohort

ObjectiveTo explore to what extent three-dimensional measures of the meniscus and femorotibial cartilage explain the variation in medial and lateral femorotibial radiographic joint space width (JSW), in healthy men and women. MethodsThe right knees of 87 Osteoarthritis Initiative healthy reference participants (no symptoms, radiographic signs or risk factors of osteoarthritis; 37 men, 50 women; age 55.0±7.6; BMI 24.4±3.1) were assessed. Quantitative measures of subregional femorotibial cartilage thickness and meniscal position and morphology were computed from segmented magnetic resonance images. Minimal and medial/lateral fixed-location JSW were determined from fixed-flexion radiographs. Correlation and regression analyses were used to explore the contribution of demographic, cartilage and meniscal parameters to JSW in healthy subjects. ResultsThe correlation with (medial) minimal JSW was somewhat stronger for cartilage thickness (0.54≤r≤0.67) than for meniscal (−0.31≤r≤0.50) or demographic measures (−0.15≤r≤0.48), in particular in men. In women, in contrast, the strength of the correlations of cartilage thickness and meniscal measures with minimal JSW were in the same range. Fixed-location JSW measures showed stronger correlations with cartilage thickness (r≥0.68 medially; r≥0.59 laterally) than with meniscal measures (r≤|0.32| medially; r≤|0.32| laterally). Stepwise regression models revealed that meniscal measures added significant independent information to the total variance explained in minimal JSW (adjusted multiple r2=58%) but not in medial or lateral fixed-location JSW (r2=60/51%, respectively). ConclusionsIn healthy subjects, minimal JSW was observed to reflect a combination of cartilage and meniscal measures, particularly in women. Fixed-location JSW, in contrast, was found to be dominated by variance in cartilage thickness in both men and women, with somewhat higher correlations between cartilage and JSW in the medial than lateral femorotibial compartment. The significant contribution of the meniscus’ position on minimal JSW reinforces concerns over validity of JSW as an indirect measure of hyaline cartilage.

Effect of dietary antioxidant supplementation on reproductive characteristics of male broiler breeders during the post-peak production phase

Because of their membrane constitution, sperm cells of male broiler breeders are prone to lipid peroxidation, which affects their fertilizing capacity. The aim of the present study was to evaluate the effects of antioxidant diet supplementation on the reproductive characteristics of 12 male broiler breeders (Cobb) older than 50 weeks. The roosters were randomly distributed in a completely randomized experimental design with two treatments (treatment 1: commercial feed; treatment 2: commercial feed supplemented with canthaxanthin, lycopene, and vitamin C) and 6 replicates. Semen samples were collected by abdominal massage, and then underwent evaluation of semen volume, sperm concentration, motility, vigor, and morphology. Morphometric analyses of testes, combs, and dewlaps were performed at 68 weeks. Testes samples were collected for morphometric analysis of seminiferous tubules and analysis of cellular proliferation in the germinal epithelium by using immunohistochemical staining with anti-proliferating cell nuclear antigen (anti-PCNA) antibodies. Statistical data analysis was performed using the SAS software (SAS, 2002). No significant effects of antioxidant supplementation were observed on semen characteristics (p &amp;gt; 0.05). A significant positive effect of the antioxidant blend was observed on the percentage of normal sperm, dewlap weight and width, and testes weight and length (p &amp;lt; 0.05). PCNA-positive cell counts and morphometry of the seminiferous tubules were not affected by the treatment. Dietary antioxidant supplementation may represent a nutritional tool to increase fertility in male broiler breeder flocks during the post-peak production phase.

Presence and consequence of tooth periapical radiolucency in patients with cirrhosis.

BackgroundPeriapical radiolucency is the radiographic sign of inflammatory bone lesions around the apex of the tooth. We determined the prevalence and predictors of periapical radiolucency in patients with cirrhosis and the association with systemic inflammation status and cirrhosis-related complications.MethodsA total of 110 cirrhosis patients were consecutively enrolled. Periapical radiolucency was defined as the presence of radiolucency or widening of the periapical periodontal ligament space to more than twice the normal width. Predictors of periapical radiolucency and the association with systemic inflammation markers and cirrhosis-related complications were explored by univariable and multivariable logistic regression analyses.ResultsPeriapical radiolucency was present in one or more teeth in 46% of the patients. Strong predictors were gross caries (odds ratio [OR] 3.12, 95% confidence interval [CI] 1.43–6.79) and severe periodontitis (OR 3.98, 95% CI 1.04–15.20). Also old age (OR 1.10, 95% CI 1.01–1.19) and smoking (OR 3.24, 95% CI 1.02–17.62) were predictors. However, cirrhosis etiology (alcoholic vs nonalcoholic) or severity (Model of End-Stage Liver Disease score) were not predictors. The patients with periapical radiolucency had higher C-reactive protein (15.8 mg/L vs 8.1 mg/L, P=0.02) and lower albumin contents (25 g/L vs 28 g/L, P=0.04) than those without. Furthermore, the patients with periapical radiolucency had a higher prevalence of cirrhosis-related complications such as ascites, hepatic encephalopathy, and/or variceal bleeding (46% vs 27%, P=0.05).ConclusionPeriapical radiolucency is often present as an element of poor oral health status and likely has an adverse clinical significance, which should motivate diagnostic and clinical attention to the findings.

Faster and more accurate improved rescue ICSI by observing changing size and position of chromosome and spindle using polarization microscope and differential contrast microscope

Unfertilization after conventional IVF is confirmed by the existence of Metaphase-II (M-II) chromosome and first polar body. Spindle examination in unfertilized eggs using the polarization microscope is useful to assist rescue ICSI. However it has limitations since this apparatus observes only the existence of spindle not the stage of nuclear maturation (M-II, Anaphase-II or Telophase-II). Nomarski differential interference contrast microscopy clarifies each stage of second meiotic cell division. We performed this retrospective study to investigate the usefulness of this new improved technique. Retrospective cohort study for development of rescue ICSI. 425 Oocytes from 38 patients who agreed to participate in this study were observed 4 hours after insemination from January 2015 to December 2015. Unfertilized oocytes were identified by the normal width of chromosomes at M-II stage without extrusion of second polar body or white colored spindle with full length adjacent to the cytoplasmic membrane. Fertilized oocytes showed half width of chromosome in a line and shortening spindle 2-3 hours after the start of the fertilization (Anaphase-II). As fertilization was proceeding, M-II chromosomes became aggregated and divided into second polar body with spindle crossing the membrane 3-4 hours later. About 4 hours after insemination, second polar body extruded with remaining round M-II chromosomes and spindle was observed close to the perivitelline space (Telophase-II). 5-6 hours later small female pronucleus appeared just below the second polar body without the spindle. 1. The 425 freshly ovulated M-II oocytes were examined. The proportion of unfertilized oocytes that remained at M-II stage was 20.4% (87/425), fertilized oocytes after completion of second meiosis was 79.5% (338/425). 2. The fertilization, cleavage, blastocyst stage rates, pregnancy and miscarriage rates in fertilized oocytes (A) and unfertilized oocytes followed by new rescue ICSI (B) are listed in Table. No 1PN or 3PN oocytes could be observed both in group A and B. Not all of M-II oocytes could be identified as having completed second meiosis after insemination. Some chromosomes were scattered or degenerated. Whether oocyte was fertilized or unfertilized was more easily and quickly identified with the combination of Nomarski differential interference contrast microscopy and polarization microscope. The early and accurate identification of fertilization is beneficial for rescue unfertilized oocytes following conventional IVF.Tabled 1Clinical outcome following new rescue ICSIFertilization rates (%)Cleavage rates (%)Blastocyst rates (%)Pregnancy rates (%)Miscarriage rates (%)A(n=328)78.564.545.333.420.5B(n=87)52.462.333.225.525.6 Open table in a new tab

Columellar-Frenulum Angle - A Significant Clinical Parameter in Assessing the Degree of Severity in Unilateral Cleft Lip.

The study was carried out to learn if the columellar-frenulum angle could be used as one of the most important anthropometric measurements to predict the clinical severity in unilateral cleft lip patients. This is a prospective case series conducted at Banaras Hindu University, Varanasi, India. The study was based on the Thomson and Reinders criteria (1995), and various anthropometric measurements, including the columellar-frenulum angle, were measured. A total of 30 patients (21 boys and 9 girls) were included in the study. The ages of the children varied from 4 months to 15 years. The left side was affected in 18 patients, and 2 gave a significant positive family history. All the patients were subjected uniformly to Tennison's cleft lip repair. Patients with strictly unilateral complete cleft lip and palate were included in the study. Microform clefts, incomplete cleft lips, and bilateral clefts were excluded from the study. The data was analyzed using Pearson's correlation coefficient. The CF angle correlated negatively with the soft tissue defect of the cleft, cutaneous lip length, and vermilion lip length discrepancies from normal and soft tissue width just behind the alveolus. CF angle promises to offer a method by which prognosis of clefts can be predicted in terms of its severity in patients with unilateral cleft lip.