Significant Difference In Thickness Research Articles

Establishing signs for acute and healing phases of distal tibial classic metaphyseal lesions.

Stages of healing for classic metaphyseal lesions (CMLs) are not well established. Follow-up skeletal surveys provide an opportunity to evaluate signs of healing CMLs. To evaluate the sequence of CML healing phases by comparing initial and follow-up skeletal surveys in children with distal tibial CMLs on the initial survey. Findings could assist in child abuse investigations. We identified all distal tibia CMLs with initial and follow-up skeletal surveys performed January 2009 through December 2018 at our institution. Two pediatric radiologists reviewed the surveys using Likert score from 1 (no CML) to 5 (definite CML). Only cases with score of 4 or 5 by both radiologists were selected for the study. The initial and 2-week follow-up skeletal surveys were reviewed in consensus for presence of the following signs: corner fracture, thin bucket handle fracture, thick bucket handle fracture, bucket handle fracture with endochondral bone filling the gap, subphyseal lucency, deformed corner, and subperiosteal new bone formation. We used the Kruskal-Wallis test to evaluate for significant difference in thickness among thin bucket handle fracture, thick bucket handle fracture, and bucket handle fracture with endochondral bone filling the gap. We included 26 children (12 girls) with age range 1-9.9months who had a combined 34 distal tibia CMLs. Thin bucket handle fracture (n=13, 38.2%) was only seen on initial survey. On follow-up, six children had thick bucket handle fracture and four had bucket handle fracture with endochondral bone filling the gap. Fourteen thick bucket handle fractures (n=9) or bucket handle fractures with endochondral bone filling the gap (n=5) were noted on initial surveys; on follow-up, three (21.4%) had deformed corner, one (7.1%) had corner fracture, one (7.1%) had subphyseal lucency, and five (35.7%) were normal. None demonstrated thin bucket handle fracture on follow-up. Two of the nine (22.2%) thick bucket handle fractures became thicker, and 3/9 (33.3%) became bucket handle fractures with endochondral bone filling the gap. The metaphysis normalized in 8/34 (23.5%) CMLs on follow-up surveys. The thickness of thin bucket handle fracture was less than 1mm (mean±standard deviation [SD] = 0.6±0.2mm), which was significantly thinner (P<0.0001) compared with thick bucket handle fracture (1.7±0.5mm) and bucket handle fracture with endochondral bone filling the gap (1.9±0.6mm). The lack of thin bucket handle fractures on any follow-up skeletal surveys suggests this sign represents an acute phase of injury. The next phases of healing appear to be thick bucket handle fracture followed by bucket handle fracture with endochondral bone filling the gap. It is important to note that normalization of the metaphysis at 2-week follow-up does not exclude CML because this was seen in about one-fifth of cases.

Controlling Softened State of Mouthguard Sheet during Thermoforming to Ensure Thickness

Mouthguard thickness is affected by the softened state of the sheet during thermoforming. The aim of this study is to establish an effective method for controlling the softened state of the sheet to prevent the mouthguard thickness from decreasing during mouthguard fabrication using a vacuum-forming machine. Mouthguards were thermoformed using an ethylene-vinyl acetate sheet (thickness: 4.0 mm) and a vacuum-forming machine. The working model was trimmed to the anterior height of 25 mm and the posterior height of 20 mm. The following two heating methods were compared: 1) the sheet was formed when it sagged 15 mm below the level of the sheet frame at the top of the post (condition T); and 2) the sheet frame was lowered to and heated at 50 mm below its usual height and the sheet was formed when it sagged 15 mm below the level of the sheet frame (condition L). For each heating method, the vacuum was applied immediately (T0, L0) or 5 s (T5, L5) after the sheet frame was lowered to the forming unit. The sheet surface temperature immediately before the vacuum was applied under each condition was measured. The differences in mouthguard thickness due to forming conditions were analyzed by one-way ANOVA and Bonferroni’s multiple comparison tests. The temperature difference between the center and the posterior depending on the condition decreased in the order T0 > T5 > L0 > L5, and that was 20°C or higher for T0 and T5, and 10°C or less for L0 and L5. At the incisal edge and the cusp, L0 and L5 were significantly thicker than T0. No significant differences were observed between conditions L0 and L5 at any measurement points. For the labial and buccal surfaces, significant differences in thicknesses among all conditions, except L0 and L5, were observed and were in the order T0 < T5 < L0 and L5. This study was suggested that the lowering the sheet frame and heating was more effective than adjusting the vacuum timing for uniform softening of the sheet.

Is Pronator Quadratus Affected In Volar Approach To Distal Radius Fractures?

Objective: One of the structures encountered in surgical incision in volar Henry approach to distal end of the radius is the pronator quadratus (PQ) muscle. It may be preferable to repair the PQ after the surgery on radius, but due to the structure of the muscle tissue, the success of repair and therefore repair indications are still controversial. Therefore, in this study, we aimed to evaluate the PQ muscle placement and functional conclusions of patients with radial distal end fractures treated with volar locking plate. Methods:74 patients with closed distal radius fractures who underwent osteosynthesis with volar plate, are over 18 year were evaluated. Quick DASH, Stewart Scoring Board, AO classification, Frykman classification, thickness of the PQ muscle with USG, ranges of motion of wrist and grip strengths were recorded. Results:In 26 patients with PQ repair and 48 without PQ repair; no significant difference was found in QDASH scores (p=0.954), grip strength (p=0.300), ranges of motion of wrist and Stewart scores. No statistically significant thickness difference was found in USG transverse (p=0.312) and longitudinal (p=0.137) measurements made in patients with or without repair. Loss of thickness compared to the intact side was found as 15.4% in all patients. Conclusion:We found that PQ repair had no significant effect on range of motion of wrist, QDASH score or grip strength. We found an average 15.4% atrophy whether it was repaired or not. We believe that the portion of PQ removed from the radius does not affect the function of hand.

Fabrication of porous bovine pericardium scaffolds incorporated with bFGF for tissue engineering applications.

The design and fabrication of porous scaffolds are important issues for tissue engineering applications. In this study, we attempted to fabricate porous scaffolds using bovine pericardium (BP) and examined whether these scaffolds were beneficial for cell ingrowth and bioactive factors delivery. A vacuum-freeze-thawing-Triton X-100 (VFTT) protocol was used to fabricate porous BP scaffolds. The porous and mechanical properties were assessed using histology, scanning electron microscopy, and mechanical assay. The fabricated scaffolds were seeded with mesenchymal stem cells (MSCs), and cell ingrowth was evaluated. Basic fibroblast growth factor (bFGF) was subsequently incorporated into the fabricated scaffolds. The bioactive factor delivery capacity was evaluated using loading and release studies. The bioactivity of released bFGF was assessed using a rat subcutaneous model. The BP scaffolds fabricated by the VFTT protocol displayed interconnected porous structures with porosity of 6.82±1.36%.There were no significant differences in thickness, ultimate load, Young's modulus, and ultimate tensile strength between the fabricated porous BP scaffolds and native BPs (all P>.05). However, the water content of BPs was slightly reduced after VFTT treatment (P<.05). Cell ingrowth analysis showed that the seeded MSCs penetrated into the porous BP scaffolds with time of culture, while MSCs were limited to the surface layers of native BPs. Furthermore, bFGF was observed to be effectively loaded onto and released from the porous BP scaffolds. The released bFGF increased the phosphorylation levels of Akt, ERK 1/2, and MEK1/2, promoted host MSC recruitment, and inhibited myofibroblast differentiation in vivo. The porous BP scaffolds fabricated using a VFTT protocol were promising natural scaffolds for tissue engineering applications, since they had considerable mechanical properties as native BPs, supplied porous channels for cell ingrowth, and possessed bioactive factors delivery capability.

Corneal Epithelial Thickness Mapping After Photorefractive Keratectomy for Myopia.

To evaluate the longitudinal changes in epithelial thickness after photorefractive keratectomy (PRK) and correlate these with refractive changes. This prospective study included 52 eyes of 52 candidates for myopic PRK. Along with standard ophthalmic examinations, corneal epithelial thickness mapping by anterior segment optical coherence tomography was performed. Epithelial thickness maps of 9-mm diameter were divided into 25 sectors, including a central 2-mm zone and eight octants within para-central (2 to 5 mm), midperipheral (5 to 7 mm), and peripheral (7 to 9 mm) annular zones. All PRK treatments were performed using the Technolas Teneo 317 model 2 excimer laser (Bausch & Lomb, Rochester, NY) and an aspheric profile with a 6-mm diameter optical zone. Follow-up was at 1, 3, and 6 months. Repeated thickness measures before and after PRK at different follow-up times showed a significant difference in thickness separately in various zones (P < .001). A significant decrease in thickness was seen 1 month after PRK in all zones. Afterward, epithelial thickening continued in all zones and reached the preoperative thickness in the midperipheral and peripheral zones 6 months later, whereas the thickness in the central 5-mm zone was significantly thicker than before surgery. There was also a significant correlation between changes in spherical equivalent and epithelial thickness from before to 6 months postoperatively in the paracentral and peripheral zones. There was a marked decrease in the epithelial thickening pattern at 1 month after PRK, with gradual thickening at 3 and 6 months. Changes in epithelial thickness and spherical equivalent were significant only for the para-central peripheral zone. [J Refract Surg. 2019;35(10):632-641.].

Patellar calcar: morphometric analysis by knee magnetic resonance imaging and three-dimensional reconstruction software-assisted.

Patellar calcar corresponds to a greater trabecular bone density area in the patella lateral facet, whose morphometry is uncertain. This study aimed to describe patellar calcar morphometry by knee MRI and develop a 3D reconstruction software-assisted. Consecutive adult patients, submitted to knee MRI, between 2014 and 2017, were entered in IMPAX software. Exclusion criteria are history of patellar surgical intervention, trauma, chondromalacia, bone edema or bipartite patella. All MRI images were retrospectively reviewed by three readers. MRI patellar calcar measurements are height, width, thickness and posterior distance. 3D model protocol reconstruction: 3D Slicer software was used to design a preliminary model for each patient, and then all were automatically merged into one, which was finalized using the software segmentation tools. For 3D patellar calcar location, the transpolar axis was designed. 250 MRI were analyzed, patellar calcar was present in 208 (83.2%); 101 men and 107 women. Mean age was 44.3 ± 15.6years. height 13.84 ± 2.42mm (male: 14.50 ± 2.42; female: 13.21 ± 2.26) (p < 0.0001), width 12.21 ± 2.26mm (male 13.14 ± 2.22; female 11.33 ± 1.93) (p < 0.0001). No statistically significant difference of thickness 0.56 ± 0.22mm (male: 0.56 ± 0.25; female: 0.56 ± 0.20) and posterior distance 2.37 ± 0.80mm (male: 2.46 ± 0.89; female: 2.29 ± 0.69) between genders was found. 3D model results: transpolar axis went through the patellar calcar in all the cases. This study shows in a 3D model reconstruction, what was previously described in the literature, determining for the first time the patellar calcar morphometry in the knee MRI and identifying it as a regular finding in this imaging test.

Outer Retinal Thickness and Fundus Autofluorescence in Geographic Atrophy

Most studies of fundus autofluorescence (FAF) in geographic atrophy (GA) have been nonquantitative, with inadequate registration of image modalities. Furthermore, as pointed out in the recent Consensus Definition for Atrophy Associated with Age-Related Macular Degeneration on OCT, it is unclear whether decreased FAF would be correlated exclusively with a single category of OCT-defined atrophy. We sought to determine how FAF intensity in eyes with GA correlates with structural changes of the outer retina and choroid as seen on co-registered spectral domain OCT (SD-OCT) images. Retrospective cross-sectional. Twenty eyes of 11 patients with GA secondary to non-neovascular age-related macular degeneration (AMD). Spectral domain OCT and FAF images for each eye were co-registered using MATLAB (MathWorks Inc, Natick, MA). On B-scans, the choroid, retinal pigment epithelium (RPE), photoreceptor (PR) layer, and outer nuclear layer (ONL) were segmented. Regions of interest (ROIs) including all atrophic and border regions were selected manually on the FAF scans. Regions of interest were subdivided into quartiles of FAF level to correlate with retinal thickness measurements taken along the B-scans. Mean choroid, RPE, PR, and ONL thicknesses were compared across quartiles using an analysis of variance factorial design testing for interaction effects, adjusted for repeated measures (on both eyes) with a within-subjects factor. Seventeen eyes of 10 patients were selected for analysis. The mean choroidal thicknesses were not significantly different across FAF quartiles, but the overall differences in mean RPE, PR layer, and ONL thicknesses across quartiles were statistically significant (analysis of variance, P < 0.001, P < 0.001, and P=0.015, respectively). Post hoc analysis demonstrated significant differences in thickness among quartiles 1, 2, and 3 for the RPE and PR layers (Tukey, P < 0.01 in each case). The FAF quartiles within GA did not correlate exclusively with single categories of Consensus Definition for Atrophy Associated with Age-Related Macular Degeneration-defined atrophy. Not only RPE but also PR layer thickness on SD-OCT varies significantly with FAF levels in GA. This suggests that although the RPE cells are losing thickness and function, evidenced by decreased FAF from fluorophores, delicate PR cells also succumb early in the disease process. These relationships should be pursued as a possibly better-detailed mechanism in GA.

How does bone thickness affect the split pattern of sagittal ramus osteotomy?

This study examined the influence of bone thickness on the split pattern of sagittal ramus osteotomy at 62 sites using Dolphin 3D software. Four measurements of thickness were obtained from the preoperative computed tomography scans: measurement A was made 1.5mm above the lingula, using the coronal and sagittal planes; measurement B was made at the same height as measurement A and 1mm from the anterior border of the ramus; measurement C was obtained 5mm distal to the last molar and 5mm below the upper border of the mandible; measurement D was made in the area between the first and second molars, 6mm above the mandibular border. Three-dimensional postoperative images were used to classify the split pattern into types, based on the classification of Plooij et al. The data were analyzed using the Kruskal–Wallis test, followed by Dunn post-hoc test. Thirty-five sagittal splits were type I, one was type II, 19 were type III, and seven were type IV. Type I presented the greatest thickness, whereas type IV presented the lowest. There was a statistically significant difference in thickness only for measurement A, when types I and IV were compared. The results indicate that thinner mandibular rami are more prone to bad splits.

Comparative Study of Single Burr-Hole Craniostomy versus Twist-Drill Craniostomy in Patients with Chronic Subdural Hematoma.

Comparative Study of Single Burr-Hole Craniostomy versus Twist-Drill Craniostomy in Patients with Chronic Subdural Hematoma.

Analysis of Glaucomatous Changes of the Macula Using Optical Coherence Tomography

In glaucoma, progressive retinal nerve fibre loss can be measured in the peripapillary and macular regions using optical coherence tomography (OCT). The goal of this study was to evaluate the impact of glaucoma on all measureable retinal layers using the spectral domain OCT (SD-OCT). SD-OCT scans using automated retinal layer segmentation were performed in both eyes of primary open-angle glaucoma patients with strictly monocular absolute visual field scotoma in the central 10° of their visual field. The same measurements were performed in one eye per person in a healthy age-matched control group. The mean thickness of all retinal layers in the central 24 × 24° of the macular region was compared between groups. SD-OCT scans were performed in 24 eyes of 12 glaucoma patients (10 female, 2 male) with a mean age of 72.3 ± 8.1 years and in 12 eyes of 12 healthy controls (9 female, 3male) with a mean age of 66,0 ± 7,6 years. Statistically significant thickness differences between the glaucomatous and the healthy eyes could be demonstrated for the retinal nerve fibre layer, the ganglion cell layer, the inner plexiform layer and the complete retinal thickness, with lower mean thicknesses in the glaucoma group. Using SD-OCT, single retinal layers of the macular region can be scanned and measured automatically. In glaucoma, a decrease in thickness of the inner retinal layers containing ganglion cells and their axons or dendrites could be demonstrated compared to healthy eyes. No corresponding difference in thickness could be found for the outer retinal layers using SD-OCT measurements.

Perubahan Berat dan Histologi Testis Tikus Putih Jantan (Rattus Norvegicus) Akibat Pemberian Fraksi Daun Jambu Biji Merah (Psidium Guajava L.)

Daun Jambu Biji Merah (Psidium guajava L.) merupakan tanaman yang banyak tumbuh di Indonesia. Kandungan kimia yang terdapat dalam daun jambu biji merah adalah alkaloid, flavonoid, tanin, minyak atsiri dan beta-sitosterol yang diduga bersifat antifertilitas. Terrjadinya peningkatan jumlah penduduk yang sangat tinggi yaitu 1,49% per tahun maka perlu dikembangkan metode kontrasepsi pada pria yang aman, efektif dan reversibelitas tinggi. Penelitian ini bertujuan untuk menganalisis perubahan berat dan histologi testis tikus putih jantan (Rattus norvegicus) akibat pemberian fraksi daun jambu biji merah. Metode penelitian yang digunakan adalah true experiment dengan rancangan post test control group design menggunakan 24 ekor tikus jantan yang dibagi menjadi 4 kelompok perlakuan yang masing-masing kelompok terdiri atas 6 tikus jantan. Setiap kelompok diberi perlakuan fraksi n-heksan, etil asetat, metanol air sebanyak 80 mg/ekor/hari selama 48 hari dan untuk kelompok kontrol diberi CMC 1% 2 ml, pemberian dilakukan dengan cara sonde oral. Hasil penelitian menunjukkan adanya penurunan rata-rata berat testis, diameter tubulus seminiferus, tebal epitel tubulus seminiferus serta penurunan jumlah sel Leydig antara kelompok kontrol dengan kelompok perlakuan. Berat testis dan diameter tubulus seminiferus pada hasil uji pos hoct tes antara kelompok kontrol dan kelompok perlakuan didapatkan nilai p&lt;0,05 artinya ada perbedaan yang sangat signifikan tebal epitel tubulus seminiferus antara kelompok kontrol dan kelompok perlakuan. Begitu juga pada tebal epitel tubulus seminiferus dan jumlah sel Leydig, pada hasil uji pos hoct test didapatkan nilai p&lt;0,05. Dari hasil penelitian dapat disimpulkan bahwa fraksi daun jambu biji merah dapat menurunkan berat testis, diameter tubulus seminiferus, tebel epitel tubulus seminiferus dan jumlah sel Leydig.

Evolution of Clays in Cretaceous Marly Series (Álava Block, Basque Cantabrian Basin, Spain): Diagenesis and Detrital Input Control

Two stratigraphic sections of carbonate sediments with significant thickness differences and without appreciable tectonic deformation were studied near the trough and on a threshold zone at the Álava Trough. Such characteristics make them appropriate to analyze the influence of a slow progression of the diagenesis over the original clay suite. X Ray Diffraction (XRD), Transmission Electron Microscopy (TEM) and Analytical Electron Microscopy (AEM) techniques were applied in natural and alkylammonium-treated samples. Diagenesis slightly modified the clay mineralogy, the disappearance of smectite, and the variation in the content and ordering of the I/S mixed layer, with burial being the most noteworthy process. The total charge in the 2:1 expandable layers of smectite and I/S shows a slight increase, preferentially located on tetrahedral sheets, with depth. The data suggest a moderate diagenesis grade for the studied materials. The combination of techniques allowed identification of several types of detrital micaceous phases, as well-crystallized K-rich micas, Na-K micas, mica-chlorite stacks, and illites, with an expandable behaviour after the alkylammonium treatment. The total charge of illites did not change with diagenesis, suggesting their detrital origin. This research shows that the detrital assemblage masks the diagenetic evolution in the basin, which indicates the importance of the combination of different techniques to infer correctly the diagenetic grade in a sedimentary basin.

Strain Ultrasound Elastography in the Achilles Tendon of Ankylosing Spondylitis Patients Treated With Anti-TNF-α: A Preliminary Study.

To compare patients affected by ankylosing spondylitis (AS) treated with anti-TNF-α for two years with controls in terms of Achilles tendon stiffness, ultrasound structure and thickness. B-mode ultrasound evaluation and strain ultrasound elastography were performed in longitudinal and transverse planes on 22 Achilles tendons of 11 AS patients and 26 of 13 controls. There were no significant differences in thickness and stiffness of the Achilles tendon between AS patients and controls, except for an increased thickness in the middle third of the tendon in the AS patients (p=0.04). The Achilles tendon stiffness ratio of AS patients was 1.02±0.36 vs. 1.14±0.38 in the controls (p=0.2). AS patients had an Achilles tendon thickness greater than controls at the middle third, but no difference in the stiffness was found among them. Strain ultrasound elastography may be useful to exclude early changes in mechanical properties of tendons.

3-D mapping of cortical bone thickness in subjects with different face form and arch form: A CBCT analysis.

To determine the relationship between face form (FF), arch form (AF), and cortical bone thickness in anterior and posterior region of the mandibular jaws, using cone beam computed tomography (CBCT). Total 90 subjects were selected. For each subject FF (euryprosopic, mesoprosopic, and leptoprosopic) was determined using Prosopic Index. CBCT scans were done for each subject to determine mandibular AF (as tapered, oval, or square in horizontal sections) and cortical bone thickness (at two vertical levels 4 and 7 mm from the alveolar crest in the anterior and posterior region of mandible in sagittal sections). Numerical data so obtained were analyzed using descriptive statistics, analysis of variance followed by Tukey HSD (honestly significant difference) test at a statistical significance level of 5%. Significant difference in thickness of cortical bone was noted between various AF and face. In square AF, mean value of thickness of cortical bone was highest both at 4 and 7 mm vertical level and tapered AF had minimum mean values at 4 mm and oval at 7 mm in anterior region and posterior region on buccal and lingual sides, in all the three-FF. Significant effects of FF and AF on cortical bone thickness were seen both on buccal and lingual side and the effect of AF was more compared to FF. The availability of the cortical bone in euryprosopic FF and square AF patients was more; therefore, implants with a shorter length may be used in these clinical cases.

Analyzing the impact of glaucoma on the macular architecture using spectral-domain optical coherence tomography.

PurposeUsing spectral domain optical coherence tomography (SD-OCT) the retina can be segmented automatically to visualize all retinal layers. In glaucoma chronically elevated intraocular pressure leads to a decline of retinal ganglion cells (RGC) which changes retinal architecture. The goal of these analyses was to gain insight into the changes induced by glaucoma within all macular layers using SD-OCT within a closely circumscribed glaucoma cohort.Materials and methodsSD-OCT measurements with automated retinal layer segmentation were performed in both eyes of primary open-angle glaucoma patients with a defined monocular absolute visual field scotoma in the central 10° of the visual field and in an age-matched healthy control group. Thickness of single retinal layers and entire retina were compared with special attention to the localization of the visual field scotoma in the glaucomatous eyes.Results30 eyes of 15 glaucoma patients and 15 eyes of 15 healthy controls were included in this study. Statistical significant thickness differences were detected in the control group between superior and inferior retina for the retinal nerve fiber layer (RNFL), the outer plexiform layer (OPL) and the outer nuclear layer (ONL). In the glaucoma group thickness differences between worse and less affected eyes in the RNFL, the ganglion cell layer (GCL) and the inner plexiform layers (INL) were found. Comparison between healthy and diseased eyes revealed significant thickness differences in the RNFL, GCL, IPL and total retinal thickness but not the outer retinal layers.ConclusionComparison between SD-OCT measurements of the macula between healthy and glaucomatous eyes in a closely circumscribed disease stage showed a pronounced disease impact on the inner but not the outer retina. These results provide evidence that GCL and IPL thickness seem to be good measures to discriminate between affected and unaffected eyes in testing for glaucoma.

Structural characterization of four different naturally occurring porcine collagen membranes suitable for medical applications.

Collagen is the main structural element of connective tissues, and its favorable properties make it an ideal biomaterial for regenerative medicine. In dental medicine, collagen barrier membranes fabricated from naturally occurring tissues are used for guided bone regeneration. Since the morphological characteristics of collagen membranes play a crucial role in their mechanical properties and affect the cellular behavior at the defect site, in-depth knowledge of the structure is key. As a base for the development of novel collagen membranes, an extensive morphological analysis of four porcine membranes, including centrum tendineum, pericardium, plica venae cavae and small intestinal submucosa, was performed. Native membranes were analyzed in terms of their thickness. Second harmonic generation and two-photon excitation microscopy of the native membranes showed the 3D architecture of the collagen and elastic fibers, as well as a volumetric index of these two membrane components. The surface morphology, fiber arrangement, collagen fibril diameter and D-periodicity of decellularized membranes were investigated by scanning electron microscopy. All the membrane types showed significant differences in thickness. In general, undulating collagen fibers were arranged in stacked layers, which were parallel to the membrane surface. Multiphoton microscopy revealed a conspicuous superficial elastic fiber network, while the elastin content in deeper layers varied. The elastin/collagen volumetric index was very similar in the investigated membranes and indicated that the collagen content was clearly higher than the elastin content. The surface of both the pericardium and plica venae cavae and the cranial surface of the centrum tendineum revealed a smooth, tightly arranged and crumpled morphology. On the caudal face of the centrum tendineum, a compact collagen arrangement was interrupted by clusters of circular discontinuities. In contrast, both surfaces of the small intestinal submucosa were fibrous, fuzzy and irregular. All the membranes consisted of largely uniform fibrils displaying the characteristic D-banding. This study reveals similarities and relevant differences among the investigated porcine membranes, suggesting that each membrane represents a unique biomaterial suitable for specific applications.

Differences Between Subtalar Instability and Lateral Ankle Instability Focusing on Subtalar Ligaments Based on Three Dimensional Isotropic Magnetic Resonance Imaging.

The purpose of this study was to assess the differences between subtalar instability (STI) and lateral ankle instability (LAI) focusing on subtalar ligaments using 3-dimensional (3D) isotropic magnetic resonance imaging (MRI). Preoperative MRIs of 10 patients with STI who failed nonoperative treatment and consequently underwent arthroscopic subtalar reconstruction were compared with preoperative MRIs of 23 patients with LAI who underwent ligament repair or reconstruction. Dimensions of anterior capsular ligament (ACL), interosseous talocalcaneal ligament (ITCL), calcaneofibular ligament (CFL), and anterior talofibular ligament (ATFL) were measured. Tears of ACL, ITCL, CFL, ATFL, cervical ligament, and inferior extensor retinaculum were analyzed. Patients with subtalar instability had significantly lower ACL thickness and width than patients with LAI (thickness: 1.48 vs 2.12 mm, P = 0.045; width: 7.30 vs 8.64 mm, P = 0.029). An ACL thickness of 1.8 mm or less had sensitivity and specificity both at 75.0%, and an ACL width of 8 mm or less had sensitivity of 75.0% and specificity of 85.0% for discriminating STI from LAI. Absence or complete tear of ACL was more frequent in patients with STI than in patients with LAI (60.0% vs 13.0%, P = 0.010). The ATFL thickness was significantly greater in patients with LAI (P = 0.001). Complete tear of ATFL was more common in patients with LAI (P = 0.008). Complete tear of CFL was common in both the STI and LAI groups without significant difference (20.0% vs 21.7%). There was no significant difference in thickness and width of ITCL and in CFL thickness. Complete tear of ITCL, cervical ligament, and inferior extensor retinaculum were rare without significant difference. In patients with STI, the ACL is thin and narrow and more commonly absent or torn compared with patients with LAI. Complete tear of ATFL was more common in patients with LAI. Complete tear of CFL was commonly encountered in both the STI and LAI groups.

Interocular Asymmetry of the Ganglion Cell-inner Plexiform Layer in Diabetic Retinopathy.

The interocular difference in the ganglion cell-inner plexiform layer thickness showed a significant correlation with the diabetic retinopathy (DR) severity. The purpose of this study was to analyze the interocular differences in the foveal, retinal nerve fiber layer (RNFL), and ganglion cell-inner plexiform layer (GC-IPL) thickness of DR patients using spectral-domain optical coherence tomography. A total of 508 eyes from 254 patients with different severities of DR and 184 eyes from 92 control subjects were included. The GC-IPL, foveal, and RNFL thicknesses were measured, and the interocular differences in these thicknesses were correlated in control subjects and DR patients. The interocular difference in the average GC-IPL thickness significantly increased with the severity of DR. The interocular differences in the average GC-IPL thicknesses of the severe nonproliferative DR (NPDR) and the proliferative DR patients were significantly higher than those of the control group. However, there was no significant difference in thickness between the control group and the group with mild to moderate NPDR. In the group with proliferative DR, the interocular difference in the average GC-IPL was greater than those in the central foveal and RNFL thicknesses. Multivariate regression analyses showed that the DR severity and the interocular difference in central foveal thickness were significantly correlated with the interocular difference in the average GC-IPL thickness. The interocular differences in the central foveal, RNFL, and GC-IPL thicknesses significantly increased with increased DR severity. However, there was no significant difference between the control group and the group with mild to moderate NPDR. The GC-IPL differences showed a significant correlation with DR severity. These findings may be an indicator of DR progression.

The Clinical Outcomes of In Vitro Fertilization/Intracytoplasmic Sperm Injection Treatments in 43 Women with a History of Gestational Trophoblastic Disease

Background: To analyze the clinical outcomes of in vitro fertilization (IVF)/intracytoplasmic sperm injection treatments in women with a history of gestational trophoblastic disease (GTD). Methods: This retrospective study included 43 patients with a history of GTD as the study group and 43 matched patients as the control group. The patients in the study group were divided into two groups according to the therapy received. Patients in Subgroup A (n = 32) underwent uterine curettage treatment only. Patients in Subgroup B (n = 11) underwent uterine curettage combined with chemotherapy. The characteristics of ovarian stimulation and outcomes of embryos and pregnancy were compared. Results: In the first cycle, there was a higher number of retrieved oocytes and normal fertilized oocytes in the control group than those in the study group (9.2 vs. 6.2 and 6.0 vs. 4.0, respectively; P 0.05). There was no difference in the outcomes between Subgroup A and Subgroup B. There was a significant difference in thickness of the endometrium between the control group and study group (10.9 mm vs. 9.2 mm, respectively; P Conclusions: Patients with a history of GTD can present with a similar normal fertilization rate and number of viable embryos. However, patients with a history of GTD may have a thinner endometrium and lower ongoing pregnancy rate. Hysteroscopy before frozen embryo transfer and usage of an IUD can improve the occurrence of IUA.

Treatment of gingival recession by coronally advanced flap in conjunction with platelet-rich fibrin or resin-modified glass-ionomer restoration: A clinical study.

Aims:The aim of this study is to compare the outcome of coronally advanced flap (CAF) along with the use of platelet-rich fibrin (PRF) versus CAF in conjunction with a resin-modified glass-ionomer cement (RmGIC) for the management of Millers Class I and Class II gingival recession coupled with noncarious cervical lesions (NCCLs).Materials and Methods:Single and multiple Miller's Class I and Class II gingival recessions were chosen for the study. Twenty participants with total of 78 sites associated with NCCL bilaterally in the anterior and premolar region of maxilla were selected. Thirty-nine sites were treated with CAF and PRF and the remaining 39 sites were treated with CAF and RmGIC. Clinical parameters such as probing pocket depth, relative gingival recession, relative clinical attachment level, NCCL height, NCCL width, width of keratinized tissue, and keratinized tissue thickness were measured at baseline, 90th, and 180th day in both the groups. The presence or absence of dentin sensitivity (DS) was determined at baseline and 180th day.Results:Both the groups showed optimal root coverage, with statistical significant difference in thickness of keratinized gingiva in Group I when compared to Group II from baseline to 90th day and from baseline to 180th day and also from 90th to 180th day. On comparing the DS between Group I and Group II from baseline to 180th day, Group II showed greater reduction in dentinal hypersensitivity as compared to Group I.Conclusion:The use of PRF along with CAF showed increased thickness of the keratinized tissue and the utilization of RmGIC resulted in decreased DS. Hence, the combination of CAF and PRF or CAF and RmGIC could provide a better treatment option in the management of gingival recession that is of esthetic concern.