Size Of Dehiscence Research Articles

Anterior segment optical coherence tomography (AS-OCT) assisted analysis of characteristics of graft dehiscence after Descemet membrane endothelial keratoplasty (DMEK) for failed penetrating keratoplasty.

To analyse anterior segment optical coherence tomography (AS-OCT) parameters of graft dehiscence after Descemet membrane endothelial keratoplasty (DMEK) for graft failure post penetrating keratoplasty (PK). Retrospective evaluation of AS-OCT images of 142 dehiscences post-DMEK in 75 eyes. Dehiscences' size, depth, location, correlation with graft-host interface (GHI) override and step at GHI were assessed. The majority of patients were male (58.7%) and mean age was 67 ± 13.6 years. Multiple dehiscences were observed in 49.3% eyes. Rebubbling was required once in 72% and multiple times in 24% eyes. Among 142 dehiscences, crossing over GHI was noted in 53.5%. The median distance of peripheral edge of dehiscences from GHI was 0.21 mm. Steps at GHI were noted in 41.5% where 22.5% dehiscences with step crossed the GHI. For dehiscences crossing versus not crossing GHI, no significant difference was noted in median depth (p = 0.268) and size (p = 0.206). For dehiscences crossing over GHI with presence versus absence of step, median depth (p = 0.23) and size (p = 0.196) showed no significant difference. No significant difference was noted in dehiscences' median depth (p = 0.16) and size (p = 0.926) among different step sizes. Incidence of dehiscence with or without steps (p = 0.8853) and graded as per size of steps, showed no significant difference. Size and depth of dehiscence were not influenced by their crossing over GHI or the presence and size of steps. Dehiscences typically occurred in close vicinity to GHI, suggesting that DMEK graft should be placed 0.25 mm centrally from the prior PK interface, independent of GHI irregularities.

Computed tomography approximated superior semicircular canal dehiscence size and location and their association with clinical presentation

ObjectiveThis study investigates the relationship of superior semicircular canal dehiscence (SSCD) size and location with patient symptomatology and audiometry. MethodsWe retrospectively reviewed SSCD cases presented to a tertiary institution between 2011 and 2022. Dehiscence length and width measured on high-resolution temporal bone computed tomography imaging were used to calculate an approximate dehiscence area (ADA). Dehiscence location was classified employing a six-grade system. Multivariable regression analyses were performed with symptomatology and audiogram metrics as outcome variables and ADA and dehiscence location as the primary covariates of interest. ResultsA total of 402 SSCD were included in the analysis. Controlling for patient age, sex, dehiscence laterality, and location, greater ADA was independently associated higher rates of autophony (aOR 1.39; 95% C.I. 1.14–1.71; P = 0.004) and hyper-amplification (aOR 1.39; 1.14–1.70; P = 0.004). Additionally, dehiscences with greater ADA exhibited significantly lower bone conduction threshold at 500 Hz (adjusted β –1.75, P = 0.006) and 1000 Hz (adjusted β –1.61, P = 0.018) and significantly wider air-bone gap at 500 Hz (adjusted β 2.22, P < 0.001) and 1000 Hz (adjusted β 1.00, P = 0.039). Dehiscence location was not independently associated with any outcome variable examined when accounting for dehiscence size. ConclusionThe size of dehiscence is more independently related to clinical presentations than the anatomical location of the dehiscence in the superior semicircular canal. Greater dehiscence size is associated with symptomatology and audiometry consistent with more severe bone conduction hyperacusis.

Southern Hemisphere Caytoniales: vegetative and reproductive remains from the Lonco Trapial Formation (Lower Jurassic), Patagonia

Macrofossil impressions of caytonialean leaves and micro- and megasporangiate organs from the Early Jurassic Taquetrén locality in Patagonia, Argentina, are described based on more than 300 hand specimens. Leaves of the organ-genus Sagenopteris are described using both discrete and continuous features allowing us to erect the species Sagenopteris trapialensis sp. nov. Associated microsporangiate organs of Caytonanthus type are the first recorded for South America and are characterized by a unique combination of architecture, size and type of dehiscence. Two specimens, one resembling an isolated Caytonia cupule, and the other a Caytonia axis, are also described. The availability of a collection with numerous specimens has proven to be an important tool in order to fully understand the intraspecific morphological plasticity of the studied species. The striking morphological resemblance of both vegetative and reproductive organ-genera with their Northern Hemisphere counterparts suggests that they were part of the same lineage, which was widely distributed during the Jurassic. Well-defined whole-plant concepts are still needed to advance the goal of deciphering the internal relationships of caytonialeans in particular, and their relationships with other groups of seed-plants in general, and thorough macro-morphological characterization of the organs that compose them, as we present here, may be of valuable use in achieving it.

FAILURE OF COLORECTAL ANASTOMOSIS. CLINICAL ANALYSIS

Failure of colorectal anastomosis was found in 1 case after 30 stapler operations and in 6 cases after 60 manual anastomoses. All the anastomoses were formed by two rows of sutures and were subperitoneal. The diagnosis of failure was mad on the basis of clinical data. One patient died. The errors in diagnosis of colorectal anastomosis failure are discussed. Visualization of a failure area by means of contrast enema and CT is essential. From 2013 to 2017 in Chernivtsi Oncological Center 90 operations were performed for rectal cancer with colorectal anastomoses. The first row of sutures was applied from the inner part of mucosa. In 25 cases invagination technique was applied. Anastomoses were made by 5 surgeons with a high level of professional work. One failure occurred on 11 day after formation of stepler anastomosis, by means of manual anastomoses failure appeared on 5-9 days. Conservative therapy was given to 2 patients. Transversostomy was performed in 4 patients, and lparotomy with resection of anastomosis – in 1 patient. In all cases surgeons were not informed about the size of dehiscence and level of drainage of subperitoneal abscess. In such situation transversostomy may be dangerous and subperitoneal abscess leads to peritonitis.

Relationship between Surgically Treated Superior Canal Dehiscence Syndrome and Body Mass Index.

Objective Examine the association between body mass index (BMI) and superior canal dehiscence (SCD) among patients who have undergone surgical repair for superior canal dehiscence. Study Design Retrospective comparison study. Setting Neurotology tertiary care center. Subjects and Methods Retrospective review of consecutive adult patients evaluated at our institution for SCD syndrome between November 2006 and August 2015. A control group who underwent imaging within the same period for reasons other than SCD was also included. Patient demographics, weight, and height were examined. We performed multiple subgroup analyses to investigate the relationship of BMI, surgery vs no surgery, and correlation between patient BMI and SCD size. Results Of the 268 patients with SCD, 99 underwent surgery; 96 of these patients had complete medical records and were eligible for inclusion. Eighty-eight patients were noted to have arcuate eminence defects, and the mean BMI of this surgical cohort was 28.09 ± 5.26 kg/m2. Nonsurgically treated patients with SCD with available data (n = 94) had a mean BMI of 27.97 ± 6.95 kg/m2. A control group of 204 patients who underwent computed tomography for non-SCD-related causes was analyzed, of whom 155 had available data with a mean BMI of 27.91 ± 6.38 kg/m2. Conclusion We demonstrate that adult patients who undergo surgery for SCD are not obese (mean BMI <30), and size of dehiscence poorly correlates with BMI. Our observations call into question the proposed theory that patient weight is a risk factor for the development of symptomatic SCD involving the arcuate eminence.

Long-term efficacy of vacuum-assisted therapy (Endo-SPONGE®) in large anastomotic leakages following anterior rectal resection.

Background:The aim of our study was to test the long-term efficacy of Endo-SPONGE® therapy in a group of patients treated in our center with vacuum-assisted therapy because of anastomotic leakages after colorectal surgery.Methods:Eleven patients [male: 6; mean age: 71 (range: 44-82) years] who had anastomotic leakage treated with Endo-SPONGE® placement were included in the study. Patient records were examined retrospectively. All patients with documented anastomotic leakage on abdominal computed tomography following an anterior resection of the rectum for rectal cancer underwent sigmoidoscopy to determine the extent of the anastomotic defect and the size of the presacral abscess.Results:Ten of the 11 patients (90.9%) showed closure of the anastomotic leakage after a mean of 16 sponge changes. During follow up [mean: 29 (range: 6-64) months], we observed two cases of anastomotic stricture. Treatment failure was observed in one patient who presented an increased size of dehiscence after 23 sessions of endoscopic treatment, despite an initial good response.Conclusions:Our study substantially confirms previous conclusions and reaffirms that Endo-SPONGE® treatment for colorectal anastomotic leakages, performed in suitable patients, represents a successful and safe approach. The reduction in wound closure time, mild-to-moderate discomfort and possibly shorter hospitalization suggest that Endo-SPONGE® treatment can be a prominent therapeutic regimen with adequate patient acceptance.

Correlation of Superior Canal Dehiscence Surface Area With Vestibular Evoked Myogenic Potentials, Audiometric Thresholds, and Dizziness Handicap.

To correlate objective measures of vestibular and audiometric function as well as subjective measures of dizziness handicap with the surface area of the superior canal dehiscence (SCD). Retrospective chart review and radiological analysis. Single tertiary academic referral center. Preoperative computed tomography imaging, patient survey, audiometric thresholds, and vestibular evoked myogenic potential (VEMP) testing in patients with confirmed SCD. Image analysis techniques were developed to measure the surface area of each SCD in computed tomography imaging. Preoperative ocular and cervical VEMPs, air and bone conduction thresholds, air-bone gap, dizziness handicap inventory scores, and surface area of the SCD. Fifty-three patients (mean age 52.7 yr) with 84 SCD were analyzed. The median surface area of dehiscence was 1.44 mm (0.068-8.23 mm). Ocular VEMP amplitudes (r = 0.61, p <0.0001), cervical VEMP amplitudes (r = 0.62, p <0.0001), air conduction thresholds at 250 Hz (r = 0.25, p = 0.043), and air-bone gap at 500 Hz (r = 0.27, p = 0.01) positively correlated with increasing size of dehiscence. An inverse relationship between cervical VEMP thresholds (r = -0.56, p < 0.0001) and surface area of the dehiscence was observed. No association between dizziness handicap and surface area was identified. Among patients with confirmed SCD, ocular and cervical VEMP amplitudes, cervical VEMP thresholds, and air conduction thresholds at 250 Hz are significantly correlated with the surface area of the dehiscence.

Inheritance analysis of anther dehiscence as a trait for the heat tolerance at flowering in japonica hybrid rice (Oryza sativa L.)

We analyzed the heredity of anther morphology in rice (Oryza sativa L.) using incomplete diallel crosses of six japonica restorer lines and eight cytoplasmic male-sterile (CMS) lines, and 48 F1 combinations resulting from these crosses. We analyzed four traits: the length of dehiscence formed in the apical (ADL) and basal (BDL) parts of the anther and the respective widths, ADW and BDW. The ratios of V gca (variance of general combining ability) to V sca (variance of specific combining ability) were 8.0 for BDL, 1.4 for BDW, 3.0 for ADL, and 2.8 for ADW. Narrow-sense heritability (H N 2 ) was 76.5 % for BDL, 37.9 % for BDW, 66.0 % for ADL, and 65.9 % for ADW. The effects of GCA (general combination ability) for BDL ranged from −67.0 to 68.9 μm (CMS lines) and from −33.4 to 43.0 μm (restorer lines); those for ADL were −46.7 to 44.0 μm (CMS lines) and −29.5 to 34.0 μm (restorer lines). We conclude that BDL and ADL have high heritability, and we can modify the size of apical and basal dehiscence by selecting suitable CMS and restorer lines.

Outcomes of Wound Dehiscence Post-Penetrating Keratoplasty.

Penetrating keratoplasties (PKs) carry a lifetime risk of developing wound dehiscence, which can lead to severe consequences to vision. To better understand the risk, we analyzed the characteristics and outcomes of a series of patients with wound dehiscence post-PK. Data were collected retrospectively on 31 eyes from 30 patients with a history of wound dehiscence repair post-PK between January 1, 2009, and April 30, 2014, and followed up at the Cornea Service at Wills Eye Hospital. Only patients who had surgical repair of an open wound dehiscence were included, excluding those with wound slippage but no aqueous leak. The mean age at wound dehiscence was 56 years with a mean time from PK to dehiscence of 9.8 years. Among the 31 eyes, 26 (26/31, 84%) had trauma-induced dehiscence, while 5 had unknown causations or no reported trauma. The mean size of dehiscence was 153 ± 66 degrees. Visual outcomes ranged from 20/50 to no light perception, with a majority between 20/100 and hand motion (18/30, 60%). Twenty eyes (20/26, 76%) lost their lens at dehiscence. All 10 phakic eyes lost their lenses. Five patients retained their lens implants and had a better mean visual outcome (average = 20/400) than the 10 patients who lost their implants (average = 20/800) (1 lens status was unknown postdehiscence). Wound dehiscence is a lifelong risk after PK regardless of the age, indication for corneal transplant, and time since transplant. A better visual outcome was associated with retained pseudophakia and clear corneas.

Long-term results of middle fossa plugging of superior semicircular canal dehiscences: clinically and instrumentally demonstrated efficiency in a retrospective series of 16 ears

The objective of this study is to report the surgical outcome after middle fossa approach (MFA) plugging in patients suffering from a superior semi-circular canal dehiscence (SCD) syndrome. This is a retrospective case review. Tertiary referral center. Sixteen ears in 13 patients with a SCD syndrome suffering from severe and disabling vestibular symptoms with a bony dehiscence on CT scan >3 mm and decreased threshold of cervical vestibular evoked potentials (cVEMPs). We assessed preoperatively: clinical symptoms, hearing, cVEMPs threshold, size of dehiscence and videonystagmography (VNG) with caloric and 100 Hz vibratory tests. Postoperatively, we noted occurrences of neurosurgical complication, evolution of audiological and vestibular symptoms, and evaluation of cVEMP data. Tullio’s phenomenon was observed in 13 cases (81.3 %) and subjectively reported hearing loss in seven (43.7 %). All patients were so disabled that they had to stop working. No neurosurgical complications were observed in the postoperative course. In three cases (16.6 %), an ipsilateral and transitory immediate postoperative vestibular deficit associated with a sensorineural hearing loss (SNHL) was noted, which totally resolved with steroids and bed rest. All patients were relieved of audiological and vestibular symptoms and could return to normal activity with a mean follow-up of 31.1 months (range 3–95). No patient had residual SNHL. cVEMPs were performed in 14 ears postoperatively and were normalized in 12 (85.7 %). Two of the three patients operated on both sides kept some degree of unsteadiness and oscillopsia. MFA plugging of the superior semi-circular canal is an efficient and non-hearing deteriorating procedure.

Combined Endoscopic Transanal Vacuum-Assisted Rectal Drainage: A Novel Therapy for Colorectal Anastomotic Leak after TME for Cancer

Introduction: Low colorectal and colo-anal anastomosis leakage after anterior resection of rectum occurs in up to 24% of cases. Leak is the main cause of morbidity and mortality in postoperative period and can result in a permanent stoma in up to 25% of cases. Loop ileostomy or colostomy does not reduce the percentage of fistulas, but reduces flow rate. Conservative management imply long times to heal. Endosponge® system (B. Braun Aesculap AG, Germany) was recently acquired in clinical practice. This system accelerates healing process through vacuum creation, removal of fluids and edema, infection control, local increase of blood flow and stimulation of granulation tissue formation. The device consists of a cylindrical polyurethane sponge, with 400 to 600 micron pores, standard dimension of 7 cm, which can be cut to fit the estimated size of the abscess cavity. The drain tube is connected to a Redyrob Trans Plus®bottle which exerts a constant suction during the therapy. Materials and Methods: From November 2012 and March 2014 four patients were treated with Endosponge® system, all of them underwent operation of anterior resection of rectum for cancer and developed anastomotic leakage during postoperative course. All patients had loop ileostomy, none presented signs of sepsis. The Endosponge® system was then placed endoscopically. In all cases, after the first placing, the authors utilized sterile foam dressing from negative pressure wound therapy kit, tailored to better fill the abscess cavity and connected with Redyrob Trans Plus?bottle. Device changes were performed every 5 - 7 days, according to the size of the cavity and the amount of secretions produced. The treatment was started during hospitalization first and then continued as outpatient. Results: There was no mortality. The amount of secretions was related to the initial size and the degree of contamination of the abscess cavity. Antibiotic therapy was discontinued after an average of 21 days, with a range between 14 and 32 days. Complete healing was achieved in a median of 82 days (30 to 148) in all patients with good functional results, no further surgery was required. Conclusions: The results of therapy with Endosponge® seem encouraging. Success of therapy is higher if initiated as soon possible after the intervention and is also related to the size of dehiscence and abscess cavity. In cases with large abscesses, it is not clear whether this new treatment leads to reduction in healing time, however, can prevent the packaging of a (often definitive) colostomy. Further studies will be able to select patients who will most benefit from the procedure.

15th Yahya Cohen Memorial Lecture — The Relationship between the Air-bone Gap and the Size of Superior Semicircular Canal Dehiscence

This study aimed to examine the relationship between the air-bone gap (ABG) and the size of the superior semicircular canal dehiscence (SSCD) as measured on a computed tomography (CT) scan. The study design was a case series with chart review. Twenty-three patients (28 ears) from a tertiary referral centre were diagnosed with SSCD. The size of the dehiscence on CT scans and the ABG on pure-tone audiometry were recorded. The size of the dehiscence ranged from 1.0 to 6.0 mm (mean, 3.5 ± 1.6 mm). Six ears with a dehiscence measuring less than 3.0 mm did not have an ABG (0 dB). The remaining 18 ears showed an average ABG at 500, 1000, and 2000 Hz (AvABG(500-2000)) ranging from 3.3 to 27.0 dB (mean, 11.6 ± 5.7 dB). The analysis of the relationship between the dehiscence size and AvABG(500-2000) revealed a correlation of R(2) = 0.828 (P <0.001, quadratic fit) and R(2) = 0.780 (P <0.001, linear fi t). Therefore, the larger the dehiscence, the larger the ABG at lower frequencies on pure-tone audiometry. In SSCD patients, an ABG is consistently shown at the low frequency when the dehiscence is larger than 3 mm. The size of the average ABG correlates with the size of the dehiscence. These findings highlight the effect of the dehiscence size on conductive hearing loss in SSCD and contribute to a better understanding of the symptomatology of patients with SSCD.

Variety of Audiologic Manifestations in Patients With Superior Semicircular Canal Dehiscence

To present diverse symptoms, signs, and findings on diagnostic tests of 11 patients with superior semicircular canal dehiscence (SSCD) syndrome and surgical treatments for dehiscence of 3 patients. Retrospective case review. Tertiary neurotologic and audiologic center. Patients with SSCD documented by history, physical examination, vestibular function testing, and high-resolution computed tomographic scans. Two patients underwent surgical procedures through middle fossa approach, and 1 patient underwent transmastoid repair. The rest underwent conservative treatments. Eleven patients were identified as SSCD. The variety of clinical manifestations, including 1) hearing presentations: mix hearing loss (4 of 11), conductive hearing loss (3 of 11), profound sensorineural hearing loss (2 of 11), and normal hearing (2 of 11); 2) vestibular manifestations: chronic disequilibrium (8 of 11), Tullio phenomenon (7 of 11), Hennebert sign (8 of 11), tinnitus (3 of 11), and autophony (3 of 11); and 3) accompanying disorders: encephalomeningocele (1 of 11). Abnormal nystagmus was identified in 3 patients. Dehiscence of bone overlying superior semicircular canal was confirmed by high-resolution computed tomographic scan in all cases. Three patients underwent operative management. (2 through the middle fossa approach and 1 through a transmastoid repair). Superior semicircular canal dehiscence demonstrates diverse and complex clinical features. Tegmental or petrosal bone rarefaction or mild dehiscences can be a harbinger or an aggressive cause of developing SSCD. No correlation was observed between the size of dehiscence and the severity of vestibular symptoms or the degree of hearing loss. Surgical repair of dehiscence can relieve symptoms with low morbidity.

Heat-Induced Floret Sterility of Hybrid Rice (Oryza sativa L.) Cultivars under Humid and Low Wind Conditionsin the Field of Jianghan Basin, China

Projected global warming is expected to increase the occurrence of heat-induced floret sterility (HIFS) in rice. However, there are few field-scale studies that could aid in predicting the potential risks to rice yield and developing countermeasures against yield losses. The aim of this study was to elucidate the factors that induce floret sterility under high temperature conditions during the flowering season in the field condition in China. Studies were conducted in irrigated paddy fields with the regional hybrid-rice cultivars grown in Jianghan Basin where air temperature is not so high during the flowering season but HIFS frequently occurs. The microclimate, panicle temperature, floret sterility, pollination, and size of dehiscence formed at the base of anthers were investigated. Significant losses in seed set were observed under the high temperature condition. Although the maximum atmospheric temperature was approximately 35ºC, the relative humidity was very high (around 70% at the time of maximum temperature), with low wind speeds, occasionally below 1 m s1. Under such conditions sunlit panicle temperature exceeded atmospheric temperature by as much as 4ºC. Moreover, the anthers of some cultivars exhibited short basal dehiscence, and the dehiscence length was positively correlated with the percentage of sufficiently pollinated florets (r=0.859, P<0.05, n=7) and with seed set (r=0.827, P<0.05, n=7) across the cultivars. The results suggest that the combination of hot, humid, and windless climatic conditions with short basal dehiscence of anthers induces HIFS in hybrid rice grown in this region.

The relationship between the air-bone gap and the size of superior semicircular canal dehiscence

Objective To examine the relationship between the air-bone gap (ABG) and the size of the superior semicircular canal dehiscence (SSCD) as measured on a computed tomography (CT) scan. Study Design Case series with chart review. Setting Tertiary referral center. Patients Twenty-three patients (28 ears) diagnosed with SSCD. Main Outcome Measures The size of the dehiscence on CT scans and the ABG on pure-tone audiometry were recorded. Results The size of the dehiscence ranged from 1.0 to 6.0 mm (mean, 3.5 ± 1.6 mm). Six ears with a dehiscence measuring less than 3.0 mm did not have an ABG (0 dB). The remaining 18 ears showed an average ABG at 500, 1000, and 2000 Hz (AvABG 500-2000) ranging from 3.3 to 27.0 dB (mean, 11.6 ± 5.7 dB). The analysis of the relationship between the dehiscence size and AvABG 500-2000 revealed a correlation of R 2 = 0.828 ( P < 0.001, quadratic fit) and R 2 = 0.780 ( P < 0.001, linear fit). Therefore, the larger the dehiscence, the larger the ABG at lower frequencies on pure-tone audiometry. Conclusions In SSCD patients, an ABG is consistently shown at the low frequency when the dehiscence is larger than 3 mm. The size of the average ABG correlates with the size of the dehiscence. These findings highlight the effect of the dehiscence size on conductive hearing loss in SSCD and contribute to a better understanding of the symptomatology of patients with SSCD.

顔面神経管裂隙に関する組織学的研究

The incidence, location and size of dehiscence of the facial canal were determined from histologic examination of serially sectioned temporal bones.Dehiscence was measured at its widest diameter. One hundred and twenty-one temporal bones from 63 subjects were examined,5 being unpaired. Dehiscences were found in 101 t emporal bones (83%). Dehiscences with diameters 0.5 mm or larger were found in 86 temporal bones (71%). Ninety percent of the dehiscences were located in the tympanic segment and 10% in the mastoid segment. Of all dehiscence,66% were located adjacent to the oval window. Of the 58subjects in which both temporal bones were available for study,44 (76%) showed dehiscences in both ears.The present stu d y brings to attention the possible frequent occurrence of the dehiscence and close attention should be paid to surgical procedures concerning the eradication of inflammatory granulation tissue or cholesteatoma matrix from the epitympanic space.

Pollen Production in Some Anemophilous Angiosperms

Abstract Pollen production in terms of number per anther along with the particulars of anther number per flower, anther length, filament length, pollen grain size and mode of anther dehiscence was determined for 82 angiospermous plant species occurring in Andhra Pradesh, India. Pollen production varied widely from genus to genus, and from species to species within the same genus. The non-Poaceae and non-Cyperaceae members proved to be high pollen producers. The level of pollen production was directly related to anther size and inversely related to pollen grain size. There was no correlation between high pollen production and mode of anther dehiscence in general, but the high pollen producers of Poaceae are porous dehiscing. It is presumed that high pollen producers are crosspollinated, whereas low pollen producers are either self-pollinated or apomictic.