Vertical Fusion Research Articles

The Effect of Prism Presentation Order on Near Vertical Fusional Vergence Ranges of Normal Young Adults.

Fusional vergence ranges (FVR) quantify the oculomotor system's ability to overcome heterophoria, playing a critical role in diagnosis and treatment.This study investigated the effect of prism order on near vertical FVR using the smooth and step methods. Normal participants were randomly assigned to either the smooth or step testing method and to Base-Up (BU, infravergence) first or Base Down (BD, supravergence) first prism type. After an hour, they crossed over tothe alternative testing method and prism-type. The mean of two consecutive measurements of break and recovery values for one eye in each of the 16 experimental conditions were compared using the Friedman test with post-hoc Bonferroni correction, and non-parametric Bland and Altman analysis. The mean break/recovery values of 27 participants (mean age: 22.5±2.0, range: 20-29, 20female) when BU or BD were measured first were BU: 4.20±1.15Δ/3.07±1.04Δand BD: 4.20±1.21Δ/3.00±0.96Δfor step, and BU: 4.31±0.98Δ/2.97±0.85Δand BD: 4.15±1.14Δ/2.70±0.87Δfor smooth methods, respectively. When measured second, they were BU: 3.74±1.02Δ/2.63±0.93Δand BD: 3.85±1.09Δ/2.64±1.06Δfor step, BU: 3.91±0.99Δ/2.73±0.93Δand BD: 3.81±1.04Δ/2.54±1.04Δ for smooth, respectively. The Friedman test found a significant effect of prism order on break values of the smooth (p<0.001) and step (p<0.02) methods, and recovery values of the step method (p<0.005), but post-hoc tests showed no significant differences. Mean differences were below 0.50Δindicating clinical insignificance. Unlike horizontal FVR, prism order does not affect near vertical FVR using the smooth and step. This simplifies clinical assessment and suggests that horizontal and vertical fusion systems may be treated as separate entities.

Stiffness-related disability following long segmental posterior instrumentation and fusion: is it influenced by postoperative spinopelvic alignment?

PurposeThe aims of this study were to investigate the correlations between Chinese version of Lumbar Stiffness Disability Index (C-LSDI) and other clinical outcomes, and to identify the factors independently affecting stiffness-related disability after long-segment fusion in patients with degenerative lumbar scoliosis (DLS).MethodsWe performed a retrospective study of 118 consecutive surgically treated DLS cases at a single institute. Pre- and post-operative radiological parameters and postoperative health related quality of life (HRQOL) were examined to determine their correlation coefficients with postoperative C-LSDI. Patients were divided into two groups by the medium number of postoperative C-LSDI: low-stiffness group (C-LSDI < 48 points) and high-stiffness group (C-LSDI ≥ 48 points). Subsequently, differences between the two groups were assessed, and the presumed factors affecting C-LSDI evaluation were further analyzed.ResultsCoronal parameters and global sagittal parameters showed significant correlations with postoperative C-LSDI. The correlation coefficients between C-LSDI and Oswestry Disability Index (ODI), Japanese Orthopedic Association-29 (JOA-29), the Scoliosis Research Society-22 questionnaire (SRS-22) Function, and the Short Form-36 Health Survey (SF-36) Physical Component Scores were over 0.5. In multiple linear regression, postoperative sagittal vertical axis (β = 0.084, p = 0.025), fusion levels (β = 2.13, p = 0.012), and body mass index (β = 0.867, p = 0.022) were independent related factors for C-LSDI.ConclusionThis study showed that all HRQOLs demonstrated the varying degree of correlations with C-LSDI, of which the ODI, JOA-29, SRS-22 Function, and SF-36 PCS were most relevant, with moderate strength of associations.Moreover, longer fusion levels, higher BMI, and greater postoperative SVA independently affect C-LSDI after long segmental posterior instrumentation and fusion for DLS.

Titanium-Coated Polyetheretherketone Cages Vs Full Titanium Cages for Stand-Alone 1- or 2-Level Anterior Cervical Discectomy and Fusion: A Comparative Study.

Anterior cervical discectomy and fusion (ACDF) for the surgical treatment of cervical degenerative disease often includes an intervertebral cage, which restores disc height and lordosis while promoting fusion . Cage materials include titanium (TTN) or polyetheretherketone (PEEK). Controversy in material selection stems from higher fusion rates with TNN, despite a higher subsidence rate, while PEEK cages demonstrate superior preservation of interspace height. Combining the advantages of both materials, TTN-coated PEEK (TCPEEK) cages were developed, featuring a PEEK core with similar stiffness to the bone, enveloped with a TTN coat, improving osteointegration. However, the potential superiority of TCPEEK over TTN cages has not been investigated. This study aimed to compare clinical and radiographic outcomes following single- or double-level ACDF using either TTN or TCPEEK cages. This retrospective single-center study included patients undergoing single- or double-level ACDF between 2017 and 2019. Clinical outcomes included the Neck Disability Index and revision surgery incidence. Radiographic parameters included cervical and segmental lordosis, C2 to C7 sagittal vertical axis, fusion, subsidence, and adjacent segment degeneration at a minimum 12-month follow-up. A total of 45 patients (16 TTN; 29 TCPEEK) and 58 cervical levels (21 TTN; 37 TCPEEK) were included. Both cages significantly improved Neck Disability Index scores (TTN -10.0; TCPEEK -14.1) without significant differences. Two single-level TCPEEK patients required revision surgery due to non-union. In the radiological assessments, no significant difference was found for subsidence rates (TTN 52.4%; TCPEEK 56.8%), adjacent segment degeneration, cervical and segmental lordosis, and changes in C2 to C7 sagittal vertical axis. Though not statistically significant, fusion rates trended slightly higher with TTN (90.5%) vs TCPEEK cages (86.5%). TTN and TCPEEK cages achieve satisfactory clinical and radiological outcomes in single- or double-level ACDF. This finding suggests that the choice between them can be based on other factors, such as surgeon preference or availability, rather than specific material properties. This study found that the selection of ACDF cage material did not affect clinical outcomes.

Research progress in molecular mechanism of palatal development

Cleft palate is one of the most common maxillofacial birth defects, which can occur alone or accompany with many known deformities. Palatal selves need to complete the process of vertical growth, elevation, adhesion and fusion in a specific time window of embryo development. Any abnormality in this process will lead to cleft palate. Although previous studies have identified many molecular networks that regulate the growth, location and fusion of palatal selves, there are still many unknown mechanisms for palatal development. The pathogenesis of cleft palate has not been clarified so far. In recent years, the molecular research on palate development has been deepened continuously. Here we summarize major recent advances and integrate the genes and molecular pathways with the cellular and morphogenetic processes of palatal shelf growth, patterning, elevation, adhesion, and fusion, in order to comprehensively understand the genotype-phenotype functional relationship and provide assistance in formulating effective prevention strategies for cleft palate disease.

Cross-View Attention Interaction Fusion Algorithm for Stereo Super-Resolution

In the process of stereo super-resolution reconstruction, in addition to the richness of the extracted feature information directly affecting the texture details of the reconstructed image, the texture details of the corresponding pixels between stereo image pairs also have an important impact on the reconstruction accuracy in the process of network learning. Therefore, aiming at the information interaction and stereo consistency of stereo image pairs, a cross-view attention interaction fusion stereo super-resolution algorithm is proposed. Firstly, based on parallax attention mechanism and triple attention mechanism, an attention stereo fusion module is constructed. The attention stereo fusion module is inserted between different levels of two single image super-resolution network branches, and the attention weight is calculated through the cross dimensional interaction of the three branches. It makes full use of the ability of single image super-resolution network to extract single view information and further maintaining the stereo consistency between stereo image pairs. Then, an enhanced cross-view interaction strategy including three fusion methods is proposed. Specifically, the vertical sparse fusion method is used to integrate the interior view information of different levels in the two single image super-resolution sub branches, the horizontal dense fusion method is used to connect the adjacent attention stereo fusion modules and the constraint between stereo image consistency is further strengthened in combination with the feature fusion method. Finally, the experimental results on Flickr 1024, Middlebury and KITTI benchmark datasets show that the proposed algorithm is superior to the existing stereo image super-resolution methods in quantitative measurement and qualitative visual quality while maintaining the stereo consistency of image pairs.

A Vertical Channel-Enhanced Fusion Method Based on RINS and Barometric Altimeter for UAVs in GNSS Denial Environments

A Vertical Channel-Enhanced Fusion Method Based on RINS and Barometric Altimeter for UAVs in GNSS Denial Environments

How Lingering Fusional Adaptation Influences the Bielschowsky Head Tilt Test in Superior Oblique Paresis.

The lack of a positive Bielschowsky head tilt test (BHTT) is commonly seen as an indicator that superior oblique paresis (SOP) is not present. This study investigated the influence of fusion on the BHTT in unilateral SOP. We analyzed vertical fusional vergence using our eye-tracking haploscope and the value of BHTT difference (BHTTD) in 11 patients who were diagnosed with congenital unilateral SOP and able to fuse. Patients used one of three different mechanisms of vertical vergence to achieve fusion. The three fusional mechanisms were associated with a significantly different BHTTD (p < 0.05). Seven of the eleven patients used vertical recti-mediated fusion and had a mean BHTTD ± SD of 21.7 ± 6.3 prism diopters (PD). Three of these patients whom we measured after a patch test for at least 30 min showed a decreased BHTTD (12.7 ± 3.8 PD). Three of the eleven patients used a mixed (oblique/rectus) fusional mechanism and had a mean BHTTD ± SD of 9.3 ± 8.6 PD. Of these patients, the one whom we measured after patching showed an increase of 11 PD in BHTTD. The remaining patient used oblique muscle-mediated fusion and had a BHTTD of only 3 PD that increased to 21 PD after patching. One explanation for this BHTT behavior in the latter patient involves lingering vergence adaptation of the "paretic" superior oblique muscle (SOM) and contralateral inferior oblique muscle, which makes these muscles more effective when activated, as is the case on ipsilateral head tilt (part of the ocular counter-roll mechanism), lessening the expected increase in hyperdeviation. Similarly, in our patients with mixed fusion, the vergence-adapted "paretic" SOM and contralateral superior rectus muscle are activated on ipsilateral and contralateral tilt, respectively, lessening the hyperdeviation in both directions. In the other seven patients, however, the vergence-adapted ipsilateral inferior rectus muscle and contralateral superior rectus muscle are activated on contralateral tilt, accentuating the BHTTD. Depending upon the specific muscles used for vertical fusion, the BHTTD is decreased or increased. The presence of a large BHTTD points to lingering or persisting fusional tonus involving the vertical rectus muscles. The lack of a positive BHTT does not rule out the diagnosis of SOP, but rather may be caused by lingering or persevering fusional tonus involving the oblique muscles. Performing the BHTT after a patch test for a minimum of 30 minutes may be necessary to reveal the BHTTD, supporting the diagnosis of SOP.

Isolated Sudden-Onset Trochlear Nerve Palsy Associated with Mild Novel Coronavirus Disease (COVID-19) Infection

ABSTRACT Purpose To present a case of sudden isolated unilateral trochlear nerve palsy of new onset associated with a COVID-19 infection without a severe course. Methods A 49-year-old previously healthy man suddenly noticed seeing double while going down the stairs to go out for the first time the day after the completion of medical treatment and home isolation for COVID-19. There was no systemic disease or history of trauma. Results Magnetic resonance imaging of the brain and orbits was normal and the neurology examination revealed no pathology. The acute onset of the diplopia, the small vertical fusion amplitude, and the lack of facial asymmetry supported acquired trochlear nerve palsy. Conclusions Trochlear nerve palsy has rarely been reported in association with the various types of viral infections. To the best of our knowledge, this is the first case of isolated unilateral trochlear nerve palsy with no additional neurological finding or any radiological finding that is possibly associated with mild SARS-CoV-2 infection.

The European Council as a crisis manager and fusion driver: assessing the EU’s fiscal response to the COVID-19 pandemic

ABSTRACT As with previous crises, the European Union’s (EU) reaction to the COVID-19 pandemic has again highlighted the European Council’s pivotal role in the EU’s institutional architecture and development. In creating the ‘Next Generation EU’ recovery package in July 2020, it provided the Union’s main instrument for coping with economic damage resulting from the pandemic. In both the run-up to and aftermath of this history-making decision, the European Council acted as the driver of a horizontal and vertical fusion of responsibilities: horizontally, it instructed and partly relied on other EU institutions; vertically, it satisfied and further developed close links between the EU and national levels of government. Scrutinising the different phases of a policymaking cycle (preparation, decision, implementation, control), this article highlights and puts into perspective the European Council’s key activities at each stage.

Candidate Genes in Testing Strategies for Linkage Analysis and Bioinformatic Sorting of Whole Genome Sequencing Data in Three Small Japanese Families with Idiopathic Superior Oblique Muscle Palsy.

Idiopathic superior oblique muscle palsy is a major type of paralytic, non-comitant strabismus and presents vertical and cyclo-torsional deviation of one eye against the other eye, with a large vertical fusion range and abnormal head posture such as head tilt. Genetic background is considered to play a role in its development, as patients with idiopathic superior oblique muscle palsy have varying degrees of muscle hypoplasia and, rarely, the complete absence of the muscle, that is, aplasia. In this study, whole genome sequencing was performed, and single nucleotide variations and short insertions/deletions (SNVs/InDels) were annotated in two patients each in three small families (six patients in total) with idiopathic superior oblique muscle palsy, in addition to three normal individuals in one family. At first, linkage analysis was carried out in the three families and SNVs/InDels in chromosomal loci with negative LOD scores were excluded. Next, SNVs/InDels shared by the six patients, but not by the three normal individuals, were chosen. SNVs/InDels were further narrowed down by choosing low-frequency (<1%) or non-registered SNVs/InDels in four databases for the Japanese population, and then by choosing SNVs/InDels with functional influence, leading to one candidate gene, SSTR5-AS1 in chromosome 16. The six patients were heterozygous for 13-nucleotide deletion in SSTR5-AS1, except for one homozygous patient, while the three normal individuals were wild type. Targeted polymerase chain reaction (PCR) and direct sequencing of PCR products confirmed the 13-nucleotide deletion in SSTR5-AS1. In the face of newly-registered SSTR5-AS1 13-nucleotide deletion at a higher frequency in a latest released database for the Japanese population, the skipping of low-frequency and non-registration sorting still resulted in only 13 candidate genes including SSTR5-AS1 as common variants. The skipping of linkage analysis also led to the same set of 13 candidate genes. Different testing strategies that consisted of linkage analysis and simple unintentional bioinformatics could reach candidate genes in three small families with idiopathic superior oblique muscle palsy.

Determining vertical fusion values from digital photographs of healthy eyes.

To determine the mean difference of vertical corneal light reflex (VCLR) among healthy eyes via digital photography. Retrospective study. The study enrolled 155, healthy eyes participants, 71 males and 84 females with a mean age of 14.7years (range 12-19years). The participants received complete eye examinations and 2 digital photographs were taken, with the flash on, while participants fixated their eyes on a near and a distant target. Two hundred and eighty qualified photographs were analyzed by Photo-Hirschberg testing using computer software. The vertical corneal light reflex ratio (VCLRR) was calculated as the distance of the corneal light reflex (CLR) to the inferior limbus or to the pupillary border divided by the horizontal corneal diameter, defined as VCLRR1 or VCLRR2. VCLRR was analyzed using Spearman's correlation. The mean ± SD of horizontal corneal diameter in near and distance photographs was 11.47 ± 0.62 and 11.37 ± 0.58mm, respectively. For correlation analysis, at 1m fixation and 6m fixation, the number of participants within an acceptable range of vertical fusion were 94.6% and 100% of participants. The 95th percentiles (estimated as the mean ± 1.64SD) in VCLRR1 between the two eyes at near and at distance fixation were 0.0316 and 0.0272, respectively; whereas the corresponding values for VCLRR2 were 0.0309 and 0.0240, respectively. The normal range of the vertical corneal light reflex ratio suggests that the Photo-Hirschberg test could be used for screening vertical strabismus cases depending on iris pigment.

Research on Data Fusion of Photoelectric Measuring Instrument Based on UKF Algorithm

The UKF algorithm-based data fusion technique was researched in this work in order to tackle the issues of conventional data fusion methods such as lengthy fusion processes, high recall rates of findings, and big errors. First, the photoelectric measuring principle is examined in this procedure. On the basis of UKF filtering operation on the data sample set, the fusion processing of photoelectric measurement instrument is completed through the steps of data pretreatment, vertical and horizontal fusion, and fusion quality optimization. The experimental results show that the fusion process time of this method is between 0.27 min and 0.40 min, the recall rate of the fusion result is always lower than 6%, and the fusion deviation is small, indicating that the design expectation is achieved.

Horizontal and vertical features fusion network based on different brain regions for emotion recognition

Deep learning technology has been universally adopted in emotion recognition, which becomes a promising method that has recently achieved good recognition performance. However, the existing methods cannot reflect the influence of electroencephalography (EEG) signals from different brain regions on emotion recognition. Therefore, in the article, we raise a horizontal and vertical features fusion network based on different brain regions (HVF2N-DBR) for emotion recognition. The HVF2N-DBR method not only considers the influence of EEG activity in the various brain regions on affective recognition but also obtains the temporal–spatial characteristics of EEG signals. Specifically, EEG signals firstly are grouped according to the various brain lobes (frontal, parietal, temporal, and occipital lobes). Then, a horizontal–vertical features fusion module (HVF2M) is designed to learn multiple direction features of different brain regions. Afterwards, finer features of different brain regions are learned separately through hybrid dilation convolutions, then they are concatenated to capture richer and more discriminative emotional information. The designed architecture can achieve higher recognition performance. Finally, on three databases, i.e., SEED, SEED-IV, and DEAP, extensive experiments are implemented to estimate the capability of the designed HVF2N-DBR network. Results validate that the recognition performance of proposed model is superior to many existing models. Meanwhile, the ablation experiments also reveal that EEG signals related to emotion recognition mainly situate the frontal and parietal lobes of the cerebral cortex.

Automated diagnosis of age-related macular degeneration using multi-modal vertical plane feature fusion via deep learning.

To develop a computer-aided diagnostic (CADx) system of age-related macular degeneration (AMD) through feature fusion between infrared reflectance (IR) and optical coherence tomography (OCT) modalities in order to explore the superiority of multi-modality CADx system and the optimal feature fusion patterns between multi-modality inputs. This is a dual center retrospective study. We retrospectively collected 2006 pairs of IR and OCT images to develop the algorithms. Two single-modality models and three multi-modality models were constructed for the comparison of the diagnostic efficacy. The multi-modality models were designed utilizing a novel feature fusion method, namely, vertical plane feature fusion (VPFF). The results were validated using an independent external validation dataset and compared by three ophthalmologists. In the test set of the ZJU dataset, our best model named OCT_MAIN demonstrated diagnostic efficiency with an overall accuracy of 0.9608 and area under the curve of 0.9944 for the normal category, 0.9659 for the dry AMD category, and 0.9930 for the wet AMD category. The external validation exhibited an overall accuracy of 0.9159. Its diagnostic efficiency was comparable to that of the senior ophthalmologist. The VPFF method was successfully employed to develop a multi-modal intelligent diagnostic system for the AMD classification. This is a valuable complement and optimization to the existing CADx system, which reveals a wide application prospect and research potential.

Multiframe Joint Enhancement for Early Interlaced Videos.

Early interlaced videos usually contain multiple and interlacing and complex compression artifacts, which significantly reduce the visual quality. Although the high-definition reconstruction technology for early videos has made great progress in recent years, related research on deinterlacing is still lacking. Traditional methods mainly focus on simple interlacing mechanism, and cannot deal with the complex artifacts in real-world early videos. Recent interlaced video reconstruction deep deinterlacing models only focus on single frame, while neglecting important temporal information. Therefore, this paper proposes a multiframe deinterlacing network joint enhancement network for early interlaced videos that consists of three modules, i.e., spatial vertical interpolation module, temporal alignment and fusion module, and final refinement module. The proposed method can effectively remove the complex artifacts in early videos by using temporal redundancy of multi-fields. Experimental results demonstrate that the proposed method can recover high quality results for both synthetic dataset and real-world early interlaced videos. At the same time, the method also won the first place in the MSU Deinterlacer Benchmark. The code is available at: https://github.com/anymyb/MFDIN.

Subregion Multifeature Fusion Oblique Vehicle Detection Algorithm

Reducing traffic accidents and relieving traffic congestion are two main topics for Chinese road traffic management. Vehicle vision-based vehicle detection and tracking technology is the primary link in road environment perception. The detection technology for forward vehicles is becoming increasingly mature, and commercial products have appeared. Detection is more complicated for oblique vehicles. This research mainly studies the detection and tracking of oblique vehicles. The main work is as follows: First, the image preprocessing method in image processing technology is mainly studied. With focus on research of lane line detection algorithm, an improved lane line detection algorithm combining Hough transform and K-means clustering is proposed to improve the accuracy. With the lane line taken as the standard, the vehicle detection area is divided and combined with the ROI area extraction to further narrow the detection range. With the aim of performing vehicle detection, a two-level optimization algorithm is proposed. First, the method of initial inspection and machine learning detection verification of feature detection is presented. The vehicle target feature and image vertical edge feature fusion are used to generate the suspected target region. An improved dual threshold segmentation algorithm is then proposed to improve the effect of shadow feature extraction. The cascading AdaBoost classifier is combined to generate the target verification area. To address the real-time problem, kernel principle component analysis using Gaussian kernel function is applied to reduce the dimensionality of image feature and improve real-time performance. Experimental results show that the identification accuracy is up to 90% for oblique vehicles when the optimization algorithm of the mixing of shadow feature and image vertical edge feature is used. In good weather, the accuracy is up to 95% when using the AdaBoost classifier combined with HOG+Haar-like feature; The detection time is reduced by 26% when kernel principal component analysis is used. The result of this project is valuable for dynamic oblique vehicle detection.

Adjacent two-level anterior cervical discectomy and fusion versus one-level corpectomy and fusion in cervical spondylotic myelopathy: Analysis of perioperative parameters and sagittal balance

ObjectivesThe optimal surgical strategy for cervical spondylotic myelopathy (CSM) remains controversial; thus, the current study was designed to compare the outcomes of two different anterior approach surgeries for two-level CSM, namely, adjacent two-level anterior cervical discectomy and fusion (ACDF) and one-level anterior cervical corpectomy and fusion (ACCF). Patients and methodsA total of 53 patients who underwent adjacent two-level ACDF and 68 patients who underwent one-level ACCF in the Spinal Surgery Department from January 2010 to October 2017 were retrospectively analyzed. Independent sample t tests and chi-square tests were used to compare perioperative parameters (hospital stays, bleeding amounts and operation times), clinical parameters (Neck Disability Index scores and Visual Analog Scale scores for neck and arm pain), and radiologic parameters (difference in segmental height, T1 slope, C2-7 sagittal vertical axis, C2-7 lordosis, segmental angle, and fusion rate). ResultsThe length of hospital stay (p < 0.01), bleeding amount (p < 0.01), operation time (p < 0.001) and difference in segmental height (p < 0.001) were significantly greater in the ACCF group than in the ACDF group, whereas C2-7 lordosis (p < 0.05) and the segmental angle (p < 0.001) were significantly lower in the ACCF group than in the ACDF group. Other parameters were not significantly different between the two groups. ConclusionBoth ACDF and ACCF provided satisfactory clinical outcomes and fusion rates for CSM. However, adjacent two-level ACDF was associated with shorter hospital stays, less blood loss, shorter operative times, fewer differences in segmental height and greater improvement in segmental lordotic curvature. On most occasions, when either surgical method could be selected, adjacent two-level ACDF as a surgical treatment for CSM may be a worthwhile alternative method to one-level ACCF.

45. Non-communicating Uterine Horn with a Single Cervix and Vagina in the Setting of a DSD: a Case Report

The incidence of Mullerian Anomalies has been estimated to be around 3-5% however this likely underrepresents the true prevalence.1, 2 In a series of events involving paracrine signaling, invagination, lateral and vertical fusion, and canalization, Mullerian structures are formed from 6 to 20 weeks gestation in a cephlad to caudal progression.3 Mullerian anomalies arise when there is agenesis or a failure in any one of these processes. Thus, with knowledge of embryology, uterine anomalies should follow a predictable progression.

Role of Ultrasound and Magnetic Resonance Imaging in Assessment of Müllerian Duct Anomalies

Abstract Background Müllerian duct anomalies (MDAs) occur as a result from abnormal development of the uterus, cervix, and upper vagina. Many classification systems are presented, aiming to provide a more suitable and accurate categorization of female genital anomalies. Ultrasonography (US), Magnetic Resonance Imaging (MRI), or a combination of both are considered the gold standard in evaluation of uterine anomalies. Aim of the Work The main purpose of the study is to determine the diagnostic role of MRI and US in assessment of Müllerian duct anomalies and its subtypes. Patients and Methods This prospective analytical study was conducted at 14 patients suspected to have MDAs at Al-Demerdash Hospital-Ain Shams University in the period from September 2017 to May 2018, Their ages ranged from 15-40 year-old. All cases underwent Pelvic U/S and MRI, findings were correlated with laparoscopy. Results In this study the Mullerian duct anomalies were categorized into four groups: (a) congenital absence of the Müllerian ducts, or the Mayer-Rokitansky-Kuster-Hauser syndrome (n = 8), (b) disorders of vertical fusion (n = 1),(c) disorders of lateral fusion (n = 3) and (d) MDAs mimics(n = 2).MRI allowed correct diagnosis of 14 uterine anomalies (accuracy 100%) whereas US was correct in 13 out of 14 cases (accuracy 92.8%). Conclusion Two dimensional ultrasound stands as the first imaging modality of choice. MRI remains the reference imaging modality in diagnosis of Mullerian anomalies and it is subtypes and should be preserved for doubtful or complex cases.

Surgical treatment of vertical strabismus. Part 2. Indications, scheduling, methods

Treatment of vertical strabismus will almost inevitably involve surgery when it is associated with hyperfunction of the inferior oblique muscle due to the weakness of vertical fusion (3.0-4.0 ave dptr), the presence of cyclotropy and torsional diplopia. Many operations aimed at weakening the lower oblique muscle have been described. However, they have a number of negative aspects associated with high invasiveness, difficulty of technical implementation due to the need for manipulations in the inaccessible area of the eye in proximity to the optic nerve, macular area, large vessels, as well as long duration of the operation, inability to dosage the result of the operation, low functional results. They are, to a large extent, absent in the operation of anterior transposition in which the neurofibrovascular bundle serves as the axis of rotation of the lower oblique muscle changing the vector of its action and increasing the effectiveness of treatment. Despite all the advantages of that technique, its use is still limited due to the lack of methods for controlling the amount of anterior transposition for the treatment of hyperfunction of the inferior oblique muscle, especially of small degrees.