Morphometric study of supratrochlear foramen of the humerus related with clinical implications in a thai population / Estudio morfométrico del foramen supratroclear del húmero relacionado con implicaciones clínicas en una población tailandesa

SUMMARY: Supratrochlear foramen (STF) is a perforation of bony wall that separates the olecranon fossa and the coronoid fossa. Its incidence varies among different races. The aim of this study was to investigate the prevalence and morphometry of supratrochlear foramen among Thai population. A total of 640 dry humeri from 320 skeletons, 160 paired humeri of each sex, and known age were collected to study the prevalence of STF. The prevalence is reported categorized by sex and the side of humerus to identify whether there is a correlation. STF is categorized by shape and their metrics measured with digital vernier calipers. The ratio of transverse diameter (TD) and distance from the medial epicondyle to the lateral epicondyle (DMLE) were calculated to represent the size of STF. From 640 humeri, 404 cases were translucent septum, 133 cases were opaque septum, and 103 cases were recorded as foramen. In this study, the majority of supratrochlear foramen were oval-shaped, followed by irregular-shaped and round-shaped foramen. The ratio between TD and DMLE was 0.09±0.44 mm on the right and 0.08±0.41 mm on the left which was not significantly different. The findings can be used to understand the variation and location of supratrochlear foramen to help radiologists and orthopedic surgeons to avoid misdiagnosis of cystic lesion at the distal humerus.

RESUMEN: El foramen supratroclear (FST) es una perforación de la pared ósea que separa la fosa olecraneana y la fosa coronoides. Su incidencia varía entre las diferentes razas. El objetivo de este estudio fue investigar la prevalencia y la morfometría del foramen supratroclear entre la población tailandesa. Se recolectaron un total de 640 húmeros secos de 320 esqueletos, 160 húmeros emparejados de cada sexo y edad conocida para estudiar la prevalencia de FST. Se reportó la prevalencia categorizada por sexo y lado del húmero para identificar si existe correlación. FST se clasificó por forma y sus métricas se midieron con calibradores vernier digitales. Se calculó la relación del diámetro transversal (DT) y la distancia desde el epicóndilo medial al epicóndilo lateral (DEML) para representar el tamaño de STF. De 640 húmeros, 404 casos presentaban tabique translúcido, 133 casos tabique opaco y 103 casos se registraron como foramen. En este estudio, la ma- yoría de los forámenes supratrocleares tenían forma ovalada, seguidos de los forámenes de forma irregular y redonda. La relación entre DT y DEML fue de 0,09 ± 0,44 mm en el lado derecho y de 0,08 ± 0,41 mm en el lado izquierdo, no existiendo diferencias estadísticamente significativas. Los resultados pueden ser útil para comprender la variación y la ubicación del foramen supratroclear y ayudar a los radiólogos y cirujanos ortopédicos a evitar un diagnóstico erróneo de lesión quística en el húmero distal.

The determination of the piriform aperture morphometry and golden ratio in healthy Turkish subjects: a CT study / Determinación de la morfometría de la apertura piriforme y la proporción áurea en sujetos turcos sanos: un estudio con TC

This study was undertaken to determine the morphometry of the piriform aperture width and height in Turkish population aged between 18-60 years. It was a retrospective study in which 200 subjects were included 106 males and 94 females, ranging from 18 up to 60 years. Subjects having brain CT in the Radiology Department. Statistical analysis were evaluated with SPSS 21.00 programme. ANOVA Test were used to determine the significance between measurements and age group. The p<0.05 value was considered as significant. The groups were divided into four groups according to age. The overall means and standard deviations of the measurements were: piriform aperture height, 45.19±2.91 mm; piriform aperture width, 24.98±2.85 mm; the golden ratio, 1.84±0.19 in males, respectively whereas, the same measurements were 42.84±2.88; 23.46±2.15 mm; 1.83±0.19 in females, respectively. Also there were an increase in piriform aperture width measurement as the age increased. These anatomical values provides more important knowledge to determine the dimensions of these structures in clinic, surgical processes.

El estudio se realizó para determinar la morfometría del ancho y la altura de la abertura piriforme en la población turca de entre 18 y 60 años. Se llevó a cabo un análisis retrospectivo en el que se incluyeron 200 sujetos 106 hombres y 94 mujeres, entre los 18 y 60 años. Sujetos con TC cerebral en el Departamento de Radiología. El análisis estadístico se evaluó con el programa SPSS 21.00. La prueba ANOVA se utilizó para determinar la importancia entre las mediciones y el grupo de edad. El valor p <0,05 se consideró significativo. La muestra se dividió en cuatro grupos según la edad. Las medias generales y las desviaciones estándar de las mediciones fueron: altura de apertura piriforme, 45,19 ± 2,91 mm; ancho de apertura piriforme, 24,98 ± 2,85 mm; la proporción áurea, 1,84 ± 0,19 en varones, mientras que las mismas medidas fueron 42,84 ± 2,88; 23,46 ± 2,15 mm; 1,83 ± 0,19 en mujeres. También hubo un aumento en la medición del ancho de apertura piriforme a medida que la edad aumentó. Estos valores anatómicos proporcionan un conocimiento más importante para determinar las dimensiones de estas estructuras en procesos clínicos y quirúrgicos.

Supratrochlear Foramen Of The Humerus: Two Cases From The Hellenic Region Of Magnesia

The supratrochlear foramen (STF) of the distal part of the humerus bone presents a known anatomical skeletonvariation. On the other hand the cause for its appearance remains obscure. Its incidence is reported to be from0% up to 60% among the adults, depending of the population. Results. Our research on dry bone skeletal remainsdemonstrated a very low incidence of 0.8% in the Magnesia region of the central Greece. Conclusions. STFincidence presents a huge percentage interval depending on the region in study. Due to various interventionalprocedures performed in the distal part of the humerus clinicians should be aware of this rare anatomicalvariation.

Cosmetic lateral canthoplasty / 中华整形外科杂志

" Cosmetic lateral canthoplasty" and " vertical enlargement of the palpebral aperture" have been in heated discussion in the field of cosmetic surgery in recent years.The author attempted to summarize and analyze both surgeries, including the history of technical evolution, anatomical basis, clinical research and complications, in order to provide a clear and correct understanding.

A Study On The Incidence And Size Of The Supratrochlear Foramen Of The Humerus In South Indian Dry Adult Humeri With Its Clinical Importance

Introduction: Supratrochlear foramen of the humerus is usually not mentioned in most of the anatomy andorthopaedics literature. Knowledge of supratrochlear foramen is important in the treatment of supracondylarfractures of the humerus, intramedullary humeral nailing, and preventing misinterpretation of X-Rays at theelbow joint, alteration of fracture patterns.Materials and Methods: The present study was carried out on 132 dried human humeri of unknown sex and age.Incidence, shape, and size of the supratrochlear foramen was recorded. Vertical and transverse diameters weremeasured by using a double tipped compass and sliding calipers.Results: Out of the 132 bones studied, 34 bones showed the presence of supratrochlear foramen. It was observedthat the incidence was more on the left side than on the right. The most common shape observed was oval in19.69%, round in 3.03%, bilobed in 1.51% and irregular in 1.51% of the specimens. Mean transverse diameter ofthe supratrochlear foramen on the left and right sides were 7.25mm and 8.1mm respectively. The mean verticaldiameter of supra trochlear foramen on the left and right sides were 5.3mm and 5.4mm respectively.Conclusion: Knowledge of supratrochlear foramen of the humerus helps clinicians in diagnosis and treatmentstrategies, while dealing with the elbow pathologies, fractures of the lower end of the humerus and supracondylarfractures of the humerus.

Incisivo central único de la línea media del maxilar, holoprosencefalia y estenosis congènita del orificio nasal anterior en un recién nacido prematuro: a propósito de un caso / Solitary median maxillary central incisor, holoprosencephaly and congenital nasal pyriform aperture stenosis in a premature infant: case report

El síndrome del incisivo central único de la línea media del maxilar es un trastorno raro que implica anomalías de la línea media, como holoprosencefalia, anomalías de las fosas nasales, fisura palatina, labio leporino, hipotelorismo, microcefalia y panhipopituitarismo. La estenosis congénita del orificio nasal anterior es una causa mortal de dificultad respiratoria neonatal debido al estrechamiento del orificio nasal anterior, y podría confundirse con la atresia de coanas. En este informe, presentamos el caso de un recién nacido con síndrome del incisivo central único de la línea media del maxilar acompañado de otras anomalías, tales como holoprosencefalia, estenosis del orificio nasal anterior, microcefalia y panhipopituitarismo. El cariotipado mostró una deleción heterocigota en el gen SIX3 en la región 2p21, que produjo una forma más grave de holoprosencefalia.

Solitary median maxillary central incisor syndrome is a rare disorder involving midline abnormalities such as holoprosencephaly, nasal cavity anomalies, cleft palate-lip, hypotelorism, microcephaly, and panhypopituitarism. Congenital nasal pyriform aperture stenosis is a lethal cause of neonatal respiratory distress due to narrowing of the pyriform aperture anteriorly and it can be confused with choanal atresia. In this report, we present a newborn infant with solitary median maxillary central incisor syndrome accompanied by other abnormalities including holoprosencephaly, nasal pyriform aperture stenosis, microcephaly and panhypopituitarism. Chromosomal analysis showed heterozygous SIX3 gene deletion at 2p21 region resulting in a more severe form of holoprosencephaly.

Retinal pigment epithelium aperture: A late-onset complication in adult-onset foveomacular vitelliform dystrophy

Purpose: The purpose of the study was to report aperture of retinal pigment epithelium (RPE) as a late complication and an unreported finding during the natural course of adult-onset foveomacular vitelliform dystrophy (AFVD). Methods: Four diagnosed cases of AFVD followed for a period ranging from 4 to 8 years. All patients had documented records of clinical examination, fundus autofluorescence and fluorescein angiography, and spectral domain-optical coherence tomography at regular intervals. Results: Besides the known stages in the natural course of AFVD, RPE aperture was noted as an additional finding during the vitelliruptive stage of the disease. The vitelliform material was noted beneath the disrupted RPE before disappearance. Accumulation of vitelliform material continued even after the vitelliruptive stage. Conclusion: RPE aperture may represent an ongoing process in the natural course of AFVD.

Performance Evaluation of a CyberKnife VSITM System / 中华放射肿瘤学杂志

Objective To evaluate the accuracy and reliability of the CyberKnife VSI system for stereotactic radiotherapy.Methods First,the mechanical accuracy of the robotic manipulator system,the repeatability of the Iris variable aperture collimator system,the couch position accuracy of the patient positioning system,the tacking precision of the target locating system and the dosimetric beam characteristics of the linac system for each subsystem of CyberKnife VSI system were tested.Finally,the total beam delivery precision of the CyberKnife VSI system was evaluated.Results The mean positioning deviations of the mechanical arm movement of the robotic manipulator system were less than 0.1 mm,and the maximum positioning deviation of single note was ≤ 0.29 mm.The repeatability of the aperture sizes for the Iris variable aperture collimator system was ≤ 0.28 mm.The couch position accuracy of the patient positioning system was＜0.2 mm and the tracking precision of the target locating system was less than 0.5°.The linac beam-laser beam axes coincidence between the Iris and fixed collimators was better than 0.4 mm.The 6-MV beam parameters,such as beam quality and profile,were found within the acceptance limits.The deviations of output reproducibility,linearity and constancy versus linac orientation were less than 1.0％.The transmission factors of two types of collimators were lower than 0.4％.End-to-end test demonstrated that the maximum deviation of the total delivery precision of CyberKnife VSI system was 0.87 mm.Conclusion The CyberKnife VSI system is accurate and reliable for stereotactic radiotherapy.

Margin expansion for treatment field of volumetric modulated arc therapy for breast cancer / 中华放射肿瘤学杂志

Objective We developed a method to expand margin of beam aperture for VMAT treatment planning of breast cancer and evaluated its effectiveness in clinic. Methods An expanded VMAT (E-VMAT) plan for breast cancer using Pinnacle39. 10 planning system was made. A small tissue-equivalent bolus was added at the middle of the breast surface as part of the target and the VMAT plan was generated with beam aperture automatically expanded. Then the tissue-equivalent bolus was removed and the final dose distribution was calculated. Ten patients with breast cancer undergoing breast conserving surgery were tested. The dosimetrical metrics and delivery efficiency were compared between the E-VMAT plans and the routine VMAT plans. Results On the BEV view, it was observed that in E-VMAT plans the collimator and MLC leaf positions was extended outside the skin along the anterior-posterior direction of the thorax. There were no significant differences in conformity index and homogeneity index of target volume between the two types of plans and the planned delivery efficiency was consistent (P>0. 05). Conclusions The method established in this study can automatically generate expansion of VMAT beam apertures and prevent missing of target volume due to respiratory motion and/ or setup error of the patient. The method does not require programming skill and available for different treatment planning systems.

A gradient-based direct aperture optimization / 生物医学工程学杂志

Aiming at the disadvantages of traditional direct aperture optimization (DAO) method, such as slow convergence rate, prone to stagnation and weak global searching ability, a gradient-based direct aperture optimization (GDAO) is proposed. In this work, two different optimization methods are used to optimize the shapes and the weights of the apertures. Firstly, in order to improve the validity of the aperture shapes optimization of each search, the traditional simulated annealing (SA) algorithm is improved, the gradient is introduced to the algorithm. The shapes of the apertures are optimized by the gradient based SA method. At the same time, the constraints between the leaves of multileaf collimator (MLC) have been fully considered, the optimized aperture shapes are meeting the requirements of clinical radiation therapy. After that, the weights of the apertures are optimized by the limited-memory BFGS for bound-constrained (L-BFGS-B) algorithm, which is simple in calculation, fast in convergence rate, and suitable for solving large scale constrained optimization. Compared with the traditional SA algorithm, the time cost of this program decreased by 15.90%; the minimum dose for the planning target volume was improved by 0.29%, the highest dose for the planning target volume was reduced by 0.45%; the highest dose for the bladder and rectum, which are the organs at risk, decreased by 0.25% and 0.09%, respectively. The results of experiment show that the new algorithm can produce highly efficient treatment planning a short time and can be used in clinical practice.

Dosimetric study of intensity modulated direct aperture optimization radiation therapy for testicular seminoma / 医疗卫生装备

Objective To compare the field-matching techniques and dosimetric characteristics in the target area of testicular seminoma including the abdominal and pelvic cavities between direct aperture optimization intensity modulated radiation therapy (DAO-IMRT) and 3D conformal radiation therapy (3D-CRT),and to analyse the advantages and disadvantages of DAO-IMRT.Methods DAO-IMRT and 3D-CRT plans were designed with Pinnacle treatment planning system for 7 testicular seminoma patients,and the characteristics of both the irradiation methods were analyzed and evaluated by means of the parameters like dose homogeneity indexes,dose volume histograms and etc.Results DAO-IMRT had the hot and cold volumes in the target areas both significantly smaller than those by 3D-CRT,while the conformity index and homogeneity index superior to those by 3D-CRT.The mean doses (Dmean) by DAO-IMRT of the organs at risk (OAR) except the left femur head were all lower than those by 3D-CRT,aud the V15 values of liver,double kidney,small intestine and rectum by DAO-IMRT were statistically lower than those by 3D-CRT (P＜0.01).3D-CRT had the V5 values of OAR all lower than those by DAO-IMRT,in which the differences of double kidney,small intestine,bladder,left femur head and normal tissues were significant statistically (P＜0.05).The monitor units by DAO-IMRT roughly doubled when compared with those by 3D-CRT,and the difference was also significant (P＜0.01).Conclusion DAO-IMRT with easy operation and high reliability can avoid the connection of fields in the target area of testicular seminoma,and is superior to 3D-CRT in dosimetry.

Clinical effect of large speckle modulated Q1064nm laser combined with Xiaoyao pills in treatment of chloasma / 中华医学美学美容杂志

Objective To investigate the clinical efficacy of large spot modulated Q 1064 nm laser combined with Xiaoyao pills in the treatment of chloasma.Methods 90 patients with chloasma were treated in the hospital.The patients were randomly divided into 3 groups:treatment group were treated with Q 1064 nm laser combined with large spot Xiao Yao pill;the control group 1 was treated with large spot Q 1064 nm laser only,and control group 2 was treated with Xiaoyao Pill only.Results After 8 weeks of treatment,the effective rate was higher in the treatment group than the control group 2 (P＜0.05);after 16 weeks of treatment,the efficacy was better in the treatment group than the control group 1 and control group 2 (P＜0.05).The combination of the two methods can improve the curative effect and inhibit the recurrence.Conclusions The treatment of chloasma with large speckle modulated Q 1064 nm laser combined with Xiaoyao pills is effective and worthy of clinical promotion.

The Effect of Different Sagittal Angles of the Tibial Guide on Aperture Widening of the Tibial Tunnel during Modified Transtibial Anterior Cruciate Ligament Reconstruction: A Randomized In Vivo Study

PURPOSE: The effect of sagittal plane angle of the tibial tunnel on the severity of tibial intra-articular aperture expansion caused by iatrogenic re-reaming in anterior cruciate ligament (ACL) reconstruction using a modified transtibial technique is unknown. The purpose of this study was to compare the severity of intra-articular aperture widening at different angles (40°, 45°, and 50°) of the tibial guide (TG). MATERIALS AND METHODS: Ninety-seven patients who underwent modified transtibial ACL reconstruction were randomly allocated to TG 40°, 45°, and 50° groups. Intra-articular tibial aperture width (TW) and tibial tunnel length (TTL) were measured intraoperatively using an arthroscopic ruler and a depth gauge. RESULTS: The TG 50° group had significantly greater tibial aperture widening than the TG 40° group. There was a significant difference among TG 40°, 45°, and 50° groups and the percentage of knees with TTL <35 mm was 8%, 9% and 3%, respectively. There were 2 females with TTL <35 mm in TG 40° and 45° groups each. The average mediolateral length of the tibial plateau was 75 mm. CONCLUSIONS: This study shows that the TG angle of 40° would reduce the severity of intra-articular aperture widening of the tibial tunnel compared to 45° or 50° in modified transtibial ACL reconstruction.

Evaluation on repeatability of the aperture sizes of CyberKnife VSITM Iris collimator / 中华放射医学与防护杂志

Objective To evaluate the repeatability of the aperture sizes based on the Iris variable aperture collimator (Iris collimator) of CvberKnife VSITM.Methods Radiochromic films were placed at 800 mm of source-to-axis distance (SAD),and Iris quality assurance (QA) software was used to extract the information from the digital images,which were exposured by X-ray beams.Results The average aperture accuracy of Iris collimator was better than 0.11 mm over the beam range 5-40 mm,and the accuracy for 50 mm and 60 mm beams was within 0.19 mm.Conclusions The results suggest a good repeatability of aperture sizes for the CyberKnife VSITM Iris collimator.

Anthropometric Measurements of Infraorbital Foramen and its Anatomic Variations in Dried Human Skulls.

Aim: This study was to determine the distance between IOF and IOM, IOF and pyriform aperture,the presence of accessory foraminae, orientation and location in relation with teeth on both the sides. Materials and Methods: Fifty dried human skulls (100 sides) irrespective of age and sex were used for this study. The distance between the IOF and IOM and the distance between the IOF and pyriform aperture were measured by using manual vernier calliper. The orientation, location in relation with teeth and presence of accessory foramina were observed macroscopically. Observations and Discussion: Accessory foramina may give complications during anaesthetization of this region. The mean distance between the IOF and infraorbital margin was 22.6mm and 15.2mm on the left and right side respectively. Mean distance between I.O.F and pyriform aperture was 26.2mm and 25.8mm on the left and right side respectively. In 30% skulls the IOF were directed vertically downward on the right side and in 38% on the left side. In 66% downward medially on the right side and 56% on the left side and in4% skulls medially on the right side and 6% on the left side. The majority of IOF were oriented to second premolar teeth on the right side and between second premolar and first molar on the left side.Accessory foraminae were found in 6% of skulls. The results of our study may be helpful during surgical procedures in the maxillary region in reduction of Lefort fracture, and giving regional nerve block.

Morphological Study of Supratrochlear Foramen of Humerus and its Clinical Implications

Background: The supratrochlear foramen (STF), alternatively termed septal aperture of humerus is a deficit of the bony septum in the distal end of humerus that separates the coronoid fossa from the olecranon fossa. The study is focused on the STF owing to its significance in the preoperative planning of supracondylar fractures of humerus. The humerus with STF has narrow medullary canal so ante grade route is advised for nailing supracondylar fractures in humerus with STF. Materials: This study was conducted on 355 dry human humeri belonging to south Indian race. Results: The supratrochlear foramen was present in 76 bones (21.4%). The incidence of STF was more on the left side (23.3%) than the right side (19.6%). The transverse and vertical diameters of STF were measured using digital Vernier caliper. The mean transverse diameter on right side was 5.67 ± 1.71 mm and 5.39 ± 1.57 mm on left side. The mean vertical diameter was 3.9 ± 1.32 mm on right side and 3.84 ± 1.20 mm on left side. Various shapes of STF were noted among which oval shape was maximum. The translucent septum was frequently found more on the right side (56.3%). Conclusions: The STF may be mistakenly interpreted as a cyst or tumors in X rays. Besides its anthropological interest, the knowledge of STF will be helpful for orthopedic surgeons and radiologists.

Land cover classification of Lago Grande de Curuai floodplain (Amazon, Brazil) using multi-sensor and image fusion techniques / Classificação da cobertura da terra na planície de inundação do Lago Grande de Curuai (Amazônia, Brasil) utilizando dados multisensor e fusão de imagens

Given the limitations of different types of remote sensing images, automated land-cover classifications of the Amazon várzea may yield poor accuracy indexes. One way to improve accuracy is through the combination of images from different sensors, by either image fusion or multi-sensor classifications. Therefore, the objective of this study was to determine which classification method is more efficient in improving land cover classification accuracies for the Amazon várzea and similar wetland environments - (a) synthetically fused optical and SAR images or (b) multi-sensor classification of paired SAR and optical images. Land cover classifications based on images from a single sensor (Landsat TM or Radarsat-2) are compared with multi-sensor and image fusion classifications. Object-based image analyses (OBIA) and the J.48 data-mining algorithm were used for automated classification, and classification accuracies were assessed using the kappa index of agreement and the recently proposed allocation and quantity disagreement measures. Overall, optical-based classifications had better accuracy than SAR-based classifications. Once both datasets were combined using the multi-sensor approach, there was a 2% decrease in allocation disagreement, as the method was able to overcome part of the limitations present in both images. Accuracy decreased when image fusion methods were used, however. We therefore concluded that the multi-sensor classification method is more appropriate for classifying land cover in the Amazon várzea.

Dadas as limitações de diferentes tipos de imagens de sensores remotos, classificações automáticas do uso e cobertura do solo na várzea Amazônica podem resultar em índices de acurácia insatisfatórios. Uma das maneiras de melhorar esses índices é através da combinação de dados de distintos sensores, por fusão de imagens ou através de classificações multi-sensores. Desta forma, o presente estudo teve o objetivo de determinar qual método de classificação é mais eficiente em melhorar os índices de acurácia das classificações do uso e cobertura do solo para a várzea Amazônica e áreas úmidas similares - (a) a fusão sintética de imagens SAR e ópticas ou (b) a classificação multi-sensor de imagens ópticas e SAR pareadas. Classificações da cobertura do solo com base em imagens de um único sensor (Landsat TM ou Radarsat-2) foram comparadas com as classificações multi-sensor e classificações baseadas em fusão de imagens. A análise de imagens baseada em objetos (OBIA) e o algoritmo de mineração de dados J.48 foram utilizados para realizar a classificação automática, cuja precisão foi avaliada com o índice kappa e com as medidas de discordância de alocação e de quantidade, recentemente propostas na literatura. Em geral, as classificações baseadas em imagens ópticas apresentaram melhor precisão do que as classificações baseadas em dados SAR. Uma vez que ambos os conjuntos de dados foram combinados em uma abordagem multi-sensores, houve uma redução de 2% no erro de alocação da classificação, uma vez que o método foi capaz de superar parte das limitações presentes em ambas as imagens. Contudo, a precisão diminuiu quando foram usados métodos de fusão de imagens. Concluiu-se que o método de classificação multi-sensor é mais apropriado para classificações de uso do solo na várzea amazônica.

Comparison of Intracorneal Inlay for Presbyopia Correction: Hydrogel and Small-Aperture Inlays with a Six- Months Follow-Up

PURPOSE: To study the safety and efficacy of corneal reshaping and small-aperture inlays and compare the clinical results. METHODS: From February 2014 to November 2014, 22 corneal reshaping inlays were inserted at Asan Medical Center and from October 2012 to March 2013, 26 small-aperture inlay surgeries were performed: 6 eyes at Asan Medical Center and 20 eyes at Samsung Medical Center. The preoperative and postoperative parameters were reviewed retrospectively and included monocular uncorrected distance visual acuity (UDVA; log MAR), uncorrected near visual acuity (UNVA; log MAR), refraction and corneal curvature based on automated refractor keratometry, reading distance and patient satisfaction. RESULTS: In the hydrogel inlay group, preoperative mean monocular UNVA was 0.83 +/- 0.05 and monocular UDVA 0.07 +/- 0.03. At 6 months, mean monocular UNVA was 0.23 +/- 0.05 and UDVA 0.05 +/- 0.02. The most preferred mean reading distance in the hydrogel inlay group was 39.38 +/- 3.18 cm. In the small-aperture inlay group, preoperative mean monocular UNVA was 0.4 +/- 0.06 and monocular uncorrected visual acuity 0.27 +/- 0.04. At 6 months, mean monocular UNVA was 0.11 +/- 0.02 and UDVA 0.09 +/- 0.05 and the most preferred mean reading distance was 44.23 +/- 5.17 cm. Although 85% of patients in the corneal reshaping inlay group were satisfied or very satisfied, only 20% of patients in the small-aperture inlay group were satisfied. CONCLUSIONS: Both inlays are considered good options for correcting presbyopia. However, postoperative satisfaction score was higher and less glare symptoms were reported in the hydrogel inlay group.

Clinical study on low transphincteric perianal fistula treated with contra-aperture dissection and skin bridge preservation / 中国综合临床

Objective To evaluate the curative effects and safty of contra-aperture dissection and skin bridge preservation in the treatment of low transphincteric perianal fistula.Methods Sixty subjects of low transphincteric perianal fistula were randomly divided into two groups.Thirty cases of treatment group were treated by contra-aperture dissection and skin bridge preservation,and 30 cases of control group were treated by anal fistulectomy.On the second,seventh and fourteenth day after operation,the postoperative pain,exudate and fever were recorded and scored.The curative time was observed.Anorectal dynamic changes were compared simultaneously to evaluate the curative effects and safety of contra-aperture dissection and skin bridge preservation.Results The scores of pain and exudate were significantly different between the treatment and the control group(P＜0.01).The wound-healing time was shorter in the treatment group than that in the control group((27.37±8.93) d vs.(32.73±9.45) d,P=0.000).There were significant differences in the anal resting pressure,anal maximal contraction pressure and active systolic pressure between the two groups (t =13.12,10.21,12.10;P＜0.01).There was no significant difference of total effect between the two groups(100％ and 93.3％;x2 =2.07,P＞0.05).Conclusion Contra-aperture dissection and skin bridge preservation can reduce postoperative pain,exudate and fever,shorten wound-healing time and protect anal functions in the treatment of low transphincteric perianal fistula.

Visual estimation of apertures for wheelchair locomotion in novices: perceptual judgment and motor practice

The aim of the present study was to determine the effects of motor practice on visual judgments of apertures for wheelchair locomotion and the visual control of wheelchair locomotion in wheelchair users who had no prior experience. Sixteen young adults, divided into motor practice and control groups, visually judged varying apertures as passable or impassable under walking, pre-practice, and post-practice conditions. The motor practice group underwent additional motor practice in 10 blocks of five trials each, moving the wheelchair through different apertures. The relative perceptual boundary was determined based on judgment data and kinematic variables that were calculated from videos of the motor practice trials. The participants overestimated the space needed under the walking condition and underestimated it under the wheelchair conditions, independent of group. The accuracy of judgments improved from the pre-practice to post-practice condition in both groups. During motor practice, the participants adaptively modulated wheelchair locomotion, adjusting it to the apertures available. The present findings from a priori visual judgments of space and the continuous judgments that are necessary for wheelchair approach and passage through apertures appear to support the dissociation between processes of perception and action.